LEXINGTON, Ky. (Nov. 7, 2016) — Many people think of allergies and asthma as two completely different diseases. In Kentucky, up to 4 percent of the population has nasal allergies, and 8 percent of the population has asthma. However, allergies are one common trigger for asthma, and often a common thread for the development of asthma. Certain allergens, such as cat dander, dust mite, and grass pollen, have been shown to be associated with the development of asthma in children. But the fall season can be harsh on asthmatics too.
During the fall, children are back in school, which means upper respiratory infections are on the rise; ragweed is pollinating; people are raking leaves and mulch; heating units are turned on; and mold spores from Alternaria will be rising.
The symptoms of a mold nasal allergy can be similar to pollen allergy symptoms; however, my clinical experience has suggested that mold allergic patients don’t sneeze or complain of runny or itchy nose, but are more often stuffy and have more sinus complaints. Additionally, mold spores can flare asthma.
Mold is a fungus that produces spores that travel through the air in dry, windy weather; some outdoor molds spread when the humidity is high. Outdoor molds can cause allergies symptoms spring, summer, and fall. Indoor molds cause year round symptoms and are often due to a water leak and high humidity.
In Kentucky during the fall, Alternaria is on the rise. The increase exposure to these mold spores are two fold; one due to an increase of spores in the air in the fall, and second from exposure to decaying vegetation which is often commonplace during fall activities.
Alternaria is a normal agent of decay and decomposition, and can be found in soil and plants. Alternaria is one specific mold that has been associated with fall asthma attacks, and has been associated with an approximate 200-fold increase in the risk of a life-threatening asthma attack. Seventy percent of patients demonstrating allergy to mold are found allergic to Alternaria, and allergy to Alternaria has also been found to be more common in patients with asthma than in those without asthma. Recent studies, have also found Alternaria in indoor environments, but fall activities such as hayrides, walking through pumpkin fields, and raking leaves can be risky activities for an asthmatic.
Helpful hints for managing your exposure to Alternaria include wearing a mask when raking leaves and working in the yard and avoid decaying vegetation. Also be sure to be consistent with your prescribed asthma and allergy medications, and carry your rescue inhaler in the event of symptoms. And, if you can’t resist that hayride, using a scarf to cover your nose and mouth may help prevent inhalation of mold spores. Use your rescue inhaler and immediately leave the environment if you become symptomatic. And if you have symptoms of asthma or allergies and are not controlled or have been diagnosed, ask your primary care physician for a referral to a board certified allergy specialist.
Dr. Beth Miller is division chief of Allergy and Immunology at the University of Kentucky and director of UK Allergy, Asthma and Sinus Clinics.
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