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.

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.

A new study published in the December issue of the Journal of Allergy and Clinical Immunology (JACI) found a higher likelihood of anaphylaxis, or severe and/or life-threatening allergic reactions than previously reported.

In the study, Wyatt W. Decker, MD, Chief of Emergency Medicine at the Mayo Clinic in Rochester, Minnesota, reported that the incidence rate of food-allergic reactions increased significantly from 1990 to 2000. Researchers reported about a 10 percent increase in cases of life-threatening allergic reactions over the 10-year period of the study. 

Children ages 0 to 19 are at the highest risk for these severe reactions. Based on the new study, it’s estimated that food allergies cause 50,000 emergency room visits per year, with overall cases approaching 150,000 annually.

“This study shows anaphylaxis affects significantly more people, many of whom are children, than previously reported,” said Anne Muñoz-Furlong, Founder and CEO of the Food Allergy & Anaphylaxis Network (FAAN). 

Increased prevalence of peanut and tree nut allergy

Almost every day I am asked by patients, colleagues and the media why there are so many new cases of food allergies — particularly, nuts and peanuts. The prevalence of peanut allergy in the U.S. has been estimated to affect as many as 6 million people. The incidence of peanut allergy is said to have doubled in American children in the five years between 1998 and 2003.

Since there is no treatment or cure for food allergies, avoidance and education are the most important methods of reducing risk. Another important strategy is to become a “label detective.” To better understand food labels, carry a “food allergy identification card” (especially when eating outside of the home), and be prepared to treat severe allergic reactions when they occur. 

For more information on food allergy, contact FAAN at (800) 929-4040 or visit www.foodallergy.org.  In addition, see a board certified allergist for testing, and if you or a family member has food allergies, ask for a food allergy action plan!  

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.

The Yule log is burning in the fireplace and various holiday ornaments are back in use for the holiday season. This is a particularly tricky time for those affected by indoor allergies, sinus problems, asthma and other respiratory disorders. Each year my staff and I take the extra time to educate our allergy sufferers and better prepare them for the onslaught of holiday and winter-time allergies. 

First, do you notice that when the family Christmas tree, complete with holiday ornaments makes its appearance in your home, your nasal, eye, sinus and various respiratory symptoms begin to worsen?  Live Christmas trees can trigger mold allergies and the spores that thrive on their branches can trigger weeks of suffering. 

Many people consider pine tree pollen to be the primary cause of their allergy symptoms during the holidays. But, while it’s possible to have an allergy to pine tree pollen, you’re much less likely to have symptoms during the Christmas season because pine trees mostly pollinate in the spring.

Christmas trees are a source for mold spores which attach to the branches and needles. Because these trees may be cut up to two months before they arrive in your home, and are kept alive by daily watering, which over time, can lead to mold growth. 

Typically, spore counts in your house climb when evergreen trees are brought indoors. Connecticut allergist Philip Hemmers, who recently studied this holiday phenomenon, found that indoor mold counts in a home with a Christmas tree increased to five times the normal level within two weeks of bringing the tree indoors. So if you are allergic to mold, try running an air cleaner in the same room as the tree and shorten the length of time you have the tree in the house to limit mold exposure. And for those who are sensitive to odors, avoiding live Christmas trees may be a wise decision because the aroma could irritate their eyes and nose.

Terpene, which is found in the oil and sap of many evergreen trees and wreaths, is also a potential allergy culprit. Terpene can cause skin rashes when it comes in contact with the skin of allergic individuals. 

So, how can you reduce the risks of Christmas tree allergies interfering with your holidays? Here are some tips that may help:

• When handling a live tree, be sure to wear a long-sleeved shirt and gloves, to prevent sap and resins from irritating the skin. 
• The American Academy of Allergy, Asthma and Immunology  suggests that you allow your tree to dry out on an enclosed porch or garage before bringing it indoors, while keeping the trunk in a bucket of water so it doesn’t die.
• You also may want to explore whether your tree retailer provides a shaking machine, which will physically remove some allergens from the tree.  
• Be sure to clean ornaments and lights before decorating your tree to rid them of dust and mold. 

Artificial trees remain an option for people with mold allergies, but even artificial trees can aggravate allergies. They tend to collect dust and mold since they’re in storage for most of the year. If you have an artificial tree, store it in a cool, dry place, and wipe it down or wash it before putting it up.

The risks associated with a real or artificial tree can be reduced significantly by following simple precautions:

• Use a cloth to wipe clean your artificial tree.
• Decorations stored for the past year in a damp basement may harbor molds or dust mites. Whenever possible, keep ornaments and decorations stored in dry areas, off the floor in plastic bags. It is also a good idea to wash your hands after unpacking them.
• The ever popular holiday plant, the poinsettia, belongs to the same plant family as the Brazilian rubber tree from which latex is obtained. Direct contact with a broken poinsettia leaf can trigger a rash or allergy symptoms if you are sensitive to latex rubber.  
• Candles and incense can trigger allergies, but by using soy and beeswax candles you can reduce your risk of suffering respiratory symptoms.

There has been much debate surrounding the dramatic increase of asthma in the United States and throughout the world over past several decades.

A study released by a group of researchers from New Zealand published in the September 20, 2008  issue of the The Lancet found an association between paracetamol use in infancy (known as acetaminophen in the U.S., and a very commonly used non-aspirin containing analgesic) and childhood risk of asthma, allergy and eczema in children at 6-7 years.  The authors suggested  the use of this commonly prescribed pain reliever and fever reducer might be a risk factor for the development of childhood asthma. 

 There has been an increased use of these non-aspirin containing analgesics over the past five decades, especially in children.  Additionally, the researchers reported those children that were given more frequent doses were more likely to develop asthma on a risk adjusted basis. 

 It is important to note that approximately, and this is just an estimate,  about 10 percent of adults and children with asthma find aspirin and non-steriod anti-inflammatory drugs (NSAIDS) actually worsen their asthma.  Aspirin “intolerance” appears to be more common in those patients with moderate to severe asthma, particularly individuals that also have nasal polyps and sinus disease. 

Another study reported in the journal Thorax found at least in adult women that aspirin may reduce asthma risk.  The authors cautioned  their findings were “still not enough to recommend taking aspirin regularly.”  Separately, the incidence of asthma is increasing and other asthma researchers believe another cause for this possibly is an association with obesity and dietary factors. 

In any event I have not observed any issues with acetaminophen analgesics in our allergy and asthma patient population when used in appropriate dosages and for the correct reasons.  Obviously more work and further studies are needed to explain the explosion of new cases of asthma, both in adults and children.

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.

Summer allergies and oral allergy syndrome

If you are one of the thirty million people suffering from summertime seasonal allergies, it is important to know about pollen-food syndrome, also known as oral allergy syndrome (OAS), caused by allergens such as ragweed pollen. 

Each year, grass pollens and weeds cause seasonal suffering and ragweed begins to bloom around early August in many areas of the U.S.  In the warmer climates weed pollens may be seen during much of the year.

Itchiness of the mouth and throat immediately after eating fresh fruits or vegetables are common symptoms of OAS. Oral allergy syndrome results from a cross-reaction between allergy antibodies directed towards pollens with similar proteins that are found in foods in about one-third of seasonal allergy sufferers.  Individuals with ragweed allergies might experience these symptoms when consuming foods such as:

• Banana
• Cucumber
• Melon
• Zucchini
• Sunflower seeds
• Chamomile tea
• Echinacea

Grass pollen allergic individuals might experience symptoms when ingesting

• fig
• melons
• tomatoes
• oranges

Mugwort (weed pollen) allergic sufferers may suffer after eating:

• carrots
• celery
• coriander
• fennel
• parsley
• peppers

Generally, cooking or microwaving the food will eliminate a reaction, but not always.  Less commonly it is possible for the OAS to induce mouth and throat swelling if you are allergic to various foods. 

For additional information from the American Academy of Allergy, Asthma and Immunology at http://www.aaaai.org/media/news_releases/2006/08/080206.stm.

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 to diagnose or treat any condition.

Dr. Bassett

In the July issue of American Journal of Respiratory and Critical Care Medicine researchers found “consistent positive associations” between the amount of nuts eaten during pregnancy, including peanuts, and respiratory symptoms (i.e. shortness of breath, wheezing) in their children through the first 8 years of age. 

The study which took place at Utrecht University in the Netherlands interviewed over 4,000 pregnant women with and without a history of allergy and asthma.  Daily ingestion of nuts in these women increased the likelihood that their child would have “wheezing” and shortness of breath, compared to those mothers who rarely consumed nuts.  The researchers felt it was too soon to recommend a nut restricted diet during pregnancy, and agreed these results should be confirmed by future research. 

I have generally adopted the practice of recommending that women with a strong history of asthma and allergic conditions (i.e. hives, food allergy, seasonal allergies, eczema) should consider a nut restriction during pregnancy. 

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 to diagnose or treat any condition.

FDA Advisory to switch to HFA propelled quick-relief (bronchodilator) asthma inhalers

Just a brief note to remind all individuals and/or family members with asthma that the US FDA requires that CFC based quick relief bronchodilator inhalers be removed from the US market by year end.  If you are currently using a CFC inhaler you will need to transition prior to the ban to more environmentally friendly HFA quick relief inhalers.  Bottom line: the asthma medication, a rescue bronchodilator, is exactly the same and is not changing, only the propellant that pushes the medication out of the canister inhaler when you inhale will be different.

Many of my patients, in fact, probably almost all of them have already made the switch to HFA.  Go to www.fda.gov/cder/mdi/albuterol.htm for more detailed information about this.

Make it an opportunity to review a day to day asthma action plan with your provider or asthma specialist.

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 to diagnose or treat any condition.

So you’ve gotten the hamburgers and hot dogs ready, the barbecue is heating up and the grand ‘ol flag flying high in the sky. But before you salute Memorial Day weekend here are some tips to help prevent taking the bite out of your holiday. Allergist, Dr. Clifford Bassett, weighs in.

How does one identify the insect doing the biting and stinging? Learn what stinging insects such as yellow jackets, honeybees, wasps and hornets look like to be properly prepared. Check out these quick facts about stinging insects: Stinging Insect Allergy Tips and Facts

Stinging Insect Survival Tips

* My best advice to prevent stings that means staying out of their territory and nests. In general, if you encounter a stinging insect, move away slowly.

* If you smell nice and look like a flower, then you will be a target for stinging insects.

* Around the BBQ try to keep food covered and consider wearing closed shoes

Getting treated

* First if you have had a serious or generalized reaction after being stung, stop reading and immediately make an appointment with an allergist familiar with the evaluation and treatment of stinging insect allergy!

* Speak to your allergist to learn if you are a candidate for a life saving treatment known as “immunotherapy”. This is a series of injections to “venom” that can provide up to 98% protection for those with venom allergies!

* Make sure you have a prescription epinephrine auto-injector with you if you have had a systemic allergic reaction (such as respiratory symptoms, throat tightness, hives and swelling) especially during the prime biting months in your area.

For some additional tips and information on what to do if you are stung check out these links to keep you informed:

The Sting of Summer

Tips to Remember Stinging Insect Allergy

Don’t let stinging insects take a bite out of your summer!

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 to diagnose or treat any condition.