Environmental Allergies | Everything You Need to Know

Allergies are everywhere. 

When you are out jogging, it can be the dust on the road. 

When you are out mountain climbing, allergies can be in the trees and plants around you. 

Scared yet? 

If you have allergies, you actually have reason to be scared!

The risk for anaphylaxis is high in environmental allergies like venom allergy. In a study done, it was noted that between 1.6% and 5.1% of US citizens are estimated to have experienced anaphylaxis. (1)

Anaphylaxis is a life-threatening and severe allergic reaction that happens within seconds or minutes after exposure to an allergen. Common allergens that cause anaphylaxis are food (peanuts, shellfish, eggs), medicine (aspirin, antibiotics), or insect stings (bees and wasps stings). 

This is why it is important to know what your allergies are.

And there are a lot of ways to test and know what you are allergic to. 

How Do We Test for Allergies? 

Here is a quick list of how to get tested on what you are allergic to:

1. Allergy Skin Test or Patch Test

A skin or patch test is a very convenient way to know what your allergies are. They are non- invasive, meaning, no needle is injected and causes no pain. In our clinic, we use the AllergiEnd® Allergy Testing for patch testing and it can detect results in as fast as 20 minutes. 

It has the ability to test for more than 70 different allergies and has very little side effects, it is safe and easy to do. 

1. Allergy Skin Prick Test

Allergy skin prick test is done by pricking the skin and testing for allergies in the prick. It is done either in the back of the forearm. This is more invasive than patch testing.

What are Environmental Allergies? 

Environmental allergies are reactions by your body from something in the environment that is supposed to be harmless. It is different from food allergies because they are not ingested; rather they happen when your body reacts to something that you have come in contact with. 

This can either be from touching or inhaling these allergens.

What are the Symptoms of Environmental Allergies? 

Environmental allergies may often be mistaken as symptoms of cold because they are similar. 

These symptoms may be any of the following:

1. Sneezing
2. Shortness or difficulty in breathing
3. Headache
4. Wheezing
5. Runny nose
6. Fatigue
7. Itchiness of eyes, nose or face 
8. Watery eyes
9. Nasal congestion
10. Hive or skin redness and swelling

If you have asthma, its symptoms may be aggravated when you are exposed to these environmental allergens. 

What are the Common Environmental Allergens?

There are a lot! It can be as unassuming as being allergic to dust mites to pollens and even to animal dander and trees. Environmental allergens are also fairly common and most people live their life thinking they have a recurrent infection from the flu or think they have allergic rhinitis but never get tested for the specific allergens. 

Common environmental allergies are the following:

Pollen

Pollen allergy or hay fever is one of the most common causes of environmental allergies in the United States and about 7.8% of the population aged 18 years and above suffers from it. 

Hay fever affects the mucous membranes of the nose and eyes.

People who suffer from it often develop symptoms like itchy and watery eyes, nasal congestion, nasal discharge, itchiness of the roof of the mouth, and even the inner ears.

These symptoms are consistently seen in patients who also have allergies to the pollen of trees, grasses, and weeds. This is because when the allergen comes in contact with the immunoglobulin E (IgE) in the body’s tissues, these tissues release histamine or leukotrienes which causes the symptoms.   

Pollen allergy can happen commonly through inhalation but can also occur when a patient touches the allergen and it comes in contact with the skin or the mucous membrane. 

Pollen allergies can happen all year round but some may experience an increase in symptoms during spring when most trees or flowers are in bloom. 

Depending on your allergies, it may occur specifically in seasons where the pollen you are allergic to blooms like for those with allergies to ragweed, they may experience these symptoms during late spring or early fall. 

Common pollen allergies are:

1. Birch pollen allergy

Birch pollen allergy is very common since it can become airborne during spring. The wind can scatter tiny grains of pollen and can travel as much as 100 yards. 

1. Oak pollen allergy

Oak pollen allergy can also happen during spring but is a mild allergen compared to a birch pollen tree allergy. The problem with oak pollen is that it can stay for longer periods in the air thus can cause severe symptoms due to the prolonged exposure. 

1. Ragweed pollen allergy

Ragweed pollen is common during late spring and autumn. The wind can carry the pollen and can scatter up to a hundred miles causing symptoms to those who come in contact with it. 

1. Grass pollen allergy

Grass pollen is more common during the summer and can cause severe symptoms that are difficult to treat. 

Treatment of pollen allergy is often through taking medications like antihistamines or decongestants to manage the symptoms. Pollen is very difficult to avoid and most people find better benefits in immunotherapy. 

Allergy Immunotherapy is the process where little amounts of allergens are introduced to the body. This allows a person to develop a state of tolerance towards agents that cause the hypersensitivity reaction. (3) Immunotherapy is also called allergy desensitization or hyposensitization. 

Aside from allergy immunotherapy, you may improve your pollen allergy with these tips:

1. Remove clothes that you have worn outdoors to make sure that the pollen that has attached to it won’t continue to cause you symptoms. At the same time, you have shortened your exposure to it.
2. Dry your clothes in a tumble dryer rather than hanging them outside especially in the seasons where your pollen allergens may be present the most.
3. Avoid opening your car or windows. Use HEPA filters at home and air- conditioners. 
4. Wear a mask when working outside.

Pet Dander

A lot of people get brokenhearted because they have allergies to their cats or dogs.

Technically pet dander can occur in any animal that has a protein that causes an allergic reaction to humans. This protein can be in their dead skin (dander), saliva, and even urine. With the number of breeds of cats and dogs, you can develop allergies more to some breeds than the other. 

Patients who have asthma may have a more severe allergic reaction to pet dander. The problem with it is that the fur may spread on carpets, walls, furniture, and clothing which causes prolonged allergic reactions. 

You can have yourself checked with an allergic patch test to see if you have allergies to animal dander prior to buying a pet. This is important in children, especially when asthma exacerbations and allergic reactions can be fatal in their age group. 

Symptoms of pet dander allergy can range from being mild, which can be treated with an oral antihistamine to severe, which may require an emergency room visit. The symptoms are tricky since they may not appear right after exposure but after several days. 

Here are symptoms that may lead you to suspect a pet dander allergy: 

1. Itchiness of the nose and eyes
2. Nasal congestion or runny nose
3. Redness or swelling of the nasal area or the around the eyes 
4. Patches of red on the skin (face, neck and chest) with or without swelling. 
5. Itchiness of the throat and coughing
6. Shortness of breath 10 to 30 minutes after exposure to a pet
7. Rashes after a pet lick your skin
8. Severe asthma attack in a patient who is a known asthmatic

Treatment of pet dander allergy can be done by giving over- the- counter antihistamines like diphenhydramine (Benadryl), cetirizine (Rexall or Reactine), levocetirizine (Xyzal, Zyrtec), or loratadine (Claritin) if the symptoms are mild.

Nasal decongestants like Nasonex and Flonase may also be given to help with the nasal congestion. 

Immunotherapy is a long- term treatment that can provide not only symptom relief but desensitization from the allergen itself. 

To further decrease allergic symptoms bathing your pet weekly using a pet- friendly shampoo (by somebody who is not allergic) can help decrease pet dander. Remove carpets, blinds, curtains, or furniture that may accumulate their fur or keep your pet outside of your home or look for breeds of dogs and cats that are hypoallergenic. 

Molds or Fungi

Molds and fungi are often seen on days when there is an increase in humidity or dampness in the environment. 

The allergy in a mold is caused by the mold spore that can travel in the air and end up in your respiratory system. This causes allergic reactions and asthma exacerbations. 

Molds are a fungus that grows in areas of increased moisture, both indoors and outdoors. 

Indoor molds may be caused by a leak from a roof or a plumbing problem, moisture build-up, or damp areas beneath carpets or near curtains that are left unnoticed. 

Molds grow the whole year thus it is not seasonal but rather a constant annoyance to those who have this allergy.

Symptoms of mold allergy are like those of the flu. It can be any of the following:

1. Sneezing
2. Nasal congestion or runny nose
3. Coughing
4. Watery and itchy eyes
5. Difficulty of breathing and chest tightness especially in those with asthma

Children can be a target of mold allergy since they can get exposed to school buildings, daycare centers, or when they are outside in the playground.

It is important that if you have a family history of allergies, you have your children checked for any allergies through a patch test.

Patch testing is more ideal than allergic skin prick because it is not painful since no needles are involved, making it more ideal for children.

One dangerous complication of a mold allergy is hypersensitivity pneumonitis (HP) which can develop over time in patients with mold allergy. 

Hypersensitivity pneumonitis is classified as an interstitial lung disease characterized by a complex immunological reaction in the lung as a response to repetitive inhalation of an allergen. (4) 

Examples of hypersensitivity pneumonitis are those seen in farmer’s lung where fibrosis (scar tissue in the lung) occurs and causes damage to the point where people who have it have difficulty breathing even when doing simple tasks. 

Farmer’s lung is often seen in those working in livestock farming. 

HP is a combination of the different hypersensitivity reactions. Symptoms include fever, malaise, cough, and difficulty of breathing in a person with heavy exposure to the allergen.  

Dust Mites, Cockroaches 

Dust mites are one of the most common environmental allergens that people have. They are microscopic bugs that live in mattresses, furniture, and carpets. They love areas that are humid and can cause sneezing, coughing, difficulty breathing, and asthma exacerbations. 

Cockroaches are also a common trigger of allergies and asthma the whole year-round. Patients with asthma are at a greater risk of getting exacerbations from cockroaches. They love dark and damp areas like cabinets or closets. Cockroaches shedding, feces, and saliva are the components that trigger allergies.

Taking your antihistamines can be helpful but immunotherapy works best for dust mites. Cleaning areas regularly and switching to mite-proof mattresses and pillows can help decrease your allergy exacerbations.  

Conclusion 

There are still more environmental allergens around us and each person has a different allergen than the other. This is why getting tested for the specific allergens that you may have is of utmost importance.

Let’s recap the information we covered about environmental allergies:

Allergy patch testing is helpful not only for adults but for children as well. A lot of preparation and lifestyle modification is needed when somebody has allergies, more so, if these allergies are unknown. 

Aside from allergy patch testing, one important discovery is allergy immunotherapy. It is the only treatment known to target the reason behind an allergic response and not just manage the symptoms.

If you are interested in allergy patch testing or allergy immunotherapy, you may contact us here for more information.  

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References:

1. Wood R.A., Camargo C.A., Jr., Lieberman P., Sampson H.A., Schwartz L.B., Zitt M. Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol. 2014;133:461–467.
2. Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010. By Jeannine S. Schiller, M.P.H., Jacqueline W. Lucas, M.P.H., Brian W. Ward, PhD and Jennifer A. Peregory, M.P.H., Division of Health Interview Statistics.
3. Tanno, L. K., Calderon, M. A., Papadopoulos, N. G., Sanchez-Borges, M., Rosenwasser, L. J., Bousquet, J., Pawankar, R., Sisul, J. C., Cepeda, A. M., Li, J., Muraro, A., Fineman, S., Sublett, J. L., Katelaris, C. H., Chang, Y. S., Moon, H. B., Casale, T., Demoly, P., & Joint Allergy Academies (2016). Revisiting Desensitization and Allergen Immunotherapy Concepts for the International Classification of Diseases (ICD)-11. The journal of allergy and clinical immunology. In practice, 4(4), 643–649.
4. Chandra D, Cherian SV. Hypersensitivity Pneumonitis. [Updated 2020 Jul 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499918/