Allergy tips

For all you peanut allergic individuals, have you ever wondered about eating at restaurants that use peanut oil for cooking. Five Guys and Chick-fil-A are probably the two most well known examples. They use peanut oil in their fryers.

Cooking oils used by most restaurants, especially the big commercial franchises that use peanut oil, use a highly processed, refined peanut oil. Why is this important? The refining process involves high heat, deodorization, bleaching, purification, and other methods of processing to strip away the peanut proteins that are responsible for the allergic reaction to peanuts and leaves a purified, refined oil.

The peanut oils to avoid are often the gourmet peanut oils. These types of oils may have things like "cold-pressed," "natural," "unrefined," "gourmet" or "aromatic" on the labeling of the bottle. Found in the cooking oil aisles at supermarkets or specialty stores, these oils often forego the refining process and retain allergic proteins.

There are research studies that back up these findings, and the FDA makes specific note of oils in Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) [Paragraph 1-201.10(B)]. So, if you are craving those fries cooked in the peanut oil, chances are you can probably feel safe eating them. Now, the only reasons to avoid Five Guys might be the actual peanuts in their restaurants or your expanding waistline.

Always inquire about the oil before ordering, and discuss with your allergist if you have any questions or reservations.

For more information on FDA guidelines concerning food allergens or for a convenient way to let restaurant staff know about your food allergies, try our convenient food allergy cards.

I came across this on the drive in to work yesterday morning, and it reminded me of just a few short years ago.  From time to time I would babysit my godson, and for quite a while, he used a pacifier (which I always call a "binky").  Like many babies and very young children, he took comfort in a pacifier.  It was often the "go-to" thing at bedtime or when he was fussy.  When babysitting, the pacifier would inevitably fall from his mouth and land on the floor.  More often than not, I would see it happen, pick it up, make sure there was no dog hair or big chunk of dirt on it then pop it back in.  I can hear a few people gasping, but generally speaking, "dirt don't hurt" was a saying that my brothers and I practiced on a daily basis as children. My one brother's nickname was literally "dirt" since he was generally filthy from playing outside so much.  This is all a bit circuitous, but it leads me to two things, the hygiene hypothesis and a recent study published in Pediatrics.

While my approach in cleaning the pacifier is probably not taken by many, this recently published study I mention focuses not only on how parents cleaned their children's pacifier but also how it may impact the development of eczema and allergies.  In examining 184 children, researchers studied what the children were sensitive to, how parents cleaned their pacifiers, and analyzed the bacteria in the children's mouths.  At 18 and even 36 months, children whose parents cleaned their pacifiers by sucking on them, showed remarkable protection against eczema and asthma.  Yes, you read that correctly.  Some parents clean their child's pacifier by sucking it clean then giving it back to the child.  Odd as it may sound, this is believed to be the key findings of the study.

Regardless of how "clean" we, as a species, think we are, there are literally billions of bacteria living on and even inside of us.  On our skin, in our digestive tracts and in our mouths, bacteria play a very important part in everything from our immune system to the way in which we break down our food.  The theory is that by sucking on the pacifier the parent not only cleans visible dirt or debris from it, but they actually place bacteria back onto it.  That bacteria is then introduced to the child, exposing the child's immune system to a broader array of bacteria.  This ties into the hygiene hypothesis in that many believe children in western societies are "too clean," and because of this, are at an increased risk of developing things like eczema, asthma or allergies.

When we are infants, our bodies' systems are developing.  Think of the immune system like a defense mechanism that is untrained.  By nature, this system is designed to find things harmful to us and fight them, so at a very early age, the immune system is trying to determine what is dangerous and what can be ignored.  The hygiene theory suggests that lack of exposure to a variety of bacteria and germs means the system doesn't get thorough training and often identifies innocuous substances as harmful.  "Well, we have to find the shady characters to defend you against, and I don't like the looks of these guys." So when they immune system cannot find real enemies, they start identifying harmless substances as dangerous.

The hygiene hypothesis is just that, a hypothesis, and there are some studies that run counter to this.  This piece of research, though, suggests that there is some validity to it.  While it is too early to suggest that parents start sucking on their kid's pacifier to clean it, it really can't hurt.  Oh, and just for the record, most parents simply rinse the pacifier.  I guess I all into that "other" category.

For an abstract of the pacifier study.

Author: KevvyG

With Spring finally here, the many months of keeping up with my yard begins. From pressure washing away red clay and pollen to mowing and trimming, lawn care is one of those outdoor tasks that can really aggravate those with allergies or asthma. Pollen levels are up but so is the grass, so aside from hiring someone to take care of your lawn (or napalming it), what can you do about allergies? There is one simple item that can help regardless of the season - a mask.

Since I'm not allergic to pollen, I personally don't wear a mask for this reason, though during the dry summers, I do wear one to eliminate dust. Masks remain one of the most effective ways to block tree, weed and grass pollen without having to change your regular lawncare routine. N95 masks are the most common type available. Inexpensive paper masks like this are an easy way to block reaction causing allergens. Most N95 masks are disposable, so after a use or two, you simple replace it.

The N95 rating is a NIOSH classification that means any mask with this rating traps 95% of particles 0.3 microns or larger. While this certainly isn't HEPA, it works well in many situations. With this type of filtration, it will block most of your pollens as well as dust and other particulate in the air. If you try one of these masks but find that the filtration isn't quite doing the job, you can step up to a P100 or N100 rated mask/respirator instead.

NIOSH 100 rated masks meet HEPA standards, trapping 99.97% of particles 0.3 microns or larger. This type of filter represents the gold standard when it comes to particle filtration in masks. Some of these masks are disposable while others have replaceable filters, but both types will provide the extra protection against allergens for those who need it.

Aside from keeping up with your lawn, masks also work well for simple gardening. We all like the look of a well put together flower bed or the taste of a fresh tomato from a plant in the backyard (I know I do!) but planting this time of year presents the same problems as cutting the grass for the first time. With gardening, you often don't stir up pollen like you do when mowing, but this can often involve digging around in decaying or moldy vegetation or leaves. Again, an N95 mask can often be your best bet, but if allergies aren't as severe you may be able to go with something like a Silk or Vogmask. The filtration level on these is a bit lower than N95 but both can help to reduce exposure to particles that can cause allergies or asthma to flare. Plus, these types of masks are a little easier on the eyes, fold up to fit neatly in your pocket, and are generally a bit more comfortable.

Regardless of whether your mowing, gardening or simply cleaning up after your dog, masks an easy and convenient way to block particles while helping to keep you enjoying the outdoors longer.

Author: Kevin G.

Well, it's time for Atlanta's annual rite of passage - spring pollen, and particularly pine pollen.  While there are certainly more tree pollens than just pine floating around in the air, pine pollen is what gives this city it's lovely yellow hue this time of year.  For those affected by allergies or have allergy-induced asthma, the next several weeks can be miserable without taking some steps to control exposure.

We generally recommend you first start at home.  What's floating around outside cannot be helped, but what's floating around inside your house can.  This time of year it's important to remember that a few simple steps can help keep many of those allergens outside, where they belong.

• Take your shoes off.  It seems pretty self-explanatory, but you can track a lot of pollen into the house.  This is also true for pets.  While your cat or dog probably doesn't wear shoes, using a pet wipe or simply damp rag to quickly wipe them down when they come in can help keep them from tracking throughout the house.
• Change the filter.  This can apply to a couple things.  Your HVAC filter is likely due for a change.  After spending much of the winter indoors, these filters can work overtime trying to keep your indoor air clean.  Start with a fresh filter every two to three months.  If you are using a HEPA air purifier, keep tabs on when your filter change is due.  Often they'll have timer based indicators, but keep this running properly can help reduce the pollen that you're bringing in the house.
• Don't skimp on the spring cleaning!  Regular vacuuming, washing, and dusting are more important during high pollen times than at any other point in the year.  By letting allergens build you can easily quickly increase your "allergen load" past the tipping point and be overwhelmed with symptoms.
• Keep the windows closed.  In places with high levels of pine pollen opening the windows can be about the equivalent of coating everything in your home with baby powder, except it will be yellow and likely cause a lot more sneezing.  If you do want to keep the windows open without the mess and allergens, try using a window filter.  They're not a efficient as a HEPA filter, but they do a good job in removing larger particles and much of the pollen in the air.  Besides, if they were HEPA rated, no air at all would pass through.

While these tips can help to keep pollen out of your home, we don't want people to be shut-ins.  So when you're out and about, plan certain tasks around specific times of the day.  Late morning and midday are often your worst times for peak pollen.  There are also a variety of resources that will give you a daily pollen count.  So if something could be pushed off from a particularly high pollen day, you can do a bit of short term planning.  If you are going to be out and about, whether for fun, work or exercise, OTC medication can help prevent and treat many of the symptoms, and a high quality allergy mask can block most of the allergens in the air.  Using a nasal irrigation device can help rinse away reaction causing pollen and other allergens that collect in the nose and sinuses.

None of these things cost much money.  More than anything, it is simply spending a little extra time or stepping up the frequency of things that you are already going.  Spring is here, so buckle up!  We have about three weeks of this lovely yellow powder ahead of us!

Author: Kevin G.

One aspect of my job here at Achoo puts me in touch with people with little to no knowledge of environmental control, allergy bedding or how specific things inside the house can be causing certain symptoms. One piece of information that I commonly pass along is based on previous studies of allergies and asthma that show links between allergic diseases like allergies, asthma and eczema. About 70% of the time, if a child has asthma, s/he also has at least one allergy. A study recently published in the Annals of Allergy, Asthma and Immunology clear up this picture for adults with asthma who likely also have allergies. The results were a bit surprising to most professionals in the field.

By studying and comparing data from over 2500 patients in two age groups, 20-40 and 55+, researchers found that for asthmatics, allergic sensitization was present far more often than not. For the first age group, 20-40, those with asthma were also allergic to at least one allergen 75.4% of the time. In the second group, 55 years and older, asthmatics were allergic to at least one allergen 65% of the time. While this type of overlap has been studied and identified in children, most believed that the link between allergies and asthma wasn't as strong with adults.

Within this data, there is some variation between the types of allergens that these age groups showed the most sensitivity to. For the older set of patients, the most common allergen was dust mite. Over one-third of those who were asthmatic and allergic were sensitive to dust mites. Rye grass, cats, dogs and cockroaches followed. For the younger set of patients the allergen sensitivities were similar with dog and the dust mite allergen leading the way.

Allergies and asthma are two very closely related animals. One is like a llama while the other is like an Alpaca. Both are different but fairly closely related, and like llamas/alpacas, sometimes people confuse the two.

In terms of helping people, this stronger correlation can help doctors and allergists better diagnose conditions in older adults. And while asthma and an allergy may be the cause of a particular set of symptoms, some of the same measures to help control your indoor environment will work for both.

To read the article's abstract or access the full article.

Three Ways to Reduce Allergens in Your Bedroom

Author: Kevin Gilmore

With Easter and Passover now behind us, the spring allergy season is set to begin making millions across the U.S. miserable. And while there is no shortage of weather forecasters and others singing "doom and gloom" for this allergy season, I am somewhat more optimistic about it. Why would I be optimistic about this spring allergy season you ask? There are a few reasons why I think the "doom and gloom" crowd are missing the mark.

Don't get me wrong here. Spring allergy season is going to really stink for tens of millions of people. It has, and likely always will, but think back to last year around this time. Do you remember the stories about the upper third of the country being buried under snow? Nope. Instead what we had was record setting high temperatures.

Remember this? A little digging around shows that temperatures in the upper Midwest ranged as widely as almost 70 degrees warmer on days last year versus the same days this year. Speaking strictly in terms of averages, much of the country is still above temperature averages for 2013 (1.9 degrees according to NOAA), but 2013 went even further (3.6 degrees). All that warmer weather last year meant spring, sprung early.

More than simply the temperature, the entire jet stream pattern is different. If you check out images from NOAA for March of this year and last year, you can see a big dip in the west that helped pull warmer air and temperatures up and disperse them throughout the country. This year the pattern more closely resembles the norm, and with it has come more normal winter temperatures and a more than healthy amount of snow to much of the country.

In February of 2012, people in different parts of the country began their annual trek to the allergist, and for most, this was a month sooner than they were used to. It was little wonder though. At the end of last March, we here in Atlanta saw the old pollen count record shattered by 55% (9369 vs. 6013). We didn't see anything even remotely close to that last week.

Again, I'm not saying spring allergy season took a vacation this year. Sneezing and coughing are likely to be the common sounds you hear for the next couple of months, and now is the time to start preparing for another round of springtime sniffles. However, I don't work for a company that has to make a news story out of everything as mundane as an inch of rain. So, time will tell but, I'm not buying that 2013 will be the worst allergy season ever. To quote Dana Carvey (impersonating G.H. Bush), "Wouldn't be prudent. Not gonna do it."

For good information on comparing historical trends, from year to year, visit The National Climatic Data Center, a division of NOAA (National Oceanic and Atmospheric Administration).

Author: Kevin Gilmore

People who suffer from COPD (Chronic Obstructive Pulmonary Disorder), sleep apnea or other respiratory conditions have some familiarity with wearing a mask while sleeping. Perhaps not the most comfortable, these masks often help keep airways open or deliver concentrated oxygen to assist breathing when lung functionality or airways are compromised. Sometimes bulky, these masks provide a very real and much needed benefit to ensure oxygen levels remain at levels that keep the body healthy and feeling refreshed after a night's rest. For those who suffer from other respiratory conditions like asthma or allergies, masks serve a different purpose. They block particle allergens like dander and pollen while some also filter out odors, smoke and chemicals. While these types of masks are often worn during the day, there may also be some benefit to wearing them at night.

In the February issue of The Journal of Allergy and Clinical Immunology, a research piece explores the idea of asthma sufferers wearing a mask while sleeping. While allergen avoidance is a commonly recommended course of action for people with allergies or asthma, one type of intervention alone is rarely sufficient. This has long been the reason why we have traditionally recommended an overarching approach that includes allergy bedding covers, air filtration, and regular cleaning to removal of carpet and the use of an allergy mask. It is this last part that these researchers focused on.

This randomized, four week study focused on children with asthma and rhinitis and tested to see how sleeping with a mask (even when they continued on their normal medication) would affect them. What they found was that those who slept with a mask at night to help filter allergens or irritants reported more asthma control days (days where their asthma was under control) and a higher peak expiratory flow than their non-mask wearing counterparts.

While no single measure, wearing a mask, encasing bedding, or regular cleaning, can effectively control allergies and asthma alone, what the study shows is that when added to a regimen, wearing a mask at night may be beneficial to some children in their efforts to control asthma. If wearing an allergy mask at night is something you want to consider for your child, keep in mind a few things - size/fit, effectiveness, and airflow. While even something as simple as a N95 rated mask will help, comfort, correct sizing and adequate airflow can all impact how likely the child is actually to keep the mask on while s/he sleeps. And if it comes off during the night, don't worry! In the study, almost half of the children who did wear masks, woke up with them no longer on but still benefitted.

To read the full published research article.

Author: Kevin Gilmore

It took two years of nagging, but I finally persuaded my parents into investing in new flooring.  The old farm house my parents live in was fully carpeted almost two decades ago, so from bathroom and bedrooms to the living room and kitchen, there was nothing but carpet.  Not only was it terribly worn (nearly threadbare in spots), but in a house with three asthmatics, it was also unhealthy.

For years, doctors and allergists have recommended that carpeting be replaced with hard flooring.  The biggest drawback to carpet is that a layer of matting/padding covered by a layer of carpet essentially acts as a giant sponge.  Dirt, allergens, moisture all work their way deep into the carpet fiber and the pad below.  When they settle this deep, they are nearly impossible to extract.

In the one picture, you can see the Miele Bolero (now the Auto Eco Upright) that I purchased for my mother a couple years back.  Even a vacuum like this Miele with the AirClean System (certified to remove 99.99% of particles 0.3 microns or larger) and powerful suction simply cannot pull fine particles that have settled into and below the carpet pad back up.  Many people turn to hot water extractors/carpet cleaners to try to remedy this.  While these do remove more of the dirt and soil that has settled to the sub flooring, they leave behind more than enough moisture to < create a dust mite and/or mold problem.

So for people with severe asthma, allergies, COPD, or emphysema, one of the best things you can do is simply remove the carpet.  Dirt, allergens and other particles then have nowhere to hide from your vacuum.

Choosing a simple laminate over the expense of true hardwoods, laying the flooring is something I have done in several homes. It requires little more than a couple rubber mallets, a circular saw, chop saw, and claw hammer. I also find that a quality wood rasp and flexible, mini Japanese saw (nokogiri) are indispensable for custom cut pieces around the door frame and register vents. For those who have laid any time of flooring before, you will understand this next part. Invest in knee pads. And if you forget yours, like I did, just scoot around on a couple old throw pillows.

When you remove the old carpet, it's a good idea to wear a dust mask as a lot of dust and microparticles are now going to be stirred up. I used simple broom and dust pan to sweep up and remove large piles of fine dust then used the Bolero with smooth floor tool (not included) to finish removing years of soil, dirt and dust. Despite freezing Ohio temperatures, I kept both exterior doors in the dining, cracked while I removed the old carpet and vacuumed. Finally, after two days and some much appreciated help from my siblings, we replaced the flooring in both the kitchen and dining room.

Mom promptly begin laying rugs down in front of all the doors, the sink, refrigerator and stove, and with a little care, that should be the last flooring that my parents will have to worry about in those two rooms. In the long term, it not only looks twenty times better, but I'm hoping that it will help to improve my father's condition. He's likely only a few tests away from being diagnosed with COPD or emphysema. Too many years of severe asthma and smoking having taken a harsh toll on his ability to breathe. Small measures have helped. After talking to him I was glad to hear that small Honeywell air purifier he's been using for several years was helping him sleep better. So I'm hopeful that this too makes a difference.

That was my Christmas to them this year. Next up, replacing the carpet in the bathroom with ceramic tile! And thankfully, my knees have a full year to recover.

Author: Kevin Gilmore

For those who suffer from pet allergies, the most common type of reaction is a respiratory one. Sneezing, wheezing, congestion, puffy eyes are often symptoms of pet allergies. There are also skin reactions that can accompany pet allergies. These can include itching, redness, and hives. As puzzling as allergies can often be, some people can exhibit one type of reaction without necessarily exhibiting both.

For the respiratory symptoms, the first step is to get away from the allergen. Once you remove yourself from the situation, to help to relief coughing, sneezing, congestion, watery eyes, etc., an over the counter antihistamine generally provides quick relief. For those who may suffer an asthma attack because of pet allergies, rescue inhalers can open airways and provide relief.

Hives caused by pet dander can create a slightly different set of circumstances. Hives are the byproduct of histamine which causes small amounts of the blood's plasma to leak into the skin. This is why you often see raised, red bumps or many that merge together to form patches or "plaques". Hives itch and burn, and can last anywhere from a few minutes to days.

Hives can be treated with several types of products, and as with other allergic reactions, remove the trigger first. Before you buy something from your local pharmacy, try cooling the area first with a cool compress or even ice. Avoid tight-fitting clothing and the use of hot water or harsh soaps on the affected area. In terms of over the counter medications, antihistamines will help some, but have the greatest benefit when used very shortly after or prior to exposure (to help prevent hives). Other types of anti-itch lotions can prevent scratching and topical analgesics or steroid creams can reduce the swelling, pain, and itching from hives. In severe instances, a shot of epinephrine can be administered.

Related to hives is angioedema. Angioedema is similar to hives with the biggest difference being that the swelling occurs beneath the skin instead of as raised welts and that the swelling is often localized around the eyes, mouth, hands or feet. Angioedema is most often associated with food allergies, but can be brought about by many types of allergens. Treatment of angioedema is the same as hives - remove the allergen, treat the symptom and if severe, visit the doctor.

For reactions caused by pets or pet dander, avoidance is key. If finding a new home for your favorite pet isn't an option, there are some simple steps you can take to reduce the dander that you come in contact with. For removing dander from the air use a sealed, HEPA air purifier, and vacuum with a quality HEPA vacuum cleaner. Both can remove dander that can be in the air, on the furniture and throughout your home. Limit areas of the home where the pet can roam. Ideally, this means you keep your pet out of your bedroom and off of your bed.

In terms of caring for your pet, regular and frequent brushing can remove excess hair that often holds dander, and by using an anti-allergen pet shampoo with more frequent baths, you can remove dander from your pet's coat.

For me personally, I have no reaction to my dog unless he snuggles up against me. I bathe him with the pet shampoo by Ecology works and frequently dust and sweep (hard flooring only in my home). I also limit the areas of the house available to him by keeping my bedroom door closed. Occasionally I do let him sleep on my leather couch with me, though I throw an Allergy Armor mattress cover over the couch and my blanket to create a barrier between his hair and dander. So while there are many options, even a few simple steps such as these can reduce pet dander and limit both respiratory reactions and skin conditions like hives.

Author: K. Gilmore

As a dog owner, keeping my dog clean and free of ticks and fleas can sometimes seem like a real chore. Over the years I have tried a few different methods in controlling fleas and ticks. Though I never used a flea collar, I have tried the shampoos and the treatments that you apply down the back of the dog. A few years ago, I stopped using both of these things, particularly after actually reading up on some of the chemicals that these products contain, mainly insecticides. (Though when a bottle of shampoo has to have a disclaimer about being toxic to aquatic life, I should have taken that as a bad sign.) Beyond potential issues with your pet's health, they can also have an adverse effect on some people.

The active ingredient in most modern tick and flea shampoos is commonly a pyrethroid, a class of organic compounds related to natural pyrethrins found in some flowers. Most household insecticides stem from this class of chemicals. The problem with many of these is that, quiet bluntly, they are toxic. Most have labels that state as much, particularly with regard to animals and aquatic life. Pyrethroids are considered safe for vertebrates since they have the enzymes and biology in place to break down these chemicals in fairly short order.

Except for cats... Ostensibly, dogs and humans can break down these insecticides in the liver in kidneys without long term effects. Because cats cannot breakdown a common pyrethroid used in flea and tick treatments, phenothrin was pulled by most manufacturers in 2006. Adverse reactions ranging from tremors and hair loss to salivation and death were reported when used with cats.

Cats notwithstanding, most pets and humans are fairly safe when using products that contain pyrethrins. Be even if these products are relatively safe for use around humans and dogs, there are still other compounds found in these can produce adverse reactions in people and pets alike.

D-Limonene (smells like oranges and sound innocuous enough, right?) is assumed to be the culprit in a case where a Pomeranian in Washington recently suffered a severe allergic reaction. The family pet developed edema throughout her body but ultimately recovered. Limonene is also used as a solvent in cleaners, air fresheners, and even glues. While D-Limonene is used commonly used in cosmetics and as an insecticide, the FDA recommends against using this hydrocarbon on cats or dogs, and some with sensitivities may develop contact dermatitis or a general sensitivity to the compound.

In another instance where chemicals in flea and tick repellents more directly impacted a person, a pet shampoo distributed by Sogeval Laboratories, Inc., with an ingredient, phytosphingosine, was associated with the death of one woman who was bathing her dog with the product. An acute asthma attack was the cause of death, and just a few days later, another asthmatic family member suffered a mild asthma attack while bathing the pet with the same product. The belief is that the particular substances used in that formulation of pet shampoo triggered the two asthma attacks in the individuals involved.

This is not to say that all pet shampoos are going to cause problem for you or your pets, but what it does highlight is two things. First, read labels. If there's something you're unfamiliar with, look for a known alternative. When you do come across an unknown compound, check online for the MSDS sheet or visit the manufacturer's website to get as much information as you can. You can then search for these compounds to find out more about them and potential hazards. This may seem like a lot, but it literally takes 10-20 minutes of searching online. Second, some ingredients in flea and tick treatments, as well as cosmetics, cleaners, and other household products, can react differently with different people (particularly those who have an existing allergic or asthmatic condition and those who have shown a sensitivity to chemicals that don't affect most others).

As a side note, for fleas and ticks, I use the Ecology Works pet shampoo. Personally, I like the smell, it lathers well, and I've yet to find a flea or tick on my dog (despite my roommates dog having fleas a couple times since we have lived together.

Author: Kevin G.