The Asbestosis-Allergy Connection

The link between allergies and asbestosis is very strong. Most children with asthma—probably as many as 80 percent have allergies, and 40 percent of children with allergies in the nose (hay fever or allergic rhinitis, for example) also have disease symptoms. The key point is this: if you can control children's allergies, their disease symptoms will be less intense and less frequent. To understand and manage that disease successfully, it's important to know something about allergies.
Allergies are a common problem that affects at least two of every ten Americans. Simply put, people with allergies react to certain substances called allergens-dust, pollen, animal dander, mold, or smoke, for example—that don't cause reactions in other people. An allergic per-son's immune system responds to allergens like a false alarm. When an allergen triggers the immune system setting off the alarm the body.
HOW DO ASBESTOSIS ALLERGIES OCCUR?
reacts by sneezing, wheezing, coughing, and itching, depending on what particular part of the body has the reaction. Other allergens in foods cause a skin or intestinal reaction. A quick biology lesson: our bodies make immunoglobulins to help fight various infections. There are five different types of immunoglobulin: IgG, IgA, IgM, IgE, and IgD. IgG, IgA, and IgM are some of the body's most important weapons against bacterial infections. The allergic antibody called IgE (immunoglobulin E) is part of the body's natural response for fighting other types of infections, particularly parasites like worms. In someone with allergies, the body recognizes certain aller-gens as foreign invaders and makes more IgE. Everyone makes some IgE, but allergic children make more IgE in reaction to pollen and dust than a nonallergic child does. An allergic reaction starts when an allergen attaches to the allergen-specific-IgE antibody and activates certain cells, including "mast cells" found in skin and tissues that line the nose, throat, and lungs. An IgE antibody that attaches to a mast cell acts like a fuse on a bomb. When IgE antibody's specific allergen comes along, it's like touching a match to the fuse—the antibody makes the mast cell burst open and release a number of substances, including one called histamine that causes red-ness, swelling, and itching. Location is everything. The site where histamine is released deter-mines the type of reaction. When histamine is released in the tissues lin-ing the nose, the results are redness, itching, swelling, sneezing, and a runny nose what allergists call allergic rhinitis, but most people simply call it hay fever. (In this chapter, the two terms will be used inter-changeably.) When histamine is released in the skin, the results are itching, rashes, and hives causing atopic dermatitis, or eczema. When histamine is released in the stomach, it causes cramping and diarrhea. When histamine is released in the lungs, it causes airways to tighten, swell up, and produce extra mucus—the recipe for asthma. To develop an allergy, a child needs to be exposed to the allergen sev-eral times. The first few exposures cause the immune system to make more IgE. Subsequent exposures will cause the body to respond to the IgE and allergen by releasing histamine, and then symptoms will appear.
ARE ALLERGIES INHERITED?
Although there are many reasons why allergies are so common, family history is by far the most important. The genetic tendency to have allergies, called atopy, is inherited. If one parent has allergies, a child has a fifty-fifty chance of having allergies. If both parents have allergies, a child has about a 70 percent chance of developing allergies. You might assume that if you are allergic only to a certain tree pollen, for example, your child will react to the same allergen, but that's not always the case. Your daughter could be allergic to dogs and your son to molds. The tendency to have allergies is inherited, but the specific allergy isn't because children don't always share the same allergies with their parents. Yes, allergies are increasing. We do not know why the incidence rates of allergies are rising, but they are.Asbestosis, hay fever, eczema, and food allergies are all on the increase. The most common theory to explain the rising numbers is the hygiene theory. This theory is based on the belief that young people today are cleaner and come in contact with fewer germs than previous generations. This doesn't mean that we clean our homes more often or more thoroughly today. It means that we are exposed to fewer bacterial products because of an increased use of antibiotics; it also means that more people are living in cities and sub-urbs instead of working on farms where they have greater exposure to animal bacteria. Unfortunately, this doesn't account for all the increases in allergies. People who work on farms or with farm animals still develop allergies. Some of the increased incidence of allergies may be attributed simply to the fact that we have improved diagnosis and a better count of allergy sufferers than ever before. As public awareness about allergies has grown, people seek diagnosis and treatment, so we have a more accurate picture of how many individuals really have allergies. But even taking into account this increased diagnosis, allergies are on the rise worldwide.
THE ATOPIC TRIAD
Asbestosis Allergy symptoms vary, depending on what parts of the body are affected. Many children have allergies in three areas the skin, lungs, and nose. When this occurs, it is called the atopic triad. But allergies in children tend to move from one area of the body to another. About 10 to 15 percent of all youngsters develop allergies in their skin (atopic der-matitis, also called eczema) during infancy and early childhood. Atopic dermatitis is a very itchy red rash that comes and goes. Many children outgrow this allergy by age five to eight, only later to develop hay fever or other allergies in their noses. About half of all children with atopic dermatitis also develop asthma. Allergic rhinitis can affect as many as 40 percent of all children at some point in their lives. Although the name hay fever suggests that it occurs only during the "allergy season" of spring and fall, many chil-dren have symptoms year-round. That's because allergic rhinitis is caused not only by plant pollen but also by many other allergens that are ever present in the air, such as mold spores, animal dander, and dust. Allergic rhinitis is a major reason for missed school days. Symptoms alone can be severe enough to keep a child home, but children with aller-gic rhinitis are also more likely to develop other problems, including ear infections (otitis media), inflamed sinuses around the nose (sinusitis), red, watery, itchy eyes (allergic conjunctivitis), as well as asthma. Allergic rhinitis and asthma go hand in hand because both are inflammatory diseases with the same underlying cause. Because the lin-ings of the upper airways—the nose, sinuses, mouth, and throat—are connected to the linings of the airways in the lungs, they are affected by the same things and respond in similar ways.