Does Bedding Affect Allergies And Asthma?
Two different articles in a recent issue of The New England Journal of Medicine
(July 17, 2003) studied the evaluation of different kinds of bedding in preventing
various forms of allergies and asthma. People affected by allergies and asthma
are often advised to use impermeable mattress and pillow covers to reduce exposure
to dust-mites. These are the microscopic creatures that often live and proliferate
in mattresses and bedding, feeding off of shedding skin and hair particles.
Both studies showed that the use of these dust-mite-proof covers had no demonstrable
clinical benefit for patients with asthma or allergic rhinitis and the authors
concluded that the money spent on these covers is probably not worthwhile as
part of an allergy-avoidance strategy.
The authors of these two negative studies had hoped that they would be able
to show that these covers on patients' mattresses would provide significant
benefit for patients with rhinitis or asthma and both studies were well-conducted.
What is important about these studies is that they do not imply that allergen
avoidance doesn't work (or should not be recommended)for patients with asthma
who are allergic to dust mites. What their study shows is that recommending
allergen-proof covers to patients with asthma or allergic rhinitis in general
is unlikely to be effective as a single measure; for these patients a
comprehensive avoidance strategy is needed. The obvious conclusion from
these studies is that mattress covers are not worth the price. The more complete
conclusion, however, considering information from other studies combined with
this new information, is that the best treatment requires identifying what patients
are specifically allergic to whenever possible, providing additional avoidance
recommendations (beyond the use of just mattress and pillow covers), and allergy
Dust mites are not the only allergen that can affect allergies or lung function.
The home is an important source of nonspecific irritants as well as other allergens.
Cat allergens are an excellent example: they have been demonstrated to affect
asthma and allergy symptoms, and they can be measured in floor dust. There is
increasing evidence that children raised in a household with a cat are less
likely to become sensitized to cat allergen and that high levels of exposure
induce a form of tolerance.
What is clear from these studies is that the overall treatment of allergies
and asthma is fairly complex. We also know that the frequency of allergies
and asthma is increasing significantly, so we can assume that some sort of changes
in diet, lifestyle, cleanliness,or housing have contributed to this. Our challenge
is identify the responsible factors and to develop a comprehensive treatment
approach. While medications are extremely helpful in symptom management and
control, we need to do a better job identifying preventive factors.
Created: 9/12/2003  - Donnica Moore, M.D.