Chelsie Derman is an associate editor for 

who covers psychiatry, sleep medicine, geriatrics, migraine, and allergy. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

Chelsie Derman

According to a recent study, exposure to high 

concentrations was linked to increased all-cause and chronic respiratory mortality among older adults.

“We found mixed evidence to suggest lag associations between exposure to common classes of pollen species and respiratory related mortality in a temperate, Midwestern state of the United States,” wrote investigators, led by Peter S. Larson, PhD, from the Social Environment and Health Program, Institute for Social Research, at the University of Michigan. “Risks varied by exposure level and lag exposure days, suggesting that the timing between exposure and death can be as long as two weeks for extreme levels of deciduous broadleaf and as little as one week for ragweed pollens.”

Plant-derived aeroallergen levels are rising due to the elongation of growing seasons and intensifying anthropogenic climate change.

 Increased pollen exposure can be harmful to people, especially older adults, increasing their mortality risk from respiratory causes.

Investigators sought to determine the short-term associates of 4 species classes of pollen—ragweed, deciduous trees (maple, alder, birch, mulberry, sycamore, poplar, oak, elm), grass pollen, and evergreen trees (Cupressaceae and Pinaceae families)—with respiratory mortality in Michigan.

Pollen data was collected from a prognostic model of daily pollen concentrations at 25 km resolution.

The team examined for all-cause and chronic and infectious-related mortality, obtaining records for all Michigan deaths from 2006 – 2017 from the Michigan Department of Health and Human Services. They selected deaths from infectious and chronic respiratory-related causes using the International Classification of Diseases (ICD-10) codes.

The study included 127,163 deaths from respiratory causes between January 1, 2006, and December 31, 2017, with 51.4% female, 90% White, and 9.42% Black. 61.2% of deaths were due to chronic lower respiratory causes and 19.9% were due to infectious respiratory causes. COPD was linked to 54.9% of respiratory deaths.

The team examined the risk of death at high levels of cumulative exposure (90th percentile) compared with no exposure for lag days 0, 0 – 1, 0 – 7, and 0 – 15. Investigators had attempted to include precipitation, temperature, and air pollution as potential confounders in the analyses’ model, but these variables resulted in unstable parameter estimates due to the fact precipitation and temperature are both used to determine pollen concentrations.

Cumulative daily high concentrations (90th percentile) of deciduous broadleaf, grass, and ragweed were linked to all-cause respiratory mortality. For instance, people exposed to deciduous broadleaf pollen at the 90th percentile had a 1.14 greater risk at 1-day lag exposure for all respiratory deaths (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.02 to 1.27) and a 1.81 greater risk at cumulative 7-day lag exposure (95% CI, 1.04 – 3.15).

Furthermore, exposure to high concentrations of grass and ragweed pollens were associated with an increased risk of death from chronic respiratory causes. At an exposure of 2 weeks, investigators observed a significant protective effect of grass pollens on all respiratory (OR, 0.55; 95% CI, 0.41 to 0.73) and of infectious respiratory mortality (OR, 0.52; 95% CI, 0.28 to 0.98).

“The significant results for grass exposure could reflect differences in exposure to grass pollens through outdoor occupations and activities such as lawn maintenance or recreation,” investigators wrote.

1-day lag exposure of ragweed was significantly associated with all respiratory mortality (OR, 1.31; 95% CI, 1.11 to 1.56) and for chronic respiratory mortality up to 1 week (OR, 2.16; 95% CI, 1.22 to 3.80). The odds of death from COPD were linked to a ragweed exposure of ≥ 1 week (OR, 2.07; 95% CI, 1.14 to 3.77).

Investigators observed no association between any pollen species and death from infectious respiratory causes; however, there was a positive but non-significant association of exposure to deciduous broadleaf and ragweed pollens. Moreover, evergreen pollen was not observed to be linked to any kind of mortality.

“…our study provides new evidence that specific types of pollens may be associated with increased risk for mortality from respiratory causes,” investigators concluded. “With projected increases in pollen levels with climate change, pollen-associated health effects, including mortality, stand to increase, efforts to prevent pollen-associated health effects should be increased, including prompt diagnosis and treatment of pollen allergies, immunotherapy, and enhanced pollen forecasting to adapt to a changing climate.”

Larson PS, Steiner AL, O'Neill MS, Baptist AP, Gronlund CJ. Chronic and infectious respiratory mortality and short-term exposures to four types of pollen taxa in older adults in Michigan, 2006-2017. BMC Public Health. 2025 Jan 16;25(1):173. doi: 10.1186/s12889-025-21386-3. PMID: 39815234; PMCID: PMC11737261.

Anderegg WRL, Abatzoglou JT, Anderegg LDL, Bielory L, Kinney PL, Ziska L. Anthropogenic climate change is worsening North American pollen seasons. Proc Natl Acad Sci U S A. 2021 Feb 16;118(7):e2013284118. doi: 10.1073/pnas.2013284118. PMID: 33558232; PMCID: PMC7896283.

Articles

Exposure to high pollen concentrations is linked to increased respiratory mortality among older adults, with risks varying by pollen type and exposure duration. The study analyzed data from Michigan, focusing on four pollen species classes and their association with respiratory mortality. High levels of deciduous broadleaf, grass, and ragweed pollen were associated with increased all-cause respiratory mortality. Grass pollen showed a protective effect against respiratory mortality at two-week exposure. The study highlights the need for enhanced pollen forecasting and preventive measures due to rising pollen levels from climate change.

A new study found high concentrations of pollen from 3 species classes—ragweed, deciduous trees, and grass—are linked to increased chronic respiratory mortality.

High Pollen Exposure Linked to Increased Chronic Respiratory Mortality

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A recent study indicated that the comorbidity of cluster headache with 

“The comorbidity with fibromyalgia was especially associated with an increased disease burden in terms of additional medical comorbidities, sleep disturbance, mood impairment, quality of life impairment, and heavy HCRU,” wrote investigators, led by Elena P. Calandre, from the Institute of Neurosciences at University of Granada in Spain.

Comorbid diseases can increase a patient’s physical and psychological burden. While migraine is a known comorbidity of cluster headache, the prevalence of the 2 co-existing ranges from approximately 10% to 16.7%, studies have yet to identify other comorbidities.

 Migraine is a well-investigated comorbidity of fibromyalgia, so investigators theorized cluster headache may also be a frequent comorbidity of fibromyalgia.

Investigators sought to describe the comorbidity and impact of fibromyalgia or migraine on patients with cluster headache by conducting an observational, cross-sectional study between 2020 and 2021. They uploaded a survey to the website, “Asociación de cefalea en racimos y primarias de España,” which translates to the Spanish association of cluster headache and other primary headaches. The association has members from Spain and Spanish-speaking American countries.

The survey collected sociodemographic and clinical data, including age, sex, marital status, educational status, and questions related to physician-diagnosed comorbid diseases. Participants aged ≥ 18 years completed questionnaires that measured depression, sleep quality, health-related quality of life, and healthcare resource utilization over the previous 6 months.

Among the 91 respondents with cluster headache, 42.9% (n = 39; 61.5% males) only experienced cluster headache, 16.5% (n = 15; 73.3% females) experienced cluster headache and migraine, 11% (n = 10; 100% females) experienced cluster headache and fibromyalgia, and 29.7% (n = 27; 85.2% females) experienced cluster headache with comorbid fibromyalgia and migraine.

Participants who experienced comorbid cluster headache and fibromyalgia were predominantly female, had a greater number of comorbid medical conditions, and had the greatest depression and sleep disturbance scores and the lowest health-related quality of life scores.

Moreover, respondents across the subgroups had moderate depression scores and positive suicidal ideation. Sleep quality and health-related quality of life were consistently poor across the subgroups, with significantly lower scores among participants diagnosed with cluster headache and comorbid migraine and fibromyalgia. Patients with cluster headache and comorbid migraine and fibromyalgia were the subgroup to have the lowest percentage of university education (

Osteoarticular conditions, particularly osteoarthritis, were the most frequently associated medical disease in patients with comorbid cluster headache, fibromyalgia, and with or without comorbid migraine. Other comorbidities reported included anxiety, depression, gastrointestinal and cardiovascular disorders, chronic fatigue syndrome, multiple chemical sensitivity, and food intolerance. Every subgroup had suicidal ideation, with 41% in patients with cluster headache, 33% with cluster headache and migraine, 90% with cluster headache and fibromyalgia, and 37% with cluster headache, migraine, and fibromyalgia.

The comorbidity of cluster headache with fibromyalgia and/or migraine appeared to be frequent. Like all comorbidities, this comorbidity increases patients’ psychosocial burden and reduces overall quality of life.

Investigators concluded by emphasizing the need for further studies to investigate the frequency and clinical relevance of cluster headache and comorbid fibromyalgia.

“We suggest that the risk of suicide in these populations should be further evaluated using a population-based study that increases representativeness, allows a better categorization of diagnoses, and includes a harder outcome measure such suicidal attempts and/or mortality due to suicide,” investigators wrote. “The potentially high rate of suicidal ideation in these patients suggests that careful screening and monitoring of the risk of suicide are of particular importance in clinical practice.”

Calandre EP, Ordoñez-Carrasco JL, Slim M, Rico-Villademoros F, Garcia-Leiva JM. Comorbidity of migraine and fibromyalgia in patients with cluster headache: psychological burden and healthcare resource utilization. A cross-sectional study. J Oral Facial Pain Headache. 2024 Mar;38(1):32-39. doi: 10.22514/jofph.2024.004. Epub 2024 Mar 12. PMID: 39788574.

Song T, Lee MJ, Choi Y, Kim B, Chung P, Park J, et al. Differences in characteristics and comorbidity of cluster headache according to the presence of migraine. Journal of Clinical Neurology. 2019; 15: 334–338.

A study explored the comorbidity of cluster headache with fibromyalgia and migraine, revealing a significant disease burden, particularly in females. The research, conducted via a survey, highlighted increased depression, sleep disturbances, and reduced quality of life in patients with these comorbidities. Osteoarticular conditions, anxiety, and depression were common among these patients. The study emphasized the need for further research on the clinical relevance of these comorbidities and suggested careful screening for suicidal ideation due to its high prevalence in this patient population.

A study found frequent comorbidity between cluster headache, fibromyalgia, and migraine, as well as heightened depression and sleep disturbance among these individuals.

Cluster Headache Often Comorbid with Fibromyalgia, Migraine

A recent study demonstrated that a digital mindfulness-based program is an easily accessible way to alleviate employee

 Using the mindfulness app for approximately 5 to 10 minutes demonstrated greater stress reduction; however, using the app for < 5 minutes relieves stress more than doing no meditation.

“This study confirms prior findings indicating psychological benefits of mindfulness practice for employees and extends them to a digital platform,” wrote investigators, led by Rachel M. Radin, PhD, from the department of psychiatry and behavioral sciences at the University of California San Francisco.

Research has shown mindfulness meditation helps to reduce work-related stress.

 Many workplaces have implemented in-person mindfulness programs to address workplace stress and enhance employee well-being. Still, these programs are often challenging to distribute widely, leaving many employees without sufficient opportunities to manage stress.

Investigators wanted to see if digital mediation programs would be an effective option for managing workplace stress.

 They conducted a randomized clinical trial to assess the effects of digital mediation on general and work-specific stress compared with a waiting list condition. The team also wanted to see whether greater engagement in the intervention moderated the effects.

The study recruited 1458 adults aged ≥ 18 years (mean age, 35.54 years; 80.80% female) from May 16, 2018, through September 28, 2019, who worked at a large academic medical center, reported mild to moderate stress, and had access to a web-connected device. Participants were randomized 1:1 to a digital meditation program (n = 728) or the waiting list control condition (n = 730). The digital meditation program required 10 minutes of meditation per day for 8 weeks, whereas the control group continued their normal activities and did not do any meditation during the study period.

The primary outcome was a change in Perceived Stress Scale score at 8 weeks, and the secondary outcome was a change in job strain, measured as work effort-reward imbalance. Investigators measured stress, job strain, burnout, work engagement, mindfulness, depression, and anxiety at baseline, 8 weeks, and 4 months. The data was analyzed from March 2023 to October 2024.

Participants in the meditation group showed greater improvements in the Perceived Stress Scale score (Cohen d, 0.85; 95% confidence interval [CI], 0.73 to 0.96) and in job strain (Cohen d, 0.34; 95% CI, 0.23 to 0.46) at 8 weeks compared with participants who did not do any meditation. These improvements were maintained at 4 months (Perceived Stress Scale: Cohen d, 0.71; 95% CI, 0.59 to 0.84; job strain: Cohen d, 0.37; 95% CI, 0.25 to 0.50). Participants who meditated also showed significant improvements at 8 weeks in work burnout, depression, anxiety, mindfulness, job reward, and work engagement.

People who used the meditation app longer, from 5 to 9.9 minutes per day compared with < 5 minutes per day, demonstrated a greater stress reduction (mean Perceived Stress Scale score difference, -6.58; 95% CI, -7.44 to -5.73).

“The mechanisms by which digital mindfulness interventions impart benefits for both general and work-related stress may include an improved capacity to cope with and positively reappraise stressful situations, as well as enhanced mindfulness and attention regulation,” investigators wrote. “In a work context, these enhanced coping abilities may lead to the reappraisal of demands as manageable and work stressors as within one’s control, leading to decreased job strain.”

Investigators noted that the findings were limited by a limited sample of participants who identified as service workers, Black or African American, or males—all groups who were likely high in work burnout. The team also added how they were unable to determine whether treatment effects were due to nonspecific factors such as time or attention or mindfulness-based factors.

“Given the strong effects of digital mindfulness and the low cost, greater dissemination across workplace settings could be beneficial,” investigators concluded. “Future studies are needed to enhance adherence and to better characterize treatment mechanisms.”

Radin RM, Vacarro J, Fromer E, et al. Digital Meditation to Target Employee Stress: A Randomized Clinical Trial. 

 2025;8(1):e2454435. doi:10.1001/jamanetworkopen.2024.54435

Jamieson SD, Tuckey MR. Mindfulness interventions in the workplace: A critique of the current state of the literature. J Occup Health Psychol. 2017 Apr;22(2):180-193. doi: 10.1037/ocp0000048. Epub 2016 Sep 19. PMID: 27643606.

A digital mindfulness-based program effectively reduces employee stress, with benefits persisting for four months. The study involved 1,458 adults at a medical center, comparing a digital meditation group with a control group. Participants meditated for 10 minutes daily over eight weeks, showing significant improvements in stress, job strain, burnout, depression, anxiety, and work engagement. Longer app usage correlated with greater stress reduction. The study highlights the potential of digital mindfulness interventions for workplace stress management, though limitations include a lack of diversity in the participant sample.

A new study shows that employee stress improves when using a mindfulness meditation app for under or above 5 minutes (the more effective option).

Mindfulness App Maintains Improvements in Employee Stress at 4 Months

A new study found telemental health care diffused rapidly after the onset of the COVID-19 pandemic among Medicaid beneficiaries with 

“Our study shows that after the onset of the COVID-19 pandemic, telemental health care diffused rapidly to deliver care to Medicaid beneficiaries with schizophrenia across New York’s state-licensed mental health agencies,” wrote investigators, led by Sharon-Lise Normand, PhD, from the department of health care policy at Harvard Medical School. “This is evidenced by most agencies having reached the diffusion target indicating routine use in less than 3 weeks, which may be an adequate spacing of visits for individuals with acute presentations of schizophrenia.”

Receiving mental health care through telehealth increased after the COVID-19 pandemic onset. A study last January found that mental health video visits have had consistent increases since the COVID-19 pandemic peak around May 2021.

Although many people utilize these services, not much is known about the speed of adoption of telemental health care for individuals with schizophrenia.

Investigators sought to characterize telemental health care diffusion in mental health agencies treating Medicaid beneficiaries with schizophrenia, as well as the association of telemental health care use with race and ethnicity.

 They conducted a retrospective study using New York State Medicaid data from March 1, 2019, to February 29, 2020 (pre-pandemic period), and from March 11, 2020, to March 31, 2021 (pandemic period) from 261 agencies serving 30,990 beneficiaries with schizophrenia who had ≥ 1 mental health visit during the pandemic period.

Investigators collected data on agency type (freestanding, hospital-affiliated, or state-operated), race, and pandemic severity, determined by COVID-19 hospitalization rates per a 10,000 population. The primary outcomes were the days to 10% cumulative telemental health care use within agencies, time to the first telemental health care visit, and telemental health care visit in catchment areas.

The analysis examined 261 agencies (18 state-operated, 79 hospital-affiliated, and 164 free-standing) and 30,990 beneficiaries with schizophrenia. The sample had a mean age of 43 years, 59% male, and a race breakdown of 38% Black, 25% White, 20% Latinx, and 7% Asian or other.

95% of agencies (n = 248) reached 10% cumulative telemental health care visits in a mean of 18 days. 2% of agencies (n = 6) never adopted telemental health care.

Investigators found participants in racial or ethnic minority groups (23%) were not linked to telemental healthcare diffusion in the pre-pandemic period. Compared to White participants, the time to first telemental health care visit was slower in participants who were Asian or other (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.88 – 0.98), Black (HR, 0.90; 95% CI, 0.87 – 0.93), Latinx (HR, 0.95; 95% CI, 0.91 – 0.99).

Beneficiaries from a racial or ethnic minority group were less likely than White participants to have a telemental health care visit regardless of pandemic severity and area. However, there were fewer differences when pandemic severity was greater (HR, 0.70; 95% CI, 0.63 – 0.79), such as in New York City, but more differences when pandemic severity was low (HR, 0.59; 95% CI, 0.53 – 0.67). At times of high pandemic severity, Black people were more likely to have a telemental health care visit.

The team observed race and ethnicity differences in healthcare systems with varying levels of stress. The differences were more prominent when the severity of schizophrenia was greater, showing that vulnerable groups may be prioritized when the healthcare system is under stress.

The study also revealed diffusion was quicker in state-operated than free-standing agencies (hazard ratio [HR], 2.44; 95% CI, 1.21 – 4.95). Investigators theorized this may be because state-operated agencies are more familiar with state government procedures, leading to rapid implementation of new state policies and regulations.

Hospital-affiliated agencies were slower to adopt telemental health care, and the team believed this could be because free-standing agencies were smaller, more vertically integrated, and had a more cohesive workforce focused on mental health care.

“Although these features may not be easy to replicate across all mental health care provider organizations, greater administrative and workforce integration is a desirable feature for any organization,” investigators concluded.

Race and Ethnicity and Diffusion of Telemedicine in Medicaid for Schizophrenia Care After Onset of the COVID-19 Pandemic. JAMA Network Open. 2025;8(1):e2454776. doi:10.1001/jamanetworkopen.2024.54776.

Derman, C. Telemedicine Reduced After COVID-19 Peak, Mental Health Video Visits on Rise. HCPLive. January 24, 2024. 

https://www.hcplive.com/view/telemedicine-reduced-after-covid-19-peak-mental-health-video-visits-rise

Telemental health care rapidly expanded among Medicaid beneficiaries with schizophrenia following the COVID-19 pandemic onset, with most agencies reaching routine use within three weeks. The study analyzed data from 261 New York State agencies, revealing racial and ethnic disparities in telemental health adoption. Minority groups experienced slower access compared to White participants, with disparities lessening during high pandemic severity. State-operated agencies adopted telemental health faster than free-standing or hospital-affiliated ones, likely due to familiarity with state procedures. The findings highlight the importance of administrative and workforce integration in mental health care delivery.

Despite the surge in telemental health use in patients with schizophrenia, fewer people in racial or ethnic minority groups had a telemental health visit compared to White people.