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.
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.
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 practising 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:
For the bed:
Changes that are harder to implement include:
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:
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:
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:
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.