Health: The disease that lurks in the dust

Asthma can affect each and every one of us, at any time. But there are many precautions we can take to prevent it.
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The Independent Culture
For the 3.4 million asthma sufferers in Britain, the automatic reflex is still to reach for the blue or brown inhaler. Such a reflex, though, cost the NHS pounds 466m in England alone last year. Also, relying on these drugs can mask the underlying disease and damage the lungs. Which means it is time to look at some other alternatives.

Although you can't create a totally allergy-free environment, there are lots of steps you can take to reduce allergens around the home.

I found this out through bitter experience. Just over four years ago, my family had no symptoms of asthma. Within a year, three out of the four of us had contracted it. After that, a day didn't go by without use of asthma drugs.

Sometimes, my very young daughter had to visit casualty or use a nebuliser, a machine for more serious attacks that turned the medicine into a mist.

The fact that we developed asthma shouldn't have been too surprising, as a whole host of potential triggers were present.

We had a cat, carpets and curtains that harbour dust mites, a decrepit vacuum cleaner and fan heaters to spread the dust; there were open gas fires, and a gas cooker that spewed out another trigger, nitrogen dioxide. We lived on a busy road in the London borough of Greenwich, which has more than its fair share of the disease. To convince myself that traffic pollution has an effect on asthma, I just had to ask my children's paediatrician. He said that the number of children he treated in my road for respiratory disease was well out of proportion. We considered moving to the country until we realised that asthma rates do not differ greatly around Britain, whether rural or urban. All that happens is that the allergens change.

So we moved to a quieter road, replacing curtains with blinds and shutters, and carpets with bare wood, washable rugs and tiling. We opted for an electric cooker and central heating instead of open fires. The house needed renovating, so we stayed away while it remained a heady cocktail of crumbling plaster, dust and the fumes from paints and wood treatments.

We bought anti-asthma bedding and aired the house regularly at night during times of high pollen. Smoking was banned. Reluctantly, we said goodbye to the cat. We doubted whether such steps would make much difference, but they did.

After three months in our new home we stopped using inhalers, and soon after that our symptoms had all but disappeared.

How to combat asthma:

House-dust mites are one of the greatest culprits. They live in dust building up around the house in bedding, beds, soft toys and soft furnishings. If the droppings from dust mites are a cause of the asthma in your home, consider buying a high-filtration vacuum cleaner.

An inefficient vacuum cleaner with an infrequently changed bag can exacerbate the problem.

Throw out feather dusters and dusters and instead damp-dust surfaces regularly or use a vacuum attachment. Put soft toys in the freezer for 24 hours twice a month and then wash at 60oC or above, to kill the mites. Use anti-dust mite covers to cover mattresses, pillows and duvets and wash them weekly and duvets and pillows monthly, at 60oC.

Although it's against the general eco-friendly principles of conserving power, regularly airing the home and having a number of sources of ventilation, rather than trying to close them all up and double-glaze, will help the war against dust mites.

Think minimalist: plain wooden bed frames are better than upholstered beds and bed boards, while upholstered furniture can be replaced with leather, wood, plastic or cane. It is best to avoid clutter.

When decorating, use non-solvent-based paints or opt for wooden panelling, except for pine. On the floor, use tiles, sealed cork or wood or lino. If you can't live without carpets, at least select short-pile ones and avoid them in areas where they may become damp, such as kitchens and bathrooms. Lights built into the ceiling are better than lampshades and hanging cords.

Bathrooms tend to be warm and humid, which encourages mould, so as well as airing the room regularly, dry clothes and towels outside and use bleach to kill any fungus present. Ensure that tumble-driers have outside ventilation.

Formaldehyde can irritate asthmatics. It is present in chipboard, kitchen units, carpets and open fires. Try to opt for formaldehyde-free furniture and formaldehyde- and formalin-free cavity wall insulation. Gas and solid- fuel heaters and tobacco smoke can emit nitrogen dioxide, so avoid smoking indoors, and get boilers and heaters serviced and chimneys swept regularly. It's better if a gas-fired central heating boiler can be sited outside the home.

If you're looking to buy a new home try, as far as possible, to avoid old or damp accommodation, or anywhere near rivers and canals. Homes requiring extensive renovation should be avoided if possible, as should those with signs of mould.

Gardens can be a great source of moulds, pollens, scents, spores and dust, which can trigger asthma, hay fever and eczema. Choose insect- rather than wind-pollinated plants and avoid heavily scented plants. Hedges, lawns and grasses harbour pollen, mould and dust, so consider replacing them with low-maintenance paving, gravel mulch and fencing, brick or stone walls. Water is an excellent dust-collector, so consider installing a small pond.

Common trees such as oak, ash, birch, pine, elder, hazel, horse chestnut and willow are wind-pollinated and produce masses of pollen, so go for trees with blossom, which are usually insect-pollinated. Sweetcorn, arum lily, bamboo, the daisy family (including Michaelmas daisy), dahlia, chrysanthemum and heavily scented flowers such as carnations, jasmine, wisteria and hyacinths can exacerbate asthma. Avoid compost heaps, as moulds build up. Do the gardening on damp days or early in the morning. For further horticultural ideas, visit the National Asthma Campaign's low-allergen gardens, open to the public, in Middlesex and Truro.

Safe herbaceous plant families with little pollen and scent include acanthus, brunnera, campanula, dicentra, viola, geum, prunella, salvia, tiarella, geranium, iris, delphinium and veronica. Good annuals are antirrhinum, impatiens, nigella, tropaeolum and mimulus. If possible, select trees such as Catalpa bignonioides `Aurea' (Indian bean tree), Malus hupehensis (crab-apple) and prunus `Shirofugen"; shrubs could include Aucuba japonica, Cornus alba, Viburnum opulus and V tinus, Weigela florida and Phormium tenax.

For ground cover opt for Ajuga reptans, vinca, bergenia cultivars, hosta cultivars, lamium cultivars (deadnettle) and Lysimachia nummularia (creeping Jenny).

Note: because allergic reactions can be triggered by so many substances, and it can be difficult to establish these, take the easier and less expensive steps first to see if there's an improvement. Buying an expensive, high- efficiency vacuum cleaner is futile if you are not allergic to dust mites. Make an appointment with an allergy clinic to establish your allergies, before making costly changes.

Anti-asthma products: a range available from The Healthy House (01453 752216); carpeting from Kingsmead Carpets (01290 421 5111); paints from Lakeland Paints (01539 732866); bedding from Medivac (01625 539401).

Further information: National Asthma Campaign helpline, Mon-Fri 9am- 7pm (0345 010203); British Allergy Foundation (0181-303 8583; helpline 0891 516500); Free leaflet, `Good Air Quality in your Home' available from the Department of the Environment (0870-122 6236)