Environmental Allergies

What are Environmental Allergies?

The term allergy is used to describe an overreaction of the body to a substance in their surroundings that is ordinarily harmless to most people. This substance is called an allergen, and one can be exposed to it in several ways. Environmental allergens enter the body through inhalation or contact with the skin. Often, people inherit a tendency to develop allergies.

Symptoms

Symptoms of environmental allergies may occur in almost any organ in the body and may be year-round or seasonal. Common symptoms include sneezing, stuffy nose, runny nose, polyps (growths) in the nose, itching and puffy eyes, frequent sore throats, asthma, skin rashes, and behavioral problems such as hyperactivity in children. Allergic symptoms may also include the outer, middle or inner ear. Some examples are:

Outer Ear

Chronic itching or frequent infections of the ear canal may be due to allergy.

Middle Ear

Repeated ear infections and long-standing fluid behind the eardrum may be a result of an underlying allergy. Both of these are more common in children. Children who require more than one set of PE tubes for recurrent ear infections or fluid are more likely to have an allergy than those who only require one set.

Inner Ear

Meniere’s disease in one or both ears may sometimes be aggravated by allergies. Allergy may also play a role in chronic “dizziness” that is not specifically spinning vertigo, and migrainous vertigo.

Common Environmental Allergens

Pollen is a fine powder produced by trees, flowers, grasses, and weeds. The allergy to pollen, often incorrectly termed hay fever, occurs when it is dispersed through the air and inhaled into the respiratory system. Pollen is affected by the seasonal blooming of different types of plants, mostly in spring, late summer, and fall.

Animal dander is the saliva, urine, or skin of a cat, dog, horse, bird, or other animals with fur or feathers. Like the skin, dried saliva or urine containing allergens may flake off from the animal’s fur and become airborne. The most common animal allergen is cat dander. 70% of all households have cat dander whether or not a cat is present in the home because it is very sticky and easily transferred.

Mold or fungi spores can cause allergic reactions. Mold can thrive in almost any environment that provides some moisture, organic debris, and low light. Outdoors, molds and fungi grow on rotting logs, fallen leaves, compost piles, grasses, grains, and other damp areas. Indoors, they can often be found in the bathroom, kitchen, or basement. When a source of molds is disturbed, mold spores can be released into the air and inhaled, producing symptoms.

Dust mite fecal matter is a common indoor allergen. Dust mites are microscopic bugs that live in mattresses. It is a year-round allergen but may be aggravated in spring and summer months because they prefer warm and humid environments. The average bed has 2 million dust mites, and each of those deposits 10 to 20 drops of fecal matter every day, which are very light, airborne, and easily inhaled.

Diagnosis

Environmental allergies are most often identified through skin tests. Small amounts of allergens are introduced into the arm using needles that barely penetrate the skin’s surface. Little bumps called wheals will form on the skin at the site of the test. After 10-15 minutes, the wheals are measured. The wheal size helps to determine both if an individual has allergies, and how sensitive. It may also help indicate at what strength allergy injections should start.

Skin tests at the House Ear Clinic are usually either prick testing and/or Intradermal Titration Tests. With Intradermal Titration Tests, small amounts of allergens are injected under the skin in differing concentrations to measure allergic response. The test starts with a very diluted solution to lessen the chance of a severe allergic reaction. Skin prick testing may also be used, whereby a small amount of allergen of only one concentration is injected. This test is less sensitive than Intradermal Titration. Intradermal Titration Tests may be used at times if the skin prick test was negative, and it is still believed that the individual is allergic to the allergen.

An In Vitro test, sometimes called a RAST test, is a blood test commonly used to test children, patients with skin conditions that prevent skin testing or take certain medications or have other medical conditions. After exposure to an allergen, the immune system of an allergic person produces a specific antibody to that allergen called Immunoglobulin E (IgE). An In Vitro test measures the production of allergen-specific IgE in the serum, and may also be used to diagnose food or environmental allergens.

Treatments

Most allergic people have a genetic predisposition that cannot be changed. Instead, desensitization therapy is used for symptoms that don’t improve sufficiently with environmental protection, oral or intranasal antihistamines, or the use of an intranasal steroid. Ear symptoms of allergy may require additional treatments with ear drops, steroids, or other medications. Desensitization therapy involves receiving injections containing the allergen(s) to stimulate the production of a protective substance called blocking antibody to help prevent allergic symptoms. Initially, shots will be administered on a weekly basis, then, the frequency of the shots will decline to every two and then every three weeks. This is not a lifelong commitment; patients usually see improvements in 6-12 weeks and often no longer need shots after 3-5 years. At the House Allergy Department, the first shot is given in the office, while the next five shots must be administered in a doctor’s office. For most adult patients, after about six weeks, an adult patient or family member can be trained to administer the shots on their own. We have successfully and safely treated patients on 6 continents, most of who give their own shots at home.

Remedies & Tips

Mild allergic symptoms require no specific test for diagnosis. They can be well controlled with a combination of the following remedies below.

Antihistamines can be effective for dripping nose, sneezing, and itching but are not very effective for congestion. Side effects of antihistamines may include dry mouth, urinary retention, and drowsiness. They may also be given in an intranasal spray or in an eye drop for allergic conjunctivitis.

Prescription Nasal Sprays are mild topical steroids that can be very effective for most nasal allergy symptoms, including congestion, dripping, sneezing, and itching. Side effects include occasional nosebleeds or nasal crusting.

Decongestants shrink swollen (congested) tissue, such as the mucus membrane of the nose. They are often combined with antihistamines. Side effects include insomnia, rapid heartbeat, and potential prostatic obstruction in men.

One of the most effective ways of managing your allergy symptoms is by creating an allergy-free home. You can manage your symptoms by trying some of the tips below.

Use HEPA air filters to remove microscopic allergens such as pollen or mole spores.

Use impermeable mattress and pillow covers to lessen the exposure to dust mites.

Avoid down comforters and pillows. If you use down comforters and pillows, use hypoallergenic covers to seal in the allergens.

Keep pets out of the bedroom and use mattress covers to prevent allergens in the bed.

Limit paper storage, use of paper bags, and storage of cardboard boxes. Cockroach dander is more common now, and exposure may be found in paper and cardboard. Also, the use of canvas and other bags is better for the environment!