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Spring is Here, Along With Allergies

This column originally appeared in the April 7, 2008 issue of the St. Louis Post-Dispatch.

Spring is finally here, and for many people, including children, that means spring allergy season. As the weather warms up, the trees are germinating, grass is growing, and that leads to large quantities of pollen getting into the air.

Warmer temperatures often bring greater humidity and an increase in mold, which can cause problems for allergy sufferers.  As if that weren’t enough, the recent flooding in several areas around St. Louis may add to the mold problems.

The body’s immune system is designed to defend against particles it perceives as foreign, like germs. What happens with allergy is that our body reacts differently, producing too much mucus and fluid.  That makes the membranes in the nose boggy and thick, and that can really cause a lot of problems for young people.

Allergy’s symptoms are all-too-familiar to many St. Louisans: sneezing, watery eyes, runny nose, scratchy throat and lots of congestion, often in response to just going outside.

There are a number of things you can do for yourself and your children.  One is to avoid the allergens, so when we hear reports of high pollen and mold counts, stay inside. Air conditioning is actually very good for filtering those things out of the air. You can also get rid of some of the allergens after you breathe them in. For example, we all know to wash our skin when it’s exposed to something we are allergic to.  The same holds true for your child’s nose: If you know that she is allergic to things in the air, it’s a good idea to get a saline nasal solution, like Ocean Spray, spray it in and then have her blow or suction her nose before her body has a chance to react against the allergens.

If your child’s allergies are really bad, talk to her pediatrician because there are medications that can help in more severe cases. Non-drowsy antihistamines like Claritin and Zyrtec are now available over the counter, but it’s still a good idea to talk to your child’s doctor before using them. Anti-inflammatory nasal sprays like Flonase and Nasacort can also be helpful for adults and kids, but you need a prescription for those.

Dr. Ken Haller, a pediatrician at SSM Cardinal Glennon Children’s Medical Center and an Associate Professor of Pediatrics at Saint Louis University School of Medicine, says allergies can lead to other ailments.

“The nose does a lot of important things, including draining fluid and mucus from our eyes, our sinuses and our middle ear. When the nose gets clogged up, the stuff that is supposed to be drained out can build up, leading to sinus infections or ear infections,” Haller explains. “Keeping those passages as clear as possible by avoiding allergens, washing away allergens with a saline spray or drops, and using medications if your doctor recommends them, can be very helpful in avoiding infections that result from allergies.”

The National Institute of Allergy and Infectious Diseases (NIAID) advises creating a “dust-free bedroom” to minimize the effects of pesky indoor allergies.  Dust may contain molds, fibers, and dander from dogs, cats, and other animals, as well as tiny dust mites. These mites, which live in bedding, upholstered furniture, and carpets, thrive in the summer. The particles seen floating in a shaft of sunlight include dead mites and their waste products. The waste products actually provoke the allergic reaction.

The routine cleaning necessary to maintain a dust-free bedroom also can help reduce exposure to cockroaches, another important cause of asthma in some allergic people. To create a dust-free bedroom, NIAID also suggests the following guidelines:

Preparation
• Completely empty the room, just as if you were moving.
• Empty and clean all closets and, if possible, store contents elsewhere and seal closets.
• Keep clothing in zippered plastic bags and shoes in boxes off the floor, if you cannot store them elsewhere.
• Remove carpeting, if possible.
• Clean and scrub the woodwork and floors thoroughly to remove all traces of dust.
• Wipe wood, tile, or linoleum floors with water, wax, or oil.
• Cement any linoleum to the floor.
• Close the doors and windows until the dust-sensitive person is ready to use the room.

Maintenance
• Wear a filter mask when cleaning.
• Clean the room thoroughly and completely once a week.
• Clean floors, furniture, tops of doors, window frames and sills, etc., with a damp cloth or oil mop.
• Carefully vacuum carpet and upholstery regularly.
• Use a special filter in the vacuum cleaner.
• Wash curtains often at 130 degrees Fahrenheit.
• Air the room thoroughly.

Carpeting and Flooring
Carpeting makes dust control impossible. Although shag carpets are the worst type to have if you are dust sensitive, all carpets trap dust. Therefore, health care experts recommend hardwood, tile, or linoleum floors. Treating carpets with tannic acid eliminates some dust mite allergen. However, tannic acid:
• is not as effective as removing the carpet
• is irritating to some people
• must be applied repeatedly

Beds and Bedding
Keep only one bed in the bedroom. Most importantly, encase box springs and mattress in a zippered dust-proof or allergen-proof cover. Scrub bed springs outside the room. If you must have a second bed in the room, prepare it in the same manner.
Use only washable materials on the bed. Sheets, blankets, and other bedclothes should be washed frequently in water that is at least 130 degrees Fahrenheit.
• Lower temperatures will not kill dust mites.
• If you set your hot water temperature lower (commonly done to prevent children from scalding themselves), wash items at a laundromat which uses high wash temperatures, or dry the items in a dryer on high heat until dry.
Use a synthetic, such as Dacron, mattress pad and pillow. Avoid fuzzy wool blankets or feather- or wool-stuffed comforters and mattress pads.

Furniture and Furnishings
• Keep furniture and furnishings in the bedroom to a minimum.
• Avoid upholstered furniture and blinds.
• Use only a wooden or metal chair that you can scrub.
• Use only plain, lightweight curtains or blinds on the windows.

Air Control
Air filters-either added to a furnace or a room unit-can reduce the levels of allergens. Electrostatic and HEPA (high-efficiency particulate absorption) filters can effectively remove many allergens from the air.
A dehumidifier may help because house dust mites and mold need high humidity to live and grow. You should take special care to clean the unit frequently with a weak bleach solution (1 cup bleach in 1 gallon water) or with a commercial product to prevent mold growth. Although low humidity may reduce dust mite levels, it might irritate your nose and lungs. Allergic children do best when the indoor humidity is kept between 40 percent and 50 percent.

Children
In addition to the above guidelines, if you are caring for a child who is dust-sensitive
• Keep toys that will accumulate dust out of the child's bedroom
• Avoid stuffed toys
• Use only washable toys of wood, rubber, metal, or plastic
• Store toys in a closed toy box or chest

Pets
Keep all animals with fur or feathers out of the bedroom. If your child is allergic to dust mites, they could also be allergic or develop an allergy to cats, dogs, or other animals.

 

Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Medical Center and is a Professor of Pediatric Medicine at Saint Louis University School of Medicine.

4/7/2008