Allergy and asthma sufferers will go to great lengths to find relief from the sneezing and sniffling, including buying expensive air filters and purifiers.
But do they really work?
Most allergists say no – or at least not as well as traditional allergy shots and treatments.
Joe Vero of Caledon swears by the stand-alone air filtration system he purchased recently for his Mississauga office. A lifelong allergy sufferer, Vero says the usual suspects trigger his asthma attacks: dust, pollen, animal dander from the family cat and mould.
“I know when I’m walking into a building with even the slightest bit of mould it will trigger an asthma attack – that’s why I carry my puffer,” says Vero, who owns a property management company.
The high-efficiency particulate air (HEPA) filter he bought is designed to pick up even the tiniest particles in the air.
“I’ve noticed since we’ve had this machine now for the last couple of months that I haven’t been sneezing at the office,” says Vero, who also has an electronic filter attached to the furnace in his home.
A true HEPA filter must remove 99.97 per cent of all respirable particles (those small enough to get through the nose and into the airways and lungs). Experts say the typical price for a true HEPA filter is $600 to $700 – anything less is probably not going to be effective.
The unit Vero purchased is an Amaircare 3000 HEPA Portable Air Filtration System, which sells for between $650 and $800.
The system is designed to remove dust, pollen, smoke, bacteria, animal dander and mould spores through a three-stage filtration process: a pre-filter to capture large particles such as dust, a HEPA filter to nab smaller particles, and a VOC (volatile organic compound) filter to remove gases and odours.
“There is a cost associated with having one, but it beats being stuffed up and sniffling,” Vero says. “I still get my allergy symptoms, but they’re not as frequent. Even with my asthma, when it triggers, it’s not as frequent. I used to use my puffer every day. I haven’t changed the medication or dosage, so it tells me there’s got to be something else improving it.”
Vero stopped getting allergy shots when he was younger. “You have to go every week,” he explains. “When I was a kid and in my teens, I decided it was too much trouble – it’s not something I bother with.”
Mariana Grezova of Toronto also believes she can control her allergy symptoms by controlling her environment. She has suffered with allergies for 20 years and is allergic to dust, mould and pollen.
Grezova doesn’t get allergy shots either, but uses an air cleaner with an ionizer that cost her about $600, which she leaves running all day in her home.
“It has a HEPA filter and you just wash it and you don’t have to replace it,” she says.
Vero and Grezova are typical of most asthma sufferers, says Toronto allergist Dr. Mark Greenwald, an associate professor of pediatrics at the University of Toronto and vice-president and chair of the Asthma Society of Canada’s Medical and Scientific Committee.
He says too many allergy and asthma patients have foregone proven medicine in favour of quick fixes.
“If it comes down to a choice between allergy shots and air purifiers, I’d go for the allergy shots, where there is proven benefit to a significant degree,” he says. “Allergy shots are the only intervention that can change an abnormal immune system back to normal.”
About 10 per cent of the Canadian population has asthma and, of those 3.3-million people, Greenwald says less than half have their symptoms under control.
When it comes to treating asthma symptoms, he takes a zero-tolerance approach. That means no pets, no carpets, no smoking and no dust-collectors such as stuffed animals. And he insists on dust mite-proof encasings for mattresses and pillows.
His patients must also follow the prescribed protocol of allergy shots – something he says many people take out of the equation, creating greater probability for chronic problems.
“We’re not achieving good control of asthma, even with what we’re doing, even before we get to the air purifier stage,” he says.
“We accept a low-level ongoing chronic rate of disease, which we should not, and that’s where we get into trouble.”
The Lung Association takes a similar stand, suggesting air filters should only be considered if everything else has been tried.
“There are a lot of unsubstantiated health claims,” says Brian Stocks, air quality manager with the Ontario Lung Association in Windsor.
“We’ve issued a fact sheet that addresses the issue because of the number of products out there … that claim to be air purifiers when they don’t necessarily do that.”
Greenwald puts air purification systems at the bottom of the list when telling patients how to control their symptoms.
“I think the message has to be that it is part of a completely integrated program. It’s not a matter of `Should I get an air cleaner and not a dust mite encasing?’ No, you should not,” he says.
He stresses allergy sufferers should do their research before buying any product, since many don’t live up to their claims. “The dust mite encasing has to be dust mite-proof, and that’s where there are a lot of companies out there selling stuff they shouldn’t be selling.”
First and foremost, Greenwald says patients must get a proper diagnosis, get rid of things that exacerbate symptoms and use medication properly.
“If all that fails, as an added function, if you’re having a lot of problems, maybe consider air purification as being critical,” he says.
With all controls in place, Greenwald says allergy patients should experience no coughing or wheezing, no need for breath assistance, no symptoms at night and no limits on physical activity.
“It means no loss of school or work and completely normal function,” he says. “If you set the numbers at zero, zero, zero, that’s something they can relate to. But doctors are accepting of a certain level of disease, which they shouldn’t.”
If you’re still considering an air purifier, Greenwald offers this last bit of economic advice: “A $600-machine would cover three years of allergy treatments,” he says. “Allergy treatment is covered by most drug plans but machines typically are not.
“And, if you really look at the scientific evidence,” he adds, “there is excellent evidence that shows that if you have a kid aged 4 to 10 years of age with typical allergies and give them allergy shots, you can actually prevent the evolution of asthma.”
