Many of us don’t realize that we spend about one-third of each day at home (except less for workaholics) and during this time we are exposed to potential indoor allergens. 

The most common causes of indoor or year-round allergies include house dust, dust mites, pet dander, feather bedding, mold spores and cockroach allergens. During the wintertime, indoor air is rather dry and we may feel it with parched, chapped lips and dry skin.  Many people prefer to use an indoor humidifier to moisturize the air for greater comfort as well as to soothe dry nasal and sinus passages.

The number one indoor allergen for most people with allergies is the “house dust mite” (a potent indoor allergen within dust).  These spider-like critters (fortunately you cannot see them without a microscope) love to inhabit warm, cozy places like pillows, mattresses, box springs and duvet covers in the bedroom.  You may have as many as two million dust mites in your bedding!  So what do they need to survive? Moisture! As we moisturize the indoor air with a humidifier, we are actually mobilizing them for a real party as they absorb water from the nearby environment.

If you happen to use a humidifier, it is essential to monitor the level of indoor humidity with a hygrometer (costs about $10-15).  You want to avoid over doing it and keep the level of humidity indoors below 50 percent (shoot for range of 30-50percent).  Follow the manufacturer’s instructions for cleaning a humidifier and refill with fresh water daily.

Get some more expert advice from the American Academy of Allergy, Asthma and Immunology at: http://www.aaaai.org/patients/topicofthemonth/1107/  and http://www.aaaai.org/winterallergy/2006/. 

Check out the American College of Allergy, Asthma and Immunology’s website at: http://www.acaai.org/public/indoor/indoor.htm.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Ever since the early ‘70s, we have been on the universal precautions bandwagon. 

First, we introduced latex gloves in the healthcare setting in doctors’ offices and in hospitals.

Next, individuals who prepare and serve food in restaurants, cafeterias, etc. also started using latex rubber gloves.  So what are the chances you can develop an allergic reaction to latex rubber?

The majority of those affected develop only localized symptoms such as skin irritation and burning, itchiness, redness and/or swelling of the hands or those areas exposed to the latex.  Next, are those unlucky allergic people who may have reactions that are more serious and progressive.  Higher-risk areas include the dentist’s office, operating room or emergency department and gynecologists’ offices ― just to name a few.  So get a medical identification card and/or bracelet to inform of your latex allergy! 

So where else do we see allergic reactions to latex rubber?

What am I seeing in my office?  Just the other day, a restaurant owner who supervises food preparation (personally) was exposed to foods and products served by staff who wear latex rubber gloves. When tested, we learned she had become allergic to latex rubber and had two potentially life-threatening reactions as a result of exposure in her own restaurant. 

If you are allergic to latex, be aware you may also react to the following foods: Bananas, avocados, chestnuts, apples, carrots, celery, papayas, kiwi, melons, potatoes and tomatoes.

Finally, defense being your best option, click here  for a consumer-friendly list of products that may contain latex rubber.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Hey, guess what? You have probably been eating foods colored by ground-up insects for quite sometime now.  I’m sure you did not know this. Carmine (a red food coloring made from beetles) has been used as a coloring agent in many foods from yogurt, ice cream, juices, candies, and even in cosmetics. 

University of Michigan allergist Dr. James L. Baldwin reported a number of patients with an apparent life-threatening allergic reaction to the insect-based food coloring.  Cases of asthma and hives and even anaphylactic shock, have been described. The carmine food dye may be a risk for those individuals that are sensitive or allergic to the ground-up insects. 

The NY Times reported a recent rule change at the Food and Drug Administration (FDA) that will mandate food manufacturers list carmine on a food label.  At present, the FDA does not require the components of food coloring agents to be named on a label. 

Natural food colorings can be added to foods and this new rule change is set to begin in 2011 (although food companies may voluntarily list the components of natural food coloring agents sooner).  It is highly likely that ingesting natural food dyes won’t cause any particular health problem, however if you experience an allergic reaction after ingesting a food product with carmine food dye, it may be something to discuss with a food-allergy savvy allergist.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Our soon-to-be First Family faces a personal struggle that millions of other American families face every day: Their daughter suffers from allergies.

An estimated 10-15 percent of people with allergies in the U.S. are allergic to dogs or cats. And about two million people who have cat allergies apparently live with at least one cat in their households. For many pet allergy sufferers, the importance of keeping their pet outweighs the difficulties present due to their allergies. 

The major pet allergens are produced in glands in the skin and can easily get into the animal’s fur, hair and saliva as well.  These chemicals can cause an allergic reaction if an individual is allergen-sensitive.  There are a variety of allergy symptoms including itchiness of the eyes, nose and throat, as well cough, asthma and hives.

If you have pet allergies, consider the following proven survival tips:

• Create an “allergy free” bedroom (where we spend about one third of each day).
• Use a high-efficiency HEPA air cleaner in the bedroom.
• Purchase allergen mattress and pillow covers which may help to prevent pet hair brought into the bedroom from getting into the bedding.
• Use a vacuum cleaner with a HEPA filter and/or a double-bag filter to better catch pet allergens.
• Some studies indicate weekly bathing of a pet may substantially reduce the level of pet allergens in the fur (speak with your vet about any specific suggestions on best ways to do this).
• Learn which prescription or OTC allergy medications are helpful if you have pet-allergic symptoms.
• Allergy injections for pet allergies can be helpful in reducing symptoms if avoidance measures are not successful.
• One study found that it’s easier to transfer pet allergens form person-to-person when wearing wool rather than cotton.
• Washable wall covering, wood and linoleum flooring is easier to clean and remove adherent pet allergens than other surfaces. 
• Ask a non-allergic friend or family member when animal grooming is required.  It is best to do this on non-carpeted flooring. 
• Avoid the area around the cat’s litter box if you suffer with cat allergies.
• Wash your hands after handling a pet to keep from transferring the allergens to your eyes and nose.

LIVE SMART WITH YOUR PETS!  

Check out more tips about pet allergies from the American Academy of Allergy, Asthma and Immunology at their consumer friendly website at: http://www.aaaai.org/patients/just4kids/pet_allergies.asp

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

It’s time for the old end-of-year office party or family holiday dinner.  During the holiday season the likelihood that you will ingest high-risk foods that may cause allergic reactions is at an all-time high.  So if you are one of the estimated 11 million people affected by food allergies, focus on being a label detective in order to avoid these potentially hazardous ordeals. 

Sharing meals during the holidays is one of the highlights of the season for many families. The most common food allergens in the U.S. are cow’s milk, eggs, soy, wheat, fish, shellfish, peanuts and tree nuts.  Unfortunately, food allergies make up over tens of thousands of emergency room visits annually. Peanut allergy is associated with potentially fatal allergic reactions and often, allergic individuals will not outgrow it.

When invited as a guest to the home of a friend or family member during the holidays, it’s important to explain what your food issues and concerns may be. By doing this, you can hopefully avoid unnecessary trips to the emergency room.

Watch our for these holiday culprits:

• Eggnog (the word albumin on a label indicates the presence of eggs)

• Fruitcakes (may contain nuts)

• Glazed rolls and bread or other bakery items (containing egg)

• Mixed nuts

• Chocolate, candies and other confectionery items (many contain nuts, milk)

• Dips, fondues and salsas (may contain diary cream and egg)

• Quiches (often contain egg)

• Fried foods – if you are seafood-allergic (as the same oil used in the fried fish may also be used in the preparation of other fried foods such as French fries)

• At least some alcoholic beverages (if you are grain or wheat sensitive)

• Soybean oil salad dressings – (if soy sensitive)

• Caesar or Greek salad (may contain anchovies)

• Marzipan (a paste made of ground almonds, egg and/or milk)

• Worcestershire sauce (may contain fish)

• Yams, sweet potato pie (may contain egg, pecans, walnuts or dairy)

• Pumpkin pie (may contain peanut/nuts, nutmeg)

• Gingerbread cookies (may contain egg, milk, soy, corn and wheat)

• Potato pancakes served for a Chanukah celebration (may contain egg)

Here are some strategies for the holidays:

• Use caution if you eat Chinese, Vietnamese, Thai and Mexican cuisine as many foods may contain nuts. 

• Keep a “restaurant food allergen ingredient card” with you to make the kitchen staff aware of your food allergy when dining out.  Ask for a list of ingredients before ordering.    

• Be a label detective! Learn to read food labels as many ingredients can be misleading or confusing.  Check out the recommendations on “How to Read a Label” at www.foodallergy.org.

• When visiting with friends and family, let your host know if you need to avoid certain foods so they can prepare alternate choices. 

• Bring safe, homemade, allergy-free dishes when invited to someone’s house.

• Keep a spot in the food preparation area of the kitchen free of food allergens.

• Be sure and know the earliest signs of an allergic reaction and how to give the emergency medication(s) prescribed by your allergist/physician.

• Develop an emergency plan that includes ample medication, including epinephrine auto-injectors (be prepared for prolonged reactions).

• Plan ahead if you need to travel during the holidays and have safe snacks and foods with you, especially if you have a food-allergic child.

• Stay with “simple dishes” that avoid hidden ingredients.

• Avoid salad bars where containers can have traces of allergens and cross contamination is common.

• Use caution when ordering deli meats where the same equipment may be used to slice meat and milk-based cheeses.

Having an allergy to a food does not mean you cannot enjoy the many and varied holiday foods this time of the year.  Many alternate foods can be substituted and still ensure a safe and enjoyable holiday season!  For more tips on avoiding food allergens during the holidays, vitit www.aaaai.org or www.acaai.org.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

During in the fall and early winter time in most 4-season regions of the US, we see an upswing in the number of individuals who suffer with a variety of respiratory and allergy symptoms as a result of greater exposure to pet cats and dogs.  Almost 70% of U.S. households have one or more domestic pets, equally divided between cats and dogs, accounting for 100 million pets.

Allergic owners suffer from reactions to their pet’s dander, skin flakes, saliva and urine. Hair or fur also can collect pollens, mold spores and other outdoor allergens. Americans love their pets and a recent Japanese study found that one in four patients with pet allergies continue to keep a pet despite allergy- and asthma-related problems.  In addition, the study indicated approximately 80 percent of the pet owners surveyed kept their pets inside the home most of the time. 

The presence of allergic dander in cats and dogs is not affected by length of hair or fur, and there are no truly “hypoallergenic breeds.” According to another study I conducted at The Long Island College Hospital in Brooklyn, NY, the color of a cat’s hair may influence true allergic symptoms in people exposed to the dander. Preliminary data from a self-administered questionnaire of 400 households with pet cats indicated a significantly greater amount of allergy-related symptoms (such as sneezing, runny nose, watery eyes and itchy skin) with exposure to dark cat hair. As expected, the severity of allergy symptoms also was greater in owners who permitted their pet’s unlimited access to the bedroom.

Keeping animals outdoors is only a temporary solution since pet dander will eventually accumulate in the house, carried inside on clothing. Even the type of clothing worn can affect the transportation of pet dander.

Taking Control

Keeping pets out of the bedroom can reduce unnecessary suffering since people spend approximately one-third of each day in this room. The presence of cats and dogs on owners’ beds contributes greatly to the amount of airborne allergens in the home. Exposure to airborne allergens, which also are spread by air currents, can be reduced by restricting the pet’s presence in bedrooms, dens or living rooms with upholstered furniture.  

Because pet dander is quite light and buoyant, and floats freely in the indoor air, electrostatic or HEPA air cleaners can be a big help in removing unwanted allergenic particles, especially cat dander. The size of the space determines the size filter necessary, and units are available as tabletop models or can be adapted to central air conditioning systems. Placing a screen or filter over room vents may keep dander from traveling through the heating and air conditioning system. Bear in mind that it may take six months or more to completely rid the home of cat dander particles even after the pet is removed.

There are a variety of other measures that can be utilized to minimize contact with pet allergens:

• Get allergy tested and learn if you are really allergic to your pets!
• Avoid hugging and kissing pets if you are truly allergic to them.
• Remove litter boxes from direct contact with allergy sufferers and place them away from areas of air filtration intake vents in homes with central heating and air-conditioning.
• Wash hands after handling or touching a pet to help avoid spreading the dander.
• Consider placing plastic covers on the couch or other upholstered furniture (which may harbor pet allergens) where the pet sleeps or rests.
• Utilize washable mattress  (encasings) covers, pillow covers and bedding in 130 degree hot water
• Replace carpeting with tile, linoleum and hardwood or other solid-surface flooring.
• Wash your pet on a weekly basis. Recent studies have indicated that some significant reduction in the amount of pet allergens occurs with weekly washing of dogs and cats. This activity appears to reduce the amount of dander that causes allergy symptoms
• A non-allergic individual should brush the pet regularly, outside of the home.
• Speak with your pet’s veterinarian to get a well balanced diet for your pet. This change in diet may help to minimize hair loss for the pet and this can reduce dander indoors.
• Use a double or micro-filter bag and a HEPA filter in the vacuum to augment the filtration of the vacuum cleaner and, in turn, reduce the amount of pet allergen present in carpeting that leaks back into the room air. 
• Finally, for those allergy sufferers who want to keep their pets, look into the administration of allergy shots (immunotherapy) by your allergist/immunologist to reduce the unnecessary suffering associated with having a pet in the home.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Asthma may affect as many as one out of ten children in the US.  During the fall months and in to winter we see a tremendous increase in the number of children with active symptomatic asthma.  A respiratory viral infection is a rather frequent co-conspirator responsible for a higher number of children suffering with worsening asthma.  Other important factors include a change in weather, cooler, drier air as well as increased exposure to indoor allergens. Another issue is children who are given less medication during the later summer and early fall now more than ever need a provider directed asthma regimen to prepare for cold and flu season as well as winter. 

According to a study presented at a meeting held by the American College of Chest Physicians it was observed that October and November are the peak months for children’s asthma, including ER visits, hospitalizations as well as needed asthma medication. Make it an ideal time to review asthma “action plan” (including the proper use of a peak flow meter) with your physician or health care provider at:

http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_actplan.htm

What are some symptoms that may indicate that your child’s asthma may not be well controlled?

• Recurrent and persistent cough
• Cough as a result of exposure to pets, exercise and even laughing
• Wheezing
• Trouble breathing or catching your breath
• Tightness of the chest and “congestion”
• Worsening asthma after cold virus and sinus infections
• Nighttime cough
• Increased use of quick reliever “rescue” inhalers

Why are more children suffering from asthma?

Read on in an upcoming blog in order to assist you in reducing asthma symptoms in your child.  Don’t forget the flu shot!   

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

What have we learned from previous year’s Halloween celebration? It can be done safely and wisely with kids enjoying their special day (or night).  One of the most important things to do for this holiday (as well as anytime) is to be a LABEL DETECTIVE! That’s right as a parent you must read each and every label of packaged foods.  Many snack foods and candy may contain peanuts, nuts, egg and milk (among the most common food allergens in kids).   

Learn more about safe food allergen labeling and consumer information which will simplify whether a food contains one of the top 8 food allergens to protect consumers with food allergy @  http://www.cfsan.fda.gov/~dms/alrgqa.html. 

So here is a partial list of ways I have found to enjoy a safe Halloween.

·     The American Academy of Allergy, Asthma and Immunology have a great check- list of things to do for a safe Halloween at:  http://www.aaaai.org/patients/elements/1008/08halloween_checklist.stm

·     Go shopping with your child and pre-purchase safe foods and snacks that do not contain suspect allergens before the “trick-or-treating” begins

·     Attend a Halloween party with your child to ensure that you can monitor to keep your child safe and resolve any food allergy concerns

·     Bake safe foods and treats at home and bring them with you to parties and during trick-or-treating on Halloween (if your child has gluten intolerance or celiac disease, this will be particularly important)

·     If your child is allergic to egg and egg products watch out for the appearance of “shiny” food products that may signal egg coating on bakery foods

·     Keep your child’s emergency medication on hand, such as an epinephrine auto injector, if they have prescribed for potential use if a food induced allergic reaction should occur

·     Consider non food items such as stickers, crayons,  in lieu of snacks, candy and food

Check out www.foodallergy.org (The Food Allergy and Anaphylaxis Network) for more food allergy safety tips to keep it safe and an enjoyable holiday for your family 

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition. 

Many of us are searching for a more natural way to get healthy and treat allergies.  One of the approaches is to work with an “integrative medical specialist” to complement traditional allergy care for ourselves and family members if you have allergies.  First, let’s get the proper testing to make sure you have allergies that require care.  Second, how to “boost” our immune system to assist in conquering allergy symptoms with healthful foods? Great question, now I have some answers after talking with my colleague, Aran Degenhardt, MD, MPH who is a specialist of Integrative Medicine and on the Faculty of NYU Langone Medical Center in NYC. 

Dr. Degenhardt also recommends fruits and vegetables for anti-oxidants (Vitamin C, selenium) and quercetins (gives fruits/veggies their color).  In short, eat lots of fresh and colorful fruits and veggies.  He feels they are even better choices if uncooked. Here are 5 more integrative tips for the allergy season:

1) Increase your intake of dietary omega-3 fatty acids, as found in fish (i.e. salmon), nuts and flax seed

2) Sinus irrigation with aerosolized water (hot shower, wet sauna, steam) using fresh ginger, lemongrass and eucalyptus

3) Drink plenty of water and keep well hydrated

4) Consider fresh ginger (frequently used in Chinese medicine)

5) Herbal remedies and supplements include butterbur and stinging nettle may provide relief

Of course it is essential with work with your health care provider and/or an integrative medicine specialist to develop a safe and individualized approach that is sound and right for you! 

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Generally, cooler months dictate we will spend a greater amount of each day indoors.  This fact translates into more exposure to indoor allergens, very relevant if you have indoor allergies and asthma.  Very good questions include: “shall I use an air filter, humidifier or do I try and avoid dusting or using a vacuum”, if I suspect I may have indoor allergies?

Each fall a change-over from the warmer and humid summer into the cooler and drier air found during the fall occurs each year.  Make it an opportunity to look at the ventilation in your home (i.e. forced air heating, central air-conditioning, air filtration, closed windows, etc).   Have you noticed more nasal congestion upon arising in the morning, sneezing, cough or red, irritated eyes?  If so, you may something in common with the 40 million Americans who suffer with indoor allergies.  Indoor allergies can also trigger asthma and be associated with sinus complaints as well.

What are the “most wanted culprits” that are responsible for indoor allergies? Here they come! First, the ubiquitous, indoor house dust mite, a microscopic spider mite that loves to inhabit your mattress and pillows (in fact there are about 2 million mites in bedding). They are probably the most likely indoor allergy allergen that causes allergy symptoms.

Second, molds also may float in the air, like pollens and are present throughout the year. They may be more likely to be present in indoor spaces such as attics, below ground basements and playrooms, bathrooms, from refrigerator drip pans and leaky faucets.  In many cases a mildew odor may be a tip off that you have a “mold problem”. 

Third, pets are found in over 100 million households in the US (a 50/50 spread between cats and dogs, again just an estimate). About 10-15 of individuals with allergies have “pet” allergies.  Does the color of cat hair or the gender of your pet dictate whether you may suffer more?  Stay tuned for an upcoming blog on pet allergies. 

Another additional indoor allergy is duck or goose feather found in bedding and pillows.  Remember, get tested as you may not be allergic or bothered at all by feather pillows, so find out for sure! Lastly, cockroach allergy can trigger indoor suffering as well as asthma, especially in apartment complexes in urban areas.  They are most likely to inhabit kitchens. 

For some terrific strategies to get your home ready if you or a family member has indoor allergies check out the American Academy of Allergy, Asthma and Immunology at http://aaaai.org/patients/topicofthemonth/1005/ or the American College of Allergy, Asthma and Immunology at http://www.acaai.org/public/facts/indoor.htm to learn more about how to reduce exposure and allergic triggers.   

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.