Asthma results generally from hyper responsiveness that is inherent in some people.
Asthma occurs as a variety of symptoms: wheezing, cough, chest tightness, shortness of breath and sputum production. It happens because whenever the body recognizes an antigen (a foreign body), it endeavors to remove it or at least minimize its effect on body’s cells through inflammation. It is an immune response that is exaggerated in some people and it causes allergic asthma.
There are 2 types of responses which human body may produce: a primary response and a secondary response. A primary response takes place on first exposure to an antigen or a foreign body. It is short lived starting after certain period of time and producing less mediators or chemicals but able to cause sensitization. A secondary response appears whenever the body is exposed again to the same antigen. It occurs readily, is more serious and produces more inflammatory mediators, which results in more signs and symptoms. These responses lead to changes in the organism which constitute the symptoms of asthma. Dust mites are very little spiders, seen with a microscope only. Dust mites can mainly be found in household dust, especially in the bedroom where they feed on the large portion of the skin flakes that are shed.
The growth of dust mites is enhanced in a warm and humid environment. The thousands of mites that inhabit just a pinch of dust leave up to 200 times their body weight in waste. This waste contains a protein that is an allergen for many people. Dust mites can not be completely eliminated It is also difficult to entirely wipe out them from household.
However, their effects may be minimized with an aggressive action. Some of the measures for these allergens involve keeping the humidity level at home below 50% for dust mites. When using dehumidifiers, they should be drained regularly to clean the condensation coils and bucket.
It is also relevant to wash bedding every week in water that is at least 130′ F to remove dust mites and the potential for other pathogens created by perspiration. Furthermore, using allergen-impermeable covers on the mattress and pillows can also be helpful, making sure to tape over zippers. It is also recommended to remove the bedspread at night. In addition to this, we should remove from our bedrooms all carpets.
Window coverings should be made of plastic or washable materials. Clothes should be placed in plastic bags in the closet. For cleaning or dusting a damp mop should be used. Dusting and vacuuming should only be performed by people who are not allergic to dust mite. Moreover, allergic people should stay away from the area until the stirred up dust can settle.
But if someone has no choice but to clean house himself, a filtering mask is recommended. There are special filters available for vacuums decreasing the amount of mite waste that can recirculate into the air.
For floor coverings in other areas of the house, low pile carpets are preferable, as they can be often steam cleaned. However, hardwood floors, tile or linoleum, are easier to clean. Area throw rugs can be easily washed also in hot water.
A first step to decrease the severity of asthma is minimizing the influence of identified environmental risk factors such as house dust mites, cats, and dogs. Although environmental control is quite hard, it should be an integral part of the overall management of allergen sensitized patients.
In a recent workshop of British thoracic society it was pointed out that there is an urgent necessity to develop appropriately powered, randomized, controlled research to examine the prospective benefits of low allergen domestic environments in people suffering from allergic disease.
Such research needs to address compliance, cost effectiveness, be of adequate length for example one year, and be adjusted to various socioeconomic groups and age. According to the 1995 revision of the British Thoracic Society asthma guidelines, support for house dust mite avoidance measures reflects a change to the 1993 guidelines, but further research studies methodology and duration of action of these measures is necessary.
If the benefits attributable to avoiding allergen were instead attributed to a new medication, that medication would be the subject of global experiments. Unfortunately, the perceived lack of commercial benefit discouraged large scale, population-based experiments.
Still, there is an urgent necessity to develop a large scale trial of the widespread applicability of mite allergen avoidance and the effect on the symptoms patient reveals, exacerbation rate, use of medicines, and overall health costs.
