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HOUSE DUST MITES

If children are exposed to house dust mite while they are babies or very young, this may contribute to the development of asthma. It is worthwhile making an effort to control house dust mite while your children are young, especially if there are people in the family who are prone to allergies. (Not all people with asthma are sensitive to house dust mite. Talk to your doctor).

WHAT ARE HOUSE DUST MITES?

House dust mites are very tiny creatures about one third of a millimetre long. They live in their thousands in warm moist places and they feed on the dead skin scales that come from everyone's skin. It is the house dust mites' faecal matter (droppings) which can give a strong allergic response. These droppings are found in dust in all parts of the house. All houses have house dust mites. It is not a sign of being dirty.

House dust mites are less likely to do well in dry conditions. They are much more common around the coastal areas of Australia and are scarce in drier inland places.

House dust mites are mostly found in bedclothes and bedding and mattresses and carpets. Only a small proportion get into the air and cause problems.

WHAT PARENTS CAN DO

It is important to try to reduce the house dust mite in bedrooms and carpets as one way of preventing asthma attacks.

REDUCING ASTHMA TRIGGERS IN YOUR HOME

Many triggers for asthma and allergy are found in and around the home - including dust mites, pet hair, fumes, mould and so on. While these cannot be eliminated entirely there are things you can do to make your home safer if you have someone in the family who suffers from allergies or asthma.

Here are some things that will help.

• Good ventilation and natural light help.
• Use heating that can be controlled by a thermostat (eg panel heaters) and without fans, which can stir up dust.
• Use evaporative or humidified air conditioners.
• Fit large windows with shutters or internal blinds (curtains hold a lot of dust).
• Have as few horizontal surfaces (eg shelves) as possible to reduce dust.
• Use exhaust fans in bathrooms and cooking areas to reduce humidity and growth of mould.
• Use electricity for cooking to avoid fumes.
• Low irritant paints and varnishes may be helpful.
• Tiles or wooden floors may be better than carpet - which can hold a lot of dust.

BEDROOMS

• Keep bedrooms well aired and well lit with natural light if possible.
• Use protectors for mattress, doona and pillows (made from "dust mite impermeable" material). Clean the covers regularly following the directions on the cover.
• Wash bedding eg sheets, pillow cases and blankets in hot (more than 55C) soapy water at least every two weeks and quilts every six weeks. Cold water does not kill the dust mite. Eucalyptus oil added to the wash is helpful. If possible dry in the sun. The hot cycle on clothes driers will also kill mites.
• Cotton blankets may wash better than wool.
• Vacuum the mattress and upholstered furniture weekly. Vacuuming more often does not seem to help. Use an efficient vacuum cleaner, preferably one with a good dust filter.
• Put fluffy toys in the freezer once a week for 24 hours (high and low temperatures kill dust mites).
• Try not to store things under the beds or on top of the wardrobes.
• A shower before going to bed may help.
• If the child is allergic to a pet, make sure that the pet is not allowed into the child's bedroom.
• Cleaning the air using a high efficiency air cleaner and a vacuum cleaner that has special filters can lower the amount of allergens from pets, plants and other sources in the air. This may be helpful for some children. But talk to your doctor before spending a lot of money on air cleaners or special vacuum cleaners, because they are not always helpful.

Note: Even doing all of this may only reduce dust mite levels slightly.

CARPETS AND FURNITURE

• Vinyl or hard floor coverings are better than carpets if anyone is sensitive to dust mite, especially in rooms used a lot by children. They are much easier to clean.
• Wooden, vinyl or leather furniture is better than soft covered furniture. If you have soft covered furniture, vacuum it once a week.
• Sheepskin products are best avoided but if you do use them wash them in hot water (over 55C) or place them in the deep freeze for 24 hours each month.
• Choose window coverings that are easily cleaned.
• When buying a new vacuum cleaner make sure that it has an adequate triple stage dust filtering system.
• Try not to vacuum with any child or person who has a tendency to allergy in the room. Allow the dust to settle for half an hour before going into the room.
• Vacuum with doors and windows open.
• Dry cleaning kills the mites but has little effect on the faecal matter which causes the allergy problems. Also fumes from dry cleaners can trigger asthma.
• Chemicals have limited effect and may be dangerous to children. They kill the dust mite but do not remove the droppings.

PETS

If your child is sensitive to animals or birds the following suggestions may help.

• The best pets for an allergic child are ones that don't shed hair such as turtles, hermit crabs, fish or reptiles.
• Avoid close contact.
• Keep dogs, cats and other 'furry' pets out of bedrooms, preferably out of the house.
• Make sure that pets are kept outside if they are moulting or being brushed, to prevent shedding hairs.
• Make sure that the pet's litter box is cleaned out regularly.
• Wash your cat or dog weekly. If frequent washing causes dry skin, see your vet.
• If your pet comes into the house, have a washable sheet for it to sit on. This should be changed every day.

MOULDS

Mould spores can trigger allergic reactions such as asthma. To help prevent this:

• keep the house well aired
• keep airconditioners clean
• indoor plants may need to be removed
• avoid disturbing rotting vegetation such as mulch and compost, especially in hot, humid weather.

POLLENS

It is difficult to avoid pollens but you could try the following:

• find out about grasses and trees in your area which have wind-borne pollens and avoid them
• keep windows closed on windy spring days and try to keep an allergic child indoors on those days
• keep children inside while the lawn is being mowed
• grow native plants which are pollinated by bees.

FOODS

Foods can trigger asthma attacks in some people either from food allergy or chemical intolerance. These reactions can be very serious but can be avoided by medical testing to discover what foods to avoid. Foods which have been shown to cause allergic reactions in some people include nuts (especially peanuts), fish, shellfish, milk, egg and various seeds. Cow's milk allergy can cause stomach upsets but is unlikely to be the cause of asthma. If cow's milk is causing a problem for your child you may need advice from a paediatric (child) specialist. Do not remove any food permanently from your diet without consulting your doctor or a dietitian. Diets for the treatment of asthma are only necessary where medical tests have shown specific food allergies.

FOOD ADDITIVES

Only metabisulphite and sulphur dioxide (220-228) have been shown as frequent causes of asthma. They are found in many foods including most 'fast foods'. MSG is not a common trigger for asthma attacks, although it can be a cause of severe attacks.

REMINDERS

• If children have chronic or severe asthma they need to have skin tests and medical advice. Reducing dust mites is difficult and the above methods may not be successful in reducing them enough to help children with asthma.
• Keep carpets out of bedrooms.
• Wet mop rather than vacuum hard floors.
• Keep your house and car smoke-free.
• If in doubt seek medical advice.

RECENT RESEARCH

The numbers of children who develop asthma have been increasing for the last few decades in developed countries, but in developing countries there has not been this same increase.  It is thought that this is likely to have some relationship to the environment that children live in. One theory being investigated is that in developed countries children are mostly in a 'clean' environment and they do not now get so many infections, especially gut infections caused by viruses, in their early years.  It is possible that getting gut infections in the early months of life acts on the immune system so that later in life viral infections are controlled by the immune system without triggering asthma.  Not enough is known about this yet to plan any changes in the ways that children live.