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Holiday Asthma and Allergy Triggers

By Christine Cioppa

A trip to the ER is not a fun way to spend Christmas Eve or Christmas Day. The culprit for some: a live Christmas tree in the home.

It’s becoming more commonly known as “Christmas Tree Syndrome.” And, unfortunately, it’s not always easy to connect the dots between an asthma attack and a Christmas tree since allergy symptoms can appear days after putting up a tree and can peak around Christmas Eve or Christmas.

The week before Christmas day to the week after is noted for “epidemic peaks of respiratory illness” in adults and children, according to one study published in the Annals of Allergy, Asthma & Immunology

One of the researchers, Lawrence Kurlandsky, MD, recently shared what he knows about asthma, allergies and the holidays.

When he studied the issue several years ago, he and his colleagues focused on Christmas tree mold. They set out to identify what types of mold might be causing the problem. A few years earlier, in 2007, other researchers found that Christmas tree mold spores were shown to multiply by as much as 600 percent per cubic meter (800 spores to 5,000 spores) after two weeks in the home.

“My 2011 study was prompted by the observation in my allergy practice over many years that many children with known allergies, especially to molds, became acutely symptomatic in the presence of a live Christmas tree and unfortunately ended up in an ER or hospitalized on Christmas Eve or day. It seemed clear to me that live trees might be playing a role,” Kurlandsky said.

Though figures are hard to come by, one study found that 7 percent of allergy patients experience allergies to a live Christmas tree.

That doesn’t mean you necessarily have to toss your live tree. It could be your pet, your visitors’ pets, your humidifier, your stress level and more triggering asthma or allergy symptoms around the holidays, Kurlandsky said. Read the full interview below to find out what you can do this holiday season to reduce the risk of wheezing and other allergy symptoms.

 

Q&A with Lawrence Kurlandsky, MD:

 

Q. In 2007, several news outlets reported on Christmas trees and mold and how airborne mold spores inside an apartment can multiply 600 percent per cubic meter (800 spores to 5,000 spores) after a tree is brought inside the home and left there for two weeks. Has this been refuted and/or can you confirm that mold spores increase in the air in confined spaces like small condos, homes and apartments?

 

A. Mold spores can increase in small living spaces over time if the source continues to be present and especially if the site remains humid. The 2007 report has not been refuted. However, one criticism is that the mold spores may not have come from the tree but could have come from another source, such as house plants, whose soil can give off mold spores, or an unclean humidifier that might be used in a home with dry air in the winter due to the heat being on.

 

Q: When you've studied the types of mold spores found on Christmas trees, are those types associated with asthma and allergies? 

 

A. Yes, of the 11 different types of molds that were identified, 4 are known to be clearly associated with asthma and allergies. These are Aspergillus, Alternaria, Cladosporium, and Penicillium.

 

Q. For people with severe tree, ragweed, mold and grass allergies, what do you recommend if they enjoy having a live tree?

 

A. If people with severe allergies have had no previous problems with a live tree, then I would recommend no action. If previous problems have been suspected, then hosing a tree with water or using a "leaf blower" to clean it off outside or in the garage have been suggested.

 

Q. Can the levels of allergens from a live tree in the home be dangerous enough to trigger severe asthma attacks and allergies, even in people who don't normally have these allergies?

 

A. This is unknown. People may develop new allergies at any time, but if a person has not been allergic to molds, dust mites, or grass or ragweed pollens, then it is unlikely that allergens from a live tree would trigger symptoms.

 

My 2011 study was prompted by the observation in my allergy practice over many years that many children with known allergies, especially to molds, became acutely symptomatic in the presence of a live Christmas tree and unfortunately ended up in an ER or hospitalized on Christmas Eve or day. It seemed clear to me that live trees might be playing a role. Evergreen pollens are not present during the winter months, so it seemed that molds, which readily grow on tree bark, might be the culprit.

 

However, I do not wish to impugn Christmas trees as the sole issue for triggering allergies or asthma over the Christmas holidays. Other factors may be involved such as family or friends visiting who might have pet dander on their clothes that a household member might be allergic to or different holiday foods that may contain an ingredient that someone is allergic to and does not appreciate its presence. One could also postulate that the excitement or anxiety of the holiday might trigger asthma symptoms.

 

Q. Is an artificial tree any better and what allergy risks, if any, does this tree pose?

 

A. Many people have found that an artificial tree creates no problems where previously the presence of a live tree was associated with allergy or asthma symptoms (suggesting that a live tree may present problems to some people). However, an artificial tree may harbor dust (dust mites) or animal dander, which can also trigger allergic symptoms in sensitive people. So depending on where it came from and how it was stored from year to year, it may also need to be cleaned in the same manner as a live tree.

 

Want to learn more about allergies that appear around the holidays? Read on:

 

“Allergies, Asthma and Winter Holidays” article from the American Academy of Allergy, Asthma & Immunology: https://www.aaaai.org/conditions-and-treatments/library/asthma-library/allergies,-asthma-and-winter-holidays

 

“Allergic to the Holidays?” article from the Christmas Tree Association:

http://www.christmastreeassociation.org/allergic-to-the-holidays/

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