Aeroallergens

Major indoor aeroallergens are derived from dust mites, cockroaches, cat, dog, and other furry-animal debris, and fungi.

Avoidance Measures and Interventions

The physician has the following 3 treatment options for individuals with allergic diseases, including allergic asthma:

Aeroallergen avoidance
Medications

Allergen immunotherapy

Avoidance of the offending agent is the first line of treatment for allergic disorders and asthma. It is the most cost-effective treatment modality, and it sometimes results in complete resolution of an allergic problem. Modification of the home environment is the primary measure to reduce allergen exposure. 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.

Dust mites

Dust mite bodies and fecal pellets are the major source of allergens in house dust.^[1, 2]More than 80% of homes in the United States and 85% of day care facilities have detectable levels of dust mite allergens^[3]; half of US homes have levels higher than the proposed threshold levels for sensitization, and about 25% have levels at or higher than those required to induce asthma.^[3]

Avoidance strategies for dust mite allergens are as follows:

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

Furry pets include, for example, cats, dogs, ferrets, and rabbits.

Avoidance strategies for furry animal allergens are as follows:

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

Avoidance strategies for rodent allergens are as follows:

Restrict access to the home, building, or other dwelling
Eliminate food and water supply
Use rodent predators
Use rodent traps

Cockroaches

Avoidance strategies for cockroach allergens are as follows:

Clean thoroughly
Use pesticides – Preferably gel or baits, selectively placed in the kitchen after thorough cleaning
Eliminate food and water supply

Fungi

Most of the fungi recovered from an indoor environment emanate from outside. However, certain species, such as Penicillium and Aspergillus, can be found in greater quantities indoors.

Avoidance strategies for fungal allergens are as follows:

Reduce spore infiltration – Keep windows and doors closed as much as possible
Control moisture – Decrease the indoor humidity level to less than 50%, if possible
Cleaning – A detergent solution with 5% bleach is useful for washable wallpaper and paneling
Use central air conditiong HEPA filters

Wear masks when cleaning

https://emedicine.medscape.com/article/137911-overview

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Author

Bhumika Patel, MD Chief Fellow, Division of Allergy and Immunology, Johns Hopkins All Children's Hospital, University of South Florida Morsani College of Medicine

Bhumika Patel, MD is a member of the following medical societies: American Academy of Allergy, Asthma and Immunology, Clinical Immunology Society

Disclosure: Nothing to disclose.

Coauthor(s)

Richard F Lockey, MD University Distinguished Health Professor, Professor of Medicine, Pediatrics and Public Health, Joy McCann Culverhouse Chair in Allergy and Immunology, University of South Florida College of Medicine; Director, Division of Allergy and Immunology, James A Haley Veterans’ Hospital

Richard F Lockey, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Allergy Asthma and Immunology, American Association for the Advancement of Science, American College of Occupational and Environmental Medicine, American College of Chest Physicians, American College of Physicians, American Medical Association, Florida Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Michael A Kaliner, MD Clinical Professor of Medicine, George Washington University School of Medicine; Medical Director, Institute for Asthma and Allergy

Michael A Kaliner, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association of Immunologists, American College of Allergy, Asthma and Immunology, American Society for Clinical Investigation, American Thoracic Society, Association of American Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Salman Abdullah Aljubran, MD Allergist and Immunologist, Associate Director of FARE Center of Excellence, Children's Mercy Hospitals and Clinics; Assistant Professor of Medicine and Pediatrics, Division of Allergy, Asthma and Immunology, University of Missouri-Kansas City School of Medicine

Salman Abdullah Aljubran, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology, American Medical Association, Clinical Immunology Society

Disclosure: Nothing to disclose.

Acknowledgements

Robert K Bush, MD Professor of Medicine (CHS, Emeritus), University of Wisconsin School of Medicine and Public Health; Chief of Allergy (retired), William S Middleton Veterans Affairs Hospital

Robert K Bush, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology and American College of Physicians

Disclosure: Nothing to disclose.

Steven L Cole, DO Consulting Staff, Park Lane Allergy and Asthma Center, Baylor University Medical Center; Volunteer Clinical Faculty, University of Texas Southwestern Medical Center

Steven L Cole, DO is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology, and Joint Council of Allergy, Asthma and Immunology

Disclosure: Nothing to disclose.

Michael R Simon, MD, MA Clinical Professor Emeritus, Departments of Internal Medicine and Pediatrics, Wayne State University School of Medicine; Adjunct Staff, Division of Allergy and Immunology, Department of Internal Medicine, William Beaumont Hospital

Michael R Simon, MD, MA is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology, American College of Physicians, American Federation for Medical Research, Michigan Allergy and Asthma Society, Michigan State Medical Society, Royal College of Physicians and Surgeons of Canada, and Society for Experimental Biology and Medicine

Disclosure: Secretory IgA, Inc. Ownership interest Management position

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment