Clinical Reference Systems: Pediatric Advisor 10.0
Environmental Control and Asthma
Children with asthma have extra sensitive airways. Asthma
symptoms can be started by many things in the environment
and these triggers are unique to each child. Some common
triggers of asthma symptoms are cigarette smoke, perfume,
strong odors, and cold air. Other environmental factors
that can affect children with asthma include weather and
climate changes, pollens, house dust, molds, and animals.
Try to limit your child's contact with these triggers,
especially where the child spends the greatest amount of
time, such as at home and school.
Pipe, cigarette, and cigar smoke are harmful to children and
adults in general, but the smoke poses a special problem for
all children with asthma. Even the smell of smoke on
clothes can trigger asthma symptoms in a child with
sensitive airways. Smoking in the home of a child with
asthma can be life threatening and is unacceptable.
Lightweight airborne pollens from grasses, weeds, and some
trees can be carried for miles. These pollens strike the
eyes, nose, and airways, triggering the symptoms of asthma.
Flower pollens are heavier and do not travel as far.
Although it is difficult to avoid pollens totally, some
- Keep the child's bedroom windows shut and use central air
conditioning during the allergy season. Bedroom windows
should be kept closed during the early morning hours,
when weed pollen counts are highest. If a room air
conditioner is used, recirculate the air rather than pull
outside air indoors. Wash or change air filters every
- After working or playing outside during high-pollen
seasons, your child should shower and change clothes
immediately. Dirty clothes should be kept outside the
- Mow the lawn frequently to limit the amount of pollen
Molds are found year-round throughout the house, outdoors,
and in certain foods, but especially in areas of high
moisture. Molds produce lightweight spores that can travel
for relatively long distances on air currents in the house.
Bathrooms and damp basements are two common areas for mold
growth, but swamp coolers, humidifiers, and the refrigerator
drip pan and crisper also promote growth of molds. Here are
some suggestions to decrease mold growth:
- Light and ventilation significantly deter mold growth.
Thoroughly clean tile, floors, shower curtain, and tub
surround and clean under plumbing fixtures on a routine
basis. Use a fungicide such as dilute household bleach
(1 cup of bleach to 10 cups of water) if necessary.
- For painted surfaces, enamel paint inhibits mold growth
more effectively than latex paint. An antifungal
substance can be added to paints to inhibit growth even
- Dehumidifiers deter mold growth in damp areas such as
basements. Areas that become damp from hard rains are
ideal for mold growth and should be fixed.
- Evaporative coolers, vaporizers, and humidifiers with a
reservoir are ideal places for mold and bacteria to grow.
When these appliances are operating, molds and bacteria
can be sprayed throughout the house. In general, these
appliances are not recommended. If you do use one, the
empty the reservoir daily, clean it with soap and water,
and dry it thoroughly. The reservoir should be refilled
just before use.
- Greenhouses, compost piles, and homes with many plants
also are frequently sources for molds. Cover the potting
soil of houseplants with foil to decrease spreading of
- Foam pillows and mattresses can be sites for mold growth.
Replace foam pillows with washable polyester ones, and
cover foam mattresses with a nonporous covering (for
House dust is made of many things, including dirt, insect
debris, dust mites, animal proteins, human skin fragments,
food crumbs, bacteria, fungi, and other materials. House
dust collects on every item in the home, including
mattresses, upholstered furniture, clothes, rugs, drapes,
and stuffed animals.
It is very difficult to avoid house dust, but the following
recommendations will decrease your child's contact with
- Avoid clutter and dust catchers, particularly in the
bedroom. These include wall decorations (pictures,
pennants, and fabric wall coverings), drapes, and
venetian or miniblinds.
- Give your child washable, "nonallergenic" stuffed toys
when possible. Store ordinary toys, dolls, and play
equipment outside the bedroom or in the closet.
- Keep the bedroom closet door closed. Vacuum the closet
floor often. Store only in-season clothes in the closet.
- Bare floors are ideal. Carpeting can be tolerated if you
vacuum done frequently and thoroughly. Ideally, you
should vacuum and dust early every day to let dust settle
before nap or bedtime. Be sure to clean under the
furniture and in the closet.
- Mattresses and box springs should be encased in allergen-
proof coverings. Zippers or openings should be taped.
Use only polyester pillows and wash them several times a
year. Bed linens and covers should be washable cotton or
synthetic fibers. Avoid use of feather, wool, kapok, or
- Forced-air furnaces should have a dust-filtering system.
Filters should be changed every 2 weeks during the
heating season. Filters can be cut to cover room vents
if the central furnace filters are not changed every
2 weeks. Cold and warm air ducts can be professionally
cleaned at least every four to five years.
A substance in animal saliva, dandruff, and urine causes
allergic reactions in many people. Children may be more
sensitive to one type of animal (such as cats) than another.
All furred animals have the potential to cause allergic
Removing a family pet is very difficult, but if your child
has significant sensitivity, it may be necessary. Once the
pet is removed from the house, animal residue may remain in
the house for months. Thorough cleaning is essential, with
particular emphasis on stuffed furniture, rugs, drapes, and
the heating/cooling system.
If a child with limited animal sensitivities has a pet, the
pet should live outside and NEVER be in the child's bedroom.