Environmental Medicine

Environmental Medicine -
Intro to Inhalant Allergy

Inhalant allergy is the most common form of environmental illness in the state of Oklahoma. Allergic rhinitis and conjunctivitis are so prevalent that many patients consider those diseases to be an everyday occurrence in their head and neck region. However, allergic rhinitis can severely compromise a patient's quality of life by impairing sleep and stimulating recurrent sinusitis and otitis. If pharmaceutical products fail to control the symptoms, then standardized intradermal allergen testing is performed to determine what pollens, molds, and epidermal antigens are causing the symptoms. Immunotherapy is then recommended for long term control of the allergic rhinitis. Dr. Govett uses the standard subcutaneous injection therapy in his office. For patients that live a distance from his office, children with needle phobias, and patients with time constraints that cannot make it into the office for weekly injections, sublingual immunotherapy is offered. Low Dose Allergen Therapy (LDA) is also offered as a treatment for desensitization of allergic disease. It requires an injection every two months in the office initially and works well for inhalant and food allergies. Once the patient has reached maintenance therapy, Dr. Govett recommends three years of immunotherapy at the maintenance level in order to achieve long term control of the symptoms. However, some patients will require immunotherapy indefinitely.

Mold allergy sometimes needs special consideration. If the patient is living in a moldy home or working in a moldy environment, immunotherapy will not help control the symptoms due to the overwhelming number of mold spores present. A standard principle of environmental medicine is to remove the patient from the offending environment; if the environment is moldy, then the patient needs to be removed from the mold exposures. Certain molds such as penicillium, fusarium, and aspergillus are known to secrete myotoxins. Mycotoxins are covered in a separate section.