Feb. 23, 2000 DENVER -- Spring is here or just around the corner in cities and towns throughout the United States. National Jewish Medical and Research Center doctors, who treat patients for a variety of allergies, have put together some of their top health tips to get people through allergy season, including pollen and food allergies, and spring cleaning hazards.
Spring is Nothing to Sneeze at (Unless You Have Allergies)
Spring is here and summer is coming. Are you prepared with more than sunblock and cool drinks? Allergy and asthma attacks can spoil summer fun, but they can be prevented, say National Jewish allergists.
Tree and grass pollens are only a few of the many allergens that can trigger severe attacks. Different trees pollinate throughout the spring and summer, and the months they pollinate vary from tree to tree. Hayfever sufferers may do better at the shore, since the wind often blows in from the sea. Or one can head for the mountains, where pollen counts tend to be lower. Here are a few tips:
- When you know where you will be traveling, find out which plants will be pollinating. For example, Hawaii has grass pollination year round.
- Southern states typically have the longest pollination period. Grasses pollinate 10-11 months of the year.
- Trees pollinate early, but have limited seasons. For example, Elm trees pollinate for 2-3 weeks. The exception to this is a milder winter, which can cause pollination to peak higher and last longer.
- Know when the plants that trigger your allergies are in bloom and avoid visiting at that time of year. Time your trip to coincide with low levels of pollen.
- If traveling by car, close the windows and use the air conditioner.
- Fill allergy and asthma prescriptions before leaving home.
Get Rid of Unwanted House Guests…Dust Mites
Moist, balmy air, good weather and spring break may attract more than relatives to your home. Dust mites, microscopic creatures related to spiders, thrive on moisture. When moisture gets trapped inside a home, dust mites settle in and reproduce rapidly.
“Dust mites live off of human skin scales,” says Harold Nelson, M.D., an allergist at National Jewish. “People slough off dead skin cells all the time, and, in the process, dust mites infiltrate the soft surfaces of bedding, pillows, sofas and carpets.”
Almost everyone is exposed to dust mites, but not everyone is sensitive to them. “In one study, children allergic to dust mites were five times more likely to have asthma than children who were not allergic to the microscopic bugs,” he notes.
Since humidity is the environmental sanctuary for dust mites, the first step is to measure your home’s moisture level. “The easiest, least expensive way,” Dr. Nelson says, “is to buy a $15 hygrometer to assess indoor humidity.
Optimally, humidity in your home should be below 40 percent.” Humidity content between 40 and 50 percent is marginal in terms of dust mite control. In the 50 to 60 percent range, dust mite proliferation can be bothersome, and over 60 percent is very bad. Air conditioning is the most effective way to control indoor moisture, because it reduces moisture in the air. “If you have an inside air conditioner,” he says, “make sure you have good drainage, so there is no standing water inside the cooler.”
Pillows and mattresses are prime habitats for dust mites, and the bed is the main source of human exposure. Dr. Nelson recommends using “special allergen-impermeable casings for mattresses and pillows to keep allergens from reaching you.”
The casings are available as tightly woven fabrics and can be purchased at stores carrying allergy-related items.
Terrazzo and tile flooring also limit dust mite exposure. These floorings don’t provide the soft nesting areas that carpets do.
Fishing for Answers—Seafood Allergies Impact Few, can be Deadly if Undiagnosed
Holy mackerel! Americans are eating more fish and seafood than ever—14.9 pounds per person in 1998 for a U.S. total of more than 4 billion pounds of domestic and imported seafood.
Seafood, a high-protein, low-fat food, offers many choices for grilling, frying, baking and fresh food dining. Unfortunately, for a percentage of people, different types of fish and shellfish, no matter how it’s cooked, can trigger dangerous allergic reactions.
“Fish and shellfish are among the most common foods that trigger severe allergic reactions,” says Dan Atkins, M.D., a National Jewish physician who treats people with food allergies.
For someone with extreme sensitivity, anaphylaxis may occur, resulting in a sudden drop in blood pressure and swelling of the bronchial tissues, causing severe breathing difficulty.
These reactions can arise in seconds and can be deadly. Severe anaphylactic shock is fatal if not treated immediately. General allergic symptoms—occurring within a few minutes to a few hours of eating shellfish—include tingling and swelling in the mouth and throat; runny nose, sneezing, nausea, vomiting, diarrhea, swelling, hives and difficulty breathing.
“If someone has a life-threatening reaction to one crustacean, such as shrimp, testing will usually show that other crustaceans—crab, lobster and crayfish—will also cause a reaction,” Dr. Atkins says. “This relationship is known as cross-reactivity.”
Raw or cooked, fish can still cause allergies. “For most sufferers it doesn’t matter how fish is prepared,” he says, “since the allergenic proteins in cod, shrimp, lobster or any other fish that causes allergic reactions are not destroyed by cooking.”
Minimal exposure to seafood can cause symptoms for some people. “Handling fish, or inhaling fish vapors while walking through a fish market or in a restaurant can cause a reaction in extremely sensitive individuals,” Dr. Atkins says.
Exposure can occur by eating another food cooked on the same surface as fish or absorbing fish protein through a cut.
The good news about food allergies is that only 1 to 2 percent of adults has a true food allergy of any kind. If you suspect you’re among this group, meet with your personal physician and, if necessary, devise a treatment plan.
Precautions can be taken to avoid triggering a reaction: avoid contact with the food, inform those around you about your food allergy and wear a medical alert bracelet. Have a plan for treatment of reactions. Know the medicines used to treat reactions and carry them at all times.
“Food allergies may be misdiagnosed without a careful patient history and an appropriate evaluation,” Dr. Atkins notes. “If you had just eaten shrimp before a reaction, the assumption might be made that shrimp is the cause of the reaction. It may be, but other potential causes such as another food or ingredients in sauces eaten at the same time need to be considered. Testing is necessary to determine the source of the problem.”
Spring-Cleaning Stirs Up Dust and Dander
Spring-cleaning may make you feel good about your home, but if you’re one of 50 million people in the United States with allergies, spring-cleaning may make you sick.
Dust and other irritants stirred up by vacuums are making people throughout the United States feel the effects of spring-cleaning in their eyes and noses. One way to limit exposure to airborne allergens and irritants is the use of a high efficiency particulate air (HEPA) filter. These filters can be effective for people who have problems with airborne allergens and irritants such as animal dander, pollen and dust.
“People who use HEPA filters say they feel better and have reduced symptoms,” says Maria Gutierrez, M.D., a National Jewish physician who treats people with allergies and asthma. “Studies do show some reduction in the amount of cat and dog allergens with the use of HEPA filters. To date, though, the majority of clinical studies do not prove conclusively that HEPA filters result in a reduction of medication use.”
Freestanding filter units trap airborne allergens, such as pollen and animal dander, and don’t re-release them back into the air. HEPA filters attached to vacuum cleaners reduce dust by trapping the small particles, comprised largely of dust mites, and don’t re-release “dirty” air. Regular vacuums redistribute into the air the same dust, dirt and allergens that are sucked out of carpet and furniture.
Many people with allergies have a freestanding HEPA filter in the bedroom, a HEPA filter attached to a vacuum cleaner or both. Filters need to be changed regularly in freestanding units and vacuums. Vacuums equipped with HEPA filters require enough power to draw up all dirt and allergens, and need to be airtight to ensure that the smallest particles don’t escape.
“Neither filtering device, however, is a substitute for standard medical treatment,” Dr. Gutierrez says. “For pet allergies, the best defense is still to reduce exposure to pets, keep the dog or cat out of the bedroom or living room, and bathe the animal frequently. For non-airborne allergens, such as dust mites, follow standard precautionary measures, including encasing pillows and mattresses.”
Spring-Cleaning can be Hazardous to Your Health
Seasonal deep cleaning—airing out bedding, washing walls and windows, and cleaning screens and floors—is generally a good thing. However, this rite of spring can harbor some very real health threats. “The three primary sources of potential danger are cleansers combined improperly; pesticides, even when used according to direction; and lead in paint,” says Sandra Mohr, M.D., an environmental and occupational health specialist at National Jewish.
Household cleansers such as bleach, disinfectants and deodorizers that contain hypochlorite salts, should never be mixed with acids or alkalis (ammonia products).
“Even one instance of over-exposure can cause serious respiratory damage,” Dr. Mohr says. “Many people think that ‘mixing’ means putting both chemicals in a bucket, and they wisely avoid this. But ‘mixing’ also refers to using two cleaning agents on the same area. If bleach doesn’t eliminate a stain in a sink or tub, don’t apply ammonia over it.”
Fumes from this toxic combination can cause eye, throat or nose irritation, or even serious lung problems. If the room is poorly ventilated, permanent, asthma-like symptoms may develop. Read labels on cleaning items and use accordingly.
Ventilate cleaning areas, and if toxic fumes are inhaled, seek medical attention immediately.
Insecticides can be dangerous to humans, even when used according to direction. Fogging insect bombs instruct users to set them in the middle of the room, close the house and leave for six to eight hours. “While you’re gone,” Dr. Mohr notes, “the carpet, drapes, sofa pillows and children’s soft, plush toys absorb the pesticide. Infants and toddlers, prone to chewing and mouthing these items, may ingest toxic chemicals.”
Protect absorbent surfaces with plastic or remove them from the room before using an insect fogger. Likewise, remove or cover all items in an area such as the kitchen before spraying a pesticide. Initial symptoms of exposure to the most commonly used insecticides are tearing eyes, salivation, runny nose, nausea, vomiting and diarrhea. People with severe poisonings may experience toxic psychosis, unconsciousness, incontinence, convulsions, difficulty breathing or death.
Because lead paint in homes was not regulated until 1977, paint in older homes or paint applied before 1977 can be a health risk. “Paint chips or flakes accumulate with house dust,” Dr. Mohr says. “If a child drops a lollipop, picks it up and puts it in his or her mouth again, lead flakes can get in the gastrointestinal tract. “For children, a blood lead level of over ten micrograms per deciliter is dangerous,” she says. “Higher blood lead content can result in lower IQ scores, cognitive deficits, speech and language problems, attention deficits and hearing loss.”
Children from 6 months to 2 years are most at risk because they are in the crawling and mouthing-behavior stage and have a tendency to chew on rattles, bottles and toys, which are frequently dropped. “Children exposed to lead can receive special medical treatments that help remove lead faster than the body can eliminate it,” Dr. Mohr says. “If you are concerned, have your doctor take a blood sample to screen for lead. Treatment is recommended, but find the source of lead. Your home may be safe, but consider where else your child spends time—at day care or with grandparents.”
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