The purpose of this study is to examine the natural history of hay fev
er among former college students who were diagnosed with this disease
either before or after their freshman year. The diagnosis of hay fever
or seasonal allergic rhinitis was based on a history of watery, itchy
eyes, rhinorrhea, and sneezing occurring for at least 2 consecutive y
ears during the same seasonal period. A total of 738 former Brown Univ
ersity students (69% males and 31% females) who were evaluated and und
erwent skin testing during their freshman year completed a 23-year fol
low-up questionnaire inquiring of their history of allergies and asthm
a. The mean age of this group at the time of the follow-up study was 4
0 years. During the 23 years subsequent to the original study, 131 dev
eloped new hay fever in addition to the 175 who had hay fever as colle
ge freshman, totaling 306. At the time of the 23-year follow-up, impro
vement was noted by 84.8% (28/33) of those with hay fever onset 1-5 ye
ars, 63.6% (56/88) of those with onset 6-12 years, 55.6% (40/72) of th
ose with onset 13-19 years, and 38.7% (41/106) of those with onset 20
years and older. Among those with an unknown age of onset, 42.9% (3/7)
reported improvement of hay fever symptoms. The trend of increasing p
ercentage of improvement with younger age of onset of hay fever is of
statistical significance (p value of <0.0001) using the chi-squared te
st for trend. A total of 54.9% (168/306) had noted improvement, of whi
ch 22.9% (70/306) reported being symptom free and 32.0% (98/306) repor
ted being better but not symptom free. Of the remaining 45.1% (138/306
), the hay fever was unchanged in 33.3% (102/ 306), worsened in 9.2% (
28/306), and unknown in 2.6% (8/306). This study suggests that over a
long period of time, hay fever symptoms will improve in the majority o
f individuals.