Asthma and indoor air quality
Catherine Sutton, mum to Edward, who has severe allergies and asthma, explains the recommendations of the recent Royal College of Paediatrics Report into Indoor Air Quality and Child Health and new NICE guidelines on Indoor Air Quality and their relevance to asthma prevention.
In January 2020 the Royal College of Paediatrics and Child Health published an evidence-based Report into Indoor Air Quality and Child Health. NICE has also published guidelines on Indoor Air Quality with accompanying NHS allergy prevention guidelines.
The RCPCH Working Party found that poor indoor air quality at home and in schools is linked to health effects in people of all ages. Health effects in children can include breathing problems, chest infections, low birth weight, pre-term birth, wheeze, allergies, eczema, skin problems, hyperactivity, inattention, difficulty sleeping and sore eyes. They established that improving indoor air quality helps to promote good respiratory health and can reduce the risk of respiratory infections.
The Working Party also found that air quality changes from building to building, place to place, over time, and in response to the activities taking place indoors. The main way people are exposed is by inhaling pollutants, but it can also be ingested or absorbed through the skin.
Common sources of indoor air pollutants include house dust mites, mould/fungi, pollen, pet hair and dander, formaldehyde, VOCs, tobacco smoke and smoke from heating, cooking and burning candles.
There were important recommendations about asthma contained in the RCPCH Report.
It was recommended that healthcare professionals and carers discuss an asthma sufferers’ home environment and actions that could be taken to improve indoor air quality.
For those suffering from asthma causing allergens such as house dust mite allergen, moulds, tree pollen, grass pollen, cat and dog dander, the most effective way to avoid poor indoor air quality is to avoid pollutants coming into the space. Taking steps to reduce exposure to inhaled allergens is recommended to reduce symptoms and exacerbations.
Depending on the allergy/trigger and the home environment, measures which can help include:
- Washing bedding and covers (at 60°C every two weeks) or using allergen-impermeable covers;
- Reducing dust and dampness in the home;
- Reducing items that can collect dust such as soft toys and, if possible, replacing carpets with hard flooring;
- Avoiding direct exposure to furry pets if the child is sensitised;
- Increasing ventilation during and after activities that produce pollutants or moisture especially when using cleaning or cosmetic products, cooking, bathing, and painting, decorating or buying new furniture.
- Avoiding using ventilation without filtration during periods when the air outside is polluted, for example keeping windows closed during rush hour and opening them at different times of the day.
Vacuum cleaning is one of the simplest methods to clear dust. However, vacuum cleaners can release and resuspend dust and allergens. It is important that the bag or dust collection chamber retains the dust efficiently and is replaced or emptied regularly. My personal experience is that one with a sealed/disposable bag and hepa filter is the most effective.
Additionally, the NICE Indoor Air Quality guidelines specified actions for healthcare professionals to give advice about indoor air quality to people with breathing or heart problems, those who were allergic to dust mites and pregnant women and babies under 12 months as well as actions for local authorities, architects, designers, builders and developers.
The Indoor Air Quality Working Party are a group of indoor air quality and health experts working together to advance public understanding, equality of access and experience of healthier indoor air for children and other vulnerable groups within the wider population. Further information and resources following on from the RCPCH report will be published at www.theinsidestory.health
Catherine Sutton is a director of Airborne Allergy Action, a community interest company set up to raise awareness of the benefits of inhaled allergen and other pollutant avoidance for asthma and other allergic illness alongside prescribed medication. The Airborne Allergy Action Facebook Support group is at https://www.facebook.com/groups/329891854479577, we are on Twitter @AirborneAllergy and our website is at www.airborneallergyaction.org