Allergens: Avoidance and Management

Allergen avoidance can be a very effective measure to reduce symptoms in sensitized patients. Many allergens can be avoided, such as house dust mites, pets, mold, and occupational agents. Of course, total allergen avoidance is often impractical or impossible to implement, but many simple changes can be made in homes to reduce allergen exposure. Pet avoidance can be very effective, but very often recommendations are not followed. The minimal recommendation is to remove the pets from bedrooms, but it is, of course, best to remove the pets completely from the home. Continuous high-efficiency particulate air (HEPA) filtration is also recommended in the bedrooms to reduce indoor allergen exposure. Bathing animals as often as possible has shown mixed results in clinical studies.

Dust mite avoidance is probably one of the most effective methods to reduce allergen exposure. Dust mite covers should be placed on the mattress and pillows as well as the box springs. Bedding should be washed at least weekly in hot water. The humidity in the home, if kept below 50%, may reduce indoor dust-mite allergen levels. It is best to remove carpets and replace them with linoleum, tile, or wood floors when possible. Alternatively, solutions to denature allergens, such as tannic acid spray, may be used on carpets or fabric-lined furniture. Curtains should be replaced with blinds that can be wiped clean. Stuffed animals should be removed, but alternatively may be washed or frozen once or twice weekly.

Mold avoidance is very difficult when outdoor humidity levels are very high, as found in tropical and subtropical environments. Removing carpets from the home, especially from the bedroom, may be effective in reducing mold and dust mite buildup and exposure. Live plants should be removed from the home to reduce mold contamination from soil. Air conditioners should be run often and filters should be changed or cleaned frequently to reduce humidity and assist with air filtration. Also, windows of homes and cars should be kept closed.

Pollen avoidance is usually low yield, but may be effective and should therefore be considered. Avoiding outdoor activities during the high-pollen season or when pollen counts are highest -- usually between the hours of 5 AM and 10 AM -- can also be helpful. Also, it would be best not to plan a camping trip during peak ragweed or other significant pollen seasons.

Bill Ziering

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