Come and visit us at The 2012 Allergy & Free From Show! It is the UK’s largest annual gathering of people living with allergies, eczema, hay fever, asthma, and chemical sensitivities.

Come along to our stand for fantastic special show promotions and talk to one of our experts. 

Follow the link below to register for FREE tickets complimentary of us here at Allergy Cosmos. 

See you soon!

www.allergyshow.co.uk/go/allergycosmos

A recent report from the National Environmental Engineering Research Institute points to widespread construction activity throughout the city as the major cause of air pollution in Mumbai. The city's transport department noted that the amount of heavy machinery like diggers, forklifts and cranes has more than trebled in the last ten years, with an accompanying massive increase in dust and PM pollution.

Meanwhile, the Brihanmumbai Municipal Corporation (BMC) latest report on the status of the environment in Mumbai points to a dramatic increase in carcinogenic polyaromatic hydrocarbons (PAH) in the city's air.  Specifically, the report shows that levels of highly carcinogenic benzopyrene has gone up eight times and there have been similar increases in levels of other PAHs, including phenanthrene, pyrene and benzanthracene.  These PAHs come from smoke arising from combustion of rubbish and from vehicle exhaust and the BMC attributes the added pollution to the massive increase in construction activity and rapid industrialisation in Mumbai. Unsurprisingly, the citizens of Mumbai are beginning to pay the price in terms of their health.  Deaths from respiratory disease are up 20 per cent, with a focus on asthma and chronic obstructive pulmonary disease. 

However, the city authorities are doing something to try to address the problem. First, a bridge has been built across the Arabian Sea to join the suburbs of Bandra and Worli, which will ease traffic congestion. This is the first bridge of its kind ever to be built in India. Furthermore, a monorail is being piloted in the city which will save on fuel and cut down pollution. 

There are also new measures to improve waste disposal procedures, with medical waste carrying vehicles now being fitted with sophisticated tracking devices.  And, as with other cities around the world, including London, cycling is being made higher-profile, as an alternative to driving.  These measures are a start – but much more needs to be done to tackle the rapidly escalating air pollution problem in Mumbai.

For further information see 'The air we breathe in Mumbai'. 

China has one of the highest concentrations of PM2.5 pollution in the world, but the impact that air pollution exposures have on the health of the Chinese population is not well understood.  A team led by Haidong Kan of Fudan University in Shanghai studied PM2.5 pollution in Xi’an, which is one of China’s most polluted cities. It is the largest city in northwestern China and has a population of over 8 million. The researchers looked at mortality data for residents of the inner urban area and at daily levels of PM2.5. They also measured levels of PM2.5 components like organic carbon, elemental carbon, ions including nitrate and sulphate, as well as a number of elements including nickel and chlorine. 

During the study period, the average daily concentration of PM2.5 was 182.2 micrograms per cubic metre – which is way above the World Health Organization’s recommended upper limit of 10 micrograms per cubic metre. In Beijing, which gets a lot of bad press about its pollution, the corresponding levels are ‘only’ 122 micrograms per cubic metre.  

Taking the pollution measurements with mortality data showed that there was a significant link between exposure to PM2.5 and daily mortality.  On a ‘bad air’ day people were more likely to die of heart disease, lung disease or, indeed, of any cause. Digging deeper into the data, the researchers showed that the following components of PM2.5s were linked to increased mortality:

• organic carbon
• elemental carbon
• sulphate ion
• ammonium ion
• nitrate ion
• chloride ion
• chlorine
• nickel. 

The researchers note that these specific components of PM2.5s are associated with the burning of fossil fuels (mainly coal, heavy oil) in Xi’an. They note that this is the first study to link the health of the population of a developing country to specific components of PM2.5s. These new findings are consistent with the famous Six Cities study which showed the link between PM2.5s and mortality in the United States urban environment.  Pollution is a global issue and a major public health problem, particularly where the combustion of fossil fuels is inadequately controlled. The study should push the Chinese authorities into setting out tighter environmental legislation to protect the health of its citizens.  The announcement that they are publishing PM2.5 daily data may be a good start but, clearly, much more needs to be done. 

http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1103671

1.) Keep the animal outdoors as much as possible – a garden dog, a cat flap, a rabbit in a hutch can all help keep indoor pet allergen levels down.

2.) Be sure to keep bedroom doors closed at all times – a cat on the bed can cause severe problems for someone with asthma.

3.) Short-haired dogs may shed less allergen than long-haired breeds – although a recent research paper did seem to argue against this.  Labradoodles and cavapoos  are among the dog breeds said to by hypoallergenic.

4.) Clean your pet, its blankets and the area where is spends time regularly with products that is designed to naturally destroy pet allergens, like the anti-allergen spray, pet shampoo and laundry detergent in the Pet Lovers Package to keep pet allergen levels down.

5.) Are you sure pet allergen is really the cause of your allergy? Could be that house dust mite, mould or pollen is the real culprit. An allergy specialist will be able to offer tests to pinpoint the true allergen.

6.) Pet allergen sticks to clothes, carpets and furniture so be sure to keep dust levels down by regular damp dusting and using an air purifier to capture pet allergens in the air. Also consider using a vacuum fitted with a high efficiency particulate air (HEPA) filter to remove pet allergen particles.  

7.) If you are allergic to animals, be careful if you are moving house. Vendors are obliged to disclose any problems with neighbours when they sell. But they don't have to say whether they are pet owners. Try to find out, because animal allergens can linger for many months after an animal has left the premises. 

8.) Although cuddling a pet is part of the fun of ownership, try to avoid this if you are allergic. At the very least, be sure to wash your hands after touching an animal and wash clothes that may have come into contact with pet hair or fur.

9.) If you, or a family member, has allergies and you are just considering introducing a pet (but don't yet have one), think very carefully – because for some people the risks unfortunately outweighs the benefits, even if you take all the necessary precautions. There are other ways of expressing your love for animals.  For instance, you could adopt an animal through WWF and help protect an animal and its habitat, or sponsor a guide dog. The schemes offer a photo of 'your' pet and regular updates on its welfare. 

1. Declutter. Ornaments, old newspapers, unused or broken appliances, unwanted furniture – they all collect dust. Do a little at a time, go through each room, and aim to get surfaces clear so they can be dusted quickly and easily. If an object isn't useful, beautiful or of real sentimental value, get rid of it. 


2. Dust like a professional. Never use a feather duster, as all it does is stir up the dust and make it airborne.  Invest in some good quality dusters and use them slightly damp. Another option is an electrostatic dust cloth which will attract the dust to its surface so it is properly removed. 


3. Wash your pet with allergy friendly pet shampoo. Proteins found in the sweat and saliva of cats and dogs act as potent allergens that readily become airborne on microscopic flakes of their skin. Reduce the load of pet dander in the house by washing (not showering) your pet weekly, using a special allergy friendly pet shampoo such as PET+. If your pet does not like getting wet, you should make it fun and give him a treat afterwards.  And, during the spring cleaning project, clean up any upholstery your pet has made a bed on with an allergy friendly dust spray such as the award winning ADMS from Allersearch. 


4. Tackle mould. Check your bathroom, any unheated rooms – particularly cellars or conservatories – for patches of mould. It may be black, but it comes in other colours as well – such as pink, grey, green and even white (depending on the species). Mould release spores which can cause very severe allergic symptoms. The old fashion way of treating mould is with white spirit or surgical spirit or a mixture of two to one water and bleach. For more long-lasting and thorough job, use the specially designed Allermold Mould Spray, it will desroy the mould naturally and help preventing it from growing back. Complete your efforts with the purchase of a new shower curtain (or replace it with a screen). 


5. Invest in a new leakage free HEPA vacuum. Don't assume that vacuuming a carpet or other soft furnishings will automatically remove allergen-laden dust. It may make things worse by stirring up the dust and making it airborne. You need one that sucks in, and keeps in - i.e. a leakage free HEPA vacuum cleaner. Yes, there are vacuum cleaners specially targeting the allergy market – but check to see if they have been properly tested for this purpose by a knowlagable and independent body. Just because an allergy related charity put its approval on it does not necessarly mean that it has been properly tested and actually works, it only means that the manufactuerer paid the charity to recommend it.


6. Check your paint and DIY products. Volatile organic compounds (VOC) are molecules that are added to paints, varnishes and stains to improve their properties. Unfortunately, being volatile, they readily evaporate from the product into the air, where they may trigger very strong allergy symptoms or reactions from people with multiple chemical sensitivities, particularly if ventilation is poor. The industry has brought in new legislation to minimise the content of VOC in paint and other DIY products. Products should be now labelled 'VOC 2010 compliant' so check this out. And if you're considering using old paint stocks to touch up, at least make sure the area is well-ventilated to protect yourself and others from its VOC content. If you have to move in before the paint smells are gone, consider using an air purifier such as the IQAir GC VOC, it is guranteed to capture and retain harmful paint chemicals. 


7. Repair holes. Check your home inside and out for cracks, holes, and loose or faulty window fittings. These could be making your home damp, which encourages the growth of mould and house dust mite.


8. Improve ventilation. Modern homes tend to be too 'air tight' which encourages the build-up of indoor pollution. Consider sleeping with the bedroom window slightly open. If you have asthma, cold air may trigger symptoms so, instead, air the room in the afternoon instead. If you have a pollen allergy, keep windows closed at night and air the room in the afternoon when the pollen count is lowest. Purchase an effective air purifier (a lot of air purifiers are to small or are ineffective in cleaning the air), you will have it for years to come and it will let you sleep better through out the different seasons.  Windows in the bathroom and kitchen should be opened after bathing or showering or during cooking. 


9. Replace your carpet.  A carpet is an ideal reservoir for allergen-laden dust and vacuuming might just stir it all up. Children may well come into direct contact with these if they play on the floor. Replacing carpet with a hard floor removes this major source of allergens from your home and is easier to keep free of dust. Laminated or solid wood, vinyl, or linoleum are popular hard floor options, the choice depending on the room.  


10. Replace your bedding. If you are buying new bed linen, remember that the bed is home to the house dust mite and therefore a danger zone to a person with asthma. Anti-mite barrier covers can be purchased to enclose the mattress and pillows, to prevent contact between the person and house dust mite allergen. Look for covers made of a microporous material, rather than plastic – the latter are very uncomfortable. As far as the bedding itself is concerned, a weekly wash with Allergen Wash Laundry Detergent will keep down the house dust mite load.


11. Clear out old books and papers. Paper absorbs moisture and encourages the growth of mildew, which is a film of mould with a whitish or black colour. Mildew has a characteristic mouldy smell and will give off spores into the air, which could trigger your allergy symptoms. The best approach is to have a regular clear out of old books and papers from your home office and living room. 

What is the petition for?

Sara and Bruce want to change the law so that people in their homes have the same legal redress when affected by local external influences, (such as building work) as people in the workplace would have from their employers. 

Sara sufferers with severe asthma and is affected by any kind of building works and roadworks that is done near her home. The local housing association have decided to start a major works program which is replacing the roofs of 7 blocks of flats within the area, over a period of 4-5 months. They are started on the nearest 2 and will be moving on to the rest, which are all within half a mile which will affect Sara.

Sara and Bruce write: "We have had to move out whilst the works are done. The housing association are under no obligation to do anything to help us, and as you can imagine they have not.

We started this campaign to get 1,000 people who would sign an e petition to the UK government, to change the law so that these companies would have to make provision for asthma sufferers. We have gathered 25 people so far and am getting offers of help from numerous asthma and respiratory groups.

We have had to move out of our home to a relative in Chester. This is really disrupting our business and will be going on for months. It cannot be right. If we caused them to be off site for any time whatsoever we would be sued. 

The law is different for asthma sufferers, they appear to be excluded from nuisance law, as people who are ultra sensitive are excluded. So asthma sufferers cannot use this legislation. Workers can use employment law, but the asthma sufferer in their own home have nothing. The law is outdated and needs to be changed."

Sara & Bruce Campbell invite people to join them in trying to change the law by supporting their e- petition to the UK Government.  Sara & Bruce suggest that 1000 group members would give the e-petition a chance. 

We would like to encourage everyone to spread the word about this group. 

Please follow the link below to sign the Asthma E- Petition: 

http://epetitions.direct.gov.uk/petitions/33111

Willow Sycamore

Oak

Hazel

Chestnut

Birch

Ash

Cypress

Cedar

Currently, the focus is upon birch pollen which is expected to be more abundant this year because of the mild winter.  Weather conditions also mean that the birch pollen season is going to start a couple of weeks earlier than usual – around March 15 in the south of England, making its way north during early April. It will last for three to four weeks, depending upon the weather. For more on birch pollen distribution throughout the UK, check pollen expert Jean Emberlin's map.

Symptoms of hay fever include runny nose, runny eyes and nasal congestion.  Hay fever can interfere with sleep and has been shown to have an impact upon exam results.  If you suffer, try these self-help tips (and let us know if you have some of your own to share): 

• Change into indoor or relaxing clothes when you get home from work; also shower and wash your hair to get rid of pollen
• Try wearing wrap around sunglasses to keep pollen out of your eyes
• Don't hang washing outside when pollen counts are high 
• Wash your clothes in allergy friendly laundry detergent such as Allergen Wash 
• Dust and treat carpets with allergy friendly cleaning products such as Allersearch
• Limit time outdoors when pollen counts are high, especially in early morning and late evening when pollen levels are at their highest
• Create a save-zone in your bedroom by keeping windows and doors closed and putting your air purifier on a high setting. Also consider using a unit in your office or place of work.
• Do use the information in pollen forecasts to plan activities if you have to leave the house 

Besides self-help and allergen avoidance, it's important to get your hay fever medication right.  What you use needs to be safe and effective.  If you are still using sedating anti-histamines, think about the impact the side effects may have on work or school performance and on activities like driving or operating machinery. There are non-sedating alternatives available. It may also be that your medication is not effective for the level of your hay fever symptoms. Again, there are many other options. Most hay fever medications are available over-the-counter but if your usual tablet or spray is not controlling your symptoms, or if you are experiencing side effects, it's worth asking your community pharmacist for advice – or visit NHS Choices for further advice. 

• Four plumbers
• 20 tradesmen
• Six electricians
• Eight joiners.

Asbestos fibres penetrate the lung and are responsible for:

• Mesothelioma, a cancer of the lining of the lungs which is always fatal and is almost always caused by exposure to asbestos
• Asbestos-related lung cancer, which is often fatal
• Asbestosis, a scarring of the lungs which is not necessarily fatal but is very debilitating
• Diffuse pleural thickening, which is a thickening of the membrane surrounding the lungs. This causes breathlessness by restricting expansion of the lungs. 

Like other forms of air pollution, asbestos fibres are invisible so you may not know if you are been exposed. It can take between 15 to 60 years for symptoms of an asbestos-related disease to develop. Asbestos was widely used as a building material between the 1950s and mid-1980s, because of its strong insulating properties. It was banned in the United Kingdom in 1999, but houses, business premises, hospitals, and other buildings constructed before 2000 may contain asbestos in some form. There is background level of asbestos in the environment but exposure to this is not likely to cause any health problems.  The risk increases with the number of asbestos fibres breathed in. Intact asbestos is unlikely to cause any problems – it is release of asbestos fibres into the air that is the danger. 

Asbestos comes in many forms, some of which are potentially more dangerous (because of their ability to release fibres) than others. If you are a contractor working in premises where there is asbestos, or if you live in a home or work in an office where refurbishment is going on, it's possible you'll get exposed to asbestos. So it is worth knowing what the different forms of asbestos are, and whether they are a potential source of airborne asbestos fibres.

Asbestos cement

This is ordinary cement that is mixed with asbestos and it is found in roofs, downpipes, gutters and walls. The asbestos component is tightly packed so there is not much risk of asbestos fibres being given off, unless the cement is sawn or drilled.

Textured coatings

Used to create a decorative finish on ceilings and walls, these coatings had various trade names (such as Artex). The asbestos is tightly packed but might be released if the coating is sanded down.

Floor tiles, textiles, composites

These materials do not look different from their non-asbestos containing counterparts. Asbestos floor tiles are sometimes hidden under a carpet, and the textiles are sometimes found in old fuse boxes (beware during rewiring work). Old fire blankets are notorious for being made of asbestos textiles. All should be treated with caution.

Sprayed coatings

These are white or grey with a rough surface. They contain up to 85% asbestos and break up very easily, releasing fibres. Sprayed coatings are one of the most dangerous asbestos-containing materials. You must have an HSE licence to work on asbestos sprayed coatings. 

Asbestos insulating board

This was commonly used as a fireproofing material and may be found in: partition walls, fireproofing panels in fire doors, lift shaft linings, ceiling tiles, panels below windows. It is hard to tell the difference between these and their non-asbestos containing counterparts. The board readily releases fibres when disturbed and, except for minor tasks, you must have an HSE licence to work on asbestos insulating board. 

Lagging and insulation

This is mostly found in or on heating systems and is a fibrous material that easily breaks up. Therefore this is also a dangerous form of asbestos material so you would need an HSE license to work on it.

If you are concerened that asbestos is in your home or place of work, and you want to clean the air with the use of an air purifier, it is key to look for quality.  We would only recommend units such as the medical-grade IQAir line of air cleaners. Their Hyper-HEPA filtration reaches the highest filtration efficiency while providing you with a gurantee for the units overall top performance. There is a wealth of information and advice on the HSE website on how to proceed if you have concerns about the presence of asbestos in a property. If in doubt, don't put yourself or others at risk – check it out!

To learn more about the best air cleaners for removing harmful air pollution visit Commercial Air Filtration. 

A group of 70 people with type 2 diabetes, aged 40 to 84 and living in Boston, took part. The researchers measured PM levels, focusing upon PM2.5 (particles with size less than 2.5 microns and known to be more hazardous to health than larger particles). They also measured carbon particles and ozone which, again, are health risks.  Meteorological data, including temperature, was also recorded.  The participants' blood pressure readings were also taken on a number of occasions.

Blood pressure was found to increase with increasing levels of PM2.5 and black carbon. However, increases in ozone concentration were linked to a decrease in blood pressure. Temperature increases were also associated with a decrease in blood pressure. 

The researchers conclude that people with diabetes are particularly sensitive to environmental stressors like air pollution and heat. The impact on their blood pressure could explain why previous research has found that short-term increases in air pollution are linked to more instances of heart attack and stroke among those with diabetes. 

You may think that the two effects on blood pressure cancel one another out – increased with PM exposure, decreased with ozone exposure. It is certainly true that lowered blood pressure is usually a health goal for people with diabetes. However, the lowering with exposure to pollution occurs rapidly, which is not good for the heart or circulation. What pollution does is to exacerbate the already disordered control of blood pressure in people with diabetes – and that is dangerous. 

So what should someone with diabetes do? Exercise – particularly regular walking – is one of the mainstays of managing type 2 diabetes and is very important in its prevention. At home you can effectively protect yourself throught the use of a good air purifier. Key here will be to achive enough complete air exchanges per hour at a consistently high filtration efficiency. You should also find out more about your city's pollution levels and do your walking in areas that are less polluted, or even head for the countryside. And, of course, more should be done to control levels of pollution in our cities. This study took place in Boston where pollution levels were not even particularly high. Just imagine what might be happening to people with diabetes in cities like Beijing, or London. 

There are coloured index bands for each of the key pollutants, namely:

• Nitrogen dioxide
• Sulphur dioxide
• Ozone
• PM10s (particles of size 10 microns or less)
• PM2.5s (particles of size 2.5 microns or less).

Levels of pollution are classed from 1-10, depending on the level measured. Levels 1-3 are classed 'low', 4-6 'moderate', 7-9 'high' and 10 'very high'. Each index band is linked to advice for both healthy people and those with asthma and other lung problems, or heart problems.  

This strikes me as being a good way of displaying the information that is measured, day in day out, by the UK's network of air pollution monitoring stations. 

On the day of writing this (a wet mid-February Saturday) I checked out the DAQI for several sites in London and was relieved to find levels of all five pollutants were low. You get information for your area by clicking on Defra's interactive map. I suggest you check back often – not just if you have asthma but just in the interests of being a concerned and informed citizen! You then have all the facts at your disposal to lobby against any local pollution sources, such as traffic congestion. 

As far as PM2.5s are concerned, it looks as if the UK and Beijing are on the same page.  The US Embassy in Beijing has been broadcasting PM2.5 data via Twitter for some time now and has, seemingly, embarrassed the Beijing government into stating that it, too, will publish official figures on PM2.5 pollution. Click here to learn more. 

PM2.5 air pollution penetrates deep into the lungs and may even enter the bloodstream.  Exposure causes coughing, wheezing, decreased lung function and aggravated asthma. It has also been linked to premature death among those with existing lung and heart disease.

Just for comparison, I checked PM2.5 levels in London and Beijing on the same mid-February day.  In London, the highest level (Marylebone Rd – one of London's busiest roads) of PM2.5 was 25 micrograms per cubic meter, while in Beijing it was over four times higher at a level of 105. Clearly the Chinese capital has a long way to go in cleaning up its pollution levels. And London cannot afford to be complacent either – a low PM2.5 reading on that single day, to be sure, but how will levels change in the coming months. 

Here you can find out what pollutants and allergens can effect you and your family in your home. Feel free to add this Infographic to your website or blog, as long as you retain the embeded code to recognize Allergy Cosmos. You can find the code to embed this infographic into your site below. 

If you want to protect yourself from air pollution or are looking for the best allergy relief products visit us at Allergy Cosmos.

In spring and summer my son’s allergies often become so strong, that he cannot leave the house, let alone go to school. And the problem is that if you do not keep your main allergies under control all the other minor allergies flare up too, and my son gets severe food allergies if we do not actively control his hay fever.

We have been using the IQAir HealthPro 250 for more then a year now and my husband and I are so very happy with its performance and the improvement it made to my sons allergy symptoms.  We turned it on a year ago and never turned it off again. The thing about this machine is that it allows our son to be in a room that is free of allergens and gives him a chance for his immune system to recover - and that makes all the difference.

For people who are concerned about their child’s allergy and asthma symptoms, I can assure you that the IQAir HealthPro is very well worth the investment.  We tried many other air purifiers and they were all worthless. This product has worked where all else has failed and it did exactly what it promised it would do - which is absolutely fantastic!

Thank you Allergy Cosmos.  

Amanda Manners"

Cooking, either with solid fuel or gas, can be a major source of indoor air pollution, alongside cigarette smoke and fumes emitted from furniture, DIY products and office equipment. A new study from Spain shows how cooking with gas at home during pregnancy is linked with problems with infant brain development. The work was reported in the journal Epidemiology and described in Environmental Health News.

Babies born to mothers cooking with gas scored slightly lower on intelligence tests aged one and two compared to those who did not cook with gas. The fact that scores were better when there was an exhaust fan above the cooker does suggest (but not prove) a link with pollution from the stove.

All forms of combustion tend to produce nitrogen dioxide and the gas has already been linked with various health effects. Car exhausts are a major source of nitrogen oxide pollution and levels in cities are regularly measured using pollution monitoring networks. Levels of nitrogen dioxide indoors are not monitored.

Gas cookers used natural gas, propane or butane as fuels and produce nitrogen dioxide as one of their emissions, along with carbon monoxide and other gases. Levels of nitrogen dioxide are up to two times higher in homes with gas cookers.

Previous work has suggested that the presence of gas appliances in the home do have an effect on children's neurological functioning at the age of four. This study involved more than 2,000 pregnant women who were asked what type of cooker they used (gas, electric or other) and whether they had an exhaust fan to deal with emissions. This question was asked during the third trimester of the pregnancy.

At age 11 and 22 months, the Bayley Scale for Infant Development was used to assess the newborns mental development. Infants with gas cookers present in their home scored about 2.5% lower than those whose families did not use gas. Note that this study just suggests a link.  The actual level of the pollutants involved, and their identity was not measured. Nor does this study tell us what the mechanism on the brain was that resulted in the lowering of intelligence scores.  The research does, however, point the way towards further investigation of the impact of the presence of a gas cooker on infant brain development. This is particularly important because cooking with gas is so common. 

For instance, California may sound like a dream destination but, in fact, an area in the Central Valley has just recorded the worst US air quality for several years.  Apparently, dry stagnant air in recent weeks has caused levels of ozone and PM to soar between the towns of Modesto and Bakersfield, breaking federal standards on most days. 

So it was no surprise to learn from the American Lung Association's 2011 State of Air report that Bakersfield is America's pollution hot spot, with asthma rates three times the national average.  Checking the data shows that annual average PM levels are 23 micrograms per cubic metre.  The World Health Organization guideline maximum values are 20 for PM10s, and 10 for the smaller, and more dangerous, PM2.5s. By contrast, PM levels in America's cleanest city, Cheyenne, Wyoming, is just 4.0 micrograms per cubic metre. 

Of course, the reasons for these wide differences are many and complex. But what stands out for me is the ease of access of this important data from the American Lung Association's website. You can just key in your city or post code and immediately find out where the location stands with regard to ozone and PM pollution, with health risks to people with asthma and other conditions clearly explained. Do we have an equivalent site in the UK? I think not (which is not to take anything away from our excellent network of air pollution monitoring stations – the UK data is there, and of high quality too). 

Ideally, there'd be easily accessible data on urban air pollution available all around the world so people can make informed decisions about travel and relocation. A recent report suggests that China is, at last, beginning to take note of this 'need to know'.  Beijing has been notorious for its smogs and the air pollution problem is beginning to threaten the country's status as an emerging economic and political power. After all, who will want to locate to a country where urban air pollution threatens your heart and lung health? But now an announcement on the Beijing Council's website says they will publish hourly air quality reports based upon PM2.5s, having previously focused upon PM10 pollution only. There are also to be new national air quality standards which, according to China's Ministry of Environmental Protection, will include PM2.5 data.  The move has been forced, apparently, by data flying around the world on Twitter and on blogs which have shamed the Chinese government into acting.  It's to be hoped the more disclosure on the internet (whether from professional organisations or from individuals) will help clean up the air worldwide – from California to China. 

Polyfluorinated compounds are water and stain-resistant and they have been used for many years, for this reason, in a variety of everyday applications. These include:

• Non-stick cookware
• Windshield wash
• Carpet and furniture stain-protectant coating
• Food-contact paper coatings.

Because PFCs are also very resistant to degradation by heat and chemicals (which, of course, also makes them useful in their various applications), they do tend to accumulate in the environment. Their presence has long been noted in the air, water, wildlife, and the human body. 

Does this matter? Research on exposure to PFCs in animals show an impact on liver health, cholesterol levels, early development, and immunity. Animal studies have also shown an increase in liver, pancreatic, and testicular tumours on exposure to perfluorooctanoic acid (PFOA), one of the most studied of the PFCs. There is less evidence for adverse effects in humans but there is a suggestion that exposure to PFOA is associated with lower birth weight, thyroid disease, and increased cholesterol levels. We also don't know too much about how PFCs get into the body. Exposure could occur through consuming PFC-containing food and water, and through breathing air containing the compounds, possibly absorbed onto tiny dust particles. 

In this new study, the researchers looked at the airborne route for PFC exposure.  Their participants were 31 office workers based in Boston. Their office buildings were classified as follows:

• Building A (six offices) – newly built, with new carpets throughout the hallway and offices, and new furniture, including upholstered chairs.
• Building B (17 offices) – recent partial renovation with new carpets, but no new furniture or paint.
• The rest of the office buildings – no new furniture or paint, no carpeted hallway, though offices themselves had carpet.

The researchers did regular air sampling (both particles and gas) and obtained blood samples from the workers, analysing them for a number of key PFCs. 

One PFC, known as fluorotelomer alcohol (FTOH) was present in highest levels in the air of the new office building (building A), next highest in the renovated building (building B) and at lowest level in the buildings that hadn't been renovated. The researchers believe that it is outgassing of FTOH from the new carpet, new upholstery and new paint. This gradual outgassing is well-known with formaldehyde. 

In the body, FTOH does break down into PFOA, which was described above. Levels  of PFOA in blood were linked to levels of FTOH in the air. Exposure was linked to the amount of time the person spent in the office, with each extra hour resulting in an increase of 2% of the blood level of PFOA. The researchers also note that levels of FTOH are up to five times higher than have been previously noted in household air.  

This is the first study to measure both environmental (air) and biological (blood) levels of PFCs. Therefore, exposure to PFCs in office air, particularly in new and renovated offices, is a potential health hazard (though we need to know much more about exactly what these hazards might be).  The take-home message is that while a pleasant office environment is important, the new or renovated office may cause undue exposure to PFCs. Adequate ventilation and the use of an offiice air cleaning system is important (in this study, windows were closed most of the time and no air cleaning systems were used). Proper sampling of air quality and installing either free standing or HVAC integrated air cleaning systems are recommended to protect the health of office workers. 

To learn more about the best air filtration for your office environment, contact us anytime at: 
Commercial Air Filtration
www.CommercialAirFiltration.com
Tel: 020 3176 0524 info@commercialairfiltration.co.uk

House dust mite

But what is the best way to reduce the burden of house dust mite allergen in your home? The following measures are most often recommended:

• Use of mite-impermeable mattress covers
• Locating an leakage free air purifier in the bedroom with enough power to clean the room at least twice an hour
• Intensive and regular damp dusting
• Using fragrance free and allergy friendly cleaning products
• Vacuuming with a leakage free vacuum fitted with a high efficiency particulate air (HEPA) filter 
• Improving ventilation and keeping humidity low

But which method of allergen avoidance is the most effective – and should you do just one thing, or several things at the same time? Two new scientific papers in the journal Allergy may help point you in the right direction. 

Researchers at Utrecht University have used participants in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study to look at the effect of mite allergen-impermeable mattress covers (or Anti-Allergen Bedding as they are often called) on levels of house dust mite allergen and the development of sensitization and allergic symptoms during the first eight years of life, with annual follow up. Nearly 900 pregnant women, already known to be allergic, received either mite-impermeable polyester-cotton mattress and pillow covers, or ordinary equivalent cotton bedding. The anti-allergy bedding and the regular bedding were used to cover the parents’ and the baby’s bed. They weren’t told what kind of bed cover they had till after the study was over. 

The parents gave information about any allergic symptoms in their child every year till they were eight years old.  The researchers also took dust samples to analyse for Der f1 and Der p1 when the children were three months old and a second lot of samples when they reached the age of eight. 

There was a temporary decrease in asthma symptoms at the age of two years among those who used the mite-proof covers and lower levels of Der f1 (but not Der p1). Overall, however, the mite-proof covers alone did not have any protective effect. In fact, those using the mite-proof covers were even more likely to develop eczema than those using pure cotton. The researchers were surprised to find this and they believe the increased risk of eczema might be because children sweat more when using dust mite-proof bedding.  

This study’s findings are different from others, which have found that anti-allergen bedding are protective against asthma and allergy. The researchers point out that the difference is that allergy friendly bed covers were only one element in an allergy avoidance campaign in these others studies. Other common measures were also used. So the take-home message is that the key to effective allergen avoidance is taking a multi-pronged approach. 

Meanwhile, a review of the scientific evidence on house dust mite avoidance in perennial allergic rhinitis found only nine clinical trials covering 500 participants (the one study from The Netherlands mentioned above involved nearly twice that number). These looked at mite-proof bedding, chemicals that kill mites (acaricides), HEPA air filters, and a combination of these approaches. All studies agreed with the Dutch study that mite-proof bedding alone is not enough for effective allergen avoidance.

State media outlets have said that Beijing will act to reduce air pollution levels by 15 per cent by 2015 and by as much as 30 per cent by 2020. They'll achieve this by phasing out the older, more polluting cars, closing down or relocating dirty factories, like cement works which emit a lot of dust, and they will also plant many new forests. 

Citizens of Beijing have been calling for this type of action for some time now. Beijing's pollution is the very visible kind – it is so bad that the airport had to be closed owing to lack of visibility. Cancelled flights are, of course, bad for business. But worse still is the impact of breathing in air pollution on your lungs. The Beijing Health Bureau admits that lung cancer rates have gone up 60% in last decade even though smoking rates have not increased. In a recent article, Dr Richard Saint Cyr, a family doctor working in Beijing, noted that spending a month in the city's smog is the equivalent of smoking five cigarettes.  Put like that, maybe the problem doesn't sound so bad – but recent air quality data from Beijing do tell an very alarming story.

People are angry because, till now, it looks as if officials blamed visible air pollution and the airport closures on the weather. The United States Embassy set up a now famous Twitter feed which relayed daily information on levels of PM2.5s levels from a monitoring station on top of the Embassy building. This seemed to be broadcasting the truth about Beijing pollution while its own government seemed to be in denial. Doubtless the publicity has helped forced the government to act and come up with these new anti-pollution measures. If you check the Twitter feed, you'll see that levels of PM2.5s are classified according to the Air Quality Index as 'unhealthy' or 'very unhealthy' on many consecutive days. 

The term PM2.5 refers to particles with a diameter of 2.5 microns or less. Pollution levels in Beijing generally come out as 100 micrograms per cubic metre or more. The World Health Organization recommends upper limits of 10 (annual mean) and 25 (24 hour mean) for PM2.5 exposure. That's because being so small, they can penetrate deep into the lungs and even into the bloodstream from where they reach every part of your body. Health effects of PM2.5 exposure include increased respiratory problems, such as airway irritation, asthma attacks, chronic bronchitis and decreased lung function. Then there is irregular heartbeat, premature death among those with heart or lung disease and non-fatal heart attacks. Plus, of course, there's that worrying rise in lung cancer rates in Beijing.

Beijing's location doesn't help. Being on a flat plain with mountains on three sides traps pollution from an unhealthy mix of heavy traffic and industrial activity. China's continued reliance on coal, combustion of which is a prime source of particulate pollution, doesn't help either. So it is good to know that the city's consumption of coal is to be reduced by more than half current levels by 2020. 

Of course, these measures will take time to reduce Beijing's air pollution. It will probably be many years before the benefits are felt. In the meantime, citizens need to do something to protect themselves from urban air pollution.  Home air purifiers are becoming increasingly popular in this part of the world. They are often the only way to protect your health. Those fitted with a high efficiency particulate air (HEPA) filter such as IQAir’s air purifiers will trap PM2.5 and smaller pollution entering homes and offices from the outside environment. Key here is that the units are leakage free. The Swiss made IQAir air purifiers offer a level of sophistication and filtration performance that far outperforms the offen more 'gimmicky' air purifiers in the local asian market. 

http://airnow.gov/index.cfm?action=aqibasics.aqi

Supplementing with a group of PUFAs called n-3 PUFAs made the newborn gut more permeable. This would enable bacteria and other substances to pass through the gut lining to the bloodstream more easily.  Which, in turn, may help the immune system develop and mature faster which could protect the child from developing an allergy. Previous research has suggested that an intake of n-3 PUFAs in pregnancy also helps with maturation of the central nervous system of the child. There have also been studies that suggest fish and walnut oil supplements during pregnancy do help protect the child from allergies. This new study sheds light on the possible mechanism of this protective effect. 

Unfortunately, intake of n-3 PUFAs in the Western diet has been going down in recent years, according to one of the researchers in this study. The n-3 PUFAs are found in fish and in nut and flaxseed oils, but there's been a trend towards using corn oil which contains different fatty acids. So, although there's no official recommendation as yet, if you are pregnant or planning to be, you might want to consider adding flaxseed oil, eating more fish, or taking a fish oil supplement.

Meanwhile, if your child does have an allergy, there's an article on KidsAllergies that's worth a look. The take home message is that while there are allergens in some vaccines, generally the benefit of having the vaccine outweighs the risk. But do alert your doctor if your child is allergic to eggs (some vaccines are still manufactured in eggs) or some other vaccine component. Generally, the vaccine can still be given, but medical supervision might be needed.  If your child has asthma, a flu vaccine will be important as colds and flu are triggers for around 90% of people, including kids, who have asthma. It's recommended that all children with asthma aged over 6 months who require use of a preventer (continuous or repeated) or who are on oral steroids, should get the seasonal flu vaccine. The recommendation also applies to any child over 6 months who has been admitted to hospital with a lower respiratory tract infection.  

Leading allergy specialists also agree that allergen avoidance should be practiced year in and year out, limiting your childs overall exposure to allergy and asthma triggers. Click here to learn more about allergy avoidance.

Source: F. De Quelen et al N-3 polyunsaturated fatty acids in the maternal diet modify the post-natal development of nervous regulation of intestinal permeability in piglets, Journal of Physiology 2011 

Chemicals used in the clinical research environment may be:

• Toxic
• Corrosive
• Reactive
• Flammable
• Radioactive.

There could be hundreds of different chemicals used in the hospital research lab – some, like methanol, in large volumes, others, such as radioactive tracers, in tiny amounts.  Hazard to health can arise (and be prevented) at any stage. For instance:

• Ordering – avoid bulk purchase, look for safer substitutes
• Storage – safe, secure, labelled
• Handling – with protective equipment, ventilation
• Disposal – protect the water supply, follow procedure.

Solvents are an important group of chemicals used in the clinical research environment. They are needed in almost all procedures to dilute and dissolve. Probably the four most common are:

• Methanol
• Ethanol
• Toluene
• Xylene.

All four are classed as volatile organic compounds (VOCs), being liquids with a relatively low boiling point and a tendency to readily evaporate into the air. Thus exposure to a VOC by inhalation is a potential health hazard. These four solvents are also highly flammable and pose a fire hazard if not stored properly. 

Let's focus on xylene, a colourless hydrocarbon (chemically related to toluene and benzene) which is widely used in processing tissue for making microscope slides. The health hazards of xylene have been known for many years and are described in a recent review Xylene: An overview of its health hazards and preventive measures.  Short-term exposure causes effects on the central nervous system (headache, dizziness), lungs (chest tightness, shortness of breath) and irritation of the eyes and throat.  Longer-term exposure to xylene may result in a condition known as 'organic solvent syndrome whose symptoms include:

• Headache
• Irritability
• Depression
• Fatigue
• Impaired concentration
• Memory loss.

A recent report links xylene and toluene exposure in hospital laboratory workers to an increased incidence of Raynaud's syndrome, a painfual condition involving narrowing of the blood vessels in the hands.

Xylene is one of the 500 substances which have a Workplace Exposure Limit set through the UK Government's Control of Substances Hazardous to Health regulations. The limits set are 50 parts per million (ppm) for 8 hour exposure and 100 ppm  for 20 minute exposure. The United States National Institute for Occupational Safety and Health sets limits of 100 ppm and 200 ppm respectively for xylene exposure. 

 There are three ways of reducing the impact of xylene in the hospital research laboratory:

• Substitution. Various alternatives to xylene has been tried – none of them ideal. They include limonene (an extract of citrus fruit peel) and mineral oil. Research in 'green chemistry' continues to look for safer and more environmentally friendly alternatives to conventional chemicals in common use – so they may well come up with an improved substitute for xylene in due course.
• Air purification.  Removing the contamination from the lab by use of air cleaning systems designed for research laboratories.
• Protection.  Use of personal protective clothing like gloves is an essential when working with xylene. 

The study asked 3,600 health care professionals (doctors, nurses, respiratory therapists, and occupational therapists) based in Texas about their experience of work-related asthma symptoms, work-exacerbated asthma, and occupational asthma.  The latter is new-onset asthma, brought on by workplace exposure, while work-exacerbated asthma is existing asthma made worse by the workplace. They also asked about exposure to a number of cleaning products, including:

• Bleach
• Ammonia
• Detergents
• Disinfectants
• Room cleaners
• Toilet cleaners.

These products are used in general hospital cleaning. Participants were also asked about exposure to products used in cleaning and sterilisation of instruments (very important in avoiding hospital infections among patients). These included:

• Formalin/formaldehyde
• Glutaraldehyde/ortho-phthaldehyde
• Chloramines
• Ethylene oxide.

Many of these cleaning products are volatile and chronic exposure of healthcare professionals to a whole cocktail of them is likely. This new study is first to investigate the impact of exposure to cleaning-related products in the hospital environment. 

Prevalence of work-related asthma symptoms, work-exacerbated asthma, and occupational asthma were 3.3%, 1.1%, and 0.8% respectively. Exposure to both general cleaning, and sterilising, products raised the risk of work-related asthma symptoms. Broken down according to individual cleaning products, this increased risk was lowest for formalin/formaldehyde and highest for toilet cleaners. 

The risk of work-exacerbated asthma was significantly increased with exposure to bleach and formalin/formaldehyde and for occupational asthma, the risk was significantly increased (five fold) by exposure to chloramines. 

Cleaning products are very widely used in the hospital environment and this will continue (maybe even more so, as pressure on hospitals to reduce infection intensifies). Glutaraldehyde, for instance, is used to disinfect and sterilise heat-sensitive instruments such as surgical and dialysis equipment, endoscopes and bronchoscopes. Exposure to glutaraldehyde has been linked to asthma and other lung symptoms in other studies and it is known that poor ventilation may lead to higher level exposures. In the United States, the Occupational Safety and Health Administration (OSHA) has suggested action should be taken should levels exceed 0.05 parts per million. In the UK, the Control of Substances Hazardous to Health (COSSH) regulations quote the same limit and also say glutaraldehyde should be substituted by a safer chemical wherever possible. 

We have warned previously about the dangers of formaldehyde. In hospitals, formalin, a formaldehyde solution, is used to fix, stain and preserve tissue. Healthcare professionals can be exposed to formaldehyde vapour when they are preparing formalin solutions or doing other lab work. The OSHA limits are 0.75 ppm (8 hour average exposure) and 2 ppm (short-term exposure). COSHH limits are 2 ppm, at present. Bleach, ammonia, and chloramines were also linked to an increased risk of asthma in this study and other research has found these cleaning products to be a health hazard in other workplace environments. 

In England, around one million people work for the NHS. That's not to say they are all exposed to cleaning products but there are sure to be some cases of workplace asthma linked to cleaning products.  Around one quarter of all cases of adult asthma in the USA and Europe are thought to be work-related. Of course, there are guidelines governing the safe use of these effective cleaning products but this study suggests that more should be done to make sure they are followed. The cleaning products described here are also used in many other workplace settings, and in homes. More research is needed to see how they affect our health – and whether safer alternatives could be developed.  

Click here to see our range of Hospital Air Purifiers.

Holmes describes an intriguing complex called 'the personal cloud' which came to light in house dust experiments carried out in the 1990s. A group of 178 participants based in California were wired up to personal dust monitors, which they wore for 12 hours at a time as they carried out their usual activities. The scientists, from the US Environmental Protection Agency, also monitored indoor and outdoor air for dust.  The results showed that the personal dust monitors registered much higher levels of dust than the external measurements – in other words, the individuals were actually emitting dust themselves. That's where the idea of the personal cloud comes from.  Lance Wallace, one of the EPA team, noted that the personal cloud accounts for a large amount of the dust in your home.

So what does this invisible cloud actually consist of? Skin flakes were the major known component. In 12 hours, the dust monitor collected 150,000 to 200,000 skin flakes per individual. In fact that's just a small percentage of the skin we shed from the epidermis every day. The total amount shed is about 50 million scales which, as we know, is the prime diet of house dust mite, whose dropping contain the potent allergen dreaded by asthmatics everywhere. Most of this skin flake burden gets rinsed off when you bathe or shower. And, according to Wallace, you breathe in 700,000 skin flakes per day while the rest sinks into the carpet, your bed, or your furniture. These skin flakes amount to around 10% of your personal dust cloud. 

Another component is lint – the tiny fibres emitted from your clothes. But, again, this amounts for only a minor proportion of the personal cloud. The rest of its components are still unknown. However, Wallace's team carried out further experiments which did shed some light. He wired up his own house with dust and gas monitors and found how they spiked each weekday morning with a cloud of car exhaust – even though the road was over a mile away. So the monitor network was very sensitive to any dust-generating activity. 

One day Wallace accidentally waved his arm towards a monitor and noted how it recorded a sudden dust flurry. A colleague was unable to reproduce this effect and it turned out that this man had his shirts laundered and wrapped in plastic till he put them on. Wallace's shirt were home-laundered and hung in the wardrobe, collecting dust particles ready to be emitted when he moved his body (that is what the dust monitor picked up when he waved his arm). Even working quietly at a computer will multiply dust levels in a room.  It'll be interesting to learn what the other components of the personal dust cloud are, and whether they are allergens. In the meantime, get a grip on the house dust by dusting, vacuuming with a leakage free HEPA vacuum cleaner and using a high grade air purifier. 

http://www.time.com/time/health/article/0,8599,1966870,00.html

Asthma UK has been shortlisted for the Poundland Charity of the Year 2012.  We are of course thrilled and hope that Asthma UK will win, to not only raise vital funds, but also raise awareness of both asthma and Asthma UK! 

It’s now down to you if you would like to help.  If you can, please spare 20 seconds, click on the link below and vote for Asthma UK to win the Poundland Charity of the Year award. Every vote counts so feel free to forward this post to colleagues, customers, friends and anyone else you think will also vote!  

http://www.poundland.co.uk/charity/

Thank you for supporting Asthma UK! 

1. Ventilation. This is a very important thing you can do to improve the quality of air in your home if airborne contamination originated from within your home, and the outside air in the area where you live is relatively clean. So, when did you last open a window? Get into the habit of opening several windows for at least a few minutes every day. This will remove pollutants that originate in your home which, in a well-insulated and heated home, tend to build up and increase your exposure.  To limit mould growth, consider installing extractor fans in the bathroom and kitchen to remove steam build up after bathing and cooking. Use an air purifier to eliminate pollen and other outdoor pollutants enter your home.

2. Shampoo your pets.  Are you trying to balance living with an allergy with keeping a pet? Pet dander, especially from cats and dogs, is a potent allergen. Around 40% of people with asthma are sensitive to cats. But if you wash your pet with an allergy friendly dog or cat shampoo such as PET+ Pet Shampoo, this will destroy allergen in their fur on contact. Your animal probably loves his or her routine, but it's also crucial to limit their access to rooms in the house. If they are in the habit of lying on your bed, train them out of it.  If your pets are of the soft toy variety, remember that they harbour house dust mite – get rid of these by washing the toy with Allergen Wash Laundry Detergent on a regular basis. You can also use this detergent to wash your bedding with it.

3. Switch to electric.  An electric cooker is better for your health than a gas cooker. So bear this mind if you are refurbishing your kitchen. There have been many studies showing this. For instance, kids growing up with gas in the kitchen have twice the risk of developing asthma as those who grow up with second hand smoke, and women looking with gas are twice as likely to develop respiratory problems as those cooking with electric.

4. Check labels on DIY products. Formaldehyde is a volatile organic compound which, even at low concentrations in the air, can give rise to eye, nose, and throat irritation, particularly among those with asthma. It has also been classed as a carcinogen by the International Agency for Research on Cancer. Board-based wood products used in flooring, shelving, and flat pack furniture may have high concentrations of formaldehyde which can outgas into the air for many months.  Medium density fibreboard (MDF) is the main culprit – if you are using this, look for the 'CE' mark that should certify that it has minimal levels of formaldehyde content. 

5. Tear up your carpet. Did you know that a carpet can harbour between 8 and 170 grams of 'deep dust' per square metre? Vacuuming tends to bring this up to the surface, but does not necessarily remove it. Where you have dust, you have house dust mite and its allergen. Consider replacing the carpet with hard flooring which is easier to keep dust-free.

6. Use an air purifier. A portable system, fitted with a HEPA-like filter, will reduce airborne allergens such as house dust mite, pet dander, mould and pollen. Using an air purifier with Hyper HEPA filtration will furthermore capture ultra fine pollution and take out virtually all particulates out of the air.  Place the air purifier in the bedroom and living room to clean the air where people spend most of their time.

7. Plan ahead for the pollen season.Bookmark a site that gives pollen counts. On days when the count is high, try not to introduce pollen into the home. Change from your outdoor clothes,  and wash your hair free of pollen, when you come in.  Keep windows closed too and use your air purifier 24/7.

8. Get rid of damp, mould. House dust mite and mould are two allergens that love damp conditions. Tackle any mould spots in the bathroom, check your shower curtain, and get rid of any old clothes or books which may harbour mould spores.

9. Don't smoke.  Public places are now free of second hand smoke in the United Kingdom. But people can still smoke in their own homes and cars. Maybe you smoke and your resolution for 2012 is to quit. Good luck! Second hand smoke triggers asthma and exposure has also been linked to a 25-30% increased risk of heart disease and a 20-30% increased risk of lung cancer.

10. Declutter.  We finish our 2012 recommendations with another really simple tip – get rid of clutter. All those papers, ornaments, books and gadgets that you don't use don't just get in the way – they collect dust and provide a home for allergens. At the bar minimum, keep surfaces clear so you can easily wipe them clean.  

Just a little investment in improving indoor air quality during 2012 could see you freer of allergy symptoms by 2013 and will improvements in long-term health through breathing in fewer pollutants. 

There have long been complaints from airline staff about ill health caused by poor cabin air quality. But, according to the Department of Transport

In modern aircraft, your cabin air comes from the environmental control system which controls the pressure and temperature in the cabin, and maintains air quality by filtering out any particles and adsorbing gases and odours in the air. The air itself is 50% air from outside, drawn in through the engine, and 50% filtered, recirculated air. There is a cabin air particulate filter in the recirculation loop which may (or may not) be a true HEPA filter. If it is the latter, rest assured that there should be a very high standard of particulate removal and control of microorganisms in the recirculated portion of the cabin air (assuming the filter is well maintained). The most likely source of cabin air pollution is therefore the outside air, which is not usually filtered. There could be volatile organic compounds (VOC), some of which cause odours, and particles in this component of cabin air. 

You might feel happier if all the air in the cabin was filtered. But first, we need to know which pollutants need to be filtered out, so the right air purifier can be selected. And it turns out there's long been a gap in our knowledge about the extent of cabin air pollution. There are occasional odour incidents (known as 'fume events') when pilots and passengers become aware of a bad smell. However, such events may not be harmful and they are estimated to occur in only one in 2000 flights (0.05%). In 2010, 207 such incidents were reported out of 1.18 million passenger and cargo flight (a much lower rate than the estimate – 0.018%). 

To see whether further action is needed on cabin air quality, the government commissioned a study on cabin air quality from Cranfield University which released its report earlier this year. The study monitored 100 flights in five different aircraft types (Boeing 757, Airbus 319, 320 and 321 and the BAe 146 ). A series of air samples were taken at defined points on all flights, and all flight crew, cabin crew and researchers were also requested to complete a post-flight questionnaire including questions about any fumes or smells that occurred during the flight. The study's objective was to analyse cabin air for volatile organic compounds, semi-volatile organic compounds, particles and carbon monoxide in normal operations during all phases of flight (climb, cruise, descent), and to detect and characterise any increases of these components during any 'fume events'.

The study concluded that there was no evidence for target pollutants occurring in the cabin air at levels exceeding available health and safety standards and guidelines. Moreover, levels observed were comparable to those typically experienced in domestic settings. The European standard 'Aircraft internal air quality standards, criteria and determination methods' sets safety, health and comfort limits for a number of substances, including two that were measured in the study – carbon monoxide and toluene. The study's results indicate that concentrations of both of these pollutants remained within these limits. In the absence of specific cabin air standards for the other pollutants measured in the study, the study referred to other standards and guidelines established, for example, for domestic (home) or occupational environments. Again, none of these standards or guidelines was exceeded.

So that's all right then? In fact, the Cranfield Report has been heavily criticised by campaigning group Aerotoxic and the Royal Society for the Prevention of Accidents. They note that the study did not measure the most toxic components of tricresylphosphate (TCP), an anti-wear additive of engine oil, nor the oil antioxidant or an engine oil antioxidant called N-phenyl-α-naphthylamine – both of which are potentially carcinogenic. Nor was the air sampled for the full duration of the flight and the number of flights investigated was relatively small and unlikely to detect the rare 'fume events'. Clearly, we need more thorough research to get the full picture on cabin air quality and what needs to be done to improve it.  

http://www.dft.gov.uk/publications/cabin-air-quality-faqs

I am writing to compliment you and Allergy Cosmos on your excellent service and products.  

We live in the City of London and were hoping to improve the quality of our air, given the high background pollution levels and our beloved four Burmese cats.  We also have Cystic Fibrosis and Asthma in the family and believed an air purifier would assist us.   

We had an expert indoor air assessment done of our flat, and we were truly shocked by how high the particle count was outside our apartment.  Inside we found the expected high level of larger particles (in our case cat dander and building dust), but outside was a high level of more dangerous small particles (traffic pollution). 

We found your website on the Internet and having researched the options, called you to ask about the IQAir HealthPro 250.  You were extremely helpful and assisted us in making a VAT exempt purchase, as the product was to be used within our home for personal use only and for a diagnosed chronic medical condition.  

So we were happy that you offered us free next day delivery.  The IQAir air filter arrived next day. It is on casters and can be moved around the apartment with ease.  It is designed to run 24/7 and the HyperHEPA filter will last longer if the pre-filter is changed on schedule.  Even after just four days of constant running on a low setting, the IQAir HealthPro was making a difference to our breathing.  You can just about 'taste' the difference in the air.  This might sound fanciful, but the air tastes softer and cleaner, especially in our bedroom, although the effect can be felt in the rest of the apartment also.  

As for our health conditions, we have all noticed the difference.  I used to wake up with a stuffy nose, often struggling to breathe.  I also have regular asthma attacks. One week after installing the air filter, I am no longer using my emergency inhaler on a daily basis, as I simply do not need it.  None of us are coughing or wheezing as much.  Had we known quite how dramatic a difference the IQAir air filter would make, we would have done this sooner.  As it is, we are already considering purchasing more units and are recommending you and your products to friends and family.

I am aware that you may use this as part of your customer testimonials.  Accordingly, to anyone reading who is wondering, as we did, if you would even notice the difference an air filter would make, please trust me, the difference with the IQAir HealthPro 250 is huge.  If you have allergies or asthma or wake up every morning having to blow your nose, all of this becomes a thing of the past.  You can breathe easily again and it feels wonderful. 

Yours sincerely,

Linda Van Deussen"

“We love the fact that the ADMS Dust Spray can be used on carpets, furnishings, car interiors et al to neutralise allergens such as pollen, mildew, house dust and dust mite allergens.”  Janey Lee Grace – Imperfectlynatural.com

The Anti Allergen Dust Spray is part of a range of Anti-Allergen products exclusive to Allergy Cosmos.  Allersearch Anti-Allergen Dust Spray is the ideal solution for anyone suffering from allergies, asthma and general respiratory problems. ADMS is a natural and non-staining formula that safely neutralises household allergens such as pollen, mildew, mould, pet dander and dust mite remains. Ideal for all water safe surfaces, this dust spray is a great all around cleaning product that will limit your day to day exposure to harmful allergens.

Try the ADMS Dust Spray today and receive 10% off! Simply enter the following discount code during the checkout process: sp4xty7

If you have asthma or another allergy, there is a wide range of different products that can help with allergy avoidance. Whether it’s a room air purifier, or just an alternative choice when stocking up for a spot of DIY, there’s likely to be something in the shops, or online, that’ll help in your allergy avoidance campaign.

Paint. If you are sensitive to volatile organic compounds (VOCs), then you need to shop for paint with care. Water-based paint, used for walls, and oil-based paint, used more for woodwork, can both contain high concentrations of VOCs which will continue to outgas once the paint has dried. DIY chain B & Q pioneered a ‘Globe’ symbol which all paints sold in its shops must carry. The Globe range goes from ‘minimal’ (0-0.29% VOC) to ‘very high’ (50-100% VOC). There are also paint ranges specially formulated to have no VOC content, such as protein or resin-based paints.

Pet shampoo. Sad to say, but a cat or dog can be a living, breathing source of allergens for some people with asthma. If you want to keep the pet, then a regular wash with allergy/asthma friendly pet shampoo could be a useful part of your strategy to keep down the pet dander load. Animal dander is the name given to those microscopic flecks of skin, sweat and saliva containing allergen proteins which float around in the air. Keeping your pet’s coat clean with regular shampooing will at least help reduce pet dander in the air, if only temporarily.

Detergent. House dust mite droppings contain a potent allergen which can linger indefinitely after the mites themselves have been killed. A wash in warm or cold water for sheets, pillowcases and duvet covers (remembering the bed is the main exposure area) with AllerWash laundry detergent kills mites and removes allergen. AllerWash is fantastic because it destroys allergen on contact and is effective with any water temperature - cold, warm or hot.

Environmentally friendly glue and other DIY products. Many adhesives, preservatives and cleaning products contain VOCs. Formaldehyde which is a potent irritant also linked to cancer, is emitted from board-based wood products, foam-backed carpets and wood preservatives. Water-based DIY products are a safer choice. Solid wood and hard flooring (or hessian or felt-backed carpet) can be used instead of chipboard and foam-backed carpet. Otherwise, if there are products in our house that offgas VOC's, think about purchasing a VOC air purifier.

Air purifiers. An air purifier plays an important role in allergy management, helping rid the air in your home of pet dander, mold spores, house dust mite allergens and indoor pollen grains. A HEPA filter can remove a wide range of particle sizes (for instance, the IQAir HyperHEPA will take out particles down to a size of 0.003 microns, which is 10 times smaller than a virus). To remove VOCs, which are in the molecular size range, the air purifier would need to be fitted with an activated charcoal, or similar, filter.

Carpet cleaners. Steam cleaning of your carpets - there are several methods - can be a very good way of cutting down on HDM and its allergy (see our blog post on steam cleaning your carpet). It is like putting your carpet in the washing machine! You could either do it yourself, or get a professional in. One method, involving very hot ‘dry’ steam penetrating deep into the pile, is proven to kill HDM and break down the allergen. Afterwards, you just vacuum away the dead mites and their allergen.

Dust sprays. Getting rid of dust is key to allergen avoidance. Damp dusting is more effective, of course, than dry dusting. There are various products that contain substances than can attract allergens, or neutralise them, so you should use them on a regular basis if you have asthma. The ADS dust spray and the ADMS dust spray are especially desigened for people suffering with allergy or asthma. 

The IQAir HealthPro air purifier was recently named Best Air Purifier Overall by ConsumerSearch.Com, an organisation which analyses expert and user-generated consumer product reviews in order to recommend the best product. This fact alone need not lead you to choose this product if you are looking for an air purifier to help you deal with allergies or chemical sensitivities. But it should remind us of the importance of doing research, and getting questions answered, when investing in products, like air purifiers, which are meant to improve air quality and reduce exposure to allergens and other pollutants. 

Two key questions to think about, when choosing an air purifier, should be:

• What is the technology inside the air purifier ‘black box’ and how does it work?
• What allergens do I want to get rid of?

The IQAir HealthPro 250 (or HealthPro Plus as it is called in North America) has a HEPA (high efficiency particulate filter) capable of removing more than 99.5% of particles down to 0.003 microns in diameter. To put this into context, here (in microns and in descending order) are the particle sizes of some common allergens:

• Fungal spores - 1.2 to 120
• Pollen, pollen fragments - 0.25 to 100
• House dust mite allergen - 0.1 to 30
• Pet allergen - 0.1 to 10
• Tobacco smoke - 0.01 to 1

Another way of defining particulate pollution is purely by size, rather than by content (as above). So PM10s have a size between 10 and 2.5, PM2.5s are 2.5 and below, while the size of ultrafine particles is in the range 0.1 to 0.001 microns. Bear in mind that the heavier particles will tend to settle as dust and can be becpme airborne again when disturbed.  Meanwhile, the lighter the particle, the longer it will hover in the air, and when inhaled the more deeply it can penetrate into the lungs. The smallest particles will even reach the bloodstream, causing potential long term damage to the body (heart disease, for instance, possibly through setting up chronic inflammation). Beyond the ultrafine range, air pollutants take the form of nanoparticles or gaseous molecules and an air purifier will need to be fitted with a special adsorbent gas filter material to trap them. The HealthPro Plus includes a granular activated carbon adsorbent cell for this purpose.  Key here is the use of high quality granular carbon, and using enough of it.

Other questions you might ask about an air purifier are:

• How often does the filter need changing?
• What volume of air can the air purifier handle and at what rate? Is the size and performance of the purifier too little for the room it is going to work in? The amount of clean air delivered to your room should be in a healty relation to the kind and amount of pollution you are being exposed to.
• Is the unit leakage free? It is little use if the unit handles large amounts of air if only half of it actually passes through the filter.
• How much noise does the fan in the air purifier make and what kind of sound is it?
• If you are considering reviews and awards won, make sure the testing has been done by truly independent and qualified organisations and not just marketing campaigns in disguise.   

Due to its outstanding filtration, the HealthPro 250 has received more true #1 awards then any other air purifier. Here are just a few:

Editor's Choice Award - Reviewboard Magazine, 2004/2005

Best Buy - Consumers Digest, 2004/2007/2009/2011

Best Air Purifier - ConsumerSearch.com, 2005/2006/2010

Seal of Approval - Parent Tested Parent Approved, May 2009

Best Air Purifier - ApartmentTherapy.com, April 2008

Best Buy - Consumer Guide, 2006

Best Air Purifier - Wired Magazine Test, September 2006

http://www.consumersearch.com/air-purifiers

Paint accounts for less than 1% of all UK VOC emissions. In fact, VOCs are found in a wide range of DIY and cleaning products. They are small carbon-containing molecules which readily evaporate from products containing them (a process known as 'outgassing'), so they form part of the gaseous component of indoor air pollution. Outdoors, VOCs are produced by car exhausts and can react with nitrogen oxides (also from car exhausts) to produce ground-level ozone, a powerful pollutant and the main component of photochemical smog. VOCs have also been implicated in global warming.

Most VOCs are synthetic, but a few are naturally occurring, like the strong-smelling odours given off by a peeled onion or an orange. VOCs are irritants, rather than true allergens, and may provoke symptoms like sneezing, wheezing, watery eyes, and tight chest among people with allergies. Formaldehyde, a common VOC, is a known carcinogen. Exposure to VOCs is also a particular problem for people with multiple chemical sensitivities. 

Here are the most common possible sources of VOCs:

• Paints
• Varnishes
• Adhesives
• Cleaning products
• Board-based furniture, flooring boards
• New carpets
• Toiletries
• Air fresheners
• Dry-cleaned garments
• Non-iron/easy-care/crease-resistant fabrics

It is good to know that VOC levels in products will be coming down thanks to this new legislation. There are also measures you can take to reduce the VOC burden in your home. Ventilation is an important step in stopping levels from building up indoors, but during the winter time it becomes difficult to ventilate as much as you might like to.  If you are very sensitive to VOCs, you should consider investing in an air purifier fitted with absorbent filters designed to remove gaseous and odour pollution from the air. The leading Swiss manufactuerer of domestic and commercial air purifiers offers a unit that is especially designed to filter VOCs out of the air- it is the IQAir GC VOC.

In fact, VOC 2010 doesn't apply to the consumer. If you have stocks of non-compliant paint, stain or varnish, you can use them up during 2011 and beyond. But, having read the above, would you really want to?

http://www.icipaints.co.uk/products/2010/legislation.jsp
http://www.allergycosmos.co.uk/blog/formaldehyde-exposure-seven-key-qestions/

The EAC's inquiry was undertaken to assess how far government had implemented processes outlined in its November 2010 response to an earlier report. They slam government for failure to act on what is seen as a major public health crisis and single out London Mayor Boris Johnson for his failure to achieve acceptable air quality in London (which we must now call 'The Olympic City'). 

Simon Birkett, Founder and Director of Clean Air in London (CAL) welcomed the report and said. 'No Parliamentary Select Committee can ever have published a more damning report of a Government's failure to protect its people from harm. Furthermore, CAL has found hard evidence the Government has not considered the glaring socio-economic impacts of this invisible public health crisis.' 

CAL notes the following air pollution crisis points:

• Preliminary results for England show that poor air quality is associated with areas of low income, low employment, and lower educational attainment, with differences in exposure to air pollution between different ethnic groups. Indeed, the worst affected groups are exposed to up to 50% more nitrogen dioxide pollution than those least affected. 
• The European Commission granted the UK a temporary and conditional exemption till June 11 2011 to comply with daily PM₁₀ limits in London. The UK had to amend its London air quality plan and submit it by 30^th November. The report was submitted in June but the UK failed to consult, was challenged on this, and had to launch a consultation which closes on 6 January 2012. Clean Air in London concludes that the UK unlawfully submitted the plan to the EC. Watch this space!
• Unlawful levels of nitrogen dioxide have been found in up to 75 marginal Parliamentary constituencies and 24 London boroughs in 2010.
• Recent research has shown that living near roads travelled by 10,000 or more vehicles per day on average could account for 15-30% of all new cases of asthma among children and of chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD) among adults aged 65 or older. In all the 10 cities studied in this research, 15-30% of exacerbations of asthma in kids, and acute worsening of COPD and acute CHD problems are down to air pollution.

Birkett continued 'Clean Air in London supports wholeheartedly the EAC's recommendations which include setting up a Cabinet Office lead Ministerial Group to oversee delivery of a new cross government air quality strategy. Only the Prime Minister and the Deputy Prime Minister have the authority to respond to and accept the EAC's report and recommendations. They must do so urgently.' 

For more from Clean Air in London on these issues, visit: http://www.cleanairinlondon.org/blog/_archives/2011/11/14/4938683.html

Smoking and cancer go together in public perception. But never-smokers and ex-smokers get lung cancer too, and the cause is often exposure to carcinogens like certain industrial chemicals, asbestos and radon gas. There is also mounting evidence that air pollution plays a role in lung cancer. In a recent study researchers in the United States and Canada found a link between exposure to PM2.5 pollution and lung cancer. PM2.5 stands for particulate matter consisting of particles of diameter 2.5 microns or less. These tiny particles are readily inhaled and are known to contribute to heart and lung disease.

Drawing on the population of the long-running Cancer Prevention Study, the team followed more than 180,000 non-smokers for 26 years, during which time 1,100 participants died of lung cancer. The study population was drawn from 50 different states, plus Puerto Rico, and their post codes were used to estimate how much PM2.5 air pollution each person had been exposed to, measured as micrograms of particles per cubic meter of air. These levels varied with location from a low of six to a high of 38, and fell over time to an overall average of 17. The study found that each extra 10 units of PM2.5 exposure was associated with an increase in lung cancer risk of between 15 and 27%. Although this risk is small, compared to the risk posed by smoking, it is not insignificant, particularly since people cannot usually help being exposed to air pollution (whereas they can quit smoking). Also, there's been other research tying air pollution to lung cancer. A study from China showed an increased risk of lung cancer with exposure to indoor air pollution caused by burning coal and wood for heating. There have also been studies in Europe that show a link between exposure to soot and vehicle exhaust and lung cancer.

Between 10 to 15% of lung cancer cases occur in never-smokers, most of them women. So do not assume that if you do not smoke, you cannot get lung cancer. Unfortunately, awareness of symptoms seems to be low - the Roy Castle Lung Cancer Foundation carried out a survey that only one in ten of those asked knew that a persistent (more than three weeks) cough could mean lung cancer. Here are the other symptoms that the Lung Cancer Awareness Month people would like you to be aware of:

• Worsening or change of a long-standing cough
• Repeated chest infections
• Coughing up blood
• Unexplained persistent breathlessness
• Unexplained persistent tiredness
• Unexplained persistent weight loss
• Persistent chest and/or shoulder pain.

Of course, there are many 'innocent' explanations for these symptoms, but they should be checked ought, because lung cancer is curable if caught early enough.

Ref.:

• www.lunguk.org
• www.roycastle.org
• http://ajrccm.atsjournals.org/cgi/content/abstract/201106-1011OCv1
• http://www.cancer.org/Research/ResearchProgramsFunding/cancer-prevention-study-overviews

Hypoallergenic dogs may not live up to their harmless reputation, according to a new study which shows they shed just as much allergen as non-hypoallergenic breeds. The two main dog allergens are known, for short, as Can f1 and Can f2, and they readily become airborne through skin flakes containing dog saliva, known as dander. If you are an animal lover, but are unfortunate enough to suffer from allergies like asthma when exposed to dog dander, you might wonder whether some dogs are more likely to provoke allergies than others. This could well be an issue if you, or a family member, want to replace a beloved pet that has passed on, or whether you want to get a canine companion for the first time.

There are a number of dog breeds that are said to be hypoallergenic - generally, as you might expect, those which are hairless or have short coats and therefore do not shed as much. The new report from researchers at Henry Ford Health System, Detroit suggests that hypoallergenic dogs do not, in fact, shed any less allergen than any other breed. They list 60 dog breeds, including 23 terriers and some with exotic names, like the Bouvier des Flandres and the Peruvian Inca Orchid, as being hypoallergenic. There were 190 one-dog families in the study and 17 of these did not let their dog indoors at all (and the researchers did not analyse dog allergen in these homes). All the families had a very young baby, because the participants were recruited at an antenatal clinic and the home visited one month after the birth. The researchers hovered up dust from the baby's bedroom and analysed it for the presence of Can f1. They found that 163 of the homes had detectable levels (and that's with a one month old baby in the house!). What is more (although this wasn't the focus of this study) around half of the owners allowed the dog in the baby's bedroom. Needless to say, dog allergen levels were higher in these cases. But allergen levels did not depend upon the breed of dog. The researchers believe further research is needed to confirm whether the hypoallergenic label is of any use at all to people with allergy to dog dander. So it could be that you might as well be guided by your heart, not the breed, when choosing a dog

I noticed a couple of things about this paper that are worthwhile to mention. First, the low number of households in this sample - just 17 - who kept their dog outside. Second, the fact that around half of the owners let the dog into their baby's bedroom. This doesn't seem very sensible to me, for the presence of the dog allergen might sensitize the baby, leading him or her to develop childhood asthma or rhinitis. And if anyone else in the family had an allergy, all that dog dander floating around is likely to provoke an attack. If you do want to keep a dog indoors, a kennel by the door in the kitchen is a good idea. And here are a few more tips for keeping allergy at bay if there's a dog around.

• Wash the dog with Pet+ pet shampoo from Allersearch. It will breakdown the allergy symptom causing allergens on contact
• Wash your hands after touching the dog
• Vacuum regularly with a vacuum that has a HEPA filter and is leakage free
• Use allergy friendly cleaning products, such as Allersearch's ADMS dust spray
• Get rid of clutter which accumulates dander-containing dust

Consider purchasing a HEPA air purifier like the IQAir HealthPro 250 which filters animal dander particles as well as odours out of the air, and will lower the allergen load in bedrooms or other rooms used by someone with asthma or another allergy

http://www.dogbreedinfo.com/allergy.htm

http://www.ingentaconnect.com/content/ocean/ajra/2011/00000025/00000004/art00021

A study of the public cycle sharing scheme in Barcelona (called Bicing) reveals that the overall effects on health are positive, and there are significant reductions in carbon emissions. The results could be applicable to London, where a bike sharing scheme has been up and running since 2010 and has so far attracted over six million hires.

Bike sharing schemes in cities are meant to benefit our health by reducing traffic congestion. In fact, London was a little late to this particular party. Barcelona launched its scheme in 2007, the same year as Paris, Seville and a year later than Lyon and Stockholm. The idea has spread to China with Hangzhou starting a cycle sharing in 2008 and Guangzhou last year. In the United States, Los Angeles and New York are likely to join in soon.

The proliferation of cycle schemes will provide a lot of data on how increasing the popularity of cycling may impact on urban air quality and also on citizens' health. Contemplating cycling in the city, you may wonder whether you are more at risk of lung or heart disease from exposure to particulate matter, from diesel exhaust and other pollution sources, or whether the impact on your fitness and heart health will outweigh these risks. This new study, undertaken by researchers in Barcelona, with colleagues in Madrid, Poland, and Finland, provide some answers.

Direct outcomes on health from increased urban cycling are hard to measure. Instead, the researchers used a new computer model that can integrate data from scientific studies and local measurements. Around 11% of the population of Barcelona (just over 182,000 people) uses the bike share scheme, with most journeys done for commuting to work or school. Here are the main findings:

• Air pollution. Exposure to particulate matter (PM2.5s and finer particles) which has strong associations with all cause mortality, was assessed. Each year, there were an extra 0.13 cyclist deaths from exposure to air pollution. It would take many years before the number of deaths from exposure to air pollution was significant. Remember that London's poor air quality is said to cause 4,300 deaths per year, to put the risk from cycling into context.
• Mortality from road traffic accidents. The roads are dangerous - most cyclists would acknowledge that. The Barcelona study found that there were an estimated 0.03 extra cyclist deaths from bike sharing - maybe far fewer than you might have feared.
• Physical activity. This was where the main benefit in cycling lies. An extra 12 lives a year would be saved by bike sharing. The reason is that obesity and inactivity are such major causes of serious health problems and mortality.
• Carbon dioxide emissions. Emissions of 9,000 tonnes of carbon dioxide pollution a year are averted by cycle sharing, presumably because if people are on a bike, they cannot be driving a pollution-emitting vehicle.

Of course, many questions remain. What about the impact of more cycling on other emissions - especially PMs and nitrogen oxides? Carbon dioxide itself does not have a direct impact on health - it is more of a long term problem in the form of climate change. Urban areas like London need to restrict dirty vehicles, as well as encouraging cycling. Are these results from Barcelona applicable to other cities? And how do these results from a computer model compare with other ways of measuring the health impact of public transport? But let's hope people are encouraged by this news of how urban cycling can, overall, benefit health - because more cycling will also improve the air quality in our cities with further positive impact upon health. But, of course, it can only be a small part of an overall transport policy that puts public health at the top of the agenda.

http://www.bmj.com/content/343/bmj.d4521.abstract?sid=9f033d90-3cba-4632-b2c4-e16416ac28ef

http://www.tfl.gov.uk/roadusers/cycling/14808.aspx

Childhood asthma affects around 10% of children in both the UK and the USA and is thought to arise from an interaction between a genetic disposition and environmental factors. A new report from the Cincinnati Childhood Allergy and Air Pollution Study now points to exposure to household mold as being one of the key environmental factors in the development of childhood asthma. The researchers followed 176 children for seven years, after which time 18% had developed asthma. This was already known to be a high risk group, because of a family history of asthma. The level of mold in the home was measured when the children were aged one and aged seven. A measure called the Environmental Relative Moldiness Index (ERMI) was used to assess mold levels. The ERMI depends upon carrying out DNA analysis to assess the presence of 36 different molds in the environment.

Children living in homes where the ERMI was 5.2 or more were more than twice as likely to develop asthma compared to those living in homes with an ERMI less than 5.2. This finding was only true at age one - by age seven, ERMI had no effect upon asthma risk. The other asthma risk factors of significance were parental asthma and sensitisation to house dust mite.

This study should motivate expectant parents to reduce mold levels in the home to protect their baby from asthma. Here are some simple measures we'd recommend.

Clean off any visible mold patches on walls, around windows, or on ceilings, with white spirit or products from the Allersearch range of allergy friendly cleaning products. You also need to be vigilant in checking for new growth:

• Replace your shower curtain regularly - it's a favourite location for mold
• Regularly check shower heads and rubber seals on fridges and freezers for mold
• Get rid of items that smell of mildew - this includes furniture, books, and old newspapers. They may well be harbouring mold spores
• Never allow food to go moldy - check the fridge and bread bin regularly
• Keep the kitchen door closed when cooking, and reduce steam by putting lids on pans
• Dry clothes outside whenever you can
• Open the windows after you have a bath or shower
• Keep the whole house ventilated - open windows when the weather is dry
• Vacuum regularly - dust is full of mold spores

A High Efficiency Particulate Air (HEPA) filter like the IQAir HealthPro 150 or IQAir HealthPro 250 will trap 100 % of mold spores (which have a range between one and 100 microns) that will go through it, and will improve the air quality in the room where your baby or children sleep.

When carrying out these mold-clearing tasks, make sure it is a non-allergic family member who does them. Since allergy tends to run in families, it is likely that an adult, or another child in the family, will suffer from mold exposure too. Not only will tackling mold reduce the risk of asthma in the new baby, it will also help anyone else who suffers symptoms from these potent allergens.

http://www.lungusa.org/lung-disease/asthma/resources/facts-and-figures/asthma-children-fact-sheet.html

http://www.annallergy.org/article/S1081-1206(11)00313-9/abstract

Eczema is one of the most common occupational skin problems, with 80% of newly diagnosed work-related skin disease being eczema caused by irritant exposure. That is why the National Eczema Society is using National Eczema Week (11 to 18 September) to turn the spotlight on occupational eczema.

Six million people in the UK suffer from eczema, which is not actually a disease in its own right. The word eczema, which comes from the Greek word for 'boiling', refers to a characteristic reddish skin rash which has a variety of causes. Most common is exposure to an allergen, like house dust mite, pet dander, and certain foods, in which case the condition is referred to as atopic eczema. People with atopy, which is a tendency to allergy, are also likely to suffer from other allergic conditions like asthma and hay fever. The terms dermatitis and eczema are often used interchangeably although strictly speaking dermatitis is any inflammation of the skin, not just eczema. Contact dermatitis is another term often used. This is characterised by a rash caused by an irritant or allergen coming into direct contact with the skin. But whether it is atopic eczema, or contact dermatitis, it can still cause big problems in the workplace.

The Health and Safety Executive lists the following occupations as being high risk for occupational skin disease:

• Catering
• Hairdressing
• Healthcare
• Dentistry
• Printing
• Metal machining
• Motor vehicle repair
• Construction

If you are still in education and thinking about a career, or considering a career change, and have eczema, you should certainly note the risks involved in entering the above areas.

Other jobs may involve exposure to irritants or allergens that can cause occupational skin disease. Employers and employees alike should check hazard warning signs on any product used in the workplace. And, of course, a substance doesn't have to be a 'chemical' to cause problems. Substances generated through work activities, like wood dust or fumes, or pollen from handling plants and flowers, may also be potent irritants or allergens. Frequent or prolonged contact with water (so-called 'wet work'), especially with soap or detergents, can also lead to dermatitis.

The HSE advises the APC approach to preventing occupational skin problems like eczema. APC stands for AVOID, PROTECT, CHECK.

AVOID.

• Eliminate irritants and allergens from the workplace, if feasible
• Keep a safe working distance between the problem substance and the skin

PROTECT

• Wear personal protective equipment, such as gloves, but select these carefully
• Wash hands before eating or drinking
• Dry hands thoroughly after washing
• Protect hands by moisturising often and especially at the end of the day (this is the hallmark of managing eczema)

CHECK

• Look often for signs of red, itchy or dry skin
• Seek medical advice if a skin problem seems to be developing

It is well worth following the APC route, because eczema can have a severe impact on a person's ability to work. A study showed that 20% of people with occupational eczema had had prolonged sick leave and 23% had even lost their job because of their condition. And a survey by the National Eczema Society showed that four out of ten of those with eczema (out of 584 with hand eczema interviewed) said that they experienced family problems because they can't work.

Margaret Cox, Chairman of the National Eczema Society, said "People often overlook the huge impact eczema has in the workplace. Sadly, this can be extremely detrimental to sufferers, with some even being forced to give up work because of their condition. If you suffer from eczema, just carrying out your day-to-day job can bring many challenges - from the office temperature, the fabric your uniform is made from and even the negative reaction from work colleagues and the public to a highly visible skin condition." She added " It's vital that employers are aware of these challenges faced by their staff, so they can ensure best practice in the workplace for eczema sufferers." If you have concerns about air contamination in your workspace, contact Commercial Air Filtration at 020 3176 0524.

As part of National Eczema Week, the National Eczema Society has developed new literature on contact dermatitis and eczema at work. 'Working with eczema' for people with eczema, as well as a guide for employers and occupational health workers entitled 'Contact dermatitis at work.' Copies will be available free of charge from September on the Society's helpline 0800 089 1122 or online from www.eczema.org

http://www.ncbi.nlm.nih.gov/pubmed/15656807

One of the enduring images of the World Trade Center terror attacks is of survivors fleeing amidst dense and choking clouds of debris issuing from the Towers. What toll might such massive exposure to dust pollution have on the long-term health of your lungs, and other body organs? Ten years on, we have some answers, thanks to two studies from researchers at Mount Sinai Medical School and elsewhere in the United States, which have just been published in The Lancet. The new research agrees with earlier studies, finding that rescue and recovery workers involved in the 9/11 disaster have a high risk of developing a range of physical and mental problems, including asthma and impaired lung function.

Around 50,000 people worked in rescue and recovery both in the immediate aftermath and in the weeks and months following 9/11. These included firefighters, police officers, construction and municipal workers. For most, I would imagine this act of public duty involved exposure to several lifetimes' of airborne and particulate pollution. Damaging components of the 9/11 pollution would include burning jet fuel from the hijacked aircraft (rich in polyaromatic hydrocarbons, glass and asbestos fibres, lead, dioxins and cement dust).

More than 27,000 rescue and recovery workers were recruited to the study, starting in mid-2002. Some of the group have now been followed up for nine years. At the start of study, 10.5% had asthma and the number of cases increased steadily, year on year, so that by year 9 around one third (of those who had been in the study for that length of time) has asthma. Among the general population, around 8-10% has asthma. Similarly, prevalence of sinusitis increased from 10.7% to 42% at year 9. Impaired lung function was seen in 42% of the group at year 9.

A further study looked at mortality among survivors of 9/11. Among 13,337 rescue and recovery workers, there were 156 deaths, and among non-rescue and non-recovery participants (those who were just caught up in the disaster, like local residents and WTC office workers) there were 634 deaths. Overall, the death rate in those exposed to air pollution from the 9/11 terror attacks was not increased. However, in non-rescue and non-recovery workers, there was an increased risk of death from heart disease with higher levels of pollution exposure, compared to those exposed to lower levels of pollution. This increased risk was not found in the rescue and recovery workers.

There has been concern that exposure to the levels of carcinogen in the 9/11 pollution cloud could increase the risk of cancer. It is likely too soon to say if this risk will be borne out - for the time lag between exposure to a carcinogen and the development of cancer is often more than ten years. But there is already some evidence of increased cancer risk, particularly of thyroid cancer, melanoma, and lymphoma, among firefighters involved at the WTC site.

This example, although an extreme one, underlines the importance of occupational exposures to pollution in asthma and lung disease. Firefighters recalling 9/11 have noted that they were not given protection other than paper masks and overalls, and went home each day still wearing contaminated clothing. It's to be hoped that brave individuals involved in disaster work are always at least given proper protection against the immediate, and long-term, health risks of air pollution exposure. That's one of many lessons that can be learned as we reflect, ten years later, on the 9/11 terror attacks.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61180-X/fulltext

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60966-5/fulltext

The focus of our news round-up this month is on childhood asthma - how an air purifier can improve symptoms, the risks of low birth weight, the benefits of breast-feeding, and how asthma is linked to chronic lung disease in later life.

Exposing children with asthma to second-hand smoke makes their asthma worse. Second-hand smoke also increases the risk of ear infections, bronchitis and other lung infections in children. Obviously, the best way of protecting kids from the dangers is to quit, but sometimes family members are unable or unwilling to do so. Researchers in the United States have discovered that using an air purifier can protect children with asthma from the dangers of second-hand smoke. In this study 126 children with asthma living with a smoker were divided into three groups. One group used an air purifier, the second group used an air purifier and also had access to a health coach, and the third group received neither and acted as a control. After six months, there was a 50% fall in the amount of dust, smoke and particulate matter in the air of the homes of families who used the air purifier. The children in these homes reported more days free of asthma symptoms. Access to a health coach did not, however, result in further improvement.

The cause of asthma in children is influenced by birth weight. A new study of extremely low birth weight children (less than two pounds three ounces) showed that the rate of current asthma did not change between ages 8 and 14, being 23% at both ages. For children of normal birth weight, current asthma rates increase from 8% at age 8 to 17% at age 14. The differences reflect the underlying differences in causes of asthma. For premature babies, asthma is linked to abnormal and incomplete lung development while in normal birth weight children asthma tends to result from a genetic susceptibility interacting with environmental factors. Low birth weight children have a higher risk of many chronic diseases, including asthma, and their health therefore should be monitored closely throughout childhood and adolescence.

Previous research has suggested that breast-feeding protects children from developing asthma. A new report from researchers in The Netherlands goes further by linking the time and exclusivity of breast-feeding to asthma risk. They collected information on how more than 5,000 children were fed during the first year of life. The children were examined each year until the age of four, and any asthma-like symptoms, such as wheezing, cough, and shortness of breath, were recorded. Children who were never breast-fed were more likely to develop such symptoms than those who were breast-fed for more than six months. Moreover, those fed other milk, or solids, in addition to breast-feeding in the first four months, were more likely to develop asthma symptoms than those who were exclusively breast-fed during this time. This means that official advice, to breast-feed a baby for at least six months, is still the right advice when it comes to reducing the risk of asthma.

And finally, severe asthma in childhood increases the risk of chronic obstructive pulmonary disease (COPD) in later life, according to research presented at a recent American Thoracic Society meeting. As part of the Melbourne Asthma Study, patients were followed from age 7 to age 50. Having severe asthma as a child increased the risk of COPD by a factor of 32 compared to not having asthma. Mild childhood asthma was not linked to an increased risk of COPD.

Click here to find our best asthma air purifiers.

http://archpedi.ama-assn.org/cgi/content/short/165/8/741

http://www.nhs.uk/Conditions/Asthma-in-children/Pages/Introduction.aspx

http://jama.ama-assn.org/content/306/4/394.abstract

http://www.babycentre.co.uk/baby/breastfeeding/

http://www.sciencedaily.com/releases/2011/07/110721212452.htm

There are so many different kinds of air purifiers and air cleaners on the market, that it’s hard to know where to start if you want to buy an air purifier for your home. Let’s start by listing the main types of air purifiers, and how they can help you. In other words, what’s in the box, and how does it work? I can’t tell you which air purifier to buy, because different models and brands have different strengths - but let’s imagine your primary concern is particle pollution in form of house dust mite allergens (whose allergen particles range from 0.1 to 10 microns in diameter).

HEPA Air Purifiers

The US Environmental Protection Agency recommends HEPA (high efficiency particulate air) filters, saying they are the most effective of the mechanical air cleaners. The HEPA is a specialized filter consisting of a folded mat of fibres. It has three different modes of action, each of which acts upon a different size of particle. Interception deals with particles above 0.4 microns in diameter and involves the particle sticking to a fibre in the HEPA filter when it comes close to it. In Impaction, the particle is blown towards the fibres by the airstream on which it is travelling, collides and sticks to it. Then there is Diffusion, which mainly affects smaller particles, of diameter below 0.1 microns. The particle collides with air molecules which throw it off course. Diffusion keeps the particle within the filter until it is captured by impaction or interception. What of particles between this size range? They are captured, but with a very small decrease in efficiently. In fact, the ability of a HEPA filter to capture particles of size 0.3 microns is actually used as a measure of its effectiveness. The DOP penetration test involves sending a test stream of particles of this size through the filter and using a particle counter to measure the particles in the ingoing stream and outgoing stream to see what proportion is removed by the filter. A leakage free HEPA air purifier will remove 100% of house dust mite allergen in the air.

Electronic Air Purifiers

'Electronic' air purifiers work by giving the particles of pollution that pass through the unit an electric charge and then using electrostatic attraction (positive attracts negative and vice versa) to trap the particles. There are different kinds of electronic air purifiers - two popular versions are electrostatic precipitators and ionizers. The electrostatic precipitator sucks air into the unit, charges up the particles in the first section and then passes the stream to a pair of plates bearing an opposite charge. So the particles stick onto the plates. A mere ionizer acts externally rather than internally in that it releases ions into the environment. This charges up the particles in the air and they become attracted to their surroundings by electrostatic attraction (ever tried rubbing a balloon on your jumper and making it stick to the wall, or curtains? You’ve got the idea!). A problem here is that electrically charged pollution can be an inconvenience when it sticks to walls, furnishing and other objects in your house. For that reason we do not recommend air purifiers that use mere ionization and do not combine it with a HEPA-like filter. Another concern is that the ionization process can emit ozone, which is a pollutant and lung irritant in its own right.

UV Air Purifier

Ultra-violet (UV) light is very short wavelength radiation which kills living particles like viruses, bacteria, and molds (generally known as microorganisms) if they are exposed to the light for a significant amount of time. The performance in terms of killing microorganisms with an UV light depends upon the dose of UV light the air pollution is exposed, the actual length of time the microorganisms are exposed to the light, and the nature of the microorganism involved (not all bacteria are killed by UV, nor are mold spores). In general microorganisms have to be exposed to UV light for several hours to be killed. Given that the air passes through an air purifier within a fraction of a second, UV light is not an effective way to eliminate microorganisms from the air.

Gas / Chemical Air Purifier

What if you’re concerned about volatile organic compounds (VOCs) rather than house dust mite allergen or other particles? These are gaseous molecules, rather than particles, and none of the above air purifier types by themselves will remove them. VOCs, as other chemicals, are removed by purifiers containing activated granular carbon, or equivalent, filters. Important here is the quality of the carbon that is being used. Carbon dust (which is relatively cheap) will not be effective. Some air purifiers, like the IQAir HealthPro 250, combine a HEPA filter with a powerful gas filter, thereby removing the wides range of pollutants.

We have £18 million to spare to help improve London’s air quality before next year’s Olympics - now that the construction of the venues has come in under budget. And if the Mayor doesn’t get on with it, we stand to face a £175 million fine from the International Olympic Committee. That’s the price of exceeding EU pollution limits during the event and is laid down in a contract that was signed by the Mayor and the government in 2005. So they have had six years to put measures in place to make sure London’s air quality meets the required standards. What progress has been made?

There is the Low Emission Zone (LEZ) scheme, which was introduced in 2008 to help protect us from the health hazards of diesel. Under the LEZ, vehicles like lorries, coaches, and vans (not cars or motorbikes) are encouraged to deal with emissions by fitting a filter, replacing their vehicle with a cleaner model, or face a fine of £100 to £200 a day for driving within a zone that covers most of central London. The scheme is to apply more stringent criteria from January 2012. At the moment, vehicles have to meet the Euro III standards for PM10 emissions (applies to all vehicles registered as new on or after 1st October 2001). Next year, they will have to meet the tighter Euro IV standards, which apply to all vehicles registered as new on or after 1st October 2006. This will take more of the older, dirtier vehicles off the roads of central London - or make them clean up, or pay by the day for poisoning us with their fumes.

The London Assembly has also been debating the possibility of introducing a Clean Air Zone which would bring more vehicles under the controls currently imposed by the LEZ such as cars and taxis that do not meet the Euro IV standards. Given this is just at the discussion stage and the scheme is not universally favoured, it is unlikely to come into effect in time for the Olympics. I don’t know how well the LEZ is working, but it can’t be perfect because there have been a number of well-publicised incidents this year that reveal that the capital is still one of the worst spots in Europe for air pollution.

It now seems likely that we will be resorting to short-term fixes for the Olympics - such as severe restrictions on the number of vehicles on the road during that time period. What an opportunity lost to put some effective long-term policies in place, and make them work!

Simon Birkett, Founder and Director of Clean Air in London told us “We promised the world ‘the greenest Games ever’. With a year to go, this promise looks very hollow.” He explains that:

• The government is saying that it won’t comply with legal standards for nitrogen dioxide (these were set in legislation in 1999 to be met by January 2010) in London until 2025
• Air pollution looks set to be a ‘Top Five’ issue for the Mayoral elections in 2012
• All of this while air pollution may be contributing to one in three of all deaths in London at an average additional loss of life of three years for those affected.
• “Instead of playing ‘mind-Games’ with Londoners to keep them off the roads or a last minute odd and even number plate ban, our leaders should be implementing and keeping a Clean Air Zone for inner London that would ban the most polluting older diesel vehicles from the most polluted part of London.”

http://www.government-news.co.uk/greater-london-authority/201107/assembly-examines-potential-of-clean-air-zone-for-inner-london.asp#

http://www.allergycosmos.co.uk/blog/london-air-pollution-out-of-control/

Air pollution is usually invisible. You normally only see it indoors when it settles as dust or layer of grime on your furniture and other surfaces. In fact, air pollution is a complex mixture of liquid droplets, and solid particles, that come in a range of sizes classed as coarse, fine and ultrafine. These tiny particles are bombarding your body the whole time, indoors and outdoors. Some, like pollen grains, may make their presence felt by irritating your nose and eyes, as in an attack of hay fever. Others, like carbon monoxide molecules, may penetrate into your bloodstream and cause long-term damage to the heart. It pays to know a bit about the three main size classes of particle, so you can think about reducing your exposure.

Coarse particles.

These range in size between 2.5 and 10 micrometres in diameter and include fungal spores, which may trigger asthma and hay fever. The fungus Aspergillus may also cause aspergillosis, the name given to a range of lung infections, ranging from mild to life-threatening. Coarse particles are sometimes known as PM10s. A significant source of PM10s outdoors is traffic pollution. The particles, which are a byproduct of combustion, are emitted from vehicle exhausts. PM10s enter the lungs and will exacerbate any existing lung disease, including chronic obstructive pulmonary disease, and asthma. PM10s are also bad for people with coronary artery disease and heart failure, possibly through causing inflammation. Young children and the elderly are often more vulnerable to many diseases than adults, and the same is true of the health effects of particulate pollution. This is why there has been so much concern recently over the impact of traffic pollution near schools.

Fine particles.

These range in size between 2.5 and 1.0 micrometres diameter and include pollen grains or fractions of pollen grains, house dust mite allergen, and pet dander - all of which are key allergens that have long been implicated in asthma and other allergies. The fine particles are known as PM2.5s. They are also bad for those with heart and lung disease and, indeed, may pose even more of a threat than PM10s, because they can penetrate further into the body - as far as the bloodstream - because of their small size.

Ultrafine particles.

These are particles whose diameter is less than 0.1 micrometre and would include tiny particles in cigarette smoke and pollution at the molecular level, such as formaldehyde and other volatile organic compounds emitted from various household and DIY products, or carbon monoxide from ill-ventilated boilers or gas cookers. These molecules irritate the throat and lungs and, more seriously, chronic exposure to some of them has been linked to cancer.

If you want to tackle indoor pollution, an air purifier with a HEPA filter will trap coarse and fine particles, but the air purifier will also need to be fitted with an absorbent HEPA filter such as an HyperHEPA H12 filter to remove those in the ultrafine range (See the IQAir HealthPro 250 or HealthPro 150). To effectively filter out chemical and gases, the air purifier needs to be equiped with an activated carbon filter. Air purifiers such as the Blueair 450E or Blueair 270E combine ionisation with a HEPA-like filter to reach high levels of air movement and be ultra silent.

http://www.nhs.uk/conditions/aspergillosis/Pages/Introduction.aspx

http://www.airnow.gov/index.cfm?action=aqibasics.particle

What is formaldehyde?

Formaldehyde is a volatile organic compound (VOC) which is found in many modern household products and contributes to indoor air pollution by a slow leakage process called outgassing. It is a colourless gas with a characteristic pungent odour. Many VOCs cause health problems, particularly in people with asthma, rhinitis, or multiple chemical sensitivity. VOCs act as irritants, rather than allergens. Formaldehyde can produce symptoms at levels as low as 0.1 parts per million (ppm).

What products contain formaldehyde?

The glue used in board-based wood (plywood, particleboard, fibreboard), furniture (especially flat pack furniture), flooring, and wall panelling

• Foam backing on carpets
• Paint preservatives
• Fabric treatment in ‘easy care’, ‘crease-resistant’ or ‘non-iron’ polyester or polycotton textile products
• Urea-formaldehyde insulation
• Cigarette smoke and incompletely vented fuel-burning appliances (gas stoves, kerosene heaters, wood-burning stoves)

Formaldehyde is used as a fungicide and disinfectants in certain workplaces (eg mortuaries, laboratories). It is also used in hundreds of industrial processes including manufacture of paints, plastics, paper, textiles, carpets, woods and furniture, glues and reisns.

How long do products give off formaldehyde?

Formaldehyde can outgas from household products for several months and sometimes years, the amount decreasing with time.

What are the health effects of formaldehyde?

• Sneezing, coughing
• Eye, nose, throat irritation
• Long-term exposure causes impaired lung function, skin problems including eczema and dermatitis

The International Agency for Research on Cancer cites formaldehyde as human carcinogen and studies suggest it is a cause of throat and nasal cancer and leukaemia.

Who is most at risk of formaldehyde exposure?

People with asthma, rhinitis and multiple chemical sensitivity are most at risk. Those with existing skin complaints and the elderly, the very young, and pregnant women are also more at risk.

What is the law on formaldehyde levels?

In the UK, the Control of Substances Hazardous to Human Health legislation (COSHH,) says ‘ The current workplace exposure limit (WEL) for formaldehyde is two parts per million (2ppm), time weighted average over eight hours. The short-term limit (averaged over ten minutes) is 2ppm. In fact the HSE’s own research shows that eye irritation can occur by exposures of 0.01 ppm - which is 200 times less than the WEL.

The WEL for formaldehyde is currently under review and subject to possible change.

A worker's exposure to formaldehyde should not exceed this WEL and every effort should be made to reduce the exposure as low as is reasonably practicable, and in any case below the WEL.’ In Sweden and Germany the maximum possible indoor level is 0.1ppm.

In the USA, the Occupational health and Safety Administration has set a lower level of exposure to formaldehyde, at 0.75 ppm.

How can I protect myself from formaldehyde pollution?

Shop wisely. Consider buying solid wood rather than board-based wood or look for ‘low gas’ or ‘zero gas’ products. . You could use metal or glass for shelving. If you are doing a DIY job with board-based wood, leave it outside, covered over, for a week to get rid of the worst of the formaldehyde. Use a face mask when you are carrying out the work. Then use paint, or varnish, to seal surfaces of board-based wood products to prevent the formaldehyde from outgassing. When choosing a carpet, go for one with a hessian or felt, rather than foam, backing.

If you have no choice but to stick with board-based wood products, be sure to ventilate your home properly to get rid of any formaldehyde build up. An air purifier with a gas absorbing filter can remove formaldehyde from indoor air. For instance, the IQAir GC MultiGas Air Purifier contains four advanced filter cartridges with activated carbon and potassium permanganate impregnated alumina. The same filtration material can also be found in the IQAir HealthPro 250 and the HealthPro 150.

http://monographs.iarc.fr/ENG/Monographs/vol88/index.php

From allergen and air pollution studies, to a high tech cure, there is plenty going on in the world of asthma research this month.

Kids living in homes in which mold is present have an increased risk of allergies and asthma, say researchers at the German Research Center for Environmental Health writing in the European Respiratory Journal. We’ve already reported that mold has an adverse impact on lung function, but the situation with asthma is particularly interesting. For previous studies have suggested that invisible components of mold in house dust could actually reduce the risk of asthma. So the German researchers have been comparing studies on visible mold with research on invisible mold. Children living in homes with visible mold were 49% more likely to have asthma than children not thus exposed. They also had an increased risk of nasal allergy.

Meanwhile, doctors in the UK have begun treating patients with severe asthma with a new procedure called bronchial thermoplasty which destroys some of the muscle tissue that constricts during an asthma attack, causing wheezing and coughing symptoms. The technique uses short bursts of radiowaves to heat and destroy the tissue. This is the first proven non-drug treatment for asthma (it has been through several successful clinical trials) and will initially, at least, be used in severe cases where drug treatment does not seem to help.

Scientists from the Aphekom project, which is working to better understand the impact of air pollution on health in Europe, have just reported that living near busy roads increases problems with asthma and chronic obstructive pulmonary disease. They found that over 50% of the population in 10 major European cities live within 150 metres of roads travelled by over 10,000 vehicles per day. Living near these busy roads could account for 15-30% of all new cases of childhood asthma and make a significant contribution to heart disease and COPD in adults.). Simon Birkett, Founder and Director of Clean Air in London said ‘This burden is substantially larger than previous estimates of exacerbations of chronic disease, since it has been ignored so far that air pollution may cause the underlying disease as well. Related research indicates that associations of asthma with traffic-related pollution from nearby sources at schools were independent of estimated effects of exposures at homes.’

Finally, two more new stories about the impact of air pollution on asthma. In the first, researchers studied nearly 500 adults with asthma in five French cities. They looked at both respiratory health and exposure to ozone, nitrous oxide, and PM10 pollution. Around 44% of the participants had well-controlled asthma, while 29% had partially controlled asthma and 29% had asthma that was poorly controlled. There was a strong link between poorly controlled asthma and exposure to ozone and PM10s. The risk of uncontrolled asthma was 69% higher among those exposed long-term to ozone and 35% higher among those with long-term exposure to PM10s. In the second study, psychosocial stress among parents was found to increase lung-damaging effect of traffic pollution in children. The study, carried out by researchers at the Division of Environmental Health at Keck School of Medicine, Los Angeles, is the first to show a link between growing up in a stressful household and greater impact of pollution upon lung health. It is thought that stress and air pollution may both increase inflammation on the body, which adversely affects lung function.

If you, or your child, have asthma, you’ll know that allergen avoidance is the key to your management plan, along with vaccination against the flu and being prescribed and using appropriate treatments. The first study shows how important it is to get rid of visible mold and any underlying damp if mold spores are one of your triggers. Controlling other allergens like house dust mite and pet dander may be equally important if these are your triggers. If your allergens are airborne, an air cleaner or air purifier should be a key element in your plan. Research shows that a good air purifier will help relieve asthma symptoms. The positioning of the air purifier is crucial - make sure it is where the person sufferering from asthma spends most of their time, such the person's bedroom.

http://erj.ersjournals.com/content/37/5/1050.abstract?sid=8b5d56ae-49c4-4547-adf3-7463317e37f2

http://www.btforasthma.com/

http://www.aphekom.org/c/document_library/get_file?uuid=5532fafa-921f-4ab1-9ed9-c0148f7da36a&groupId=10347

www.cleanairinlondon.org

If you have hay fever, you are allergic to pollen - the microscopic grain released by the male part of a flower. So you’ll be only too familiar with the following allergy symptoms:

• Sneezing
• Itchy nose, mouth, throat, eyes
• Watery eyes
• Blocked or streaming nose

Allergen avoidance is not easy when it comes to pollen, but it’s not impossible. Pollen grains are small and light (ranging in size from 0.5 to 100 microns) and they are very widely dispersed - so pollen allergy is as much a problem in the city as in the country. Indeed, pollen grains have even been found several miles out at sea - that’s how far they can travel. It’s really useful to be aware of exactly what type of pollen you are allergic too (this can be done by skin prick tests at an allergy clinic such as the Queen Anne Street Allergy & Immunology Centre) and when the pollen season starts and finishes.

The pollen season is different for different plants and, put simply, it last from early spring to late autumn. With global warming on the horizon, it may be that our pollen season will get longer and longer. Here’s what to expect:

First out is tree pollen from mid to late March to mid-May. The season for each tree species lasts three to four weeks. These trees (listed from early to late with respect to their season) are associated with pollen allergy: Hazel, alder, poplar, ash, birch and oak. This year, the start of the pollen season has been delayed because of the harsh winter.

Next is the grass pollen season, which begins in mid-May and ends in July. Grass pollen allergy is more common than tree or weed pollen allergy. Grass pollen grains are relatively large and tend to affect the nose and eyes more than the lungs. Foxtail, oat, dogstail, timothy and meadow grasses are most usually associated with allergy in the UK. The grasses release their pollens from April to July.

Finally, the weed pollen season overlaps and extends beyond the grass pollen season - from the end of June to September, the exact duration depending on the species of weed. Dock weed has the longest pollen season. Other weeds associated with pollen allergy include nettle, sorrel and ragweed.

Note that brightly coloured garden plants, like roses, are not much associated with allergy because their pollen grains are too heavy to be widely dispersed by the wind (they are distributed from plant to plant by insects like bees which are attracted to the bright colours).

The weather also affects the amount of pollen in the air on a particular day. There is more on a sunny day, less on a rainy day. Cloudy days are associated with a build up of pollen in plants that is released as soon as the weather improves.

Time of day also affects the likelihood of encountering pollen allergens. Be aware that

• Grass releases pollen from around 7 in the morning - later if the ground is damp. Some grass species don’t release their pollen till the afternoon though.
• Birch trees release their pollen between noon and 6pm.
• Warm air lifts pollen high into the atmosphere during the day. When air cools down, as dusk falls, pollen starts to descend. You may well be exposed to one of these ‘pollen showers’ in the early hours of the morning if you sleep with a window open.

These are just guidelines. For more detailed information, see the Met Office chart on typical pollen seasons for different plants. If you have hay fever, you should take pollen forecasts as seriously as the weather forecast and know when to step up your allergen avoidance precautions. Good ideas include:

• Washing your hair when you get home from work
• Changing your outdoor clothes and wash them and all other laundry with hypoallergenic laundry detergent
• Clean your home with allergy friendly cleaning products
• Use a mask or scarf to cover your nose, or a dab of Vaseline inside each nostril
• Consider investing in a HEPA air purifier (such as the IQAir HealthPro 150 for example) to filter pollen grains out of indoor air

http://www.bbc.co.uk/news/health-13572602

http://www.metoffice.gov.uk/health/public/pollen-forecast#calendar

http://www.netweather.tv/index.cgi?action=pollen;sess=

However house proud you are, it is not easy to eliminate indoor dust. It is an inevitable by-product of living in your home. You shed skin and hair all the time, you bring in soil particles on your shoes, pollen on your clothes. There’s a constant influx too, of particles and gas pollution from outside, especially from traffic fumes through open windows, or any cracks, gaps or holes in the walls or roof. Lighter particles in dust float in the air, heavier ones settle onto your furniture and into carpets and other soft furnishings. Settled dust is easily stirred up by movement and activity. If you could visualise house dust, you would see a constantly-changing situation - and one that you need to manage if you have an allergy. For five common allergens are a common component in house dust.

Animal dander. The sweat and saliva of dogs, cats and other pets contains a lightweight allergen that is very readily stirred up into the air. It may settle after a few hours but, being so light, it easily becomes airborne again. Horses also produce a potent allergen. Of course, you wouldn’t keep a horse indoors! The problem is that you carry the horse allergen indoors on your clothes and hair when you have been riding. Small mammals like mice and guinea pigs - so popular with children - have allergens in their urine which can become airborne in dust. Reptiles like lizards carry allergens which are released in tiny skin particles that float in the air. Click here for more advice on living with pet allergies.

House dust mite. This tiny spider-like creature gets its name from its favourite home - your house dust. It is the droppings of house dust mite that contain the allergen, one of the most intensively studied because it is behind so many cases of asthma and allergies. The house dust mite allergen is heavier than that from animal dander so it tends to occur in settled dust rather than the airborne kind. It’ll be in your bedding, your carpet, cushions, soft toys - and it is persistent, remaining long after the mites themselves have been killed. Cleaning or vacuuming actually stirs up house dust mite allergen, releasing it into the air.

Mold. Where there’s damp, mold will grow. Did you know that, even though you can’t see them, mold spores (their ‘seeds’, if you like) are a major component of dust. In Britain, the record is over 160,000 mold spores per cubic metre of air (that’s compared to a record of 2,800 pollen grains per cubic metre). Mold might be growing in only one location in your house - under the shower head, for instance - but the spores can travel all over.

Cockroach allergen. Not a nice prospect, but I suspect that cockroaches (often thought to be a problem mainly in the United States) will become more common here as a result of climate change. They tend to favour warmer weather and are unlikely to survive the winter. Cockroach allergen is found in the skin, saliva and droppings of these insects. A recent report underlines the importance of cockroach allergen for city kids with asthma.

Volatile organic compounds. Formaldehyde, acetone, and other volatile small molecules are emitted from paints, glues and other DIY products, while gases like carbon monoxide are produced by cooking with gas, and smoking. They can be absorbed onto dust particles and are a particular problem for people with multiple chemical sensitivity.

What’s the best way of tackling allergen-bearing indoor dust? Never use a feather duster as this just stirs up the dust and releases it into the air. Go for a dust-attracting electrostatic cloth, or a dampened duster, to which the dust will actually stick. Similarly, vacuum carpets, rather than sweeping them. In fact, vacuuming a carpet with a good machine (maybe with a HEPA filter) is as good as replacing it with a hardwood surface.

When it comes to dealing with airborne dust, a HEPA air purifier will reduce the particle levels enough to relieve allergy symptoms. For instance, the IQAir HealthPro 150 can capture pet and cockroach allergen particles as well as house dust mite allergen, fungal and mold spores. For volatile organic compounds, the IQAir GC VOC and the IQAir GC MultiGas cleans the air of the largest spectrum of chemical pollution such as formaldehyde and other gaseous irritants.

http://www.dawn.com/2011/06/14/cockroaches-may-be-asthma-culprit-for-city-children.html

http://www.consumersearch.com/blog/air-purifiers-what-they-could-can-and-cant-accomplish

People who work with poultry often report a wide range of respiratory symptoms including cough, eye irritation, breathlessness, chest tightness, nasal congestion and wheezing. Agricultural workers in general tend to have a much higher incidence of occupational asthma than the national average and poultry workers seem to be particularly at risk. The longer someone has worked in a poultry farm, the more likely they are to develop chronic respiratory problems. Workers in cage-housed facilities seem to have more problems than those in floor-housed facilities.

This is hardly surprising, for they are exposed to a potent and complex mix of toxins and allergens in the form of poultry dust. The evidence that components of poultry dust are harmful to health is so strong that it is listed in Control of Substances Hazardous to Health (COSHH) regulations.

The various activities that go on in a poultry farm, including handling and inspection of birds, removing their litter, upkeep and cleaning of their cages and laying down litter, all contribute to the complexity of poultry dust. It may vary in its composition from pure wood dust to a mixture of organic and inorganic components including feathers, dander, mites, fungi and bacteria. As well as particles ranging in size from 0.5 to 50 microns, poultry workers are also exposed to gases like ammonia and hydrogen sulphide.

Research has shown how specific components of poultry dust are linked to ill health. For example:

• Wood dust. Poultry bedding often consists of softwood shavings and comes from pine, yew and cedar. Exposure to softwood dust has been linked to skin problems, rhinitis, and occupational asthma.
• Poultry feed. Usually, feed is in the form of grain, pellets or meal, with their major component being cereals. Feed is very prone to fungal growth, and fungal spores can be a potent allergen. It may also contain various wheat allergens and pollens. Stored feed attracts mites - many of them close related to our old enemy, the house dust mite, and equally prone to cause allergy problems. Grain dust will contain many contaminants including: bacteria, microbial toxins, insects, animal hair, feathers, insect or animal droppings, pollens and pesticides. Inhaling grain dust is known to cause asthma, bronchitis, and nasal and eye irritation.
• Vaccines. Part of the poultry worker's job is to vaccinate the birds which involves close handling and exposure to feathers and dander which are also potent allergens.
• Bacteria and fungi. Any agricultural environment will contain lots of soil and dust, which are a breeding ground for bacteria and fungi. The bacteria can cause gastrointestinal problems. Meanwhile, long-term or repeated exposure to airborne fungal spores in agricultural environments is known to be a contributing factor in lung function decline and in allergic disease such as asthma.
• Toxins. Endotoxins, which come from the cell walls of certain bacteria, are a component of poultry dust. Exposure to endotoxin causes acute respiratory symptoms, including cough, shortness of breath and lung function impairment with those with existing lung problems being more susceptible.

In summary, poultry dust contains many components which could trigger allergic respiratory disease and make existing disease worse. Three components in particular - softwood dust, grain dust and storage mites - are known asthmagens (substances that cause occupational asthma). Therefore, employers in the poultry industry have to undertake a careful health surveillance of their employees (this is a legal duty). Another requirement (under COSHH regulations) is to ensure that levels of poultry dust are prevented, or at least adequately controlled, which means paying attention to ventilation and air purification. Click here for our range of commercial air purification solutions, or contact us at 0203 176 0713 to talk to one of our experts.

http://www.asthma.org.uk/all_about_asthma/asthma_at_work/occupational_asthma.html

http://www.hse.gov.uk/agriculture/poultry/guide.htm

Throughout the crisis around Japan’s Fukushima nuclear power plant, we got asked a lot if air purifiers can help filter out radioactive air pollution. The high efficiency particulate air (HEPA) filter is well established in its ability to trap radioactive particles. The HEPA filter system was developed by the United States Army Chemical Corps and the United States Atomic Energy Commission during the Manhattan Project (development of the atom bomb) to protect against the spread of radioactive dust. The first HEPA filters were rigid and unwieldy machines, quite unlike their modern counterparts. They contained asbestos imported from Africa or Bolivia. Concern over the health impact of asbestos led to the development of alternative materials. There were also concerns about leaks and defects in the filter so, again, research was needed into a better filter material.

The HEPA filter was by no means the first air purifier. People have always been concerned about the quality of the surrounding air. The great Leonardo Da Vinci had the notion that finely woven cloth dipped in water would protect the military from toxic powders. At the end of the 18th century, the German explorer and naturalist Alexander von Humboldt devised a primitive respirator for use in mining, while Lewis P. Haslett’s ‘lung protector’, which received its patent in 1848, used moistened wool with a one way valve to filter dust out of the air.

A true HEPA filter meets specifications of the United States Department of Energy for DOE regulated applications. Air purifiers labelled ‘HEPA-type’, ‘HEPA-like’ or even ‘99%-HEPA’ will most likely not meet the same performance standards. A true HEPA filter has to be able to remove 99.97% of airborne particles of size 0.3 micrometers diameter passing through it. Of course, it can remove particles bigger and smaller than this, but it is the 0.3 micrometer particles that are hardest to trap in the filter, so that is why these are the particles used to judge performance.

HEPA technology was ‘top secret’ during the Manhattan Project but, after the war, the government declassified the technology so it could be used in commercial and residential settings. Modern HEPA air purifiers are used in hospitals and in the aerospace, electronics and pharmaceutical industries. In the home, vacuum cleaners fitted with HEPA filters can be used to remove dust containing house dust mites, pollen, pet dander and other particle pollution which might otherwise provoke asthma or allergy symptoms. HEPA filters remove particles by trapping them in mesh of fibres by one of three different mechanisms (interception, impaction and diffusion) depending on the particle size. But HEPA filters do not remove molecules, so if you want to get rid of, say, volatile organic compounds, you would need a system that also incorporates activated carbon which will absorb gases.

http://www.hss.energy.gov/nuclearsafety/ns/techstds/standard/std3020/std3020.pdf

Diesel exhaust emissions can inflame the lungs and increase airway resistance - and that’s just in healthy people. For those with asthma, exposure to diesel fumes can significantly worsens their conditions. Recently, there was a study carried out in London’s Oxford St (high diesel emissions) and Hyde Park (low diesel emissions) which showed increased airway inflammation among participants with asthma after being in the former environment. Oxford St, as Londoners know, is restricted to diesel-powered buses and taxis so this was a good place to determine the impact of diesel traffic on lung health. But people in Oxford St are exposed to more pollutants than just diesel fumes - there are particles from brake and tyre wear and tear and from road surface abrasion. Diesel fumes or exhaust itself is a complex mixture (it can be compared, in this respect, to tobacco smoke) of particles less than 0.1 micrometre in diameter and gases including carbon monoxide, nitrogen and sulphur oxides, and volatile organic compounds, including potent irritants like formaldehyde.

In a new study, Ian Mudway of King’s College London and colleagues in Sweden and Southampton exposed volunteers with asthma and also healthy controls to filtered air and diesel exhaust (no particles from other traffic-related sources). They found an increase in inflammation, as measured by a higher concentration of immune cells, in the healthy controls with exposure to diesel. But no such response was found among participants with asthma. What does this mean? The researchers suggest that the known increased sensitivity of people with asthma to traffic-related air pollution cannot be attributed to a ‘classical’ acute inflammation response (as was seen in the healthy controls) or to the usual indicators of allergic asthmatic inflammation. Something else is going on here and further research is needed to nail down the details of exactly what is going on when someone with asthma is exposed to diesel fumes.

Meanwhile, in another study, David Newby of the British Heart Foundation (BHF,www.bhf.org.uk) and colleagues, looked at the impact of a new diesel filter on the heart health of a group of 19 healthy volunteers. The study was funded by BHF and by the equivalent charity in Sweden. The men breathed in filtered air (such as you would get from a HEPA or HEPA-like purifier), diesel exhaust and diesel exhaust treated with the new filter. They inhaled each gas for one hour during which time they alternated 15 minute bouts of moderate exercise with 15 minutes of rest.

The exhaust filter removed 98% of all particles in the diesel exhaust and 99.8% of the smallest and most damaging particles. Compared to filtered air, diesel exhaust also impaired the ability of blood vessels to dilate after exposure while breathing filtered air improved the release of a compound which dissolves blood clots. By contrast, diesel exhaust increased the tendency of the blood to clot, which is a major factor in heart attack risk. These findings suggest that fitting vehicles with diesel exhaust traps could help improve heart health among those exposed to traffic pollution. The study also suggests that it is the particles, rather than gases, in the diesel exhaust, which have an adverse impact upon the heart.

Click here for our best air purifiers for City Pollution.

Sources: Behndig AF et al Proinflammatory doses of diesel exhaust in healthy subjects fail to elicit equivalent or augmented airway inflammation in subjects with asthma Thorax;66:12-19

Newby D et al Circulation Online April 11 2011

Modern medicine and an aging population have combined to increase the frequency of invasive fungal infection. We are surrounded by microbes, including fungi. They live in the surrounding air, on our skin, and inside our bodies. In a healthy person, these fungi often do not cause any problems. But everyone with a lowered immunity, such as the elderly, patients with cancer or HIV/AIDS, and those who have had an organ transplant or who are on chemotherapy, are prey to all kinds of microbial infections (sometimes called opportunistic infections). The risk is even further increased if the patient is in intensive care, because procedures like mechanical ventilation and the use of catheters tend to increase the risk of infection.

Invasive aspergillosis (IA) is infection by the common fungus Aspergillus and it is a leading cause of death among patients with impaired immunity. Invasive aspergillosis accounts for nearly half of all invasive fungal infections. It’s rapidly progressive and fatal in between 30% to 95% of cases. Major outbreaks have been linked to hospital maintenance, construction and renovation, because these activities stir up the Aspergillus spores into the air.

There is really no point in waiting until cases of invasive aspergillosis occur, because an aspergillosis infection is hard to diagnose and treatment outcome is very uncertain, as can be seen from the mortality rates quoted above. Prevention of infection is the key to dealing with the threat of IA. Researchers have found that a portable high-efficiency particulate air (HEPA) filter is one of the most effective ways of reducing the risk of invasive aspergillosis infections in hospitals.

The efficiency and benefits of fixed HEPA filters in IA prevention have already been established. This new study, based in a major Hospital, looked at the impact of portable IQAir HEPA air purifier which were being used in selected wards. Data were collected for three years. In wards where there was an IQAir HEPA air filter, the incidence of invasive aspergillosis before installation was 34.61 cases per 100,000 patient days. Afterwards, the rate dropped to 17.51 cases per 100,000 days. Where there was no IQAir air purifier, the rate of IA infection did not change over time. Therefore the presence of an IQAir HEPA air purifier can reduce the risk of IA by 50%. Portable IQAir HEPA air purifiers are readily available, easy to install. Certainly, this study suggests that the right HEPA filters are a worthwhile investment that will pay for themselves in terms of reduced healthcare costs. The researchers suggest that further studies could be done, over longer time periods and on specific patient groups, to further prove the impact of HEPA filters upon prevention of IA.

For a free expert consultation about the best medical grade air purifiers for your home, business or hospital, please contact us anytime at 0203 176 0524.

If you have asthma or some other allergy, then allergen avoidance has to be your top priority. Allergen avoidance can help you gain control, reduce symptoms and reduce your reliance on medication. But how best to go about limiting your exposure to every day allergens? What is practical and realistic? Dr. Thomas Platt-Mills, of the Asthma and Allergic Diseases Center and the University of Virginia Medical Center provides some excellent advice on how to best avoid house dust mite, cat and insect allergens.

House Dust Mite

Dr Platts-Mills has been named ‘Dr House Dust Mite’ because of his expertise in this area:

• House dust mites love moisture, so control the humidity in your home. In a dry area, opening the windows regularly may be enough. If you live in a more humid place, then consider air conditioning or a dehumidifier.
• Deprive the house dust mites of a place to settle by removing carpets and curtains wherever possible. Bedding is their favourite place of course, so investigate mite-proof bedding and wash covers at high temperatures (60°C or 140°F) or use an allergy laundry detergent such as Allergen Wash from Allersearch, which destroys dust mite allergens on contact and at any water temperature, hot or cold.

Cat allergen

Cat allergen is readily air-borne and has a ‘sticky’ quality which means it can travel far and settle in places where the cat itself has not been present. Try these tips:

• As with house dust mites, removal of carpets, curtains and other soft furnishings will reduce cat allergen load. Vacuum often, preferably with a cleaner fitted with a HEPA filter which will trap cat allergen-bearing particles.
• Clean your home and laundry with specialty allergy cleaning products such as Allersearch.
• A HEPA or HEPA-like air cleaner can also effectively remove cat allergen from the air in your home. But you should make sure that you buy the right kind of air purifier in terms of its effectiveness, your area of concern and the space that you want to clean the air in.

Insect allergen

Not a nice thought, but cockroaches and other insects can be present in warm places, especially if food is lying around. Buildings that are heated all year round like apartment blocks or hospitals, are more likely to harbour cockroaches.

Insecticides can kill cockroaches and their relatives, or you could use some kind of bait to trap them. Dr Platts-Mills mentions that baits with boric acid and hydromethylnon have been proven to reduce insects infestation in New York City.

• Get rid of cracks or gaps in your building where the insects may be entering.
• Control the food supply so as not to encourage insects. Keep it in fridge or in covered containers and do not leave unwashed pans and dishes lying around.
• Aggressive spring cleaning will get rid of accumulated, yet invisible, insect allergen.

Dr Platts-Mills take home message in regard to allergen avoidance is that although specific advice varies for these three allergens, there are general measures you can take for avoidance of a range of allergens. Minimize allergen ‘reservoirs’ like carpets, sofas and curtains. Keep your home dry which reduces mold as well as house dust mite. A room air cleaner is very helpful, especially if used in conjunction with the above measures. Allergen avoidance may involve time, effort and expense, but the investment should pay off in terms of reduced symptoms and better quality of health and life.

There are hundreds of chemicals in use in the workplace that create air pollution and can harm your health. You might come across this air pollution in the form of dust, fibres, fumes or liquids. Industrial chemicals most often cause harm by inhalation or skin contact and the damage to your health can be immediate (a splash of acid causing a skin burn, for instance) or long term (mesothelioma - the deadly cancer caused by breathing in asbestos fibres). It is therefore important to know how to protect people from respiratory, and other, hazards, in the workplace. In the UK, we have workplace exposure limits (WELs) which are set under the Control of Substances Hazardous to Health (COSHH) regulations. WELs are concentrations of hazardous substances in the air (measuring in milligrams per cubic metre or parts per million) beyond which the employee should not be exposed. WELs are averaged over a period of time and both long term (eight hours) and short term (15 minute) exposures are specified. Prevention (keeping levels below the WEL) is achieved by employers in three ways:

• Change the process so the hazardous substance is no longer used.
• Replace the hazardous substance with a safer alternative (this is one of the main focus areas in ‘green chemistry’ which aims to transform many industrial processes so they are more human and environment-friendly.
• Enclose the process, or provide other appropriate protection measure such as air purification systems, so that everyone is protected.

There are hundreds of chemicals which have WELs and if a substance does not, do not assume it will be safe. Sometimes we just don’t know enough about a particular chemical and its effects on the human body. So it always best to err on the safe side and minimise exposures. The employer must do whatever it takes to remove hazardous, or potentially hazardous, substances from the air in the workplace. After all, no-one wants sick employees on their conscience, or to be subject to legal proceedings because insufficient protection was given. And, of course, the employee must play their part. Employees must follow the given safety rules. There are great number of options to create a save indoor environment, and Allergy Cosmos works with the leading manufacturers air cleaning systems in the industry to provide you with the best commercial air pollution solutions.

If you do not take the right precautions and there is a problem in regard health issues in the workplace, the Health and Safety Executive can investigate. Here are just three case studies to show how problems can be solved with HSE intervention:

Welders at work.

 Welding fumes can cause various lung problems, including chronic obstructive pulmonary disease (COPD), bronchitis and (rarely) asthma. A HSE inspector visited a welding company in Birmingham and found there were no proper measures in place to protect workers from the fumes. The management was asked to find ways of reducing exposure, but this was not done. So the company was served with a notice requiring them to do this work. At this point local air purification systems were fitted to all the welding benches.

A baker with asthma.

A maintenance fitter aged 54 had worked at a bakery for about 22 years. He was a non-smoker who had no history of asthma prior to this job. He complained of breathlessness, wheezing and coughing. His condition had been getting worse for 15 years and he found his symptoms improved when away from work. Tests revealed an allergy to flour dust. Management then made sure he worked away from the most dusty areas, issued him with air cleaning devices, and also improved overall air quality in the workplace. Two other workers with flour allergy have been identified in this bakery - and they are in better health, perhaps because their problem was discovered earlier.

Soldering problem.

Soldering fumes can cause breathing difficulties and this was so for an employee at a large company in Gloucester who developed occupational asthma. The company was found not to have adequate control measures in place. They delayed replacing rosin based solder (the source of the problem) with rosin-free solder for a considerable length of time. HSE fined the company £100,000 plus £30,000 costs for this breach, and they were subject to considerable adverse publicity.

If you have questions about improving the indoor air in your company, call us anytime for a free expert consultation at: 0800 0148 667.

The UK has one of the highest rates of children with asthma in the world, and London, as I often have to point out here, has a particularly bad air pollution problem, compared to other European cities.

So, is there a link between asthma in children and air pollution? We’re going to get some answers, for researchers at Guy’s and St Thomas Hospital, and King’s College, London, are studying children in Tower Hamlets, East London, who go to school near busy main roads. Childhood asthma is particularly bad in East London, with as many as 18% of kids being affected. The EXHALE (Exploration of Health and Lungs in the Environment) study is looking at the impact of London’s Low Emission Zone (LEZ), a scheme which charges the most polluting vehicles to drive in most parts of Greater London. The LEZ is the largest of its kind in the world. However, Mayor Boris Johnson has cancelled a third phase, which would have brought more vehicles into the scheme’s restrictions. He is worried about the impact it would have had on the owners of small vans and minibuses. So what is more important - the health of London’s children, or the financial outgoings of ‘white van man’? But I’m getting ahead of myself here. I can’t say that the LEZ does improve the health of kids with asthma, or prevent them getting asthma in the first place. But the findings of this new study should shed some light on this question, for it will compared data on children collected before the LEZ was introduced into Tower Hamlets in 2008 with data collected afterwards - then we’ll see what impact reduction in vehicle emissions has on childrens’ health.

Fortunately, there are measures that can be taken inside a school to improve air quality when there is pollution outside. One study showed that installing proper filters inside the heating, ventilation, and air conditioning system can be very effective. The research was carried out in nine classrooms in three schools in Southern California. Ultrafine particles, PM2.5 and PM10 particles, black carbon and volatile organic compounds (all part of the potent cocktail that is traffic pollution) were measured. A panel filter, a register based air purifier, and a standalone air purifier were all tested. Coupling a register based system with a panel filter reduced black carbon, ultrafine particles, and PM2.5s with an efficiency between 87 and 96% and the panel filter alone could achieve an efficiency of around 90%. It was not so easy to remove the PM10s, however, because these larger particles are easily stirred up and re-suspended with activities like walking and cleaning. Given that traffic pollution in London is not going to significantly improve in the near future, maybe schools should be looking at installing air cleaners to protect the respiratory health of their pupils?

And if you do have a child with asthma, there is also lots of good advice on how you can work with the school to keep them free of asthma attacks while they are in the classroom. We would also recommend to equip your child's bedroom with an asthma air purifier, such as the IQAir HealthPro 250.

http://www.allergycosmos.co.uk/blog/london-air-pollution-out-of-control

http://www.kcl.ac.uk/medicine/research/divisions/aalb/news/featured/exhale.aspx

It makes sense to clean up the air in your home with a HEPA (high efficiency particle arresting) filter, and there are many scientific studies backing up their use. Some of the studies have been larger and for longer then others. With a quick search, I found ten trials on the impact of HEPA filters, but the largest one involved only 45 people. Two of the studies involved children, which is a helpful because, we get often asked about HEPA filters by parents who want to improve their children's asthma symptoms. We do know, from previous research, that HEPA filters can reduce levels of airborne particles and of nicotine. A new study shows how HEPA filters can help children with asthma who are exposed to secondhand smoke. Not only does secondhand smoke make asthma worse, it is of course also associated with many other health risks.

A group of 225 children took part in the 'Cincinnati Asthma Prevention Study'. All the children in the study had physician diagnosed asthma and were divided into two groups. The first group got two HEPA filters, one of which was installed into the main activity room in the house, the other HEPA filter was installed into the child's bedroom. The other group acted as a control, with two inactive HEPA filters being controlled. All of the children were being exposed to secondhand smoke to the level of five cigarettes a day, or more.

So how did the active HEPA filters do? Very well! Having a real HEPA filter installed lead to a nearly 20% reduction in unscheduled asthma visits to the hospital. There was also a significant reduction in the level of airborne particles of less than 0.3 micrometres diameter in the group with the HEPA air filters, which is what you would expect from a HEPA filter. However, here were no reductions in gaseous pollution levels in the homes (that is, nitrogen oxide levels did not go down). This was of course expected, because gas pollution requires a different kind of filtration than particle pollution. That is why air filters such as the IQAir HealthPro 250 uses a medical grade HEPA filter in addition to a 5 pound blend of granular activated carbon and impregnated alumina.

The study also showed that a mere particle filter is not enough to significantly reduce asthma symptoms in children. The reason is that for controlling asthma symptoms, it is important to capture particle as well as gas pollution - both of which can be severe asthma triggers. To effectively reduce asthma symptoms in your child, it is also important that you buy the right kind of HEPA filter. The amount of air flow, system leakage, as well as different filter stages are key factors to consider. 

Ideally, children would not be exposed to secondhand smoke at all. But in the real world, tobacco control is imperfect and more than one fifth of children are exposed to secondhand smoke at any given time and for most of them, this will exacerbate their asthma. According to this study there is much that can be done to reduce indoor air pollution - better ventilation, for example, as well as having a HEPA air filter are part of a multi-faceted strategy to do so.

Source: Lamphear BP et al Effects of HEPA air cleaners on unscheduled asthma visits and asthma symptoms for children exposed to secondhand tobacco smoke Pediatrics online December 13 2010 

http://www.cincinnatichildrens.org/research/project/enviro/projects/cinti-asthma/default.htm

Another concerning fact about Brazilian Blowdry and other hair-straightening procedures has caught my attention. In March, The Mail ran an alarming piece about how the straightening treatment caused a salon in the UK to fill with headache and nausea-inducing formaldehyde fumes and, it turned out, this was far from an isolated case. The article stated that the makers of Brazilian Blow Dry face a class action lawsuit from over 200 people who claim it has caused health problems.

Now the Occupational Safety and Health Administration (OSHA) in the US have issued a hazard alert on Brazilian Blowdry and other hair-smoothing products. OSHA has been investigating complaints from stylists and salon owners and found formaldehyde in the air when some of these products are used. This is despite the fact that some of the products are actually labelled as being ‘formaldehyde-free’ and come without any kind of warning.

Formaldehyde is a colourless, pungent-smelling gas which may present a serious health hazard if it is inhaled, or comes in contact with the eyes or the skin. It can irritate your eyes and nose and cause coughing and wheezing. It is a potent sensitiser and may cause allergic reactions of the skin, eyes and lungs. It can even cause blindness and has been linked to development of cancer of the nose and lung. (For more information on the health consequences of being exposed to formaldehyde, see the OSHA formaldehyde fact sheet on their website). Formaldehyde's role in hair straightening is to bond the keratin (a natural hair protein) in the product to the hair. Formaldehyde has long been used in the textile industry to straighten wool.

The way formaldehyde reacts in the hair smoothing products mean that it could well be present in a different (but still hazardous) chemical form. This provides a loophole that allows the product to be labelled ‘formaldehyde-free’. These other forms are: methylene glycol, formalin, methylene oxide, paraform, formic aldehyde, methanol, oxomethane, oxymethylene or CAS Number 50-00-0. So stylists, salon owners - and customers - need to check labels carefully. If any of these chemicals are present at a concentration of 0.1% or more then a number of measures should be implemented in the salon - such as installing air cleaners, proper ventilation, staff training, availability of hazard information sheets, and so on. The European Union has set the ‘safe’ level of formaldehyde in a hair straightening product at 0.2% and Italy, German, France and Ireland (but not the UK) have banned products containing more formaldehyde than this.

Air quality in hair salons is really important - even more so for the employees who are there day in day out than for clients. Hair smoothing lotion is only one of many, many potentially hazardous chemicals which may be present on the premises. Adequate ventilation and air purification is, of course, key to a safe salon. If formaldehyde is present, then an air purifier fitted with the right gas absorbent filter cartridge will be able to deal with the problem. The best available stand alone systems include the IQAir GC Chemisorber or the GC MultiGas.

If you are looking to improve the air quality in your hair or nail salon, call us anytime for a free expert consultation at 0800 0148 667.

In the largest food allergy study to date, researchers at Johns Hopkins Children's Center, and elsewhere, reveal that 2.5 percent of the US population have at least one food allergy. They also found a strong link between food allergy and asthma. This is a particularly valuable study - not just because of its size but because the researchers measured antibodies in the blood as well as asking participants if they have an allergy. So all reported cases of allergy were confirmed clinically.

The study involved more than 8,200 participants who suffer with allergies, aged between one and 60. The researchers investigated for four different food allergies and for links between food allergies and asthma, eczema and hay fever. The most common food allergy was peanut allergy, affecting 1.5 percent of the population. Next came shrimp (1 percent), eggs (0.4 percent) and milk (0.2 percent). And 1.3 percent were affected by more than one food allergy. Allergies were most common in children aged five or younger, with 4.2 percent being affected. This age group was more than twice as likely to have an allergy as those aged over 20. Also, african-americans were three times more likely to have a food allergy than white americans, and men were twice as likely as women to be affected. Therefore, african american boys were more than four times more likely as white women over 20 to have a food allergy.

Food allergies were also more common among those with asthma. For people with asthma, the risk of having a food allergy was increased four fold compared to those who did not have asthma. And people with food allergies had a seven fold increased risk of needing emergency treatment for asthma compared to those without food allergy. People with food allergies were also rather more likely to be diagnosed with hay fever, but this link wasn't nearly as strong as the link between food allergy and asthma.

'Our findings confirm a long-suspected interplay between food allergies and asthma, and that people with one of the conditions are at higher risk for the other,' said investigator Dr Robert Wood, who is Director of Allergy and Immunology at Hopkins Children's Hospital. He notes how many children experience what he calls an 'allergic march', developing food allergy first, and then getting asthma and hay fever later. Does this sound familiar? While this research was not designed to identify a 'cause and effect' relationship between food allergy and asthma, it certainly paints a compelling picture of the state of allergy today.

The best way to control allergy and asthma symptoms is to practice allergen avoidance. Check out our range of allergy and asthma friendly cleaning products from Allersearch and filter the air in your home through the use of an indoor air purifier.

Liu A National prevalence and risk factors for food allergy and relationship to asthma: Results from the National Health and Nutrition Examination Survey 2005-2006 Journal of Allergy and Clinical Immunology October 2010

Is air pollution in London now out of control? Simon Birkett, Director of Clean Air in London has just pointed out that the capital has, by far, the worst nitrogen dioxide pollution in Europe. London stands to face huge penalties from the European Commission, which oversees legal standards for pollution levels in Member States. A number of other areas in the UK are not far behind London levels of nitrogen dioxide pollution (Eastern, East Midlands, Glasgow, Kingston upon Hull, Greater Manchester, North East, North West and Merseyside, The Potteries, Southampton, South East, South Wales, Teesside, West Midlands, West Yorkshire, and Yorkshire and Humberside).

Simon Birkett said: "London has the highest concentration of nitrogen dioxide of the 27 capital cities in Europe after a decade of inaction by successive Governments. London has twice now breached within days legal standards required since 1999 to be met by January 2010 and concentrations near our busiest roads average well over twice the legal limit."

So, if you do live near a busy road, these are a couple of the short term health threats you face when you step out of doors:

• Flare ups for asthmatics
• Decreased lung function in chronic obstructive pulmonary disease
• Increased risk of lung infection for kids
• Eye, nose, throat irritation.

The long term health effects of air pollution are more severe and range from cancer, heart attacks to low birth weight. Nitrogen dioxide is a product of burning. Outdoor nitrogen dioxide pollution - which UK environmental legislation is clearly failing to control - comes mainly from vehicles burning petrol and diesel. But don’t think you can escape nitrogen dioxide by staying indoors. There really is no hiding place. Outdoor air pollution can accumulate indoors as it seeps in through windows, doors and other openings. Furthermore, gas stoves, heaters and environmental tobacco smoke are potent sources of nitrogen dioxide pollution. So that in many homes, indoor nitrogen dioxide pollution actually exceed levels outdoors.

You should protect your health from nitrogen dioxide by taking the following steps:

• Install and use an exhaust fan vented to outdoors over gas stoves or change to an electric stove.
• Have a thorough check of gas central heating every year.
• Keep all your gas appliances properly adjusted.
• Use an air purifier with a significant amount of quality gas filtration media.

There are no agreed standards for acceptable maximum levels of nitrogen dioxide in indoor air (the same goes for many other pollutants). But we do have standards for outdoor air. How come other countries are tackling the problem and stay within legal limits for nitrogen dioxide pollution? If you have some suggestions please let me know. Until then: Come on Boris, Dave - give us a convincing plan. We don’t want EC fines and penalties - the NHS needs that money to treat people that already have chronic respiratory problems due to the high levels of air pollution in the UK.

Research carried out by Dr. Bill Wolverton at NASA's Stennis Space Center has investigated how plants are able to remove pollutants from indoor air. The goal of Dr. Wolverton's decade long research was to find out how plants can help humans spend long periods of time in outer space. Dr. Wolverton was especially interested in preventing the inhabitants of the Skylab space station from getting sick due to off-gasing of chemicals from building materials. Formaldehyde, benzene, and trichloroethylene are just some of the potential carcinogens and irritants that building materials produce as by product. These irritants can quickly accumulate and create a toxic indoor environment, leading people to suffer from what is called "Sick Building Syndrome".

Dr. Wolverton's research showed that some plants emit water vapour that pull contaminated air towards their roots. Leaves, roots and bacteria in the potting compost can then work together, through a series of complex biochemical mechanisms, to pull pollution out of the air. Some of the plants that are better at removing pollution from the air then others are:

• Mother-in-law’s tongue. A semi-succulent with sharp, thin leaves. Tough, survives neglect and does not care for over-watering.
• Janet Craig. Very easy to look after. Grows large so you could put it on the floor. Does not like too much water and survives low light. Related species are Marginata and cane plants (look for species starting with Dracaena).
• Peace Lily. Likes humid conditions, away from the sun. They will flower if you keep them nearer to a window.
• Bromeliads. These plants have lovely striking flowers and can last for months. They will require regular watering. Good for warm rooms.
• Zanzibar gem. Almost impossible to kill off - can survive with little water and little light.
• Yukka. A long-lived, slow growing plant which does not like too much water and needs to be near a good light source.

Dr. Wolverton found that philodendron, spider plant and golden pothos (Devil’s ivy) were best at removing formaldehyde, which is very common and is a particularly troublesome indoor pollutant. Flowering plants gerbera daisy and chrysanthemum also remove small amounts of pollution - good if you like a splash of colour.

It is important, however, to point out that it is not realistic to significantly reduce the levels of general air pollution in your home through the use of household plants alone. It would require an entire building filled with plants to improve the air quality in a small flat. The reason for this is that plants do not process air fast enough to clean an indoor environment. So if you are serious about improving indoor air quality, we would not recommend to rely upon indoor plants to do the job, but rather use an electronic air purifier with a HEPA filter.

The US Environmental Protection Agency (EPA) recommends to consider the MERV rating of an air cleaner. MERV stands for Minimum Efficiency Reporting Value, which is the ability of the purifier to clean the air. A good HEPA filter should have a MERV value between 17 and 19 and, if it does, you can be sure that it will be between 99.97 and 99.999 % efficient in removing particles of 0.3 microns diameter. Remember, too, that HEPA, as the name suggests, filters particles out of the air, but not vapour or gas molecules. So you might need to add an activated granular carbon filter to deal with gaseous pollution. Also, bear in mind that HEPA-type or HEPA-like filters are not the same as HEPA filters (which must meet certain standards to qualify as a proper HEPA filter). The term HEPA-type can mean almost anything, but some air purifiers with HEPA-like filters can be a good alternative if you are looking for a unit with a high air flow rate and a very quiet operation. The drawback is that the filtration efficiency can be significantly less.

Paediatric allergist Dr. Adam Fox explained to an audience of hay fever sufferers at this years Allergy Show that there are four approaches to managing allergic rhinitis. These are:

• Allergen avoidance
• Medication
• Desensitisation
• New and emerging therapies

Allergen Avoidance

Pollen gets everywhere so this is one allergen that’s especially hard to avoid. And 2011 is shaping up to be a bad year for pollen in many places. Aim to keep pollen out of your bedroom at the very least. ‘A lot of my patients find washing their hair when they come indoors useful,’ said Dr Fox. It’s also a good idea not to go into your bedroom in outdoor clothes - get changed into relaxing or night time clothes first. Pollen traps like Haymax may be helpful for some people.

Cat allergen is very light and easily stirred up into the air. It can persist up to two years after the animal has left the premises - and some people are so sensitive to cat allergen that they will react even if they sit next to someone who owns a cat (at school, for example). Advising on house dust mite avoidance, Dr Fox said that using a leakage free vacuum cleaner with a HEPA filter on a carpet could be as effective as replacing that carpet with hard flooring. As with pollen, the focus with HDM allergen should be on removing it from the bedroom. A high quality mattress cover can help here (do your research, because quality of products on the market does vary a lot, and most allergy bedding is not breathable so that it can get very warm and sweaty). 

We would also recommend as part of allergen avoidance to use allergy friendy cleaning products as well as a high quality air purifier.

Medication

Always go for a long-acting non-sedating antihistamine to control sneezing and other allergic rhinitis symptoms, said Dr Fox. Too many people mistakenly go for the short-acting sedating antihistamine which will produce drowsiness (already bad enough if your hay fever interferes with sleep). For nasal congestion, choose a nasal steroid. ‘This is probably the most effective medication we have for rhinitis,’ commented Dr Fox, adding that parents need not worry about the safety of these drugs. ‘Take medication regularly and start before onset of hay-fever symptoms for maximum effectiveness.’

Around 80% of people with asthma also have allergic rhinitis. The current thinking is that the two conditions are closely linked because they affect the bottom (asthma) and top (rhinitis) of what is essentially a continuous ‘united airway’ system. Effective rhinitis treatment has now been shown to reduce the risk of hospitalisation for asthma, so it is worthwhile finding the medication that works best for you. If antihistamines and nasal steroids do not do the job, then there is Singulair (montelukast) which is a prescription medicine used for asthma and allergies.

Desensitisation/allergy shots/immunotherapy

In the desensitisation approach, the system is ‘flooded’ with allergen so that the body will eventually learn to ‘ignore’ it. It is actually the 100th anniversary of the first use of this approach this year - although it has only recently come into its own as a successful allergy treatment. Patients have to be carefully selected, and treated in a specialist centre. The procedure now involves only four injections and has been shown to give good results. There is also a home version known as sublingual immunotherapy, in which the patient places medication under the tongue (currently only available for grass pollen allergy). People with hay fever are eight times more likely to have asthma, which fits in with the ‘united airway’ idea. The significance of treating your allergic rhinitis for long-term results with immunotherapy is that it may prevent asthma in the future. ‘This will be a huge result if it turns out to be the case,’ said Dr Fox, referring to an ongoing European study designed to test this.

Emerging therapies

A number of other approaches to managing hay fever have been suggested including:

• Saline nasal douching
• Probiotics
• Ultraviolet light
• Acupuncture

Kissing (apparently a Japanese study suggests that half an hour of kissing can alleviate hay fever!)

On a more scientific note, there is a new - but very expensive - antibody drug called omalizumab which targets the IgE antibody produced by the allergen. This approach gets to the root cause of hay fever, because IgE activates mast cells, making them produce histamine which triggers the allergic symptoms.

Cats are in most households a much-loved member of the family, but its odour and dander can create severe problems for anyone with allergies or multiple chemical sensitivity (MCS). Exposure to cat dander increases the likelihood of developing allergies or asthma and experiencing allergy symptoms. But even if you are not allergic, cat odour is just unpleasant around the home and it builds up over time. My friend who is also a cat lover had particular problem with the odour from her cat when she want to sell her home. She did not mind it too much, but her estate agents and potential buyers noticed it right away and were not pleased.

There are a number of things you can do to cut down on cat odour in your home. If your cat is an indoor cat - as many are in urban areas - then you will need to use a litter tray. Make sure this is cleaned out regularly. Yes, it is another chore but a dirty litter tray puts you and your family’s health at risk. High quality cat litter will also absorb more odor than the cheap stuff. Also, did you know that cats fed on cheap cat food tend to emit more odor than those fed on quality brands - so please don’t be tempted to economise (at least not on your cat!). Male cats emit stronger odour than females - they use it to mark out their territory. But females produce extra ‘scents’ when they are on heat. Don’t be tempted to burn candles or use air fresheners to mask cat odour - people with MCS may well react to the smoke or chemicals in these products, and the chemicals will make general allergy and asthma symptoms worse.

Cat odour comes mainly from the animal’s urine and a major component in it is ammonia (the smell of rotting fish). An air purifier such as the IQAir GC AM is especially designed to remove molecules of ammonia and related compounds known as amines. The GC AM air purifiers contain specialty gas filter cartridges packed with 5.4 kilograms of wide-spectrum media mix of granular activated carbon and KMnO4 impregnated alumina. This media mix absorbs ammonia, amines, and ammonia-based odours. The GC series of air purifiers are the most effective air cleaners of their kind, and they are used in domestic as well as professional environments where odors and gases are a problem, such as veterinary settings, mortuaries and autopsy labs, hospital wards and hair, nails and beauty salons. Another IQAir purifier model of the GC series is the IQAir MultiGas. It removes the wides range of chemicals and odors from indoor air. The GC MultiGas air cleaner has especially been developed for people with multiple chemical sensitivity.

Of course, cats - and other animals - also produce dander, which can be a potent allergen. The proteins in a cat’s saliva and sweat can trigger asthma attacks or other allergy symptoms. The IQAir series of air purifiers contain a HEPA filter, so that they will filter out virtually all allergens from the air. Cat dander particles are very small - typically between 2.5 and 0.5 microns in diameter and are readily stirred up into the air. The HEPA filter, however, will easily trap them, as well as much smaller particle such as fine dust and viruses.

The house dust mite is one of the most potent and common triggers of allergic reactions like hay fever symptoms (running eyes, sneezing), asthma (wheezing, breathing difficulties) and childhood eczema. House dust mites are tiny (200-300 micron long) eight-legged creatures related to the spider and they are found in every human habitation. There are two common species of dust mites - the European house dust mites (Dermatophagoides pteronyssinus) and the American house dust mite (Dermatophagoides farinae). It is not dust mite itself which is the allergen, but digestive enzymes (proteins) contained in its droppings. The whole droppings themselves are particles between 4 and 20 microns in size, but may crumble into smaller particles that can be as small as 0.5 microns across.

How to kill dust mite?

Know your enemy! Here are some important facts about house dust mite which you can use to help rid your home of this pest.

• The fight is endless - dust mites are everywhere and even if you were able to get rid of all of them in your home, new ones would still appear (they are carried into your home on people’s clothing, for instance). So look for long-term solutions which will reduce your HDM burden.
• Dust mites are to be found mainly in bedding, soft furnishings and, to a lesser extent, carpets. It is easy to disturb them - getting into and out of bed, for example - and throw up a large cloud of allergen which tends to stay near the source, rather than float in the air.
• House dust mites feed on the skin scales in dust
• Mites prefer humid conditions. To survive they absorb water from the air and when humidity is less than 50% they tend to dry out

Here are some good tips for keeping house dust mites under control.

• If you are thinking of serious home improvement anyway, think about replacing upholstered sofas and armchairs with leather or vinyl covered furniture, which house dust mites cannot penetrate. Consider replacing carpets with hard flooring. This will create an entirely new environment which could seriously reduce the dust mite burden in your home.
• Tackle dust mites in bedding - start afresh with new mattress and pillows and cover with mite-allergen proof covers (research has shown this does improve asthma in children allergic to house dust mite). Washing bedding regularly with allergy friendly laundry detergent such as Allergen Wash from Allersearch.
• Damp dust everywhere regularly to get rid of the house dust mite source of food. Use an effective allergy dust spray such as ADS or ADMS from Allersearch, it will destroy the allergy symptom causing protein on contact. Get rid of any clutter where more dust can build up.
• It is crucial to get rid of dampness in your home. Ventilate by opening windows, and check for condensation in the kitchen and bathroom.

How to get rid of dust mite allergens?

Killing dust mites by lowering humidity and removing dust will not automatically remove dust mite allergen in your home although over time the amount is sure to decrease because you have tackled it at source. The allergen will still persist in bedding, soft furnishings and so on. Therefore, tackle these reservoirs of allergen. Vacuum (we recommend Miele), use a good air purifier (ideally IQAir), dust with an allergy friendly cleaning product, and wash laundry with Allergen Wash to remove as much allergens as possible.

Hay fever (seasonal allergic rhinitis) affects hundreds of thousands of people, according to Dr Adam Fox paediatric allergist at Guy’s and St Thomas’ Hospital, London. He told an audience (mainly consisting of hay fever sufferers) at The Allergy & Gluten Free Show 2011, held in London recently, that hay fever is a relatively new disease, first described in 1819. It took nine years to accumulate sufficient hay fever cases to present a paper describing the new condition and the hay fever symptoms to a medical journal. Nowadays hay fever is so much more common, particularly in the UK, which has more cases than anywhere else in the world (followed closely by Ireland, New Zealand, Australia and Canada). ‘We do not have a good answer as to why this is,’ noted Dr Fox, adding that:

• 10-25% of adults in the UK have hay fever
• Hay fever affects 10% of children aged 6-7 and 15% of those aged 13-14
• Today, hay fever is also being seen in children as young as three and four

According to Dr Fox, pollen is the most common allergen involved in causing hay fever symptoms. Grass pollen (in season between April to June) is the most common pollen allergen, followed by tree pollen (in season between February to April). Other allergens, including house dust mite, cockroach, traffic pollution, mold, dog, cat, and horse, are involved in non-seasonal allergic rhinitis.

Typical hay fever symptoms are runny eyes and nose, sneezing, nasal congestion. But hay fever also has a significant impact on quality of life. Note that GCSE exams occur within the pollen season and impaired concentration, from either hay fever itself or the medication taken for it, has an impact on performance. We know this is so from a study carried out by Dr Sam Walker at the Royal Brompton Hospital. She looked at nearly 2,000 GCSE candidates aged 15-17 in the West Midlands and found that those who had hay fever were 40% more likely to drop a grade between their mock exams, held earlier in the year, and the formal exam held in the summer, when compared to those who did not have hay fever.

Moreover, those who took sedating antihistamines to control their condition (which Dr Fox does not recommend) were 70% more likely to drop a grade. Dropping grades between mocks and GCSEs is unusual. Students often find their mock grade a motivating factor and might be expected to improve on it, or at least do no worse. The fact that hay fever, and sedating antihistamines, interferes with academic performance in this way should highlight the need for early and effective treatment of allergic rhinitis. Dr Fox went on to describe the hay fever treatments available today - including some exciting new developments. We will describe these in an upcoming blog post.

Source: Walker S et al Seasonal allergic rhinitis is associated with a detrimental effect on examination performance in United Kingdom teenagers: case-control study. J Allergy Clin Immunol 2007;120:381-7

Environmental tobacco smoke (ETS) is the smoke emitted from cigarettes, pipes and tobacco. Now that smoking has been banned in so many public places, pollution through secondhand smoke is not a problem anymore in most pubs, restaurants or clubs. Nevertheless, indoor air pollution due to cigarette or cigar smoke is still a major concern for many people within their home. If you have a neighbour that is a heavy smoker, or live near a place where people smoke (such as the garden of a pub), chances are that you will be exposed to a significant amount of chemical pollution from secondhand smoke.

Environmental tobacco smoke is a potent cocktail of over 4000 different substances and chemicals - some in particulate form (over a wide range of particle sizes from over 10 microns to as small as 0.01 microns) and some in the form of gas molecules (which are even smaller). Over fifty of these are known to cause cancer and, of course, ETS is also bad for the heart and lungs. You’re probably well aware of the health hazards of cigarette or cigar smoke, but here are a few reminders:

• Tobacco smoke also causes lung problems and makes kids more prone to bronchitis
• Tobacco smoke triggers asthma attacks in many and makes the condition worse in the long term
• If you had asthma as a child and ‘grew out’ of it, it is likely to reappear if you take up smoking as an adult

Added to this, stale cigarette or cigar smoke creates bad odors which linger long after the smoking has stopped. It clings to your furniture, curtains and carpets. There are two types of environmental tobacco smoke - the mainstream, which is the smoke the person smoking exhales, and the sidestream, which is the smoking coming from the burning end of a cigarette, pipe or cigar. Sidestream smoke actually has higher concentrations of toxic compounds than does mainstream smoke. Sidestream smoke tends to contain smaller particles, the ones most likely to lodge deep in your lungs when inhaled. In a smoke-filled room, 85% of cigarette or cigar smoke is of the sidestream variety, putting the health of the non-smokers present at risk.

So what can you do to protect your health from cigarette and cigar smoke? An air purifier can be the most effective step in controlling tobacco smoke air pollution in your home. To effectively capture and retaining smoke pollution, an air purifier has to fulfil a couple of general and specific criteria.

As with all air purifiers, you want to make sure that the purifier uses a high efficiency filter, that the filtration system is more or less leakage free, and that the unit creates enough clean air for the room size that it is used in. The particle pollution of tobacco smoke is best captured by a HEPA or HyperHEPA filter, because these filters have the best filtration efficiency without obstructing the air flow too much.

The chemicals and odours that are produced by cigarette smoke can be controlled by a filter that consists of a mix of activated granular carbon and activated alumina which is impregnated with potassium permanganate. Activated granular carbon can remove gas molecules and trap them in its porous carbon structure through an absorption process. Activated carbon does that especially effectively for molecules with a high molecular weight. (Important is here that it is granular and not carbon dust). Gas contamination with a low molecular weight is best controlled through chemically activated alumina, which is made out of activated alumina (AI203), which is impregnated with potassium permanganate (KMn04). This material binds the molecules and destroys them through an oxidation process.

So when buying an air cleaner for tobacco/cigarette smoke, make sure to check what material the air purifier is using to actively capture and retain the particle and gas molecules that are produced through smoking. You also want to make sure that an adequate amount of the smoke controlling material is being used.

The IQAir GC MultiGas is generally acknowledged as the best air purifier for smoke and chemical pollution. It can effectively trap particulate pollution and absorb gaseous molecules in ETS. The high efficiency particulate (HEPA) filter traps 99 % of particles down to 0.3 microns and the system also contains 17 pounds of gas phase filter media in four cartridges to remove the gaseous element.

If someone in your family or home has asthma, an asthma air purifier can help by reducing the load of common asthma triggers in the air. Common asthma triggers are animal and house dust mite allergens, pollen, fungal/mould, chemical, as well as general traffic pollution.

Animal allergens (sometimes known as pet dander).

Cats, dogs, horses and smaller animals like hamsters and mice, fancy rats, snakes and insects all produce proteins within airborne particles which can trigger asthma, although their source varies. With cats, it is the sweat and saliva that contain the allergen, while with mice, rats and rabbits, it is their urine. The size of animal allergen particles varies between 0.1 to 10 microns. Cat allergen particles are at the lower end of this scale and are easily stirred up into the air, which means that they can readily be trapped by a HEPA filter (high efficiency particulate air filter) in an asthma purifier. This could be a satisfactory alternative to the more drastic and often dramatising solution of giving your pet away. You might also consider washing your pet with Pet + pet shampoo, it is especially developed for people suffering from asthma and allergies. Keep in mind that using an air purifier and asthma friendly cleaning products will not only protect yourself and your family from increased asthma and allergy symptoms, but can also protect your pets from developing respiratory problems.

House dust mite

The dead bodies and the droppings of this microscopic spider-like creature contain one of the most potent asthma allergens. House dust mite (HDM) has been very extensively studied. We know that dust mites live on house dust (which is mainly flakes of shed human skin) and they like dark and damp conditions. That should immediately suggest two simple, practical ways of dealing with the problem. 1.) Don’t allow clutter, which collects dust, around your home, and 2.) keep humidity levels low, by keeping the place well ventilated and refrain from using a humidifier. But what about an air purifier? Dust mite droppings are in the size range 0.1 to 30 microns. Some dust mite droppings break into tiny pieces that are at the lower end of this size range, but the whole droppings are heavier than cat allergen particles and are less likely to be stirred up into the air. Therefore, an air purifier with a high filtration efficiency and a large enough air flow can take all dust mite allergens out of the air 2-3 times per hour. But you should also make sure that pillows and mattresses (a major source of direct inhalation) are as dust mite free as possible, and are washed with asthma laundry detergent, such as Allergen Wash Laundry Detergent from Allersearch.

Pollen grains

 Some people suffer from pollen asthma and will notice that their asthma is worse in the pollen seasons. But, unlike those with hay fever, they tend to have symptoms all year round. Like other forms of outdoor pollution, pollen grains can easily travel indoors (through an open window or on your clothes when you come indoors, for instance). Pollen grains have a size range of 0.3 to 100 microns. Most whole pollen grains are between 20 and 35 microns in size but some plants, like ryegrass, produce tiny fragments of pollen which are nearer to the lower end of the size range. You also have to be aware that pollen grains can easily fracture and break into many small pieces - which can cause strong asthmatic reactions. For that reason, you might not notice much of a difference when using a pollen screen on your windows. These kind of screens will only block the largest pollen grains from entering your home. A HEPA purifier such as the IQAir HealthPro 250, however, will help you rid the air in your home of pollen allergens of any size.

Fungal/mould spores

Mould is a microscopic type of fungus (a mushroom is a much bigger fungus!) and its spores are like the seeds of a plant - they are the way it reproduces itself. Mold spores travel through the air and, like pollen, they are readily brought indoors. Mold spores can also trigger severe asthma symptoms. The best approach to tackling mould is to get rid of damp in your home. But a HEPA filter can back up such efforts by filtering the tiniest mold particles out of the air.

IQAir HealthPro 250, HealthPro 150 models and the Allergen100 all contain a hospital grade HEPA filter called HyperHEPA which removes 99.5% of particles larger or equal to 0.003 microns in diameter and are ideal for people suffering from asthma. The IQAir range of air purifiers can deal with all of the asthma allergens described above and more...

If you have asthma then Tuesday May 3 is your special day. World Asthma Day has been held on the second Tuesday in May every year since 1998. It is organized by the Global Initiative for Asthma (GINA), and works to improve quality of life for people with asthma around the world. GINA brings together healthcare professionals and public health experts in campaigns to reduce the global prevalence, morbidity and mortality of asthma.

Just a few facts and figures on asthma:

• The World Health Organization (WHO) says that 300 million people around the world have asthma and its prevalence is increasing.
• WHO believes there will be another 100 million people with asthma by the year 2025.
• Globally, around quarter of a million people die because of asthma every year.
• Recent research from the Tasmanian Longitudinal Health Study suggests that children with eczema and hay fever are more likely to develop asthma in adult life.
• According to a new study in the Journal of Sexual Medicine, asthma almost doubles the risk of erectile dysfunction.

The theme of this year’s World Asthma Day is ‘You Can Control Your Asthma’ continuing the more positive patient-centred outlook begun in 2007. I think positive phrases make a difference to these health days. Compare the above to ‘The Burden of Asthma’ (2004) and ‘Unmet Needs of Asthma’ (2005, 2006) - which create an image of asthma patient as victim. Better to take control, don’t you agree?

On World Asthma Day, GINA will be launching the next phase of its campaign to reduce hospitalizations for asthma by 50% by 2015. Did you know that according to Asthma UK 75% of all admissions to hospital for asthma are avoidable. One good step is avoiding asthma triggers in your home, school or place of work.

It makes a lot of sense to target an asthma campaign on hospital admissions - because these usually indicate treatment failure, they are disruptive to the person’s family and work life, and they are expensive to the NHS. And it is easy to measure a hospital admission because the figures are recorded and accessible to researchers.

The Asthma Control Challenge that GINA is running are asking for public health authorities, government health departments, non-governmental organisations, and respiratory societies to form groups dedicated to join in the Challenge. They will collect data on admissions and work out strategies for improving asthma controls. GINA will support their efforts with guidance on data collection, developing evidence based guidelines on asthma control, and collecting and sharing the results.

In the UK, there are a couple of interesting events going on to mark World Asthma Day 2011. Central Manchester Foundation Trust reflects the ‘control and management’ theme by focusing upon correct inhaler use. And in Liverpool, there are activities showing how acupuncture might help with asthma.

My husband and I have been living in London for four years now, and enjoy it very much. However, there are some downsides, such as the high level of air pollution in the city. At first I did not notice it, but after a little while the pollution level became very apparent. You just have to blow your nose after taking the tube or look at the collar of your shirt at the end of the day and you will see what I mean.

I started looking for an air purifier. At first, I casually checked my local Tesco and Argos stores. I knew the quality of the air cleaner might not be the best, but I wanted to know my options. The sales people in both stores did not know very much about the purifiers they were selling. I had to trust the manufacturers’ claims listed on the box. All of these claims were too good to be true. I could not shake the feeling that I could be buying just another ‘gadget’ that would not work and would end up cluttering my closet - just like the ‘reasonably priced’ iron I bought a little while ago at Argos. It was cheap, but it did not iron, and in the end it was £25.00 wasted.

From the research I did on air purifiers, I know the unit needs to produce enough clean air to make a difference in our bedroom. Most units I saw were either too small or did not specify how much clean air they produced - which made me very skeptical. The purifier should also have a filter, ideally a HEPA filter. If the purifier does not have a filter, where does the pollution go? Another thing that was important to us was the sound level. The air purifier must be very quiet, because my husband is a light sleeper.

In the end I decided on the Blueair 450E purifier. It ticked all the boxes in terms of what we were looking for. It generated enough clean air for our bedroom, but also for our large living room, in case we decide to move it there. It does not have a HEPA filter but instead has a 'HEPA-like' filter, which is supposed to capture almost all particle pollution. (I was told that the difference between a HEPA filter and a HEPA-like filter is that the HEPA-like filter needs to be replaced more often - every six months). The unit also promised to be extra quiet. Additionally, I liked having the option of using a smoke-stop filter at a later point. This would be excellent for the summer when my husband and I host guests - some of which smoke.

Ordering online at www.AllergyCosmos.co.uk was very easy. I used my PayPal account when placing the order, which was quick, and the air purifier arrived the next morning. I was very happy to see that VAT and the cost for express shipping was included in the original price I was quoted, and that there were no hidden costs. The purifier was very well packaged, with several layers of foam support on all sides. Besides the air purifier, the shipment came with a user manual, power cord and a manufacturer’s warranty card. The Blueair 450E had a solid grey colour down the middle and an off white colour on the sides. I was very pleased with the design and colour combination because it blended in well with our house decor.

When I turned the 450E on, its electronic display came on, and the unit was already set on “Automatic” mode. When the Blueair 450E is on automatic, it assesses the pollution level in the room and chooses the appropriate speed setting. This is quite practical because we don’t have to think much about changing the settings. In the compartment next to the display, which is on top of the unit, there is a remote control. On level two, the Blueair 450E is near silent. I put my hand in front of the purifier to feel the strong air flow, to make sure it was running. One of the side panels opens for when it is time to exchange the filter.

The Blueair 450E is now in our bedroom and it is always on, alternating most of the time between level one and two. Sometimes we put the setting on level three. We have had the unit for four weeks now and I can truly say that we are very happy with it. My husband and I have even decided to buy a 650E for our living room.

Click here to see the entire range of Blueair air purifiers.

A HEPA air purifier is a powerful weapon in your fight against mold because it will effectively capture mould spores in the air. But it is also important to tackle the main cause of mold, which is damp conditions and, if mold has built up, to remove it - either with a bleach-based cleaner, a non toxic anit-allergen spray such as ADS from Allersearch, or if it is really bad, with professional help.

Mould is the name given to small, multi-celled fungi. Mushrooms are also fungi, as are yeasts, which are single-celled fungi. Moulds include the black mould Stachybotrys chartarum which is often mistaken for ordinary household dirt and the dark-coloured Alternaria mould which often lurks in bathrooms and can trigger severe asthma attacks. A recent paper in the journal Thorax reveals that the presence of mould and dampness in the home can lead to a deterioration in lung function. Researchers in Uppsala, Sweden, carried out lung function tests on participants in the European Respiratory Health Survey once between 1990 and 1995 and again nine years later. Dampness (water damage, damp spots) and indoor mould were also assessed and a dampness and mold score assigned to each participant’s home. Dampness and mould were common, affecting around half of all the dwellings. Their presence was associated with a decline in lung function, particularly among women.

The problem with moulds is that they produce spores which are like the seeds of a plant in that they are the means by which the mould reproduces. Mould spores (sometimes also called fungal spores) are very easily carried around your house or office by air currents. The spores have a diameter between one and 100 micrometers (microns - a millionth of a metre). Like other particles, such as the PM10s found in traffic pollution, mould spores can cause a range of respiratory problems if they are inhaled. They are best dealt with by being trapped in a HEPA filter such as the hospital grade filter found in the IQAir HealthPro 250 and HealthPro 150 which removes particles down to 0.003 microns with more than 99% efficiency. We recommend the IQAir purifiers, because they move the right amount of air for an average to large room (40-380 m3 per hour depending on its speed setting), its filtration efficiency is the highest in the industry (filtering virtually all particle pollution out of the air, including viruses and bacteria), and each purifier comes with a guarantee that 100% of the air that comes out of the unit has been cleaned.

But with moulds, as with any other allergen, it is also important to look at allergen avoidance. Be aware of where, and how, mould patches can develop and be vigilant on preventing this happening. Molds love damp so you are likely to find them flourishing in the following locations:

• Rooms with a lot of indoor plants (check the conservatory, for instance) because there are invisible moulds on the surface of the soil in the pot
• Cellars and basements, where there is damp air because of limited ventilation
• Farms, holiday cottages
• Unheated rooms, where condensation is more likely
• Buildings near water - lakes, seaside, rivers - because the air is damp
• Old houses
• New houses with insufficient ventilation - where too much emphasis is placed upon energy efficiency
• Bedrooms with wardrobes full of old clothes - be specially wary of that mildew smell

Tackling mould involves getting rid of the damp and then getting rid of the mould itself. Reduce moisture by getting rid of humidifiers and dealing with any cracks, leaks or rising damp. Close the kitchen door and/or open a window when you are cooking and consider having an extractor fan in the bathroom. Dry clothes outside whenever you can. And do get rid of carpet in the bathroom. Don’t be afraid of fresh air! Open the windows and let some air in whenever you can. Anti-mold sprays, a mixture of white spirit or surgical spirit, or a mixture of bleach and water can be used to remove any mould patches. But take care to read the label on any products and be aware that many of them themselves can be irritants. For non toxic and natural cleaning products, check out our line of Allersearch products.

There may be a holiday mood around, but there are no celebrations in order when it comes to air quality. First of all, the London Air Quality Network reported on April 21st that the concentration of PM10s (particulate pollution linked to a range of health issues) at its Marylebone Rd monitoring station had gone above the EU limit of 50 micrograms per cubic metre for the 36th time this year. We have now breached the legal limit for PM10s for a whole year in London (35 exceedances are allowed in a calendar year) and it is only April! You may remember that London is already in trouble with the EU for breaching air pollution laws and a £300 million fine is looming. Can Londoners bear the cost - and I don’t mean the financial cost, but the toll on their health?

Commenting on London’s air quality crisis, Simon Birkett, Founder and Director of Clean Air in London, said:

“It is shocking that the legal standard, which is itself twice the World Health Organisation (WHO) guideline for human exposure, has been breached for the whole of 2011 before the end of April. This is more than two months earlier than last year.

“Mayor Johnson’s backward steps have aggravated London’s air pollution problems. These have included deferring Phase 3 of the low emission zone from 4 October 2010 to 3 January 2012 and rejecting advice from his own consultants on the actions needed to tackle PM10 exceedances at hotspots.

“The Mayor has backed himself into a corner where the only way to avoid £300m fines per year looks likely to be a prolonged odd and even number plate ban. Such a ban is looking inevitable also to keep London moving during the Olympics as the Mayor continues to refuse to introduce an inner low emission zone.

“The Mayor should be giving Londoners advice about protecting themselves (adaptation) and reducing air pollution for themselves and others (mitigation). People should be walking down side streets not busy roads and walking or cycling or using public transport rather than driving particularly older diesel vehicles. Who has warned people that bonfires over Easter will make air pollution worse still in London?

“We need Mayor Johnson and the Government to tackle an invisible public health crisis with as many premature deaths attributable to air pollution in London in 2008 as we thought occurred during the Great Smog of 1952.

“Last but not least, let’s remember than the hourly limit value for nitrogen dioxide (NO2) was breached for the year in early January and annual concentrations for NO2 exceed twice the guideline level set by the WHO as with PM10.”

And people outside London cannot rest easy when it comes to air quality either. Instead of enjoying the Easter break, people with asthma now have to worry about the possibility of an attack brought on by smog. The Department for Environment, Farming and Rural Affairs (DEFRA) has issued a smog alert, warning of high levels of air pollution lasting over the Easter weekend. Smog is a combination of smoke and fog. Old-fashioned smog, so common in the 1950s when it claimed thousands of lives, arose from coal-burning and the dangers of smog led to the establishment of ‘smoke-free’ zones and restrictions on domestic coal burning. Today’s smogs arise from a potent combination of vehicle emissions and sunlight, particularly in hot sunny weather such as the kind we are currently enjoying in the UK. DEFRA says that some people, including those with asthma and the elderly, may be affected by the smog and should avoid exercising outdoors, especially in the afternoons when smog levels will be at their highest. And, if you are planning to go out over the bank holiday, please do not use your car for short journeys - this will only compound the smog problem. I dread to think what will happen to air quality in the future if global warming brings us many hot, sunny summers and nothing drastic is done to control vehicle emissions nationwide!

Hardly a week goes by, it seems, without some new research on the impact of poor air quality on health. Time for yet more information on the impact of air pollution on your health…this time, it’s about brain damage and risks to people who have had a lung transplant.

• Writing in Environmental Health Perspectives, researchers at the University of Southern California have found that particulate matter (PMs) causes brain damage in mice which is not unlike that found in memory loss and Alzheimer’s disease. They collected air samples containing PMs from a local urban freeway and created a suspension with it, to which the mice were exposed over a ten week period. The researchers also did some experiments where they applied the simulated air pollution to rat brain cells. They discovered a distinct pattern of brain damage, one that involves a brain chemical called glutamate. That’s concerning, because glutamate is involved in learning and memory. Faulty glutamate pathways have been implicated in dementia. Of course, research on mice is a long way from doing experiments in humans living in real situations (but often findings in mice are replicated in the human situation). There could be serious implications here for children attending schools near roads where traffic pollution is heavy. Maybe a case for installing an air purifier in the school to protect them from pollution crossing windows and doors into the school itself?
• Patients who have had a lung transplant tread a fine line for the rest of their lives. Their immune system will naturally tend to reject their new live-saving organ. This means they must take powerful drugs to suppress their immunity - but this leaves them at increased risk of infection and cancer. Too little suppression means possible organ rejection, too much leaves the body undefended. There is a condition called bronchiolitis obliterans syndrome (BOS) which signifies rejection in lung transplant patients. Researchers in Belgium did a study on the impact of traffic air pollution on the risk of BOS in 288 patients who had had a lung transplant. During five years of follow up, 41% of patients developed BOS and 21% died. Patients living close to a major road were twice as likely to develop BOS and twice as likely to die as those living further away. It would be interesting to know if air pollution is linked to similar risks in people with other types of organ transplant, such as kidney and heart. The impact of indoor air pollution on transplant patients is also worthy of investigation, since people spend so much of their day indoors.

The above study focuses upon the impact of air pollution on the risk of rejection. But what about the other side of the coin - the risk of infection from a suppressed immune system? HEPA air purifiers are used in leading hospitals to reduce the spread of viruses and bacteria. Viruses are very small - some less than 0.03 microns in diameter. Best removal of viruses comes from mechanical HEPA filtration, such as an IQAir Cleanroom air purifier or IQAir HealthPro 250. It is a set up which, if properly configured for airflow, will go a long way to protecting transplant patients from infection.

Sources:

1. Morgan T et al Glutamatergic neurons in rodent models respond to nanoscale particulate urban air pollutants in vivo and in vitro Environmental Health Perspectives April 7 2011

2. Nawrot T et al The impact of traffic air pollution on bronchiolitis obliterans syndrome and mortality after lung transplantation Thorax Online First 23rd March 2011

The pollen season is in full bloom and there is a cluster of bank holidays coming up. So for some of you, thoughts are turning to home improvements and spring cleaning! A few days is all you need to start allergy-proofing your home and deal with any indoor air quality issues that can affect your family's allergy symptoms. To practice the best allergen avoidance, we've come up with a few ideas in the area of dusting, carpets and paint/VOCs.

• Dust & Dust Mite Allergens. If you have asthma or another allergy, dust is one of your biggest enemies. The main component of dust is dead skin scales, which is food for house dust mites. Therefore, dust also contains house dust mite and it's droppings - which can cause severe allergic reactions. Other ingredients of dust include moulds, pollution particles and pet dander - a very potent mixture of allergens, in other words. Dust tends to accumulate in the most heavily used parts of your house such as beds, carpets and furniture upholstered with fabric. If you normally only have time to flick a duster over the main surfaces, a spring cleaning day is the ideal opportunity to tackle dust in other areas. Never use a feather duster, because it just stirs up dust and the allergens in it, rather than removing it. Damp-dusting is best, with a cloth - you might want to make the job easier with a dust-attracting, or electrostatic, cloth. Alternatively, suck dust away with your vacuum cleaner (here you want to make sure to use a vacuum cleaner that uses HEPA filtration, and that is leakage free). While you’re at it, think about how you could cut down on your dusting for good. There are two ways to do that. Either remove clutter - which only collects dust - from your room, or get a proper air purifier. Get rid of any unused furniture, like chairs, or tables, and minimise the number of ornaments, books and other bits and bobs that are out on display. You might be pleasantly surprised by how spacious your room now appears! The right home air purifier and the right set up for the air purifier can enable you to reduce dust up to 95% in your home. Ideally do both - remove clutter to make room for an air purifier.

• Cleaning allergens out of your carpet. How many years have you had your carpets? The older it is, the more dirt there will be trapped in its fibres. Apparently a carpet can hold eight times its own weight in dust (including house dust mites & dust mite remains), outside dirt such as car exhausts, pollen, mould and so on. A good going over with a leakage free vacuum fitted with a HEPA filter will improve and refresh your carpet but you might get an even better result by investing in a deep steam clean, which will kill off house dust mites and bacteria. For keeping allergens under control, you should use allergy and asthma friendly cleaning products such as the Allersearch on a regular basis. The X-Mite Carpet Cleaner is very effective in eradicating dust mites and other allergens and is easy to use. You might also want to consider replacing carpets, with a hard surface flooring which will be easier to clean and will not accumulate as much dust. Suitable alternatives to carpet include hardwood, ceramic tiles, linoleum or vinyl.

• Chemicals & gases. There’s nothing like a lick of fresh paint to set off your spring cleaning efforts. Painted walls attract less dust than walls covered with wallpaper, so this might be a good change to make to cut down the allergy-provoking potential of a room. Choose your paint with care, though. Many paints contain volatile organic compounds (VOCs). Paints are either water-based or oil-based. The latter tend to have a higher VOC content. Water-based paints are used for walls, oil-based for woodwork. Solvents, which are VOCs, are used in paints to thin the oil content and make the paint easier to apply to a surface. As the paint dries, the VOC content evaporates and should not be inhaled by anyone, but it is especially harmful for people with multiple chemical sensitivity or allergies. It may be best to look out for allergy-friendly products and make use of a VOC air purifier.

   

There has been some rather sensational reporting on the impact that Japan’s earthquake has had - and will have - upon the Fukushima Daiichi nuclear power plant and how this will impact air quality both in Japan and around the world. Some newspapers and TV channels have been comparing the radiation leaks from the plant with the Chernobyl nuclear disaster that happened in the Ukraine in 1986. Well, this is a fast-moving story and who knows what might happen in weeks and months to come? But it seems to me that such a comparison is irresponsible scaremongering. Here are a few of the facts that we know:

• Excess radiation from Japan had not been detected by UK monitoring stations straight away - but then low levels of radioactive iodine were found in the air over Glasgow and Oxford at the end of March, according to the Health Protection Agency.
• Although radiation from Japan has reached the West Coast of the United States , the US Department of Energy and the Environment Protection Agency say levels are 100,000 times smaller than the daily background dose of radiation
• Increased radiation has been detected in Tokyo but this is not thought, at present, to pose a health risk
• Increased levels of radiation have been found in foodstuffs close to Fukushima; the Japanese government says that drinking contaminated milk for a year would give you the same radiation dose as a CT scan and the corresponding annual intake of spinach the a dose one fifth that of a CT scan

By contrast, after Chernobyl a huge plume of radioactivity drifted over Europe and background levels of radiation were increased 100-fold in Sweden, Finland and Eastern Europe. Milk and dairy produce in the UK was contaminated with radioactive caesium for many years, and their sale banned.

So, people in Japan will benefit from the use of a good HEPA air purifier to clean their air of radioactive dust, you do not need to worry here in the UK about removing excess radiation from the air (though don’t hesitate to use an air purifier to rid your indoor air of ultra fine dust from cars and planes, pet dander, pollen and other allergens and irritants).

I may deplore sensationalist coverage of the dangers emitting from the Fukushima Power Plant but I can certainly understand why people are scared. We fear nuclear power because radiation and is invisible, hard to control and, once inside our bodies, it can damage cells, causing cancer and birth defects. In fact, it is fossil fuels that should frighten us. Particles emitted from coal-fired power stations kill far more people than nuclear ever did - 13,200 people per annum in the US alone, according to ‘The Toll from Coal’, a report from the Clean Air Task Force.

I think the take home messages from the crisis in Japan is the following. Be altruistic and think about what people there are suffering (give a donation if you can - www.redcross.org.uk). And be aware that this suffering is coming overwhelmingly from the direct effects of the earthquake, not from meltdown of the Fukushima nuclear power station.

Ref.:

www.hpa.org.uk

http://www.catf.us/resources/publications/files/The_Toll_from_Coal.pdf

The London Olympics tickets have gone on sale and pressure on government and Mayor Johnson to improve the capital’s air quality is sure to increase in the run up to the event next August. In a recent development, the European Commission (EC) granted the UK a temporary and conditional exemption for the Greater London area from the EU’s quality standards for PM10s, small airborne particles that have been linked with a range of health effects, including asthma. The UK has now got till June 2011 to meet the PM10 standards (currently written as an annual concentration of 40 microgram/m3 and a daily concentration of 50 microgram/m3, not to be exceeded more than 35 times in a calendar year). The extension is conditional on a new short-term air quality plan being introduced by the deadline.

EC Environment Commissioner Janez Potoĉnik said ‘Air pollution from PM10 has serious impacts on human health. That is why EU legislation sets strict standards. The Commission expects Member States to clearly demonstrate that they are doing the utmost, in the interests of their citizens, to comply with the standards in the shortest possible time.’

The Mayor has postponed certain long-term measures on air quality, such as Phase 3 of the low emission zone, so what will the new short-term plan consist of? Banning of certain ‘dirty’ vehicles, at least for a while, could be one element. It should also be borne in mind that the EC is not letting Britain off the hook - they can still refer us to the European Court of Justice at any time if conditions for the new extension are not met. And that could be embarrassing, to say the least, in the run up to the Olympics. Campaigning group Clean Air in London has welcomed the EC ruling as a way of increasing pressure on the UK to comply with pollution laws. But is Mayor Johnson taking the EU threat seriously? Addressing the London Assembly recently, he said he had no intention of upgrading his long-term air quality plans. He believes short-term measures to target pollution hotspots and introduction of hydrogen-fuelled buses will ensure that London does not exceed PM10 limits. We’ll how how matters stand in June - but should Londoners really have to bear a £300 million fine (as well as threats to their health) just because Boris will not heed this wake-up call?

And talking of the Olympics, what can we learn from what was done to clean up air pollution ahead of Beijing, 2008? China, the world’s largest developing country, has an increasing problem with air pollution with levels of PM10s being very high in cities like Beijing. The pollution has already been linked with premature mortality and heart disease among the Chinese population.

To clean up air quality for the 2008 Olympics, China put several measures into place, including an odd-even car ban (based on number plates, cars allowed on the road only on alternate days), suspension on the use of large number of government vehicles, limiting pollution from coal, and stopping production from the most polluting factories.

Research since has shown how these measures reduced levels of nitrogen oxides, carbon monoxides, volatile organic compounds, and PM10s by about 50%. The famous ‘blue sky’ over Beijing was, however, achieved at the expense of a fall in domestic product growth rate and, for this reason, the controls were soon lifted again after the Olympics. So, the Beijing experience shows that air quality can be improved, but much needs to be done to maintain such improvement in the face of political and economic factors. What will London learn about air quality from the recent EC rulings and Beijing’s Olympic experience? Time will tell if we can push through some long-term improvement in air quality.

Methicillin-resistant Staphylococcus aureus (MRSA) is a hard-to-treat infection that is relatively common among hospital patients with compromised immunity, such as those in the intensive care unit.

MRSA was a factor in 781 deaths in England and Wales in 2009, a decrease of 37% over 2008 figures. So infection control may be getting better. You certainly see much more awareness of hand washing in hospitals these days. But there’s no room for complacency, because many other bacteria can, and have, become antibiotic resistant. Infection with such ‘superbugs’ is always going to be hard to treat. So prevention is better than cure.

While hand washing and general hygiene are the most powerful weapons against MRSA and other superbugs, there is evidence that air cleaning systems for hospitals play an important role as well. Researchers at Nottingham City Hospital have evaluated the effectiveness of a portable high-efficiency particulate air (HEPA) filtration unit (the IQAir Cleanroom H13 air purifier) at reducing surface contamination with MRSA in a hospital setting.

MRSA contamination was measured in the ward side rooms of three patients known to have MRSA and to be dispersing the bacteria into their surroundings. The researchers used plates containing a special growth gel to trap the bacteria and this was therefore a measure of surface contamination. Three different filtration rates of the IQAir Cleanroom H13 air purifier were used - from 60 to 235 cubic metres per hour and compared with no filtration. The majority of the plates tested positive for MRSA when there was no filtration. Air filtration of the IQAir Cleanroom H13 air purifier at 140 cubic metres per hour (one patient’s room) and 235 cubic metres per hour (the other two patients’ rooms) was linked to a highly significant decrease in MRSA deposition on the plates. The study suggests that air filtration could be a very useful addition to standard infection control measures - for it leads to less contamination on surfaces, so less contamination to clean up.

We already know that portable HEPA-filtration air purifiers can remove airborne particles. They have been used to remove spores of the fungus Aspergillus near building sites and so reduce the risk of infection of workers with aspergillosis. Particles of the size of bacteria, droplets (often infected) and fungi can be removed efficiently and quickly. Removing MRSA bacterial particles before they can settle is likely to reduce the risk of cross infection. Because cleaning is not 100% effective in clearing MRSA - there’s a certain amount of spreading it around that occurs as well. So reducing the contamination in the first place, by purifying the air, will reduce the unintended consequences of ineffective cleaning. There are many places in a hospital where a portable HEPA-filtration unit could be used with advantage - such as in the intensive care unit or in wound dressing clinics. Further work is needed to see how the units perform in larger or open-plan areas, and how reduction of surface contamination with MRSA reduces infection rates.

Source: Boswell TC and Fox PC Reduction in MRSA environmental contamination with a portable HEPA-filtration unit Journal of Hospital Infection 2006; 1-8

Claims made by manufacturers of air purifiers often look great, but then the system itself may fail to live up to your expectations. Air quality is important to your and your family’s health, whether it is at home, kindergarten, school or workplace. Therefore, we put together some guidelines for you to consider, before you invest in an air purifier.

Theoretical versus actual efficiency of an air purifier. High efficiency particulate air (HEPA) is the key word these days when it comes to marketing an air purifier. HEPA air purifiers give excellent performance in hospitals and industrial clean rooms. But be cautious when an air purifier manufacturer claims that their home purifier removes ‘99%’ of air pollutants down to 0.3 microns. Often, the removal efficiency will be below 80% and sometimes even 50%. So why the claims of 99%? That is the theoretical efficiency of the filter material itself, used in the air purifier. There is usually a performance gap between what the manufacturer says and the actual air cleaner performance, because the filter is easily damaged, or is not actually a HEPA-rated filter, or there are leaks in the system and not all the air passes through the filter.

Overstating the air cleaners air delivery rates. Depending on the size your room, you need a certain amount of air per minute to be processed by the air purifier to guarantee a significant reduction in air pollutants. Often, the air handling capacity of the motor of the air purifier without filters is stated, rather than the actual airflow rate with the filters installed in the air purifier which would be lower of course (I know that that is odd and sounds like cheating). Few manufacturers state this particular performance specification, quoting instead the room size that they want their air purifier to be used in, but not saying how many air changes an hour you could expect in the room when the air purifier is in action.

ULPA versus HEPA air purifiers. Ultra Low Penetration Air (ULPA) technology can remove smaller particles than a HEPA filter, and with greater efficiency. Naturally, this has led some manufacturers to claim that ULPA-based air purifiers are superior. In fact, the ULPA air purifier tends to be less effective than the HEPA air purifier in a typical room. This is because there is a reduction in air flow caused by the denser ULPA filter. Typically, then, you’d get 20-50% less air going through the ULPA filter media than the HEPA filter, resulting in fewer air changes per hour.

Air purifiers with ineffective gas filtration. Gaseous contaminants and odours are a key component of indoor air pollution. Activated carbon is the main technology for removal of gaseous pollution. In its granular form, it is undoubtedly very effective. But did you know that many air purifiers contain only fibre pads impregnated with activated carbon dust. Carbon dust is not very effective in capturing gases and odours, because it is the granular structure that allows carbon to capture gases and chemicals effectively. It is also impossible for a mere activated carbon filter to remove all gaseous pollutants. You need a special sorbent for formaldehyde and ammonia.

Issues with the air purifiers long-term performance. The real value of an air purifier comes with its air cleaning effectiveness over months and years, not within the first few hours. But filters often suffer from ineffective pre-filtration, which causes them to get clogged up, thereby reducing air flow. If the air purifier has got a granular carbon filter, lack of pre-filtration will quickly lead to a loss of gas absorption potential. Some manufacturers will say you only need to replace your filter every three to five years. If you followed this, then your air purifier would be doing very little to improve air quality. Regular maintenance and filter replacement are needed to keep air purifier performance up.

Expensive, frequent filter replacement. While some air purifiers itself may be relatively inexpensive, cost of replacement filters can be quite steep. Lack of effective pre-filters often leads to clogging requiring replacement that is more frequent than it need be. Some filter cartridges are too small, and reduced capacity means low capacity for pollutants and increased frequency of replacement. And sometimes several filter stages are combined in one filter cartridge, so all filters have to be replaced, even if only one of them is used up.

One size does not fit all. Look at air purifier model ranges. Do the different systems differ in technology, or only in size? Can one unit really remove pet allergens, mould, tobacco smoke, odours and chemicals? Sometimes a manufacturer will say that use of several filter stages makes their air purifier more versatile. In fact, more filters mean more resistance to air flow and lower air delivery.

The take home message is, be very careful about the claims made by manufacturer of air purifiers. Look for independent evidence (not just other customer reviews) and test if the retailer really knows what they are talking about, that they really know what air purifier to use for your specific concern and budget.

Click here for FAQ about air purifiers.

The clocks have gone forward and we have longer and sunnier days. Time to think about sunscreen (though, ideally, you should be wearing it all year round) - not just to prevent skin cancer, but also to protect against skin ageing. However, ultraviolet light from the sun is not the only factor that can age your skin. Did you know that exposure to air pollution also plays a vital role in skin ageing?

Researchers in Germany, Switzerland and the USA, recently published results on the impact of air pollution on aging in a group of 400 women aged 70 to 80 years. The ageing of the women’s skin was assessed by a well-established skin aging score called SCINEXA (score of intrinsic and extrinsic skin ageing). Traffic-related air pollution exposure where the women lived was determined in two ways. Traffic particle emissions and the amount of soot in fine dust were both measured. The researchers also looked at background particle pollution levels.

Analysis showed that exposure to air pollution was significantly linked to skin ageing and particularly to pigment spots (sometimes known as liver spots). A link between air pollution exposure and wrinkles was weaker. An increase in soot and traffic particle pollution was linked to a measurably large number of pigment spots on the forehead and cheeks. And background particle pollution, not necessarily arising from traffic pollution, was also linked to more pigment spots on the face. There was also a link found between exposure to particulate air pollution and the appearance of those ageing skin folds down the side of the nose.

One of the researchers, Professor Jean Krutmann of the Institute of Environmental Medicine at the University of Dϋsseldorf has put forward some ideas why poor air quality can trigger skin ageing. The carbon particles in air pollution are so small that they enter the body and are able to stimulate cells’ production of the pigment melanin - hence you get more age-related pigment spots. There could be a technical solution, however. A skin cream that contains a substance that blocks the entry of the particles to the melanin-producing cells is already being developed. To benefit from all the positive health effects of cleaner air, we recommend using an indoor air purifier. The best place for an air purifier is normally the bedroom, where people spend most of their time when they are at home. It might also be worth thinking about using an air purifier at your place of work. Offices are notorious for poor indoor air quality. Cheap ventilation systems, carpets, cleaning products as well as dust from printers can quickly create toxic indoor environments.

Click here for the Best Home Air Purifiers!

Source: Vierkötter et al Airborne particle exposure and extrinsic skin aging Journal of Investigative Dermatology December 2010 130: 2719-2726]

http://www.nature.com/jid/journal/v130/n12/full/jid2010323a.html

Hairdressing and beauty salons have always been a potential source of indoor air pollution, because harsh chemicals may be applied to the hair, nails and body to achieve the desired aesthetic results. Old-fashioned perms used ammonia (today’s are much milder), hair is still bleached with peroxide, and acetone (the fruity smell is unmistakable) is an essential ingredient in nail polish remover. For the client, a visit to the salon may be just an occasional treat or a weekly routine - either way, for people with multiple chemical sensitivity being exposed to toxic chemical can have a severe impact on their well being. Even more problematic is an unhealthy indoor environment for the employees who work in a salon day in, day out. Poor ventilation, as well as improper use, storage (not putting the lid back on containers, for instance) or disposal of the many chemicals used in modern beauty treatments will quickly cause air quality inside the salon to deteriorate.

If you have asthma, you may well find that stress makes your symptoms worse. But a new study shows that stress may actually be a cause of asthma too. The effect is only small - but it's significant, because it might help us understand more about how asthma works.

Writing in the journal Allergy, Dr. Adrian Loerbroks and his team at Heidelberg University in Germany, described a study of over 5,000 adults followed up for nearly ten years. Those who reported high job stress at the start were twice as likely as those with low levels of job stress to develop asthma. However, the absolute numbers of new asthma cases were low. The study found that 2.4 percent of those reporting a lot of stress at work developed asthma, compared to 1.2 percent of those who were not stressed. Also, this study does not actually prove that occupational stress causes asthma - it just demonstrates a link. It could be that there is some underlying common factor that makes people feel stressed and also predisposes them to asthma.

The researchers note that there is other evidence that chronic stress exposure, distressing life events, and stress-related personality traits also increase the risk of asthma. But this is the first study to show a link between work-related stress and new cases of asthma. We already know that job stress, particularly lack of control over workload, can cause increased risk of heart disease, diabetes and depression - probably also through chronic exposure of the body to the stress hormone cortisol. It may be that some similar effect is operating among people susceptible to asthma experiencing job stress.

It's easy to say you feel stressed by work, but how do researchers measure it? In this study, the participants were asked how much strain they felt at work and how often, at the end of the working day, they were still thinking about their job or felt exhausted or unable to cope. Not only did those with high work stress have a greater risk of developing new asthma, but those reporting stress were also more likely to have asthma to start with.

So the link between stress and asthma is quite complex. It may be that chronic stress has an impact upon the hormonal and immune systems which goes on the affect the airways. Further investigation of the link by research would probably be worthwhile. But reducing occupational stress would only prevent a very few cases of asthma, as the numbers involved in this study are so small. Companies should, instead, focus upon keeping employees safe at work by reducing exposure to triggers and indoor pollution. This study reflects recent findings on outdoor pollution and asthma. It used to be thought that pollutants like particulate matter merely worsened existing asthma. Now a report from the Committee on the Health Effects of Air Pollution showed that air pollution, particularly near busy roads, can actually cause asthma in people with a genetic susceptibility to the disease.

Source:

Loerbroks A et al Work-related stress, inability to relax after work and risk of adult asthma: a population-based cohort study Allergy 2010;65:1298-305

Multiple chemical sensitivity is a condition where various bodily symptoms arise from exposure to various everyday chemicals. It generally starts with one acute or chronic exposure and then worsens to include many more chemicals. As the name suggests, the irritants are multiple, which makes MCS hard to deal with. You might like to be aware of some of the common triggers to MCS, however. These are:

• Perfumes and other scented products, such as candles
• Second-hand tobacco smoke
• Pesticides, wood preservatives
• House paints
• Regular household cleaning supplies
• Formaldehyde in new clothes, furniture and various other products
• Carbonless paper, inks, copying machines and laser printer toner
• Offgassing of new carpets
• Gas stoves

The symptoms of MCS are legion - and can include breathing difficulties, insomnia, memory loss, headache, abdominal pain, irritated eyes, ears, nose and skin. Some people with MCS are sensitive also to loud noises, bright lights, and extremes of heat and cold. MCS is most common among women and may start at any age, though it usually begins in late puberty to mid-life.

The only way to treat MCS is by avoiding the chemicals that trigger it. An obvious approach is to look at air quality in your home or working environment. Removal of those materials associated with chemical exposures is an essential way of improving your air quality. Of course, there are many air purifiers on the market, used for different purposes. So what should you look out for if you want one to help with MCS?

The chemicals that trigger MCS can be present in both particle-bound and gaseous form. Therefore your air purifier should offer both particle filtration and a gas phase filter. Only this two-fold approach will lead to a significant reduction in background levels of chemicals and improve your air quality. Many air purifier units have gas phase filters that are really too small to meet the needs of those with MCS. Air cleaners with granular media, like granular activated carbon, provide the best kind of removal efficiencies for gaseous chemicals in the air. But carbon alone cannot offer complete removal of gaseous chemicals. Activated carbon is good at removing volatile organic chemicals (VOCs) but not so good at taking away some of the semi-volatile organic compounds such as formaldehyde.

Air cleaners that offer both granular activated carbon and a chemically active alumina remove the widest range of chemicals. Note that the combination of granular activated carbon and zeolite, marketed by some companies for MCS, is not as good as you might expect - for there is no sound scientific evidence that zeolite has any special advantages in this context. It is also best if the air cleaner’s gas phase filter is protected by a high-efficiency pre-filter to prevent premature particle contamination which otherwise blocks the micropores of the gas filter, reducing the system’s efficiency and service life.

The IQAir GC Series was specially developed for removal of gaseous chemical. The wide spectrum gas phase filter of the IQAir MultiGas GC unit captures a wide array of gaseous chemicals is ideal for areas with high concentrations of chemicals.

Click here to learn more about MCS.

The Best Air Purifiers for MCS:

• IQAir GC MultiGas

This week Allergy Cosmos spoke with Dr Patrick O’Brien as part of our series of interviews with allergy and asthma experts across the UK. It is our hope that reading about these experts' opinions and research work will provide you with valuable insight into your own life with allergy, asthma and general air pollution.

Dr Patrick O’Brien is the spokesperson for the Royal College of Obstetricians and Gynaecologists and Consultant and Senior Lecturer in Obstetrics and Gynaecology at University College London Hospitals. He spoke to Allergy Cosmos about allergy and asthma during pregnancy.

Q. If you are pregnant and have asthma or another allergic condition, is it safe to carry on with your medication? Do any of the drugs you might be using pose a risk to the unborn child?

A. In pregnancy, one third of women with asthma find their condition improves, in another third, it gets worse, and in the rest there is no change. Most asthma medicines, like Ventolin, come as inhalers and they are completely safe for the baby. In fact, if you do have an asthma attack in pregnancy it is very important to treat it, because if your oxygen levels are low, that is bad for the baby. Some women with asthma will be prescribed steroid tablets. These too are completely safe for the baby.

Q. What is the latest thinking on what causes babies to be born with asthma or allergy?

A. This is a difficult question to answer! The whole basis of what causes asthma or allergy in new-borns is still unclear. The best we can say at the moment is that there is often an underlying genetic predisposition to asthma or allergy and contact with some factor in the environment triggers it.

Q. Is there anything a woman can do during pregnancy to protect her baby from asthma or allergies?

A. We used to advise women to avoid peanuts to prevent their babies developing peanut allergy. New research looked at this again and showed that peanut consumption in pregnancy does not, in fact, increase the risk of babies being born with an allergy. Smoking in pregnancy is bad, of course, for so many reasons - it damages the placenta, reduces the baby’s oxygen supply and causes all sorts of other complications. But there is not a lot of evidence that smoking in pregnancy increases the risk of allergies.

Q. What about breast feeding? Does that have any bearing on whether your baby will develop asthma or any other allergic disease?

A. It has always been believed that long-term breast feeding protects a baby from allergy. But recent research published in the British Medical Journal suggests that delaying the introduction of solid foods actually increased the risk of allergy and breast feeding should perhaps be stopped at around six months rather than continued for longer. [note that RCOG has not changed its advice on breast feeding, as yet, in the light of this new evidence]

Q. Any other advice for women who are pregnant, or trying to get pregnant, on managing allergies and protecting their baby from allergy?

A. A woman’s skin is often more sensitive during pregnancy. If you have a skin allergy, like eczema, do carry on using your steroid creams, E45, diprobase and so on - they are all safe for your baby. Women should also be aware of a liver problem called cholestasis which can harm the unborn child. Cholestasis can cause itching to get worse. If this happens, don’t assume it is your skin allergy flaring up - check with your midwife or doctor straight away.

Biography

Pat O’Brien has been a Consultant & Honorary Senior Lecturer in Obstetrics and Gynaecology at University College London Hospitals since 1999. He qualified as a doctor in Ireland, but all his postgraduate training has been in London. He specialises in Maternal Medicine and high-risk obstetrics, and at UCLH jointly runs a multi-disciplinary antenatal clinic involving consultants in Fetal Medicine, Cardiology, Haematology, Diabetes, Anaesthesia, and an Obstetric Physician. He has a particular interest in complications of pregnancy. He lectures widely in the UK and abroad, and runs courses on fetal monitoring, medical problems on the delivery suite, psychiatric problems in pregnancy.

He is the Chair of the International Division of the Institute for Women’s Health in London, and a spokesperson for the Royal College of Obstetricians & Gynaecologists. He is a reviewer for the Cochrane Collaboration and several medical journals. He examines for the DRCOG examination. He is a member of the obstetric guideline development group of the National Institute for Clinical Excellence in the UK. He also works with BBC Television (British Broadcasting Corporation) as an obstetric advisor.

Do you ever wonder how much your asthma, or other allergy, costs you - both financially and emotionally? According to the British Lung Foundation and Asthma UK, asthma costs nearly £2.3 billion per year. That's £1,226 million in lost work productivity, £889 million in NHS costs and £161 million in benefits. There are around five million people with asthma in the UK. I won't divide that number into the costs figure to get an average - that'd be misleading because people vary so much in the severity of their disease. You'll have a good idea yourself what your asthma and allergies cost you and your family.

So wouldn't it be worthwhile - if you haven't already - investing in the long-term management of your allergy? There are many different and effective things you can do. There are so many options that you could be overwhelmed. But you have to be careful, many of the things that are being offered as non-madical allergy and asthma treatments are questionable in their effectiveness. So let's just look at a few ideas today - some requiring an investment of time, others needing you to spend a bit of money (and maybe a bit of both!)

Allergy reduction through home improvement

Leading allergy and asthma specialists agree that one of the first step in treating allergies is to practice allergen avoidance. The idea is to avoid the triggers that cause your allergy and asthma symptoms. There are many different things that can trigger your allergy and asthma symptoms, such as pet dander, mould, dust mites, dust, traffic pollution, pollen, as well as gases and fumes.

Complementary medicine

Many people with asthma want to try non-drug approaches to managing their condition - and complementary therapies is often part of that. It has to be said that scientific evidence that these complementary therapies will help is still quite limited, but many people seem to be happy with the results.

You might want to try:

Yoga. Postures and breathing are the mainstay of yoga. Pranayama yoga exercises have been shown to be beneficial in asthma with participants in studies having fewer attacks. Whether it is stress reduction, or some improvement in the breathing pattern, which helps has not yet been established.

Hypnosis. In hypnosis, your therapist creates a state of mind which helps you focus. It has been applied to many health problems and some find it helpful with asthma. Again, stress reduction may be the key to the success of hypnosis.

Acupuncture. A system of ancient Chinese medicine, acupuncture has been shown, in some studies, to show benefit in asthma, at least in the short-term.

Homeopathy. Where the allergic trigger, such as house dust mite, is known, taking homeopathic medicines containing tiny, tiny, amounts of trigger has shown some encouraging results.

If you do want to try a complementary therapy, remember it should not replace your regular medicines and you should discuss any remedies or therapies you are taking with your doctor. For more information, contact the British Complementary Medicine Association (BCMA) at www.bcma.org.uk.

Our best Air Purifiers for limiting exposure to allergy and asthma triggers in your home:

• Blueair 450E 
• Blueair 270E 
• IQAir HealthPro 250 
• IQAir HealthPro 150

Our best Allergy & Asthma friendly cleaning products:

• Allergy & Asthma Free Home Package
• Allergen Wash Laundry Detergent
• ADMS Anti-Allergen Dust Spray
• All Rug Anti-Allergen Carpet Shampoo

I will admit that, till now, I’ve not tried the London Cycle Scheme. One reason is that I was put off by the prospect of signing up and paying a deposit. But the bigger reason is worry about being knocked off my bike by a careless motorist. However, I’m reconsidering. The Scheme is now open to casual use - just find a bike stand and pay on the spot with a card (no need to fill a form in) which is a great opportunity to just give it a go!

If you really care about the quality of London’s air, it is not enough to just harangue Mayor Boris on the weakness of his air quality strategy. If you do as he does and actually get on your bike then you are surely doing your bit to reduce air pollution in the capital.

Cycling is good exercise too. Remember, we are advised to take 30 minutes of moderately vigorous exercise five times a week on average, to optimise physical and mental health (the duration and intensity varying with your age and level of health and fitness, of course). Did you know cycling uses up to 650 calories an hour and that makes it great for weight loss and body toning? Another benefit of cycling is that it may help boost your levels of vitamin D through exposure to sunlight (there’s mounting evidence that low levels of vitamin D are implicated in many chronic diseases, and the sunshine vitamin is important for far more than just bone health). Cycling is a good use of your time as well. I discovered that the same four mile journey in central London by bike takes just over half the time it takes in a car.

Of course, we all worry about safety when cycling. There’s good advice on the London Cycling Campaign website about how to behave on the road and how to get yourself properly kitted out for cycling. But you might also be concerned that cycling in London puts your long-term health at risk by exposure to air pollution. A recent study published in The Lancet is hardly reassuring - for it suggests that exposure to air pollution through cycling (or driving) to work might be a significant factor in triggering a heart attack. While there are lots of other risk factors for heart disease, and cycling in general improve your heart health, I think cyclists need to be given more information on the potential risks of pollution on the road.

A recent piece on BBC News highlights some of the issues. It points out that cyclists breathe more deeply, because of the physical exertion of cycling, than do car users or people on public transport; this might lead to cyclists inhaling more of the particulate matter that has been linked to heart and lung problems. But other research suggests that the limited ventilation inside a car or bus leads to higher exposures to pollution, while cyclists are less exposed because they are in motion most of the time. Which is more important? We need some proper studies! One thing is for sure, you have to be careful when comparing driving in a car to riding a bike, scooter or motorcycle when it comes to exposure to air pollution. The reason is that most cars have HEPA filters in their ventilation systems, so that the actual exposure to particle pollution is significantly limited if they are using the cars ventilation or air conditioning system.

If you are on a bike, scooter or motorcycle, here are ways of minimising your exposure to air pollution:

• Plan your routes so you keep away from heavy traffic and traffic jams, commuter routes, and main roads.
• Try to keep as much distance from cars and buses in front of you.
• Seek out tree-lined avenues and parks. Trees and green spaces counteract pollution.
• Notice the routes black caps take to avoid traffic - they will show you the best short cuts.
• When you are at the traffic lights, do not get stuck downwind of vehicles’ exhaust pipes - adjust your position so you are in front of vehicles, not behind (although not in front of the lights, of course).

Pregnant women have to be very careful about smoke, alcohol and medications - in case their unborn baby should come to any harm through being exposed to toxins. What they often do not think about is that general indoor and outdoor air quality can also pose a threat. There is a lot of evidence of a link between air pollution and harm to the unborn child. Just look at these studies:

• Dr Adrian Barnett of Queensland University of Technology studied ultrasound scans of 15,000 foetuses. Their mothers were all living within 14 kilometres of the city of Brisbane. The size of each foetus was measured, along with the levels of air pollution where the mother was living. Those mothers with higher exposure to air pollution were carrying foetuses that were, on average, smaller than those living in less polluted air. This is concerning, because babies of lower birth weight have poorer health in later life.
• Researchers at the University of Medicine and Dentistry of New Jersey studied nearly 336,000 births in the state between 1999 and 2003 and also monitored the air quality around the state. They found a significant link between traffic pollution and low birth weight.
• Columbia University carried out a six year study in the Chinese city of Chongqing and found that poor air quality from coal pollution was linked to low birth weight, height and impaired development among children born in the region.
• The California Birth Defects Monitoring Program looked at information on over 9,000 babies born in four counties (Los Angeles, Orange, San Bernardino and Riverside). Women exposed to higher levels of ozone and carbon monoxide were up to three times more likely to give birth to a child with a heart defect. The risk was worst for exposure during the second month of pregnancy.

It is also important to understand how exposure to indoor air pollution may affect the unborn child (note how the above studies were focused on the exposure to mere traffic pollution, or outdoor air pollution). The Born in Bradford study, one of the largest of the child health studies, covering 10,000 babies born in the city, will focus not only on the traffic pollution that you are exposed to in your home, but also other indoor air pollution. Homes can have a toxic indoor environment that is created through the off gassing from furniture, carpets, and paints. Other sources of indoor air pollution are heating devices, gas ovens, candles, pets, dust mites, and mould for example. The Born in Bradford study will measure the air quality in the homes of pregnant women (along with many other factors) to see how they affect the health of the child. It will be some years before the results of this study are known. In the meantime, and given the evidence we already have, it is wise for pregnant women to avoid exposure to air pollution as much as possible, for the sake of the health of their unborn child. One of the best ways to avoid indoor air pollution is the use of a bedroom air purifier and/or an office air purifier.

The Best Air Purifiers for your home and nursery:

IQAir HealthPro 250

Sources: 1. Hansen JA et al The effect of ambient air pollution during early pregnancy on fetal ultrasonic measurements during mid-pregnancy Environmental Health Perspectives 2008 volume 116

2. Rich DQ et al Ambient air pollutant during pregnancy and the risk of fetal growth restriction Journal of Epidemiology and Community Health 2009;63:488-496

3. Perera F et al Benefits of reducing prenatal exposure to coal burning pollutants to children’s neurodevelopment in China Environmental Health Perpsectives online 14 July 2008

4. Ritz B et al Ambient Air Pollution and Risk of Birth Defects in Southern California American Journal of Epidemiology 2001;155:17-25

One of the main pollen forecast websites in the UK opens its 2011 season on March 17th. If you have pollen allergies, hay fever, or your asthma is triggered by pollen, you’ll be only too familiar with seasonal cycles. If you’re not, here’s how it tends to go:

• Tree pollen (oak, willow, birch, sycamore) is around from late winter to early summer
• Grass (rye, oat, foxtail) pollen peaks in the summer
• Then you get weed pollen (nettle, dock) peaking in August
• In the autumn, it is the turn of fungal spores
• And as winter sets in, you finally get some relief!

Some people who have allergies all year round (such as pet allergies or dust mite allergies for example), might not be effected by being exposed to a high pollen count. However, most people who have asthma or allergies react to more then one trigger and will experience the typical allergy and asthma symptoms. Time of day when you are exposed to pollen can be important - for instance, grass emits pollen from early morning, while birch starts emitting pollen only at noon. Your symptoms toward pollen may be especially strong late in the day. The reason is a pollen shower, which is pollen descending in the evening as the air it is borne upon cools and sinks.

Pollen comes from the male part of a plant and consists of microscopic grains (typically 10 to 40 microns diameter, but some plants produce a light pollen dust whose grains are less than five microns wide). It is the wind-pollinated plants, like the grasses, which have small, inconspicuous flowers, which are responsible for most allergies. Having said that, some people are also allergic to the pollen of cut flowers, like lilies, which are insect-pollinated. Pollen is just like dust - millions of grains travel through the air and get into the mouth, nose and lungs.

You can protect yourself in several simple ways. For instance,

• Wear sunglasses, especially the wrap-around kind
• Try a dab of Vaseline inside your nostrils - it will trap pollen grains
• A HEPA OR HEPASilent air purifier will remove pollen grains from indoor spaces
• Dry your laundry indoors
• Remove stamens from cut flowers if you are allergic to, say, lily pollen
• Fit air conditioning in your car so you don’t have to get stifling hot driving with the windows closed to keep pollen out
• Stay indoors when pollen counts are high or, if you can’t, change your clothes as soon as you get home to get rid of pollen clinging to them
• Use allergy and asthma friendly cleaning products, they will eliminate the pollen on contact

Pollen count is the number of pollen grains in a given volume of air over a 24 hour period. A count of 50 or less is considered low, and a count of 1000 or more is high. People do vary, however, in how sensitive they are to pollen. One person’s ‘low’ may be someone else’s ‘high’. The pollen forecast, like the weather forecast, depends upon temperature, the time of year, and humidity.

A report out in the Proceedings of the National Academy of Sciences gives some indication on how climate change may affect the pollen season. Researchers at the United States Department of Agriculture used 15 years of pollen data to conclude that the ragweed season has lengthened by 16 days in North Dakota and Minnesota and by 27 days in Canada. Ragweed produces one of the most potent pollen allergens. The same team also noted that ragweed in New York was producing five times more pollen than in rural areas. Ragweed is native to North America but has spread to hotter parts of Europe, like Eastern France. Ragweed has not been an important allergen in the United Kingdom because our climate is too cool and damp for plant populations to become established. You do sometimes see ragweed on waste ground, rubbish tips, and in gardens and allotments - but it does not come back year after year. That may change, as our climate becomes hotter. Climate change could also cause the birch pollen season to start and end earlier, while the grass pollen season may start earlier (each degree rise in temperature could bring the season forward by a couple of weeks).

Related blog posts:

• Misunderstanding Air Pollution
• Allergies Made Worse by Climate Change

 

Inhalers play a leading role in helping to manage asthma and chronic obstructive pulmonary disease (COPD). Indeed, they can even be lifesaving! But to do their job of delivering medication, they do need to be used correctly. So it is concerning to read a study from the University of Chicago that shows how the majority of patients do not use their inhaler as intended.

The researchers asked 100 adults who had been hospitalised for either asthma or COPD (so we can assume they had severe disease) to demonstrate how they actually used their inhalers. Most of them made some kind of error. The good news is that it didn’t take very long for them to learn how to use their inhalers in the right way.

There are two types of inhaler - preventers and relievers. A preventer protects the airways and reduces the risk of an asthma attack. A reliever is the one you use when you are having an attack - it gets rid of the symptoms. There are several different designs of inhaler. This study involved a metered-dose inhaler and a Diskus inhaler. The metered-dose inhaler is mainly used as both preventer and reliever while the Diskus inhaler is used as a preventer. The important point is that they are used in different ways. Since many patients with asthma will have both types, it’s important to be aware of the differences. With the metered dose inhaler, you have to inhale slowly. With the Diskus, you inhale sharply. In this study, metered-dose inhalers were used incorrectly nearly nine out of ten times, and Diskus inhalers seven out of ten times. The main error was failing to breathe out completely before using the inhaler.

Eyesight seemed to be an issue as well. Nearly all of those with vision problems did not use the Diskus inhaler correctly, compared to more than half of those with no vision problems. It might be that people with poor eyesight have difficulty reading the instructions for the inhaler, as these tend to be written in small print.

Half of the participants were then taken aside and given a lesson on how to use the inhaler. Within a very short time, all had mastered the technique for both type of inhaler.

Next to the regular best practice non medical treatment for asthma, it is so important to be using your medication correctly if you have asthma or COPD. If your symptoms are not well controlled, could the reason be that you are not using your inhaler correctly? Ideally, your doctor should have shown you how, but this doesn’t always happen. Don’t be afraid to ask questions if you are not sure and don’t assume that you are doing it right! This video from AsthmaUK shows how to use several inhalers, including the metered dose. There are instruction on how to use a Diskus inhaler.

Source:

Press V et al. Misuse of respiratory inhalers in hospitalized patients with asthma or COPD

Journal of General Internal Medicine online January 19 2011

We’ve heard quite a bit about particulate matter PM10s and PM2.5s as components of air pollution that we are exposed to on a daily bases. Recent research papers are highlighting the dangers of ultra fine particles (UFPs), which have a diameter of less than 0.1 micrometres (or 100 nanometres). By contrast, the diameters of particulate pollution from PM10s and PM2.5 are 10 micrometres or less and 2.5 micrometres or less. This ultra fine particle pollution is so small that it never settles on the ground, but hovers in the air indefinitely. UFPs concern me because they are part of the nanoworld. Although there’s rightly a lot of excitement about the potential of nanotechnology and nanomedicine, there are also safety issues around just what happens when nanoparticles (like UFPs) penetrate the body. They are so small that they can penetrate far deeper into the lung than PM10s orPM2.5s and they can even get into your bloodstream. Once in your bloodstream the particle pollution can reach every part of your body- from the heart to the brain. Because of this danger, the Environmental Protection Agency is funding several studies on the impact of UFPs on our health.

I’m sitting next to a laser printer as I write this. Most of us spend time either using, or around, an office printer without being aware of the pollution it can create. A study from Canada that came out in 2007 showed that a significant number of printers tested in a study emitted high amounts of UFPs. The researchers said the impact was not dissimilar to sitting next to someone who is smoking.

There was another recent study, by Australian scientists, that measured UFP emissions of 62 printers. Forty per cent did emit UFPs, some of them in very high concentrations. Printer use increased indoor particle counts fivefold during work hours. More particles were emitted when operating with new toner cartridges and when printing graphics and images, which need more toner.

Another study, published last year, measured particle emissions from three modern laser printers into a chamber simulating an office room. This confirmed that most of the particles emitted were URPs and, when the printers were in action, they increased the particle concentration in the ‘office’ to a level 11 times that of the background level. Another problem is, that even if you are not sitting right next to the printer, modern ventilation systems distribute the particle pollution through out the entire office.

But it’s not just printers that emit UFPs. Researchers in the United States reviewed other sources and say that exposure can occur from many sources such as cooking, driving, smoking, or operating a hair dryer. They spent three years measuring ultra fine particles with portable monitors in homes, cars and restaurants. Cooking with gas and electricity was a major source of UFPs. Other sources included cigarettes (as you might expect), hair dryers, steam irons and candles. The take-home message here, I think, is that indoor exposure to UFPs is often much more significant than outdoor exposure. The researchers believe that 47% of your exposure to UFPs comes from indoor pollution, compared to just 36% from outdoors and 17% from being in a car. So, as we have said here before, do not underestimate the health impact of indoor pollution.

The positive note is that you have much more control over this kind of  air pollution in your office than you do over outdoor pollution. Ventilation systems in offices can be equipped with high efficiency particle filters. Most office ventilation systems come with a filter, as I am sure your employer will be happy to point out - but don't be fooled. Those standard filters are there to protect the ventilation system engine from large dust particles, hairs, flies etc., they are not there to protect your health and they will not filter any fine or ultra fine particle pollution.

Small and medium size office rooms are best equipped with a stand alone, plug and play unit such as an IQAir HealthPro 250, IQAir HealthPro 150 or Blueair 450E. Larger rooms would require a unit such as the CleanZone 5000. But whatever your air pollution needs are, contact us anytime and we happy to provide you with a free expert consultation. You can also set up a indoor air assessment, during which one of our experts measures the pollution levels in your home or place of work and helps you find the best solution for creating a healthy indoor environment. Call us at: 0203 176 0713.

Click here for the best Air Purifiers for your office.

Sources:

He C et al. Particle emission characteristics of office printers Environmental Science and Technology August 1 2007;41:6039-6045

Koivisto A et al. Impact of particle emissions of new laser printers on modelled office room Atmospheric Environment June 2010;44:2140-2146

Wallace L and Ott W Personal exposure to ultrafine particles Journal of Exposure Science and Technology online 20th January 2010;21:20-30

This week Allergy Cosmos spoke with Professor Jon Ayres as part of our series of interviews with allergy, asthma and air pollution experts across the UK. It is our hope that reading about these experts' opinions and research work will provide you with valuable insight into your own life with allergy, asthma and general air pollution.

Jon Ayres, is Professor of Environmental and Respiratory Medicine at the University of Birmingham. Prof. Ayres received his science and medical degrees at Guys Hospital, London, and has been in his post at the University of Birmingham since 2008. He currently heads the Institute of Occupational and Environmental Medicine which is part of the School of Health and Population Sciences. He also chairs two government advisory committees - the Committee on the Medical Effects of Air Pollution (COMEAP) and the Advisory Committee on Pesticides (ACP).

Dr. Susan Aldridge: "What is COMEAP's brief?"

Professor Jon Ayres: "COMEAP is a government advisory body formed in the early 1990s. Its role is to advise the Chief Medical Officer and the Department of Health on matters associated with air pollution and health."

SA: "Which of COMEAP's achievements are you most proud of and why?"

JA: "Pretty much all of them really. COMEAP has been extraordinarily effective, not only in enabling cross government departmental collaborative working in developing the air quality strategy, a remarkable achievement in itself, but also in producing a series of state of the art reviews on a range of issues from asthma and air pollution to the cardiovascular impacts of air pollution and, more recently, quantification of the extent to which air pollution impacts on health. These documents are widely respected and quoted worldwide and, indeed, are used in the development of air quality strategies around the world, including the World Health Organisation. These are available to all on the COMEAP website. which has recently been improved to make it more accessible and attractive to those who want to use it as an information source."

SA.What influence does COMEAP have on policy makers and on the public?

JA: "As far as the public is concerned, we are aware that communication of the effects of air pollution on health is difficult to understand because of its complexity. Our most recent document on the effects of air pollution on mortality has made major efforts to make difficult science more explicit and clear to the lay reader."

SA: "You recently published an interesting paper on occupational asthma in the journal Thorax. Could you summarise your conclusion for us?"

JA: "Occupational asthma is common, under recognised and preventable. If individuals are not exposed to asthmagenic substances in the workplace then they wouldn't get occupational asthma! The aim of our study was to try and see where the costs of occupational asthma lie. If there was a substantial cost to the employer then this might persuade them to improve their approaches to prevention of this condition. To our surprise only 3% of the costs fell on employers' shoulders. Yet nearly half of the burden falls on the patient themselves. This is a difficult and sensitive area. Many employees in small and medium sized businesses, which include workplaces where occupational asthma is common, do not have access to occupational health expertise. This might result in lower awareness of asthma both by employers and employees. Our findings suggest that if we are going to increase our chances of preventing occupational asthma, financial levers are not the way to go and that education will remain key."

SA: "What is the most significant threat to health, indoor or outdoor pollution?"

JA: "There is no doubt that outdoor air pollution has a major impact on health in cities worldwide, especially in those cities where emissions from vehicles are not as well regulated as they are in, for instance, the UK. Indoor air quality in the UK can affect health, especially in those environments where cigarette smoking occurs. The benefits from the ban on smoking in public places, an area in which we have done work, show how toxic second-hand smoke is. However, over half the world's population (3+ billion) are exposed on a day-to-day basis to smoke from burning of solid fuels such as coal and biomass and it is quite clear that this is conferring a major impact on health, particularly in its ability to cause illness and death from respiratory problems in infants. While attempts have been made to quantify the impact of outdoor air pollution, attempts to do the same for indoor air pollution are in my view less robust. My own view is that, worldwide, indoor air pollution is probably taking a greater toll than outdoor pollution, particularly because of the number of infants who die as a consequence of exposure, but it is certainly an issue that could be debated one way or the other."

SA: "What can Allergy Cosmos visitors do to protect themselves from air pollution health hazards?"

JA: "One thing to do is to read the Department of Health or Department for Environment, Food and Rural Affairs websites which alerts at-risk individuals of the impacts on health of air pollution on a day-to-day basis. Both these contain a banding system to alert individuals to the health effects of air pollution but is about to be restructured, the new version being a real improvement. From an indoor point of view, tobacco smoke is a major source of health problems and particularly for children, smoking indoors, even in the next room, will increase their chances of getting respiratory problems. As far as outdoor air pollution is concerned, being sensible in terms of exposure and if air pollution levels are forecast to be high and you are an individual at risk (e.g. a patient with existing heart or lung disease) then reducing exposures by remaining indoors, or at least not exerting while outdoors, would be sensible. Guidance on this is excellent on the Department of Health, DEFRA and COMEAP websites (see above). The use of masks outdoors is totally unproven although people may feel that they are at least trying to do something to help themselves!"

SA: "Perfect. Thank you very much for your time Professor Ayres."

Have you had time off work this winter for a cold or flu? Or do you and your colleagues always feel you have to 'struggle in' or go back before you were really well, because of pressure of work? If it's the latter, then it's likely that your office is a hotbed of germs (microbes) at the moment - and that poses an immanent threat to people suffering with allergies and asthma. So I've rounded up some of the latest tips to help your keep the workplace bug count down so you can continue 2011 happy and healthy.

Cold and flu viruses, food poisoning bacteria, and fungi that trigger asthma, may be lurking invisibly on all kinds of office equipment that you handle every day. So it's worth knowing where the hotspots for germs in your office are. Microbiologists have carried out many surveys of microbe counts in the office environment, and these findings are . Here's a typical example for germs in your place of work:

• Toilet seats have around 50 microbes per square inch
• Photocopiers have around 70 microbes per square inch
• A computer mouse houses nearly 2,000 microbes per square inch
• A computer keyboard has another 50% more microbes as a computer mouse (around 3,300 microbes per square inch)
• The office phone is the worst hot spot for microbes - with over 25,000 microbes per square inch

Charles 'Dr. Germ' Gerba of the University of Arizona points out that shared pens, lift buttons, door handles, vending machine buttons, escalator handrails, coffee mugs and chair armrests are also notorious for collecting germs. The water cooler might be the worst place of all for bugs - the US public health organisation NSF International found that the tap might harbour as many as 2.7 million germs per square inch! And in the restroom, there are far more germs on the toilet handle and on the door handle than on the toilet seat itself.

So, how can you protect yourself and fight off all these office microbes? Makes sense that the office cleaner would concentrate effort on the washrooms and maybe stay away from your desk for fear of disturbing your work. Do you clean your keyboard and screen every day? It'd be a sensible precaution. First, hold your keyboard upside down and brush out the dust and dirt between the keys with a soft brush. Then wipe over with an alcohol swab, or a lint-free cloth moistened with alcohol. You might want to cover your keyboard with dust cover when not in use. If you have a mouse attached to your keyboard, clean this in the same way. Apply the same treatment to your phone.

Alcohol is a good component for antiseptic wipes because it draws water away from bacteria, viruses and fungi, making it harder for them to survive. Antibacterial wipes won't kill flu and cold viruses, so go for an antiseptic product instead (and be wary of claims of killing 99.9% of all germs - it can be hard to back these up with scientific evidence). Keep one of these products on your desk and use it to keep your hands clean (as well as regular hand washing while in the office). And when you're having a coffee, stick to disposable cups or have your own mug that you wash regularly.

The air in your office should be cleaned by using an office air purifier. A good air purifier uses true HEPA filtration, and is able to filter 99.95% of particle pollution down to 0.3 microns. It will take out bacteria and viruses, as well as other harmful pollution that can trigger allergy and asthma symptoms. Toner dust and traffic pollution are common problems. If your office has central ventilation, chances are that bacteria, viruses as well as toner dust and other pollution is consistently spread through out the entire office. The best solution for that will be to integrate an appropriate filter into the HVAC system. Another option is to clean your individual room through the use of a stand alone air purifier.

Contact us anytime at 0203 176 0713, for a free consultation about how you can best protect yourself and everyone around you in your office.

Click here for our best stand alone Office Air Purifiers.

Asthma and allergic conditions like rhinitis affect more than 100 million people around the world. In the UK alone, 5.2 million adults and 1.1 million children are receiving treatment for asthma, creating a significant burden on the NHS, to say nothing of the personal suffering involved. Yet there have been no new treatments for asthma and allergy for 20 years. Existing treatments only target the symptoms; they do not tackle the allergen itself.

But there is hope on the horizon. Researchers at The University of Manchester and St George's, University of London, are developing novel drugs for allergy called Allergen Delivery Inhibitors (ADIs). They block the action of allergens before they can cause any damage to the respiratory system. In 2009, the team was awarded a £4.3 million award to for their work on ADIs by The Wellcome Trust, the world's largest medical research charity and they have now been received a further £390,000 from Wellcome to progress the work.

Professor David Garrod, of the faculty of Life Sciences at The University of Manchester explains that they found that disease-causing compounds (allergens) from house dust mites cause damage to the lining of the respiratory tract, allowing them to enter the body and trigger the allergic symptoms. This is because allergens are actually so-called proteolytic enzymes that can degrade the seals between the cells lining the nose and lungs. "It was a logical step to realise that if drugs that inhibit these enzymes could be developed, they would have the potential to both alleviate and prevent the disease."

At present the researchers are studying the properties of compounds that have high potency in blocking HDM enzymes. The work is a successful collaboration between an industrial chemistry company called Domainex, based in London, who produce the compounds and Professor Clive Robertson's team at St George's, and the Manchester- based team, who are testing them. It is too soon to say whether there is an ADI for each different allergen but Prof Garrod says. "There are reasons to believe that ADIs for house dust mite may be more widely beneficial. On the other hand, we have preliminary evidence that allergens such as pollen and Aspergillus may operate through their own proteolytic enzymes. In the long term, it may be beneficial to develop ADIs specific for these." He adds that they have sought funding to characterise pollen enzymes, but so far without success, which is a pity as millions worldwide suffer from hay fever or pollen allergy.

I asked Prof Garrod how widely applicable ADIs will be and when they'll be available. 'We think ADIs will be applicable to all patients suffering from house dust mite allergy, the major cause of allergic asthma,' he said. 'We hope that simple puffs from an inhaler will alleviate symptoms for all and prevent mild disease from developing into severe disease.' But there is a long road ahead. It is hoped that the ADIs currently being investigated will prove suitable for human clinical trials and if these prove successful the new drugs will reach the market, although that will be several years from now.

It also occurred to me that we don't hear many hopeful stories of this kind about new allergy drugs, but we do hear a great deal about cancer research. Prof Garrod commented. 'There is never enough money for research in any area. If you wish to make a comparison between cancer and asthma and allergy, it is estimated that there are 7.9 million deaths worldwide per year from cancer and 250,000 from asthma. Nevertheless, asthma is a serious disease, which affects over 300 million people globally, including many children. In its moderate and severe forms, it has a serious effect on lifestyle with patients suffering from coughing, wheezing, shortness of breath and tightness to the chest - and it can be fatal. It places an enormous burden on health services. Current treatments alleviate symptoms, but do not prevent or cure the disease. There is thus a major unmet clinical need in the area of asthma and allergy and, in my view, there is unquestionably a need for new drugs.'

These are our Best Selling Air Purifiers against House Dust Mites:

• IQAir HealthPro 250
• Blueair 650E
• Blueair 450E

and these are our Best Selling Allersearch Cleaning Products, which eliminate year round allergy and asthma risk factors such as House Dust Mites:

• X-Mite Carpet Cleaner
• ADS Anti-Allergen Dust Spray
• Allergen Wash Laundry Detergent

Your heart as well as your lungs are at risk if you are exposed to air pollution, according to two new research stories. And there's worrying news about the dangers of 'third hand smoke' (as if second hand smoke wasn't enough of a danger to health). So here's my round-up the latest news on air pollution and health.

• A team of researchers at Toronto General Hospital studied the effect of exposure to concentrated ambient particles (CAPs) emitted from cars and burning fossil fuels on 25 healthy volunteers. They also did separate experiments on exposure to ozone, and to CAPs and ozone together. A combination of the two pollutants caused concerning changes in heart rhythms. The levels of exposure were carefully calculated to match those typically found in both developed and less developed countries. The researchers conclude that while these heart rhythm changes might not bother a healthy individual, they could have serious implications for those with pre-existing heart disease. They urge doctors to push for pollution reduction for the sake of their heart patients.

• First-hand smoke is the smoke your breathe in yourself if you are a smoker. Second-hand smoke, you breathe in when you are a non-smoker in a smoky atmosphere (less of that now, with so many public smoking bans in countries around the world). But did you know about third-hand smoke? It is the invisible remains of cigarette smoke that deposits upon carpets, clothing, furniture and other surfaces. A new study from researchers in Israel notes that third-hand smoke is a health hazard. Nicotine in the third-hand smoke can react with ozone in indoor air (itself a potent pollutant) to form further pollution. Babies crawling on the carpet, people sitting on the sofa or those eating food that's come into contact with third-hand smoke may be exposed to more pollution than they realise. The researchers studied interactions between nicotine and indoor air on a variety of materials similar to those found in typical indoor surfaces. They found interaction between third-hand smoke nicotine and ozone did indeed produce even more toxic pollutants. So if you are in an environment where third-hand smoke is present, it might pay to be extra-vigilant on cleaning any surfaces it might contaminate.

• And finally, researchers in Denmark are saying that long-term exposure to even low level air pollution may increase the risk of chronic obstructive pulmonary disease (COPD). This is the first time a study has shown that air pollution is linked to development or progression of COPD - so it's important. Dr Zorana Andersen, team leader, from the institute of Cancer Epidemiology in Copenhagen, used data from the Danish Diet, Cancer and Health Study, which covers over 57,000 individuals aged 50 to 64 during 1993 and 1997. They used hospital data to find out who got COPD and addresses where people lived to check out levels of air pollution nearby. A significant link was found between chronic air pollution exposure and the risk of developing COPD. Most notable was that this risk was highest for those with pre-existing asthma and diabetes. And the risk could be even greater, because those with mild COPD would likely not have been included as the data came from hospital admissions, which are more usual in severe COPD. The study, of course, justifies further action on air pollution reduction. It also highlights a potential link between asthma, diabetes and COPD.

For the best home air purifier for COPD see IQAir HealthPro 250

For the first and second had smoke pollution see IQAir GC MultiGas

Click here for the best Air Purifiers for City Pollution

Sources: Sivagangabalan G et al The Effect of Air Pollution on Spatial Dispersion of Myocardial Repolarization in Healthy Human Volunteers Journal of the American College of Cardiology Jan 11 201157:198-206

Dubowski et al Thirdhandsmoke: heterogeneous oxidation of nicotine and secondary aerosol formation in the indoor environment Environmental Science and Technology

Andersen Z et al Chronic obstructive pulmonary disease and long-term exposure to traffic-related air pollution: a cohort study American Journal of Respiratory and Critical Care Medicine 2010

There are around 3,000 new cases of occupational asthma diagnosed in the UK every year (and there may be many more cases going undiagnosed). Most of these cases could be prevented, if the right steps for controlling air pollution at the work place are taken. In a new study, Professor Jon Ayres at the Institute of Occupational and Environmental Medicine at the University of Birmingham, and colleagues, reveal the costs of occupational asthma. They find that the majority of these are borne by the individual, their family, and the state. The employer gets away lightly when it comes to protecting people from getting asthma due to unhealthy work conditions, or helping them once the condition has developed.

The paper looks at three hypothetical cases to work out the total cost of each scenario. These were isocyanate, latex and biocide (eg glutaraldehyde), and flour exposure. Isocyanate is found in many types of paint and, typically, people involved in motor vehicle repair are often exposed. Healthcare workers may come into contact with latex and biocide. Flour particles may cause breathing problems for those working in the baking industries. Other common factors that contribute to poor air quality in offices are toner dust from printers and fax machines, off gassing from building material (such new floors or carpets, wall insulation, heating devices), traffic pollution through nearby roads, airports or harbours.

The impact on the individual with occupational asthma varies and so do the costs relating to an employee developing asthma. It’s unusual for anyone to gain from developing asthma from workplace exposure - more often than not, they lose out. They may struggle on with their job, risking a worsening of their health. Or they may find a different job with the same employer, that doesn’t involve exposure to their allergen - like the motor mechanic who is offered a desk job, or the nurse moving off the wards into admin. Some may move to an entirely different job or even retire from the workforce altogether. These changes involve indirect costs, where the individual and their family may well suffer from loss of income (and the employer suffers lost productivity, and additional cost of training a new employee). Then there are direct costs arising from the person with occupational asthma’s use of the NHS and any benefits they may claim.

So how does it all add up? Here is the burden of occupational asthma - a total of 209 cases - estimated for the three exposures:

• Latex or glutaraldehyde - 7 male, 21 female
• Isocyanates - 104 male, 4 female
• Flour or grain - 45 male, 28 female

The total cost to society for all 209 cases was estimated to be £25million to £27million over a lifetime. And the total cost, of all cases of occupational asthma arising in one year, would be between £71 million and £100 million. These costs are shared more or less equally between the individual with asthma and other taxpayers (public money being the source of NHS costs). The employer bears only around 3-4% of the costs resulting from occupational asthma (not including the cost for training a new employee). Professor Ayres points out that removal or reduction of exposure to allergens in the work place can be very effective and is often easy to implement. These air pollution measures at the work place could save the individual and society up to £100 million, just by avoiding one year’s worth of new cases. I think it is time employers are pressured to be more responsible and take the necessary steps to reduce exposure to airborne pollution at the work place.

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Source:

Ayres et al Costs of occupational asthma in the UK Thorax January 2011

Coughs are very common at this time of year. So common, in fact, that many people just dismiss them as an annoyance which is likely the result of a lingering cold. This may well be the case, but cough symptoms may also indicate asthma, or some other serious respiratory (lung) disease. Here are the most usual symptoms of respiratory disease:

• Cough. The two types are dry and chesty (the latter produces phlegm - a colourless or yellow/green discharge)
• Breathlessness (clinical name, dyspnoea). Could be at rest, on exercise, or on lying down. May involve wheezing noise and be worse at certain times
• Chest pain. Might be mild to severe, sharp or aching, worse on exertion

There are several important respiratory diseases, including asthma, so how does the pattern of symptoms fit the diagnosis? Warning, this is for information only! If you are worried about respiratory symptoms, see your doctor without delay!

Asthma

Asthma has three main characteristics which marks it out from other respiratory diseases:

• Narrowing of the airways and impeded air flow in and out of the lungs that are reversible with treatment
• Over sensitivity or 'twitchiness' of the airways
• Inflammation of the airways and production of lots of mucus which narrows them even more

Asthma is an inflammatory disease and most cases are caused by an allergic response to a trigger like house dust mites, traffic pollution or pet dander. Irritants like tobacco smoke make asthma worse.

Symptoms of asthma include episodic coughing, wheezing, chest tightness and breathlessness. Recent research has shown that nasal congestion may also be present and is often overlooked as an asthma symptom. These symptoms are often worse early in the morning or last thing at night. Asthma attacks vary widely in their frequency and severity.

Chronic obstructive pulmonary disease (COPD)

COPD is the name given to chronic bronchitis and emphysema (most COPD patients have both conditions). It is characterised by irreversible lung damage which obstructs breathing out and makes breathing increasingly hard. The progressive nature of COPD distinguishes it from asthma. The main symptom of chronic bronchitis is a chronic cough (sometimes called "smoker's cough") while the main symptom of emphysema is chronic breathlessness. Smoking is a major risk factor for COPD.

Pneumonia

Pneumonia can be caused by a virus (influenza), bacterium (Streptococcus pneumoniae) or fungus (Aspergillus). The under fives and over-65s are most at risk, as are those with weakened immunity. It's also possible to pick up pneumonia from travelling abroad or from faulty air-conditioning (Legionnaire's disease). Symptoms of pneumonia include fever, cough, breathlessness and coughing up blood. Since pneumonia can follow a bout of flu, it's wise to get a flu injection if you are in an at risk group (for example, if you have asthma).

Lung cancer

More people die in Europe and the USA from lung cancer than from breast, prostate and colon cancer combined. The disease has a worse outlook than for many other cancers. The majority of cases of lung cancer are linked to smoking with the risk increasing with the number of cigarettes smoked and the number of years the person has been a smoker. Long term exposure to urban air pollution, as well as high levels of indoor air pollution can also cause lung cancer. Symptoms of lung cancer include a worsening cough, coughing up blood, chest pain, hoarseness, breathlessness on exertion and unplanned weight loss.

We began this post with the symptom of cough and we'll end in the same way. Don't ignore a chronic (more than three weeks) cough. Yes, it may be the aftermath of a cold, but it might also be something more serious. Also keep in mind that a high-end air purifier can lead to a 90% reduction of dust and air pollution in your home, capturing particulate and gas pollution that otherwise your lung would need to deal with.

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Asthma has been very much on the medical research agenda in recent weeks, so we thought it was time to bring you an update on the latest news.

• New findings from the West Sweden Asthma Study suggest that severe asthma may disguise itself as nasal congestion. Dr Jan Lötvall and his team, from the University of Gothenburg, asked 30,000 people about symptoms like nasal congestion, runny nose, wheezing and breathlessness. He found that around 2% of the population of West Sweden actually had asthma, which was more than expected. The researchers noted that 60% of those with asthma also reported some kind of nasal disease and nasal symptoms were more common among those with severe asthma. 'These findings suggest that some parts of the immune system that are activated in connection with chronic nasal problems might be linked to severe asthma,' said Lötvall. 'This insight could lead to new forms of treatment in the long run.' He believes the new study could lead to the identification of new subgroups of asthma and the relationships between asthma and other chronic conditions like rhinitis. Take home message? If you're worried about a chronic stuffy nose, get it checked out thoroughly - could be you've actually got asthma.

• Wheezing and respiratory infections are more common among newborns with lower Vitamin D levels, according to a new study from the New Zealand Asthma and Allergy Cohort Study, which is following up more than 1,000 children in the cities of Wellington and Christchurch. During the first five years of life, the lower the vitamin D level at birth, the higher the risk of wheezing in the first five years. The wheezing generally came from chest infections. There was no link between low vitamin D and increased risk of asthma at age five. So, even though low vitamin D can does not cause asthma, it can certainly make it worse if it already exists. It may be that vitamin D supplements can help here (although further research would be needed to confirm this) by protecting a child from infection, particularly during the months when sunlight levels are low, since lack of sunlight exposure is a major factor in vitamin D deficiency.

• New research in the journal Pediatrics suggest that babies given antibiotics in the first year of life are 12% more likely to develop asthma than babies not receiving antibiotics. The risk increased with the number of courses of antibiotics received. So babies receiving more than four courses of antibiotics had a 30% increased risk of asthma. The study was carried out by Dr Fawziah Marra and colleagues at the University of British Columbia. Dr Marra says. 'While I do not think this study means your child should not take antibiotics if they really need them, it may make you think twice about asking for them if your doctor doesn't prescribe them.'

• Finally, could breast feeding increase the risk of your child developing an allergy? The World Health Organization recommends breastfeeding for six months before introducing solids. But researchers at University College London's Institute of Child Health now say this might not be the best approach. Put simply, they say the latest evidence suggests that earlier exposure to potential allergens, through solid foods, may be protective of allergy.

Sources Journal Respiratory Research

Lötvall J et al Multi-symptom asthma is closely related to nasal blockage, rhinorrhea and symptoms of chronic rhinosinusitis-evidence from the West Sweden Asthma Study Respiratory Research 2010;11:163

Camargo C et al Cord-Blood 25-Hydroxyvitamin D Levels and Risk of Respiratory Infection, Wheezing, and Asthma
Pediatrics, Jan 2011; 127: e180 - e187

Marra F et al Antibiotic Use in Children Is Associated With Increased Risk of Asthma Pediatrics March 2009;123:1003-1010

Fewtrell M et al Six months of exclusive breast feeding. How good is the evidence?

British Medical Journal 13 January 2011 http://www.bmj.com/content/342/bmj.c5955.full

The common environmental mould known as Aspergillus fumigatus is a well-known trigger for asthma and other allergic diseases. Around half of people with severe asthma have evidence of allergy to Aspergillus fumigatus. New research suggests that there may be no getting away from this particular trigger - for it can actually grow in the lungs of people with asthma. Researchers at the Institute for Lung Health, at the University of Leicester and Glenfield hospital, were funded by the Midlands Asthma and Allergy Research Association and the European Regional Development Fund to investigate the presence of the mould in asthmatics' lungs.

In this study, 79 patients with asthma, of whom 89% were classed as having severe asthma, were classified into groups according to whether they were sensitised to Aspergillus fumigatus (either very, or moderately sensitised) or not. They were compared to 14 healthy controls. The researchers looked at sputum samples to see if they contained Aspergillus fumigatus and correlated its presence with clinical data. Sputum is the matter which is expelled as phlegm, mixed with saliva, from the respiratory tract.

Aspergillus fumigatus was found in 63% of patients highly sensitised to it and in 39% of those moderately sensitised to it. And 31% of non-sensitised asthma patients had the fungus in their sputum, compared to just 7% of healthy controls. Those who were sensitised to the fungus had worse lung function and more inflammation than those people with asthma not sensitised to it. Clearly Aspergillus fumigatus is a powerful allergen. Team leader Prof Andy Wardlaw said 'Our research concluded that it is possible that fixed narrowing of breathing tubes in many people with asthma could be caused by Aspergillus fumigatus growing in their lungs.' The next step is to see whether treating people with asthma who have Aspergillus fumigatus in their lungs with anti-fungal drugs might improve their condition.

Aspergillus fumigatus is all around us - in compost heaps, bird cages and rubbish tips - anywhere, in fact, where you might find decomposing material. We know that the spores can get into the lungs - but this study now shows that infection correlates with worse asthma. In most people, the fungus is harmless. There is a separate condition called aspergillosis (short for allergic bronchopulmonary aspergillosis) which is an infection plus allergy. Often it is mistaken for asthma. Where it differs is that aspergillosis produces nasty rubbery plugs of brown or green phlegm and a fever. The newer anti-fungal drugs, like itraconazole and terbinafine, might be useful in ridding the lungs of A.fumigatus. Although usually found outdoors, this mould can migrate indoors, especially under damp conditions, so make sure your home is adequately ventilated and you are using the right HEPA air purifier to avoid this. And don't forget its mouldy cousin, Aspergillus niger which is responsible for those nasty black patches on damp walls - it's also a potent allergen. So check the bathroom, windowsills and basements for damp spots where these moulds might grow, be sure to clean the shower regularly with bleach or our range of allergy and asthma friendly cleaning products, and make sure window frames do not leak. Moulds love to grow on food too, so keep the kitchen free of waste.

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Source:

Fairs A et al IgE sensitization to Aspergillus fumigatus is associated with reduced lung function in asthma American Journal of Respiratory and Critical Care Medicine December 2010

Late last year, the Committee on the Medical Effects of Air Pollutants (COMEAP) brought out the most detailed report to date on the impact of air pollution on the UK population. COMEAP Chairman Professor Jon Ayres commented that it is difficult to express these health impacts numerically but they have looked carefully at the many ways in which these effects are reported and the different relationships between them. The report is mainly about the impact of PM2.5s - particles with a diameter of 2.5 micrometers or less. Concentrations are measured as mass per cubic meter of airborne PM passing through the inlet of a sampler. Here's what COMEAP has concluded on the health impact of PM2.5s:

• In 2008, exposure to PM2.5s was responsible for the loss of 340,000 years of life among the UK population
• This is equivalent to 29,000 deaths
• Air pollution also makes a smaller contribution to the premature deaths of 200,000 people with average loss of life due to air pollution being less than two years
• Another way of looking at this is as a loss of life expectancy from birth of six months

If we reduced PM2.5 concentrations by just one microgram per cubic metre, life expectancy at birth would go up by 20 days and the UK population could gain an extra 4 million years of life over the next 100 years! If we could clean our air completely (no PM2.5s at all) the predicted life gain among our population would be 36.5 million years, which works out to an increase in life expectancy at birth of six months. You can of course significantly reduce air pollution levels in your home by using an effective air purifier in your home.

I was left thinking that the UK population deserves lower levels of particle pollution. So how disappointing to learn last week (12 January) that the government is trying to keep secret some sections of ministerial briefings on air pollution in London, believed to relate to the western extension of the congestion charge and air quality. The government is appealing two previous rulings to make this information public. Environmental campaign groups Clean Air in London and Friends of the Earth are leading the fight for disclosure at a freedom of information tribunal.

In a related matter, the European Commission is to decide early February whether the UK is to be allowed a time extension to comply with the PM10 limit daily value in London. PM10s are a bit larger than PM2.5s but every bit as much a health hazard (the World Health Organisation advises there is no safe exposure limit with PM10s). If the request for an extension is turned down, we will end up in the European Court of Justice over these breaches of air quality laws.

So now I turn to Mayor Boris Johnson's plans for cleaning up the capital's air - the worst in the UK and one of the worst in Europe. He removed the western extension of the congestion charging zone on 4th January, he postponed the introduction of Phase 3 of the low emission zone from October 2010 to January 2012. London's new air quality measures also back off from tougher measures to clean up emissions from black cabs. Previously there was a pledge to get cabs over 10 years old off the road by 2015 but that's been watered down to get cabs over 15 years old off the road by 2012. As a result, the target for PM10 reductions has been revised downwards from 33% to 31%. A small revision of just 2%, you might argue. Unfortunately, it is 2% in the wrong direction and it is sure to cost lives, as the COMEAP report shows.

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What is your experience of eczema? There are many different types of eczema, and its appearance can also be very variable - even between individuals who have the same diagnosis. But certain features, such as itchy rash and dry skin, are common to most forms of the condition.

Here's how atopic (allergic) eczema might look in a young child:

The initial symptom of atopic eczema is often a rash on the face, scalp or trunk appearing when a child is no more than two or three months old. The baby tends to rub or even scratch at the affected area, which makes it raw and 'weepy'. The rash might disappear, or it may spread to the body and limbs. Often it will settle in the creases of the elbows, wrists, buttocks, knees or ankles.

However, it should be borne in mind that atopic eczema is an unpredictable condition, affecting individual children in different ways. The rash can appear on any part of the body, although nearly every child with eczema has an affected patch in the crease beneath the ear lobe while, conversely, some sites - such as the nose - are almost never affected. Has your child been affected like this?

If the condition persists as the child gets older (and, of course, eczema often clears up before adulthood) then the rash takes on a different distribution - being more often found on the surface of the body, rather than the creases. The hands are often affected, as are the neck, trunk, feet and scalp in diffuse itchy patches.

The severity of atopic eczema varies widely at all ages. It may be no more than a mild irritation, or it may be severely distressing and disabling. Its tendency to fluctuate over time can be frustrating, but it also means that there may be things you can do to modify the severity of 'flare ups' or even avoid them altogether, the main one being simply strict allergen avoidance.

The itching problem

Few diseases cause such an intense urge to itch as eczema. However, itching can be a sign of many other illnesses, both physical and psychological, and should always be investigated by your doctor. Have you noticed how itching seems to become worse when you're tired or when the skin suddenly becomes cooler - typically on undressing? That's probably why an itch that's hardly noticeable during the day becomes suddenly unbearable at night. The natural response to an itch is to scratch it. But that's what causes much of the skin damage and distress associated with eczema. The scratching may relieve the itch but it does nothing to clear up the eczema - it only makes the condition worse.

Vesiculation and crusting

In eczema, fluid leaks from tiny blood vessels beneath the skin, leading to the accumulation of tiny blisters called vesicles. Individually, a vesicle is almost invisible but together they give the skin a bubbling, boiling appearance known as vesiculation. The inevitable scratching will break the vesicles and fluid then exudes onto the skin surface itself, causing a 'weeping' appearance. As the fluid dries, it tends to coagulate, forming scabs.

Dryness, scaliness and thickening of the skin

Even when the red, weeping rash is absent, the skin of someone with eczema has a characteristic appearance. Typically it is very dry, lacking the 'bloom' of a healthy skin. If you have eczema, do you find that your skin smarts if it's exposed to soap and water? The surface of the epidermis - the outer layer of the skin - acts as protection from the outside world, rather like varnish on a piece of furniture. This surface layer normally flakes off and is replaced every day or so, without our being aware of it. In eczema though, it tends to crack and peel, giving the skin a scaly appearance. Meanwhile, scratching often leads to a thickening of the epidermis which leads to a leathery appearance.

Eczema also affects the skin cells which produce the pigment melanin, which gives our skin its tone. This often leads to a loss of pigment, so that people with eczema don't get a tan when exposed to the sun. It's also possible to get release of pigment granules, which gives the skin a dirty, unwashed, appearance.

But it doesn't have to be this bad! Allergen and irritant avoidance and looking after your skin are the key to keeping away from those distressing flare-ups.

Related Blog Posts:

• Living with Eczema - Cleansing and Moisturising
• Living with Eczema - What's Your Experience?

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I'll make no apology for returning to the subject of swine flu because the British Medical Journal has just put out an advisory note that I would like to share with you.

This follows the shocking news of the death of a healthy baby from H1N1 flu. Three year old Lana Ameen fell ill with what was apparently a cold on Christmas Eve and died just two days later. Now her mother, Gemma, is calling on health ministers to make HINI vaccine available to all children, not just those with risk factor asthma. Official advice remains that the flu jab should only be given to children aged six months and up who have risk factors. Whether this will change remains to be seen.

I visited the website for an update on H1N1 deaths and it makes disturbing reading. There have been 50 deaths from flu since the start of the flu season in October, 45 of which have been from H1N1. Most of these deaths were in people under 65, and five were in children under five. Should we be doing more to protect our children from H1N1? What do you think?

Now to what the BMJ had to say today. 'Swine flu is one of the major strains of flu around this winter. While for most people it is an unpleasant but mild illness, it can be serious. It has already caused a number of deaths this year.'

This is how you should protect yourself, according to the latest research and evidence

• The seasonal flu vaccine for 2010/2011 protects against swine flu and other types of seasonal flu and is unlikely to cause any serious side effects.
• People with chronic diseases (like asthma or heart disease), people over 65, and pregnant women are all being encouraged to get vaccinated because they are more at risk of complications from flu.
• Treatments that are likely to work if you have swine flu are the antiviral medicines oseltamivir (Tamiflu) and zanamivir (Relenza). These medicines are not a cure for flu, but they may cut the time you are ill by about one day and you may be less likely to get complications from flu, such as pneumonia, although the evidence about this is not clear.
• If you're pregnant and you suspect you have flu, you should call your doctor immediately. It's important for pregnant women with swine flu to start taking antiviral medicines as soon as possible.
• Breastfeeding will help protect your baby against the virus, so you should carry on breastfeeding if you can, even if you get sick. You can continue to breastfeed while taking antiviral medicines.
• For most children, symptoms of swine flu are similar to those in adults, and the disease is not likely to be severe. Children can also take antiviral medicines, on the advice of a doctor.

The best way to avoid catching swine flu (or any other type of cold or flu) is to wash your hands regularly with soap and hot water. Other sensible hygiene measures to help prevent the spread of swine flu are:

• Cover your nose and mouth when you cough or sneeze, using a tissue where possible
• Dispose of used tissues quickly and sensibly
• Clean regularly-touched hard surfaces (e.g. door handles and kitchen surfaces) frequently, using normal cleaning products
• Make sure your children follow these hygiene rules

There is no evidence that wearing masks on the street, or while going about your daily business, will protect you against swine flu. Most masks are designed to stop you from passing on the germs you breathe out, not to stop germs getting in. Masks might be helpful if you have swine flu, to avoid giving it to people who are caring for you, or if you are caring for someone at home with swine flu.

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As part of our series of interviews with allergy and asthma experts across the UK, we spoke with Ms. Delia Balan, an asthma nurse specialist at Asthma UK. It is our hope that reading about allergy and asthma specialists, their work and favoured treatments, and what they think about the future of allergy and asthma treatment will provide you with valuable insight into your own allergy and asthma treatment options.

Ms. Balan, how would you describe your work in the asthma field?

I am part of a small friendly team of asthma nurse specialists who provide independent confidential advice and support to people with asthma, their families, friends and carers and also healthcare professionals. We receive queries about what asthma is and what causes it, triggers, symptoms, treatments and inhaler devices. We're also often asked about allergies, exercise, diet, housing location and many other concerns that people have about asthma. We offer a range of services including a Telephone Adviceline service, an interpreting service and are able to receive Typetalk calls.

We also respond to letters, emails, media enquiries, provide clinical input into the Asthma magazine, factfiles and other written materials. We attend many conferences raising awareness of Asthma UK and the needs of people with asthma. We do this by promoting our Adviceline service, the Asthma UK website, our written materials and by networking with other Health Professionals. We also provide training on asthma to schools, Health Professionals, people with asthma and their carers, Asian Melas, corporate events, and shows such as The Allergy Show.

What do you love about your job?

I enjoy keeping up to date with trends and research in asthma and most of all I value talking to people with asthma, listening to their needs and supporting them on how best we can help them now and in the future. I am part of a wonderful friendly team of asthma nurses who come from a variety of medical backgrounds and also have the full support of our two very experienced professional Clinical Leads. Asthma UK creates a great working environment and cares about their employees as well as striving to improve and meet the needs of people with asthma. Through our work we enjoy the contact we have with people with asthma and know that the advice we give can make a huge difference to people's lives by helping them manage their asthma and empowering them to have better control of their condition and an improved quality of life.

Could you tell me a little bit about your background and why you decided to become a specialist in the asthma field?

I spent a number of memorable years working in the NHS as a ward sister on a medical ward treating and caring for many patients with asthma and other respiratory conditions. Then having a daughter with asthma got me more interested in the work of Asthma UK and I decided to train as asthma nurse specialist and applied to work on The Adviceline and I have never looked back.

If you could suggest one thing for your patients with asthma what would it be?

I would recommend that they carry their blue reliever inhaler with them wherever they go, take their preventer inhaler regularly and make sure that they have their asthma under control.

Where do you see asthma treatment and management going in the future?

It would be great to see better standards of care and treatment for all people with asthma, this includes much better education provided by GPs and asthma nurses to people with asthma at the point of diagnosis and ensure that every person with asthma has a Personal Asthma Action Plan and has an annual review of their asthma. We hope the Government and The Department of Health will consider extending free prescriptions to all people with asthma.

Is there anything else you'd like to add?

I would like to see every school with an asthma policy and that all teachers and school staff are trained and know how to treat every student or pupil with asthma in their school should they have an asthma attack.

Great - thank you very much for your time Ms. Balan.

It's well worthwhile making sure your children eat a healthy diet, if you want to protect them from asthma. A new study shows that the Mediterranean diet , ri ch in fruit, vegetables and fish, reduced the chance of developing asthma and wheezing, while eating three or more burgers a week increased the risk.

The study appears in the leading asthma and respiratory disease journal Thorax . It is part of the International Study on Allergies and Asthma in Childhood (ISAAC) a unique, worldwide project set up in 1991 to investigate asthma, rhinitis and eczema in children because of concern that these conditions were increasing in western and developing countries. ISAAC is now the largest worldwide collaborative research project ever undertaken, involving more than 100 countries and nearly 2 million children and its aim is to develop environmental measures and disease monitoring to reduce the burden of allergic and non-allergic diseases, especially in children in developing countries.

One major interest of ISAAC is whether diet can affect the risk of childhood asthma. In this new study, researchers from the UK, Spain and Germany, looked at data collected from 50,000 children aged from eight to 12 in 20 different countries between 1995 and 2005. They found that fruit intake was linked to low prevalence of current wheeze in both affluent and non-affluent countries. Consumption of fish in affluent countries and green vegetables in non-affluent countries was similarly linked to low rates of current wheezing. Overall, more frequent consumption of fruit, vegetables and fish was linked with a lower lifetime occurrence of asthma, while eating burgers - but not overall meat consumption - was linked to higher risk of asthma. However, childrens' diet did not protect against developing allergies to tree or grass pollen. This is not the first study to show that a healthy diet protects against asthma, but it is an impressive one because it was done on such a large scale.

The researchers say 'Fruit and vegetables contain antioxidants and other biologically active factors which may contribute to the favourable effect of fruit consumption in asthma. In particular, foods rich in vitamin C have been reported to relate to better lung function and fewer asthma symptoms.' The vital components in the Mediterranean diet for people with asthma are likely carotenoids, vitamin C and vitamin E. Try sweet potato and carrots for carotenoids. An easy way to increase carotenoid intake is to make sweet potato wedges in the oven to replace ordinary chips. You can also mash sweet potato with carrot for a carotenoid-rich topping for shepherd's pie. Another winter healthy eating tip is to buy plenty of vitamin C-rich clementines - sweet, and easy to peel, making them an ideal snack.

Related Blog Posts:

• Allergy & Asthma Relief in the UK-Dr Mike Thomas
• Eating Out with an Allergy
• Can milk protect against asthma & allergy?

Source:

Nagel G et al Effect of diet on asthma and allergic sensitisation in the International Study on Allergies and Asthma in Childhood (ISAAC) Phase Two Thorax 2010;65:516-522

One form of rhinitis is hay-fever, but it is not the only one. While asthma is an allergy affecting the lungs, hayfever is a seasonal allergy affecting the mucous membranes of the nose and eyes. The usual symptoms of hayfever include:

• Itchy nose, mouth, throat and eyes
• Frequent sneezing
• Streaming eyes

Other symptoms of hayfever include: dry throat, swollen eyelids and blocked nose, leading to lack of sense of smell. Symptoms may be only mild, or severe enough interfere with work, study of driving. Typical hayfever allergens include grass pollen and moulds. Hayfever wasn't really known until early in the 20th century but it affects between 15 to 20% of the UK population today. In the UK the main hay fever allergen is grass pollen, but in the USA it is ragweed, and in Japan, cedar pollen. The UK hay fever season is from June to August; therefore young people with hayfever may be badly affected during exam time.

Perennial Allergic Rhinitis

Perennial allergic rhinitis is 'hayfever' that occurs all year round. If that is the case, then it is likely that grass pollen, which is only really around in the summer, is not the culprit. You are likely allergic to something else, like mould, pet dander or house dust mite, urban air pollution (i.e. exhausts from cars, trains, plains etc.). Rhinitis itself - like any other word ending in 'itis' - is just a name for inflammation. The word 'rhino' means nose, of course! Two other conditions that look like allergic rhinitis, but are not, are triad and NARES. Triad has three symptoms: allergic rhinitis, nasal polyps and asthma. It is often linked to aspirin sensitivity. NARES stands for Non-Allergic Rhinitis with Eosinophilia and occurs when immune cells called eosinophils migrate to the nose and cause a severe inflammatory reaction.

The language of rhinitis

• Rhinitis - inflammation of the nose
• Hayfever - allergic rhinitis caused
• Allergic rhinitis - rhinitis caused by allergy, may be seasonal or perennial, depending on when symptoms occur
• Vasomotor rhinitis - a non-allergic form of rhinitis, relieved by decongestants but not by anti-allergy drugs
• Sinusitis - inflammation of the sinuses, the air pockets within the bones of the skull and face, which are connected to the nasal cavity. It can be caused by allergic rhinitis, the presence of polyps in the sinuses, or bacterial infection of the sinuses. It may be acute or chronic
• Post-nasal drip occurs when excess mucus produced in allergic rhinitis runs down the back of the nose, into the throat and into the airways, causing a persistent cough through irritation

Rhinitis Treatment

One of the problems of perennial rhinitis is that even though it can have a severe impact on a person's life, it is often undiagnosed. Lack of awareness about the condition is often to blame.

Antihistamines, which are available in non-sedating forms, are effective to the treatment of rhinitis. One of the standard prescriptions for mild rhinitis is Beconase Aqueous Nasal Spray, a low level corticosteroid nasal spray. The active ingredient is beclometasone dipropionate 50 mcg/spray. Don't worry - the dose of steroid is very small. But beconase does have a number of side effects - one in ten people will be affected by:

• Bad nose bleeds
• Skin rashes or hives
• Less common side effects include,
• Blurred vision
• Damage to your nose
• Swelling of face and throat

Related Blog Posts:

• Allergic Rhinitis Reduced by Farm Life
• Nasal Irrigation in the Spotlight
• Hay-fever is Trivialised - by Doctors & Schools

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Last year there was talk of swine flu being a scam put out by the pharma companies to get governments to buy up millions of shots of HINI vaccine. Why did 'only' 457 people die of the disease, when 65,000 fatalities had been predicted? Why do we have 20 million unused shots of HINI vaccine? Actually, I am not a big fan of conspiracy theories and I know, from talking to infectious diseases experts, how unpredictable viral illnesses, including a flu such as the swine flue, can be. Wouldn't you rather the vaccine was there - even if it's not needed, in the end - than have to worry about shortages?

I'm not at all surprised that swine flu has, sadly, already claimed the lives of 14 people in the last three months, according to the Health Protection Agency. Particularly concerning is the death of Kay Burdett, from Liverpool, who was being treated for asthma. Currently there are around 300 people across the country who are in intensive care with flu complications (it's not known how many of these patients have swine flu).

If you have asthma, you'll likely be well aware of the danger posed by flu. In people with heart and lung conditions what is normally a mild (albeit miserable) illness can develop into serious, even life threatening, pneumonia. Swine flu is no different. For most people, swine flu poses no real long-term threat to health. But people with asthma are at risk of complications, just as they are from regular flu.

Dr Mike Thomas, GP and Chief Medical Advisor to Asthma UK says 'We urge people with asthma to have the swine flu vaccine. Although swine flu is mild in most cases, people with asthma are at risk of serious breathing complications such as pneumonia if they do develop the illness.' So if you have been too busy to get your jab in the Christmas rush, don't delay. HINI vaccine is entirely safe for people with asthma. And, while it can't offer 100% protection, it will certainly help if you are exposed.

Don't just rely on the vaccine though. Simple hand hygiene goes a long way in protecting against colds and flu. As you probably know, the viruses are spread by droplets in coughs and sneezes. If you touch a surface that's contaminated by the flu virus, you are exposed to it. So wash the virus away often by washing your hands. Use tissues to catch a cough or sneeze. Sounds simple, I know (and I apologise for pointing it out because I am sure all of you reading this are well aware). But it's surprising how many people don't take these simple precautions, isn't it? Another easy way to protect yourself and the people around at home and in your office by using a true HEPA air purifier. The right air purifier will clean the air in a given room 2-3 times per hour and will filter out all viruses and bacteria. And if you already have a viral infection, why not consider staying indoors and stop spreading it about. You can always use this cold weather as an excuse for not venturing out.

Meanwhile, an expert from the European Centre for Disease Control and Prevention warned that flu tends to move from West to East in Europe, so continental Europe may experience more cases of H1N1 in the months to come.

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We spoke with Dr. Mike Thomas as part of our series of interviews with allergy and asthma experts across the UK. It is our hope that reading about these physicians' practices or research work, their favoured treatments, and what they have to say about the future of allergy and asthma treatment will provide you with valuable insight into your own allergy and asthma treatment options.

Dr. Mike Thomas trained in medicine in London. After several junior hospital posts, including a time working on a hospital chest unit, Dr. Thomas became a GP in the Cotswolds in 1989. He also works a clinic a week in the local hospital chest unit outpatient's clinic. For the other 50% of his time Dr. Thomas is the Asthma UK Senior Research Fellow with the University of Aberdeen. He undertakes research in asthma, allergies and other lung diseases, and has published over 70 research papers in medical journals. Dr. Thomas is the Chief Medical Advisor to the charity Asthma UK, and sits on various UK and international guideline groups. He is an advisor to the Department of Health on asthma, and sits on a number of national committees.

Dr. Mike Thomas research is concerned with improving asthma care in the general practice. These days most people with asthma and allergies are mainly treated in general practice, and there is a great need to improve treatment in the community. Dr Thomas' research aims to find out how GPs and nurses can give better care to people with asthma and allergy.

Dr. Thomas has a particular interest in non-drug treatments, including the use of breathing exercises to control asthma. He has also published research on allergic rhinitis, a common and often ignored allergic condition, which often exists alongside asthma.

Dr. Thomas is a Fellow of the Royal Collage of Physicians of London, and was awarded a PhD for his research on breathing exercises for asthma.

Allergy Cosmos: How big is your practice?

I work in a 4-partner practice serving 8000 patients in rural Gloucestershire. I've worked here for over 20 years, at first as a full-time GP, but for the last 10 years (since I've been more involved with research) working half time as a GP and half time as a researcher.

I'm lucky to live and work in a lovely part of the country with a stable population - I've known most of my patients for many years, and some of them for all their lives!

I am also a member of the Department of Academic Primary Care at the University of Aberdeen, part of a research team specialising in asthma, allergy and lung research in GP settings. My main research interest is in asthma, but I am also interested in allergic rhinitis and respiratory infections- and, of course, in the large overlap between these conditions

What do you love about your job?

I enjoy treating patients and getting to know them over time - the great attraction of general practice is that you form a close personal link with your patients over the years. I would very much miss my clinical work if I went into 'full-time' research. I also think that seeing patients regularly allows me to be a better researcher, and allows me to focus in on the really important questions.

However, I also love research, which I view as a truly creative activity of the human mind and soul. It's very rewarding when one's research results in a tangible change for the better for one's patients. I also enjoy being able to help represent the patient's perspective through my work with Asthma UK, and to try to influence the Department of Health to shape good respiratory and allergy care in the UK

If you could suggest one thing for (your) patients what would it be?

I would like to see a cure for asthma! However, I don't think this is likely in the near future.

What is your favourite allergy relief product?

We are luck to have excellent inhaled treatments for asthma, and inhaled steroids have had a dramatic effect in saving lives and improving people's quality of life in my lifetime. I know that some people worry about side effects, but when used properly they have an excellent benefit to safety profile. Having said that, many people still get bad asthma symptoms despite such treatment, and we are still in real need of new treatments.

Where do you see allergy treatment going in the future?

There is still so much that we don't understand about why allergy is so common in the modern world, but we are making steady inroads into understanding the complicated interaction between our genetic makeup and the environment we inhabit. I think that the way asthma and allergy treatment is headed is in recognising that everyone is different, and that it's unlikely that a 'one size fit all' approach will be successful. The future is likely to be targeted treatments for specific people after careful assessment - so-called 'personalised medicine'

Is there anything else you'd like to add?

Allergy has been sadly ignored for many years, and there is a great need to prioritise allergy research and treatment. Allergy is a real blight on many people's lives, and many people in the UK don't have access to the best assessments and treatments. This needs to change!

We completely agree. Thank you for your time Dr.Thomas.

Do you feel nervous of having a meal out because of your allergy? Do you avoid visiting restaurants with friends, or Sunday lunch at the pub with the family? Well, maybe you can relax a bit now, because six pub/restaurant chains have now signed up to the Food Standards Agency Healthy Eating Initiative. Whitbread (Beefeater, Brewer's Fayre, Premier Inn), Mitchell & Butlers (All Bar One, Harvester, Browns restaurants), JD Wetherspoon, Marston's and the Spirit Group (Punch taverns, Chef and Brewer) are the companies who have committed to a number of projects, including making nutritional information more readily available to their customers.

JD Wetherspoon (popular for its Sunday roasts, curry club and steak club evenings) seems to have made quite a bit of a progress on the allergy information front. Eating in one of their pubs a few days ago, I noticed there were food and nutrition leaflets on display. These list information of whether dishes on the menu contain gluten, nuts, sesame seeds, soya, egg, seafood and milk. There's also information on calories, fat content, fibre and salt to help you make a healthy - as well as a safe - choice. So, if you have multiple allergies the sweet potato, chickpea and spinach curry with poppadums is a good choice because it contains none of the above. In the kids' section, the Happy Monkey Strawberry & Banana Smoothie is equally allergen-free.

I checked progress in the other pub/restaurant chains and learned that Spirit group will be giving nut and seed allergy information in all new menu launches. Whitbread has been working with the Coeliac and Anaphylaxis Society on the development of dishes suitable for allergy sufferers and makes allergen information available on its website. Marston's is developing a full database of nutritional information. Menus on Mitchell & Butler's Harvester website list detailed information on content of peanut, fish, shellfish, milk, tree nut, soya, eggs and gluten (though I haven't seen these detailed menus in the restaurants themselves).

This is all good news - because most serious incidents involving people with a food allergy happen when they are eating out. Until clear and accurate allergen information is available everywhere, there are some simple guidelines you should follow to protect yourself. If you have peanut or shellfish allergy, it's best to avoid Thai or Chinese cooking, although you will be fine if you have a milk allergy because these cuisines tend not to use it. If you are at all unsure as to whether you might be exposed to an allergen when eating out, ask the waiter or waitress and if they don't know what's in a dish, talk to the chef. If you, or your child, is very sensitive to peanut or some other allergen, do remember the kitchen will not necessarily be allergen-free (even if the allergen is not actually in the dish you have chosen). Traces of allergen can easily be transferred from surfaces in the kitchen to your food. The big six restaurant chains are to report back to the FSA on a six monthly basis, so we can look forward to further progress on safe eating out.

Source: http://www.food.gov.uk/news/newsarchive/2010/mar/pubprogress

Rising carbon dioxide levels are encouraging the growth of ragweed and poison ivy and boosting the proliferation of fungal spores. As a result, plant-based respiratory allergies are on the increase and there is more ragweed pollen in the air, according to Lewis Ziska, a plant physiologist with the United States Department of Agriculture. 'Climate change is affecting plants and human health, especially that of allergy sufferers,' he said at a recent meeting of the American College of Allergy, Asthma and Immunology. Moreover, leaves fed by increased levels of carbon dioxide allow fungi to reproduce more rapidly and spread more allergenic spores.

Climate change is also likely to increase indoor air pollution in homes, schools and offices. This is because it increases indoor humidity which is known to allow house dust mite and mould to thrive. Also, higher temperature and humidity decompose discarded food faster, which encourages insect allergens such as cockroaches.

Allergy is not the only health problem arising from climate change. Medical experts from the Climate and Health Council, writing in the British Medical Journal, say that an increase in car and plain use and the advent of cheap, energy-dense food from intensive agriculture have not just increased carbon emissions - they have also led to increased levels of obesity, diabetes and heart disease because people are relying on their cars too much. Some, but not all, studies also show a link between obesity and asthma. Meanwhile, rising temperatures also lead to malnutrition, childhood diarrhoea and malaria.

All these are good reasons to put health at the centre of climate change negotiations. For instance, curbs on traffic would increase walking and cycling and people would get fitter and slimmer. Reduce livestock production, and people would eat less meat, which may decrease rates of colorectal cancer (currently the second most common cancer among men, after lung cancer). This is why the Climate and Health Council is asking health professionals to sign the pledge at www.climateandhealth.org/pledge to ensure that the links between climate policy and health policy are fully taken into account at the next big climate change meeting in South Africa in 2011.

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Source:

(1) 'Climate change and its impact on respiratory health' Symposium at the scientific meeting of the American College of Allergy, Asthma and Immunology, November 2010

(2) Richards I and Stott R Doctors and climate change BMJ 2010;341:c6357

The festive season brings some challenges for people with allergies, mainly because you could be exposed to triggers that are specific to the Holiday Season and New Years. But with a little forward planning and thought, you can relax and enjoy yourself without fear of an asthma or rhinitis attack.

First, those decorations. Did you know that Christmas trees can harbour a lot of pollen? And that the terpene in the sap that's released when they are cut can be a potent allergen? The American College of Allergy, Asthma and Immunology suggests that you go over the tree with a leaf blower, and then spray it with water, leaving it to dry outside before bringing it indoors. That will help bring down the mould and pollen levels emitted from the tree. You may, of course, opt for a pretty artificial Christmas tree - but these are big dust traps if stored during the year. The same goes for that box of Christmas decorations you bring down from the attic at the start of December. Unpack your artificial tree and other decorations outside, and vacuum and dust them thoroughly before displaying them inside.

Candles are popular during the Holiday Season. But try to buy beeswax or soy candles. A report to the American Chemical Society last year revealed that paraffin candles release a lot of particulate matter which will add to your burden of indoor air pollution. Avoid scented candles if someone is allergic to strong perfumes.

Have you finished your shopping for the Holiday Season? Here are some tips for what to buy someone with an allergy. An IQAir or Blueair HEPA air purifier would be our first suggestion. Maybe your children still hanker after a pet, even if they have asthma. There are certain steps you can take to limit exposure of pet allergens and thus limit allergy and asthma symptoms. (For more information check out 'Is it Possible to be Allergic & have a Pet?' ). But for people with severe asthma or allergies living with a pet might not be possible. An alternative for children with asthma or allergies might be a hypoallergenic washable soft toy instead. Jewellery is always a nice present - but do avoid nickel (which is so common in costume jewellery) because so many people are allergic to it. If you can afford it, buy gold. If not, look for an alternative gift. Perfume and perfumed products may well cause rhinitis in someone who is sensitive to strong scents, and can cause other allergy as well as asthma symptoms. If you are buying a warm jumper or cardigan for some one with allergies, avoid luxury fabrics like angora and cashmere - and even wool - because they can trigger eczema. Pure cotton is best (why not go for a long brushed cotton nightie or a pair of cosy cotton pyjamas?) A plant is also a lovely present - but stay away from the popular Christmas poinsettia if the recipient has an allergy to latex - because it is a member of the rubber family. Roses or orchids are a better bet for the plant lover with allergies.

Maybe you've decided to get away from it all for the holidays. Country cottages with roaring log or coal fires are a romantic, cosy option at this time of year. Unfortunately, the smoke from these traditional fires are loaded with particulate matter and carry a high risk of triggering asthma attacks.

And finally, just a few simple commonsense tips. If the weather gets really cold - as we've been promised - you might stay indoors more than usual, especially if you are off work. Make sure you have enough ventilation to protect against indoor pollution (be especially vigilant that condensation does not build up - increased humidity encourages house dust mite and moulds.) Use an air purifier to capture dust, traffic pollution and other common allergens. If your doctor has recommended a flu jab, don't miss out on it in the Christmas rush. Wash your hands a lot to avoid colds and flu. And - easier said than done, I know - watch those stress levels, because some people find it triggers their asthma. Happy holidays!

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Nearly 20,000 people aged 16-79 responded to a questionnaire about allergic symptoms and their lifestyle and life history. Those who had lived on a farm during the first five years of their life had protection from hay fever during the rest of their life. What is more, hay fever was more common among those living in an urban environment - something that has been noted in other studies.

So why are farms a protective environment against allergic rhinitis? It may be exposure to animal sheds, hay lofts or consumption of unpasteurised milk protects against hey fever. Another theory is that exposure to endotoxin, which is a compound made by certain bacteria, shifts the immune system so it is less likely to respond to common allergy and asthma triggers. But, to be honest, it is far from clear why growing up on a farm decreases your risk for developing allergies. However, the protective effect against allergic rhinitis of the farm/rural environment fits nicely with the other theme of this study, which is that the urban environment positively encourages allergy.

The Swedish researchers note that there is no difference in living in a mid-sized town to living in a large city such as Gothenburg when it comes to allergy risk. They speculate that there is a certain level of traffic related air pollution found in urban environments that sets the scene for allergy and is a large contributor to causing allergic rhinitis. Another theory is that reduced exposure to pollen in cities can make people less tolerant of it and therefore more likely to suffer from allergic rhinitis.

What is the take home message of this hey fever/allergic rhinitis study? Farming and rural communities are on the decline all over Europe. So opting to bring your family up on a farm, in the hope of avoiding allergies, is hardly a practical option. But what we can do is to press strongly to make the urban environment healthier, which means taking measures to reduce traffic-based pollution. And there needs to be more research into the precise environmental factors in rural and urban environments which model the immune system away from, or towards, allergy.

Source: Erikkson J et al Growing up on a farm leads to lifelong protection against allergic rhinitis Allergy 2010; 65: 1397-1403

Do you ever look up medical definitions on the internet? Have you noticed how they vary, sometimes ever so slightly, depending on the source? Because I have always been fascinated by medical dictionaries, and we thought it would be helpful to our site visitors, we have set ourselves the task of compiling an allergy glossary. In this glossary I am trying to define and describe all the terms you might come across if you have asthma, or another allergic disease. The first instalment consists of ten important asthma terms. Do you agree with my definitions? Are there other words you would like to add? Let us know!

Asthma. Three features affecting the bronchial tubes (airways) that distinguish asthma from other chronic lung conditions: narrowing (bronchospasm), inflammation with mucus production, and twitchiness (hyperresponsivity). Exposure to a trigger (allergen or irritant) causes the symptoms of an asthma attack which include wheezing, coughing and chest tightness.

Extrinsic asthma. Sometimes used interchangeably with 'allergic asthma', extrinsic asthma tends to affect younger patients and is usually triggered by a clear external allergen like house dust mite, animal dander, mould or certain foods. Often, the patient with extrinsic asthma will have a family history of asthma or other allergic disease. The term extrinsic asthma is not often used these days

Intrinsic asthma. Less common than extrinsic asthma, intrinsic asthma can affect patients of any age, but particularly those over the age of 30. Intrinsic asthma is not a true allergic disease. It is triggered by factors such as chest infection, such as bronchitis or pneumonia. There are a wide range of other triggers for intrinsic asthma, including exercise, stress, cold air, cigarette smoke, aspirin and other factors which are not classical allergens. Someone with extrinsic asthma will also often find their condition is worsened by these irritant factors. Again, the term intrinsic asthma is not often used these days (doctors will tend, instead to refer to exercise-induced asthma and so on, referring to the trigger factor). But maybe it is still useful to be aware of the distinction if it helps people be aware that asthma is a complex disease.

Allergic asthma. Also known as atopic or extrinsic asthma, allergic asthma accounts for most asthma cases. It is caused by exposure of the lungs to an inhaled, airborne allergen like house dust mite or mould. The allergen causes the immune system to produce IgE antibodies, which bind to immune cells called mast cells in the lungs. The mast cells then release histamine, which makes the muscles of the bronchial tubes in the lungs contract (known as bronchospasm), narrowing the airways and making breathing difficult. Allergic asthma is the most common type of asthma, affecting 90% of children with asthma and around half of adults.

Preventable asthma. Asthma is not usually thought of as a preventable disease in that there is no vaccine that can protect against it. Nor are there specific lifestyle changes, like healthy diet, which are often used to prevent heart disease or diabetes. If you have a tendency to allergy and become sensitised, then no intervention that we know of can stop the allergy from taking hold. However, the latest research on air pollution suggests that at least some cases of asthma are preventable. Air pollution can cause asthma in some genetically susceptible people. If these individuals live in a place with clean air, then they should not develop asthma. In other words, cleaning up air pollution could help prevent asthma.

Occupational asthma. Asthma that develops through exposure to allergens in the workplace is known as occupational asthma. Latex rubber, flour particles, detergent enzymes, paper dust, soya, wood dust and hairdressing products are just a few of the many workplace materials that can cause occupational asthma. To date, around 250 workplace allergens have been identified. Occupational asthma may be an exacerbation of pre-existing asthma, or new onset of the disease.

Brittle asthma. Hospitalisation is not uncommon in brittle asthma, a rare and severe form of the disease. Patients with type 1 brittle asthma have symptoms on a daily basis and are also subject to unpredictable, severe attacks which may need hospital. Type 2 brittle asthma is easier to control but sudden severe attacks (as in type 1) will still occur. The usual asthma medications work for brittle asthma, but they are needed in much higher doses to be effective.

Bronchial asthma. Just another name for asthma.

Laryngeal asthma. Also known as vocal cord dysfunctional syndrome, laryngeal asthma is not asthma at all. The wheezing in this disease comes from the voice box, because of an abnormality of the vocal cords, and not from the lungs, as in asthma. Laryngeal asthma will not respond to asthma drugs; it should be treated by voice therapy instead.

The asthma march. Sometimes also known as the allergic march, the term asthma march refers to a child's tendency to develop one allergy after another, as their immune system develops and matures. For instance, the child that has eczema as a baby may grow out of it, only to develop a constant runny nose (maybe rhinitis) and then asthma.

Researchers at Ohio State University reveal, for the first time, that exposure to fine particulate matter (PM) air pollution causes inflammation and changes in fat cells that lead to obesity and insulin resistance, a precursor of diabetes. So breathing in polluted air loaded up with PM might not only bring on asthma and cardiovascular disease - it could be compromising your long term health in other ways.

The researcher Qinghua Sun and his team fed mice either a normal diet, or a high fat diet. Then they exposed them to either filtered air, or to air containing a high level of PM for six hours a day, five days a week, for ten weeks to see what would happen. The polluted air in this experiment contained 111 micrograms of PMs which the researchers say is similar to the level found in many urban settings. The exposure time of the mice was equivalent to that you might expect for a toddler growing up to adolescence in an urban area. In that regard the experiments are a good indicator for what exposure to air pollution might do to humans.

The mice on the high fat diet gained more weight than those on the normal diet - as expected. But comparing the normal diet mice showed that those exposed to air pollution showed more signs of insulin resistance, including higher blood sugar, had more abdominal fat, and more signs of inflammation - all compared to mice exposed to air that was filtered by an air purifier. Fat cells in abdominal fat are known to increase inflammation and the signs of insulin resistance - all of which can set the scene for diabetes and heart disease.

'We really wanted to see how air pollution affects obesity with this early life exposure,' said Sun. 'In a real-world scenario, it would be very difficult to escape from the pervasive influence of dirty air, an influence that begins very early on in life.'

The researchers do not yet know if these effects would carry on over into adult life or, indeed, if they are reversible. Further experiments suggested that a gene called p47phox might be involved in translating the impact of PMs into increased abdominal fat and insulin resistance. But the question remains if this research is really applicable to humans. Many scientists seem to think so, and we will find out more soon- because the same researchers are to carry out a study in Beijing, China, of the impact of PM air pollution on metabolic syndrome (a collection of risk factors leading to heart disease and diabetes) and insulin resistance.

According to the US Environmental Protection Agency, one in three people in the US is at a higher risk of experiencing health effects relating to the presence of air pollution. Because of the tiny size of urban air pollution - 2.5 micrometres or less in diameter (one thirtieth of the width of a human hair) - PMs can reach deep into the lungs, blood and cells, and thus reach every organ of the body.

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Source:

Xu X et al Effect of Early Particulate Air Pollution Exposure on Obesity in Mice Arteriosclerosis, Thrombosis and Vascular Biology December 2010;30:2518-2527

The recent paper 'UK Indoor Air Quality' published by the Office of Science and Technology (OST) identifies some gaps in regulation and policy when it comes to indoor air pollution. The EU Air Quality Framework Directive defines policy on various well known air pollutants including nitrogen oxides, carbon monoxides and particulate matter. The problem is that the Directive is focused wholly on outdoor air quality. In the UK, there is a lack of 'joined up thinking' on indoor air pollution, because a number of different organisations are responsible for regulating the quality of our air (indoors and out).

OST notes that we need more research on the health effects of indoor air pollution exposure. At present, the two main investigations in regard to indoor air pollution are:

· The Medical Research Council studies into the effect of particulate matter on the lung.

· The Avon Longitudinal Study of Parents and Children (www.bristol.ac.uk/alspac) which is collecting genetic and environmental information on 14,000 families.

And while we are awaiting more evidence on how air pollution negatively affects our health, there is still plenty that could be done to improve indoor air quality. OST suggests action on four fronts:

· More co-ordination between the people who regulate air quality

· Revision of building regulations

· Tackling indoor and outdoor emissions

· Improving awareness and changing behaviour

I found the discussion on indoor air pollution effected by building regulations particularly interesting. The focus has shifted very much towards energy efficiency in recent years. All well and good - who could disagree with saving energy? But this leaves modern buildings tightly sealed and less well ventilated, which has an adverse impact on indoor air quality. A poorly ventilated home will have low oxygen levels and facilitates the accumulation of allergens through dust mites and gases and fumes. One way round low oxygen levels is to adopt the 'passive house' concept, first developed in Sweden. The passive house combines high energy efficiency with a mechanical ventilation system. According to the OST paper, there are now 17,000 of these passive homes worldwide, including a number in the UK. Ventilation by itself, however, will not be enough to provide a significant reduction in the exposure of air pollution through dust mites or pet dander. Furthermore, ventilating can bring in a significant amount of outdoor air pollution into your home too.

I've written before about the fact that monitoring sites in Central London often exceed permitted EU levels for nitrogen oxides and particulate matter. Tightening up on outdoor air pollution controls (yes, bring on those EU fines and punishments) can only help improve our indoor air quality. Indoors, the best way to cut down on pollution is through the use of an effective HEPA air purifier, and by limiting the source of the indoor air pollution. Cooking and heating appliances should be regularly maintained and serviced, and you should use allergy friendly cleaning products to fight pat and dust mite allergens.

And, finally, what about the smoking ban of 2007? It's early days to know the impact on health. But there is evidence of a 17% reduction of coronary syndrome in both smokers and non smokers in Scotland. The Royal College of Physicians has said they would like the ban extended to cover smoking in cars to protect childrens' health. Would you go further and ban smoking altogether? It'd certainly improve indoor air quality - but the OST paper stops well short of suggesting this. Let's hope it's not too long before some of the above ideas trickle down to our policy makers and some firm action is taken to tackle indoor air pollution in the UK.

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Source: Parliamentary Office of Science and Technology Note 366 UK Indoor Air Quality November 2010

Winter has well and truly set in and the chances are that indoor, rather than outdoor, air pollution is now the primary threat to your health, particularly if you suffer from allergies or asthma. A new paper from the Parliamentary Office of Science and Technology (POST) reviews the state of indoor air pollution in the UK. This study points out that while it's well known that outdoor air pollution is harmful to health, most people are not aware about the severe impact that indoor air pollution can have on your health. Indoor air pollution in your home can come from:

• Building materials, furniture and furnishings as well as cooking, heating, smoking and the use of products like paints, varnishes, ordinary cleaning products
• Outdoor pollution entering through windows, as well as cracks and leaks in a building
• Natural radon gas entering from the basement of a building - maybe less of a concern for those with allergies, but a proven cause of lung cancer
• Pets and dust mites that live in your home, as well as mould

Some of the indoor pollutants from these sources that can accumulate in your home include: nitrogen oxides, carbon monoxide, particulate matter, radon, tobacco smoke, allergens like mould and house dust mite and volatile organic compounds. While there is plenty of scientific evidence for the health impacts of carbon monoxide and radon, lack of research and monitoring mean that less is known about the dangers of exposure to other indoor pollutants.

The POST paper highlights what we do know about some key indoor pollutants - a starting point for further research perhaps? Here's a summary.....

• Particulate matter (PM) can damage the heart and lungs, with smaller particles getting deep into the lungs and causing inflammation. The ultra fine particles can reach the gas exchange regions, This, in turn, can increase the risk of blood clotting, setting the scene for a heart attack. Oh, and did you know that stir frying can produce a lot of PM, including superheated oil particles.
• Higher levels of nitrogen oxides indoors have been linked to higher levels of respiratory symptoms in children, according to the Committee on the Medical Effects of Air Pollutants. Gas, coal and wood-based cooking and heating appliances may raise levels of nitrogen oxides indoors.
• Carbon monoxide causes nearly 50 accidental deaths a year in England and Wales and there's a possibility that chronic exposure may damage the nervous system. Faulty gas cookers and solid fuel boilers are responsible for carbon monoxide emissions in the home.
• Tobacco smoke reduces lung function, triggers asthma attacks and irritates eyes.
• Allergens trigger rhinitis and asthma. The main allergens in the home are house dust mite droppings, fungal particles, pet dander and pollen.

Volatile organic compounds irritate the lungs, with children being especially vulnerable. They include both natural and synthetic chemicals like formaldehyde, coming from several sources including construction products, cleaning products, air fresheners, paints and electrical goods.

Clearly, exposure to indoor air pollution may pose a substantial health risk. So how can UK regulation and policy be improved to deal with the threat? The POST paper has some thought-provoking suggestions....(to be continued)

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Source: Parliamentary Office of Science and Technology Note 366 UK Indoor Air Quality November 2010

Indoor air pollution can be a real health issue - worsening asthma and allergy symptoms, increasing the risk of heart disease and even decreasing your live expectancy. You could be breathing in remains from house dust mites (in dust), pet dander, viruses, pollen, bacteria, volatile organic compounds and smoke particles - to name but a few. All of these are considered particle air pollution. For the most part, these particles are invisible to the naked eye.

Using a home air purifier is an effective way of reducing air pollution in your home and you may find that your asthma and allergy symptoms improve as a result. I say 'might' because it its essential that you know what kind of air pollution you want to filter out of the air and choose the right air purifier to do so. The most effective filtration technology for particulate pollution (such as dust mite allergens, pollen, a large range of traffic pollution, and mould) is high-efficiency particulate air (HEPA) filtration. HEPA filtration was initially developed over 50 years ago to remove radioactive particles from the air during the prestigious Manhattan Project.

An average indoor air purifier with a HEPA filter should remove 99.97% of airborne particle pollution of down to 0.3 micron diameter. Unfortunately, most hepa air purifiers are poorly build, so that not all the air that passes through the air purifier also passes through the hepa filter in it. So when choosing an HEPA air purifier you should ask what the filtration efficiency of the air purifier as a whole is, not the filtration efficiency of the filter by itself. The HyperHEPA filtration of IQAir has a minimum filtration efficiency of 99.5% of particle pollution down to 0.003 microns in size- which is ten times smaller than a virus. IQAir air purifiers are also the only domestic air cleaners that come with guarantee and certificate that the unit that you purchased filters out more then 99.95% of particles down to 0.3 micron. The particulate size that an hepa air cleaner filters out of you indoor air matters, because the ultra small particulate size range is known to cause the most severe health problems. Particles of that size pass by our bodily's natural defences and can reach every organ.

A HEPA air purifier has a filter that is made of borosilicate fibre matting pleated to create a big surface area to trap more particles. The action of the filter is three fold:

• Larger particles are trapped by inertial impaction. Because they are larger, they keep on moving until they hit a fibre and then they stick to it.
• Medium particles are trapped by interception. When they pass near a fibre, they are intercepted by the fibre and stick to it.
• The smaller particles are trapped by diffusion. They collide with other particles and eventually get knocked onto a fibre, where they stick.

Some HEPA air purifiers us a pre-filter, which removes larger particles before the air enters the filter proper. This allows the main filter to concentrate on getting rid of the smaller particles and does not get clogged up with larger ones. Some HEPA air purifiers combine the HEPA filter with an activated carbon filter- for the removal of gases and odours.

If you decide to purchase a HEPA air purifier, go for one that is medical-grade, and that is sold by a reputable and authorized supplier. You should shop wisely for your home air purifier to reap the best benefits in short term and long term health effects. Consider how often you will have to change the filter and how much air the home air purifier can clean in an given hour. As a rule of thumb, your hepa air purifier should filter the air in your room 2-3 times per hour.

The use of an effective HEPA air purifier will help to:

• protect you from getting sick (by filtering out bacteria and viruses),
• control your allergy and asthma symptoms (by taking particle and gas pollution out of the air),
• keep your home and your sinuses clean (by taking general dust out of the air)

But a HEPA air purifier can also improve your cardiovascular health. A recent study measured microvascular function and indoor air particle levels in the homes of 21 couples aged 60 to 75 living near heavy traffic. Microvascular function is a way of assessing the state of the inner lining of the blood vessel. If abnormal, it is a known risk factor for heart disease. The couples used a HEPA filter for two days, had their tests, then ran the device without a filter and had the tests repeated. Use of the filter removed 60% of particles and improved microvascular function by 8% - more than the researchers were expecting.

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Most flu vaccines are produced inside chicken eggs, raising concerns that people with egg allergies may have a reaction to a protein in the vaccine. Where the vaccine was essential to have, an allergist would get involved by giving the patient skin tests and maybe giving the dose of vaccine over a period of time. But in the last two years, there has been in-depth research looking at the safety of giving the vaccine to people with egg allergies.

"The evidence shows that the time to withhold the vaccine on account of somebody's egg allergy has passed," said Dr. Matthew Greenhawt, an allergist and immunologist at the University of Michigan Health Systems. Greenhawt and his colleague Dr. James T. Li, an allergist at the Mayo Clinic in Rochester, Minnesota, made new recommendations this month for administering the influenza vaccine to those with egg allergies. The vaccines can be safely given to the majority of adults and children with egg allergy, but should be given under the supervision of an allergist or immunologist.

The research also showed that current influenza vaccines contain only trace amounts of egg protein, lower amounts than in years past. And many vaccine manufacturers now include information about their products' egg content, making it possible for providers to choose vaccines with the lowest egg content. The researchers recommend that children and adults either receive the full dose of the influenza vaccine or receive the vaccine in two doses — 10 percent of the full dose followed by the other 90 percent. In each case, individuals should be monitored after each shot for 30 minutes, to see if they show signs of an allergic reaction. However, it is still not clear whether children and adults who have had a serve allergic reaction to egg in the past should be vaccinated. Several recent studies found that a severe egg allergic reaction in the past is not a risk factor for an allergic reaction to the flu vaccine.

And in the future, people with egg allergies need not worry at all about flu vaccines, thanks to new technology which allows vaccines to be manufactured in cells, rather than eggs. Celtura is an HINI (swine flu) vaccine developed by Novartis and made in animal cells. Clinical trials carried out at the University Hospitals of Leicester showed the Celtura gives a strong immune response against the HINI virus. Currently, the new vaccine is only approved in Germany and Switzerland but it could come to the UK soon. The flu jab is safe for the majority of people with asthma, but if you do have egg allergy as well, do discuss this issue with your doctor. A flu jab cannot give you flu, despite what some people say, although a few people do experience a few flu-like symptoms after having it. Being protected against flu, including swine flu, is better than exposing yourself to the risk of an asthma attack triggered by a bout of flu.

Source: Egg allergy no longer a reason to avoid getting flu vaccine
http://www.aaaai.org/media/news_releases/pressrelease.asp?contentid=10260

Researchers at Stanford University and the University of California, Berkeley, have come up with direct evidence that urban air pollution can have long-term effects on the immune system. The researchers studied a group of 181 children with and without asthma in the California cities of Fresno and Palo Alto. Exposure to air pollution was found to suppress the immune system's regulatory T cells (known as Treg for short). Treg cells have the job of putting the brakes on the immune system so it doesn't react to harmless substances (remember, asthma triggers are harmless to those without asthma). This decreased level of Treg function was linked to greater severity of asthma symptoms and lower lung capacity in the children.

"When it came out that cigarettes can cause molecular changes, it meant the possibility that mothers who smoked could affect the DNA of their children during fetal development," said study lead author Dr. Kari Nadeau, paediatrician at Stanford's Lucile Packard Children's Hospital and an assistant professor of allergy and immunology at Stanford's School of Medicine. "Similarly, these new findings suggest the possibility of an inheritable effect from environmental pollution." Forty one children came from the Fresno Asthmatic Children's Environment Study (FACES), which is led by Dr. Ira Tager, professor of epidemiology at UC Berkeley's School of Public Health, and S. Katharine Hammond, UC Berkeley professor and chair of environmental health sciences. The researchers also recruited 30 children from Fresno who did not have asthma. "I'm not aware of any other studies that have looked at how chemicals can alter cells so early in the regulatory process, and then connected that effect to clinical symptoms," said Tager. "There are people who still question the direct link between air pollution and human health, but these findings make the health impact of pollutants harder to deny."

Fresno was chosen because it is located in California's Central Valley, where trapped hot air mixes with air pollution from traffic and agriculture to create high levels of air pollution. It is also a region known for its high incidence of asthma. Nearly one in three children there have the condition, earning Fresno the nickname, "The Asthma Capitol of California." The researchers compared the participants from Fresno with 80 children, half with asthma and half without, in the relatively low-pollution city of Palo Alto. The children were matched by age, gender and asthma status, among other variables. The children were tested for breathing function, allergic sensitivity and Treg cells in the blood. Daily air quality data came from California Air Resources Board monitoring stations. The researchers calculated each child's annual average exposure to polycyclic aromatic hydrocarbons (PAH), a by-product of fossil fuel and a major pollutant in vehicle exhaust.

The study found that the annual average exposure to PAH was 7 times greater for the children in Fresno compared with the kids in Palo Alto. Levels of ozone and particulate matter were also significantly higher in Fresno. Not surprisingly, the study found that the children in Fresno had lower overall levels of Treg function and more severe symptoms of asthma than the children in Palo Alto. For example, the non-asthmatic children in Fresno had Treg function results that were similar to the children with asthma in Palo Alto. The researchers found a link between increased exposure to PAH with specific changes in a gene called Foxp3, which triggers Treg cell development. The change effectively disables the gene's function, leading to reduced levels of Treg cells. The connection between Treg function and the severity of asthma symptoms held for children in both groups. While previous studies have found associations between pollution, particularly car exhausts, and an increased risk of developing asthma, few have gone into such detail on the cells, molecules and genes involved.

"The link between diesel exhaust and asthma could simply have been that the particulates were irritating the lungs," said Nadeau. "What we found is that the problems are more systemic. This is one of the few papers to have linked from A to Z the increased exposure to ambient air pollution with suppressed Treg cell levels, changes in a key gene and increased severity of asthma symptoms."

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Source: Nadeau K et al Ambient air pollution impairs regulatory T-cell function in asthma Journal of Allergy and Clinical Immunology October 2010.

"Premature babies tend to be deficient in antioxidants and suffer from oxygen stress, so we thought that they might benefit if their mothers received vitamins during pregnancy," says Professor Anne Greenough of King's College, London. "We also thought that giving mothers antioxidants might help improve lung growth and function in their babies."

Funded by Asthma UK, Prof. Greenough and colleagues at Imperial College, followed up the multi-centre Vitamins in Pregnancy study which included a number of women under the care of St Thomas' Hospital, London. The aim of this study was to prevent pre-eclampsia (high blood pressure in pregnancy) and the 643 women took either high doses of vitamin C and vitamin E or a placebo during their pregnancy. The mothers completed a questionnaire for the researchers when their child reached the age of two. This data showed that taking the vitamins made no difference to the risk of the child wheezing. In fact, a sub-group of 118 women had their medical records analysed and this showed that the children born to women who had received the vitamins actually required more GP care and more emergency hospital treatment.

"These babies were more likely to be delivered prematurely and the costs of their care were higher - but this wasn't due to respiratory problems," Prof. Greenhough said.

So why the contradiction between these results and the earlier trials suggesting that antioxidants should benefit a baby's lungs? The initial trials were not randomised, which means there could be some bias in the results. The Vitamins in Pregnancy trial was randomised - the women and the researchers, did not know who was getting vitamins and who was getting a placebo. This makes its results more reliable and robust.

"We do not know what causes asthma in babies - it is probably very complex. Our evidence is important as it suggests that antioxidants are not helpful," says Prof. Greenhough. She adds that women should still take any vitamins that are recommended, such as folic acid, and not to worry about the impact that these high dose vitamins had on the babies in the sub-group. As ever, the best advice on preventing asthma in the unborn child is to avoid general air pollution during pregnancy.

Ref.:

Greenough A et al Respiratory outcomes in early childhood following antenatal vitamin C and E supplementation Thorax Online First October 1 2010

Milk is a common trigger for asthma and eczema. Proteins in milk may act as true allergens, and milk can also create mucus which can make asthma symptoms worse. So it's intriguing to learn that one well-respected study has shown that drinking farm (raw) milk can have a protective effect against both asthma and hayfever. Dr Marco Waser of the Institute of Social and Preventative Medicine at the University of Basel, Switzerland, and colleagues in Europe and the USA studied a group of 15,000 children aged 5-13 from farming, rural and urban communities. Those who drank raw milk had a 25% reduced chance of getting asthma and a 50% reduced chance of getting hayfever. No such protection was seen against eczema. Some of the milk was boiled before the children drank it - but the protective effect was still found. This boiling wasn't the same as commercial pasteurization so the milk was still 'raw'. The work was part of the PARSIFAL (Prevention of Allergy - Risk Factors for Sensitization Related to Farming and Anthroposophic Lifestyle) study.

The researchers wondered whether there are protective substances in raw milk. There could be specific proteins, or 'friendly' bacteria' which are destroyed on pasteurization. Another part of the PARSIFAL project showed that children with a certain variant of an immune system gene benefited most from raw milk in terms of protection against asthma and hay fever. Putting these findings together, and further research, could lead to development of a safe version of raw milk that could help protect against allergy.

The researchers were adamant that people should not start their children on raw milk in the hope of helping them avoid developing allergies. In England and Wales, the supply of raw milk is very strictly controlled and it accounts for only 0.01% of all milk consumed. Raw milk may contained harmful bacteria and must be labelled with a health warning. It can only be sold at the farm gate, by milkmen, and at farmers' markets - so you can't get it in the shops. According to the Food Standards Agency, there were only 102 producers of raw milk in England and Wales, which is down from 570 in 1997. The sale of raw milk has been illegal in Scotland since 1983 following a number of cases of illness related to its consumption. Since the ban, the incidence of such illness has fallen dramatically. In fact, the government has three times proposed a ban on raw milk in England, Wales and Northern Ireland, but was opposed by consumers and producers. There is, indeed, a small - but vociferous - raw milk movement on either side of the Atlantic. Some claim it does protect against allergies, as was found by the PARSIFAL researchers. For most people, though, surely the risks of consuming raw milk would outweigh the potential benefits?

Ref.: Inverse association of farm milk consumption with asthma and allergy in rural and suburban populations across Europe. Waser et al. Clinical and Experimental Allergy. 37, 661-670. May 2007.

When you have eczema the mainstay of your skin cleansing routine should be a cream, which is massaged gently into the skin and then rinsed off. A cream is a mixture of oil (usually a mineral oil, like soft paraffin) and water. Because oil and water don't mix, an additive known as an emulsifier has to be added to disperse the oil in the form of tiny invisible droplets within the water to make one layer rather than two. Suitable eczema washing creams for the bath or shower include Wash E45® and Aqueous cream BP.

Like all products containing water, creams can become contaminated by microbial growth, so it is especially important when you have eczema to opt for hygienic containers like pump dispensers to minimise this risk. Also be aware that emulsifiers and other additives can cause either an allergic response or irritation. However, there are several cleansing products for people with eczema beside the two mentioned above, so you're likely to find at least one that suits your skin.

A good allergy friendly moisturiser is the other key product for daily eczema prone skin care. As the name suggests, a moisturiser keeps the skin from drying out. All moisturisers work in the same way - by providing a surface layer of oil which slows down the evaporation of water from the skin. You have three main choices of moisturiser - an ointment, a cream or a lotion. Ointments are composed of oil alone while creams, as explained above, also contain water. A lotion is just a cream with a higher water content. In general, it's best to use the product with the highest oil content you can cope with - because the more oil, the better the moisturising action.

As explained above, microbes can grow wherever there is water so creams and lotions can become contaminated. What's more, preservatives - such as parabens - are often added to creams and lotions to slow microbial growth. You may find you develop an allergy to such additives or they may have an irritant effect on your skin. Some creams and lotions also contain perfume and lanolin, an extract of sheep wool used as an emulsifier. Both can cause allergy or irritation problems.

However, ointments are not without their drawbacks for eczema sufferers. Older children, adolescents and adults have naturally oilier skin than infants and may find an ointment feels too greasy and uncomfortable for daily use. What's more, ointments may rot certain fabrics, including elastic. If your pants or knickers keep falling down, your daily moisturiser may be to blame!

Related Blog Posts:

• Living with Eczema
• Living with Eczema - What's Your Experience?

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• 205,000 premature deaths
• 672,000 cases of chronic bronchitis
• 21,000 cases of heart disease
• 843,000 asthma attacks
• 18 million child respiratory illnesses
• 10.4 million lost IQ points in children (from reductions in lead emissions which otherwise affect the brain)

These benefits have occurred because 1.7 million tons of toxic emissions have been removed from American air every year since 1990 and, in the last two decades, emissions of six common pollutants are down by 41%. Data from 2006 to 2008 show that ozone air quality improved in 95 of the 126 areas previously designated to be in nonattainment for ozone air quality standards. Most of the United States is now meeting air quality targets set for carbon monoxide, nitrogen oxides and sulphur dioxide. Lead levels in the air have decreased too, which has reduced the number of children with IQs less than 70 as a result of lead poisoning. And preliminary analysis by EPA shows that in 2010, Clean Air Act fine particles and ozone programmes implemented since the 1990 amendments will prevent as many as 160,000 premature deaths. 'We are a stronger, healthier and more prosperous nation because of the Clean Air Act,' Ms Jackson concluded.

Of course, there is still much to be done. When the EPA's new vehicle and fuel rules are fully implemented in 2030, this will produce $186 billion in air quality and health benefits, with only $11 billion in costs, which makes for a 16 to 1 benefit/cost ratio. The above figures, if they work out, should give critics of environmental legislation pause for thought. When the Clean Air Act came first into force, those against the idea of limiting air pollution argued that the costs of compliance would stifle business and kill jobs. In fact, as Jackson argues, the Clean Air Act has been a good investment in so many ways. Every dollar in compliance costs spend on cleaning the air as part of the Clean Air Act is returned 40-fold in terms of health and environmental benefits.

The critics have not gone away, however. Their current tack is to block EPA's attempts to use the Clean Air Act to reduce carbon dioxide emissions. But the White House says President Obama is to veto any attempts to restrict the EPA in this matter.

What is do you think? Is clean air worth fighting for? Let us know.

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Ref.:

• http://green.blogs.nytimes.com/2010/09/14/clean-air-act-turns-40
• http://www.huffingtonpost.com/lisa-p-jackson/the-clean-air-act-by-the-_b_731564.html

The clocks have gone back, the nights are drawing in, so now is the time to prepare for winter if you or your kids have asthma or eczema. You will be spending more time indoors, so there is a danger of added exposure to particle pollution such as house dust mite allergens, pet dander, and mould and mildew spores. Other triggers for asthma and allergy symptoms are carbon monoxide gas from heating devices, cigarette smoke, and fumes from paints and furniture. Outdoor air pollution might also be coming into your home and can cause asthma and allergy symptoms as well as other negative health effects.

The following tips may help you enjoy a winter free of allergy and asthma symptoms:

• Check windows are free of condensation - damp conditions encourage mould and mildew
• Check your home is leakproof - and that pipes are well-lagged against freezing (you don't want a damp house because of a burst pipe)
• Have your boiler serviced
• If you haven't already, why not ban smoking in your home? There's no harm in fixing a discreet 'No Smoking' sign to the front door
• To limit dust mite allergens in your home, make sure to wash all bedding and cloth regularly with allergy and asthma friendly laundry detergent
• If you have carpets make sure to clean them with allergy friendly carpet spray and powder, and have your carpets professionally cleaned every 6 month
• Clean the air in your home (especially in the bedroom) with a powerful and effective HEPA air purifier
• Soothe and protect your skin agains allergens by using an eczema friendly moisturizing crème

Cold weather itself can also be a trigger for both asthma and eczema, as can sudden changes in the weather. So keep a close eye on the weather forecast. If your asthma is triggered by the cold, you could try to warm the air up before it enters your lungs by either breathing through your nose or wrapping a scarf around your nose and mouth. If you have eczema, make sure fibres in your winter clothes are not triggering a flare up. If it is very cold, it's probably best to just stay indoors if you can.

Cold winter air tends to be drier. Your nasal passages and skin will be drier than usual and this may make you more sensitive to triggers. Therefore, use your moisturiser more often than usual and drink plenty of water!

If you have asthma, you know how important it is to avoid colds, flu and chest infections. According to Asthma UK, colds and flu are a trigger for as many as 90% of people with asthma. A high quality HEPA air purifier will take bacteria and viruses out of the air in your home and prevent you from getting sick and from spreading airborne infections. Also build up your immunity to winter bugs with a diet rich in fruits and vegetables and perhaps take a multivitamin supplement or extra vitamin C. Some people swear by the herbal remedy echinacea for preventing colds. However, the European Medicines Agency says it should only be used in people over 12 and not during pregnancy or lactation. It should not be taken for more than 10 days at a time. Meanwhile, your doctor or asthma nurse has probably advised a flu jab. It is best to get this in the autumn, before the flu virus starts to circulate in earnest.

Do you have any winter tips to share- please let me know.

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Many people in the UK suffer from eczema. It affects between two and ten per cent of adults and up to 15 per cent of school-age children. Eczema is an inflammation of the skin, which usually causes intense itching - its hallmark symptom. The word eczema actually comes from the Greek word meaning 'boiling' ; this is a good way of describing the blisters that often erupt beneath the inflamed skin of someone with eczema. The terms dermatitis (literally, 'skin inflammation') and eczema are often used interchangeably by dermatologists.

The best known form of eczema (there are many different diagnoses) is atopic eczema, which is caused by an allergic response to a specific substance, like house dust mite, certain foods or pollen. Atopic eczema is most common among children, and seems to run in families. Only a small proportion of those affected by atopic eczema as a child still suffer from the condition in adult life and, contrary to parents' fears, there is usually no lasting damage to the skin. Typically - but not always - the condition starts between three and six months, and begins to fade by age three.

We carried out a survey of our regular site visitors regarding eczema. Here is what some of you had to say:

"My two year old is the one with eczema. He was born with it on just his hands. At age two months, it was on his face and by the time he was six months it affected his entire body. Today he is a lot better. He still has eczema but his face and torso are clear. His only problem areas are the limbs."
Florence

"My eczema became noticeable when I was in high school. The amount of stress from my schoolwork make my skin very itchy and unbearable. There would be red patches on the insides of my elbows and behind my knees."
Karen, 27

"It first began when I was only three months old ; it was awful when I was a child and it had come down to being only mild with a few flare-ups at my young age of 15."
Sarah, 15

"My son started getting eczema when he was about two years old …and it went undiagnosed for about two years. At six years old, he only gets bad flare-ups in winter."
Tricia

"It started 20 years ago when I was six and I was on the beach. I had a problem with my feet and then eczema appeared."
Monica, 26

As you can see, eczema is very much an individual thing - although there are common patterns. Where eczema persists into later childhood and adult life, it tends to follow a relapsing and remitting course for many years. The typical symptom of eczema is a 'weeping' itchy rash and redness of the skin. Inflammation in the deeper layers of skin causes fluid to leak from underlying blood vessels and this 'bubbles' up to form fluid-filled blisters just beneath the surface. The natural response to an itch is to scratch it (however hard you try not to!). The scratching breaks the surface of the blisters and so the rash starts to 'weep'.

The rash can occur on any part of the body, but is most commonly seen on the face, hands, elbows, wrists, buttocks, and knees and in folds of the skin. Scratching may cause the skin to bleed and the damage gives it a scaly appearance in the long run. Broken skin tends to dry out and is also more prone to infection. People with eczema often have very dry and thickened skin, and lack the natural sheen of healthy skin. The skin's appearance in eczema can cause a lot of distress, especially in older children and adults, but there is rarely any permanent scarring.

Here is what some of you had to say about living with eczema:

"It's important to avoid any substance that you know triggers the eczema - whether it's eggs or milk in the diet, exposure to soap or biological detergent or even stress in your life."
John

"The changes in the weather usually affect my son's eczema. Also, different environments. I had to take him out of daycare, because the center installed new carpeting which affected his eczema. We don't go to many social gatherings because of the different perfumes which irritate him, as well as people thinking they are being kind by giving my child something he is allergic to."
Florence

"Keep away from stress areas in your life !"
Sarah, 15

"Avoid chlorine."
Tricia

"I know if I can keep the stresses out of my life, my hands are better. I also try not to handle onions, potatoes, or tomatoes with bare hands."
Anon

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• If your children are very young, prepare the way with your neighbours. Give them nut-free candy ahead of Halloween and take your children to these 'safe houses' for their treats.
• If your child is older and goes out with friends, ask them to hold off eating their treats till they get home. Then remove all those with nuts or anything else that could cause an allergic reaction.
• Remember, some children are extremely sensitive to nuts, so protect them by making sure your brush your teeth and wash your hands before hugging or kissing a child with a nut allergy.

Halloween parties are another potential source of allergic reaction. Prof Cahill has this advice:

• Tell the party host about your child's nut, or other food, allergy. Provide a list of specific foods that can cause a reaction.
• If you're the host and one of your guests might have nut allergy, make sure all pans, dishes and serving utensils have been thoroughly cleaned if previously used with nuts. For instance, if brownies with nuts are baked in the same dish as brownies without nuts, an allergic reaction could still occur.
• When you are shopping for a party, check labels. Foods that have been manufactured in a factory containing nuts may cause an allergic reaction even if it does not actually contain nuts. Remember nuts and nut oils are used as ingredients in a wide range of foods. Be wary of biscuits, cakes, pastries, desserts, ice cream, cereals, confectionery and salad dressings.
• Wipe down all surfaces. Touching a surface that has been exposed to nuts can easily cause a reaction. Prof Cahill says research shows that this is the route to a reaction, rather than inhaling airborne nut particles.

Both peanuts and tree nuts can act as allergens. Peanuts are not true nuts - they actually grow underground while true nuts grow on trees. Tree nuts include walnuts, almonds, cashews, Brazils and pistachios. In the UK, one person in 100 has peanut allergy and one in 200 has tree nut allergy. Nut allergy is a growing problem, too. It often starts when a child is very young and, unfortunately, it tends to be a long-term problem. 'Though having a nut allergy is serious, kids should still be able to have fun,' says Prof Cahill. 'The key is education. Make sure your child knows what he or she can eat.'

This week we spoke with Professor Chris Corrigan. Professor Corrigan is based at Guy's Hospital, King's College London School of Medicine.

Susan: "Professor Corrigan, what is it like to work as an allergist in the UK?"

Prof. Corrigan: "I am delighted to be an allergist. Allergists in the UK are quite a rare breed. They have not flourished as they have in just about every other country, with the result that main parts of the UK are bereft of allergy specialists."

Susan: "Why is that?"

Prof. Corrigan: "Many doctors are frightened of allergic conditions because they do not understand them fully. This is not their fault: as I said, allergists in the UK are few and far between and allergy is not taught very well in UK medical schools. Like every other problem, however, it is not difficult to handle when you know how."

Susan: "So why did you decide to work with allergy and asthma?"

Prof. Corrigan: "I did not set out to be an allergist. I had trained initially at Oxford University and later at King's College Hospital in London. During my early training as a doctor I realised that I wanted to be a researcher and discover new things about diseases. The first research post as I came across offering this opportunity was in Allergy and Asthma at the Brompton Hospital, where I worked with my then supervisor and now dear friend Professor Barry Kay. More recently I have continued this work at Guy's Hospital with my colleagues, particularly my close friend and colleague Professor Tak Lee."

Susan: "What do you like best about your work?"

Prof. Corrigan: "What I like best about allergy is that it is almost always possible to help people in a very practical way. This may be through helping them to identify allergies and how to avoid exposure to the allergen, very simple advice as to how to take treatment for hay fever properly, explaining to them how to manage their asthma better and identify allergic triggers and teaching them how to deal with more serious allergic reactions such as to peanuts. One particularly rewarding ward of treatment is allergy desensitisation injections (immunotherapy) for very severe hay fever. Patients are eternally grateful to have their symptoms greatly reduced after years of suffering every summer. Most of allergy management is just simple, practical advice but almost every patient benefits."

Susan: "Where do you see allergy treatment going in the future?"

Prof. Corrigan: "In the future I think we will see major advances in allergy treatment. Several of my colleagues are working on medication to get rid of allergy which will stop allergic antibodies binding to body cells and causing reactions. This is a big task, but they may succeed within my lifetime. I think we will also see a lot more understanding about how to prevent allergy."

Susan: "If you could suggest one thing for your patients what would it be?"

Prof. Corrigan: "If I could suggest one thing for the thousands of allergy sufferers out there, it would be to ask advice about their disease from an expert. Even diseases that you think would be simple to manage can be greatly improved if you know what you are doing. This is what I love about my job: simple, practical help for everyone."

Susan: "Is there anything else you'd like to add?"

Prof. Corrigan: "Allergy is also a very academic subject and has more than repaid my wishes to undertake new research and discover new disease mechanisms. I have also had the chance to build up one of the largest allergy centres in the UK down at Guy's Hospital in London Bridge. We investigate drug and food allergy and make hundreds of hay fever sufferers better every year. Although I treat adults, my colleagues provide an equally extensive and prestigious service for children. Drop in and see us some time!"

Susan: "Great. Thank you Professor Corrigan for your time."

What is more important in medical treatment - a firm scientific foundation or the patient experience and choice? Many patients, including some with asthma, swear by homeopathy, and other complementary and alternative treatments. Yet there is little evidence (of the sort we would expect for a more conventional drug) that homeopathy has any therapeutic effect in itself. Some people believe that if homeopathy does help, then maybe it is more to do with the attention given by the homeopath to the patient, or to the placebo effect of the homeopathic dilution (sometimes so dilute as to be virtually indistinguishable from water). There is nothing to stop people buying their own homeopathic remedies if they feel they work. You can buy homeopathic remedies in many high street chemists - a fact that anti-homeopathic campaigners drew attention to earlier this year. Several of them stood outside the chemists shops and took massive 'overdoses' of homeopathic remedies as a protest at the shops for selling what they see as worthless remedies and their cynical exploitation of people's naïveté.

The debate over homeopathy really goes to the centre of what the NHS should be offering patients. For homeopathy is available on the NHS. It funds five homeopathic hospitals and remedies are available at some GP surgeries. A recent report in The Guardian said that the NHS spends as much as £4 million a year on homeopathy. Yet a Cochrane Review (the 'gold standard' on clinical efficacy, which has experts review all the evidence on a treatment) has concluded that there is no evidence that homeopathy works on asthma. So why should the NHS continue to use public money on funding it for asthma and other conditions? Things may be about to change. The government is looking at evidence from The Science and Technology Committee's Report on homeopathy (which concluded that it is hard to know how much the NHS spends on it each year). It may decide that science and cost-effectiveness are more important than patient choice and preference. The cuts are almost upon us. Will NHS homeopathy be an early victim? Let us know what you think: should homeopathy be cut, yes or no?

The answers to some questions are so obvious that the questions themselves do not seem worthwhile asking. You might call such questions 'trivial questions.' Asking about the importance of clean air seems to be such a question: Clean air is essential for being healthy, and everybody wants to be healthy! However, it makes sense to ask why it is important to breathe clean air, because the question can bring awareness to a problem that is not always right away apparent.

Air pollution is to a large extent invisible in our day to day life. Toner dust, car exhausts and dust mite allergens are so small that they cannot be seen with the naked eye. Furthermore, many of the negative health effects of air pollution are accumulative, so that our health deteriorates gradually - often unnoticed from one day to the next.

But the health effects of breathing polluted air day in and day out are severe. Countless studies from around the world have shown how air pollution affects everyone from an unborn child to the elderly. Health effects range from learning disabilities to cardiovascular diseases, worsening of allergies and asthma, as well as premature death. The American Environmental Protection Agency considers indoor air pollution one of top 5 health threats today. The ultra fine particles and gas pollution that is produced indoors and outdoors are so small that they pass through our body's natural defences. Through our nose and lungs these toxins reach our blood stream and with that every part in our body.

Why is clean air important? Raising the question is important because we are often not aware of the pollution that we and our families are exposed to and the consequences that they can have on our lives.

Our Related Products:

• IQAir HealthPro 250
• IQAir HealthPro 150
• Blueair 650E
• Blueair 450E

Ref.:

• Public Health Statement for Polycyclic Aromatic Hydrocarbons (PAHs)
• Environ Health Perspect. 2003 February; 111(2): 201-205.; Effects of transplacental exposure to environmental pollutants on birth outcomes in a multiethnic population; Frederica P Perera, Virginia Rauh, Wei-Yann Tsai, Patrick Kinney, David Camann, Dana Barr, Tom Bernert, Robin Garfinkel, Yi-Hsuan Tu, Diurka Diaz, Jessica Dietrich, and Robin M Whyatt
• Effect of Prenatal Exposure to Airborne Polycyclic Aromatic Hydrocarbons on Neurodevelopment in the First 3 Years of Life among Inner-City Children; Frederica P. Perera,1 Virginia Rauh,1 Robin M. Whyatt,1 Wei-Yann Tsai,1,2 Deliang Tang,1 Diurka Diaz,1 Lori Hoepner,1 Dana Barr,3 Yi-Hsuan Tu,1 David Camann,4 and Patrick Kinney1; www.cumc.columbia.edu
• The New England Journal of Medicine; Volume 329:1753-1759 December 9, 1993 Number 24; An Association between Air Pollution and Mortality in Six U.S. Cities; Douglas W. Dockery, C. Arden Pope, Xiping Xu.
• American Journal of Respiratory and Critical Care Medicine; 1995;151:669-674; John D. Spengler, James H. Ware, Martha E. Fay, Benjamin G. Ferris, and Frank E. Speizer, Pope CA III, Thun MJ, Namboordiri MM, Dockery DW, Evans JS, Speizer FE, Heath CW Jr; Particulate air pollution as a predictor of mortality in a prospective study of US adults.

Adverse reactions to food are not uncommon. True food allergy, however, only affects 2 to 4% of adults and 6 to 8% of children. In food allergy, specific proteins in the food you eat act as allergens, triggering the production of antibodies in the IgE class. Once sensitised like this, the next time you are exposed to the allergen IgE alerts the mast cells in the immune system. A mast cell is a resident cell that contains many granules rich in histamine and heparin, These mast cells then release histamine, and it is the histamine that causes the typical symptoms of food allergy, which may include:

• Tingling mouth
• Swelling of the lips, face, tongue and throat
• Rash
• Vomiting, cramping

If the allergen gets into your bloodstream you may even experience an extreme allergic reaction called anaphylaxis, which can lead to a potentially fatal episode of shock. Allergic reactions can be triggered by just minute exposure to allergen - for instance, people with severe peanut allergy might react if someone even opens a jar of peanut butter close by, or if they are kissed by someone who has been eating peanuts!

Food intolerances are different. In food intolerance, the immune system is not involved. Usually the problem is lack of an enzyme required to digest a certain food. This is so for lactose intolerance where milk and dairy products can't be digested because the person lacks the enzyme lactase. Symptoms of lactose intolerance include bloating, cramping and diarrhoea. Food intolerance is dose related, unlike food allergy. Someone with lactose intolerance may well be able to have a spot of milk in a cup of tea, but they would be ill if they drank a glass of milk.

If certain foods upset you, it may help to keep a food diary to see if you can see a link between specific foods and your symptoms. Another way is to go on a diet, eliminating suspect foods and noting whether you improve. Seek medical advice before doing the latter to make sure you are not missing out on nutrients. Treatment is by avoidance of the foods you are allergic or intolerant to. This means checking how meals will be prepared when you eat out and being extra vigilant about reading food labels when you are shopping.

For more helpful information please visit http://www.mayoclinic.com/health/food-allergy/AN01109

What can you expect from an air purifier? That of cause depends which brand and model of air purifier you buy. We do not recommend buying an air purifier from a company that reverse engineered their product - even if that company has a household name and produces excellent other products, such as tvs, cars or even duct tape. By reverse engineering I mean to say that the company started out by asking the wrong questions, such as: How much should the air purifier cost? How much shelf space can it occupy at the local retail store? What new and exciting sounding technologies does it combine? Who is going to do the R&D for us and how much are we willing to pay for it?

The right questions to ask are: What is the average room size? How many air changes per hour does an air purifier need to achieve in such a room? What is the best possible filtration efficiency achievable? How can we guarantee the air purifier's reliable performance? What you get when you build an air purifier based on asking the right questions is an air cleaner unit that does not make any compromises and thus sets itself apart from the rest.

The company that did ask the right questions and is market leader in air purification is IQAir. What can you expect from such an air purifier? 1) It is effective. IQAir air purifiers have the highest filtration efficiency of any home air purifier on the market. No other air purifier filters so much particulate and chemical pollution out of the air. The true HEPA filters that are used in IQAir air purifiers take nearly all particle pollution out of the air, which includes viruses and bacterias. Even in the size range of 0.3-0.1 micron - at which particulate pollution is most difficult to capture - the IQAir HealthPro 250 has a certified filtration efficiency of 99.95 percent. 2) It is reliable. My HealthPro 250 is eight years old and it still runs and performs as it did on its very first day. Due to it's mechanical filtration, it's filtration efficiency never decreases - even if you forget to change the filters for a while. 3) It is quiet. There are no shortcuts in air purification. But for an air purifier that moves as much air and has such a high filtration rate for particulate and gas pollution, the IQAir HealthPro 250 is very quiet (Lwa = 30-70 dBA).

To find out more visit our IQAir Brand page, IQAir HealthPro 250 page or call us anytime at 0800 0148 667.

Our Related Products:

• IQAir HealthPro 250
• IQAir HealthPro 150

What is asthma?

Asthma is a condition involving the airways, which are the tiny tubes carrying air in an out of the lungs. In asthma, the airways are affected in three different ways.

• Abnormal 'twitchiness' or sensitivity
• Inflammation
• Blockage with mucus

So the airways of someone with asthma are different to those of someone who does not have asthma, even when they are not having an asthma attack.

When you come into contact with something you are allergic to, or an irritant, the muscles around the walls of the airways tighten, inflammation increases and more mucus is produced. The resulting narrowing of the airways produces asthma symptoms.

What are the symptoms of asthma?

The symptoms of asthma vary from person to person. The most common ones are:

• Dry irritating cough
• Wheezing
• Shortness of breath
• Tightness in the chest

These symptoms may be present more or less all the time, or just occasionally. They may come on without warning and you may have good days and bad days. In some people, especially children, a cough is the main symptom.

What is the difference between a trigger and an irritant? A trigger is something that triggers your asthma. Everyone's asthma is different so people have different triggers. You may find you have several triggers and it is important to know exactly what they are. Common asthma triggers include:

• Indoor air pollution such as pet dander, dust mite allergens and funguses
• Outdoor air pollution from trains, plains, trains, and factories, as well as pollen
• Viral infections, like colds and flu
• Exercise

Irritants tend to affect everyone with asthma and tend to have a more transient effect on asthma symptoms while triggers make asthma worse for a longer time period. Common irritants are cold air (especially going from a warm to a cold environment), cigarette smoke, chemical fumes and aerosol sprays.

What causes asthma?

It is not yet clear what causes asthma, but it is more likely if you have a family history of asthma, eczema or allergic disease. Asthma rates have been increasing in recent years, so it is speculated that some aspects of modern life, such as cleaning products or changes in diet, have contributed to this. It is known that smoking in pregnancy increases the risk of a child having asthma. Outdoor air pollution and exposure to chemicals in the workplace have also been shown to cause otherwise preventable asthma.

Asthma can start at any age, although it tents to starts before the age of ten in around half of all cases. Childhood asthma is more likely in families with a history of allergy. A child may grow out of asthma but will have a higher chance of suffering from late onset asthma. Late onset asthma, starting in the 30s and beyond, may follow a chest infection or exposure to chemicals at home or in the workplace, and is less likely to be allergy-related.

How is asthma diagnosed?

The presence of the symptoms described above will make your doctor suspect asthma. Monitoring your lung function with a peak flow meter, a device that measures the flow of air out of the lungs, will help confirm the diagnosis. If, over a period of time, morning and evening peak flow readings vary by more than 15%, then an asthma diagnosis is likely. Another indicator of asthma is if asthma medication improves peak flow readings.

There are also more complicated lung function tests that can be done in hospital which may help confirm the diagnosis.

How is asthma treated?

There is no cure for asthma. But the condition can usually be managed successfully so you can lead a full an active life.

Treatment is based upon trigger avoidance (i.e. allergen avoidance) and medication. Keeping a diary of times and situations when your asthma is worse will help you identify your asthma triggers, which is the first step in avoidance. A high efficient air purifier, HEPA vacuum cleaner, non allergic bedding and allergy friendly cleaning products will limit your exposure to allergens in your home. Transforming your bedroom into a 'allergen free space' by effectively practicing allergen avoidance will allow you to get a better night sleep, and allows your immune system to recover.

There are two kinds of asthma medication, relievers and preventers.

• Relievers. These are inhaled drugs that are taken to relieve asthma symptoms. They rapidly relax the muscles around narrowed airways, making it easier to breathe again. Reliever inhalers are usually blue.
• Preventers. These are inhaled drugs that help to control the swelling and inflammation in the airways, and stop them being so sensitive to triggers. It is important to take them every day, even if you feel well, because the protective effects build up over time. Preventer inhalers are usually brown, red, or orange.

There are also some asthma treatments taken in tablet form, usually if you have had a severe asthma attack or if your condition is not controlled well by inhalers.

Managing asthma

Your treatment plan is intended to keep you free of asthma symptoms night and day. If you feel this is not happening, then visit your doctor or asthma nurse to review your treatment. Warning signs that your asthma is not well controlled include:

• Waking in the night with coughing, wheezing or tightness in the chest
• Feeling short of breath when you wake up in the morning
• Needing more and more reliever, or finding your reliever is not working very well
• Not being able to continue your usual level of activity or exercise because of asthma symptoms

What is an asthma attack?

Gradual worsening of your asthma symptoms over a number of days may lead to an attack, in which

• Your reliever does not help with the symptoms
• Symptoms get worse
• You find yourself too breathless to speak, eat or sleep

An asthma attack can be very frightening so it is important to know what to do before it actually happens. Here is what to remember:

• Take your reliever immediately.
• Sit down and make sure any tight clothing is loosened. Do not lie down.
• If there is no immediate improvement, take one puff of inhaler every minute for five minutes or until your symptoms improve.
• If your symptoms do not improve within five minutes - or if you are in any doubt - seek medical advice. Do not worry about causing a fuss, even at night.
• If you do have to go to hospital, take details of your medicine with you.
• Make sure you see your doctor or asthma nurse for a review, within 48 hours of the attack.
• Continue to take a puff of inhaler every minute until help arrives.

If your treatment is not working, if you are not clear what your asthma triggers are, then you should go and get a proper diagnosis. "Asthma is an umbrella term and your diagnosis might not be complete. There is no good test for asthma as there is for diabetes," noted Dr. Robin Gore, Consultant in Respiratory Medicine at the Royal Preston Hospital. To illustrate the difficulty of diagnosing asthma correctly, Dr. Gore presented four case studies at this month's British Science Festival in Birmingham.

At first sight, and without a battery of tests to hand, the patients in the case studies might have been diagnosed with asthma because they were wheezing. But they all had something else wrong with their breathing. An (incorrect) asthma diagnosis would have meant that treatment probably would not work and the patient would be left with their real problem untreated. So, for instance, if breathing in is hard there may be a problem with the vocal cords (although, to complicate things, the patient might have asthma as well). People who suffer from asthma are more likely to have a problem in breathing out. Food allergies and even panic attacks may sometimes look like asthma too.

There are good tests which can pinpoint asthma but, unfortunately, these are not widely available at the moment. One of these is the histamine challenge test, another goes by the name of respiratory inductance plethysmography and it looks at the interaction between chest movements and breathing patterns. The take home message of Dr. Gore's talk is that not all wheezing is asthma, but a proper diagnosis is both complex and time consuming. While some people may be wrongly diagnosed with asthma, when they have something else, equally a diagnosis of asthma may be missed, so the patient goes untreated. "We really need more research into a good bedside test," Dr. Gore said. We totally agree.

Today is National Nose Day (not to be confused with Red Nose Day). This date is meant to celebrate the nose as well as promote the practice of nasal irrigation for the relief of rhinitis, hay fever and other conditions affecting the nose. Nasal irrigation is a way of washing out the nose and, apparently, 17% of the UK population do this regularly. In yoga, it is called 'jala neti' and at the turn of the 20^th century, the British Medical Journal was recommending it be done by plunging the face into a basin of clean water,either cold or tepid, and taking slight sniffs, in and out, while under water. Today most nasal irrigation is done by introducing a saline (salt) solution into one nostril and let it drain out of the other nostril.

Nasal irrigation is a simple and inexpensive way of treating nasal congestion arising from hay fever, rhinitis and other allergies. It can be done with a tea pot-like device called a neti pot, a plastic bulb syringe or a regular bottle. There are also pulsatile irrigation devices and atomiser sprays available. There's some debate over what salt concentration is best. An isotonic salt solution has a salt concentration similar to that of the body's fluids and it is soothing but may not reduce congestion as much as a hypertonic solution, which is more like sea water. A hypertonic solution, however, may irritate the sinuses. Don't use water alone, because it is absorbed by the nose and it may make congestion worse. Saline sinus rinses can be bought but you could make your own with 240 ml (8 fluid ounces) warm water with quarter of a teaspoon of non-iodised salt.

Even though nasal irrigation is widely practiced - does it actually work? Is there any evidence that it works? In a recent review, doctors at the Wisconsin School of Medicine and Public Health, Madison, USA, concluded that there was good evidence that daily use of 2% liquid saline helped management of chronic rhinosinusitis but that evidence for its effectiveness in allergic rhinitis was less convincing. The study also noted that the exact mechanism of action of nasal irrigation remains unknown. It may be that the fluid washes out inflammatory compounds or has a direct cleaning effect (or both). Either way, the overall effect is to improve the functioning of the all important nasal mucosa.

Ref.:

Saline nasal irrigation for upper respiratory conditions Rabago D and Zgierska Z American Family Physician 2009 November 15 Volume 80 p 1121 Free access at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778074/?tool=pubmed

In line with our recent post about Dr. Andrew Weil and hay-fever, there is a lot of discussion about the effects that certain diets can have on your allergies. Some foods are believed to cross-react with pollens, making allergic symptoms worse at certain times of the year. For instance, it is suggested that if you're allergic to birch pollen, your hay fever can be made worse by apples. If so, it would be good to talk to a pharmacist or allergy specialist to discover what pollens you are allergic to, by establishing when your symptoms start and cease and which plants and trees are flowering in your area during that time. After that you can play around to see which foods may cross-react with these pollens and eliminate them from your diet at the appropriate times.

Here are some the pollen and food combinations that might make your symptoms worse:

CULPRIT: Birch - March to May

WATCH OUT FOR: Celery, curry spices, raw tomato, raw carrot, apples, pears, kiwi

CULPRIT: Grasses - May to August

WATCH OUT FOR: Oats, rye, wheat, kiwi, raw tomato

CULPRIT: Weed - May to August

WATCH OUT FOR: Raw carrots, curry spices

CULPRIT: Mould - September to October

WATCH OUT FOR: Yeast

Muriel Simmons advises: "Once you know what pollen you're allergic to, remove the foods known to cross-react with it from your diet for a week and note your symptoms. Then gradually reintroduce them and see what effect it has. But be aware that not everyone with hay fever is affected by foods…The good news is that most pollens are only around for two or three months so you don't have to give up these foods for ever. And in some cases, especially with tomatoes, cooking will destroy the protein that's triggering the reaction." Did you experience increased allergy symptoms when eating certain kinds of foods at a certain time of the year? If so, I am curious to hear which combination is causing you to expereince increased asthma symptoms.

Related Pages:

Allergy Fact Sheet

Ref:

• Mirror.co.uk 24/04/2007
• The Asthma Sourcebook, Francis V. Adams, M.D.
• The Food Doctor Blog
• Diet.co.uk

Most parents know that the air we and our children breathe day in and day out is polluted. But the consequences of being exposed for long periods of time to air pollution are often underestimated. The reason for this seems to be a fundamental misunderstanding.

Most parents agree that their child should not live in a completely sterile environment, sheltered from ‘natural’ dirt. By 'natural' dirt I mean pollution that has been around for million of years, such as common bacterias, viruses, pollen, and pet dander. Being exposed to natural air pollution is a part of growing up and might even help to build up an healthy immune system. Children should, however, be protected from 'urban' air pollution, i.e. air pollution from cars, trains, plains, industrial pollution, as well as gases and fumes from cleaning products, building material, heating devices and paints.

Inhaling urban air pollution is as damaging to your and your child's health as is smoking filterless cigarettes. Urban air pollution consists out of chemicals and toxins that our body is not used to. It is not the same air pollution that humans have been exposed to for thousands of years. The fine dust in air pollution has gotten smaller. It penetrates deep into our lungs and there is no natural defence for it. The pollution finds its way into our bloodstream, cells and every part of our body. Studies show how urban air pollution leads to complications during pregnancy, problems with cognitive development as well as premature death. When there is a high fine dust concentration in the air, more people are admitted to the hospital and more people die due to respiratory and heart complications.

Urban air pollution attacks and challenges our immune system in such a way that our immune system loses its ability to cope with natural air pollution, such as pollen, dust mite allergens, pet dander, dust and mould. Urban air pollution chips away a piece at a time of our natural defences, until they are so weakened that they start overreacting when we are exposed to natural everyday pollution.

Related Pages:
Air Pollution

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• IQAir HealthPro 250
• Blueair 650E
• Blueair 450E
• Anti-Allergen Dust Spray
• Allergen Wash Laundry Detergent
• All Rug Anti-Allergen Carpet Shampoo

Ref.:

• Public Health Statement for Polycyclic Aromatic Hydrocarbons (PAHs)
• Environ Health Perspect. 2003 February; 111(2): 201-205.; Effects of transplacental exposure to environmental pollutants on birth outcomes in a multiethnic population; Frederica P Perera, Virginia Rauh, Wei-Yann Tsai, Patrick Kinney, David Camann, Dana Barr, Tom Bernert, Robin Garfinkel, Yi-Hsuan Tu, Diurka Diaz, Jessica Dietrich, and Robin M Whyatt
• Effect of Prenatal Exposure to Airborne Polycyclic Aromatic Hydrocarbons on Neurodevelopment in the First 3 Years of Life among Inner-City Children; Frederica P. Perera,1 Virginia Rauh,1 Robin M. Whyatt,1 Wei-Yann Tsai,1,2 Deliang Tang,1 Diurka Diaz,1 Lori Hoepner,1 Dana Barr,3 Yi-Hsuan Tu,1 David Camann,4 and Patrick Kinney1; www.cumc.columbia.edu

If you do not have asthma, you don’t know what it can be like to live with the panic, terror, and feelings of suffocation, according to Richard Corrigan, Professor of Asthma, Allergy and Respiratory Science at Guy’s Hospital London. Prof Corrigan, who specialises in looking after the 10% of asthma patients who do not get better, was talking at this month’s British Science Festival. He paid tribute to the people with asthma who have helped with his research over the last 20 years by volunteering for bronchoscopies that have yielded valuable biopsy material.

Prof Corrigan’s work with the microscope has led him to believe that it is easier to describe the pathology of asthma than explain why some people develop it and some do not. Until our understanding of asthma advances, it has to be faced that it affects 5.4 million people in the UK. Most asthma is well-controlled but the grim reality is that 1,204 people, of whom 29 were children under 14, died from asthma in 2008, said Prof Corrigan. ‘If you are looking for a child serial killer, look no further.’ According to Asthma UK, 90% of these deaths were preventable, as are 75% of emergency hospital admissions for asthma.

The key to survival, and living well, is managing your asthma, which is about simple things like practicing allergen avoidance, using the right medication and knowing how to use your inhaler properly. Prof Corrigan things that people either don’t use their inhalers because they are afraid of them or too busy to bother, or they simply don’t do it properly. The latter is likely to be the main reason for lack of asthma control. Prof Corrigan believes strongly in the correct use of inhalers and is part of a European task force to help people with asthma get this right. Because even a small error in technique can lead to a serious shortfall in the amount of steroid being delivered to the lungs and can mean the difference between control, and an admission to A & E. Equally you should know, understand and avoid your asthma triggers which can help you live free of attacks long term. ‘We have come a long way in understanding and managing asthma in the last 20 years,’ Prof Corrigan concluded. ‘But we still need to do more to help asthmatics master their disease, rather than have it master them.’

Related Pages:

Asthma

Ref:

Source Prof Richard Corrigan ‘So what causes asthma, then?’ British Science Festival, Birmingham, September 15 2010

Vitamin D helps build strong bones and teeth - that's long been known. Exposure to sunlight is the easiest way to get your daily dose of vitamin D. It's unusual not to look to diet to get adequate nutrients but sunlight triggers conversion of a natural compound in the skin into vitamin D and is a better source than most foods. More recently, attention has been focused upon the role that vitamin D deficiency might play in many diseases, including breast cancer, diabetes, high blood pressure and multiple sclerosis and some experts have suggested its time for daily recommendations to be revised upwards to protect not just

bones and teeth, but to promote general health and avoid chronic disease. A paper in the September issue in the Annals of Allergy, Asthma & Immunology has found a possible cause-and-effect link between vitamin D deficiency and asthma as well. Researchers Manbir Sandhu and Thomas Casale, from Creighton University, Nebraska, USA, looked back at almost 60 years of research on vitamin D and asthma. So it wasn't exactly a new study, but these reviews often uncover previously hidden connections and evidence - and can be really useful in pointing the way for future studies. They found that vitamin D deficiency is linked to increased airway hyperresponsiveness - the clinical hallmark of asthma - as well as to poorer lung function and worse asthma control. This does not amount to evidence that you should add a vitamin D supplement to your regular asthma treatment. First of all, even if vitamin D deficiency was confirmed as a genuine cause of asthma, it is not the only cause. And, second, you wouldn't know you had a vitamin D deficiency unless you were tested for it. However, the Creighton researchers do make a cautious recommendation that people with asthma might consider vitamin D - but, if you want to do this, it's best to discuss it with your allergy specialist first. What's needed now is fresh, forward-looking studies to see whether taking vitamin D can help prevent asthma or help control it better if you already have it. In the meantime, if the sun's out, take advantage and get outside. You only need 20 minutes exposure to the sun (without sunscreen) to start building up long-term supplies of vitamin D in your body.

Related Pages:

Asthma

, a country is only allowed 35 'bad air' days before action is taken, following which fines may be imposed. Air pollution is an ongoing problem in London and in the UK. Mayor Boris Johnson commissioned a report, carried out by the Institute of Occupational Medicine, that London's Bryanston Square and Dorset Square had the highest levels of PM2.5 pollution, followed by the City, Bloomsbury, the West End, St James's, Hyde Park, King's Cross, Holborn and Covent Garden. What does this mean in terms of Londoners' health? The report concluded that long-term exposure to this level of air pollution is likely to lead to 4,267 premature deaths. A recent report from the American Lung Association underlines the dangers of particulate matter. Exposure to PM2.5s (particles which have a diameter of 2.5 micrometres) causes the most concern. They are so tiny, that they are inhaled deeply into your lungs, evading natural defences. Many studies link PM2.5 exposure to increased asthma attacks and hospital admissions. PMs of all kinds are linked to increased use of asthma medication in children, decline in lung function, more A and E visits and hospital admission for heart and lung problems. The particles are a double threat to people with asthma because they make both airway constriction and airway inflammation worse. What is more, it doesn't take much of an increase in PM levels to trigger these problems. The latest scheme to persuade Londoners to leave their cars at home, and avoid the congestion charge, is free (up to half an hour) bike hire. It's proving popular, but what will cycling in close proximity to cars and through such a polluted city do to your lungs?

Related Pages:

Air Pollution

would be aligned with the individual’s genetic profile with pinpoint accuracy, so minimising any side effects. We might also expect new and more effective therapies, based on a deeper understanding of the disease based on the genes involved. And a pregnant woman could get an answer to that all-important question ‘Will my baby have asthma too?’ though genetic testing. So far these promises are a long way from being fulfilled. But there’s steady progress - particularly in the field of asthma - and good reason to be optimistic. Only last month researchers for the Perinatal Risk of Asthma in Infants of Asthmatic Mothers (PRAM) study at Yale School of Public Health announced the discovery of three new genes where particular variants that can increase a child’s risk of developing asthma. But it’s important to realise these are not genes ‘for’ asthma. Unlike single gene disorders, such as cystic fibrosis and haemophilia (where if you have the gene you have the disease) asthma is influenced by many genes (including the three that have just been discovered). You need to inherit a particular pattern of gene mutations to be at increased risk of asthma. The Yale researchers found the three important gene variants in their PRAM children but there are as many as 250 or so genes that researchers have linked to asthma over the past ten years or so. How can we know which ones have any real relevance to people with asthma, or who are at risk of it? The good news is that gene chip technology can now scan a patient sample for variants of several hundred different genes, making it possible to pick out gene patterns that are the signature of not just asthma itself, but all its different subtypes. Of course, we still need to know which are the key gene variants to look for, but the recent discoveries at Yale (and elsewhere) suggest that significant progress is now being made.

Related Pages:

Asthma Information

If you're wedded to your iPhone, however, you might already have come across the free AsthmaMD app which was launched earlier this year. Dr Sam Pejham, a doctor and researcher based in California, devised AsthmaMD to help people keep track of their asthma - through entering their meds, triggers, and other data, including peak flow readings on a regular basis. This gives you an instant snapshot of your peak flow pattern and the current state of your asthma which you can link back to any triggers or activities. For a demo and setup instructions, check out this clip:

You can email the data to your doctor or asthma nurse and you can also use it to help others. Users can opt in to share this data anonymously with the AsthmaMD service where it is put together and sent to researchers. Dr Pejham and his colleagues say that, for instance, they could pinpoint a patient's location when they have an asthma attack and find out if pollutants or weather conditions at the time were responsible. They could also use the meds data to find out more about how effective they are in different age groups and how different triggers affect people. We'll probably see updates and more apps to help with allergies and other health conditions. They're part of a growing trend in using technology to drive personal health care and put the patient more in charge when it comes to managing a chronic condition like asthma.

Related Pages:

Asthma Information

Dust mites are present in more or less every home, and live in mattresses, pillows, comforters, carpets, blankets, curtains and upholstered furniture. Mites especially thrive under warm and humid conditions. Just like bed bugs, dust mites live where humans are, because their main source of food comes from the human body. Dust mites live from eating shedded human skin cells, whereas bed bugs live from human blood.

Dust mite allergies are some of the most common allergies. But it is not the dust mite directly that triggers allergic reactions and asthma attacks, but rather the dust mite's feces pellets and the fragments of their dead bodies. These particles become air borne and are then easily inhaled during the day or at night when you are sleeping. One of the main problems in fighting dust mites is that the dust mite remains can cause allergic reactions and asthma attacks long after the dust mite has died. There are, however, several effective steps you can take to fight dust mites in your home. One is to wash all your bedding with anti allergen laundry detergent. Using high quality allergy friendly cleaning products will break down the protein in the dust mite allergens (as well as other allergens such as pet dander and pollen) that is responsible for causing allergic reactions.

Another important step in limiting your daily exposure to dust mite allergens in your home is the use of a high efficient HEPA air purifier. A good air purifier will filter the air in your home and take out dust mite allergens, as well as most other air pollution. When buying an air purifier, you should make sure that it uses HEPA filtration, is powerful enough to clean the air 2-3 times per hour in the room where you will use it, and that it does not create any negative by-products-such as ozone. To learn more about buying an air purifier, click here.

Allergic encasings for your bed is another good way to decrease allergic reactions to dust mites. These encasings create a protective layer between you and the dust mites in your mattress, blankets and pillows. Allergic encasings are more tightly woven then regular bedding, so that they trap dust mites and their allergens away from you and your family. The problem with allergic bedding is that it is often too tightly woven, and thus is not breathable.

Related Pages:

Dust Mites Fact Sheet

Related Products:

• IQAir HealthPro 250
• Blueair 650E
• X-Mite
• Anti-Allergen Dust Spray
• Allergen Wash Laundry Detergent
• All Rug Anti-Allergen Carpet Shampoo

One month ago we moved into a new flat. The flat is beautiful but the carpet in it was dirty, stained and had this musty smell. It looked like it is about 10 years old and has been used by many different tenants. It did not take me long to decide to steam clean the carpet, and I am so happy I did.

Did you know that if you have a carpet at home, it is most likely inhabited by millions of dust mites? Did you also know that living with dust mites can cause you to develop allergies and even asthma and will increase the allergy and asthma symptoms you already have? To prevent this, steam cleaning the carpet on a regular basis is a good idea. Steam cleaning not only removes dirt and bacteria from your carpet, but also washes out dust mites and dust mite allergens, pollen, and pet allergens.

You can buy a steam cleaner and wash your carpet yourself or hire a professional to do it for you. I decided to hire a professional. A good steam cleaner functions like a washing machine for your carpet. The key is to use plenty of fresh water while at the same time leaves as little water behind in the carpet as possible. A professional steam cleaner uses up to 45 liters of fresh water for one to two rooms. Any descent steam cleaner will also allow you to adjust the temperature of the steam. A professional steam cleaner can release steam that is up to 160 degrees hot, which is so hot it will kill all dust mites, but also melt most synthetic carpets and shrink wool carpets (just as your wool sweater would in the washing machine). However, if the water is too cold the steam cleaner will not kill the dust mites and will not properly clean the carpet either. For a wool carpet the steam should be 50-60 degrees hot, and for most synthetic carpets you can heat the steam to 70-80 degrees.

You will be happy to know that dust mites will be killed when exposed to 60-degrees. But to break down dust mite remains and get as much dirt out of the carpet as possible, you should also use carpet-cleaning detergent with the water. For our wool carpet, the person we hired used "Formula 90 Powder," for a synthetic carpet he would have used "Power Burst." If you want your carpet to smell good as I did, you can ask to have him mix a lemon refresh deodorizer into the steaming water. All the products he used are supposedly especially allergy and asthma sufferer friendly. Just remember, wash your hands well after handling any cleaning chemicals. Allersearch makes a fantastic range of domestic allergy friendly cleaning products.

Depending on how your carpet is attached to the floor, you might find more dust collecting on the carpet along the wall. This was the case in our flat and definitely needed a bit more attention. The reason for this is that many carpets are attached to a metal rod that keeps the carpet in place. Walking on the carpet creates friction, which magnetizes the metal rods and carpet, so that they attract more dust and dirt.

After your carpet has been steamed cleaned let the carpet dry. Depending on the carpet this could take anywhere between two to four hours. If you are sensitive to gases and fumes, as I am, you might want to leave the house during that time. If possible, don't walk on the wet carpet either, especially not barefoot or with dirty shoes. To avoid your furniture from staining your carpet, you should place small plastic sheets under the legs of your furniture in every room. Because my carpet was professionally cleaned, these sheets were provided to us.

Steam cleaning your carpet (if it is done right) makes a world of difference. In the last couple of weeks since the carpet has been cleaned my allergic reactions have decreased a lot. I can sleep better, my eyes do not itch as much and I am less congested. The company we used to steam clean our carpet charged £ 58.00 for a large one bedroom flat with two walk-in closets. So, from one flat renter with dust mite allergies to the next, I can highly recommend properly steam cleaning your carpet! If you have any further tips or suggestions regarding steam cleaning your carpet, please share them with me - thank you.

Related Pages:

Dust Mite FAQ

Allersearch Product Page

I have been reading extensively about issues regarding hay-fever lately. Especially well written and resourceful was Dr. Andrew Weil’s article in the Huffington Post on 15th June. In the article Dr. Weil lists a number of steps that can be taken to prevent and alleviate the symptoms of hay-fever without the use of conventional treatment such as antihistamines. Dr. Weil outlines many of the points I have covered in my previous post on hay-fever, such as dust-proofing your home and filtering the air by investing in an effective HEPA air-purifier.

What I found particularly interesting, however, was Dr. Weil’s well-written account about diet and the impact that it can have on hay-fever and allergies in general. He writes that: “the vigilance of the immune system is influenced heavily by the consumption of pro-inflammatory or anti-inflammatory fats.” He points out that milk and milk products should be eliminated from our diet as the protein in cow’s milk can irritate the immune system and keep it in a state of over-reactivity.

Inspired by Dr. Weil account of how diet can reduce our hay-fever and other allergy symptoms, I then compiled the following list from the other articles and books I studied:

Foods to increase:

• Vitamin C and beta-carotene found in berries, dark green vegetables and numerous fruits contain the main antioxidant found in our respiratory passage and therefore these foods can offer relief from hay-fever symptoms by having a possible antihistamine and anti-inflammatory effect.
• Essential fatty acids: Foods rich in Omega-3 oil such as oily fish, nuts, seeds and their oils are recommended for fighting allergy symptoms. They contain prostaglandins, hormone-like chemicals with anti-inflammatory properties. As nuts are a fairly common allergen, please make sure you are not allergic to them first!
• Chamomile, ginger and peppermint also can have an antihistamine effect and offer relief from allergy symptoms - though to a lesser degree.
• Garlic and onions, kale and broccoli: are sources of quercetin, another powerful anti-inflammatory that can reduce allergic symptoms. Garlic and onions also boost the immune system by increasing production of white blood cells, which deal with allergic reactions. Quercetin can also be found in blue-green algae, spirulina, chlorella and kelp.
• Bromelain in pineapple and nuts is also useful in boosting the anti-inflammatory prostaglandins. It may, however, be better in supplement form as these foods are fairly common allergens.
• Consider taking a tablespoonful of local honey everyday starting a few months before the pollen season starts - this may act as a form of oral desensitisation (the honey will have been contaminated with pollen).

Foods to avoid:

As well as dairy suggested by Dr Andrew Weil, wheat and citrus fruit have also been flagged up as increasing histamine production and thus should be avoided by allergy sufferers. Wheat and dairy also increase mucus production, which makes the symptoms of hay-fever worse.

Saturated fats found in red meat, dairy and sugary foods contain pro-inflammatory substances that can aggravate allergy symptoms and increase mucus production as well.

Related Pages:

Hay Fever FAQ

Ref:

• Dr Andrew Weil, Huffington Post, 15th of June
• Times on Line
• The Food Doctor Blog
• Diet.co.uk

Related Pages:

Hay Fever FAQ

Ref:

• Telegraph.co.uk 9th June 2010

Adverse reactions to food are not uncommon. True food allergy, however, only affects 2 to 4% of adults and 6 to 8% of children. In food allergy, specific proteins in the food you eat act as allergens, triggering the production of antibodies in the IgE class. Once sensitised like this, the next time you are exposed to the allergen IgE alerts the mast cells in the immune system. A mast cell is a resident cell that contains many granules rich in histamine and heparin. These mast cells then release histamine, and it is the histamine that causes the typical symptoms of food allergy, which may include:

• Tingling mouth
• Swelling of the lips, face, tongue and throat
• Rash
• Vomiting, cramping

If the allergen gets into your bloodstream you may even experience an extreme allergic reaction called anaphylaxis, which can lead to a potentially fatal episode of shock. Allergic reactions can be triggered by just minute exposure to allergen - for instance, people with severe peanut allergy might react if someone even opens a jar of peanut butter close by, or if they are kissed by someone who has been eating peanuts!

Food intolerances are different. In food intolerance, the immune system is not involved. Usually the problem is lack of an enzyme required to digest a certain food. This is so for lactose intolerance where milk and dairy products can’t be digested because the person lacks the enzyme lactase. Symptoms of lactose intolerance include bloating, cramping and diarrhoea. Food intolerance is dose related, unlike food allergy. Someone with lactose intolerance may well be able to have a spot of milk in a cup of tea, but they would be ill if they drank a glass of milk.

If certain foods upset you, it may help to keep a food diary to see if you can see a link between specific foods and your symptoms. Another way is to go on a diet, eliminating suspect foods and noting whether you improve. Seek medical advice before doing the latter to make sure you are not missing out on nutrients. Treatment is by avoidance of the foods you are allergic or intolerant to. This means checking how meals will be prepared when you eat out and being extra vigilant about reading food labels when you are shopping.

For more helpful information please visit the Allergy Factsheet

My cousin is about to sit her public exams and is suffering terribly from hay fever. Her plight reminded me all too well of the problems of sitting exams in the summer when my allergies and hay-fever were at its worst.

I would sit in the dusty Concert Hall with a box of tissues on my desk, my eyes itching and nose running. The windows would be open to allow air, and with it, pollen and traffic pollution into the hall and for the few allergy sufferers this would exacerbate their problems. I would try and keep my sniffing and nose-blowing as quiet as possible but even so the noise would sound horribly loud and distracting in the silent hall. Fearful of the side-effects of anti-histamines and worried that drowsiness would prove more detrimental to my results than hay-fever, I didn’t take any allergy medication during the exam and the night before despite being prescribed them by my doctor.

I have always wondered why exams have to be held in the height of summer when my allergies and hay-fever are at its worst. And, when various friends were, quite rightly, given extra time to allow for their dyslexia, I sometimes thought that I should be allowed extra time to allow for having a headache, blowing my nose and wiping my eyes! I wonder if there is a solution other than moving exams to mid-Winter?

IKEA - the Swedish furnishing maker- has unveiled it's first air purifier. The air cleaner's name is “Patrull” (meaning “patrol” in Swedish) and it looks a little bit like Star Wars' r2d2 with a shiner. IKEA advertises its air purifier as a general air cleaner, effective for filtering out pollen, dust, dust mite allergens, and tobacco smoke particles. The air cleaner costs £69.99 and the replacement filters cost £14.99.

The unit is relatively small, light and has an IKEA typical family friendly design. The air purifier is made out of white plastic and has three fan speed settings. The IKEA air purifier's fan is relatively quite on all three settings, and manages to move a good amount of air.

The filter of the IKEA air purifier is a Flimmer® filter that consists of polypropylene fibres - a synthetic filament. In this kind of filter, the fibres are electrically charged through the draft that is created by the fan. The idea behind this filtration technology is to capture particulate air pollution through electrostatically charged fine polypropylene hairs - so that the filter works basically like a mechanical nostril.

The technology used by the IKEA air purifier itself is not new, and IKEA in the UK has been using it on a large scale for at least a year and a half in its Croydon store. IKEA in Wembley is also using 45 large units that use the same kind of filter technology since beginning of 2010. For stores like IKEA, this kind of air filtration technology is primarily used to minimize dust settlement and thus reduce cleaning costs.

Efficiency in Capturing Particle Air Pollution

During an Allergy Cosmos Efficiency Test regarding the ability to filter particle air pollution out of the air, the IKEA air purifier filtered out an average of 65% of particle pollution down to 0.3 micron on it's first day of testing. This is close to the manufacturers aim of achieving a 70% filtration rate at 0.3 micron. 90% of indoor air pollution, however, is smaller then 0.3 micron. This means that the IKEA air purifier will effectively only capture 7% of particulate pollution, and blow 93% back into the room. An IQAir HealthPro 250, HealthPro 150, or Allergen 100 air purifier, in comparison, has a guaranteed and certified filtration efficiency of 99.5% of air pollution down to 0.003 micron. For more information click here: IQAir Room Air Purifiers.

We did not test the IKEA air purifier's efficiency of capturing particulate air pollution over a longer period of time. In general, air purifiers that use electrostatic filtration tent to lose filtration efficiency quickly over a short period of time, and thus require you to replace the filter often.

Recommendation

The IKEA air purifier has a relatively low price and has some efficiency in collecting larger dust particulates, but this unit does not seem to be designed for asthma or allergy sufferers in mind. Indoor air pollution does not stop at 0.3 microns, and achieving a 65% efficiency rate at 0.3 microns is not going to be enough to be considered an effective allergy or asthma air cleaner. To learn more about particle size and behaviour, please see our Air Pollution Chart. There are other problems though:

• The unit is made out of plastic and has a strong smell to it, which can cause severe irritation in people with Multiple Chemical Sensitivity (MCS).
• The IKEA air purifier does not give you any indication when its filter is loaded and needs to be replaced. This kind of filter technology will always let a similar amount of air pass through the filter, so that you have no direct indication if it is filtering the air or not. Air cleaners using mechanical filtration will decrease in air flow rate when the filter is loaded and needs to be replaced.
• The polypropylene hairs in the filter are sitting very loosely in the filter carton. If they are touched, or the filter carton or air purifier is shaken, the air purifier's efficiency rating in filtering the air can further decrease.

Patrull Technical Specifications:

Dimensions: 355 x 435 x 310 mm
Weight: 5 kg
Air flow rare: 54-130 m3/h
Sound rating: 31-46 dB(A)
Filter: Flimmerfilter

Noise, air delivery rate & electricity consumption:

1. 30 dB(A), 50m3/h, 8W
2. 42 dB(A), 108m3/h, 14W
3. 45 dB(A), 135m3/h, 32W

To find reliable and affordable air purifiers, check out:

• Blueair 203
• Blueair 270E
• Blueair 270E with SmokeStop Filter

Ref:

• IKEA FAMILY Newsletter 27. Mai 2010
• www.IKEA.co.uk
• www.zehnder.co.uk

At London’s Chelsea Flower Show this week, Olivia Kirk of KKE Architects has designed a garden with hay fever, general allergy and asthma sufferers in mind. The garden was designed for the University of Worcester to provide a tranquil spot for staff and students to sit and relax. The allergy friendly garden aims to complement the National Pollen and Aerobiology Research Unit at the University, which tries to help allergy and asthma sufferers by conducting research and consultancy on large organic particles both in the indoor and outdoor environments.

Although sharing similar features with many of the other small, modern gardens at the Show, Olivia’s allergy friendly design has been carefully planned to give a balance of shade, sun and shelter. She used natural materials and low-allergen plants with the aim of causing the least irritation to people with allergies and asthma. Olivia explains, that "as a rule of thumb, if the flower is insect-pollinated, you are absolutely fine, apart from a few exceptions. If it's wind pollinated, the pollen is designed to be buoyant and it stays in the air a lot longer. But with insect-pollinated flowers - when the insect has done its job - the pollen is heavy and falls to the ground." With this in mind Olivia has used flowers such as irises and peonies. Her choice of trees for the garden was more limited as many are wind-pollinated, but she chose amelanchier.

Olivia Kirk's allergy friendly garden was awarded the Silver-Gilt Flora Medal by the RHS.

Related Pages:

Allergy FAQ

Asthma FAQ

After a serious asthma attack as a small child an asthma specialist told my mother that we could never have a pet in the home, that I had to stay away from houses where there were dogs and cats and on no account could I have contact with horses. My siblings were horrified, no puppies or kittens, no riding without changing clothes, showering and washing before re-entering the house but at least my allergies at home were now controlled.

Twenty years on I live in the country, on a farm. My husband rides but like my siblings has to shower and change his clothes away from home. We do however have a dog and are about to get another. We have taken certain measures that mean that although I can’t get too close to the dog we are able to co-exist happily and my pet allergies are controllable.

• Choice of Pet: It would seem that no breed of dog or cat is completely ‘non-allergic’ despite some claims that certain crosses can create a hypo-allergenic dog. Every dog sheds dander from its skin and it is this dander that is the cause of most allergies. However, there are certain breeds of dog that are less allergic making to some people than others and if considering buying a new pet it may be worth while spending time with certain animals to see if one breed causes you to have a greater reaction than another.

• If necessary keep your bedroom as a ‘safe zone’; and do not allow your pet in the room. Keep the carpets and curtains clean, use anti-allergy bedding. Keep any clothing that may have come into contact with your pet out of the room.

• If possible, limit the number of rooms that your pet can be in and ideally these rooms should have non-carpeted floors that can be mopped and cleaned easily. In rooms with carpets make sure they are cleaned and vacuumed regularly with a high efficiency vacuum cleaner.

• Use a high efficiency air purifiers to trap pet dander and other allergens around the house. To learn more click here.

• Wash your pet (or ideally ask someone else to) regularly. There are specialised shampoos and wipes that cleanse away allergens. If your dog has hair that moults ask someone to brush its coat regularly outside to remove excess hair and prevent it moulting in the house.

• Wash your hands regularly after playing with your pet and make other family members do the same.

• If a long time has been spent playing with your pet it may be a good idea to change and wash your clothes with allergy friendly laundry detergent as pet dander settles on clothes and can cause allergic reactions.

I know that for some allergy sufferers, sadly a pet around the house is not possible but by taking the steps outlined above it has allowed my husband to keep his beloved dog and for us all to live happily together.

Related Pages: 

Pet Dander FAQ

Allergy FactSheet

Allersearch Products 

Parent Tested Parent Approved (PTPA) Media choose IQAir’s HealthPro air cleaner to be one of it’s exclusive “Top 10 Products for Parent.”

PTPA works with a network of more then 20,000 parents, to test and review products from 500 different companies. PTPA’s mission is to “marry innovative companies with discerning consumers,” by providing a platform for companies to introduce their products for evaluation, and giving “feedback from the experts that matter most: parents!” PTPA prides itself in discovering, appraising and promoting new products designed to enrich family living. Products range from baby clothing, toys and accessories to parent-focused products that enhance the day-to-day life.

Products are rated based on innovation, quality and value for money, and awards are presented to companies whose products are deemed exceptional. IQAir’s air cleaner was chosen as best air purifier for it’s superior ability to remove a large variety of particulate and molecular air pollution. It filters out pollen and pet dander, as well as ultra fine particle pollution. The air cleaner’s granular active carbon also removes odors and eliminates harmful chemicals.

For more information please click on: IQAir or see IQAir HealthPro 250.

Poor indoor air quality can cause or exacerbate illnesses, especially asthma and allergies, in children and adults. Damage in developing years due to air pollution can lead to decreased respiratory function in later life. "Parenting has never been easy, but this year we have seen tremendous innovation in products aimed at helping parents do their job more simply and safely," says Sharon Vinderine, president of PTPA Media.

Ref:

IQAir North America, Inc.; PRNewswire

Exposure to volcano ash can cause acute respiratory morbidity, especially in those with pre-existing respiratory disease. Ultra fine air pollution such as volcanic ash and discharges of aerosol and acid gases can travel hundreds of kilometers and can cause health effects far from where they originated.

The majority of the death that are recorded as a result of volcano outbreaks are in relation to volcano induced famine, tsunamis, and mudflows. But according to Dr. Clair Horwell of the Durham University’s Institute of Hazard and Risk Research, official statistics often do not account for, or greatly underestimate, morbidity that is associated with the exposures to volcanic air pollution.

Dr. Clair Horwell writes that an important predictor of the scale and nature of respiratory effects of volcanic ash is the mineralogical composition, and the concentration of the ash particles that are inhaled and penetrate deeply into the lungs.

A 2003 risk assessment of the UK Department for International Development found, that the population in areas that are most affected by ash falls has >1% chance of developing early radiological changes of silicosis when exposed over a period of 20 years. People who work or spend much time outdoors were found to have an increased risk of 2-3% and up to 10%.

There are on average 70 volcano eruptions worldwide each year.

Ref.:

• Occup Environ Med 2006; 63:149-156. doi: 10.1136/oem.2005.022459; THE HEALTH HAZARDS OF VOLCANOES AND GEOTHERMAL AREAS A L Hansell, C J Horwell, C Oppenheimer
• Durham University 2007, http://www.dur.ac.uk/

The Keck School of Medicine at the University of California conducted a longitudinal study on respiratory health among children in 13 communities of Southern California. Researchers followed 2,497 children with no history of respiratory problems over three years. These children were tracked to see if they developed asthma in kindergarten or the first grade. The study showed that children that visit schools in high traffic areas have a 45% increased risk of developing asthma.

The Keck School suggests that it is important to consider children overall exposure to air pollution. Rob McConnell, M.D., is the lead author of the study, and he writes that: "residential traffic-related pollution has been associated with asthma” but “there has been little study of the effects of traffic exposure at school on new onset asthma…Exposure to pollution at locations other than home, especially where children spend a large portion of their day and may engage in physical activity, appears to influence asthma risk as well." Traffic-related air pollution can stem from cars, busses, plains, trains, as well as boats.

Ref.:

McConnell R, Islam T, Shankardass K, Jerrett M, Lurmann F, Gilliland F, et al. 2010. Childhood Incident Asthma and Traffic-Related Air Pollution at Home and School. Environ Health Perspect :-. doi:10.1289/ehp.0901232

PAHs enters the environment from car, truck or bus engines, residential heating, power generation, and tobacco smoke. Once the mother inhales the pollutants, they will be transferred through the placenta to the fetus. Prof. Frederica Perera is the director of the Columbia University’s Center for Children’s Environmental Health. She writes that: “These findings are of concern, because compromised mental performance in the preschool years is an important precursor of subsequent educational performance deficits.” Even though the findings of the study are alarming, Dr. Perera said, “fortunately airborne PAH concentrations can be reduced by currently available pollution controls.”

Dr. Perera’s study is part of a broader multi year research project, which began in 1998 called ‘The Mothers and Children Study in New York City’. A sample of 183 children of the age of three and of non-smoking women living in different parts of New York City, such as Washington Heights, Central Harlem, and the South Bronx were examined. In the study, the exposure during pregnancy to air pollutants was measured by personal air monitoring. Children aged three were tested using a standardized test focusing on mental and psychomotor development.

Ref.:

• Public Health Statement for Polycyclic Aromatic Hydrocarbons (PAHs)
• Environ Health Perspect. 2003 February; 111(2): 201-205.; Effects of transplacental exposure to environmental pollutants on birth outcomes in a multiethnic population; Frederica P Perera, Virginia Rauh, Wei-Yann Tsai, Patrick Kinney, David Camann, Dana Barr, Tom Bernert, Robin Garfinkel, Yi-Hsuan Tu, Diurka Diaz, Jessica Dietrich, and Robin M Whyatt
• Effect of Prenatal Exposure to Airborne Polycyclic Aromatic Hydrocarbons on Neurodevelopment in the First 3 Years of Life among Inner-City Children; Frederica P. Perera,1 Virginia Rauh,1 Robin M. Whyatt,1 Wei-Yann Tsai,1,2 Deliang Tang,1 Diurka Diaz,1 Lori Hoepner,1 Dana Barr,3 Yi-Hsuan Tu,1 David Camann,4 and Patrick Kinney1; www.cumc.columbia.edu

"The frequent use of household cleaning sprays may be an important risk factor for adult asthma", says Prof. Jan-Paul Zock of the Municipal Institute of Medical Research in Spain. The recent study that was co-authored by Prof. Zock showed that the risk of developing asthma was on average 30-50% higher among people who were regularly exposed to cleaning sprays. Cleaning sprays that are particularly harmful are air fresheners, furniture cleaners and glass cleaners.

According to the study, the exposure to certain cleaning products during professional cleaning work has been associated with asthma for sometime. This study, however, focused on the respiratory effects of nonprofessional home cleaning.

The researchers studied more than 3,500 subjects across 10 European countries. Participants were assessed for asthma, wheeze, physician diagnosed asthma and allergies during follow-up. They were also asked to report the number of times per week they used cleaning products.

Two thirds of the study population who reported doing most of the cleaning were women. 6% of them had asthma at the time of follow-up. Fewer than 10% of them were full-time homemakers.

Prof. Zock says that "the relative risk rates of developing adult asthma in relation to exposure to cleaning products could account for as much as 15%, or one in seven of adult asthma cases". For these reasons it is recommended to use allergy-friendly cleaning products.

Ref.:

• American Journal of Respiratory and Critical Care Medicine Vol. 176. pp. 735-741, (2007); The Use of Household Cleaning Sprays and Adult Asthma, An International Longitudinal Study

Air pollution due to heavy traffic is believed to cause a significant portion of preventable asthma in children. Large amounts of the outdoor as well as indoor air pollution stems from cars, trucks, plains, ships and trains. In a recent study, traffic related air pollution is shown to cause nine percent of all asthma in children in Long Beach California. The study published in the American Journal of Public Health was a collaboration between the University of Basel in Switzerland, the Centre for Research in Environmental Epidemiology in Spain, and the Southern California Children’s Environmental Health Center.

“Air pollution is a more important contributor to the burden of childhood asthma than is generally recognized, especially to more severe episodes requiring visits to clinics or emergency rooms” writes Prof. Rob McConnell who is the Deputy Director of the Children’s Environmental Health Center at the University of Southern California.

Studies in the past have shown that air pollution exacerbates asthma symptoms (Edler, 2006; Delfino 2002). Prof. McConnell research, however, evaluates if pervasive exposure to air pollution contributes to disease onset in children. Even though uncertainties regarding the exact causal relationship between air pollution associated with traffic and asthma remain, Prof. McConnell writes that the study’s “results demonstrate that the burden of asthma prevalence and exacerbation caused by traffic proximity can be substantial.”

Air pollution due to cars and plains can be substantial. The study, however, points out that “ship emissions alone contribute substantially to costal and inland air pollution.” Furthermore is the cargo going through the region of many metropolitan areas is expected to double and triple in the next 15 years.

Ref.:

• American Journal of Public Health; Global Goods Movement and the Local Burden of Childhood Asthma in Southern California; Laura Perez, MS, Nino Ku ̈nzli, MD, PhD, Ed Avol, MS, Andrea M. Hricko, MPH, Fred Lurmann, MS, Elisa Nicholas, MD, Frank Gilliland, MD, PhD, John Peters, MD, ScD, and Rob McConnell, MD

Endotoxin in household dust drastically increases the risk for asthma. Endotoxin is a heat stable toxin in the wall of certain bacteria cells. When the bacteria is inhaled and disintegrates, the toxin is released. A study published in the American Journal of Respiratory and Critical Care Medicine in April 2005 shows that exposure to endotoxins significantly effects airway inflammation. The result is that there is a clear relationship between households with increased endotoxin levels, and household residents with diagnosed asthma, recent asthma symptoms, wheezing, and use of asthma medication.

For the study, the research team of Prof. Peter S. Thorne from the Environmental Health Sciences Research Center at the University of Iowa evaluated 2,456 residents in 831 homes through out the US. Dust samples were collected from five locations with in the homes: kitchen floors, sofa surface, bedding, bedroom floors, living room floors. The relationship between increasing endotoxin levels and asthma symptoms, wheezing and use of asthma medication were the strongest for dust from bedding and bedroom floors. The highest concentrations of endotoxin in household dust were found in the living room and the kitchen floors.

Ref.:

• The New England Journal of Medicine; Volume 329:1753-1759 December 9, 1993 Number 24; An Association between Air Pollution and Mortality in Six U.S. Cities; Douglas W. Dockery, C. Arden Pope, Xiping Xu.
• American Journal of Respiratory and Critical Care Medicine; 1995;151:669-674; John D. Spengler, James H. Ware, Martha E. Fay, Benjamin G. Ferris, and Frank E. Speizer, Pope CA III, Thun MJ, Namboordiri MM, Dockery DW, Evans JS, Speizer FE, Heath CW Jr; Particulate air pollution as a predictor of mortality in a prospective study of US adults.

Ref;

• Environmental Health Perspectives 116 362-369; The Effect of Ambient Air Pollution During Early Pregnancy on Fetal Ultrasonic Measurements During Mid-Pregnancy; Hansen CA, Barnett AG, Pritchard G (2008); featured also on ABC TV and Radio, Channels 7, 9 and 10, and the major national newspapers.