Allergic Rhinitis and its Impact on Asthma - ARIA

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ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA GUIDELINES ● 2010 – V. 9/8/2010 Rodriguez Perez N (H. Matamoros, TAM. Mexico) Rosenwasser L (Children's Mercy Hospital, Kansas City, MO, USA) Ryan D (Woodbrook Medical Centre, Loughborough, UK ) <strong>and</strong> Clinical Research Fellow, University of Aberdeen, UK) Sanchez Borges M (Centro Medico-Docente La Trinidad, Caracas, Venezuela) Scadding G (RNTNE Hospital,London, UK) Shaik A (University of Edinburgh, Edinburgh, UK) Simons FER (Faculty of Medicine, University of Manitoba, Canada) Toskala E (Dept. ORL, Finnish Institute of Occupational Health, Helsinki, Finl<strong>and</strong>) Valiulis A (Vilnius University Faculty of Medicine, Vilnius, Lithuania) Valovirta E (Terveystalo AllergyClinic, Turku, Finl<strong>and</strong>) Van Weel C (Radboud University Nijmegen Medical Centre, HB Nijmegen, The Netherl<strong>and</strong>s) V<strong>and</strong>enplas O (Mont-Godinne Hospital, Université Catholique de Louvain, Yvoir, Belgium) Wang DY (Yong Loo Lin School of Medicine, National University of Singapore, Singapore) Wickman M (Sachs' Children's Hospital, Sodersjukhuset <strong>and</strong> Centre for Allergy research <strong>and</strong> Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden) Yawn B (University of Minnesota, USA) Yorgancioglu A (Celal Bayar Uni. Med. Fac. Manisa, Turkey) Yusuf O (The Allergy <strong>and</strong> Asthma Institute, Islamabad, Pakistan) Zitt M (State University of New York, Stony Brook, New York, USA) PAGE 4 OF 153
ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA GUIDELINES ● 2010 – V. 9/8/2010 Table of content Executive summary .............................................................................................................................. 8 Introduction ...................................................................................................................................... 8 Methodology..................................................................................................................................... 9 How to use these guidelines ........................................................................................................... 10 Key questions ................................................................................................................................. 10 Recommendations .......................................................................................................................... 10 Introduction <strong>and</strong> background ............................................................................................................. 21 Scope .................................................................................................................................................. 23 Methods .............................................................................................................................................. 24 Recommendations .............................................................................................................................. 28 I. Prevention of allergy....................................................................................................................... 29 Question 1 ...................................................................................................................................... 29 Should exclusive breastfeeding be used in infants to prevent allergy? .......................................... 29 Question 2 ...................................................................................................................................... 30 Should antigen avoidance diet be used in pregnant or breastfeeding women to prevent development of allergy in children? ............................................................................................... 30 Question 3 ...................................................................................................................................... 31 Should children <strong>and</strong> pregnant women avoid environmental tobacco smoke (i.e. passive smoking) to reduce the risk of developing allergy, wheezing, or asthma in children? ................................. 31 Question 4 ...................................................................................................................................... 33 Should infants <strong>and</strong> preschool children avoid exposure to house dust mites to reduce the risk of developing dust mite allergy <strong>and</strong> asthma? ..................................................................................... 33 Question 5 ...................................................................................................................................... 34 Should infants <strong>and</strong> preschool children avoid exposure to pets at home to reduce the risk of developing allergy <strong>and</strong> asthma? .................................................................................................... 34 Question 6 ...................................................................................................................................... 36 Should specific measures reducing occupational agent exposure be used to decrease the risk of sensitization <strong>and</strong> subsequent development of occupational rhinitis <strong>and</strong> asthma? ......................... 36 II. Treatment of allergic rhinitis ......................................................................................................... 38 Reducing allergen exposure ........................................................................................................... 38 Question 7 ...................................................................................................................................... 38 Question 8 ...................................................................................................................................... 39 Should patients allergic to indoor moulds avoid exposure to these allergens at home? ............... 39 Question 9 ...................................................................................................................................... 40 Should patients allergic to animal d<strong>and</strong>er avoid exposure to these allergens at home? ............... 40 Question 10 .................................................................................................................................... 42 Should immediate <strong>and</strong> total cessation of exposure to an occupational agent or exposure control be used in patients with occupational rhinitis <strong>and</strong> asthma? .......................................................... 42 PAGE 5 OF 153
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