Environmental

The aim is to reduce exposure to the allergen (1).

General measures include:

• humidity control—some people claim that many symptoms of rhinitis improve with humidifiers. However, they may be a source of allergens, such as moulds, and may promote the growth of mites
• avoidance of irritants such as cigarette smoke, ammonia, soap powder

Specific measures are dictated by the identification of particular allergens. These may include:

• removal of household pets
• removal of sources of feathers—pillows, birds, down jackets
• minimise carpeting—carpets may act as a reservoir for dust, mites, dander
• isolate bedroom from hot air heating systems, which may introduce allergens through the air ducts
• although dust mites are common allergens in allergic rhinitis, studies have not confirmed any benefit to using mite-proof impermeable mattresses or pillow covers (2)
• launder pillows and bedding regularly in hot water
• keep windows closed during pollen season (3)
• use air conditioning in bedroom and car

References:

1. Plaut M, Valentine MD. Allergic rhinitis. NEJM 2005;353:1934–1944.
2. Sur DKC, Plesa ML. Treatment of allergic rhinitis. Am Fam Physician 2015;92(11):985–992.
3. Clinical knowledge summaries, safe practical clinical answers. Allergic rhinitis.