Home Allergen Reduction Plan (HARP): avoiding exposure to allergens and triggers
The message from the asthma & allergy friendly (R) Program is that products that are certified are more suitable for those suffering from asthma and allergies. These products are recommended to be used in a ‘home allergen reduction plan’. But just what is a ‘home allergen reduction plan’ and is it really effective?
Asthma & allergy friendly strategies help reduce exposure to trigger allergens and minimize asthma and allergy symptoms. Implementing asthma & allergy friendly practices in daily routines is critical, as relying on a single avoidance technique is often insufficient due to the multiple ways we encounter allergens. For example, using bedding that reduces dust mite exposure is beneficial, but results are improved if carpet allergens are also addressed using asthma & allergy friendly methods. Similarly, for pollen allergies, regular controlled dusting is recommended, and its effectiveness is enhanced when combined with an effective air cleaner.
As such, someone who wants to reduce their exposure to allergens should engage in a home allergen reduction plan; that is, all steps necessary to reduce exposure to allergen in the home. This plan will change depending on the type of allergen to which the person is sensitive and should incorporate asthma & allergy friendly interventions whenever possible.
The use of a multifactorial approach to allergen control has been recommended by both the Report on the Third International Workshop on Indoor Allergens and Asthma (1997) as well as the National Heart, Lung and Blood Institute’s (NHLBI) National Asthma Education and Prevention Program (2007). Asthma & allergy friendly strategies are a key part of this multifactorial approach.
The original NHLBI document is extremely comprehensive and contains a range of recommendations for education and prevention where asthma is concerned. The use of a multifactorial approach to trigger avoidance is one of those. Just published this year (March, 2010) in the Journal of Allergy and Clinical Immunology is a study to assess the recommendations of the NHLBI Program and to determine their relevance and applicability to asthma & allergy friendly interventions in home and clinical settings.
As part of the approach to implement the recommendations of the NHLBI, a modularised approach to address specific risk factors was taken. This allowed the intervention to the specific risk factors to be tailored to suit the individual. A risk profile was drawn up for each participant based on their skin sensitivity, environmental exposure, psychosocial factors, difficulty accessing care, lack of an asthma plan, exposure to pets or smoking, and other factors. The investigators found that this tailored intervention, combined with asthma & allergy friendly practices directed at risks for each family, led to significant reductions in asthma symptoms, with 19.5% fewer symptom days among intervention people and 13% fewer emergency department visits compared with the control group.
Allergen or trigger avoidance is likely to have more of an effect on asthma symptoms rather than lung function per se. However, as well as the advantages of reduced asthma symptoms in general terms, their amelioration may also allow the person suffering from asthma to concentrate on treatments and approaches that will improve lung function through asthma & allergy friendly practices.
