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Indoor Allergies: Overview, Diagnosis, and Treatment
About Indoor Allergies
Indoor allergies are often the cause of year-round symptoms, which is why they are sometimes referred to as year-round allergies or perennial allergies. If patients are always sniffling and sneezing, they may think of their home as a place to escape and recuperate from what seems like an endless cold. But there are allergens found inside the home that may actually be the cause of your patient’s symptoms. Worldwide, sensitization (IgE antibodies) to foreign proteins in the environment is present in up to 40 percent of the population.1
Common indoor allergy triggers include:
- Animals
- Dust mites
- Insects
- Mold
- Mouse urine
40% to 50%
Worldwide, sensitization rates to one or more common allergens among school children are currently approaching 40 percent to 50 percent.1
Allergies to indoor triggers can appear seasonal in nature, since the allergen levels will vary with environmental conditions such as temperature and humidity.
Indoor allergy symptoms are similar to most other allergies, including:
- Itchy, stuffy nose
- Runny nose
- Sneezing
- Itchy, watery, swollen, bloodshot eyes
- Scratchy, swollen throat
- Coughing
- Wheezing
- Tightness in the chest
Worldwide, sensitization rates to one or more common allergens among school children are currently approaching 40 percent to 50 percent.1
ANIMAL DANDER
- Confine the pet to a room with a polished floor and furniture you can wipe down.
- Restrict the animal from the bedroom and keep him or her off the furniture.
- Use high-efficiency particulate are (HEPA) filters and vacuum cleaners.
- Wash your pet weekly in warm water and soap.
- Consider rehoming the pet or keeping it outdoors.
DUST MITES
- Encase mattresses, pillows, and box springs in allergen-proof coverings.
- Wash bedding weekly in 130-degree F water.
- Vacuum and reduce clutter in the home.
- Wear an appropriate mask while cleaning and avoid area 20 minutes after.
- Change furnace and air conditioner filters.
- Use a dehumidifier to reduce the humidity in your home.
COCKROACHES
- Wash dishes.
- Vacuum
- Keep food and garbage in closed containers; take out the garbage regularly.
- Don’t store paper bags, newspapers, or cardboard boxes in your home.
- Place bait traps or call a professional exterminator to eliminate cockroaches.
- Seal plumbing openings, cracks, and crevices.
INDOOR MOLD
- Identify and clean moldy areas with fungicide or bleach.
- Use a dehumidifier to reduce humidity in your home.
- Fix water leaks.
- Clean furnace filters, the refrigerator, and the dehumidifier (clean drip pans with bleach).
- Thoroughly dry clothes before storing.
RODENTS
- Seal holes and cracks from the home to the outside.
- Seal passages through interior floors, walls, the ceiling, and gaps between the bottom of cabinetry or built-in furniture and the floor.
- Keep bushes and trees at least three feet from the home.
- Ensure trash is stored in secure containers.
- Store food in rodent-proof containers.
Testing Increases Diagnostic Confidence
Adding diagnostic testing to aid in a differential diagnosis has been shown to increase confidence in diagnosis to 90 percent.i,ii Conventionally, a diagnosis of allergic or autoimmune disease relies on the case history and a physical examination. However, adding diagnostic testing to aid in a differential diagnosis has been shown to increase confidence in diagnosis.i,ii Diagnostic testing can also help to improve the patient’s quality of life and productivity, reduce costs associated with absenteeism, and optimize use of medication, in addition to decreasing unscheduled healthcare visits.iii,iv
i. Duran-Tauleria E, Vignati G, Guedan MJ, et al. The utility of specific immunoglobulin E measurements in primary care. Allergy. 2004;59 (Suppl78):35-41.
ii. NiggemannB, Nilsson M, Friedrichs F. Paediatric allergy diagnosis in primary care is improved by in vitro allergen specific IgE testing. Pediatr Allergy Immunol. 2008;19:325-331
iii. Welsh N, et al. The Benefits of Specific Immunoglobulin E Testing in the Primary Care Setting. J Am Pharm Assoc. 2006;46:627.
iv. Szeinbach SL, Williams B, Muntendam P, et al. Identification of allergic disease among users of antihistamines. J Manag Care Pharm. 2004; 10 (3): 234-238
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Management and care of patients with indoor allergies
Year-round, or perennial allergy, is caused by year-round exposure to indoor inhaled allergens (e.g., dust mites, cockroaches, rodents, pet dander). Healthcare providers are encouraged to devise a comprehensive, yet targeted, environmental remediation strategy limiting exposure to such allergens.
The treatment of year-round allergies includes the use of three different types of intervention:3,4
1. Allergen avoidance and environmental control measures
2. Pharmacological management
3. Immunotherapy
Practice parameters have been developed to classify and manage treatment of year-round allergies and guideline-directed management has been shown to improve disease control.3 Allergic rhinitis has also been found to be triggered by some year-round allergens.4
Across these practice parameters and guidelines, allergen avoidance is also a primary method of controlling comorbid conditions (e.g., asthma) that are initiated or exacerbated by exposure to indoor allergens.3
In the treatment of year-round allergies, the most effective control measures include patient education, use of HEPA filters, integrated pest management, thorough cleaning, and continuation of these practices.3
- https://www.aaaai.org/about-aaaai/newsroom/allergy-statistics
- Discover the connection: Reduce Exposure to Your Allergic Triggers. Thermo Fisher Scientific Inc. 2018.
- Wright LS, Phipatanakul W. Environmental Remediation in the Treatment of Allergy and Asthma: Latest Updates. Curr Allergy Asthma Rep. 2014 March;14(3): 419.
- Scadding GK. Optimal management of allergic rhinitis. Arch Dis Child. 2015;100:576–582.
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