Airway, Breathing and Lung Conditions
Environmental Control Measures
Families of kids with allergies should use environmental control measures that reduce exposure to the child's allergy triggers. Some require few changes in the home, while others can be costly or fairly time-consuming.
Talk with your doctor or health care provider about starting with environmental control measures that will limit those allergens and irritants causing immediate problems. But know that allergies develop over time with continued exposure to allergens — dust mites might not be a trigger now, but with continued uncontrolled exposure, could become one. The doctor may suggest taking precautions now so your child doesn't develop new allergies.
These are suggested environmental control measures for different allergens and irritants:
Controlling dust mites
- Use only synthetic polyester-fill pillows and comforters (never feather or down). Encase pillows, mattresses, and box springs in zippered dust mite-proof covers (available at allergy-supply stores and many department and discount stores). Keep covers clean by vacuuming or wiping them down once a week.
- Wash sheets and blankets your child sleeps on once a week in very hot water (130ºF or higher) to kill dust mites. Young kids should never be left alone in a bathtub or near faucets when hot water heaters are set to this degree since serious burns can occur. Hot water heater temperature should be set at a safe level (discuss this with your doctor), and only when washing bedding should water temperature be turned up. A safe alternative is to set water temperature lower at home and wash the child's bedding at a laundromat where hot water is set to 130ºF.
- Avoid upholstered furniture, window mini-blinds, and carpeting in a child's bedroom and playroom as much as possible. They can collect dust and harbor dust mites (especially carpets).
- Use washable throw rugs on vinyl or hardwood floors, and wash rugs in hot water weekly.
- Use washable curtains and vinyl window shades that can be wiped down. Wash curtains in hot water weekly.
- Dust and vacuum weekly. If possible, use a vacuum cleaner with a HEPA (high-efficiency particulate) filter to collect and trap dust mites that become airborne during vacuuming.
- Reduce the number of dust-collecting houseplants, books, knickknacks, and non-washable stuffed animals in your home.
- Remove stuffed animals from your child's bed. Only a few washable stuffed animals should be allowed in your child's room, and these should be washed weekly. (Let your child pick which washable stuffed animals can stay.)
- Using central or room unit air filters such as HEPA filters or electrostatic filters alone has not been proven to reduce dust mite allergens, although they might be helpful when used along with other environmental control measures. When using such filters, the appropriate size should be used to filter the entire room. Ozone air purifiers or ionizers are not effective and inhaling the ozone they produce may be harmful.
- Avoid humidifiers when possible because moist air promotes dust mite infestation. Humidity in the air should stay below 50%. The amount of humidity in a room can be easily checked with a humidity gauge (hygrometer) that can be purchased in most hardware and home improvement stores.
Controlling pollens and molds
- Another reason to avoid humidifiers is that high levels of humidity promote mold growth. If you must use a humidifier, change the water every day and clean the inside 2-3 times a week to prevent mold growth.
- Ventilate bathrooms, basements, and other dark, moist places that commonly grow mold. Consider keeping a light on in closets and using a dehumidifier in basements to remove air moisture.
- Use air conditioning: it removes excess air moisture, filters out pollens from the outside, and provides air circulation throughout your home. Filters should be changed once a month.
- Avoid wallpaper and carpets in bathrooms, as mold can grow under them.
- Use a weak bleach solution consisting of 1 cup of bleach per gallon of water to kill mold in bathrooms and other areas.
- Keep windows and doors shut during pollen season.
- Do not smoke (or allow others to smoke) in the house — even when the child is not present (the smoke gets trapped in the upholstery and carpets).
- Do not burn wood fires in fireplaces or wood stoves.
- Avoid strong odors from paint, perfume, hair spray, disinfectants, chemical cleaners, air fresheners, and glues.
- Some kids develop symptoms or have increased symptoms during the holidays when exposed to live Christmas trees.
Controlling animal dander
- If a child is allergic to a pet, discuss with your doctor the advisability of finding a new home for the animal — especially if your child has symptoms not controlled by medication alone, needs a combination of medications for symptoms, or has symptoms even when receiving allergy injections.
- Parents should be aware that once a pet is removed from the home it may take several months before all the dander is totally gone.
- It may help to wash the animal at least once a week to remove excess dander and collected pollens, although high levels of dander can return within a few days.
- Never allow the pet into the allergic child's bedroom and keep the door closed at all times. Consider keeping the pet outdoors (weather permitting).
- If your child has asthma and you don't own a pet, don't get one. Even if not allergic to animals now, kids with asthma can become allergic with continued exposure.
- Some studies suggest that central or room unit HEPA filters may be more effective in removing airborne pet dander than in recovering dust mite allergens.
Cockroaches carry proteins that can trigger allergies and flare ups in many kids with asthma. To limit your child's exposure to cockroaches:
- Remove all food and water sources that can attract cockroaches.
- Use a suitable pesticide.
- Seal any cracks in walls and floors.
- When mold or pollen counts are high, kids should take their allergy medication before going outdoors. After playing outdoors, they should bathe and change clothes.
- Drive with the car windows shut and air conditioning on during mold and pollen seasons.
- Don't let a child mow the grass or rake leaves.
In some cases, the doctor may recommend allergy shots (immunotherapy) when control measures and medications are not effective. Ask your doctor about these options.
Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: May 2013
Originally reviewed by: Kathleen Trzcinski, MSN, CRNP