Bedding, allergies and lung health

Image showing crumpled bedding

A recent case report in the British Medical Journal finds that a man has been treated for severe lung inflammation and breathlessness as a result of an allergy to his feather bedding. The source was found after potential triggers – such as his pets and a small amount of mould in his home – had been ruled unlikely, and it was discovered that his symptoms had begun soon after the purchase of new feather bedding. Blood tests revealed antibodies to bird feather dust and he was diagnosed with ‘feather duvet lung’, a severe immune response to the organic dust from the goose or duck down found within duvets and pillows. Left untreated the condition can cause irreversible scarring to the lungs.

Exposure to allergens can worsen the symptoms of people who suffer from allergies. In many cases, the more allergens there are in an environment, the worse it gets for the sufferer; for some people reducing the amount of allergen can help. The success of this approach depends on which allergen a person is allergic to (you can get tested by your doctor to check this), but if you find that your allergy is to indoor allergens such as dust mites or pet dander it can be worth trying to reduce your exposure to those allergens in your home. Likewise, if your allergy is to pollen or other allergens usually found outside the home, then you can attempt to filter incoming air. This may not work for you – take medical advice first before spending lots of money on ‘anti-allergy’ devices. However, if you find that there may be some point in trying to reduce your exposure to allergens in the home you will find a variety of products designed to do this on the Allergy UK website.

The Asthma charity Allergy UK provides a wide range of services to people suffering from allergies, including supervising a range of retail products that have been properly tested and assessed for efficiency at reducing our exposure to a range of allergens. For those sensitive to fungi we would point out in particular the pillow & mattress covers and HEPA filtered vacuum cleaners, but there are many more. For some homes (or places of work) there are underlying problems of damp – removing the sources of damp will also reduce the amount of fungi in your home and should improve your allergies.

The Allergy UK Seal of Approval

Our main endorsement is the ‘Seal of Approval’. When you see a product with this logo on it, you have the reassurance that the product has been scientifically tested to prove it is efficient at reducing/removing allergens from the environment, or that the product has significantly reduced allergen/chemical content.

The testing is carried out by an independent laboratory to protocols which have been created for the Seal of Approval by leading allergy specialists, specifically to benefit the sufferers of allergy, asthma, sensitivity and intolerance.

Fireworks, bonfires and aspergillosis

fireworks

From late October to new year it is common in the UK for fireworks to be lit. Traditional busy times of the year such as Bonfire Night are still the times of heaviest use but instead of all of the celebrations happening on one night, they can now spread over a week. New Year is also a time for fireworks in many parts of the world, though the actual day this is celebrated varies across the globe, with Chinese New Year celebrated at a completely different time of year compared with UK, US and much of the world outside of China.

Firework displays are enjoyed by many wherever and whenever they occur, but there is a downside for people with respiratory disease. Fireworks are made using lots of gunpowder and bonfires often contain lots of damp wood and other burnable materials. Asthma UK warns us that burning all that gunpowder and firewood causes the release of many irritants that we know can potentially cause asthmatic problems. The British Lung Foundation warns us that people with Chronic Obstructive Pulmonary Disease (COPD) are also at risk. Many people with aspergillosis also have asthma and COPD – aspergillosis often comes along with, sometimes as a consequence of other respiratory diseases.

Outside air pollution

If the outside air is very still the irritants can persist and build up in a wide area around large displays, and of course, there are often many smaller displays scattered throughout the neighbourhood. It is pretty common in urban areas for the smoke to build up into an obvious fog with a strong smell which acts as a clear warning that the air is unsafe to breathe for some. Sometimes that fog is still apparent the next morning! However irritant gasses like nitrogen dioxide gas (NO2) can build up and be completely invisible – the gas is colourless and odourless, so be aware and remain vigilant for telltale symptoms of worsening breathing (ie coughing, wheezing, tightness in the chest or shortness of breath).

Airway irritants

Irritants such as very fine particulates in the smoke and NO2 in the exhaust gasses are known to cause asthma attacks so Asthma UK advises avoiding the smoke if you can and to make sure that you have taken your preventer inhaler as prescribed, Bring your reliever inhaler with you if going out and ensure that people around you know what to do should your breathing be affected.

Aspergillosis

People who have aspergillosis might also consider that autumn is a time for many trees to drop their leaves and other plant material to die back. The presence of so much food for moulds means that there can be lots of the Aspergillus fungus on the ground and in the air at these times of the year. Try to avoid places where there is lots of leaf mould being disturbed, for example by people walking to a display and it can be a good idea to wear a facemask to minimise the number of dust and spore particles you are inhaling. If wearing a facemask makes you feel uncomfortable there are now companies making attractive scarves that contain air filtration layer so when they are wrapped over your mouth & nose they provide reasonable protection.

Advice for people with respiratory conditions in winter

Many patients with respiratory conditions like aspergillosis report increased frequency of chest infections during the winter months, and this is mentioned repeatedly in our Facebook support groups (Public, Private). The cold weather brings problems of many kinds, but respiratory infection is one of the most serious. Infections by bacteria or virus have a major impact on their quality of life as their breathing becomes restricted and often they quickly become too exhausted to carry on with tasks of daily living.

Why does the winter cause increased vulnerability to respiratory infections? Is it because of the cold weather making us weaker and unable to fight off infection? In part – yes it is! Cold air cannot hold moisture as well as warmer air and thus cold air, is drier air. Inhaling dry air tends to dry out our airways and this can make us vulnerable to infection. This has two impacts – it irritates the lining of our airways and makes us cough, which itself increases our risk of infection, but it also dries out the mucous lining our airways and makes it more difficult to move – so we end up coughing much more than normal as we try to cough up this thickened substance.

People with chronic respiratory disease such as COPD, asthma, aspergillosis are particularly vulnerable to dry air as their airways are very sensitive to irritation.

Winter holds all kinds of pressures for the NHS and one of the biggest is a huge increase in people with respiratory conditions whose condition has become worse as a result of the cold weather. This video includes some advice on how to make sure the cold doesn’t affect your condition to prevent you from needing hospital treatment.

Reproduced with thanks, produced by NHS Blackpool CCG 2019

Patient and Carer support meeting

The NAC patient and carer support meeting is held on the first Friday of every month. The meeting is an opportunity to meet other aspergillosis patients and carers and listen to talks on a wide variety of different subjects. We usually have one main speaker, followed by updates on research and other news from the NAC communications team. There will also be refreshment breaks, so there is ample time to speak to other patients and carers, or staff. The main talk varies widely and can be anything from lifestyle and coping skills (eg. managing stress) to aspergillosis research updates. We will advertise the talks here a week ahead – if you’re more interested in some subjects than others you are more than welcome to just pop in for one talk! To watch previous meetings click here.

Where?  Altounyan Suite, Wythenshawe Hospital

When? First Friday of every month 13:00-15:00 (refreshments from 12:30)

Who? NAC patients can attend in person, and anyone can watch and comment online

How? Follow signs from the Friday clinic through to the Altounyan Suite, or join the Facebook group to watch online