Do You Have Spring Allergies?

 

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From the AAAI Rhinitis Tips:
Do you have bouts of sneezing and itching, or a runny or stuffy nose that do not seem to go away? If so, you may have rhinitis.

Rhinitis is one of the most common illnesses in the United States , affecting more than 50 million people. It often coexists with other respiratory disorders, such as asthma. Rhinitis has a significant impact on the quality of life of those who suffer from it. In addition, it can contribute to other conditions such as sinus problems, ear problems, sleep problems, and learning problems. In patients with asthma, uncontrolled rhinitis seems to make asthma worse.

Allergic rhinitis
Allergic rhinitis is caused by substances that we breathe called allergens. Allergens are usually harmless substances that can cause problems only in some people. These problems are caused because the immune system of people with allergic rhinitis mistakenly identifies these substances as intruders and generates a reaction against them. During this reaction, the immune system cells release substances such as histamine and leukotrienes that cause the symptoms of allergic rhinitis; these and other substances also cause inflammation in the nasal lining that makes the nose very sensitive to irritants such as smoke and strong odors or to changes in the temperature and humidity of the air.

Causes:

1. When allergic rhinitis is caused by common outdoor allergens, such as airborne tree, grass and weed pollens or mold, it is called seasonal allergic rhinitis, or “hay fever.”
2. Allergic rhinitis is also triggered by common indoor allergens, such as animal dander (dried skin flakes and saliva), indoor mold, droppings from dust mites and cockroach particles. This is called perennial allergic rhinitis.

Symptoms

Sneezing
Stuffy nose (congestion)
Runny nose
Itching in the nose, roof of the mouth, throat, eyes and ears
Diagnosis
If you have symptoms of allergic rhinitis, an allergist/immunologist can help determine which specific allergens are triggering your illness. He or she will take a thorough health history, and then test use to determine if you have allergies. Skin tests or blood tests are the most common methods for determining your allergic rhinitis triggers.

What to Do During Pollen Season:
When outdoor pollens are high, remain indoors, particularly in the late morning. Pollen grains can cause significant allergic symptoms like asthma and allergic rhinitis, particularly during the spring and the fall. It is difficult to avoid pollen because it is windborne and can cover wide distances. Short of moving to a different location, here are some tips for avoiding pollen during the season.

1. The pollen count is usually highest in the late morning and early afternoon particularly during sunny, windy days. The pollen count measures the concentration of a specific pollen like birch tree pollen, in the area in a specific area and time. A pollen count is a useful guide for when it is advisable to stay indoors and avoid contact with pollen.
2. Keep the windows and doors closed during the allergy season.
3. Install a room air conditioner with a special filter.The special filter (High Efficiency Particulate Air or HEPA filter) traps airborne allergens. If the house does not have central air, the best spot to put the air conditioner and filter would be the bedroom. Change the filters frequently. An allergic person should also use the car air conditioner to decrease pollen exposure when commuting. Pollen allergic persons should not have a window fan blowing into their bedroom as this will maintain outdoor pollen exposure all night.
4. Avoid working outdoors, if you must wear a special face mask. The face mask is designed to filter pollen out of the air and keep it from reaching the nasal passages.
5. Consider taking a vacation at the height of the pollen season. Preferably at a location where the pollen exposure is minimal, like the seashore.

Links: Allergy Medications
Info on Allergy Shots

Stress in the Workplace and Illness

from Canadian Centre for Occupational Health and SafetyImage

Can “workplace stress” be defined?

We hear a lot about stress, but what is it? Taber’s Cyclopedic Medical Dictionary defines stress as “the result produced when a structure, system or organism is acted upon by forces that disrupt equilibrium or produce strain”. In simpler terms, stress is the result of any emotional, physical, social, economic, or other factors that require a response or change. It is generally believed that some stress is okay (sometimes referred to as “challenge”or “positive stress”) but when stress occurs in amounts that you cannot handle, both mental and physical changes may occur.

“Workplace stress” then is the harmful physical and emotional responses that can happen when there is a conflict between job demands on the employee and the amount of control an employee has over meeting these demands. In general, the combination of high demands in a job and a low amount of control over the situation can lead to stress.

Stress in the workplace can have many origins or come from one single event. It can impact on both employees and employers alike. As stated by the Canadian Mental Health Association:

Fear of job redundancy, layoffs due to an uncertain economy, increased demands for overtime due to staff cutbacks act as negative stressors. Employees who start to feel the “pressure to perform” can get caught in a downward spiral of increasing effort to meet rising expectations with no increase in job satisfaction. The relentless requirement to work at optimum performance takes its toll in job dissatisfaction, employee turnover, reduced efficiency, illness and even death. Absenteeism, illness, alcoholism, “petty internal politics”, bad or snap decisions, indifference and apathy, lack of motivation or creativity are all by-products of an over stressed workplace.

From: Canadian Mental Health Association, “Sources of Workplace Stress” Richmond, British Columbia.

I have heard stress can be both good and bad. Is this true?

Some stress is normal. In fact, it is often what provides us with the energy and motivation to meet our daily challenges both at home and at the workplace. Stress in these situations is the kind that helps you “rise” to a challenge and meet your goals such as deadlines, sales or production targets, or finding new clients. Some people would not consider this challenge a type of stress because, having met the challenge, we are satisfied and happy. However, as with most things, too much stress can have negative impacts. When the feeling of satisfaction turns into exhaustion, frustration or dissatisfaction, or when the challenges at work become too demanding, we begin to see negative signs of stress.

What are examples of things that cause stress at the workplace?

In the workplace, stress can be the result of any number of situations. Some examples include:

Categories of Job Stressors Examples of Sources of Stress
Factors unique to the job
  • workload (overload and underload)
  • pace / variety / meaningfulness of work
  • autonomy (e.g., the ability to make your own decisions about our own job or about specific tasks)
  • shiftwork / hours of work
  • skills / abilities do not match job demands
  • lack of training and/or preparation (technical and social)
  • lack of appreciation
  • physical environment (noise, air quality, etc)
  • isolation at the workplace (emotional or working alone)
Role in the organization
  • role conflict (conflicting job demands, multiple supervisors/managers)
  • role ambiguity (lack of clarity about responsibilities, expectations, etc)
  • level of responsibility
Career development
  • under/over-promotion
  • job security (fear of redundancy either from economy, or a lack of tasks or work to do)
  • career development opportunities
  • overall job satisfaction
Relationships at work (Interpersonal)
  • supervisors (conflicts or lack of support)
  • coworkers (conflicts or lack of support)
  • subordinates
  • threat of violence, harassment, etc (threats to personal safety)
  • lack of trust
  • lack of systems in workplace available to report and deal with unacceptable behaviour
Organizational structure/climate
  • participation (or non-participation) in decision-making
  • management style
  • communication patterns (poor communication / information flow)
  • lack of systems in workplace available to respond to concerns
  • not engaging employees when undergoing organizational change
  • lack of perceived fairness (who gets what when, and the processes through which decisions are made). Feelings of unfairness magnify the effects of perceived stress on health.
Work-Life Balance
  • role/responsibility conflicts
  • family exposed to work-related hazards

Adapted from: Murphy, L. R., Occupational Stress Management: Current Status and Future Direction. in Trends in Organizational Behavior, 1995, Vol. 2, p. 1-14, and UK Health & Safety Executive (HSE) “Managing the causes of work-related stress: A step-by-step approach using the Management Standards”, 2007.

Can stress cause health effects?

Yes, stress can have an impact on your overall health. Our bodies are designed, pre-programmed if you wish, with a set of automatic responses to deal with stress. This system is very effective for the short term “fight or flight” responses we need when faced with an immediate danger. The problem is that our bodies deal with all types of stress in the same way. Experiencing stress for long periods of time (such as lower level but constant stressors at work) will activate this system, but it doesn’t get the chance to “turn off”. The body’s “pre-programmed” response to stress has been called the “Generalized Stress Response” and includes:

  • increased blood pressure
  • increased metabolism (e.g., faster heartbeat, faster respiration)
  • decrease in protein synthesis, intestinal movement (digestion), immune and allergic response systems
  • increased cholesterol and fatty acids in blood for energy production systems
  • localized inflammation (redness, swelling, heat and pain)
  • faster blood clotting
  • increased production of blood sugar for energy
  • increased stomach acids

From: Basic Certification Training Program: Participant’s Manual, Copyright© 2006 by the Workplace Safety and Insurance Board of Ontario.

Stress can contribute to accidents/injuries by causing people to:

  • sleep badly
  • over-medicate themselves and/or drink excessively
  • feel depressed
  • feel anxious, jittery and nervous
  • feel angry and reckless (often due to a sense of unfairness or injustice)

When people engage in these behaviours or are in these emotional states, they are more likely to:

  • become momentarily (but dangerously) distracted
  • make errors in judgment
  • put their bodies under physical stress, increasing the potential for strains and sprains
  • fail in normal activities that require hand-eye or foot-eye coordination.

Stress can also lead to accidents or injuries directly by not giving the person the control necessary to stop the threat to their physical well-being.

Luckily, there are usually a number of warning signs that help indicate when you are having trouble coping with stress before any severe signs become apparent. These signs are listed below.

How do I know if someone is (or if I am) having trouble coping with stress?

There are many different signs and symptoms that can indicate when someone is having difficulty coping with the amount of stress they are experiencing:

Physical: headaches, grinding teeth, clenched jaws, chest pain, shortness of breath, pounding heart, high blood pressure, muscle aches, indigestion, constipation or diarrhea, increased perspiration, fatigue, insomnia, frequent illness.

Psychosocial: anxiety, irritability, sadness, defensiveness, anger, mood swings, hypersensitivity, apathy, depression, slowed thinking or racing thoughts; feelings of helplessness, hopelessness, or of being trapped, lower motivation.

Cognitive: decreased attention, narrowing of perception, forgetfulness, less effective thinking, less problem solving, reduced ability to learn; easily distracted.

Behavioural: overeating or loss of appetite, impatience, quickness to argue, procrastination, increased use of alcohol or drugs, increased smoking, withdrawal or isolation from others, neglect of responsibility, poor job performance, poor personal hygiene, change in religious practices, change in close family relationships.

Below is a quiz from the Canadian Mental Health Association of Ontario you can take to help identify your stress levels:

DO YOU FREQUENTLY:  YES  NO
Neglect your diet?
Try to do everything yourself?
Blow up easily?
Seek unrealistic goals?
Fail to see the humour in situations others find funny?
Act rude?
Make a ‘big deal’ of everything?
Look to other people to make things happen?
Have difficulty making decisions
Complain you are disorganized?
Avoid people whose ideas are different from your own?
Keep everything inside?
Neglect exercise?
Have few supportive relationships?
Use sleeping pills and tranquilizers without a doctor’s approval?
Get too little rest?
Get angry when you are kept waiting?
Ignore stress symptoms?
Put things off until later?
Think there is only one right way to do something?
Fail to build relaxation time into your day?
Gossip?
Race through the day?
Spend a lot of time complaining about the past?
Fail to get a break from noise and crowds?

Adapted from: What’s Your Stress Index?  Canadian Mental Health Association, Ontario (no date).

Interpretation of your score (based on the number of “Yes” selections):

0-5:  There are few hassles in your life.  Make sure though, that you are not trying to deliberately avoid problems.

6-10: You’ve got your life in fairly good control.  Work on the choices and habits that could still be causing you some unnecessary stress in your life.

11-15: You are approaching the danger zone.  You may be suffering stress-related symptoms and your relationships could be strained.  Think carefully about choices you’ve made and take relaxation breaks every day.

16-25: Emergency!  It is critical that you stop and re-think how you are living; change your attitudes and pay careful attention to diet, exercise and relaxation.

Do all of these signs or symptoms happen all at once and what level of help should be sought?

No, not normally. The signs and symptoms from stress tend to progress through several phases or stages. The phases can be described as below:

Phase Signs/Symptoms Action
Phase 1 – Warning 
Early warning signs are often more emotional than physical and may take a year or more before they are noticeable.
  • feelings of vague anxiety
  • depression
  • boredom
  • apathy
  • emotional fatigue
  • talking about feelings
  • taking a vacation
  • making a change from regular activities
  • taking time for yourself
Phase 2 – Mild Symptoms
Warning signs have progressed and intensified. Over a period of 6 to 18 months, physical signs may also be evident.
  • sleep disturbances
  • more frequent headaches/colds
  • muscle aches
  • intensified physical and emotional fatigue
  • withdrawal from contact with others
  • irritability
  • intensified depression
  • more aggressive lifestyle changes may be needed.
  • short-term counseling
Phase 3 – Entrenched Cumulative Stress
This phase occurs when the above phases continue to be ignored. Stress starts to create a deeper impact on career, family life and personal well-being.
  • increased use of alcohol, smoking, non-prescription drugs
  • depression
  • physical and emotional fatigue
  • loss of sex drive
  • ulcers
  • marital discord
  • crying spells
  • intense anxiety
  • rigid thinking
  • withdrawal
  • restlessness
  • sleeplessness
The help of medical and psychological professionals is highly recommended.
Phase 4 – Severe/ Debilitating Cumulative Stress Reaction
This phase is often considered “self-destructive” and tends to occur after 5 to10 years of continued stress.
  • careers end prematurely
  • asthma
  • heart conditions
  • severe depression
  • lowered self-esteem/self-confidence
  • inability to perform one’s job
  • inability to manage personal life
  • withdrawal
  • uncontrolled anger, grief, rage
  • suicidal or homicidal thinking
  • muscle tremors
  • extreme chronic fatigue
  • over-reaction to minor events
  • agitation
  • frequent accidents
  • carelessness, forgetfulness
  • paranoia
Significant intervention from professionals.

From: Anschuetz, B.L. “The High Cost of Caring: Coping with Workplace Stress” in Sharing: Epilepsy Ontario. Posted 29 November 1999.

What are some general tips for dealing with stress at the workplace?

Since the causes of workplace stress vary greatly, so do the strategies to reduce or prevent it.

Where stress in the workplace is caused, for example, by a physical agent, it is best to control it at its source. If the workplace is too loud, control measures to deal with the noise should be implemented where ever possible. If you are experiencing pain from repetitive strain, workstations can be re-designed to reduce repetitive and strenuous movements. More detailed information and suggestions are located in the many other documents in OSH Answers (such as noiseergonomics, or violence in the workplace, etc.) or by asking the Inquiries Service.

Job design is also an important factor. Good job design accommodates an employee’s mental and physical abilities. In general, the following job design guidelines will help minimize or control workplace stress:

  • the job should be reasonably demanding (but not based on “sheer endurance”) and provide the employee with at least a minimum of variety in job tasks
  • the employee should be able to learn on the job and be allowed to continue to learn as their career progresses
  • the job should comprise some area of decision-making that the individual can call his or her own.
  • there should be some degree of social support and recognition in the workplace
  • the employee should feel that the job leads to some sort of desirable future

What can the employer do to help?

Employers should assess the workplace for the risk of stress. Look for pressures at work which could cause high and long lasting levels of stress, and who may be harmed by these pressures. Determine what can be done to prevent the pressures from becoming negative stressors.

Employers can address stress in many ways.

DO

  • Treat all employees in a fair and respectful manner.
  • Take stress seriously and be understanding to staff under too much pressure.
  • Be aware of the signs and symptoms that a person may be having trouble coping with stress.
  • Involve employees in decision-making and allow for their input directly or through committees, etc.
  • Encourage managers to have an understanding attitude and to be proactive by looking for signs of stress among their staff.
  • Provide workplace health and wellness programs that target the true source of the stress. The source of stress at work can be from any number of causes – safety, ergonomics, job demands, etc. Survey the employees and ask them for help identifying the actual cause.
  • Incorporate stress prevention or positive mental health promotion in policies or your corporate mission statement.
  • Make sure staff have the training, skills and resources they need.
  • Design jobs to allow for a balanced workload. Allow employees to have control over the tasks they do as much as possible.
  • Value and recognize individuals’ results and skills.
  • Provide support. Be clear about job expectations.
  • Keep job demands reasonable by providing manageable deadlines, hours of work, and clear duties as well as work that is interesting and varied.
  • Provide access to Employee Assistance Programs (EAPs) for those who wish to attend.

DO NOT

  • Do not tolerate bullying or harassment in any form.
  • Do not ignore signs that employees are under pressure or feeling stressed.
  • Do not forget that elements of the workplace itself can be a cause of stress. Stress management training and counselling services can be helpful to individuals, but do not forget to look for the root cause of the stress and to address them as quickly as possible.

Is there anything I can do to help myself deal with the stress I am experiencing at work?

In many cases, the origin of the stress is something that cannot be changed immediately. Therefore, finding ways to help maintain good mental health is essential. There are many ways to be proactive in dealing with stress. In the workplace, you might try some of the following as suggested by the Canadian Mental Health Association:

Learn to relax, take several deep breaths throughout the day, or have regular stretch breaks. Stretching is simple enough to do anywhere and only takes a few seconds.

Take charge of your situation by taking 10 minutes at the beginning of each day to priorize and organize your day. Be honest with your colleagues, but be constructive and make practical suggestions. Be realistic about what you can change.

From: Canadian Mental Health Association, “Sources of Workplace Stress” Richmond, British Columbia.

Are there organizations that can help?*

Yes, there are many. Your family doctor can often recommend a professional for you. Other examples include the Employee Assistance Programs (EAP) or associations such as the Canadian Mental Health Association (CMHA) or the Canadian Centre on Substance Abuse (CCSA) to name just a few.

  • EAP programs are confidential, short term, counselling services for employees with problems that affect their work performance. The services of EAP providers are often purchased by your company. Check with your human resources department (or equivalent) for contact information.
  • CMHA ‘s programs are meant to ensure that people whose mental health is endangered will find the help needed to cope with crisis, regain confidence, and return to community, family and job.
  • The CCSA  promotes informed debate on substance abuse issues, and disseminates information on the nature, and assists organizations involved in substance abuse treatment, prevention and educational programming.

(*We have mentioned these organizations as a means of providing a potentially useful referral. You should contact the organization(s) directly for more information about their services. Please note that mention of these organizations does not represent a recommendation or endorsement by CCOHS of these organizations over others of which you may be aware.)

For more information on mental health, see the OSH Answers:

What else can I do to improve my overall mental health?

Good mental health helps us to achieve balance and cope with stressful times.

Ten general tips for mental health
1. build confidence identify your abilities and weaknesses together, accept them build on them and do the best with what you have
2. eat right, keep fit a balanced diet, exercise and rest can help you to reduce stress and enjoy life.
3. make time for family and friends these relationships need to be nurtured; if taken for granted they will not be there to share life’s joys and sorrows.
4. give and accept support friends and family relationships thrive when they are “put to the test”
5. create a meaningful budget financial problems cause stress. Over-spending on our “wants” instead of our “needs” is often the culprit.
6. volunteer being involved in community gives a sense of purpose and satisfaction that paid work cannot.
7. manage stress we all have stressors in our lives but learning how to deal with them when they threaten to overwhelm us will maintain our mental health.
8. find strength in numbers sharing a problem with others have had similar experiences may help you find a solution and will make you feel less isolated.
9. identify and deal with moods we all need to find safe and constructive ways to express our feelings of anger, sadness, joy and fear.
10. learn to be at peace with yourself get to know who you are, what makes you really happy, and learn to balance what you can and cannot change about yourself.

From: Canadian Mental Health Association  – National Office

Other mental fitness tips include:

  • Give yourself permission to take a break from your worries and concerns. Recognize that dedicating even a short time every day to your mental fitness will reap significant benefits in terms of feeling rejuvenated and more confident.
  • “Collect” positive emotional moments – Make a point of recalling times when you have experienced pleasure, comfort, tenderness, confidence or other positive things.
  • Do one thing at a time – Be “present” in the moment, whether out for a walk or spending time with friends, turn off your cell phone and your mental “to do” list.
  • Enjoy hobbies – Hobbies can bring balance to your life by allowing you to do something you enjoy because you want to do it.
  • Set personal goals – Goals don’t have to be ambitious. They could be as simple as finishing a book, walking around the block every day, learning to play bridge, or callingyour friends instead of waiting by the phone. Whatever goal you set, reaching it will build confidence and a sense of satisfaction.
  • Express yourself – Whether in a journal or talking to a wall, expressing yourself after a stressful day can help you gain perspective, release tension, and boost your body’s resistance to illness.
  • Laugh – Laughter often really is the best medicine. Even better is sharing something that makes you smile or laugh with someone you know.
  • Treat yourself well – Take some “you” time – whether it’s cooking a good meal, having a bubble bath or seeing a movie, do something that brings you joy.

Adapted from: Canadian Mental Health Association Mental Fitness Tips .

Additional Links:

Stress and Balance Within

Australian Department of Health and Ageing 2010 Report on Multiple Chemical Sensitivity

Due to recent comments on MCS/ IEI I am posting the following report by the Australian Dept. of Health and Ageing.  Please note that while it is open to the possibility that MCS is a definite disease entity with possible multifactorial etiology, at this time:

1. The underlying mode(s) of action of MCS, i.e. the biological mechanisms by which the chemical sensitivity occurs, remain uncertain.

2. Although non-specific neurological symptoms are common, overall there is no characteristic symptom profile that identifies MCS.

3. Presently, a diagnosis of MCS is based commonly on self-reported symptoms and chemical exposure histories. The symptom profile of MCS is indistinguishable from other multi-symptom disorders. No laboratory tests currently exist for diagnosing MCS.

4. There are no standardised treatments for MCS.

To read the Full Report, go to:

http://www.nicnas.gov.au/Current_Issues/MCS/MCS_Final_Report_Nov_2010_PDF.pdf

1
EXECUTIVE SUMMARY
1.1
OVERVIEW
Multiple Chemical Sensitivity (MCS) is the most common term used to describe a condition presenting as a complex array of symptoms linked to low level chemical exposures. The underlying mode(s) of action of MCS, i.e. the biological mechanisms by which the chemical sensitivity occurs, remain uncertain.
A common theme reported by individuals is experiences of heightened responsiveness to chemicals at extremely low exposure levels. The agents linked with MCS symptoms in susceptible individuals are numerous and chemically diverse. They include individual chemicals and chemical products encompassing air pollutants, workplace and domestic chemicals, agricultural chemicals, therapeutics and foods.
Similarly, the symptoms experienced by individuals from exposures are diverse and involve multiple organ systems. Although non-specific neurological symptoms are common, overall there is no characteristic symptom profile that identifies MCS. Nevertheless, reported symptoms can, in some cases, be debilitating.
Numerous modes of action have been postulated for MCS. These include immunological changes, respiratory/neurogenic inflammation, limbic sensitisation, elevated NMDA receptor activity, altered metabolism as well as behavioural conditioning and psychological disorders. Alternative names for MCS in part reflect views on particular modes of action.
Several attempts have been made to establish diagnostic criteria for this disorder. A set of ‘Consensus Criteria’ developed in 1999 describes MCS as a chronic condition involving multiple organ systems with reproducible symptoms following low-level exposure to multiple unrelated chemicals. These criteria have been used to a limited extent for research and survey purposes. Worldwide, a small number of available studies indicate the prevalence of medically diagnosed MCS at 0.2% – 4%. In Australia, only limited surveys of the prevalence of chemical sensitivities and MCS in the community have been conducted. South Australian state health surveys reported a prevalence of medically diagnosed MCS of 0.9%.
At this time, worldwide, MCS is not an internationally classified disorder, with only Germany and Austria (via adoption of German diseases documentation) listing MCS in their national disease classifications.
Presently, a diagnosis of MCS is based commonly on self-reported symptoms and chemical exposure histories. The symptom profile of MCS is indistinguishable from other multi-symptom disorders. No laboratory tests currently exist for diagnosing MCS. Different case definitions and the lack of a characteristic symptom profile and objective laboratory biomarkers for MCS have impeded recognition of the disorder as a distinct clinical entity.
There are no standardised treatments for MCS. Current treatments advocated for MCS include dietary changes, nutritional supplements, detoxification and desensitisation techniques, holistic or body therapies, as well as prescription medicines and behavioural therapies. The most common management regime for MCS is avoidance of agents that trigger symptoms.

A Review of Multiple Chemical Sensitivity
1.2
FINDINGS
1.2.1
Research into biological mechanisms underpinning MCS
There is considerable debate as to what biological mechanisms (modes of action) are responsible for the state of chemical sensitivity in MCS. The literature describes numerous potential causative modes of action, both physiological and psychological in nature, many of which are amenable to further testing. MCS may have a multifactorial origin.
An understanding of mode of action and how chemicals interact with organ systems would be assisted by more detailed identification of the chemical species and the exposure scenarios responsible for symptoms in MCS.
Finding 1: Targeted research into mode (s) of action
While there are a number of proposed mechanism(s) that warrant further research consideration, based on biological plausibility, testability and known research gaps, the following modes of action for MCS are highlighted for further scientific research and investigation as priorities:

Immunological variables;

Respiratory disorder/neurogenic inflammation;

Limbic kindling/neural sensitisation and psychological factors;

Elevated nitric oxide, peroxynitrite and NMDA receptor activity;

Altered xenobiotic metabolism.
1.2.2
Clinical research needs
An Australian clinical review has highlighted differences with criteria used for the diagnosis of MCS and methods to treat MCS.
Overall, a number of primary clinical research needs are evident:

Standardising diagnostic criteria that are acceptable to, and utilised by, clinical and scientific groups;

Determining the prevalence of MCS in the community, for both self-reported cases and those that are medically diagnosed;

Exploring initiating/triggering agents/events and modes of action in MCS through the use of well designed and conducted blinded challenge tests and longitudinal studies of illness course;

Determining and documenting effective treatment/management protocols for MCS based on long-term therapeutic alliances and individual self-management.
Finding 2. Longitudinal study
To get a better understanding of the clinical picture of MCS in Australia there is a need to look more closely at the natural history of people with MCS. A longitudinal clinical and sociological study should assist in identifying key elements of MCS such as how MCS is initiated and/or triggered and how sensitivities vary over time.
Such a study should examine eliciting agents/events, diagnostic experiences, clinical course and impacts of treatment/management strategies. To undertake such a longitudinal study it would be necessary to identify people with MCS who would be prepared to be involved. Findings in Appendix 1 provide some practical suggestions to address this issue.
– 6 -
A Review of Multiple Chemical Sensitivity
– 7 -
Finding 3: Education/training
A survey of clinical approaches to MCS of Australian medical practitioners identified a lack of coverage of MCS within the current Australian medical curriculum given the relatively small amount of time devoted to minor specialties. Other than hospital protocols containing practical measures to assist inpatients with chemical sensitivities, there are also currently no clinical guidelines available to inform medical practitioners as to how to provide appropriate care for MCS individuals.
The development of a clinical education program should be investigated. Such a program should be based on evidence currently available, utilise any findings from clinical research in Australia (such as a longitudinal investigation) and consider the practical guidance on approaches to MCS clinical management agreed by participants in the recent clinical review of MCS.

Laser/Biofeedback Treatment for Allergies = Snake Oil

from The Seattle Times

Miracle Machines | The 21st-century snake oil

 

The EPFX's slick and sophisticated graphics may impress, but no scientific research shows that energy machines can diagnose or cure medical problems. Still, clients may pay hundreds or thousands of dollars for treatments with practitioners. This session was at the Puyallup Fair.

Enlarge this photoALAN BERNER / THE SEATTLE TIMES

The EPFX’s slick and sophisticated graphics may impress, but no scientific research shows that energy machines can diagnose or cure medical problems. Still, clients may pay hundreds or thousands of dollars for treatments with practitioners. This session was at the Puyallup Fair.

They can cure cancer, reduce cholesterol, end allergies, treat cavities, kill parasites and even eliminate AIDS.

“Energy medicine” devices can be as small as a television remote control, or as large as a steamer trunk.

Their operators say the devices work by transmitting radio frequencies or electromagnetic waves through the body, identifying problems, then “zapping” them.

Their claims are a fraud — the 21st-century version of snake oil. But a Seattle Times investigation has discovered that thousands of these unproven devices — many of them illegal or dangerous — are found in hundreds of venues nationwide, from the Puyallup Fair, to health-care clinics in Florida, to an 866-bed regional hospital in Missouri.

These are not the devices in wide use by medical doctors, such as electrical stimulators used for sports injuries. Nor are they the biofeedback devices used at respected alternative-medicine centers such as Seattle’s Bastyr University. Rather, these are boxes of wires purported to perform miracles. Their manufacturers and operators capitalize on weak government oversight and the nation’s hunger for alternative therapies to reap millions of dollars in profits while exploiting desperate people:

• In Tulsa, Okla., a woman suffering from unexplained joint pain was persuaded to avoid doctors and rely on an energy device for treatment. Seven months later, her son took her to a hospital. She died within hours from undiagnosed leukemia.

• In Los Angeles, a mother pulled her 5-month-old son out of chemotherapy for cancer and took him to a clinic where a 260-pound machine pulsed electromagnetic waves through his tiny body. The baby died within months.

• In Seattle, a retiree with cancer emptied her bank account to buy an energy machine. Shortly before she died, her husband, a retired Microsoft manager, examined its software, finding that it appeared to generate results randomly — “a complete fraud,” he said.

Over the past year, The Times investigated these machines and the people behind them.

The investigation took us to where the manufacturers of some of these machines are based, in Hungary and Greece. We found the operators — including a cross-dressing federal fugitive who moonlights as a cabaret singer — making outrageous claims as they peddled their wares. We discovered that the U.S. regulatory system has allowed them to flood this nation with an estimated 40,000 devices.

And we learned that many operators consider our state a safe haven for these “miracle machines.”

 

Can A Laser Cure Your Allergies?

A device just coming to America from Australia claims to end allergy symptoms in as few as two treatments with the use of lasers. Can it stand up to rigorous scientific testing?There are a lot of potential patients. It’s estimated that one in five Americans suffers with allergies. Adult allergy sufferers spend more than $500 each per year on treatments, according to 2005 numbers from the U.S. Department of Health and Human Services.The report also showed that spending to fight allergies nearly doubled in the five years from 2000 to 2005 to $11.2 billion.David Tucker was among life-long sufferers looking for a cure.”It all stems back from when I was at Ohio State,” Tucker said. “On Saturday, everybody would wake up and go to football games. Because that’s when pollen season was, I’d spend time in the shower because I couldn’t breathe.”Later in life, he was selling electrodes to the chiropractic industry in Florida and suffering hay fever and allergies to cats and dust.Tucker said one chiropractor client turned him onto a device he’d seen in Australia.

Computer Diagnoses

“He’d been treated for his dairy allergy while on holiday. After 72 hours — he hadn’t drunk milk in 15 years — he had a full glass of milk and it had no effect,” Tucker said. “He set it up to have the equipment treat me for dust mites and, 48 hours later, I was fine. I’d always had to stay in a hotel at my mother-in-law’s because of cats. Now I can have cats on my lap.”Tucker said the device works based on biofeedback. The allergy sufferer wears a sensing clip on his finger for testing, and the computer simulates the bio-frequency for 10,000 known allergens. As the body responds to those stimuli, the computer lists which substances are irritants.”This digitized allergen actually matches the harmonic frequency of the actual allergen, making the body believe it is in contact with the real substance,” Tucker said. “The body will react if it is allergic to the particular substance.”The assessment takes about 20 minutes and can cost up to $250.

Curing Allergies

Once the allergens are identified, a laser stimulates biomeridian points on the body — the same points used in acupuncture and acupressure. Tucker said the idea is to strengthen organs to act properly the next time they encounter the allergen — that is, to treat them as harmless.Treatments are about $100, and Tucker said most people need two to 10 treatments to recondition the body’s response. After that, they’re done.Tucker said his own suffering, combined with his business experience, led him to bring the device to American chiropractors.He admits he doesn’t know all the science behind the device. But, he said, he thinks back on all the money he spent on shots and meds, and all the time getting jabbed, and he wonders why he didn’t have access to something so simple.

No Science Backs Device

So far, there is no science to prove the devices work, but Tucker claims a 70 percent positive response rate. He said he has patients filling out questionnaires so that researchers can begin scientific testing of the product.After opening his own AllergiCare Relief Center in Tampa, Tucker franchised the equipment to 11 more U.S. locations and two in Canada. More are planned.

PENN AND TELLER B@#$S&*#$ EPISODES ON ALTERNATIVE MEDICINE

Get Educated, don’t get ripped off! For further info on dubious medical devices go to www.quackwatch.org

Flu Shots OK for People With Egg Allergy

from Medscape:

Flu Shots OK for People With Egg Allergy

Denise Mann

October 18, 2010 — For years, people with egg allergy were told to avoid the flu vaccine because it contains egg protein and could trigger a reaction, but this advice no longer stands. People with egg allergies can — and should — get the flu shot this year, according to a new report by the American Academy of Allergy, Asthma & Immunology.

About 1.5% of young children have an egg allergy, but most will outgrow it over time, according to the Food Allergy and Anaphylaxis Network in Fairfax, Va.

Why the change?

“We now know with confidence that most people with egg allergy can receive the flu shot without reaction,” says the report’s author, James T. Li, MD, PhD, an allergist at the Mayo Clinic in Rochester, Minn.

There is a “detectable, but very low” amount of egg protein in the H1N1 and seasonal flu vaccines, and studies have shown that the majority of people with egg allergy do not have an allergic reaction to the flu shot, he says.

“The number of reactions wasn’t zero, but it was low, and most reactions were not serious,” Li tells WebMD.

Skin testing is not necessary either unless the person with egg allergy has had a reaction to the flu vaccine in the past, Li says. The flu vaccine can be given in two doses or as a single dose if someone has an egg allergy.

Caution is still advised in certain scenarios. For example, there is still some question on whether people with severe egg allergy can receive the flu shot, he says.

See an Allergist for Proper Evaluation

“If you have egg allergy or suspected egg allergy, see your doctor, and there is a very high probability that you can receive the influenza vaccine without reaction and derive the benefits,” Li says.

Elizabeth Loewy, MD, an allergist in private practice in New York City, says that she feels very comfortable giving the flu vaccine to individuals with mild egg allergy.  “An egg allergy in a child is a huge predictor for asthma, and children and adults with asthma are at greater risk for complications from the flu,” she says.

The new report “makes it easier for pediatricians to give kids with egg allergy their annual flu shots because it eliminates some of their concerns about reactions,” she says.

Loewy currently uses a skin test, and if the person does not react, she will give the vaccine as one shot. If there is a reaction, she will break it up into two doses. She may decide to skip the skin tests in the future based on this new report, she says

SOURCES:

American Academy of Allergy, Asthma & Immunology.

Elizabeth Loewy, MD, allergist, New York City.

James T. Li, MD, PhD, allergist, Mayo Clinic, Rochester, Minn.

Food Allergy and Anaphylaxis Network.

Poison Ivy Rash

from MayoClinic.com

A poison ivy rash is a type of skin irritation called allergic contact dermatitis. Poison ivy rash is caused by a sensitivity to an irritant found in poison ivy and similar toxic plants, such as poison oak and poison sumac. Each of these plants contains an oily resin called urushiol (u-ROO-she-ol) that can irritate the skin and cause a rash.

Although the itching from a poison ivy rash can be quite bothersome, the good news is that a poison ivy rash or one caused by poison oak or poison sumac generally isn’t serious. Poison ivy rash treatment consists of self-care methods to relieve itching until the reaction disappears.

Signs and symptoms of a poison ivy rash include:

  • Redness
  • Itching
  • Swelling
  • Blisters

Often, the rash looks like a straight line because of the way the plant brushes against the skin. But if you come into contact with a piece of clothing or pet fur that has urushiol on it, the rash may be more spread out.

The reaction usually develops 12 to 48 hours after exposure and can last up to eight weeks. The severity of the rash is dependent on the amount of urushiol that gets on your skin.

In severe cases, new areas of rash may break out several days or more after initial exposure. This may seem like the rash is spreading. But it’s more likely due to the rate at which your skin absorbed the urushiol.

Your skin must come in direct contact with the plant’s oil to be affected. Blister fluid from scratching doesn’t spread the rash, but germs under your fingernails can cause a secondary bacterial infection.

When to see a doctor
See your doctor if any of the following occur:

  • The reaction is severe or widespread.
  • The rash affects sensitive areas of your body, such as your eyes, mouth or genitals.
  • Blisters are oozing pus.
  • You develop a fever greater than 100 F (37.8 C).
  • The rash doesn’t get better within a few weeks.

Poison ivy, poison oak and poison sumac can all cause contact dermatitis and the resulting itchy rash.

  • Poison ivy is an extremely common weed-like plant that may grow as a bush, plant or thick, tree-climbing vine. The leaves typically grow three leaflets to a stem. Some leaves have smooth edges, while others have a jagged, tooth-like appearance. In the fall, the leaves may turn yellow, orange or red. Poison ivy can produce small, greenish flowers and green or off-white berries.
  • Poison oak can grow as a low plant or bush, and its leaves resemble oak leaves. Like poison ivy, poison oak typically grows three leaflets to a stem. Poison oak may have yellow-white berries.
  • Poison sumac may be a bush or a small tree. It has two rows of leaflets on each stem and a leaflet at the tip.

The irritating substance is the same for each plant, an oily resin called urushiol. When your skin touches the leaves of the plant, it may absorb some of the urushiol made by the plant. Even a small amount of urushiol can cause a reaction. Urushiol is very sticky and doesn’t dry, so it easily attaches to your skin, clothing, tools, equipment or pet’s fur.

You can get a poison ivy reaction from:

  • Direct touch. If you directly touch the leaves, stem, roots or berries of the plant, shrub or vine, you may have a reaction.
  • Urushiol remaining on your skin. You may develop a poison ivy rash after unknowingly rubbing the urushiol onto other areas of your skin. For example, if you walk through some poison ivy then later touch your shoes, you may get some urushiol on your hands, which you may then transfer to your face by touching or rubbing.
  • Urushiol on objects. If you touch urushiol left on an item, such as clothing or firewood, you may have a reaction. Although animals usually aren’t affected by urushiol, if it’s on your pet’s fur and you touch your pet, you may develop a poison ivy rash. Urushiol can remain allergenic for years, especially if kept in a dry environment. So if you put away a contaminated jacket without washing it and take it out a year later, the oil on the jacket may still cause a reaction.
  • Inhaling smoke from burning poison ivy, oak or sumac plants. Even the smoke from burned poison ivy, poison oak and poison sumac contains the oil and can irritate or injure your eyes or nasal passages.

A poison ivy rash itself isn’t contagious. Blister fluid doesn’t contain urushiol and won’t spread the rash. In addition, you can’t get poison ivy from another person unless you’ve had contact with urushiol that’s still on that person or on his or her clothing.

Scratching a poison ivy rash with dirty fingernails may cause a secondary bacterial infection. This might cause pus to start oozing from the blisters. See your doctor if this happens. Treatment for a secondary infection generally includes antibiotics.

Surviving Spring Allergies

If it seems like you get a “cold that won’t quit” at the same time every year, chances are it’s a seasonal allergy. Seasonal allergies, commonly referred to as “hay or rose fever”, can seem like a stubborn cold. The symptoms — including stuffy, runny nose, sneezing and wheezing – certainly match the misery of a cold. But hay or rose fever carries some telltale signs, the seasonal nature of symptoms being the major one.

About 20% of the US population or 35 million people suffer from allergic rhinitis. In the spring, tree pollen is the primary culprit in triggering allergic rhinitis, although in more humid areas outdoor mold can also spawn similar symptoms. Tree pollen can start to be a problem as early as February.

Even though symptoms and their timing can indicate a springtime allergy, allergy testing is the only way to confirm it and weed out which substances are causing the misery. It’s true that tree pollen is the main culprit behind allergies that take their leave once spring has passed. But many people with allergies are sensitive to a number of other substances; hanging out with the neighbor’s cat could also be contributing to those springtime sniffles.

In addition, people tend to seek treatment only when symptoms get severe. So even though you might be bothered enough to see a doctor only in the spring, it’s possible that other allergens — perhaps the grass pollen predominant in summer or the weed pollen that abounds in autumn — are producing milder reactions.

Treatment approach for seasonal allergies include:

1. Environmental control or Allergen avoidance
:

Pollens are difficult to avoid. Individuals who suffer from allergies should avoid outdoor activity during peak pollen times. Trees and grasses pollinate mainly during early morning hours (5-10 AM). You should keep windows closed in the house and car and operate your air conditioner.

2. Medication treatment

Several types of oral and nasal medications are known to control hay fever. Devising the right combination depends on the severity of patients’ symptoms and whether they suffer any medication side effects. Antihistamines, which block the action of symptom-spurring histamine, are a mainstay of hay fever therapy. One of the drugs’ drawbacks is drowsiness, but newer prescription and over-the-counter antihistamines are made to be non-sedating. Other potential side effects include dry mouth, constipation and, in some children, irritability and restlessness.
Antihistamines are also available as nose sprays and eye drops, which act directly on the nose and/ or eyes affected.

Oral antihistamines can quash sneezing, itching and eye symptoms, but offer little relief from congestion, so some products have an added decongestant. Decongestants work by acting on blood vessels, but side effects include increased blood pressure and sleeplessness and are problematic for people with glaucoma, hypertension, and large prostates.

Prescription nasal corticosteroids, which include medications, are another cornerstone of treatment. Corticosteroid drugs are similar to a hormone, cortisol, that the body produces naturally. Nasal corticosteroids ease a range of hay fever woes by blocking the release of inflammatory chemicals in the nasal passages. They are intended to be taken daily to prevent symptoms, starting shortly before the onset of pollen season.

Inhaled steroids can cause nasal irritation, including nose bleeds, and there have been concerns over their possible effects on children’s growth. But studies show the drugs are safe when used appropriately for allergies and asthma.

Nasal-spray decongestants offer a temporary reprieve from a stuffy nose, but should not be used for more than a few days because they can actually make congestion worse if used longer.

An “often overlooked” part of hay fever treatment is the nasal wash, a salt-water solution that can help remove mucus and pollen from the nose — and clear a path for inhaled medications to do their job.


3. Allergen vaccination/ Immunotherapy or “Allergy shots”:

For hay fever that is particularly severe or that persists beyond spring due to sensitivity to several allergens, allergy shots may be an option. This treatment, also called immunotherapy, involves injecting small amounts of the offending substance, over time, in order to normalize the immune response.Immunotherapy can quell hay fever, and may even prevent seasonal allergies from progressing to asthma.

Allergy shots are used for those with moderate to severe allergies who are not easily controlled on medications or who cannot tolerate medications. Shots can also be offered for those who desire permanent relief after 3-5 years of treatment. Allergy shots reduce the need for medications and provide the possibility of long-term benefit after 3-5 years of treatment. Related research has also shown that allergy shots prevent the development of persistent asthma and also reduce the development of new allergies. Research has also shown that allergy shots prevent the development of persistent asthma in individuals with hay fever and reduce the development of new allergies.

LINK:

Allergy Medications