AAHHH-CHOOO: Summer allergens hit area
Sneezing, coughing, watery eyes, stuffy nose, headache, fatigue – is it allergies?
Since farm and ranch environments are loaded with allergy triggers, the answer could be, “Yes.”
Dr. Chris Cleveland, Sanford Health Allergy/Immunology physician, Fargo, North Dakota, says environmental allergies tend to be worst in fall during harvest season. However, a wide variety of spring and summer pollens also spawn a multitude of symptoms.
“Everyone’s allergen response is different,” Cleveland says. “Environmental allergies are seldom life threatening, but allergic reactions might be managed with inexpensive over-the-counter medicines.”
Before you reach for drugs to manage symptoms, take time to investigate what might be causing your reaction to outdoor allergens. Pollen from grasses, trees and weeds are typical allergens. Offenders in the grass family could include Bermuda grass, Johnson grass, Kentucky Bluegrass, Orchard grass, Redtop grass, Rye grass and Timothy grass.
Weeds frequently spark allergic reactions, including Amaranth, Cockleburs, dandelions, hemp, kochia, lambsquarters, nettle, Russian thistle, sagebrush and wormwood. Offending trees often include Ash, Aspen, Beech, Birch, Box Elder (and other Maples), Cedar, Cottonwood and Elm.
Many allergy triggers, such as Timothy grass, are common to a wide number of people. However, doctors use scratch tests to assess specific allergies for patients since no two patients have the same kind of reaction to allergens.
“In a scratch test, we use a white plastic toothpick to apply a panel of about 46 different allergens on a patient’s back,” Cleveland says. “If the patient reacts to the allergen, red welts appear where the allergen was applied. Reactions are analyzed and a treatment plan is developed.”
Treatment plans are likely to include options for avoiding allergens whenever possible. For example, daily pollen counts tend to be highest between 5 a.m. and 10 a.m. On windy days pollen may cause added allergy issues because pollen is more likely to be in the air. Dry spore type molds release spore during dry, windy weather.
Spring and summer rains can help wash pollen out of the air, giving allergy sufferers some relief. However, frequent spring rains can trigger increased grass growth and pollen generation. Fall rains can lead to increased tree pollen levels. Staying indoors as much as possible during those types of weather events should help reduce symptoms.
While precautions can be taken to minimize outdoor allergen exposure to some degree, avoiding common allergens such as mold is virtually impossible.
“Pollens and molds can travel for hundreds of miles,” Cleveland says. “The only way to completely escape them would be to live in a biohazard suit. If you’re exposed to an allergen that causes particularly severe reactions, you can wear a mask to reduce allergen inhalation. That’s especially true during harvest for those working with harvested and augered grains.”
Describing what happens in an allergic reaction gets a bit complicated. Immunoglobulin E (IgE) is a type of antibody naturally present in minute amounts in the human body. IgE plays a major role in allergic diseases. IgE binds to allergens, triggering release of mast cell substances that can cause inflammation. When that happens, a cascade of allergic reaction can begin.
“IgE was used in caveman times to fight infection,” Cleveland says. “Some people are genetically predisposed to have a higher amount of IgE, which can make allergic reactions even worse.”
Some allergens are just 0.5 microns (0.000197 inches) in size, 200 times smaller than a human strand of hair. When allergens enter the body, natural antibodies can overreact to them, producing huge numbers of antibodies to repel them. The physical reaction to the immune reaction is itching eyes, a running nose, sneezing and coughing.
The microscopic dust that can trigger an allergy response is found in every crack of crevice of the average home. In just a single gram of house dust, some 100,000 mold spores can be found.
Dr. Cleveland recommends that allergy sufferers select over-the-counter medications to see if symptoms can successfully be managed that way before seeking a prescribed drug.
“Name brands such as Zyrtec and Claritin (are often effective). Nasal sprays like Flonase and NasaCort are also available without prescription,” Dr. Cleveland says. “If you try those treatments and they don’t seem to be effective, it may be time to consult a physician.”
Of six OTC oral antihistamine drugs evaluated by Consumer Reports, “all work equally well at relieving allergy symptoms, with none being clearly better or safer than the others. They differ in how much they cost – ranging from $11 to more than $200.”
The oral antihistamines rated included Zyrtec, Clarinex, Allegra, Xyzal, and Claritin/Alavert. Nasals sprays included in the study were Astelin/Astepro and Patanase.
Using nasal washes (saline) and nasal rinses may help thin mucus enough that nasal decongestants aren’t required. The most basic nasal wash equipment includes a bulb syringe, squeeze bottle or Neti Pot.
Pharmacists are good sources of information regarding which approaches may be most effective for individual symptoms.
OTC antihistamines are most effective when taken before an allergic reaction occurs.
Antihistamines that can cause drowsiness include Benadryl, Chlor-Trimeton, and Tavist. Newer antihistamines like Allegra, Clarinex and Zyrtec have fewer side effects and may be a better choice for some allergy sufferers.
Decongestants, in the form of pills or nasal sprays, reduce fluid in the nose lining, relieving swollen nasal passages and congestion. If a medication combines both antihistamines and decongestants the medication name will usually end with “-D.”
Decongestants are usually taken during the day because they can keep you awake at night. If decongestants are taken more than three consecutive days, users may experience congestion once they stop. Decongestants also increase blood pressure and anyone with those health issues should consult a physician prior to using them. Some decongestant-free medications – such as Coricidin HBP – are available for those with high blood pressure. It’s recommended that you consult a physician or pharmacist for recommendations.
Environmental allergies are seldom life threatening, however if symptoms cause difficult breathing, chest tightness, whistling sounds with breathing or swelling of face, eyelids or lips, a trip to the emergency room may be in order.
“If you start to look like a cartoon character because of an allergic reaction, it’s time to go to the ER,” Clevleand says.
In cases where allergic reactions are severe, patients may opt to go through a series of weekly desensitizing allergy (immunotherapy) shots. Since the treatment requires weekly doctor visits and can take as much as 8 years to complete, most people don’t complete desensitization.
Sometimes physicians administer cortisone-like injections (a long-acting glucocorticoid) such as Depomedrol to help treat allergies. These injections can cause side effects such as swelling, anxiety, insomnia, mania and depression.
Common air filter types include mechanical filters, electronic filters, hybrid filters, gas phase filters and ozone generators, all of which may help reduce allergens in the air. High-efficiency particulate air (HEPA) filters are the most widely known type and have been used since World War II. True HEPA filters must be able to capture at least 90% of all particles that enter it and are 0.3 microns or larger in diameter. Carefully read filter specifications to ensure they meet this standard.
Electronic filters use electric charges to attract and deposit allergens and irritants. Hybrid filters contain elements of both mechanical and electrostatic filters. Gas phase filters remove odors and non-particulate pollution such as cooking gas, gasses emitted from painting or building materials and perfume. They don’t remove allergens.
Ozone generators produce ozone which manufacturers claim cleans the air. Currently, the generators are not recommended by either the Environmental Protection Agency (EPA) or American Lung Association.
Allergic reactions can begin at any age. Cleveland frequently sees people who return to an area where they grew up and experience allergic reactions to environmental elements. Actively avoiding things that stimulate allergic reactions helps, but allergies can either dissipate with time or grow worse.
In addition to over-the-counter and prescription drugs, allergy sufferers may find relief with some emerging natural remedies. According to WebMD’s R. Morgan Griffin, natural supplements have been shown to have some effect in blocking allergy related chemical reactions in the body.
Some common natural supplements tested and recommended for treatment of allergies include Butterburr, Quercetin, and Stinging Nettle. As of yet, there are no definitive studies regarding the effectiveness of the supplements. Caution is advised in self-treatment with any natural supplement.
Fall allergy triggers are different than those of spring and summer, but symptoms can be just as severe.
Ragweed is the biggest fall allergy trigger. When August nights begin to cool, Ragweed usually starts releasing pollen. The weed’s pollen can be in the air into September and October. Some 75 percent of people allergic to spring plants are also allergic to Ragweed.
Even if Ragweed doesn’t grow in your area, the pollen can travel for hundreds of miles on wind currents. During Ragweed season, those allergic might consider avoiding foods like bananas, melon and zucchini as those are among the foods that can “cross-react” and further aggravate allergy responses.
Mold is another major fall trigger. Spores grow in basements and bathrooms but are also common in outside spots where moisture lingers. Piles of damp leaves provide an ideal breeding environment for mold in fall.
Dust mites usually become airborne the first few times furnaces come on in fall. Since dust mites are also common in school buildings, kids may exhibit fall allergy symptoms, too.
Grain dusts and molds are a big fall concern. Exposure to grain dust can occur in the combine, unloading, during drying and processing, in bins or areas around bins and while grinding/mixing grains with other feed products.
The University of Wisconsin Extension describes grain dust as “a complex soup that is made up of both organic and inorganic particles. Some of these can be easily inhaled and, depending on their size, can find their way deep into various parts of the respiratory system causing a range of adverse health effects.”
Significant health issues can result from grain dust exposure. Serious symptoms can include chest tightness or wheezing, sore/irritated throat, nasal and eye irritation and ongoing sense of nasal congestion. Chronic and/or acute bronchitis may also occur.
Massive exposure to grain dust should be avoided as much as possible to avoid development of health issues such as Farmer’s Lung and Organic Dust Toxic Syndrome. Repeated exposure to grain dust can cause the allergic response to intensify each time.
Precautionary measures to reduce grain dust exposure include using appropriate and clean fair filters in combines, avoiding direct dust exposure as much as possible, properly adjusting combines to reduce grain damage (which minimizes the amount of dust generated), and wearing a NIOSH-approved and certified N-95 dust mask. Make sure it fits properly.
Anyone with chronic respiratory health issues should avoid all dust exposure. If, after grain dust exposure, you become ill, consult a health care provider to confirm that no serious health problems have developed. Since smoking tends to intensify responses to dust exposure, not smoking is recommended.
Additional details about grain dust exposure are available at http://fyi.uwex.edu/agsafety/confined-spaces/grain-storage-and-handling/human-health-concerns-from-grain-dusts-and-molds-during-harvest/.
“One of the misconceptions people may have about allergies is that (everyday) dusty environments, smoke or heavy odors could stimulate an allergic response,” Cleveland says. “However, in those cases the dust and odors are likely just irritating nasal passages. You can’t be allergic to things that aren’t made of protein, so dust or smoke may cause sensations of nasal irritation but they’re not allergens.”
Knowing your allergy triggers is an important step in managing allergic reactions. The only sure way to know is to consult a physician about completing allergy testing. “Every year we talk about having the worst allergy season ever, but in fact that statement is true,” Cleveland says. “We’re identifying more allergens all the time and as our global temperatures climb, pollen counts from trees, weeds and grasses are increasing, too. Over-the-counter treatment is inexpensive and can be a simple and effective way to treat allergy symptoms. If that doesn’t work it’s time to see an allergist.”
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