More and more children seem to be suffering from asthma and allergies as time goes by. Does this mean that all our children need to live within a sanitised bubble? Priya Kulasagaran talks to medical practitioners to get the lowdown on what allergies as well as asthma actually are and how we can cope with them
When the annual haze hits the country, parents tend to be wary about sending their children outdoors, particularly if their little ones are prone to asthma and allergies. However, it seems that the indoors are not necessarily the most conducive environments either.
“Allergies can occur anywhere indoors!” proclaimed paediatrician Dr Amir Hamzah. “It depends on where the allergens are; in this case, your walls, toys and even furniture can be causes of an allergy attack. Walls for instance, which tend not be cleaned as often, can harbour dust, mould and bacteria that some children may react adversely to. Pets are also another source, when they shed their fur.”
Dr Amir, who is also president of the Malaysian Society of Allergy and Immunology, added that children and even adults should get themselves properly diagnosed if they suspect that they have an allergy. “Allergy actually refers to a group of diseases, which tend to affect the respiratory system, gut and skin. We shouldn’t take a ‘tidak apa’ attitude, and just pop some antihistamines to deal with the issue. But neither should we simply stop children from doing or eating certain things because of an allergy. It’s best to get it diagnosed properly, so that doctors can find the right way to treat the problem,” he said.
Meanwhile, University Malaya Medical Centre consultant paediatrician and paediatric respiratory physician Associate Professor Dr Jessie Ann du Bryune pointed out that the link between pollution and asthma is not as clear cut as it seemed. Quoting a study conducted in Germany in 1997, she said that researchers there found no significant difference in the prevalence of asthma between children from the much more industrialised East Germany compared to their peers in West Germany. “The thing with pollution outdoors is you can see the visible effects of it, such as irritation of skin. But indoor environments also play a crucial part; dust mites and third-hand cigarette smoke for instance, have shown to greatly increase the chances of a child developing asthma,” she said.
Dr du Bryune added that while parents should monitor the status of their child’s asthmatic conditions, they should not prevent them from being children. “Play is essential to a child’s mental and physical development, almost as important to a child as his or her daily meal. So you need to let them play in safe environments. You can’t let asthma control your life, you have to control asthma. As long as the child takes his or her required treatment as prescribed, they will be able to manage, even in situations such as the haze,” she said.
The two paediatricians were fielding questions from the audience during a roundtable session organised under Nippon Paint’s Wellness for Children programme. Themed “Mitigating Common Indoor Household Risks for Children”, the discussion focussed on allergies and asthma in the context of indoor environments. Nippon Paint Malaysia’s group general manager Gladys Goh said the programme aimed to give parents the relevant knowledge to make informed decisions when it comes to their children’s health and wellness.
This particular roundtable for instance, was sparked by a survey the company had carried out on some 200 parents. “We found out that 80% of parents said their children touched the walls during play, and more than two-thirds agreed that the wall can be a medium of spreading bacteria and viruses,” said Goh. “However, 88% of parents said they overlooked the wall as a spot for bacteria; many do not clean their walls as often, and they had only thought of it when we asked them the question. She added that since children spent a significant amount of time indoors, it was important for parents to carefully consider their indoor environments as well.
According to Dr Amir, the most common indoor allergies are rhinoconjunctivitis (which causes nasal congestion, runny nose, and red eyes) and asthma. “We believe this tends to be due to the higher prevalence of dust mites indoors, and sometimes children may be allergic to pets. There have been cases where the child had developed the allergy from just being around people who have pets,” he said.
Dr Amir stressed that diagnosis was crucial when it comes to managing allergies. “This can be done with a simple skin prick test, and if need be a full blood test. The closest thing we have to a cure for allergies is immunotherapy; where we ‘re-educate’ the immune system to develop a resistance to the allergen. This can take as long as studying for a degree to work – about three to five years,” he said.
Similarly, Dr du Bryune said that parents of children with asthma should not let the disease take control of their daily lives. “It is an entirely manageable condition, which is why diagnosis and treatment is important. Some parents may have fears of the steroids present in inhalants, but the dose of steroids is minimal and safe; and far outweighs the risks of having an asthma attack,” she said.
She also highlighted the fact that while many parents were aware of the risks of passive smoking, third-hand smoke is also a cause for concern. “Studies have shown that the smoke deposits that cling on to your hair, skin and clothes can combine with other noxious substances in the environment to produce even more dangerous substances. So, parents, it’s not enough to just smoke outside the house I’m afraid – you need to quit completely,” she said.
Despite these cautions, both experts were quick to say that while parents should observe good hygiene both indoors and outdoors, they should not keep their children in a ‘bubble’ of protection. “Children need to be exposed to some dirt to develop their immune systems,” said Dr du Bryune. “You need to give your body little challenges, so it can fight back if bigger challenges occur.”