The Maryland-based foundation ranks the top 100 cities in the United States, based on factors including pollen score, allergy medicine and allergists per patient ratio.
D.C. moved down a spot from last year, landing in 67th place.
The worst city to live in with allergies is Louisville, Ky. The other nine cities are in the South:
Baton Rouge, La.
Oklahoma City, Okla.
Tree pollen is the most common allergen in the spring, according to USA TODAY.
Clifford Bassett, an allergist and medical director of the Allergy and Asthma Care of New York, tells USA TODAY, “As soon as the weather gets warmer in some communities, we will see a pollen explosion in April.”