Is Your Environment Affecting Your Health? Understanding Environmental Allergies

Do you sneeze frequently? Is your nose congested, is your throat itchy, or are your eyes red and watery? Do you sometimes feel like you’re having an asthma attack? If these things happen often, you might be suffering from Environmental Allergies. Don’t worry, this is very common. Let’s look at what exactly this is, why it happens, how to identify it, and how to avoid it.

What are Environmental Allergies?

Simply put, environmental allergies occur when your immune system overreacts to certain things in your surroundings. Generally, these substances – which we call ‘allergens’ – are not actually harmful. However, if you have an allergy to something, your body reacts as if it’s under attack when that substance enters your system.

Think of it like having a security guard at your house. Usually, they protect the house from burglars. But if you have an ‘allergy,’ it’s like that security guard getting panicked and reacting aggressively even when a relative visits the house.

Who can develop these allergies?

These environmental allergies can affect anyone. However, if your parents have these types of allergies, you are more likely to develop them too. This means it can be hereditary.

These are very common. It is estimated that about 24 million people in a country like the United States suffer from this condition. There are also many people in Sri Lanka who suffer from similar allergies.

How do these allergies affect the body?

When an allergen enters your body for the first time, your immune system produces a special type of antibody called Immunoglobulin E (IgE). These `IgE` antibodies bind with ‘mast cells’ found in our mucus membranes, skin, gastrointestinal (GI) tract, and respiratory tract. Inside these mast cells, chemicals like ‘histamine’ are stored.

Now, the next time that allergen enters your body again, the mast cells bound with `IgE` become activated and release the stored histamine and other chemicals.

Histamine is what causes symptoms like sneezing, nasal congestion, and itchy eyes. These symptoms can appear within minutes. Other chemicals can also cause ongoing inflammation.

Sometimes, reactions can occur even without `IgE` involvement. For example, the body can react to volatile chemical substances like ‘Volatile Organic Compounds’ (VOCs) (e.g., paint fumes, perfumes). These are similar to `IgE` reactions, but they don’t involve `IgE` antibodies. Dust and smoke are examples of this.

What are the symptoms of environmental allergies?

Environmental allergies can cause the following symptoms:

• Nasal congestion or a heavy feeling in the nose
• Postnasal drip
• Coughing
• Dark circles around the eyes (‘allergic shiners’)
• Fatigue and tiredness
• Headache
• Hives or rashes
• Itchy and runny nose
• Redness, itching, and watery eyes (‘epiphora’)
• Sneezing
• Difficulty breathing or wheezing (a whistling sound from the chest)

Sometimes, these allergies can also trigger or worsen an asthma attack. Therefore, it is very important to pay attention to these symptoms.

What causes environmental allergies?

Many things in our surroundings can cause these allergies. The main ones are:

• Pollen: These are tiny dust-like particles from trees, grass, and weeds. They travel through the air to facilitate plant reproduction. Pollen levels are highest in the morning. Also, pollen counts are higher on warm, windy days.
• Molds: These are a type of small fungi. Their spores travel through the air. Molds grow in damp, poorly ventilated areas (e.g., bathrooms, under kitchen sinks, basements). They also grow in outdoor piles of leaves, grass, and hay. Mold spores are more prevalent on warm, wet days.
• Pet dander and saliva: This refers to the tiny flakes of skin (`dander`) that come off a dog’s or cat’s skin and fur. Certain proteins in their saliva can also cause allergies.
• Dust mites: These are microscopic creatures related to spiders that are almost invisible to the eye. They live in mattresses, pillows, bedsheets, carpets, and sofas. They feed on dead skin cells that shed from us and our pets. While they don’t bite, their waste, urine, and dead body parts can cause allergies when inhaled.
• Cockroaches: The waste, saliva, eggs, and dead body parts of these insects can cause allergies in some people.

In addition to these, things that cause non-IgE reactions include:

• Smoke: Any kind of smoke, such as cigarette smoke, vehicle exhaust, wood stove smoke, or incense smoke, can be harmful to some people.
• Dust: Household dust contains many things like dead skin cells, hair, pollen, fabric fibers, dust mites, insect parts, and soil.

Are environmental allergies contagious?

No. These allergies are not contagious from one person to another. You cannot pass your allergy to someone else.

How do you identify these allergies?

If you frequently experience these symptoms, the best thing to do is to see an Allergist (allergy specialist). They may ask you questions such as:

• Does anyone in your family have these types of allergies?
• Have you been diagnosed with allergies before?
• What are your symptoms?
• Do you take medication for these symptoms (e.g., over-the-counter pills)?
• When do these symptoms occur most often?
• Do you have pets at home?
• How often do you vacuum things like carpets? Do you wash your bedsheets?

After that, the doctor may perform certain tests.

What kind of tests are performed?

• Skin prick test: In this test, a small amount of various suspected ‘allergens’ is placed on the surface of your skin (arm or back), and then lightly scratched with a small needle. There is no blood drawn; it feels like a tiny prick. Within about 15 minutes, if you are allergic to something, the area will turn red and develop a small bump (wheal), similar to a mosquito bite. This is used to identify what you are allergic to. This can be done in less than an hour.
• Blood (IgE) test: In this test, a small amount of your blood is taken to the lab, where various ‘allergens’ are added to measure the `IgE` levels. It can take about a week to get results. Sometimes, there is a small chance of false-positive results, meaning it might indicate an allergy to something you aren’t actually allergic to.

How do you eliminate or control these allergies?

In reality, it is not possible to completely cure environmental allergies.</ However, you can manage and reduce the symptoms. This is primarily done using ‘antihistamine’ medications.

Are there side effects to antihistamines?

There are two types of antihistamines:

1. First-generation antihistamines: Examples: `Diphenhydramine (Benadryl®)`, `Clemastine (Dayhist®)`, `Hydroxyzine (Atarax®)`.

• These can cause drowsiness, dry mouth, dizziness, headache, cough, nausea, and vomiting.

2. Second-generation antihistamines: Examples: `Fexofenadine (Allegra®)`, `Cetirizine (Zyrtec®)`, `Loratadine (Claritin®)`.

• These have fewer side effects, especially less drowsiness. However, some people may experience skin rashes, itching, hives, or swelling of the face (`angioedema`).

Some studies have reported that medications like `Cetirizine` and `Hydroxyzine` may increase anxiety and depression in some users. However, more research is needed on this.

How soon will I feel relief after taking medication?

Generally, an antihistamine starts to work about 30 minutes after taking it. It works most effectively within the first few hours.

Sometimes, a doctor may advise you to take an antihistamine daily rather than waiting for symptoms to appear.

What should you do if you have environmental allergies?

Although they cannot be completely cured, you can manage symptoms effectively by avoiding allergens as much as possible and taking medication according to medical advice.</

How can you protect yourself from these allergies?

‘Fluticasone nasal spray (Flonase®)’ and similar nasal sprays are considered very effective for preventing moderate to severe allergy symptoms (congestion, runny nose, sinus pressure). These reduce inflammation in the nose. You may need to use these sprays daily. However, some people may experience nasal itching or nosebleeds. Since continuous use in people over 65 can increase eye pressure (`glaucoma`), it is best to consult a doctor before use.

For mild allergies, taking second-generation antihistamines daily can be a good option.

Additionally, these steps can help reduce allergy symptoms:

At Home:

• Keep windows closed and use air conditioning (AC) if possible. Opening windows allows pollen to enter the house. Do not place fans facing the window, as this can blow dust and pollen inside.
• Filter the air inside your home. You can place something like a thin cloth over vents to filter pollen. Using one with a ‘HEPA filter’ is also a good idea. Change filters regularly.
• Reduce humidity at home. Keeping humidity below 50% reduces mold growth and dust mite breeding.
• Avoid moldy areas. Such as basements, garages, and piles of leaves. Clean these areas frequently if possible.
• Bathe and clean pets regularly. Do not allow them on beds, sofas, or in bedrooms.
• Protect against dust mites. Use microfiber covers for pillows and mattresses. Wash bedsheets once a week in hot water (around 54°C). Avoid feather-filled pillows and furniture with lots of fabric. Leather or vinyl furniture is better as it is harder for dust mites to penetrate.
• Vacuum carpets and rugs frequently. At least twice a week. Wear a mask while cleaning. If possible, use tiles, wood, or linoleum instead of carpets. If you have rugs, vacuum and wash them regularly.
• Do not smoke indoors. Use cigarettes or incense outdoors.

Outdoors:

• Keep car windows closed while driving. Use the AC and set it to recirculate mode.
• Check the pollen count before going out. If possible, stay indoors on warm, dry, and windy days. Pollen levels are highest between 5:00 AM and 10:00 AM; try to limit outdoor activities during this time.
• Wear a mask. Wear a mask when gardening, raking leaves, or working with hay and fertilizer.
• Shower after coming indoors. Wash your hair and change your clothes to remove pollen from your body and clothing.
• Use a dryer for laundry. Avoid hanging clothes outside, as pollen and mold can cling to the fabric.

When should I see a doctor?

If you frequently experience allergy symptoms, especially if they interfere with your daily life, you should definitely see a doctor.

What questions should I ask the doctor?

• How can you confirm that I have environmental allergies?
• What exactly am I allergic to?
• What kind of allergy medications do you recommend?
• What are the full side effects of these medications?
• Should I take medication every day, or only when symptoms occur?
• Is it still safe for me to go outdoors?
• Are there certain plants in my garden or house that I should avoid?
• How can I distinguish between allergy symptoms and a cold or fever?

What is the difference between an environmental allergy and a food allergy?

An environmental allergy is when the immune system reacts to things in your surroundings.

A food allergy is when the immune system reacts to proteins found in certain foods. Common food allergies include milk, eggs, and peanuts.

Environmental allergies occur when your immune system mistakenly triggers a protective response to certain things in the environment. This response can cause various symptoms like nasal congestion, watery eyes, runny nose, and fatigue. If you experience these symptoms, consult a doctor. They can perform tests to identify your triggers and prescribe medication to manage the symptoms.

Summary (Take-Home Message)

Well then, I hope you now have a good understanding of Environmental Allergies. Remember, this is very common, so there is no need to feel embarrassed or afraid.

• The most important thing is to accurately identify your triggers. Seek medical advice for this.
• Try to stay as far away from allergens as possible. Keep your home clean and be careful when going outdoors.
• Use the medications prescribed by your doctor correctly.
• Do not ignore the symptoms. If they affect your life, seek treatment promptly.

By following these steps, you can lead a comfortable life even with environmental allergies. If you have more questions, do not hesitate to talk to a doctor.

Environmental Allergies, Allergy, Sneezing, Nasal Congestion, Itchy Skin, Pollen, Dust Mites, Antihistamine