Friday, December 30, 2016

Fa la la achoo: Holiday trappings tough for some with allergies

Michael Cosdon (center) with his family and new fake tree
Posted December 18, 2016

Ever since he was a kid, Michael Cosdon has dreaded one thing about the Christmas season: the respiratory infection he'd get.
The symptoms, including coughing and congestion, would appear about five days after his family decorated its fresh-cut evergreen tree, a tradition he continued when he started his own family. By the time Christmas Day arrived, he would have full-blown bronchitis. After New Year's Day, he'd feel better.
Until this year, Cosdon never saw a connection with his family's holiday centerpiece and his illness, though he is allergic to mold and pet dander.
“I thought it was wintertime, no big deal," the Bedminster man said. 
It turns out he's allergic to Christmas. Well, not the holiday exactly, but one of its biggest symbols.
He isn’t the only one suffering, either, according to area doctors. For people with allergies and chronic respiratory conditions, the weeks before Christmas can be the most miserable time of the year.
While live Christmas trees are a big culprit, they aren’t the only one, according to allergy specialists. The scent of cinnamon, sugar plums or candles can trigger mysterious coughing fits and trouble breathing. Arranging poinsettias or pine rope decorations can result in a sudden red and itchy rash. Getting house decorations out of storage can cause scratchy throats and watery eyes.
“They complain, but they don’t know (the cause),” said Dr. Maria Lania-Howarth, who heads the division of allergy-immunology at Cooper University Health Care in Camden, New Jersey.
Typically, during the two weeks before Christmas Day, Lania-Howarth sees an uptick in calls to her office involving sinus pain, wheezing, sneezing, itchy eyes and scratchy throats. A brief patient history often traces the onset of symptoms to not long after Christmas decorating began, according to her and other doctors.
Allergies affect as many as 30 percent of adults and 40 percent of children, and mold allergies specifically affect about 15 percent of people, according to the Asthma and Allergy Foundation of America. Allergic disease, including asthma, is the fifth-leading chronic disease in the U.S. in people of all ages and the third-most common chronic disease in children under 18 years old.
Pine trees harbor Aspergillus mold, which is found on decaying plant vegetation and can enter and grow inside a person’s airways, making it hard to breathe. Pine tree sap also contains substances that can irritate the skin and mucous membranes.
A few studies on so-called Christmas Tree Syndrome confirm that mold on fresh-cut evergreen trees can trigger severe asthma attacks, fatigue, sinus congestion and other allergy symptoms.
State University of New York's Upstate Medical University researchers found 53 kinds of mold on 26 pine needle and bark samples from live pine trees, according to a 2011 study published in the Annals of Allergy Asthma and Immunology. The study found most of the molds were allergens that could trigger reactions in infants. The respiratory illness symptoms peaked around Dec. 25, give or take a week.
Those results mirror a 2007 study in which Connecticut scientists found mold levels five times above normal two weeks after a fresh Christmas tree was placed in a room. The tree was set up 10 feet from a heat vent, and the indoor temperature was maintained at between 65 and 68 degrees.
The earlier study found that, three days after a live tree was put in a room, the spore count was 800 grains per cubic meter of air over 24 hours. Normal mold spore counts are under 1,000 spores per square meter. After the fourth day, the mold counts started rising, reaching a maximum of 5,000 spores per square meter by the 14th day, the study found.
The mold occurs within days after a fresh pine tree is cut. Evergreens have a high moisture content and mold thrives in moisture. Once the tree is placed in a water-filled stand, bacteria forms and clogs the tree's vascular tissue and it starts to decay. The process is accelerated when trees are brought into homes with central heating.
“If you get a cold the same time each year, and notice it’s after you bring out the Christmas ornaments, there may be a correlation,” said Dr. Robert Danoff, a family medical specialist at Aria-Jefferson Health System, which has a campus in Falls.
Asthma is a bronchial condition caused by spasms in the lungs that can interfere with breathing. The condition is triggered by allergies for about half of those with asthma, though sufferers might not realize the symptoms they experience around the holidays are really an allergic reaction. 
The triggers and reactions can vary — and Christmas trees aren't the only culprit, Danoff said. For example, one of his patients gets migraine headaches triggered by the smell of strongly scented balsa candles.
Other allergy specialists agreed that strong smells from candles and room sprays — along with dust on stored decorations — also can trigger symptoms.
Pine and cinnamon scents, in particular, can result in a flare-up for people with asthma or chronic obstructive pulmonary disease, commonly called COPD, according to Kim Ryan, a respiratory therapist and pulmonary rehab coordinator at Grand View Health in West Rockhill. 
She estimates 90 percent of her patients are especially sensitive to candles with heavy, synthetic or chemical scents. At Grand View's rehab, there is an artificial Christmas tree decorated for the holidays, she said. 
“Their faces light up when they see this tree. At home, most don’t even decorate because they can’t,” Ryan said. “It’s sad.”
Some people choose small ceramic trees they can dust, she said. Others decorate an outdoor evergreen. Some go artificial.
Two weeks ago, Cosdon did what he once thought was the unthinkable: He bought a fake Christmas tree.
“I got the realest-looking fake tree I could find,” he said.
So far, Cosdon said that he hasn't experienced any of the usual pre-Christmas sinus symptoms. 
“I think inside I always knew — I have a complicated relationship with my allergies,” he added.

Curbing Christmas Allergies

Live Christmas tree, poinsettias, pine rope
If you want a real pine tree clean it before bringing it indoors. Shake off as much debris as possible; use a leaf blower or air compressor to remove debris, pollen and mold spores. Then blast the tree with a garden hose or sprayer, especially the trunk. Set it in a bucket of water in a covered porch or garage for a few days until it dries.
Wear gloves and long sleeves when carrying the tree or pine rope into the house. Avoid sap touching your skin.
Avoid keeping a live tree in the house longer than one week, definitely no longer than two weeks.
Opt for a Leyland Cypress evergreen, which is less allergy inducing variety.
Poinsettia are festive but they also contain compounds similar to the ones found in latex so avoid the plant if you are allergic to latex.
Artificial trees and decorations
Use gloves and wear a dust mask when removing decorations from attic or basement.
Avoid the spray snow flock on tree and windows. Aerosolized chemicals irritate eyes, nose, and lungs and can trigger symptoms in asthma sensitive individuals.
Wipe down the tree and ornaments at the end of the season and wrap your artificial tree and secure it in a cool and dry place.
Smells like Christmas
Candles that are heavily scented with synthetic fragrances and chemicals that that can emit fumes and soot that irritate breathing and trigger allergies and asthma.
Avoid petroleum based candles for ones made with soybean, palm, hemp or beeswax and that are scented with essential oils.
Go sparingly with the scented aerosol sprays and air fresheners. They can release noxious chemicals that can irritate the eyes and airways of individuals with allergies or asthma. Instead opt for natural potpourri like cinnamon sticks and cloves.
Make sure to have a professional check your fireplace, wood burning stove and chimney to make sure it’s in good working shape. Hidden cracks, creosote buildup or venting problems that can lead to carbon monoxide poisoning.
Opt for seasoned hardwood, which burns slow and even so it produces less smoke and fumes.
For asthma sufferers it’s best to avoid firing up the fireplace since ash and smoke can trigger an attack.
Source Asthma and Allergy Foundation of America, Dr. Robert Danoff Aria-Jefferson Health system

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