Tag Archives: asthma

Did you know people are finding mold in kids’ toys; sippy cups, teething toys and rubby duckies- scary, right?

Recent headlines in the news of parents discovering black mould after breaking apart the spout on the underside of the lid of their TommeeTippee cups is real! Who would of thought there would be recalls of GoGo Squeeze Applesauce due to mold growth or CapriSun would struggle with mould in its products. It certainly heralds an new era of consumers uncovering bio-hazards right in their home, potentially in kids mouths!

So how would you even know if you have mould in your kids toys?

While sometimes it’s obvious on the surface often the mould is lurking hidden inside the toy. An easy check is by squeezing bath toys – if you notice a stream of watery, black gunk come out of the little hole at the bottom, that’s all the evidence you need that there is mould!

For products with parts that you can’t see inside, such as sippy cup valves, or bath toys without holes that have developed small cracks through which water can enter, the only way to really tell is by breaking them apart.

While Mold is gross, one may argue, is it unsafe?

After all, the mother-of-all-scientific discoveries penicillin grew from mould. The good news is that mould, while never welcome, is generally not dangerous. Any mold inadvertently ingested, like if you accidentally give your child a piece of mouldy bread will be easily disposed of by the body through the digestive process.

However, the real danger is when a child is allergic to mould. That’s when the mould spores in the air can cause allergic reactions such as runny nose, blocked nose, sneezing, itchy eyes, cough and other uncomfortable allergic skin reactions.

Obviously many of these symptoms are common in the everyday-world-of-raising-kids; so it’s not surprising that air allergy symptoms are chronically misdiagnosed or become chronic.

(I mean, who would even have thought little Johnny’s asthma and constant runny nose think was the rubber duckies fault?!?)

How does Mould allergy affect health.

Firstly mould is a type of air borne allergen; the mould spores of indoor and outdoor moulds can cause allergic rhinitis, sinusitis, bronchitis as well as asthma for those allergic.

Air allergies are common; with 1 in 5 people suffering allergic rhinitis and 1 in 10 with asthma. And the bad news……allergies are rising globally so don’t be surprised if you hear a lot more about air allergies, chronic air-related diseases and strategies for improving indoor air quality in home and workplace.

Why, because your indoor air quality is 5 times more polluted with concentrated allergens than outdoor air. Exactly why my allergy team spends so much time counselling patients on the importance of increasing their attention to the indoor air quality of their home (and workplace); ventilation, humidity, sunlight, clutter, damp, air flow – often undervalued but elemental basics vital for healthy living.

⚠️ Time to get air focused

World Allergy Organisation dedicated 2016’s World Allergy Week to raising awareness about air allergies and the predicted rise of asthma and allergic rhinitis globally. This means that while 1 in 5 of us already have air allergies … this is expected to grow. Air pollution and climate change being part to blame.

Obviously, children with suspected chronic allergy symptoms should see a doctor for a specialist air allergy assessment. According to ASCIA, the gold standard method to diagnose a suspected mould, dust mite or pollen allergy is allergy skin prick testing. For those with chronic mould allergy symptoms, immunotherapy against the mould is the most curative option outside of medications to control symptoms but first line treatment is always to reduce your environmental exposure and this means a good clean up of your home environment and bath toys are now considered one of those hazardous spaces!

#QT (Quick Tips) on how to break the mould

While most of us reach for bleach to clean indoor mould, some more naturally effective solutions can do a great job!

#QT: A Classic Essential Home Mould spray alternative is to add 2 teaspoons of Tea tree oil in a spray bottle with 2 cups of water and shake before use. Or try ever-reliable vinegar. An 80% white fermented vinegar solution. Apply the mixture to area and leave for at least 20 minutes then lightly sponge with clean water.

If You find Mould in your Kids’ Products it’s not always easy to clean adequately so replacement is often the best solution. But if you want my best advice for mould prevention toy tips the best thing is to stop water getting into toys.

#QT: Try plugging bath toys with a dab of hot glue so that water can’t get trapped inside, the breeding ground for mold. Then you must keep them clean by periodically boiling them, try washing them in a Classic Bleach-Bath water mixture or just run them in the dishwasher. For a naturally effective solution try alternatively soaking them in an Essential Eucalyptus+Tea tree-Bath water mixture.

Mould loves humidity so ensuring toys are in a low humidity environment is the most important tip for reducing mould in the home and why it’s super important to keep toys bath dry after use by allowing the toys to thoroughly air dry after cleaning.

Or maybe just ditch the bath toys, altogether?

About the author

Dr Suzie is a General Practitioner and co-founder of Australian Allergy Centre and collective.care Allergy and ENT clinics at Bella Vista – Australia’s first GP-shared care model for specialist health care. 1300 344 325.

Many people do not recognise that hayfever, otherwise known as Allergic Rhinitis, is one of the most common chronic respiratory conditions in Australia with an estimated 3.2 million sufferers (AIHW 2010). It causes serious annoyance – the sneezing and itching and irritation is one thing but the chronic blocked nose, snoring + mouth breathing, fatigue and sinus infections is often under-reported!  Even your GP may not know yet about the evolving field of AIR allergy and it’s serious complications – especially to kids! Air allergy is a new field requiring a multidisciplinary approach between GP’s, ENT, allergy, sleep medicine, orthodontists and oromyofacial therapists.

But it is the serious chronic presentations of hayfever that really interfere with day to day living leading to poor sleep, poor concentration, poorer work performance and even time off school or work. Not to mention the orthodontic bills parents have to cope with when they finally recognize that hay fever was the original cause of their child’s blocked nose which led them to mouth breathe which led to the tongue thrust and now changes in the development of their palate, jaw and face (Page and Mahoney 2010).

In addition to reducing quality of life, hay fever is also linked with the development of asthma, especially for kids. Approximately 2 million Aussies suffer from asthma and an estimated 700, 000 will have both hayfever and asthma (AIHW 2010). In fact, there is very good evidence that patients with hayfever and asthma have asthma symptoms are more difficult to control compared with  patients with just asthma alone! (Van den Berfe et. al. 2002) and we also now know that treating hayfever will in fact reduce emergency department hospital presentations for asthmatics. Makes sense to treat, right!

So basically, allergy testing for hayfever and treating hayfever is so much more important than many people recognize.  Its certainly not something to be left to just chance or a last minute over the counter pick -up from the late night chemist. It requires air allergy testing and monitoring for the complications of air allergy and getting serious about treatment with a proper chronic disease management plan rather than a  just “take this spray and see how you go!”

Really effective new treatments are now available (and guess what,  not just DRUGS too!) which can effectively treat allergic rhinitis (as well as asthma). With more and more immunotherapy options available to desensitize against allergens like pollen and dust mite (even in tablet and drop formulations) and UV intranasal phototherapy (Rhinolight)  to assist with symptom control, there is more to offer than just anti- histamines and nasal sprays that you can get from a chemist. Mind you, evidence that treating allergic rhinitis particularly with intranasal corticosteroids, can reduce asthma related hospital visits (Walls R et al) is still a strong first line treatment.

rhinolight
Light therapy for the nose is offered by our Doctors for hay fever symptom control.

Putting up with hayfever is a serious no no! People should really start seeing that air allergy is growing (WAO, 2015) really fast, just as much as food allergy! While we are all getting educated about food allergies and how they can be life threatening, people shouldn’t under-estimate the life threatening effects of air allergy. Thunderstorm asthma kills!  Yes, Thunderstorm Asthma is real and likley to get worse (WAO, 2015) and the biggest risk factor for it is…..hayfever.

My best advice – if you want to get the mos tcurrent advice and not get the run-around, see GP’s who understand allergy, the serious complications of air allergy and can connect you with the right tream of specialists. Remember, breathing is life and we shouldn’t take breathing for granted.

 

Dr Suzan Bekir is a General practitioner with private practice in Double Bay and who works at Australian Allergy Centre and collective.care Allergy/ENT. Bella Vista, Wollongong, Edgecliff. Bulk Billing air allergy testing available. 1300 344 325 for appointments. 

 

Struggling with hay fever, asthma or allergic eye symptoms? You are not alone. 1 in 5 Australians suffer from allergies. Finally there is a new era of allergy treatments available for patients suffering from allergies.

One of these new treatments is a new house dust mite allergy tablet. This month, Actair was launched heralding a milestone in specific house-dust mite allergen immunotherapy. So if you thought you had to put up with runny nose, sneezing fits and blocked nose and sinus symptoms forever, you are wrong. New allergy treatments are starting to emerge to catch up with the global airborne allergy epidemic.

It is broadly accepted we are amidst a worldwide increase in the prevalence of allergic disease especially asthma and hay fever. Although the complications of the increase in respiratory allergies are increasing, there are treatments now available to help. Although the first line management of allergic disease includes educating the patient to avoid exposure to the allergen and pharmacological treatments such as nasal steroids for symptom relief, the only really curative treatment modality is allergen specific immunotherapy.

What many people don’t realise is that although immunotherapy might seem like a bigger investment in terms of initial outlay of costs compared with over the counter medications, they are investing in a more long term solution for their health. Over the counter relief treatments and “rescue” medications such as antihistamines or nasal sprays and rinses over an allergy lifetime can total up to be very expensive to patients, therefore it is shortsighted for patients not to consider the overall health and monetary value when considering immunotherapy.

Moreover, immunotherapy for pollens or dust mite has the capacity of changing the natural course of allergic disease for patients by preventing sensitizations with new allergens and development of asthma in patients with rhinitis. And that’s a fact. Studies show that Allergy immunotherapy for allergic rhinitis effectively prevents asthma and especially so for children. Yes, there is evidence we can prevent the allergic development of asthma! Longitudinal studies have confirmed that sensitization to HDM is one of the most important risk factors for the development of asthma in children.

Given the increase in HDM-induced allergic rhinitis and asthma, then more attention should be given to treatments such as immunotherapy which can be easily and safely administered.

Whilst allergy injections (subcutaneous immunotherapy) has long been used for allergy treatment, discomfort and adverse reactions have meant alternative routes have emerged. The alternative of under the tongue mucosal route of drops (sublingual immunotherapy) and now oral dispersible tablets has meant patients have a safer more convenient way to manage their allergies.

The under the tongue oral tablet allergy treatments to treat allergies first started with the emergence of pollen allergy tablets. There are multiple studies demonstrating patients with allergic rhinitis and or asthma improving using a standardized grass pollen tablet over the last few years and showing safety, tolerability and clinical efficacy.

Now, Actair, the new House Dust mite oral tablet immunotherapy has launched and preliminary studies are indicating that symptoms scores improve and stay improved even after one year after ceasing treatment. In a European study, individual symptom scores were markedly improved for sneezing, itching and nasal congestion by 22.2% reduced compared with placebo group (9.7%).

A significant symptom score improvement of 23% was demonstrated in the Rhinoconjunctivitis quality of life questionnaire after the first year compared to the placebo group. Results such as these are promising and although there are no long-term studies after one year or data for over 65 or under 5-year-olds available as yet for Actair, this is definitely a step in the right direction to providing patients with more choices for allergy treatment.

Fast Facts
– ACTAIR is a new house dust mite allergen extract tablet now available
– It is a form of allergen immunotherapy or desensitization treatment aiming to cure of dust mite allergy
– It’s an easy-to-use tablet – given daily under the tongue, which dissolves in two minutes and then can be swallowed
– Treats allergic rhinitis (hay fever) with or without conjunctivitis and allergic asthma that is triggered by house dust mites diagnosed by an allergy test
– ACTAIR contains a mixture of American (Dermatophagoides farinae) and European (Dermatophagoides pteronyssinus) house dust mite allergen extracts

The science of it
Actair works by re-educating the body’s immune system by actually targets the cause of allergy rather than just treating allergy symptoms with medications. It is a form of immunotherapy, which means desensitization. Allergen immunotherapy changes the way the immune system reacts to allergens, by switching off the allergy. The end result is that you become immune to the allergens, so that you can tolerate them with fewer or no symptoms.

Who can use Actair:
Adults and children can use the tablet over 12 who have been diagnosed with dust mite allergy.

How will it help my dust mite allergy?
Actair has been shown clinically to reduce the occurrence and severity of allergic symptoms such as runny nose, blocked nose, sneezing fits, itchiness of the nose, throat and eyes and asthma exacerbation.
Studies also show it reduces the use of rescue medications for flares and improves the quality of life.
For many patients whose HDM allergy this means an improvement in their snoring, mouth breathing and sleep.

How quickly does it work?
Works as quickly as 4 months.

How long does it last?
Unknown. At this stage there appears to be only one year follow-up data available.

How to buy it?
– Actair is TGA-registered in Australia
– It is Not PBS listed yet but available on PRIVATE SCRIPT from your doctor
– readily available in Australia at chemists and allergy clinics ( unlike many immunotherapy treatments which can take 8-12 weeks to be received upon ordering from overseas)
– Health fund rebates are available for private scripts but obviously, depends on your levels of cover.

How Do I start
If you have allergy symptoms we recommend an allergy assessment by an allergy trained doctor. Skin Prick testing is the gold standard method to diagnose dust mite allergy. Your Doctor will then recommend a treatment plan for your allergy. Actair is only one option available for management of dust mite allergy and your Doctor will assess your suitability for this medication or whether other treatments options are better for your health.

At Australian Allergy Centre our Doctors are allergy trained GP’s who require no referral and there is no wait for allergy assessment. We have Doctors available that bulk bill consultations and bulk bill skin prick testing for air allergies as well as other nose lab tests.

We offer education on avoidance measures, medical treatments, Rhinolight treatments and immunotherapy. For complex cases or those who require assessment with an ophthalmologist for eye symptoms or ENT for nose and sinus symptoms, our specialists assist with consultations. If you would like to make an appointment to see one of our Doctors you can call 1300 344 325 or book online.

references:
Bacharier LB, Boner A, Carlsen KH et al. Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy. 2008;63:5-34
Schmitt J1, Schwarz K2, Stadler E2, Wüstenberg EG3. Allergy immunotherapy for allergic rhinitis effectively prevents asthma: Results from a large retrospective cohort study. J Allergy Clin Immunol. 2015 Dec;136(6):1511-6. doi: 10.1016/j.jaci.2015.07.038. Epub 2015 Sep 12.
Host A, Halken S. The role of allergy in childhood asthma. Allergy 2000;55 (7):600-8
Maloney J, Bernstein DI, Nelson H et al. Efficacy and safety of grass sublingual immunotherapy tablet, MK-7243: a large randomized controlled trial. Ann Allergy Asthma Immunol 2014; 112 (2):146-53
Nerin N Bahceciler, et al. A milestone in house dust mite allergen immunotherapy: the new sublingual tablet S-524101 (actair) Expert review of vaccines. May 2016 At:16:46
Actair Product Information. Study 1: European multicenter, randomized controlled double-blind, placebo-controlled study conducted over 2 years with 509 patients with 300IR dose of Actair for 12 months and followed up subsequent treatment free year.

Recent research has revealed a strong link between the two, causing a recent change in the way doctors now treat them.

Hay fever now affects 3 million Australians. This means that 1 in 5 of us have to battle through spring and summer with runny noses, watery eyes, and the other symptoms of hay fever. On top of that, Asthma Australia reports 1 in 10 Australians now suffer from asthma, and around a third of these people report having asthma symptoms that interfere with their daily lives.

In Australia, hay fever and asthma are both on the rise. This isn’t really surprising as the same things can trigger both conditions; typically dust mite, pet allergens, pollen, and moulds. What also should come as no surprise is the fact that asthma and hay fever are often found in the same patients. In fact, the Australian Institute of Health and Welfare reports that around 80% of patients with asthma also have hay fever, and hay fever is one of the biggest risk factors for developing asthma.

Despite their similarities, the two conditions have often been treated as two separate conditions because one exists in the upper airway, and the other occurs in the lower airway however things are now changing and doctors are now referencing both airways to be part of a unified airway syndrome.

The upper airway consists of the nose, mouth, sinuses, and throat. The lower airway consists of the trachea, bronchial tubes, and lungs. And when they are functioning normally, they work together to form a kind of two-step air filter. When we have a cold, laryngitis, or hay fever, the symptoms show themselves in our upper airway. But when we have bronchitis or asthma, the symptoms show themselves in the lower airway.

Traditionally many consultations were focused on the lower airway because of the serious nature of bronchial and asthmatic problems, and during these consultations, not much attention was focused on the upper airway at all.

However, recent research suggests that making a distinction between the upper and lower airways doesn’t make sense, especially as the link between hay fever and asthma is now firmly established. The unified airway is a new way of thinking for doctors and now patients.

In fact, Doctors these days are now working with the understanding that asthma and hay fever are simply two manifestations of one unified airway and that a nose reacting to allergens will very often lead to inflammation in the lower airways too . Conversely, treating the nose will most likely affect lower airway inflammation. Asthma patients who treat their rhinitis can actually reduce their number of asthma-related hospital visits.

Dr. Tobias Pincock from collective.care’s allergy and ENT clinic says, ‘Recent medical research has highlighted the importance of looking at the upper and lower respiratory systems as one airway, and treating conditions like hay fever and asthma as two manifestations of the same problem, which they are in many cases.’

Treatment for upper and lower airway infections has traditionally been different because of the structural difference between the two. However, treatments like corticosteroids treat the underlying inflammation that occurs in both.

Allergen immunotherapy can also be effective in treating co-existing asthma and hay fever. Immunotherapy is a treatment carried out by a clinical immunologist or allergy specialist that reduces the severity of symptoms over time by introducing tiny portions of the allergen in the same way a vaccine is introduced to the body to prevent an illness. Over time, the body develops immunity, and allergy symptoms significantly reduce.

“Hay fever and asthma really reduce the quality of your life”says Dr Suzan Bekir, allergy/ENT GP from Australian Allergy Centre “It’s not until after our patients receive treatment that many patients really understand the impact these conditions were having on their daily lives”.


If you have concerns about your hay fever or asthma, contact us at our BULK BILL allergy clinic on 1300 322 345 or use our 1300 MYALLERGY or our online appointment system, and book in to see one of our GP’s who are trained in allergic rhinitis and asthma to assist with making sure you get the best available treatment.