Some patients, however, are susceptible to the effects of sprayed vegetables but not to the same vegetables when they are unsprayed. The worst culprits in this respect seem to be the various members of the cabbage family (including cabbage, broccoli, and cauliflower). They are among the most heavily contaminated vegetables. One sign of this may be that until about 1950, all cooks were warned to look out for cabbage worms on broccoli. Since that time, however, no one of my acquaintance has found one of these insects on commercial broccoli. This certainly represents progress for the cook—but progress at what price?

Another practice which has contributed to the contamination of foods is the indiscriminate spraying of fruit and vegetable counters in stores and supermarkets. This is done to control bugs, molds, and especially flies, which can be unsanitary. The almost complete absence of fruit flies, even in summer, is a testimony to the effectiveness of this spraying program. Susceptible persons, however, may start to cough, wheeze, or show other signs of a reaction when they enter the fruit and vegetable section of a store. Often, of course, this reaction cannot be distinguished from a reaction to the many other chemicals one is likely to encounter in a supermarket.

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The only common side-effect of corticosteroid inhalers is Candida (thrush) infections in the throat, due to suppression of the immune response

there. This can be reduced by washing the mouth out with warm water after each inhalation. If infections do develop, they can be controlled with anti-fungal lozenges.

Acute attacks of asthma are often dealt with by giving a short course of corticosteroid tablets. Such treatment suppresses inflammation in the bronchi within a few days but is continued for about three weeks, followed by gradual withdrawal. This allows the bronchi to settle down and become less sensitive. Stopping the course of treatment before three weeks can result in a flare-up of asthma again, shortly afterwards.

For some asthmatics, controlling their attacks may require treatment with three or even four different types of drugs -sodium cromoglycate, a (32 agonist, a xanthine and a corticosteroid inhaler. By using several different drugs, good control of the symptoms can be achieved without the need for high doses of any one drug.

In hay-fever and perennial rhinitis, corticosteroid sprays are sometimes used. The drugs used include beclomethasone (Beconase), betamethasone (Betnesol, Vista-Methasone), budesonide (Rhinocort) and flunisolide (Syntaris). In general, these are very effective. Relatively little corticosteroid is absorbed, and there seem to be few side-effects, but over-use should be avoided. A sodium cromoglycate spray would be preferable if it controls the symptoms well. Students who suffer from bad hay-fever are sometimes given corticosteroid tablets to help them get through important examinations, but this only done in exceptional cirumstances.

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In practical terms, neutralization therapy involves a long session of testing (usually one to three days) with different concentrations of foods – all the foods that have been incriminated by the elimination diet. The extracts are injected into the skin of the upper arm, a process that is only slightly painful. Once neutralizing doses have been determined for each of these foods, a mixture of the extracts is prepared for use. The patient is taught to earn’ out the subcutaneous injections, which are needed every two days at first, but only twice a week, or even less frequently, once the treatment has been under way for some months. Some people eventually find that they can discontinue the

injections without ill-effects.

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Above all, make sure you are getting enough protein, vitamins and minerals, and avoid any drastic changes in your diet. If your list of suspect foods is very extensive, it may be better to split them into two groups and try eliminating each group in turn. Consult your doctor to see if your diet is adequate.

If none of this works, then you could try a full elimination diet as a last resort – but you must ask your doctor first. The elimination diet is fairly stringent, and there is a risk of being undernourished because milk-production makes heavy demands on your body. You should eat plenty of meat and fish while on the diet to ensure you get enough protein, and a vitamin and mineral supplement may be necessary.

If you manage to resolve the baby’s problems, but find yourself on a quite restricted diet, then you should retest foods after a month or two. It may be that the baby’s sensitivity has cleared up of its own accord, and you can then return to normal eating. If the symptoms recur, go back to the restricted diet.

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Skin-prick tests work well for some types of allergen, particularly inhalants. But where the allergen is found in food, they often do not produce a positive result, except in cases where the patient’s reaction to the food is immediate and violent.

Skin-prick tests can be negative even though there is a genuine allergic reaction, simply because the reaction is localized – in the gut, nose or wherever. IgE antibodies can often be demonstrated in the part of the body that is affected, but they have clearly not entered the bloodstream, which is why they are not present in the skin.

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If you are badly affected, ask visitors to your house not to wear aftershave, perfume or hairspray, and ban smoking. Keep a cloth or headscarf handy, for people to wrap or lay over hair or clothes that really upset you. Some chemically sensitive people even keep a pure cotton gown or apron for visitors to wear. This dampens down fumes very effectively. If people sitting next to you at work, school or at leisure activities are using products that bother you, see if you can persuade them to use others – giving them to them to try, if necessary. If they will not, ask to be moved.

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Some extremely sensitive people react to woods which contain natural resins, such as pine or cedar. These problems can be avoided, either by using non-resinous woods – for example, birch, beech, ash or oak – or simply by sealing the resinous wood with a few layers of varnish. Seal with varnish also the insides of pine or cedar cupboards and drawers. This is usually enough to stop problems (see Varnishes, above).

Wood Preservatives

Boric Salt powder can be used as a wood preservative. Linseed oil can be applied to preserve benches or surfaces used outside. For fences and other garden surfaces, Ronseal Fencelife and Cuprinol Garden Timber Care are water-based treatments without fungicide which protect external timber. Avoid using creosote, which can cause persistent sensitivity.

Wood Stains

Most wood stains are based on solvents such as naphtha. Use the following alternatives for preference. For internal use, Cuprinol Enhance and Ronseal Solvent-Free Varnish (water-based acrylic varnishes as above) are available in coloured as well as clear versions. Organic pigments are used as the colouring agents and are usually trouble free.

Livos sell Bela wood stains – water-based wood stains based on natural plant dyes – and will provide small samples to test. Available by post from Livos.

For external use, Ronseal and Cuprinol both produce a Quick Drying Wood Stain, water-based acrylic stains, without fungicides. Avoid any products labelled preservative wood stains – these will contain fungicides.

Woodworm Treatments

Woodworm treatments are usually based on organic solvents, and contain unpleasant chemicals, such as lindane or dieldrin, as the pesticide. Permethrin is an alternative pesticide to these chemicals. It is naturally derived and less hazardous generally to humans, but it is still toxic and known to cause sensitivity. Do not use any treatment unless you have to.

The better course of treatment is to remove and replace affected timbers if you can afford to. Some hardwoods are more resistant to worm attack than softwoods, so use these if you can.

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Nor is it normal for any baby or toddler to cry a great deal, to be constantly cranky, unmanageable, hyperactive, irritable, insomniac or unable to concentrate (or even intermittently so for no apparent reason). Other indicators of reactions that parents report disappear with avoidance are excessive thirst, waking at night, constant urination, and shiners (big black rings) under the eyes. Persistent nappy rash is not always caused by allergy and intolerance but it can be linked and often clears up spontaneously when problem foods or chemicals are avoided.

It is important not to over-analyse your baby and not to see problems that simply are not there, but it is equally important not to ignore indicators of this kind. In some babies and toddlers, allergy and sensitivity are temporary phenomena. They disappear totally as the child matures and are no more trouble in future life. In other children, the problems can go underground, symptoms can shift in nature – eczema goes away, for instance, but some other symptom comes in its place and can lead to more widespread problems – unless the causes are identified and avoided.

Even if your child is not seriously ill, if you are concerned about low level symptoms in a potentially sensitive child, it is worth insisting on a referral to a paediatric specialist. You run the risk that you may be cast as an over-anxious parent, but paediatricians do take allergy and sensitivity in babies seriously, and will do all they can to help or reassure you.

Reactions to food often get worse, or only occur on days when a baby is teething. These can be temporary intolerances, so wait for a few days and see if any pattern linked to teething develops.

Protecting a child in the first two years of his or her life is one of the few” areas of precautionary measures against allergy and sensitivity where taking extreme care has some merit. Provided you are not obsessive or paranoid about protecting your child, and you do not place excessive restrictions on your family’s life, then it is a preventative investment worth making.

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Another way to identify allergy to house dust mites is to analyse the pattern of your symptoms by answering the series of questions. If you answer ‘yes’ to several or all of these questions, then suspect allergy to house dust mites. Then try some of the avoidance measures outlined below. If these result in improvement of your symptoms, then house dust mites will be confirmed as a cause.

It is important to bear in mind that inhaling large amounts of dust is irritant for anyone, and can cause sneezing, coughing, itchy eyes or difficulty in breathing. If you need more help in working out whether your symptoms are irritation or allergy.

Tests: Are You Allergic to House Dust Mites?

DO YOU FEEL WORSE? Yes No

When you first lie down in bed _ _

On turning a mattress _ _

When the heating comes on _ _

Only in indoor environments _ _

During or just after vacuuming _ _

When making or changing beds _ _

When dusting or sweeping _ _

Overnight or first thing on waking _ _

When shaking rugs or carpets _ _

When sitting on old furniture _ _

In places with carpets _ _

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