Managing Exposure

The following is a list of things you can do to limit your child's exposure to common triggers of asthma:

• ­Dust mites  
  The allergy is caused by tiny insect-like creatures called dust mites. Dust mites are found in mattresses, carpets and upholstered furniture. They thrive in warm, humid conditions and feed on dead skin cells shed from humans. The best way to prevent allergy symptoms caused by dust mites is to limit your child's exposure. Be sure to pay special attention to the bedroom where your child spends the most amount of his time.

• ­Beds  
  Every bed in your house should have wooden or metal frames. Do not allow your child to sleep on a couch, sofa or hide-a-bed. If your child has asthma and sleeps in a bunk bed, he should sleep in the top bunk. Mattress/box spring
  Place all mattresses and box springs in a zippered, dust-proof cover and tape over the zippers with electrical or duct tape.

• ­Pillows  
  Encase pillows in zippered, dust-proof covers. Pillows should be made of dacron or other synthetic fiber. Do not use foam, feather or down pillows.

• ­Bedding  
  Avoid wool or down blankets. Wash all bedding (sheets, pillowcases, blankets) in hot water. Cold water will not kill the dust mites. Dry all clothes and bedding in the dryer to avoid pollen sticking to them when on a clothesline.

• ­Floor coverings  
  If possible, remove wall-to-wall carpeting. If not, vacuum the carpet frequently (at least twice a week). If your child has asthma, only vacuum when your child is away and will not return to the room for several hours after you have finished. Substitute multi-layered vacuum bags for regular single layer bags. Small, washable cotton rugs may be used if washed often. Wood, tile or vinyl flooring without a rug is best, and it should be mopped at least weekly.

• ­Closets  
  Remove all stored toys, boxes and other articles from closets. The closet should contain only clothing and should be as dust-free as the room. Keep all clothes in closets, never lying around the room.

• ­Furnace (heating)  
  Electric or gas heat is recommended. Do not use wood stoves or kerosene heaters. Change the air filters on the furnace every month. Cover all furnace outlets in the room with special filters, or cover the outlets with ten thicknesses of cheesecloth or muslin. This will catch dust in the furnace air. Change the cheesecloth when it gets dusty underneath (about every two weeks).

• ­Air purifier  
  A HEPA filter unit of the proper size can effectively remove airborne allergens.

• ­Air conditioners  
  Window unit or central air conditioning is ideal. Change or clean all filters every month. Windows should be kept closed, especially in the summer.

• ­Doors  
  Keep bedroom closet doors and bedroom doors closed as much as possible.

• ­Walls  
  Paint walls or use washable wallpaper. Avoid pennants, pictures, wreaths, flower arrangements or other dust-catching decorations on the walls.

• ­Window coverings  
  Avoid heavy curtains and Venetian blinds. Use window shades instead. If curtains are used, they should be washed monthly in hot water.

• ­Humidifier 
  Avoid the use of humidifiers. Dust mites grow best in high humidity. Use a dehumidifier to keep humidity in the home less than 50 percent.

• ­Furniture  
  Remove all upholstered (stuffed) furniture and replace upholstered furniture with wooden or plastic furniture. Avoid open bookshelves, as they catch dust easily.

• ­Sleeping and napping  
  Your child should nap or sleep only in his bed, which has been made dust free. When your child travels or visits, he should take a nonallergic pillow with him.

• ­Playing  
  Children with asthma should not jump on furniture or beds or wrestle on carpeted floors. Avoid fabric toys or stuffed animals. However, if your child has stuffed animals, the toys should be machine washable and washed in hot water or placed in the freezer overnight at least weekly. Store toys in a closed toy chest.

• Pollens  
  In many areas, pollens can be a problem from February through November each year. If your child is allergic to pollen, during pollen season it is important that you keep all car/house windows closed and use the air conditioning.

• Animal dander  
  Pets that have fur or feathers often cause allergy troubles. If your child is allergic to animal dander (the skin of the animal), it is best not to have pets and not to visit homes where pets are kept.

• Mold/mildew  
  Mold and mildew grow in dark, humid areas that have poor ventilation.

• Outdoors  
  Avoid damp, shady areas. Remove fallen leaves and avoid cutting the grass.

• Bathrooms and kitchens  
  Always use the exhaust fans when cooking or bathing. If you do see mold/mildew, clean the area with cleansers made with bleach.

• Indoors  
  Use the air conditioner. Avoid using humidifiers, as mold/mildew can grow in the water tank. If you must use a humidifier, clean it daily with bleach and water solution. Reduce indoor humidity to less than 50 percent—use a dehumidifier if needed. Empty and clean the dehumidifier daily.

• Cockroaches  
  Some people are very allergic to the substance the cockroach leaves behind. Cockroaches are very common in warm climates and in homes of people living in the city. However, even in climates with much cooler temperatures, the use of central heat allows the cockroaches to live. To avoid exposure to cockroaches, it is best to use roach traps or a professional exterminator.

• Exercise  
  Even though exercise is a common asthma trigger, your child should not limit his/her participation in sports/exercise, unless directed by a physician. Exercise is good for your health and lungs. Some forms of exercise such as running long distances and playing basketball may be harder for your child to do. Activities such as swimming, golf and karate are good choices for children with asthma. However, children with asthma should be able to participate in most physical activities. Always make sure your child has a warm-up before exercise and a cool-down after exercise. Using a reliever medicine, as directed by your child's physician, 15 to 20 minutes before starting exercise can be very helpful. Consult your child's physician about exercise and asthma if this is a problem for your child.

• Irritants: 

• Smoke
  Do not allow family and friends to smoke anywhere inside the house. Do not allow smoking in the car at any time. Smoke is very irritating in an enclosed area, and its odor may be trapped in the car's upholstery for a long period of time and continue to trigger symptoms. When eating out, always sit in nonsmoking sections of restaurants. You should also have nonsmoking childcare providers.

• Strong perfumes/odors
  Your child should avoid things that have a strong smell, including cleaning products, perfumes, hair spray, tar, fresh paint, gasoline, insect sprays and room deodorizers.