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b When looking for symptom triggers, consider the impact of all the various environments you (or your child) are exposed to, such as your home, garden, car, shopping centre, school, childcare centre, workplace, and/or relative s home. Allergy Unit, Royal Prince Alfred Hospital 121 Personal & home environment

CHECKLIST FOR A HEALTHY HOME Is your house (particularly the bedrooms) well ventilated and free of any damp or musty odours? Do you air newly dry-cleaned clothes before bringing them inside and putting them away? If you have an unflued gas heater, is the room where it s used well-ventilated? Do you use an extractor fan and open window instead of air fresheners in the bathroom and toilet? Do you use bicarbonate of soda and/or special cloths to clean baths and sinks? Do you have an extractor fan going to the outside from the kitchen and is it always used while cooking? Have you used low-emission paints and low-emission building materials? Do you have any furniture or carpet that smells? Do you have a cyclonic vacuum cleaner or one with a HEPA (high efficiency particle arrester) filter? Do you avoid using strong solvents and glues indoors? Do you use white vinegar instead of a spray cleaner? Do you and other carers use fragrance-free personal products for hair care, after-shaving and deodorants? Do you avoid aromatic oils, eucalyptus and/or menthol in rubs and nebulizers, incense and perfumed candles? notes 122 Allergy Unit, Royal Prince Alfred Hospital

ENVIRONMENTAL CHEMICALS Although cigarette smoke is well-known as a cause of airway irritation, there is a long list of household chemicals that can affect well-being and cause symptoms such as headaches, nausea, lethargy, congested nose and sinuses, asthma and skin rashes. Smells & fumes Some people with food intolerances find that their sense of smell gets more acute on a restricted diet. Strong perfume, freshly cut grass, car exhaust, petrol fumes, fresh paint, cigarette smoke and other irritant smells and fumes may make you feel ill or give you a headache. These reactions can be unpleasant but are not dangerous and usually resolve quickly after exposure ceases. If you re unexpectedly exposed, don t hang around leave the area and get some fresh air. Home environment Indoor air can become quite polluted with volatile chemicals released from carpets and underlays, particle board and other furnishing materials, cooking odours and cigarette smoke. Such fumes can cause headaches, nausea, lethargy and respiratory problems in susceptible people. Children are particularly vulnerable to the effects of volatile organic compounds found in a wide variety of indoor air pollutants. Make sure your home is well ventilated with fresh air, especially bedrooms, rest areas and playrooms. Avoid using products with a strong aroma such as air fresheners, toilet and nappy-bin deodorizers, mothballs, insect repellents, unflued gas heaters, concentrated detergents, perfumed candles, incense, eucalyptus oil and massage and aromatherapy oils. If you feel unwell at home and you re not sure why, check for hidden damp or mould, gas leaks and other sources of irritant smells or fumes. Recently built and renovated houses are full of problem chemicals. If you re planning to paint or renovate your home, and you re smell-sensitive, watch out for oil-based paints, glues, floor varnishes, particle board and treated timbers, all of which can emit volatile chemicals for quite some time when fresh or new. It s best not to handle these materials yourself. Consider staying somewhere else for a few days or weeks while the work is being done and airing out your home for a few days before going back. When looking for symptom triggers, consider the impact of the various environments you (or your child) are exposed to, eg. home, car, shopping centre, school, childcare centre, workplace, and/or relative s home. Allergy Unit, Royal Prince Alfred Hospital 123

PERSONAL & HOME ENVIRONMENT 124 CATEGORY SUITABLE PRODUCTS GUIDELINES AVOID VENTILATION & HEATING,Good ventilation with fresh air and a sunny orientation are best for a healthy home. Air conditioning Choose a ducted or split-system refrigerated cooling type. Heating Prefer central or column (electric) heaters. Make sure air conditioning filters can trap fine dust particles. Clean filters regularly. Heating can increase out-gassing of volatile organic compounds (VOC) from furnishings. Check gas fittings and heaters for leaks. Avoid evaporative air-conditioners. These add moisture to the indoor air and encourage growth of mould and dust mites. Avoid unflued gas heaters and open fireplaces. Allergy Unit, Royal Prince Alfred Hospital CLEANING Floor surfaces If you have allergies or asthma, floor surfaces that can be mopped are best. Use a small amount of fragrance-free detergent. Vacuum cleaning Use a vacuum cleaner with a HEPA filter (high efficiency particle arrestor) or high quality bag that can trap fine dust particles. Bathroom & toilet cleaning Use vinegar and bicarbonate of soda as cleaning agents. FOOD ALLERGEN CONTAMINATION Some allergenic foods such as peanut butter and tahini (sesame) are particularly prone to contaminate kitchen benches, fridge door handles and taps. Clean with detergent and hot water. Other allergens such as egg, milk, and fish can become airborne when boiled, fried or baked. Aerosol droplets can contaminate kitchen air and dust. Carpets hold food, animal, mould, insect and dust mite allergen particles. People with asthma and upper airway allergies should consider removing wall-to-wall carpets from bedrooms and living areas. Rugs should be vacuumed regularly and aired outdoors in sunshine. Use brushes and special cleaning cloths rather than chemicals to clean sinks, baths and toilets. If carpets are steam cleaned avoid leaving them wet (moisture encourages growth of mould and breeding of dust mites). Ensure that carpets are thoroughly dried after steam cleaning. Avoid using mothballs, insecticide sprays, cedar oils, air fresheners, aromatherapy or perfumed candles/incense. Avoid using bleach, strong-smelling detergents, eucalyptus and concentrated commercial cleaning agents.

PERSONAL & HOME ENVIRONMENT Allergy Unit, Royal Prince Alfred Hospital 125 CATEGORY SUITABLE PRODUCTS GUIDELINES AVOID INDOOR ODOURS & IRRITANT FUMES GARDEN & INDOOR PLANTS CAR TRAVEL Cooking Use a range hood or overhead extractor fan which vents to the outside. Otherwise, ensure that the fan has a filter that can absorb particles, moisture and gases. Furniture and renovations When furnishing or renovating, take items or samples home and test for odour or out-gassing of irritant volatile organic compounds (VOCs) before purchase. Use water-based or acrylic paints; polyurethane or epoxy resins. Prefer non-aromatic native plants outdoors. Use a manual or electric lawn mower. If you live in a unit, indoor pot-plants can help reduce volatile organic compounds (VOCs) through the action of micro organisms in the potting mix. Pollution can be hard to avoid. Car air conditioning with a good filter may help. The smell of new cars can be irritating for some people. If so, a 1-2 year old used car may be preferable. Try before you buy. Gas cooktops increase indoor levels of carbon monoxide and nitrogen dioxide always turn on overhead exhaust fans while cooking. When cooking, food particles can become airborne in water or fat droplets, and can be inhaled or settle on benches and floor surfaces. This is especially important for people with fish and/or egg allergies. Ensure that newly furnished, painted or renovated rooms are thoroughly aired out before moving in. Ensure that there is good drainage of the garden damp soil encourages mould and rotting of vegetation. Check under the house for seepage or water leaks which can cause rising damp. Freshly cut grass releases volatile organic compounds (VOCs) which can cause upper airway irritation. Mow lawns on a cool and breezy day. Make sure your car is in good condition and have it serviced regularly. If you are unwell in the car despite good air conditioning, check for oil or petrol leaks. Clean with fragrance-free detergent. Household members should avoid using perfumes/fragrances, scented products (deodorants, hairsprays, after-shaves, soaps, shampoos, conditioners), and cigarettes (odour can remain on clothes). Avoid moving into newly renovated houses or rooms odours from fresh paint, glue, timber, new carpet and new furnishings contain irritant chemicals. Avoid oil and mineral turps-based paints. Avoid using aromatic or treated timber (eg. pine, western red cedar). Avoid trees & plants with strongly scented flowers (jasmine, gardenia, wattle, privet) or aromatic leaves (eg. camphor laurel). Avoid petrol mowers and whipper-snippers. Avoid using strong smelling fertilizers, insecticides, and aromatic woodchips/mulch. Avoid filling the petrol tank if you are sensitive to petrol fumes, or when sensitive children are in the car. Avoid use of air-fresheners Avoid travelling in heavy traffic and keep windows closed in tunnels. Avoid underground carparks.