What is the role of avoidance measures in the treatment of allergic disease caused by aeroallergens?

Updated: Jul 07, 2019
  • Author: Bhumika Patel, MD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

Answer

Indoor allergens can be avoided using two primary techniques. First, the sensitized individual can be moved away from the allergen; second, the home environment can be modified to reduce allergen exposure. The latter strategy is usually more practical in clinical practice (see Table 2, below).

Controversy exists over the effectiveness of individual environmental control strategies, but a comprehensive approach to allergen avoidance is superior to a single intervention. [10] Conflicting results among studies that address primary prevention of atopic disorders have failed to lead to a consensus for recommendations for allergic subjects or parents who wish to decrease the risk of atopy in their children.

The recommendations for allergen avoidance cannot be uniform for everyone. A comprehensive strategy should include determining the allergens to which the individual is sensitive and implementing specific avoidance measures to reduce exposure to the offending allergens. Furthermore, no avoidance strategy is complete without a thorough discussion with the patient or the patient's family regarding the role of allergens in the disease.

The success of such a strategy depends on correct identification of relevant allergens, the physician's attitude regarding the effectiveness of avoidance measures, and patient motivation and means to apply this strategy.

Table 2. General Recommendations for Aeroallergen Avoidance (Open Table in a new window)

Major Allergen Source Avoidance Strategies
Dust mites

Use impermeable (woven) covers (on the pillows, box spring, and mattress)

Eliminate dust reservoirs when possible (carpeting, upholstered furniture, stuffed animals, and drapery)

Vacuum weekly

Wear a pollen mask when cleaning

Wash bedding weekly

Reduce indoor humidity

Furry animals (cat, dog, ferret, rabbit)

Remove the pet from the home or other dwelling

Restrict the pet's access (eg, keep the pet out of the bedroom)

Bathe the pet

Use impermeable covers

Use high-efficiency particulate air (HEPA) central air conditioning filters

Rodents (mouse, rat, guinea pig, gerbil, hamster)

Restrict access to the home, building, or other dwelling

Eliminate food and water supply

Use rodent predators

Use rodent traps

Cockroaches

Clean thoroughly

Use pesticides

Eliminate food and water supply

Fungi

Close windows and doors

Repair all leaks

Use air conditioning

Heat all rooms during the winger

Remove contaminated sources

Clean contaminated areas with bleach solution


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