Articles and Information
HOUSE DUST AND DUST MITE AVOIDANCE
What is a house dust allergy?
House dust allergy is sensitivity to a mixture of substances including waste particles from dust mites. Other component substances can include mold spores, insect debris including cockroaches, bacterial toxins and animal dander.
What are dust mites?
Dust mites are microscopic creatures that live off tiny flakes of human skin that people shed each day. They require nests to live in, a source of food and sufficient humidity (generally >50%). The major reservoirs of dust mites include mattresses, pillows, bed linens, carpets, stuffed animals and upholstered furniture. Effective avoidance measures may include reducing areas that can harbor nests in the house (e.g. carpet, furniture and drapes) and controlling humidity. Dust mite allergy is sensitivity to waste particles and fragments of the mite that become airborne and are inhaled. Because these fragments are relatively large, they do not stay airborne very long after their source is disturbed. Thus, air filtration plays very little role in controlling exposure to dust mites.
How can I help control dust mite allergies?
A “dust-free” environment is obviously an unreachable goal. However, there is substantial evidence that rigorous house dust control can reduce allergen exposure symptoms and need for medicines if enforced over a long period of time. We emphasize particular attention to the bedroom to provide an “oasis” from allergens and irritants during several hours of the day spent there.
It is our experience that patients and families who carry out the suggested measures can achieve benefits, manifested by better symptom control and reduced requirement for maintenance and rescue medicine. However, these benefits are seen only with much sustained commitment to allergen control.
In the bedroom:
- Cover pillows and mattresses with zippered covers which are impermeable to mite and mite allergen. We will give you direction on where these might be obtained.
- Wash sheets, pillow cases and blankets at 130 degrees Fahrenheit weekly. The blankets should be replaced with those that can be washed.
- Comforters should be removed, covered or washed. Remove clutter, soft toys and upholstered furniture.
- Where possible, carpet should be removed or replaced with area rugs that can be cleaned/washed.
- Use wipeable furniture that can be easily cleaned with a damp cloth on a regular basis.
In the home & air control:
- When vacuuming or cleaning, the allergic patient should wear a dust mask. The allergic patient should not be in the room for 1-2 hours after cleaning as disturbed dust needs time to settle out of the air. Consider vacuuming using a cleaner with a filtration system (Hepa-type vacuum).
- Reduce upholstered furniture, particularly old sofas.
- Ideally, one should replace carpet with polished flooring where possible. Carpets on concrete slabs or over-poorly ventilated crawl spaces should be replaced with polished flooring if possible.
- Control humidity to less that 50% relative humidity at normal temperatures, i.e. 68-72 degrees.
- Room humidifiers can be a source of mold and mite growth. Air conditioning can prevent the high heat and humidity which stimulate mite growth.
Air systems for dust mites are not thought to be effective as the particles are airborne for fairly short periods of time and are not “filterable”. There is little evidence that cleaning of duct work in home or expensive air filtration systems on central heating and air conditioning systems are of clinical benefit.
There have been chemicals tested that kill or denature mite allergens. Most investigators who have tested chemical treatment of carpets believe that the killing of mites is not possible with currently available chemicals. There may be new products in the future that are more effective.
Patients who are allergic to mites or molds may have some increased exposure and symptoms if living in basements or overly damp housing. Moving from a basement to an upstairs room may be of benefit. Consider use of portable dehumidifiers in the bedroom if these changes are not possible.
Food Families
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FOOD FAMILIES |
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This list indicates botanical relationships of several foods. Allergic cross reaction within families can occur but is unpredictable, with some groups more likely cross reactive than others. Allergy skin or blood tests help guide what needs to be avoided.
APPLE FAMILY: Apple, pear and quince. ASTER FAMILY (composite): Lettuce is most common. Others are: chicory, endive, escarole, artichoke, dandelion, celtruce, sunflower seeds and tarragon. BEET FAMILY (Goosefoot): Beet, spinach, chard and lamb’s quarters. BLUEBERRY FAMILY (Heath): Blueberry, huckleberry and cranberry. BUCKWHEAT FAMILY: Buckwheat, rhubarb and garden sorrel. CASHEW FAMILY: Cashew, pistachio and mango. CHOCOLATE FAMILY: Chocolate (cocoa) and Cola. CITRUS FAMILY: Orange, lemon, grapefruit, lime, tangerine, kumquat and citron. FUNGUS FAMILY: Mushroom and yeast. GINGER FAMILY: Ginger, cardamom and turmeric. GOOSEBERRY FAMILY: Currant and gooseberry. GRAINS (CEREAL OR GRASS) FAMILY: Wheat, corn, rice, oats, barley, rye, wild rice, cane millet, sorghum and bamboo sprouts. LAUREL FAMILY: Avocado, cinnamon, bay leaves and sassafras. MALLOW FAMILY: Cottonseed and okra. MELON (GOURD) FAMILY: Watermelon, cucumber, cantaloupe, pumpkin, squash and other melons. MINT FAMILY: Mint, peppermint, spearmint, thyme, sage, horehound, majoram, basil, savory, rosemary, balm (melissa) and catnip. MUSTARD FAMILY: Mustard, turnip, radish, horse radish, watercress and varieties of cabbage (cabbage, kraut, Chinese cabbage, broccoli, brussel sprouts, collards, kale, kohlrabi and rutabaga). MYRTLE FAMILY: Allspice, quava, clove pimento (not Pimiento). OLIVE FAMILY: Green olive, Ripe olive, Red, green, bell pepper, Chili, tobasco, Pimento. ONION FAMILY (Lily): Onion, garlic, asparagus, chives, leeks and sarsparilla. PALM FAMILY: Coconut and date. PARSLEY FAMILY: Carrot, parsnip, celery, parsley and celeriac. Also the following spices: anise, dill, fennel, angelica, celery seed, cumin, coriander and caraway. PEA (LEGUME OR CLOVER) FAMILY: Peanuts, Peas (green, field, black-eyed), Beans (navy, lima, pinto, string, soy, etc.) Less important are licorice, acacia and tragacanth. PLUM FAMILY: Plum, cherry, peach, apricot, nectarine, wild cherry and almond. POTATO FAMILY: Potato, tomato, egg plant and peppers. This family includes all food called “pepper” except black and white pepper, such as: green pepper, red pepper, chili pepper, paprika, cayenne and capsicum. (Tabacco, belladonna, stramonium and hyoscyamus belong to this family.) ROSE FAMILY: Strawberry, raspberry, blackberry, dewberry and such developed berries as loganberry, youngberry, boysenberry, etc. WALNUT FAMILY: English walnut, black walnut, pecan, hickory nut and butternut.
ANIMAL KINGDOM MOLLUSC FAMILY: Oyster, clam, abalone and mussel. CRUSTACEAN FAMILY: Crab, lobster and shrimp. FISH FAMILY: All true fish, either fresh water or salt water such as: salmon, tuna, sardine, catfish, trout, etc. BIRD FAMILY: All fowl and game birds: chicken, turkey, duck, goose, guinea, pigeon, quail, pheasant, etc. REPTILE FAMILY: Turtle, rattlesnake and frog. MAMMAL FAMILY: Beef, pork, lamb, rabbit, squirrel, venison, etc. Cow’s milk is of the same animal origin as beef. Most persons allergic to cow’s milk cannot take the milk of other animals such as goat
FOODS WITHOUT RELATIVES The following foods are the only members of their botanical family:
Arrowroot, banana, black or white pepper, Brazil nut, capers, chestnut, chicle, coffee, elderberry, fig, grape, hazelnut, filbert, honey, juniper, flaxseed, karaya gum, maple sugar, New Zealand spinach, nutmeg (mace), olive, oregano, papaya, pineapple, persimmon, poppyseed, saffron, sesame seed, sweet potato, tapioca, tea, vanilla and wintergreen.
NON-RELATED FOODS From this outline you can see there is no such thing as being allergic to all nuts, seafood, fruits, starches, greasy foods, spices, etc.
Notice that these are not related:
Notice that these foods are related:
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FOOD ALLERGY
What is a food allergy?
Food allergy is an immune reaction between small proteins in foods, interacting with sensitized cells in the gastrointestinal tract. These very specific reactions may result in mouth or throat swelling, nausea and/or vomiting, diarrhea, wheezing, hives, or generalized itching. A more severe response is referred to as anaphylaxis, which can involve asthma-like reactions, airway blockage, and/or drops in blood pressure that can be life-threatening. The foods most likely to trigger food allergy/anaphylaxis include egg, milk, peanut, fish, crustaceans (shell fish) and tree nuts. Food allergic reactions generally come on within an hour of exposure.
What is food intolerance?
These are conditions that have symptoms that may suggest allergy but have a completely different mechanism biologically. Examples would be soy protein intolerance, lactose intolerance and sprue intestinal disease. Food intolerance does not present itself as anaphylaxis. The diagnosis of food intolerance involves understanding the spectrum of food-induced illness and appropriate tests and treatment specific to the condition.
Who gets food allergies?
Food allergy often starts in young children but can affect adults as well. Often, there are other allergic conditions in food-allergic patients such as asthma, nasal allergies or atopic dermatitis. Some food allergies can be outgrown, such as milk and egg, where others tend to persist for decades, e.g. peanut, tree nuts and shell fish.
Is there a treatment for food allergies?
In treating food allergy, objective testing should be done to be clear about the specific cause of symptoms. This leads to avoidance of the offending food, which may require reading labels and being particularly careful about restaurant meals. At some point in the future, there may be treatment available for severe food allergies including the use of a synthetic antibody product that is currently available for asthma.
What do you do for an allergic reaction to a food?
Subjects who have had significant allergic reactions to foods need to carry adrenaline, such as an Pen® or Twinject®, with them for self-administration. Because these reactions come on very suddenly, adrenaline can reverse the most serious symptoms and allow time to get to an emergency room or call 911. If you are prescribed injectable adrenaline, be sure that you have this with you at all times and understand how to use it confidently.
Where can I get more information about food allergies?
The Food Allergy Network is an organization with excellent information on all aspects of food allergy. It can be accessed on the internet at www.foodallergy.org.