Dr. Waserman: Daffodils are considered “allergy-friendly,” since plants with showy flowers are generally pollinated by insects rather than the wind. Daffodils produce less pollen, and symptoms such as allergic rhino-conjunctivitis and asthma aren’t commonly associated with them.

However – handling daffodils is another story. Among florists and flower pickers, allergic contact dermatitis, irritant contact dermatitis (from sap) and hives are quite common.

Your daughter may have had an allergic or irritant contact dermatitis reaction or urticaria (hives). I recommend that she not handle daffodils and related narcissus varieties.

While unusual with daffodils, the throat symptoms might be an acute reaction, or anxiety as you suggest. Your daughter needs to be assessed by an allergist. If her symptoms and testing indicate allergic rhinitis, the allergist likely will prescribe intranasal steroids to alleviate the allergy.

We welcome your question to Allergic Living’s Ask the Allergist. Thank you for understanding that the specialists aren’t able to answer every question received.

Dr. Susan Waserman is an allergist and Professor of Medicine in the Division of Allergy and Clinical Immunology at McMaster University in Hamilton, Ont. She is also a past president of the Canadian Society of Allergy and Clinical Immunology.

There’s a lot of work in keeping an allergy-friendly home: regular dusting and vacuuming, cleaning with hypoallergenic products and ensuring low humidity levels to keep moulds away. This regimen is likely to keep indoor allergies in check, unless you have wall-to-wall broadloom. Carpets are heaven for allergy-inducing dust mites, since pile traps skin particles, the mites’ main source of nourishment.

If you’re looking to replace your dust mite settlement with a hypoallergenic floor, there are a number of good options. And esthetic appeal can still be your first consideration, according to Mark Bisbee of GreenFloors, a Virginia-based flooring company that specializes in healthy floors. “Just because it’s good for you, doesn’t mean it has to be ugly.”

Allergic Living sweeps through the following choices for a beautiful, allergy-free floor.

Bamboo

The green alternative to hardwood, bamboo is growing in popularity and dropping in price. Like hardwood, bamboo comes naturally light or dark (and can be stained) and is just as easy to keep clean. Bamboo, though, is actually a member of the grass family. It only takes three years to mature – most hardwood takes between 50 and 100 years – and it flourishes with few pesticides, so the impact of harvesting it is minimal.

Bamboo is kiln-dried and turned into a variety of floor products, from unfinished tongue-and-groove strips that are installed the old-fashioned way, with a hammer and nails, to floating floors that can be glued into place. Bamboo is durable, too, lasting between 30 and 50 years, and can be refinished. However, like any wood product, it’s not suited to a moisture-prone area of the home.

Be careful when choosing your bamboo since some brands are made using formaldehyde (known to irritate the airways), while other brands may emit volatile organic compounds (VOCs). Check also that an installer is using an adhesive that will not give off fumes. Be sure to ask a supplier for an emission-free bamboo: it is available and beautiful.

Cork

This is another great and green alternative. Bark from the cork oak tree is harvested carefully in its natural habitat, the Mediterranean, (Portugal is a major exporter) without doing any damage to the trees themselves – some of which are centuries old. The bark is then fashioned into tiles that are moisture resistant, making it a good choice, even in the kitchen.

Cork flooring products include glue-down tiles and floating-floor systems in which the cork is pre-glued to a core of particle board. Pieces snap together to make a floor. Wicanders is one brand that ensures the particle board in their floating floor is virtually formaldehyde free (less than 1 per cent).

Cork comes in a variety of colors and patterns. While it may feel soft underfoot, it is long-lasting as well as visually appealing.

Natural Linoleum

Just the word ‘linoleum’ may conjure up images of the vinyl flooring popular in 1950s kitchens. Today, the word has been reclaimed and is used to describe floors created from organic materials that are stylish and allergy-friendly.

Natural linoleum, also known by the brand name Marmoleum, is made from wood flour and bound together with flax and linseed oils to produce an anti-microbial barrier. “You can actually eat it – it’s 100 per cent biodegradable,” Bisbee says. Marmoleum comes in an incredible range of patterns and colors, from bright red to mahogany brown. It is durable, lasting about 30 years.

Next: Tiles and Stairs

Angela Doody pulled open the front door of Priestman Street Elementary school two years ago, and strode across a shiny tiled floor on her way to the office to register her two children. Looking around, she was amazed at how clean and neat the kids’ new school was. “I thought, “We get to go here?” she recalls.

Aside from the friendliness of the staff, it was well organized and uncluttered. “It just seemed like a really good place to be educated.” Doody was not aware that day that Priestman Street has been a prototype: the first school to go through the New Brunswick Lung Association’s Healthy Schools program, the first in a province to vastly improve its indoor air.

Her 11-year old daughter, Katelyn, who has asthma, has been able to benefit from this program while in Grades 4 and 5 at the school. The previous school she attended was in an older, dusty  building, and that led to a “rough year for her,” says Doody.

While Katelyn did have some trouble with asthma control in her first year at pristine Priestman – “she picked up a lot of viruses,” says her mother – this past year was far better. “She didn’t miss many days of school last year because of her asthma,” says Doody.

Missing school is a big problem for students with asthma. Too often the school environment itself is a culprit, causing symptoms like wheezing or coughing that are exacerbated by the colds spread by classmates. Science is showing that air quality in schools can have a significant impact on health, and this becomes especially important when there are children attending with asthma or environmental allergies.

Back in the 1980s, asbestos in the schools became a focus (and is still a concern in some schools), but what our school systems have been slower to address are a huge number of allergen triggers and irritants. In classrooms and portables, mould can be a festering issue, antiquated ventilation systems can lead to stagnant air and recycled allergens, while old carpeting can harbour a double whammy of dust mites and mildew.

The janitor may inadvertently spark an asthma attack by using potent cleaning chemicals, so might rodents being shown for educational purposes, while a teacher’s fragrance can aggravate a child with a sensitivity to scent. Even tools as seemingly harmless as chalk and supplies for arts and crafts can be problematic.

Children are particularly susceptible to chemicals, dust and other allergens in the air; they are not simply mini-adults. Their skin absorbs toxins at a higher rate and they breathe more air per pound of body weight than adults do.

Students with asthma, in particular, benefit from an environment free of allergy triggers. Making improvements to a school’s air quality can at times be simple, such as switching to dustless chalk. Other changes, such as overhauling ventilation systems, are a lot more costly and may require lobbying at the school board level for funding.

However, in schools where air quality improvement plans have been made, the difference has been profound. At Priestman Street Elementary, change began with a simple walk through the school.

Donna Bliss, Priestman Street’s principal, worked with a team that surveyed the one-level school’s four wings, which contained classrooms, main offices, the gymnasium, and the music room. They worked from a checklist from the Lung Association’s Healthy Schools program, which includes a range of potential problems, such as cleanliness, pest control, moisture, ventilation, furnishings, parking zones and storage and use of art and science supplies.

Bliss and the committee identified a number of issues. “We had plants in classrooms that had mould; we had to put air monitors in a couple of rooms because we thought the air was stagnant; we had to check piping because at one point they had been wrapped in asbestos,” she begins to list.

“Our service that gives us custodial supplies was just going through the transition to environmentally friendly products, and we still had some old products, so we had to dispose of them appropriately.” They also examined their outdoor grounds, which are beside a busy intersection in an area of Fredericton known as “Top of the Hill.” They found the yard lacked green space and that school bus drivers and parents were idling their vehicles on school grounds.

Next page: School Ventilation

Ragweed

Of the sources of autumn allergy misery,ragweed is by far the worst. It is the most common cause of seasonal allergies at this time of year and it’s everywhere. In the one year a ragweed plant lives, it will produce as many as one billion grains of pollen that can be carried by the wind up to 650 kilometres (400 miles) away. Giant and common ragweed are found across North America (though less commonly on the coasts), with the prime blooming season running from late August until the first frost kills off these adaptable plants.

Other Weeds

Though ragweed is the worst offender, others can be problematic for the allergic:

White Cockle (Silene pratensis) – Grows up to a metre tall, with oblong leaves that are 2 to 10 cm long (1 to 4 inches) and 2 cm (1 inch) wide. White flowers open in the evenings; a prolific seed producer.

Cow Cockle (Vaccaria pyramidata) – Also known as China cockle, this weed has pretty bright pink flowers and bluish-green leaves. Height can reach 60 cm (2 feet).

Mugwort (Artemisia vulgaris) – Perennial; grows between 0.5 to 2 metres (1.5 to 6.5 feet), with a slightly hairy stem that is often reddish-brown. Leaves are dark green on top and silvery underneath; it gives off a sage-like aroma.

Curled Dock/Narrow-leaved Dock (Rumex crispus L) and Broad-leaved Dock (Rumex obtusifolius L) – Long, dark green leaves with wavy edges form a base for a metre-long stem with clusters of green flowers.

Amaranth/Pigweed (Amaranthus) – a family of annual weeds that share similar characteristics: alternating oval-shaped leaves, green flower clusters and smooth stems. Prostrate Pigweed grows along the ground while Redroot Pigweed and Green Amaranth grow upright.

Lamb’s Quarters (Chenopodium album L) – An annual with bluish-green leaves that grows up to 2.5 metres (8 feet) high on stems with purple or red blotches. Flowers are small (up to 3 mm) green petal-lesspods with a blue tinge.

Russian Thistle (Salsola kali L) – Thin, spiky leaves sprout from multiple branches that are often striped with red. Purple-tinged stems grow to more than 1 metre (about 4 feet) tall, which dry out and break off when mature, forming “tumbleweeds” that spread seeds.

Plantain (Plantago major L) – Long, narrow flower clusters (7 to 30 cm/2.5 to 11.5 inches in length) hold numerous greenish-white flowers with wind-distributed pollen. Plant grows to 60 cm (2 feet) high, with smooth, spade-shaped leaves.

Mold

Mold can be found anywhere it’s damp, including in piles of decaying plant matter, composters, gutters, rotting wood (like those porch steps you meant to fix) and inside the house in basements, bathrooms and laundry rooms. Several types of mold cause allergy symptoms, and many of them thrive both indoors and out, including Alternaria, Aspergillus, Cladosporium, Panicillium, Epicoccum, Fusarium and Bipolaris. Your allergist can test you for sensitivity to the different types, though all are hard to avoid completely.

According to the American Academy of Allergy, Asthma & Immunology (AAAAI), the weather plays a large role in how badly a mold allergy will flare. The damper the conditions, the more mold there will be.

How Mould Behaves

Mould allergen is spread on the wind in the form of spores, much like the lighter plant pollens. However, unlike weeds, which are generally destroyed by the first good cold snap, many moulds simply become dormant over the winter, reappearing in the spring in soggy organic matter such as piles of mulch. During drier summer months, the mould allergic person’s symptoms wane, only to resurface in the fall with more rain and dropped leaves on the ground.

Inside, basements are a fungus’s best friend. With damp walls, leaky foundations, storage boxes full of paper, improper insulation and carpeting, the subterranean level can be the perfect breeding ground. That “musty” basement smell is a dead giveaway that mould has moved in.

Next Page: What can you do?

What is immunotherapy?

Immunotherapy is a form of treatment, commonly known as allergy shots, in which a patient with allergic rhinitis gets controlled exposure to allergens through injections. It will not be the first course of treatment. In immunotherapy, a doctor raises the allergen dose in your shots over a number of months and years – the intent is that as the dose rises, you become less sensitive to allergens.

Who should get allergy shots?

First, your allergist will take a history, do an examination including skin-prick tests to determine what you are allergic to, and then will prescribe medications. If you’re still suffering even with medication, allergy shots may be the next step. Candidates for this treatment are usually people who are no longer helped by allergy medications and those who have serious rhinitis symptoms for prolonged periods of time.

If you haven’t had allergies for long, you are more likely to be responsive and experience longer-lasting benefits. Children, however, should have had seasonal symptoms for at least two years before being considered candidates, says Dr. Eric Leith, an allergist based in Oakville, Ontario, and chair of the Canadian Allergy, Asthma and Immunology Foundation. The child should be old enough to understand what’s going on, he says, “and if a reaction occurs, they must be able to express that.”

Allergist Dr. Harold Kim says about 5 to 10 per cent of patients receiving immunotherapy have skin, breathing or gastrointestinal reactions. Only about 1 to 3 per cent have more severe reactions. While anaphylaxis is rare, “immunotherapy can be life-threatening,” cautions Leith. “You should be waiting in the doctor’s office for half an hour [after the treatment] to make sure you are not reacting.” If you have asthma, Leith stresses that it must be under control or the shots “may accentuate the asthma.”

How long does immunotherapy treatment last?

Immunotherapy can take years to carry out. Patients receive one to two shots a week of minimal amounts of their allergen for about six months, until they reach their “maintenance dose,” which means symptoms have improved. Then, a monthly dose is required to keep the allergies under control. Treatment can take up to five years, but the benefit of immunotherapy is that it may have a lasting effect even after the shots have stopped. Leith says there have been cases in which patients have seen their symptoms disappear completely.

Related:
• The Hay Fever Handbook
• 10 Ways to Beat the Pollen
• America’s Top 10 Spring Allergy Capitals

From the Spring 2006 issue of Allergic Living magazine.
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