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By Jeanie L. Davis – WebMD

Out of nowhere -- a sneeze attack:  Who knows what caused it? An assortment of indoor and outdoor allergens can launch a surprise assault. Pollen's a biggie; so is mold.  Whatever you can do to tame those plagues will make your life sweeter.

It's a jungle out there:  But here are tips to survive allergy triggers:

Pollen:

It's no secret that grasses, trees, and flowers produce pollen from spring to fall:  Here's their tentative schedule: Grass pollen (March to October), ragweed pollen (July to November), tree pollen (January to June), and weed pollen (April to November). The timetable varies depending on where you live.

But did you know this:  Mowing the yard stirs up grass pollens.  Gardening puts you face-to-face with flowers, those wicked little pollen producers.

To avoid pollen:

Check the clock:  Pollen counts are usually highest in the late morning and early afternoon

• When pollen counts are high, keep windows closed.  Use air conditioning.  Stay indoors as much as possible.
• Don't hang clothing or bed linens outside to dry; pollen can adhere to fabric.
• Get help with yard work.  Get someone to mow the lawn, so you won't be exposed to so much grass pollen.
• If you simply can't avoid yard work, wear an inexpensive face mask.  Take a shower afterward, and change your clothing.
• Avoid being around freshly cut grass whenever possible.
• Keep car windows and vents closed; use air conditioning.

Mold

Damp areas like basements, bathrooms, and laundry rooms are where you can find mold.  Outside, there are plenty more havens for mold.

To avoid mold:

• Don't rake leaves: That stirs up mold spores, which you might inhale.
• Steer clear of grass:  Leaf, hay, mulch piles, and compost heaps.
• Avoid other damp areas:  Like basements, garages, crawl spaces, and barns.
• Stay indoors during:  Rainy or windy days, when mold spores are likely to be airborne.
• Clean home surfaces:  (including bathroom tiles and shower curtains) with diluted bleach or bleach-based cleaning products.
• Keep an incandescent light:  On a mold-prone area of your home.
• Use a dehumidifier:  And ventilate high-humidity areas.
• Don't hang clothes or bed linens:  Outside to dry; mold spores can easily attach.

Dust Mites:

These tiny creatures live in house dust, as do animal dander, bacteria, mold, and other allergens. Bedding, stuffed animals, overstuffed furniture, rugs, and window blinds are popular hangouts for dust mites.

To control dust mites:

• Put plastic covers over mattresses, pillows, box springs; use hypoallergenic pillows.
• Don't use down-filled bedding or pillows.
• Wash bedding weekly in hot water.
• Get rid of overstuffed furniture.
• Limit use of rugs. Choose hardwood floors over carpeting.
• Avoid window blinds or long drapes.
• Wash stuffed animals and pillows in hot water; dry them in a hot drier.

Animal Dander

If you've got pets:   Animal dander can seep into upholstered furniture, carpeting, drapes, and bedding -- just as dust mites can.

Your car:  Can harbor animal dander too -- even if you don't have a pet.  When you're exposed to other animals, like a neighbor's dog, your clothing attracts high levels of dander.  Slide into your car seat, and you've deposited considerable amounts of this allergen.

To control pet dander:

• Keep pets out of dens, bedrooms, and other rooms where you spend most of your time.
• Get rid of carpeting, if possible.
• Vacuum the house twice a week.
• Vacuum the car, too.
• Bathe pets often.
• Avoid contact with animals.
• Use an air cleaner or purifier. This helps remove dander circulating in the house.
• Follow suggestions (above) for control of dust mites/house dust.

Stinging Insects

Bees, fire ants, yellow jackets, hornets, and wasps can cause allergic reactions when they bite or sting. Everyone who gets stung by an insect will have pain, swelling, and redness around the site.  However, some people have a severe or even life-threatening reaction.

To avoid stings:

• Don't wear brightly colored clothes.
• Don't wear scented deodorants, cosmetics, or hair products.
• Wear long pants and sleeves.
• Avoid outdoor garbage.

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Allergies Curb Kids’ Daily Activities

By Patricia Kirk – WebMD

Nasal allergy:  Symptoms in children may severely affect daily activities such as sleep and schoolwork, according to two new studies.

The studies analyzed:   A national telephone survey of 35,757 parents.  The parents were asked about the effect of allergy symptoms on their children's daily activities, productivity, and sleep patterns.

Five hundred children:   Between ages 4 and 17 with nasal allergy symptoms were compared with 504 children who do not have nasal allergies.

Nasal Allergies Disrupt Sleep:  

The first study, headed by Jennifer M. Derebery, MD, of the House Ear Institute in Los Angeles, showed that the rate of sleep problems in children with nasal allergies is 2 1/2 times that of children without allergies.  Parents reported allergy symptoms caused their children to have difficulty falling asleep (32%), staying asleep (26%) or getting a good night’s (29%).

The parents rated their children’s productivity at 97% on symptom-free days, compared with 68% on days when allergies are the worst.

The percentage of children with allergies that have difficulty with daily activities or accomplish less than expected was more than double that of children without allergies, note the researchers.

Nasal Allergy Symptoms Affect Daily Activities:

The second study, presented by Michael S. Blaiss, MD, clinical professor of pediatrics and medicine at the University of Tennessee Health Science Center in Memphis, looked at how severe symptoms affect children’s daily activities.

Symptoms reported as moderate to severe included nasal congestion (75%); postnasal drip (70%); runny nose (65%); headache (59%); and red, itchy eyes (56%).

Similar to adults, the most bothersome symptoms affecting daily life, however, were nasal congestion and headache.  Twenty-seven percent of parents reported nasal congestion as the most bothersome symptom in their children, and 13% reported headache.

Parents reported a 29% decrease in their children's productivity on days when nasal allergy symptoms were their worst, Blaiss reports.

Nasal Allergy Complaints Common:  

George McCrary, MD, a general practitioner from Fayetteville, Ark., says the loss in productivity is not surprising:  "If you can’t breathe, you’re not going to be very productive."

He says complaints of coughing and trouble sleeping due to postnasal drip are common among both adults and children.

"I see kids every day where the teacher has told the parent to get the child treated because of coughing in school," McCrary says.  

The studies were presented at The American College of Allergy, Asthma & Immunology Annual Scientific Meeting in Dallas

Do You Need an Air Filter?

By Carol Sorgen – WebMD

Do you sniffle and sneeze and wheeze your way through the year?  If you are plagued by allergies and/or asthma, you may be considering purchasing a home air filtration system.  But is it worth the money?  Will it actually help ease your symptoms?  Not if you don't make other changes in your environment as well, say medical experts.

"Buying an air cleaner is not my first suggestion," says Nathan Rabinovitch, MD, assistant professor of pediatrics at National Jewish Medical Research Center in Denver.  "It's more of a backup recommendation."

Minimize Exposure First:

Instead, minimizing your exposure to other allergens in the home is the first line of attack in reducing allergic and asthmatic reactions, says Rabinovitch, who offers these suggestions:

• Avoid carpeting and use smooth flooring instead.
• If you have pets, consider finding them a new home. If that's not an option, keep the pets outside. If that's not an option either, at the very least, keep them out of the bedroom, and certainly off the bed, and off as much of the other furniture in the house as possible.
• Use air conditioning in the warmer months to get rid of outdoor pollens or allergens.
• Clean all air filters, air conditioner filters, and duct filters at each change of season.
• Keep your windows closed (at home and in the car) and avoid spending time outdoors when your allergies are acting up.
• Ban indoor smoking.
• Use the hottest water possible to rid your laundry of dust mites.
• Avoid furnishings that gather dust.

Seek an Air Filter Second:

If you have tried these tactics and aren't finding adequate relief, then it may be time to consider adding an air filter.  Both the U.S. Environmental Protection Agency (EPA) and the American Lung Association recommend air filtration for people with allergies and asthma, but not as a solution by itself. Controlling allergy-causing pollution and ventilation are more important; there is disagreement on whether filters give much added relief from asthma in a clean and well-ventilated home.

This opinion is echoed by the Institute of Medicine, which has said "air cleaners are probably helpful in some situations in reducing allergy or asthma symptoms," but that air cleaning "is not consistently and highly effective in reducing symptoms."

But an air filter still might help you.  There are five basic types:

Mechanical filters:  Force air through a special screen that traps particles including allergens like pollen, pet dander, and dust mites. They also capture irritant particles such as tobacco smoke.

The best-known:   Mechanical filter is the high-efficiency particulate air (HEPA) filter. HEPA (which is a type of filter, not a brand name) was developed during World War II to prevent radioactive particles from escaping from laboratories.

To qualify as a true HEPA filter:   A device must be able to capture at least 90% of all particles 0.3 microns or larger in diameter that enter it. There are filters on the market that claim to be HEPAs, but may not be as efficient, so look for a system that meets true HEPA filtration standards.

Electronic filters:   Use electrical charges to attract and deposit allergens and irritants. If the device contains collecting plates, the particles are captured within the system; otherwise, they stick to room surfaces and have to be cleared away. The most efficient filters are electrostatic precipitators, and the best of those use a fan.

Hybrid filters:   Contain elements of both mechanical and electrostatic filters.

Gas phase filters:   Remove odors and non-particulate pollution such as cooking gas, gasses emitted from paint or building materials, and perfume. They do not remove allergens.

Ozone generators:   Are devices that intentionally produce ozone, which manufacturers claim cleans the air. They are not recommended by the EPA or the American Lung Association because ozone can be harmful to lungs at high concentrations. And the EPA says ozone at safe levels "have little potential to remove indoor air contaminants."

Still:   If you do choose to use such a device, the American Lung Association advises "choosing one that ensures high efficiency over an extended period of time (at least several months) and does not produce ozone levels above 0.05 parts per million, either intentionally or as a by-product of its design."

If your home:   Is heated or air conditioned through ducts, it may be possible to build filters into your air handling system.  A whole-house system will also save space and additional noise in your home.  On the other hand, the filters may be more expensive and more difficult to handle, and they may need to be changed more often.

Choosing a Device:

The Allergy and Asthma Foundation of America suggests asking these questions before purchasing an air filter:

• What substances will the cleaner remove from the air in my home? What substances will it not?
• What is the efficiency rating of the cleaner in relation to the true HEPA standard?
• Will the unit clean the air in a room the size of my bedroom every four to six minutes?
• What is the device's clean air delivery rate (CADR)? The Association of Home Appliance Manufacturers rates air cleaners according to their clean air delivery rates (CADR), which indicate how much filtered air the cleaner delivers. There are different CADRs for tobacco smoke, pollen, and dust. The higher the numbers, the faster the unit filters air.
• How difficult is it to change the filter? (Ask for a demonstration.) How often does it have to be changed? How much do filters cost? Are they readily available throughout the year?
• How much noise does the unit make? Is it quiet enough to run while I sleep? (Turn it on and try it, even though you will probably be in a store and may not get a true sense of just how noisy it is.)

Those with lung conditions such as emphysema or COPD might also consider buying an air filter, says Paul Enright, MD, research professor of medicine at the University of Arizona.  But if you're a healthy individual living in a relatively unpolluted environment, there's no need to spend the money.

Just remember, Enright says, that an air cleaning system is just one of the environmental changes you can make to alleviate symptoms.   "There is no single appropriate answer to coping with allergies and asthma."

Skin Testing for Allergies:

An allergy skin test:   Is used to identify the substances that are causing your allergy symptoms.  It is often performed by applying an extract of an allergen to your skin, scratching or pricking the skin to allow exposure, and then evaluating the skin's reaction.  It may also be done by injecting the allergen under the skin, or by applying it to a patch that is worn on the skin for a specified period of time.

What Happens During the Test?

• Scratch test (also known as a puncture or prick test). First, a doctor or nurse will examine the skin on your forearm and clean it with alcohol. (Sometimes, the skin test is performed on an area of your back.) Areas on your skin are then marked with a pen to identify each allergen that will be tested. A drop of extract for each potential allergen -- such as pollen, animal dander, or insect venom -- is placed on the corresponding mark. A small disposable pricking device is then used so the extract can enter into the outer layer of the skin, called the epidermis. The skin prick is not a shot and doesn't cause bleeding.
• Intradermal test. After examining and cleaning the skin, a small amount of the allergen is injected just under the skin, similar to a tuberculosis test.
• Patch test. Another method is to apply an allergen to a patch which is then placed on the skin. This may be done to pinpoint a trigger of allergic contact dermatitis. If there are allergic antibodies in your system, your skin will become irritated and may itch, much like a mosquito bite. This reaction means you are allergic to that substance.

How Long Does the Test Take?

Plan:   To spend about an hour for the entire appointment.  For the scratch and intradermal skin tests, the allergen placement part of the test takes about 5 to 10 minutes.  Then you will have to wait about 15 minutes to see how your skin reacts.

Patch tests:   Take longer, as you must wear the patch for about 48 hours to determine if there is a delayed reaction.  During this time, bathing and swimming should be avoided.  You will return to the doctor after the specified period of time to have the area(s) checked.

How Should I Prepare for the Test?

Inform :   The healthcare provider who is going to perform the skin test about all medicines you are taking, including over-the-counter medications.

Since:   Allergy medicines, including over-the-counter antihistamines, stop allergic reactions, you should not take them for a few days before the test. Talk to your doctor about discontinuing your allergy medicines prior to the test.

Your doctor:   Will give you a list of medicines to avoid before the test, since there are other drugs that can interfere with the results. Since you may not be able to discontinue certain medicines, the doctor or nurse may perform a separate "control" test to determine if that particular drug will interfere with the scratch test.

Does the Test Hurt?

The test may be mildly irritating, but most people say it doesn't hurt too much.

Is the Test Safe?

Although small amounts of allergens are introduced into your system, a skin test is safe when performed properly.  Systemic (whole body) reactions to skin testing are extremely rare.

What Happens After the Test?  

Any extracts and ink marks will be cleaned off your skin with alcohol.  A mild cortisone cream may be applied to your arm to relieve any excessive itching at the sites of the skin pricks.

If you are having a patch test done, you will go home with bandages on your arm or back that you will wear for about 48 hours.  You must avoid getting these areas wet, unless otherwise instructed by your doctor.  You will return to the doctor after this 48-hour period to be re-evaluated.

Your doctor or allergist will use the results of the test to help develop a management plan for you.

When Should I Call My Doctor?

Call your doctor or emergency number immediately if you experience any of the following symptoms:

• Fever
• Lightheadedness
• Wheezing
• Shortness of breath
• Extensive rash
• Swelling of the face, lips or mouth
• Difficulty swallowing

 What is Pollen?  

FROM NIH/NIAID:

Plants produce tiny—too tiny to see with the naked eye—round or oval pollen grains to reproduce.  In some species, the plant uses the pollen from its own flowers to fertilize itself.  Other types must be cross-pollinated.  Cross-pollination means that for fertilization to take place and seeds to form, pollen must be transferred from the flower of one plant to that of another of the same species.  Insects do this job for certain flowering plants, while other plants rely on wind for transport.

The types of pollen that most commonly cause allergic reactions are produced by the plain-looking plants (trees, grasses, and weeds) that do not have showy flowers.  These plants make small, light, dry pollen grains that are custom-made for wind transport.

Amazingly, scientists have collected samples of ragweed pollen 400 miles out at sea and 2 miles high in the air.  Because airborne pollen can drift for many miles, it does little good to rid an area of an offending plant.  In addition, most allergenic pollen comes from plants that produce it in huge quantities. For example, a single ragweed plant can generate a million grains of pollen a day.

The type of allergens in the pollen is the main factor that determines whether the pollen is likely to cause hay fever.  For example, pine tree pollen is produced in large amounts by a common tree, which would make it a good candidate for causing allergy.  It is, however, a relatively rare cause of allergy because the type of allergens in pine pollen appear to make it less allergenic.”

How common is it for someone to be allergic to pine tree pollen? 

The type of allergens in the pollen is the main factor that determines whether the pollen is likely to cause hay fever.  For example, pine tree pollen is produced in large amounts by a common tree, which would make it a good candidate for causing allergy.  It is, however, a relatively rare cause of allergy because the type of allergens in pine pollen appear to make it less allergenic.