Allergens preventing exposure

Health and safety measures should be introduced to prevent exposure of affected workers to airborne or contact allergens... 

The influence of environmental factors has been established, but remains controversial. The strategy of strict avoidance of exposure to bacteria, viruses, and allergens until sensitization diminishes belongs to the canons of prophylaxis and treatment of choice of atopic diseases. For years, elimination of allergens from the environment of potentially-affected patients was not undermined as the method for preventing allergy. According to medical instructions, children with an atopy in their case history should have stayed in virtually sterile conditions. 

Asthma is considered as a chronic inflammatory disorder of the airways. This inflammation causes recurrent episodes of symptoms, variable airflow limitation, and increased airway responsiveness. Prevention of asthma involves both the prevention of the initial development of asthma (= primary prevention) and the prevention of exacerbation in patients with asthma (= secondary prevention). Primary prevention methods include reducing exposure to indoor allergens, particularly domestic mites, avoidance of passive smoking, especially by infants, and avoidance of vehicle emission pollutants, largely from incomplete combustion of petrol by car engines. 

Prevention of bronchospasm Inhalation (nebulization) 20 mg within I hr before exercise or exposure to allergens, Aerosol Spray 2 sprays within I hr before exercise or exposure to allergens... 

Desensitization is used in the treatment of IgE-mediated disease. Increasing doses of an allergen are injected subcutaneously over a varying time span. The aim of the treatment is to decrease sensitivity to the allergen and prevent the clinical symptoms caused by exposure to the allergen. Following immunotherapy, there can be an... 

Sodium cromoglicate is known as a mast cell stabiliser. Its mode of action is not entirely understood but it is thought to act by stabilising mast cell membranes and preventing their degranulation. It counteracts both the early and late response to allergen exposure. 

In commenting on primary prevention studies, Bjdrksten [176(NC)] wrote that Efforts to prevent allergy by various avoidance regimens have at best had only marginal effects. This discouraging result may be due to the complexity and demands of the intervention which result in poor compliance or simply to the fact that allergen exposure and environmental pollution are not major risk factors to be addressed in primary prevention, although they are undoubtedly so in secondary prevention . 

Despite all that has been researched and written about allergen avoidance, the recent Cochrane Review found no significant clinical benefit on tertiary prevention of asthma and recommended larger and more rigorous trials with more careful monitoring of exposure and clinical outcomes [246(Ia)]. 

Unfortunately efforts aimed at prevention of allergic sensitisation through avoidance of allergen exposure have been largely imsuccessful, because they are very difficult to implement, and any beneficial effects are small and not sustained. 

Patients with asthma, rhinoconjunctivitis or eczema who are allergic to indoor allergens such as dust mites, cockroaches and animal danders should eliminate or reduce the exposure to improve symptom control and prevent exacerbations (A, B)... 

Early identification of susceptible individuals would allow them to be targeted at early age to prevent IgE sensitisation, and for avoidance of allergen exposure. Genetic screening in early life may become useful in preventing allergic disease. 

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