Overview of Regimen Measures for House Dust Mite Allergy

Introduction

It has been over 50 years since the house dust mite was first identified as a dust allergen and a trigger for allergic reactions. Today, house dust mite allergy significantly contributes to the overall prevalence of allergic respiratory diseases, partly because we spend more than 90% of our time indoors.

In pharmacotherapy, in addition to symptomatic drugs like antihistamines or corticosteroids, causal treatment in the form of specific allergen immunotherapy is applied. Despite advances in pharmacological treatment, comprehensive regimen measures that contribute to reducing allergen exposure still form an essential part of the treatment.

Overview of Regimen Measures

Exposure to allergens can occur at home, at school, or in the workplace. Regimen measures should focus on rooms where most time is spent, particularly bedrooms and children's rooms. Regimen measures are also easier to implement and maintain at home than at school or work. Key factors to consider include bedding materials and appropriate washing methods, indoor humidity levels, air purifiers and vacuum cleaners, the presence of carpets, and the use of chemoattractants.

For bedding, mattress covers, and blankets, finely woven fabrics that greatly reduce mite permeability are considered best. Tests have shown that living mites can pass through non-woven fabrics. Plastic materials are the least suitable as they reduce heat dissipation and increase sweating. Regular washing of blankets, pillows, and bedding is also important. Washing at warm cycles (30-40°C) is as effective in removing mites as washing at hot cycles (> 60°C). Warm cycles may be less effective in front-loading washers, but this drawback is offset by using dryers, which can kill virtually all mites.

Mites depend on environmental humidity for growth and reproduction, although they can survive longer in low humidity conditions, explaining the seasonal differences in symptoms. Therefore, it is necessary to maintain relative humidity at < 45-50% indoors and to ventilate frequently. Air purifiers with HEPA filters are beneficial, but they should be placed to avoid stirring up dust from surfaces, particularly carpets. If an air purifier is placed on a carpet, it may disperse allergens into the air more than it can absorb.

Important sources of mites include carpets, upholstery, and other textile furniture (blankets, throws, etc.). It is advisable to minimize these textiles in homes and clean them outdoors. Carpets need regular vacuuming, ideally with a steam cleaner and HEPA filter. Patients should be educated that many forms of housework (and even children's play such as pillow tossing, jumping on beds, etc.) can significantly increase allergens in the air. Allergen sufferers are advised to wear appropriate face and eye protection (e.g., respirator and goggles) during cleaning and to avoid the room for about 20 minutes after cleaning. It is also worth considering whether to keep curtains in the home, and if so, to wash them frequently. Stuffed toys should also be washed and frozen in the freezer.

The last but equally important measure is the use of chemoattractants to help remove mites from mattresses, bedding, carpets, upholstery, and other furniture. This includes a medical device in the form of a spray based on non-toxic plant extracts that simulate pheromones used by mites to communicate.

Conclusion

House dust mites are a significant cause of allergic respiratory diseases, including bronchial asthma, in both children and adults. In addition to pharmacological therapy, non-pharmacological regimen measures, such as adjusting the household, using appropriate materials, adhering to hygiene measures, and regularly using chemoattractants on critical surfaces, form an important part of treatment.

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Sources:
1. Wilson J. M., Platts-Mills T. A. E. Home environmental interventions for house dust mite. J Allergy Clin Immunol Pract 2018; 6 (1): 1-7, doi: 10.1016/j.jaip.2017.10.003.
2. Janíčková H. House Dust Mite and Mold Allergy. Pediatrie pro praxi 2009; 10 (3): 163-166.