[Allergy & Asthma Corner]

Fall : Soon to give way to winter

1) Heating System: Make certain it is working properly by having it checked. Filters should be changed if time. Don’t forget to have your service person check the central humidifier, if you have one. Keep the heat at a comfortable level but don’t over heat.

2) Humidity: No humidity is tough on the upper and lower airway. Your nose will have to work over time trying to condition the dry air being drawn into your nasal passages over night. Keep the humidity between 40 and 50%. Below 40% may be too dry when the heat is up. Above 50% creates a more favorable environment for dust mites and molds.

3) Bedside Helper: Keeping some nasal saline at bedside for the middle of the night blast of moisture is a good idea if you wake up with your mouth feeling like the Sahara Desert. Keep some soft tissue (and a small plastic bag for disposal) on the bedside table also, for use after the swigs of saline. This tip may be helpful for the winter time nose bleeders.

4) Pet Free Zone: If you have a pet whether you are allergic to it or not, restrict it (or them) from the bedroom at all times. Remember, dander, dust particles and other residue comes into your room by way of warm blooded pets. Some portion of these triggers build up in your bedroom carpet (or rug), mattress, pillow and box spring over time. Eventually your pets turn your bedroom into a chamber of triggers that may continue to bother you even when they are not around.

5) Avoid Drafts: Seal those bedroom windows if they are drafty. During the winter, drafts may shift room air temperature and humidity levels leading to more nasal congestion and drainage.

6) Dust Mite Controls: Review tips for reducing dust mite allergens (detailed in allergy handouts given to you at your first or second visit). Need further elaboration on this tip? See the links below.

7) Reduce Germs: Remind all members of the household to practice frequent hand washing at home (and away). Perhaps keeping some hand sanitizer at different places in the home would also be helpful to cut down on the passage of germs. No one should be allowed to cough or sneeze without covering their mouth (unless very young, but start training early).

8) Reduce Indoor Pollution: Check chimney flues and dryer vents to make sure they are properly working to move their emissions out of the house. If you burn wood, keep the bedroom doors closed. Consider getting a Hepa filter for the bedroom(s). Avoid potpourri, incense, scented candles and other scented products. They may smell nice but they add to the load of triggers. No smoking in the house, anywhere, anytime!

9) House Cleaning: Try to use fragrance free solutions. Avoid aerosol sprays. If you vacuum a room, stay out of it for 40-60mins to allow the stirred up dust to settle. Wood floor, tile or linoleum in the bedroom is much more preferred.

10) Other Things to Avoid: Try to avoid painting, demolition and redecorating during the winter months when the windows and doors are usually kept closed. Avoid getting new bedroom carpet during the winter. The fumes may be unbearable. This may occasionally be a problem with some new furniture (formaldehyde based, pressed wood). If you have an attached garage, don’t warm up the car inside the garage. Drive it out soon after starting it. Let it warm up further in the driveway in order to avoid those toxic fumes permeating through your home or nearby bedrooms. Why should you have to warm it up anyway, if it’s been inside?

I could tell you more but ten is a good round figure. I hope some of these tips are helpful in maintaining good respiratory health in your home. Although influenza is not necessarily an indoor winter trigger, it mostly infects people in the indoor environment. Hence, my bonus tip is: Consider getting a flu shot if you are one of my patients and have asthma, or are a parent that has a child with asthma or another chronic illness, or are 6 months to 5 years of age. (See my posting on flu season 07).

Links to check out: www.medicinenet.com/indoor_allergens/article.htm

www.aaaai.org/patients/publicedmat/tips/indoorallergens.stm

Have a nice winter and holiday!

Well, fall is rapidly turning into winter and allergy triggers for some, have disappeared (if you have seasonal allergy). If you are allergic to indoor allergens or are sensitive to irritant triggers, you are not experiencing much of a drop in nasal and / or chest symptoms.

So What Are The Current Concerns?

Regarding allergy triggers, dust mites, pets and indoor molds head the list of potential triggers. If you have seen an allergist you have already been given information on dust mite proof pillow and mattress covers, heating, filter changes, bedroom modifications and air filter devices. Literature detailing steps you can take to reduce dust mites and molds are provided as part of the allergy treatment plan. I have provided other tips on indoor allergy controls in an earlier posting: August 25th

 The live one and the stuffed one may trigger allergies!

Those pets (if you have cats, dogs or other fur bearing animals) that have not bothered you all year may be a major trigger for you now.

Why?

-More time is spent indoors during the colder months leading to longer periods of exposure.

-Forced air heat tends to stir the allergy particles (dander, mites and mold spores) around, in the rooms and in the ducts.

–More bedding material (blankets and comforters) is usually available for saturation by dander (and dust mites).

-Pets tend be bathed less frequently in the colder months. Frequent bathing has been associated with less dander levels in homes

-Other winter time factors may lower your threshold to respond to indoor triggers such as weather changes, the common cold, sinus infection, dry heat (from non-humidified, forced air heat or radiated heat), and nasal sinus changes from going in and out of your home, school or work. The difference in temperature, barometric pressure and humidity of indoor Vs outdoor environment can be extreme. This often leads to some nasal congestion and drainage that may perhaps make some people with allergy problems more vulnerable to indoor allergy triggers. This last point represents my opinion and has not been proven in research (to my knowledge).

A completely smoke free home is essential. Smoking anywhere in the home (by the window, fireplace or in the attached garage) adds to the irritant load of the indoor air. The ash can be devastating to the nose, sinuses and lungs.

Under humidified homes in the winter tend to dry out the sinuses and throat. Defense mechanisms for protection against colds and sinus infections may be more easily breached in this setting. Less than 30% humidity is too dry, but do not over over humidify. Dust mites and molds thrive at humidity levels greater than 50%.

What’s New?

A recent publication in the American Journal of Respiratory and Critical Care Medicine has emphasized the impact of fragrances and fumes from cleaning products in the indoor environment.

Regularly used household cleaning sprays and air fresheners were studied by researchers in Europe. Thirty five hundred people in ten countries were involved in the study. The findings were quite interesting. Weekly use of a spray cleaner increased asthma risk by 45 percent in women and 76 percent in men. If the cleaning sprays were used more often the risk was even higher.

See the link to a good review on this study:

www.health.usnews.com/usnews/health/healthday/071012/home-spray-cleaners-could-raise-asthma-risk.htm

Next week: Checklist on Environmental Controls for the Winter