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.

Winter is on it’s way, and allergies don’t stop there. Here are some room by room tips to help you cope with winter allergies!

Bedrooms (number one important allergen is the house dust mite)
1. Encase your pillows and bedding (mattress and box spring) with tight allergen–impermeable slip covers that “seal in” indoor house dust mites if you have allergic sensitivities to this powerful indoor allergen
2. Dust mite levels in mattresses are more closely linked with asthma attacks
3. Wash bedding in very hot water every 7–14 days
4. Remember to reduce dust collectors, particularly in the bedroom, such as drapes, horizontal blinds (tend to trap dust easily and more problematic to clean them), non-washable items (stuffed toys)
5. Washable window shades are preferred
6. Unpacking of winter clothing may have accumulated dust and mildew from open storage in basement or attic areas
7. Try and keep pets out of the bedroom if you have pet allergies

Bathrooms
Look for problem areas with excess mildew and molds, leaking faucets, damp carpets and/or rugs

Kitchen
1. Exposure to household cleaning agents, aerosols, cleaners, cockroach traps
2. Limit candle usage
3. Check refrigerator drip pans for excess mildew and moisture
4. “Always open the window or run an exhaust fan, when you’re cleaning in an enclosed space, you must always have good ventilation,” says Pramod S. Kelkar, MD, chair of the American Academy of Allergy, Asthma, and Immunology’s Cough Taskforce.

Living Areas
1. Smoke from fireplace, chemicals from carpeting and furnishings, pet hair and dander
2. Avoid scented candles and potpourri
3. Use a HEPA air cleaner (either room model or central HVAC) to remove unwanted airborne pet allergens (cat, dog hair)
4. Even if you’re not the one out of ten allergy sufferers allergic to pets, your household pets are still quite capable of bringing outdoor hidden allergens indoors on their skin and fur
5. Cover air vents with allergen filters
6. Keep humidity in check – don’t over do it with trying to over humidify your home. Get a hygrometer and measure humidity inside, try and keep it less than 40-45% to avoid a buildup of mold spores and dust mites (they love excess humidity). 
7. Avoid excessive amounts of house plants if you have sensitivities to mold spores
8. Hardwood floors and tile are better than wall to wall carpets and heavy rug
9. Vacuum frequently with a HEPA (high efficiency particulate air) filter in the vacuum cleaner which will able to catch many allergy-irritating particles (hopefully this can be done by non allergic individual)
10. Keep out of rooms recently vacuumed or dusted for about 30 minutes to let the “dust settle”
 
Remodeling, renovations and decorating your home
1. Try to choose products made with real wood and low-VOC sealants 
2. If you must use carpeting in your home, go for ones that are free of formaldehyde and use allergy-friendly paints 
3. Open the windows to properly ventilate the home
 
Garage
Exposure to chemicals, paints, mildew, fumes and gardening products
 
Additional tips
1. Control your stress during the frantic holiday period
2. Learn coping and stress management strategies (yoga, meditation) if you are one of over 17 million with asthma.  Holiday stress can tighten respiratory passages and aggravate asthma. 
3. Lastly, don’t forget if you have allergies and/or asthma have your emergency medications on hand at all times

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/ as well as from the American College of Allergy, Asthma and Immunology 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.