Allergen Avoidance

To effectively practice allergen avoidance, it is essential to determine your 'allergic status'. That is, you have to identify if you are really having allergies 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 pets, house cleaning or damp musty environments. If you suffer with asthma can be confirmed with a skin or bloodallergy testfor antibodies to specific allergens. Allergy 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, pet, cockroaches and mould.

• Identify what you are allergic to

The first step in practising allergen avoidance is to identify what you are allergic to. One way to conduct this is to have an allergy test. There are three different types of allergy tests; skin, blood and a patch test. Your GP or allergy specialist will ask you about your symptoms and habits to identify what triggers your allergy.

• Educate yourself on how to eradicate these allergens

The second step in managing allergy and asthma symptoms is to educate yourself on how you can best avoid being exposed to the allergens that trigger your allergy and asthma symptoms in the first place.

"If patients understand the role that specific allergens play in causing symptoms, then they can gain control of their illness, reduce symptoms and in many cases reduce reliance on pharmaceutical products." Thomas A.E. Platts-Mills, former President of the American Academy of Allergy, Asthma, and Immunology.

One way of educating yourself is by seeking advice from your local GP or allergy specialist. The internet is also a good way to conduct research at your own convenience. However, not everything on the internet is true and reliable, so you will need to be wary of certain pages and blogs. Especially when it comes to allergy and asthma remedies, many people tend to share their own experiences, however, this may not relate to yourself due to the nature of your allergy, lifestyle, habit and diet.

• Establish a habit of practising allergen avoidance on a daily basis

Once you have identified what you are allergic to - taking the right measures to reduce and control your allergy symptoms it is important to make this a habit and practice it on a daily basis. Applying the right changes to your lifestyle, diet and habit will help control your allergy symptoms.

Most people are not allergic to one thing but a range of allergens, consisting of primary and secondary allergens both natural and manmade. If the primary allergen can be controlled then all other allergens can be controlled too. But, if the secondary allergen is not controlled then they all will be out of control.

Patients who have allergies are at risk, or who have a child with an allergy need, above all else, education on how to avoid exposure. They do not, in the main, want to become dependent on medication although this certainly has a role to play.

The two key criteria to keep in mind when practising allergen avoidance are:

• the avoidance measure must be allergen-specific
• the average exposure to the relevant allergen must be decreased by 95% or more.

Dr Platts-Mills furthermore offers the following points as a take-home message:

• Allergen avoidance is the cornerstone of treatment for those with rhinitis, asthma or atopic dermatitis.
• Successful treatment requires correct diagnosis (skin or blood tests), education and an overall exposure reduction plan.
• The patient must always be involved.
• The relevance of other allergens should be understood.
• Exposure outside the home should be taken into consideration.

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:

• Use allergy friendly bedding
• Wash bedding every week with allergen wash laundry detergent
• Remove stuffed animals and toys from the bed
• Use an ionising or HEPA air purifier

For the bed:

• Vacuum weekly
• Use X-Mite Dust Mite Powder to clean the mattress and carpets
• Ensure that your allergy 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

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

• Try not to bring a pet into the home
• Do not allow pets into bedrooms
• Find an existing pet a new home
• Using HEPA air purifiers
• Washing the pet weekly with allergy friendly pet shampoo

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

• Close doors, windows and use air purification
• 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.