Don't be surprised to observe even your lawn care workers sneezing and otherwise suffering from allergies this spring, especially in the Cedar Creek Lake area. Dallas ranked number 24 in the top 100 cities in the nation where allergens are especially high this year, according to the Asthma and Allergy Foundation of America. Dallas' rate was 74.16, and that rating would rise even higher in the Cedar Creek Lake area because of all the farm pastures and wooded areas surrounding it. In fact, Texas appears to be an allergy capital state. Two Texas cities -- McAllen at number 2 with a 96.71 score and San Antonio at number 9 with a 84.41 score -- were included in the top 10 spring allergy capital cities cited in the report. Knoxville, TN, was number one with a 100 score. Cities in Kentucky, Mississippi, Kansas, Oklahoma and Ohio filled out the top 10. The cities' scores were factored through the analysis of seasonal pollen counts, use of over-the-counter and prescription allergy medications and the number of board-certified allergists per patient. The higher the rate, the worse the problem. The foundation noted that 40 million Americans suffer from nasal allergies, which is also known as allergic rhinitis or "hay fever," in a report released at the beginning of spring. The report was released as part of a campaign to help people recognize, prevent and manage allergy symptoms. "Unfortunately, the number of children and adults who have nasal allergies continues to grow every year," said Mike Tringale, vice president of AAFA external affairs. The annual report attributes springtime allergies primarily to tree pollination, but weeds and grasses also can be an aggravating factor. Symptoms include itchy runny nose, nasal and sinus congestion, repeated sneezing, watery itchy eyes, inflamed sinuses and difficulty breathing in severe cases. Dr. Rohit Katial, program director of Allergy and Immunology at National Jewish Health in Denver, said in the report that he recommends allergy sufferers use a daily sinus wash because it "provides a natural, easy and effective option to prevent and soothe nasal irritation." Other tips offered by the AAFA include: talking to your pharmacist about nasal rinsing and antihistamine products, talking to your doctor about prescription medications for more severe cases, preventing pollen from getting indoors by keeping windows and doors and shut, vacuuming at least weekly and spending as little time outdoors as possible during allergy seasons.