Allercy and Asthma Health
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Winter 2008

FDA Supports Nonprescription Cough and Cold Medicine Industry’s Efforts To Restrict Use in Children

New Statistics on Childhood Asthma

Healthy Tips for the Holiday Allergy and Asthma Season

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The Official Publication of AAN - MA

Healthy Tips for the Holiday Allergy and Asthma Season

PhotoBy Thomas J. Kallstrom,
BS, RRT, AE-C, FAARC

Now is the time of year when we start to think about the winter holidays — time for family, friends, religious customs, mouth-watering foods, and also a mixture of triggers that could aggravate people who have allergies and asthma.

Hospital visits for respiratory diseases have a very predicable seasonal pattern, which is often driven by the circulation of viruses. In fact, during the winter months there is a threefold higher number of visits compared to the summer months, and this is especially true for the winter holidays. Asthma problems are at their highest levels during the Christmas period and when children return to school from vacation or a winter holiday break. This is a high time for the spread of influenza and respiratory syncytial virus. While you cannot avoid returning to school or going to a social event, there are some things that you can do to help decrease your chances of getting the flu.

  • Get an annual flu shot.
  • Wash your hands frequently, especially after handling objects that others have touched (such as a doorknob or shopping basket).
  • Cover your nose and mouth when coughing or sneezing.
  • Practice good respiratory hygiene (do not sneeze into your hand but rather into a tissue or into your shoulder).

There are several other dangers you should be aware of during the holiday. It is customary for people to set out a dish of nuts for their guests to eat. For patients with a peanut allergy, this could lead to a severe reaction because about 1% of the population has a peanut allergy. In fact, one of the noted culprits that leads to more severe reactions is the cashew. Peanut allergy is also something that must be considered when flying on commercial airlines. A recent survey found that 9% of passengers aboard a commercial airplane reported experiencing an allergic reaction during a flight. Some were serious and potentially life threatening. Most of those who had a peanut reaction did not inform the airline personnel about their experience. Food allergy in an asthma patient tends to cause a more severe and life-threatening allergic reaction compared with reactions that do not involve the respiratory tract.

It is essential to know what your asthma and allergy sensitivities are and be prepared to take quick steps to address them when an exacerbation occurs. Unfortunately, about half of the people who have these problems never seek evaluation by a physician, and few people who know they have this sensitivity actually carry an auto injector or Epi-Pen with them for emergencies. An auto-injector is an important tool to have on you, but it is just as important to understand which food products you are sensitive to and practice avoidance measures at all costs.

Alcohol consumption is common during the winter holidays. Many people experience hypersensitivity and symptoms after consuming alcoholic beverages. Of particular note is the adverse reaction to wine, especially red wine. Symptoms often present as facial flushing, respiratory distress, and allergic swelling. Alcoholic beverages must be avoided if there is a known reaction.

During the winter holidays, we are likely to spend more time indoors, so it is also important to be aware of the effects of indoor combustion products on your asthma and allergies. This is generally seen with use of fireplaces, wood stoves, and gas stoves. There is evidence that children’s exposure to these in can result in asthma symptoms. In some inner-city dwellings, people may actually attempt to partially heat their home by running the gas burners on the oven. Beyond this being a fire hazard, it is also an unsafe practice because it puts particulates in the air that can aggravate asthma. Other indoor agitating exposures include secondhand smoke, frying or other cooking events, and using incense.

Trees and other outdoor plants are often brought indoors during the Christmas season. One of the most decorative and popular display plants, the poinsettia, certainly has a traditional place during the holidays, but it also shares some common allergen proteins that may cause people with latex allergy to develop a cross-sensitivity to poinsettia plants. Also, exposure to Christmas cacti has been reported to cause uticaria and rhino conjunctivitis to those who are sensitive and exposed to it.

Of course, we cannot talk about holiday triggers without including the Christmas tree. Tree pollen and airborn allergens are common with exposure to pine, fir, or spruce trees. Molds may also be on these trees when taken indoors, and exposure could cause a severe asthma event bad enough to require hospitalization. It is advisable not to bring these trees indoors if anyone in the home is sensitive to them.

The real take-home message here is you need to be aware of the offending agents that can make asthmatic conditions worse during the winter holiday season. Knowing what things you are sensitive to can help you avoid them. While you certainly cannot stay isolated during the holidays, you can know what to avoid and, of course, have rescue medications on hand should you have a reaction.

Thomas J. Kallstrom is a respiratory therapist and certified asthma educator. He serves as associate executive director and chief operating officer of the American Association for Respiratory Care and is a long-time member of the National Asthma Education Prevention Program Coordinating Committee.

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