2020 paper with recommendations to pollen allergy (and asthma) sufferers

[runcyclexcski]

Just wanted to share this 2020 (relatively new) review I read today. It's on how outdoor pollen concentration correlates with indoor pollen and with allergy/athma symptoms. It sites numerous studies on how to provide patients with relief, other than with pharmaceuticals. Plenty of references, written in relatively non-technical language. Message me if you can't see the PDF.

karger.com/iaa/article-pdf/...

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Below are some of my observations (there is much more information in the paper). I am not a medical doctor, I am just a desperate allergic asthma suferrer and happen to be scientist by trade.

Turns out, even after the pollen season 'officially' ends, the pollen persists in the settled indoor dust for the whole year -- if one uses window opening to vent (which 99% of people do, except high-end hospitals and ICUs). This is even with weekly wiping of floors and surfaces. The antigen in the dust-derived pollen (the 'active ingredient' in the pollen) also remains active for the whole year. This explains why pollen allergy sufferers may not be feel a full relief during the off-season and start suspecting other sources (mold etc) -- "pollen must be over by now!"

Fabric-like surfaces (carpets, curtains, cotton clothing, uphostery) trap pollen much better than polyester and than surfaces that can be wiped (wood floors and linoleum). Cotton traps pollen most efficiently, even with washing. I found this out by myself by doing particle-counter measurements with different materials, and found that cotton was indeed the worst in terms of dust it produced. All of my bedding is now fleece and polyester, washed at 60C weekly. No carpets anywhere, obviously. Leather is quite good (or so they say), but my wife is vegan, that's a no go.

Hair-washing before going to bed -- I do this anyway.

Wearing masks when outdoors -- I do this anyway.

Not drying clothing outdoors -- duh!

Ventilation: I've been venting by opening windows early in the morning for 10-15 min (until CO2 drops below 600 ppm). However, venting in the morning, is not always a solution, b.c., according to research they cite, pollen counts were found to be high for some trees throughout the 24-hr period. I am now moving towards venting only through a HEPA/carbon filter, by forced ventilation, 24-7 (to pressurize the flat). I have mostly stopped venting by opening the windows during the pollen season (which lasts for 6 months for me). A split AC or a 2-hose AC is a must during hot humid summe days. Single-hose ones are no good: they suck in the outdoor air.

Indoor HEPA filters: the results were inconclusive, but in my case, I believe, filters work if set up right. In my experience, most people just place the filter in the room and consider the job done. I do not think this alone can help much, unless all other measures are taken (removal of allergen-trapping particles, removal of pets, no open windows, pressurized air, forced ventilation through another HEPA etc. Only semiconductor cleanrooms and the most desperate people like myself are ready to implement all of these measures to try and to control the particles in the air.

[Jamesd1234]

wow, this is pretty fascinating, thank you for posting. I have a pretty decent air purifier and wonder how well this works in the bedroom alongside hoovering with a hepa filter and cleaning. Fortunately, I have finally found some slight relief for the first time this year and even had a few full nights sleep recently, which is amazing considering multiple attacks every night since October last year when I had Covid . So I suspect that lower pollen count is helping , but I know things could change again…. As much as we try to make our home perfect, and I can see you have put in amazing work, it would be impossible to completely avoid pollen and exposure outdoors. So I really hope that we can get more available solutions , such as biologics or immunotherapy when the anti histamines and nasal sprays don’t work. I don’t know if there are dietary things we can do or take extra supplements and how important mental health is to help prevent stress and extra symptoms (which then cause more stress!). I am about to try spiriva and a mucolytic tablet whilst waiting for biologic approval . If these help , then I won’t know if it’s the medication or time of year , and then don’t want to get discharged from the biologic referral to then find the pollen makes things bad again early next year! We really need more support from the NHS severe allergic asthma ! Not to mention that my consultant tells me that you need to have a “perineal” allergy to get xolair. I am allergic to everything but pollen is a huge problem

[MMBJI]

Hi,

Thankyou very much for sharing all of this. We go to quite a lot of trouble at our house to minimise allergen transfer into the house and car. Hepa 13 vacuum cleaner - used daily, no carpets or curtains, minimal soft furnishings (faux leather sofa,) anti-allergen sprays and laundry additive, air purifier, washing machine by the back door so that on returning to the house clothing goes straight in the washer, shoes off at the door, most socialising is outdoors, bedding changed and washed hot weekly, every surface vacuumed upstairs weekly, avoid any indoor public space - especially now that dogs are everywhere, can’t use public transport etc. Although nothing like the lengths you go to!

It’s all a lot of work. All our special measures only help when we are at home in our “bubbles.” All very isolating too.

My husband has suggested that a giant hamster ball, with its own filtered air supply, could be the way to go, in order to protect oneself outside the house!

I have severe allergic asthma- lived experience points to cat/dog/feather/horse/dust/smoke/anything scented. Tests showed grass pollen as scoring the highest , but I think that just gives me itchy eyes and a sneezy nose. The other triggers go straight to my chest.

Very interesting that cotton materials trap so much - we have generally believed that natural materials were better for several reasons. I wonder how bamboo compares? Or hemp/nettle?

Rather makes a nonsense of line drying our 100% cotton bedding outdoors.

As a household we have been moving away from polyester/fleece due to micro-plastics- rather feel damned either way.

I wish we could know more about the processes within our bodies that cause our symptoms- I feel biologics could help me but I don’t quite qualify currently. It would be good if they were more freely available.

It is so very difficult to minimise/eliminate our triggers.

It would be good to have allergen free places and spaces for us to live and work and, dare I say it, relax or take holidays. That would be a huge undertaking and rather divisive.

All the best Runcyclexcski, I look forward to your next sharing.

[runcyclexcski in reply to MMBJI]

It's appaling that they won't qualify you for biologics, given what you are going through. I was on Xolair in the USA for many years, before moving to the UK, and a lung specialist has refused to put me on it based on my prior history, saying that I "did not mean her criteria". She did not specify what the criteria were. She probably did not want to do the papework, due to time pressures etc. After being on prednisolone for a year, multiple AE trips and a hospital, I paid for a private consultation, and got my Xolair in 2 months, the best 500 quid I've ever spent. He listed the criteria for me, they were trivial to meet (by memory, it's high EOS counts, more than N=5 (?) prednisolone courses per year (reciepts for prescriptions) and variable spiromtery results. Then the private consultant, who had a double affiliation with the NHS, moved me to the NHS for the Xolair prescription.

I think there must be autoimmune things going on in some patients, even after the allergen triggers are gone.

I doubt bamboo is different, the chemistry is mostly the same (cellulose fibers).

I haven't seen any evidence of microplastics causing immediate issues, and the life expectancy of humans keeps going up despite the microplastics :). At least they cannot be as bad as pollen allergies. Always need to pick the worst of two evils. I am sure I won't live to 80, with all the drugs I am on, but w/o them I would not have lived to 40.

I am the same way with public transport, especially with upholstered seats. If it's all plastic and metal around, I am fine. Again, the respirator is the key for me everywhere.

I also have a pollen+carbon filter in the car (which is literally a "bubble"), but it's not enough. I need to implement the same HEPA/carbon system in the car as I have in the flat, with proper sized cartridges etc. These do not exist for cars as standard and need to be DIYied. They do sell in-car HEPA filters, but these do not pressurize the interior and are merely expensive gimmicks, in my mind (IQAir Atom etc).

Yeah, I guess my "hamster wheel" is the respirator :). It's a 3M mask with two A2 carbon cartridges and two additional pleated HEPA filters. It takes an effort to breathe through it and I get tired after several hours, but powered respirators have their own issues (smell of rubber is one). Every time I go shopping in the respirator I hear some made-up hysterical coughing around, probably, from covid/vaccine deniers (I was wearing the respirator for almost 20 years now).

For me, the biologics completely resolved the running eyes, running nose and exsema, so I do not need a full suit :). But I would rather have the running eyes, running nose, and the exsema than the asthma.

[ChromoneLover in reply to runcyclexcski]

As a teenager, I longed for a space-helmet, with filters, to protect me from the grass pollen. I think a Zorb ball, fitted with HEPA filters, sounds like a good idea, for outdoor activities🤓😅

[runcyclexcski in reply to ChromoneLover]

I was considering to purchase a velomobile, seal it, and run a HEPA with a small battery. But respirators are much cheaper!

[Homely2 Administrator]

Thank you for this. I have had bad control of my asthma for 6 weeks now. So am thinking that I need to do more.

I have always been puzzled as to why my bedding still provokes my asthma, despite washing it at 60c, you have given me enough clues above.

So I am off to sort the bedding out.

My asthma is very cumulative, so if I can just lower the irritant total for a day by 10 percent or so, the inhalers may get control back.

[runcyclexcski in reply to Homely2]

I agree that these measures should only be implemented together with inhalers, pills, biologics etc. For most folks inhalers are enough, and they can go on living their normal lives. But medication alone is not enough for many folks on this forum, and avoidance is the only thing left to do. I do not believe in placebo like traditional medicines, vitamines, self-hyponosis (breathing exercises) etc.

[hilary39]

very interesting thank you for sharing!

[Patk1]

Thanx for this x