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Asthma, Allergies and What to do About Them

Background

AHHC data collection indicates that hospitalizations due to exacerbation of respiratory symptoms increase during the spring of the year. We have hypothesized that they may be due to allergies triggering underlying respiratory disease. In an effort to avoid hospitalizations for our clients, we have developed this informational piece for use in decreasing allergic responses for our clients. Please read, share with your clients and their families and implement as you see fit.

Allergies and Asthma

The importance of allergy in asthma has been well established. Exposure to dust mites within the first year of life is associated with later development of asthma. Mite and cockroach antigens are common, and exposure and sensitization has been shown to increase asthma morbidity. Allergies trigger asthma attacks in 60-90% of children and in 50% of adults. Asthma is the most common chronic disease in childhood and accounts for up to 250,000 deaths per year worldwide.

Both outdoor and indoor aeroallergens sensitize and exacerbate allergic asthma and rhinoconjunctivitis. Major outdoor allergens include those derived from the pollens of trees, grasses, and weeds. Major indoor allergens are derived from dust mites, molds, cockroaches, cat, dog, and other furry animal debris. Allergens are located both in homes and in other indoor environments.

The physician has 3 treatment options for patients with allergic diseases, including allergic asthma. These include aeroallergen avoidance, medications to control symptoms, and allergen immunotherapy. In developed countries, more than 90% of the average person's time is spent indoors. This statistic underscores the importance of avoidance measures, especially in patients who are allergic to indoor allergens.

Allergen avoidance and other environmental control efforts are feasible and effective. Symptoms, pulmonary function test findings, and airway hyper reactivity (AHR) improve with avoidance of environmental allergens. Removing even one of many allergens can result in clinical improvement. However, patients frequently are not compliant with such measures.

Avoidance Strategies

While it is impossible to make the place you live in completely allergen free, there are things you can do to reduce exposure to allergens. The following tips may help.

  • Reduce exposure to dust mites. The most necessary and effective things to do are to cover your child's mattress and pillows with special allergy-proof encasings, wash their bedding in hot water every 1 to 2 weeks, remove stuffed toys from the bedroom, and vacuum and dust regularly. Other avoidance measures, which are more difficult or expensive, include reducing the humidity in the house with a dehumidifier or removing carpeting in the bedroom. Bedrooms in basements should not be carpeted.
  • If allergic to furry pets, the only truly effective means of reducing exposure to pet allergens is to remove them from the home. If this is not possible, keep them out of your child's bedroom and consider putting a high-efficiency particulate air (HEPA) filter in their bedroom, removing carpeting, covering mattress and pillows with mite-proof encasings, and washing the animals regularly.
  • Reduce cockroach infestation by regularly exterminating, setting roach traps, repairing holes in walls or other entry points, and avoiding leaving exposed food or garbage.
  • Mold in homes is often due to excessive moisture indoors, which can result from water damage due to flooding, leaky roofs, leaking pipes, or excessive humidity. Repair any sources of water leakage. Control indoor humidity by using exhaust fans in the bathrooms and kitchen, and adding a dehumidifier in areas with naturally high humidity. Clean existing mold contamination with detergent and water. Sometimes porous materials such as wallboards with mold contamination have to be replaced.
  • Pollen exposure can be reduced by using an air conditioner in your child's bedroom, with the vent closed, and leaving doors and windows closed during high pollen times.
  • Check air quality reports in weather forecasts or on the Internet. When the air quality is poor, keep your child indoors and be sure he takes his asthma control medications.

For more information about asthma and allergies go to:

WebMD: emedicine.medscape.com

Quick Reference Card

Major Allergen Area(s) of High Concentration Source of Allergen Avoidance Strategies
Dust Mite Bedding, Upholstered furniture, carpeting Mite body, Mite feces Impermeable (woven) covers (pillows, mattresses)
Elimination of dust reservoir (carpets, upholstered furniture)
Weekly vacuuming
Weekly washing of bedding in hot water
Reducing indoor humidity
Cat, dog Bedding, Upholstered furniture, carpeting Sebaceous glands, Salivary glands Pet removal, Pet washing
Impermeable covers
High-efficiency particulate air (HEPA) filters
Cockroach Kitchen Saliva, Fecal Material, Secretions, Dead cockroach bodies Pesticides, roach traps
Thorough cleaning
Elimination of food and water supply
Fungi, Mold Variable Spores Closing windows and doors
Repairing all leaks
Using air conditioning
Heating all rooms in the winter
Removal of contaminated source
Cleaning contaminated area with bleach solution



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