Environmental controls and avoidance measures.

Background: Environmental control measures refer to using 1 or more interventions aimed at avoiding, reducing, or eliminating allergens and irritants in the environment to improve symptoms of allergic rhinitis. Although avoiding known allergens is highly effective, completely eliminating an allergen from one's environment is often impractical or even impossible.

Methods: The purpose of this work is to review evidence on the efficacy of various environmental control measures aimed at preventing the development of new sensitizations, reducing the progression of allergic rhinitis, and improving its symptoms and quality of life.

Results: Current literature examining the protective effects of specific measures such as breastfeeding and early pet exposure against the development of allergic diseases including allergic rhinitis has been inconclusive. Environmental measures such as frequently washing cats and dogs, encasing bedding within impermeable covers, air filtration, and chemicals can effectively reduce levels of allergens in the home. Although environmental control measures reduce allergen exposure levels, significant alleviation in symptoms or improvement in quality of life in patients with allergic rhinitis have not been shown.

Conclusion: An evidence-based approach can assist health providers in educating patients and helping them to make informed decisions in selecting the most appropriate and cost-effective environmental control strategies to manage their disease. The greatest benefits can be achieved from using a multifaceted environmental approach aimed at routinely and systematically reducing exposure to allergens over time.