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Tips to Remember: Traveling with allergies and asthma

If you have allergies or asthma, you know they're always with you, even when you travel. To ensure that your next trip is relaxing and enjoyable, plan ahead for the changes in your environment that may affect your allergies or asthma.

Traveling

...By auto, bus or train
When traveling by auto, bus or train, potential irritants or allergens can include dust mites, indoor molds, pollens and other substances.

Common allergens such as mites and molds can lurk in the carpeting, upholstery and ventilation systems of vehicles. Before beginning a lengthy auto trip, try turning on the air conditioner or heater and open the windows for at least 10 minutes prior to entering the car. This will help remove dust mites and/or molds that may be in the system.

Outdoor allergens, such as pollens and molds, are also potential hazards, especially when traveling with open windows. If you have been diagnosed with pollen or mold allergies, close your windows and turn on the air conditioning instead.

Cigarette smoke or outdoor air pollution can worsen allergy and asthma symptoms. To avoid excess air pollution when traveling by automobile, travel in early morning or late evening, when the air quality is better and you can avoid heavy traffic. If you use a nebulizer for your asthma, get a portable nebulizer that plugs into your car's cigarette lighter or uses a portable battery pack.

...By airplane
Air quality on planes can greatly affect the allergic or asthmatic patient. While all domestic flights are now smoke free, many international flights are not. If traveling abroad, make sure you are seated as far as possible from the smoking section when getting a seat assignment.

If you have severe asthma and occasionally require supplemental oxygen, you may feel the need for additional oxygen at normal cruising altitudes of approximately 35,000 feet. If you think you may need supplemental oxygen, you must arrange for this with the airline well before the flight. No one can be refused travel for needing supplemental oxygen; however, this has to be arranged in advance.

If you have food allergies, be extremely cautious when eating airline food. Since the food comes from a vendor, no one on board may be able to tell you the specific ingredients of the foods. Make sure to carry your portable, injectable epinephrine in case you have a severe reaction while in flight.

If you have sinusitis, or a sinus or ear infection, air travel could cause significant pain. Try to delay your travel until your symptoms improve. If you usually experience severe ear or sinus pain while flying, take a short-acting oral decongestant or use a nasal spray decongestant about one hour before takeoff. In flight, sipping liquids, swallowing often and chewing gum may help decrease any pain.

The air in planes is very dry. Use saline nasal spray once every hour to keep your nasal membranes moist. This will help you to be more comfortable during and after your flight.

...By ship
When making cruise reservations, if you have severe asthma and/or allergies, ask about the qualifications of medical personnel and the availability of adequate medical care while on board the ship. Again, if you have food allergies, make sure to bring your injectable epinephrine for any possible severe allergic reactions.

If you have the skin condition eczema, be forewarned that increased exposure to water and sun can aggravate it. You may get some protection by liberally lubricating the skin with medicated ointment or over-the-counter lotion.

Keep in mind that when traveling, the climate and the season of your destination will also dictate your specific allergen and irritant exposure. In tropical, damp climates, you may have increased exposure to allergens such as mites, airborne molds and specific pollens. In cold, damp climates, you may be exposed to more house dust mites and indoor molds. Cold air in frigid, dry environments can also be an irritant for people with asthma.

Allergen sources
Many travelers stay at hotels. Hotel rooms, however, often contain large concentrations of dust mites and molds in carpeting, mattresses and upholstered furniture that can worsen your allergy and asthma symptoms. Irritant fumes from cleaning products may also cause problems.

When making hotel reservations, ask if there are allergy-proof rooms available. If you are sensitive to molds, request a sunny, dry room away from areas near indoor pools. Also, if you have allergies to any animals, inquire about the hotel's pet policy, and request a room that has been pet-free. People who are allergic to dust mites may want to bring their own dust-proof, zippered covers for pillows and mattresses, or personal bedding.

If staying in a cottage or cabin in a forest or near a beach, make sure to have it thoroughly cleaned and aired-out before you arrive. This can reduce dust mite and mold concentrations.

Visiting family and friends
Indoor environments—especially during the holidays—can be significant sources of potentially allergic hazards. Dust mites on Christmas ornaments and decorations; molds on Christmas trees, wet leaves and logs for wood-burning stoves; and strongly-scented potpourri, candles and air fresheners may all trigger allergy or asthma symptoms. Heating vents may also blow accumulated dust mites and molds.

Animal allergens, found in pets' dander, saliva or urine, can sometimes be a problem, even if the pet has been put outside or removed from the room. It takes months before the allergic residue of an indoor pet may no longer cause symptoms, so it's best to avoid staying in the homes of family or friends whose pets trigger your allergy symptoms.

People with food allergies should be careful about eating holiday treats, any of which may contain hidden, significant food allergens such as peanuts, tree nuts, eggs, milk, wheat or shellfish.

If you are allergic to seasonal pollen found in areas where your family or friends live, try to avoid visiting when that pollen is prevalent. Whether staying with relatives or friends, the key is to talk with your hosts before the visit and plan for any potential difficulties.

New experiences
Activities like camping can be fun, but they can also increase your contact with outdoor pollen as well as your chances for encountering stinging insects like bees, yellow jackets and wasps. Individuals with these allergies should take appropriate precautions, such as avoiding camping during high pollen seasons for people with pollen allergies, having appropriate medications, and carrying injectable epinephrine to treat reactions to stinging insects. (People who experience a severe insect-allergic reaction must also obtain immediate emergency medical treatment.)

If you are participating in an unfamiliar, strenuous sport, make sure that you feel comfortable with your level of activity and that you monitor your breathing. For instance, when mountain climbing, people with asthma should be particularly cautious when considering going above 5,000 feet, where the available oxygen decreases. Asthmatics should also be careful when skiing or engaging in other cold weather sports, since cold air can trigger asthma episodes.

Because scuba diving is a particular hazard for asthmatics, people with asthma should snorkel in surface water instead. On the beach, people with eczema and those taking specific medications that make them more sensitive to the sun should avoid sun bathing for extended periods.

Using an ounce of prevention

If you are traveling with asthma or allergies, follow these recommendations when planning a trip:

  1. If you have active allergy symptoms or unstable asthma, have a pre-trip physical.

  2. Pack all medications you will need on your trip in your purse, briefcase or carry-on luggage, so you don't lose them if your luggage is delayed. Make sure you bring more than enough, and store them in their original containers, which list instructions on how to take the medication and obtain refills. Also, when flying abroad, the original container identifies the medicines for custom officials.

  3. Carry a peak flow meter, an asthma control plan and a copy of your physician's phone number. Also have on hand your emergency medications, which can include antihistamines, broncho-dilators, self-injectable epinephrine, and a short course of corticosteroids.

  4. Remember the availability of portable nebulizers, and if traveling abroad, check on the local electrical currents and on adapters for electrical plugs.

  5. If you cross several time zones, allow for time differences so that medication dosage schedules will remain constant.

  6. Continue your allergy immunotherapy (“allergy shots”) if you are traveling for extended periods of time. It is important to continue this therapy, which should be administered following the recommended guidelines: having supervision by a physician for at least 20 minutes following the injection, and having injectable adrenaline available for treating adverse reactions. If possible, it is better to achieve maintenance doses of allergy immunotherapy prior to all travel. If traveling abroad with allergy extracts, ensure they are clearly labeled with your name exactly as it appears on your passport, and are refrigerated at all times.

  7. Before traveling abroad, obtain the name of an AAAAI allergist/immunologist practicing in your destination area from the American Academy of Allergy, Asthma and Immunology's Physician Referral System on the Web site, www.aaaai.org/physref

  8. Obtain travel medical insurance.

Being aware of potential hazards and taking appropriate precautions can ensure an enjoyable trip for those with asthma and allergies. Bon Voyage!

When to see an allergy/asthma specialist
The AAAAI's How the Allergist/Immunologist Can Help: Consultation and Referral Guidelines Citing the Evidence provide information to assist patients and health care professionals in determining when a patient may need consultation or ongoing specialty care by the allergist/immunologist. Patients should see an allergist/immunologist if they:

  • Have asthma and have required Emergency Department care for acute episode.

  • Experience an itchy mouth from raw fruits and vegetables.
  • Experience other possible adverse reactions to foods.
  • Experience respiratory or systemic symptoms with exercise.
  • Want to SCUBA dive and have a history of asthma.

Your allergist/immunologist can provide you with more information on traveling with allergies and asthma.


Tips to Remember
are created by the Public Education Committee of the American Academy of Allergy, Asthma and Immunology.

The content of this brochure is for informational purposes only. It is not intended to replace evaluation by a physician. If you have questions or medical concerns, please contact your allergist/immunologist.

American Academy of Allergy,
Asthma and Immunology
555 East Wells Street, Suite 1100
Milwaukee, WI 53202

AAAAI Web site
www.aaaai.org

©2007, American Academy of Allergy, Asthma and Immunology. All rights reserved. May not be duplicated or appropriated without permission. For copyright permission, please email Marianne Canter, Director of Communications and Membership, at mcanter@aaaai.org.



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