ALLERGY EPIDEMIC

Allergy, once the bane of a small, sniffling minority, is becoming epidemic in the United States. Up to 30% of adults and 40% of children suffer from allergic rhinitis, characterized by nasal congestion and itchy eyes commonly called hay fever.

Despite their ubiquity, allergies remain mysterious. Heredity plays a role, but genes cannot explain the sharp increase over the past 30 years, particularly in developed countries. “Allergy is on the rise, and it is not clear why,” sasy Ira Finegold, chief allergist at St. Luke’s-Roosevelt Hospital Center in New York.

Many culprits have been proposed, including pollution and changes in lifestyle. The most startling possibility is that allergy may be caused by the success of civilization. As modern life becomes more hygienic, the human immune system has run out of things to do. It attacks allergens, and the body itself, as if it were bored.

The problem is not just pollen, but a host of unrelated triggers, including nuts, nickel and latex. With people spending 90% of their time indoors, allergies to cats, molds, and dust mites have become a serious concern. Allergies to food and insect stings can be fatal, and allergies are the main trigger for asthma, which kill 5,000 people per year.

Many researchers are convinced that almost half the people in the developed world are now allergic to something. Allergy consistently appears in the top-10 list of reasons for visits to doctors. “Something in the Western style of living has given rise to more allergies,” says Donald Leung, head of the pediatric allergy division at National Jewish Medical and Research Center in Denver. Humans seem to have a talent not only for altering the environment, but for introducing themselves to new allergens. For the first part of the 20th century, horses were a major allergy trigger, and now cars are more common. Most adults work in a climate controlled office, and children play indoors more instead of riding bikes on the street. As a result, indoor allergens have become a plague.

Finding out what sets off a person’s allergies is not too difficult. An allergist can perform a skin-prick test, injecting tiny does of allergens into the patient’s back or forearm to see which raise itchy red welts. Blood tests are sometimes used as well to detect antibodies to allergens. It is determining what to do next that is difficult.

The primary weapon remains antihistamines. Allergy shots remain effective, but the shots sometimes set off dangerous allergic reactions. New medications in the pipeline include an “anti-IgE” drug, a monoclonal antibody designed to hobble immunoglobulin E, the human antibody that sets allergic reactions in motion. Anti-leukotriene drugs such as Accolate and Singulair, which combat inflammatory compounds produced by white blood cells, have proved useful for treating asthma since their introduction in 1996. New, safer vaccines are also in the works.

Scientists are intensely interested in finding out how to push the immune system in the right direction. The ultimate goal in allergy treatment may be to convince the body right from outset that allergens are not worthy of an immune response.

Among the different types of allergies are allergies to food. While they are rare, they can be deadly. Food allergy reactions can be so extreme that conventional allergy shots are too risky. For now, the only way to evade the risk is to avoid the food. The world is becoming more hospitable to people with food allergies, with manufacturers increasingly listing peanuts and other common allergens on food products.

Dust has become public enemy No. 1. There has been a barrage of products and advice for coping with it. If you need to take action against dust mites, the bedroom is the front line. The warm, moist conditions in beds provide the perfect microclimate for them to thrive, but there are simple ways to make the linens and mattress less hospitable.
Feather pillows used to be off-limits, but studies have proved just the opposite. These pillows have a tighter weave. Synthetic pillows actually emit more allergens and should be outfitted with good anti-allergen covers. You may also need to strip the room of carpets, which can rival beds as a dust-mite haven.

Throughout the house, frequent cleaning with a HEPA vacuum is recommended, although vacuuming a carpet removes only a small proportion of the allergens. Dehumidifiers also thwart dust mites, which can’t live in dry conditions. Whatever the source of dust, a HEPA or electrostatic filter on heating and air-conditioning systems will help capture some of it.


(Summarized from U.S. News & World Report, May 8, 2000 pp46-53. Article by Nancy Shite)