 |
|
 OTHER NAMES
- Allergy to the domestic dust
- Asthma for mites
- Rinitis for mites
WHAT ARE THERE THE MITES?
Between the most frequent causers of the asthma allergic are the domestic allergens and between them the mites of the domestic dust, belong to the subclass Acari and to the order Astigmata. The most common species in Europe are the Dermatophagoides pteronyssinus and Euroglyphus maynei, while in the USA also the Dermatophagoides farinae is more frequent. In tropical and subtropical climates there appears the Blomia tropicalis as important source of allergens of the domestic dust. We must think that the globalization also influences these populations and they must not be so you suspend the populations of mites of every climatic region.
They are inoffensive for the man, but his fecal residues possess a big power alergénico. In his development there are important factors like the temperature, environmental relative moisture and his nutrition. The ideal growth temperature is of 25ºC. The ideal relative moisture is 70-80 %, being lethal the moisture lower than 45 %, and his nutrition is based in detritus human and animal. They can be in mattresses, pillows, carpets, blankets, comforters, armchairs, bookstores, in the hair of the animals, of the children, etc. The fauna acarológica of the house dust has been studied from a biological point of view for centuries. At present, more than 30.000 species have been identifiable.
The allergens of D. pteronyssinus are the most studied and up to the date several have been characterized, of them, the allergens I and II are the most excellent from the clinical point of view and also they have been detected in other species, being able to speak therefore about Groups alergénicos. The allergens of the group I (Der p I, Der f I, Der m I, Eur m I) are enzymes proteolíticas secreted by the digestive tract of the mite and that they are in important concentrations in the fecal particles of the mites. The allergens of the group II (Der p II and Der f II) are proteins that are principally in the body of the mite. These allergens collaborate with relatively big particles (average size 2 µm) that sedimentan quickly.
The levels of allergen of mites in the domestic dust are very variable, from< 0,2 a > 50 µg Der p I/g. It has been believed that 2 µg Der p I/g is equivalent to 100 ácaros/g.
The principal allergens accumulations are in the mattresses, pillows and carpets and other textiles of the domestic environment.
RELATION OF THE MITES WITH THE ALLERGY (Rinitis, Asthma)
In 1967 Voorhost and Spieksma describe the relation of the sensitization to the mites with the allergy to the domestic dust. Then studies of the relation are realized between the environmental control and the evolution of the allergic ones to the mites with rinitis and/or asthma. An improvement appears between a control adapted with the decrease of the number of mites in his habitat with the evolution of the illness. Remaining demonstrated an evidence of which the decrease of the contamination of mites in the domestic ambience determines a decrease of symptoms of the asthma.
MEASUREMENTS OF ENVIRONMENTAL CONTROL FOR PATIENTS ALLERGIC TO THE DUST
The pursuit of the measurements that are described next, will help to improve significantly the results of the established treatment. All the stated measurements must be supported in a rigorous and continued way. The abandonment or gradual relaxation of any of them can be a cause of a worsening of the patient.
The allergic one must have an individual bedroom, good ventilated on the outside and without moisture spots. The temperature must not exceed them 22ºC. The room must contain the indispensable furniture (bed, closet, mesita) Avoids books, toys, posters, carpeting, carpets, curtains, etc. In case of the children, there must be prohibited toys of cloth or of plush. The room must be ventilated to provoke a descent of the environmental moisture and of the temperature. The ventilation do it at the time of major sunstroke after the daily cleanliness. The cleanliness of the bedroom will be done in the morning and with the open window. To use a humid cloth to eliminate the dust, this way one will prevent from moving back and forth of the room. The patient must be always absent. The mattress and the pillow must be of foam rubber a latex or of acrylic material. The isolation of the contact alergénico on the part of the patient is realized by means of the bedspreads or cases of plastic of pillows, cushions and mattresses. The ideal thing is that the materials are of plastic or compounds which allows a certain transpiration, and to support a few pores in the material minor than 10 or 20 µm of diameter. The allergens can happen if the pores are major than 10 µm, and the larvae and other products related to the alergenicidad in major pores of 50µm. The mattress and the pillow must be inhaled during 10 minutes by every face once a month and exhibit to the sun 30 minutes 2 ó 3 times a year. The blankets have to be acrylic and you must wash them every three months and air them often. At the end of the period keep them in another room. The wash to high temperatures (> 50ºC) of the textile bed material, and other textiles it manages to kill and clean of allergens to these textiles, at least 1 time must be realized for week. The mites do not survive these temperatures and the allergens are soluble in water under these circumstances. How are you temperatures are not the habitual ones of domestic wash it is recommended adding solutions of Benzyl Benzoato to 0.03 % in the wash water to obtain the same results. The wash overland, with temperatures of more of 55ºC during more than 10 minutes also it is effective to kill the mites, but in this case the allergens are supported. As soon as the cleanliness was realized, the door and the window will close and it will be avoided to enter the room until now of going to bed. With it it will be achieved that sedimenten the dust particles in the soil and that the air remains free of them during the night. To eliminate allergens the hoovers use is very useful with suitable potency and filters HEPA or of water, especially they are useful to eliminate dead mites and allergens. The use of acaricidas (benzyl benzoato, sumetrin, permetrin, acid tánico, et.) is usually still a topic to be demonstrated in his efficacy, and only when they are used by the rest of measurements it can be useful. The water vapor use to high temperatures is a controversial topic, and his benefit is not demonstrated, there are even studies that they say that it can be counter-productive. The freezing of mobile materials (toys, shelves, etc...) can be useful to kill mites, then they must be washed to eliminate the allergens. The use of environmental filters is another controversial topic, since the allergens join particles of 20µm, and for it they are slightly transportable in the air, they settle easily. If in a calm ambience, turbulencies take place what can happen is that these particles are removed and stay more in the air and in contact with the patient. The ozone devices have not demonstrated efficacy in the environmental control for the time being.
Arlian LG. Platts-Mills TAE. "The biology of dust mites and the remediation of mite allergens in allergic disease". J. Allergy Clin. Immunol. 2001, 107:S406-13.
SUMMARY
| Environmental control for the allergic ones to mites. Instructions for the patients. |
- General recommendations on the domestic environment.
- To show that there are the mites and of that they feed.
- Ideal environment conditions for his reproduction (moisture> 55 %, temperature of 22-25 º C).
- Places where the mites accumulate: pillows, mattresses, carpeting, roles, curtains, hangings, toys of plush, etc...)
|
| Priorities for the environmental mites control |
| The room. |
The house. |
- To use cases of pillow (material synthetic transpirable with pores < 10µm)
- to Use mattress cases (material synthetic transpirable with pores < 10µm)
- to Cover the furniture
- To wash the bed clothes to warm temperatures of 50ºC
|
- To inhale every week (taking mask, to leave the room during 20 minutes)
- To assure that the hoover should have bags of double layer, or filters HEPA, of water, etc...
|
| Long-term measurements. |
- To reduce the interior moisture of the house, with deshumificadores or opening windows)
- To remove the carpeting and to replace them with wooden soils, vinyl or ceramics
- To change the furniture upholstered in cloth by leather, vinyl, etc...
- To change the cloth curtains into plates of vinyl or similar others
- To avoid to live in low apartments.
|
TO SEE ALSO
WHAT DOCTOR CAN TREAT ME?
|
|
|
DENOMINATION 
