Household Experience the More Live

8/9/2019 Household Experience the More Live

1/4

Household experience the more live-threatening or costly complication of allergy,

including recurrent or chronic rhinosinusitis and asthma.

The patient directly controls environmental management. Once of history of allergy

testing strongly suggest the causative allergen, the physician must convert the

importance of environmental management to the success of allergy control.Families vary widely in their commitment to the implementation of environmental

control, their personal nancial resources, energy level, demand on time, and other

factor that are critical to the success avoidance treatment. The patients allergist can

advice and support, but diculty of compliance with the limiting and sometimes

expensive implementation of environmental control must be considered individually.

!revention of allergy

"llergic symptoms do not occur with primary exposure. #mmunoglobulin $ %#g$& to

the allergen is not generated until after one or many exposure to the allergen. Only

when sucient #g$ has been produce to occupy mast cell can the patient manifestthe symtoms. 'hich occur when the allergen cross-lin( the #g$ molecule present on

the mast cell, causing the granulation. #n the child who is at high ris( for

development of allergy because of present of allergy in both parent. $nvironmental

control should be instituted, ideally before the born of the child. Hide at al . in

randomi)ed control trial showed that environmental control for dust mites during at

rst *+ months of life in high ris( children prevent the development of allergic

rhinitis at *+ months and + months, compare with control subect. The children

treated with strict environmental control had a signicant decrease in positive s(in

pric( reaction compare with the children in home without environmental control in

place.

"llergen sensitivity may be increase with exposure to multiple factor independent of

allergen. $specially concomitant exposure tu environmental tobacco smo(e. inford

et al. in prospective study of */0 asthmatic children showed that the ris( of

sensiti)ation to cat is low %01& is there no household cat, whereas the incidence of

cat sensiti)ation increase proportional to cat exposure but is dramatically increased

if, in addition to cat there is house dampness and environmental tobacco smo(e,

with /21 of these children showing #g$ sensitivity to cat.

The other area where prevention of allergy should be strongly considered is the

patient involve with laboratory animal such as mice, rodent and rabbits. This

animal are highly allergenic, and the incidence of the sensiti)ation in patient whofail to prevent sensiti)ation through the use of gloves and mas(s is as high as 31,

substantially greater than the +21 incidence of allergies in the general

population%&. #t is far easier to prevent sensiti)ation than it is to deal subse4uently

with the results of sensiti)ation.

$56#7O58$5T" 9O5T7O #5 :$5:#T#;$< !"T#$5T:


2/4

The rst focus of environmental management should be on the bedroom because

this usually is the area of the house where inhabitant spend the most time. This

approach also ensure the achievement of highest yield from e=ort and money

spend for environmental control.

Three basic control principles apply for all inhalant allergens >

*. 7emove this source of allergen if possible+. 7emove accumulated allergen?. !revent the return of allergen

'ith indoor allergens, management consist of decreasing the presence of the

allergens, management principles emphasi)e @cocooningA the patient to avoid

exposure. The following section deal with pollen, mold, dust mite, pet %cat and

dog&, rodent, coc(roach, and tobacco smo(e individually.

!ollen

"llergenic pollen range from *B to B2 Cm in si)e %e.g., ragweed, +? Cm

diameter&. #ndoor pollen exposure is reduced by (eeping windows close during

times of high pollen counts, by the use of air conditioning to lter air, the

avoidance of inward-directed windows fans. 8ore aggressive measure include

removing allergic plant and trees that are immediately adacent to the dwelling,

and the use of room or house air ltration devices. 'ilson et al. shows that

particle more than *2 Cm in diameter are too large to reach the lower air ways

and are primarily responsible for upper airway disease %i.d. allergic rhinitis&%B&. #t

still is possible for fragments of pollen %approximately D Cm& to reach the lower

air and cause asthma symtoms %3&.

"lthough staying indoors during specic pollen season may provide considerable

relief, it also is socially restrictive and becomes ad increasing hardship if the

patient is allergic not only to trees, for example, but also to grasses, molds,

and weeds. This would essentially restrict the patient to the indoors for at least 3

months of the years in the northern climates and year round in the more

southern areas of the Enited :tates.

!ollens are most prevalent in the air in the morning as the sun rises and the air

warms. :taying indoors at this time reduces pollen exposure at the most critical

period of the day. 7egional pollen counts are published in maor newspapers and

provided by television weather forecasters in the area. 'hen pollen levels are

exceptionally high, the pollen-allergic patient should plan one spending more

time indoors. 'hen it is necessary to go outside, patients should choose calm

days when the air is still, or within + hour of a rain. 8ost pollen is washed from

the air during a rain. 'earing a hat, glasses, and a mas( limits outdoor exposure

to pollen. "fter outdoor activities, patients should remove clothing immediately

and shower and shampoo to remove pollen from the s(in and hair. 9ontrol of


3/4

exposure to seasonal pollen can be relatively simple but not practical in most

situations.

:easonal variation in pollen counts

!ea( pollination, unfortunately, occurs when people most want to be outside. #n

temperate climates, tree pollen is the earliest pollen of the year. Trees primarily

pollinate in the spring, starting as early as February in some parts of the country.

One species of tree may pollinate for a few wee(s, followed by pollination by

others species. There is considerable overlap in tree pollination and the season

may last until une, depending on the geographic area, temperature, and rainfall.

:ummer is the pea( pollination season for grasses, but it fre4uently overlaps

the tree pollination season to some degree as well as extending into the fall

weed pollination season. #n some areas, grasses pollinate throughout the year.

Fall is primarily weed pollination season, starting in august and continuing until

the rst frost, although timing and duration vary geographically. #n addition,

widespread distribution of pollen through high winds over grade distances ispossible %D&.

!atients often are unaware of the appearance of the tree, grass, or mold that in

causing their symptoms and may mista(enly attribute their symptom to a pollen

they can readily see, such as pine, which is much less allergenic than the more

buoyant pollens that are less apt to coat the ground. #n extreme situation,

removal of the shrub or plant from close proximity to the house can be

underta(en. Geeping the grass cut short can minimi)e pollination from grass.

5evertheless, pollen can still be blown great distances and the pursuit to remove

allergenic pollinating plants from the environment must be tempered with this

(nowledge. 8ary el(s has written an excellent, well illustrated short boo( onallergy plants that cause snee)ing and whee)ing. #t is a valuable tool for the

education of patients%D&.

8O

Documents

Household Experience the More Live