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In contrast to the genetic influences, the influence of environmental exposure has been well-established. The presence of pets, such as cats and dogs, in homes clearly affects whether your susceptible child will be reactive to these allergens. It is also true, however, that children can still become sensitized to allergens that have been eliminated from the home environment. Exposure to allergens, such as animal dander, is hard to avoid in school or day care and in outdoor areas as these allergens may be on the coats and clothing of children from homes with pets.
There are also currently many theories as to other possible causes for allergy in children (and adults):
- Exposure to particulate matter released from the burning of diesel fuel, mainly from trucks, triggers the allergic response. This theory has been proved in the laboratory, where certain cells exposed to diesel particulate matter show signs of an allergic response.
- Air pollution has been cited as a stimulus that can provoke the development of childhood asthma. Evidence for this is that high ozone and sulfur dioxide levels often coincide with peak asthma exacerbations or flare-ups.
- Tiny airborne mold spores (specifically, the species Alternaria), which cannot be seen, have recently been associated with epidemics of asthma in certain cities in children and adults.
- Dust mites and cockroaches appear to be major sensitization agents in our inner cities. Cockroaches have proven to be very difficult to eliminate; dust mites are only somewhat easier.
This abundance of possible causes may seem daunting, but studies have nevertheless shown that certain measures like maintaining a pet-free home, breastfeeding, or soy formula feeding for at least six months or more, along with the late introduction of solid foods (greater than six months of age) can delay the onset of allergic symptoms in susceptible children. What Is a Parent to Do?
The goal shared by both physicians and parents alike in treating childhood asthma and allergies should be to minimize the side effects of medications while maximizing the chance of our children to lead normal daily lives. Clearly identifying allergens that your children are sensitive to through allergy skin testing or using a specific blood test (called a RAST test), can be extremely helpful to you in implementing the following avoidance and control measures.
Avoidance and Control Measures for Children with Allergies
- Removing carpet, encasing bedding with breathable covers, hot laundering of linens, and keeping windows closed at night and in the early morning hours can minimize your children's allergic burden and exposure. Also decreasing the prevalence of dust mites in the bedrooms of your children who are allergic to dust mites and are asthmatic can have a major improvement in their lung function and result in a reduced need for concomitant medications to treat their flare-ups.
- Avoidance of allergy triggers, which may include such irritants and odors as perfume, tobacco smoke, and colognes, will also help your allergic children. Unfortunately, since viruses, particularly rhinoviruses (the cause of the common cold), are the most common stimulant of childhood asthma, and there are as yet no specific practical means available to deal with inactivating this virus or decreasing its penetration in the upper respiratory tract, we are powerless to prevent virus exposure. However, vaccination with flu vaccine and appropriate new agents, as they are released and shown to be safe for children, will be very worthwhile.
- Weather changes can be extremely provocative of asthmatic symptoms as are other seasonal factors, such as presence of pollen. Unfortunately, they are difficult to avoid.
- Scheduling outdoor playtime or exercise at non-peak pollen periods, such as afternoons or early evening, can be effective.
- Having your child wear a mask when helping with gardening, vacuuming, or dusting can be very helpful.