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Environmental Allergen Control

Allergen avoidance is crucial in the battle with allergy. In the home there are a number of simple steps one can undertake to control your allergy and asthma symptoms. The American Academy of Asthma, Allergy and Immunology (AAAAI) issued the recommendation that all patients with chronic allergic asthma be advised on environmental allergen control (also called allergen avoidance), as part of their allergy and asthma management plan.

Assessment of allergic status

To effectively practice environmental allergen control it is essential to determine a patient’s allergic status before making recommendations. That is, does the patient really have allergic asthma and what specific allergens are involved? A personal, or family, history of eczema, rhinitis or food allergy is one classic indicator. Another is a history of increased symptoms during the pollen seasons, or during exposure to animals, house cleaning or damp musty environments. A suspected allergic asthma diagnosis can be confirmed with skin testing or blood testing for antibodies to specific allergens. Tests should always be used in conjunction with a medical history to give the diagnosis. A number of studies have linked sensitisation to common indoor allergens to the development and severity of asthma, the most common of which are: house dust mite, animals, cockroaches and fungi.

Dust mite allergens

Specific proteins in house dust mite droppings and bodies have been shown to trigger perennial allergic rhinitis and allergic asthma symptoms, and thus are an important part to consider in practicing environmental allergen control. These proteins can be quantitated in dust samples by laboratory assays and it is known that mite allergen levels above 2 micrograms per gram of dust are a risk factor for sensitisation.

House dust mites colonise soft furnishings, soft toys and beddings. The allergens themselves are carried on particles that become airborne. Heaviest exposure occurs from bedding when the patient lies down. Fortunately, there has been a great deal of research into environmental allergen control and house dust mite allergens and we therefore know of avoidance measures that will improve symptoms. Here is a checklist of worthwhile recommendations that are a key part in environmental allergen control for house dust mites:

For the bedroom:

  • Encase pillows in covers that have pores less than 10 microns in size
  • Encase mattress in vapour-permeable or plastic cover
  • Encase box springs in vinyl or plastic
  • Wash bedding every week with allergen wash laundry detergent
  • Remove stuffed animals and toys from the bed

For the bed:

  • Vacuum weekly
  • Ensure that your vacuum is leakage free and has a High-Efficiency Particulate Air (HEPA) filter on its air outlet and double thickness bags

Changes that are harder to implement include:

  • Reducing indoor humidity
  • Replacing carpet with polished wood flooring
  • Replacing upholstered furniture with leather, vinyl or wood
  • Replacing curtains with washable shades or blinds
  • Avoid living in basements

Animal allergens

Cats, dogs, rats, mice, horses and cows all produce allergens that can cause acute and chronic allergic asthma. The following environmental allergen control measures have been shown to be effective:

Cockroach allergens

Several cockroach allergens have been identified. Highest levels are generally found in the kitchen or bedroom. Cockroaches can hide in cracks, so extensive cleaning to remove allergens is important if extermination is performed. Research into the impact of cockroach environmental allergen control is limited, but the following measures are worth trying:

  • Exterminate with pesticides
  • Vacuum and wet-wash the home every day
  • Place rubbish outside every day
  • Store food in sealed plastic containers
  • Seal cracks
  • Remove sources of standing water

Fungal allergens

Sensitivity to fungal spores is common among people with asthma. Mostly exposure to fungal allergens occurs outdoors, although many species can invade the home through open cracks or windows. Less is known about sources of allergen exposure with fungi than for house dust mite, animals and cockroaches. Environmental allergen control measures worth pursuing include:

  • Close doors, windows and use air conditioning
  • Control moisture by dehumidification, sealing water leaks, ventilating kitchens and bathrooms
  • Clean and remove contaminated material by using an allergy friendly mould spray
  • Use HEPA air purifiers to remove spores
  • Maintain ventilation and air conditioning systems
  • Use personal protective equipment when removing contaminated materials

In conclusion, most patients with allergic asthma are actually sensitive to multiple allergens. This may involve changing many aspects of their home environment, as listed above, which can be confusing and burdensome. However these changes can dramatically help a person suffering with allergy and make their life a lot easier.

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