Slide 22: Reducing Exposure to House
Dust Mites
Dust mites thrive in soft furnishings like pillows, mattresses, carpets,
and drapes. These microscopic organisms give off particles that cause
allergic reactions when inhaled. They need moisture to survive and
therefore thrive in humid environments. Decreasing the number of dust
mites to which people with asthma are exposed may help control their
asthma. One key way of doing this in the bedroom is by using mattress
and pillow case covers. These bedding encasements, which are available
commercially, may be plastic or vinyl and are covered with cotton,
nylon, or knit fabric. They provide a barrier between the dust mites and
the person with asthma. A sheet and pillow case are usually placed over
the encasement for increased comfort. Any linens placed over the
encasements should be washed weekly in hot water.
Down-filled pillows, quilts, or comforters should not be used. Down
filling consists of tiny feathers that contain large numbers of dust
mites. Also, stuffed animals and clutter should be removed from the
bedroom.
If a child with asthma wants to play or sleep with a stuffed toy, wash
the toy frequently in hot water, or put it in the freezer for a few
hours every 2 weeks. Freezing cold kills dust mites as effectively as
hot water. The hot water needs to be about 130 degrees to kill mites,
and this is generally hotter than most household hot water. If you
re-set your hot water heater thermostat to 130 degrees, you have to take
other precautions to prevent scalding.
Another thing to consider in the bedroom is getting rid of fabric
curtains and replacing them with shades or mini-blinds. Replace
upholstered chairs with plastic or wood, and, if possible, get rid of
carpeting in favor of vinyl or wood floors with area rugs that can be
shaken out frequently. Because dust mites need high humidity, try to
keep the humidity levels in your home to under 50%. In hot, humid
climates, this requires the use of air conditioning and possibly
dehumidifiers. In dryer, cooler climates, you may be able to achieve
this by opening windows and ensuring good air flow.
Slide 23: Reducing Exposure to
Environmental Tobacco Smoke
Any discussion of reducing harmful exposures that exacerbate asthma in
children must include steps to combat exposure to ETS. Parents of
children with asthma should try to stop smoking. Until they can
successfully quit, they should smoke only outdoors, not in the home or
in the family car. They should not allow others to smoke in the home and
should make sure the child's school is smoke-free.
The effects of ETS and other indoor air pollutants are sometimes
compounded by the fact that many homes and offices built from the 1970s
on were built tightly for energy efficiency, which allows little fresh
air circulation and increases the potential for exposure.
Slide 24: Reducing Exposure to
Cockroaches
Allergy to cockroaches is an important risk factor for worsening asthma.
Decreasing exposure to cockroaches in the home can help reduce asthma
attacks. To do this, remove as many water and food sources as possible
because cockroaches need food and water to survive. That is why kitchens
and bathrooms are areas where we commonly see cockroaches. Food,
including pet food, or water anywhere in the home will attract roaches,
so immediately wash soiled dishes, throw away discardable food
containers, and remove standing water from all rooms. Keep trash in
closed containers, and keep food covered and put away. Discard grocery
bags, newspapers, cardboard boxes, and other clutter.
People tend to eat where they watch television. As a result, cockroaches
and cockroach remains are frequently found in living rooms, family
rooms, and bedrooms. You may find cockroaches any place where food is
eaten and crumbs are left behind. These areas will need to be vacuumed
or swept at least every 2-3 days to get rid of food crumbs.
Slide 25: Reducing Exposure to Pets
Animals are a common source of allergens. They shed fur and feathers;
they leave saliva, urine, and feces. Cats and rodents are potent asthma
sensitizers, whereas dogs cause less allergic sensitivity than other
mammals. People with asthma may find that their pets trigger an attack.
The simplest solution to this situation is, of course, to find another
home for the pet. However, some pet owners may be too emotionally
attached to their pets or unable to locate a safe new home for the
animal. Fortunately, other steps can be taken to reduce the impact of
pet allergens in the home.
At the very least, any animal causing an allergic reaction should not be
allowed in the bedroom of the affected person. Pets such as cats and
dogs should be kept outside as much as possible. Frequent vacuuming will
help to minimize the presence of the allergen. If the room has a hard
surface floor, it should be damp mopped weekly. If you have carpeting,
try to use a vacuum cleaner equipped with a high-efficiency particle
arresting or HEPA filter. At a minimum, use specifically designed
micro-filtration vacuum cleaner bags, which can be purchased at any
department store. Use pet beds or blankets that are washable, and wash
them weekly. If the veterinarian says it's OK, bathe the animal every
week or two.
Slide 26: Reducing Exposure to Mold
When mold is inhaled, it can cause asthma attacks. Mold grows outdoors
and indoors, especially in humid areas like bathroom showers and
basements. Eliminating mold throughout the home can help control asthma
attacks. To do this, one needs to keep humidity levels between 35 and
50%. A gauge called a hygrometer can be used to monitor humidity levels.
When the humidity is above 60%, a dehumidifier or air conditioner should
be used and the windows kept closed. If a humidifier must be used, it
should be cleaned weekly with diluted bleach, and the water should be
changed daily so that mold does not grow.
In the kitchen, use an exhaust fan to remove water vapor when cooking.
Each week, empty water pans which are found below self-defrosting
refrigerators. Remove spoiling foods immediately. Empty trash frequently
to keep the home clean. In the bathroom, use an exhaust fan or open a
window to remove humidity after showering. Use a squeegee to remove
excess water from the shower stall, tub, and tiles.
Vent a clothes dryer by attaching a vent hose to it and running the hose
outside. Dry clothes immediately after washing, either in a dryer or by
hanging clothes outside.
Do not lay carpet and pad on a concrete floor. Correct seepage or
flooding problems, and remove any previously flooded carpets. Ideally,
people with asthma should not have bedrooms on the basement level,
especially if the basement tends to be humid. Also, they should not have
potted plants in their bedroom because the soil is a breeding ground for
mold.
Slide 27: Other Asthma Triggers
In addition to the indoor agents studied extensively by the Institute of
Medicine, there are other possible triggers for asthma that affect some
people. These triggers can include strenuous physical exercise; adverse
weather conditions like freezing temperatures, high humidity, and
thunderstorms; and some foods and food additives and drugs. Strong
emotional states, either positive or negative, can lead to
hyperventilation and an asthma episode. However, with proper management,
many of these episodes can be avoided.
Outdoor air pollution, caused by industrial emissions and automobile
exhaust, also can cause an asthma episode. In fact, in large cities that
have air pollution problems like Los Angeles, Houston, and Atlanta, the
number of emergency department visits for asthma episodes goes up during
ozone action days when the air quality is especially poor.
