This is a special kind of dust isolated from the inside of a house and recognized as early as 1922 as a potent and common cause of allergy. It is totally different from the dust found in the streets because it is composed of the emanations, the excretions, and the remains of the dead bodies of the common house mite. It may be obtained from a vacuum cleaner whose dust can be purified and used for testing and desensitization.

Precautions Against House Dust

An atopic child should have a room which he uses for sleeping purposes only; he should dress and undress and keep his clothing and books in another room. The bedroom must be made comfortable, pleasant, and colorful, and it must be kept free from dust by using the following precautions.

Cleaning. The room must be vacuumed daily, and it must be given a thorough cleaning once a week: the floor, the furniture, the tops of the doors, the window frames, the sills, etc., must all be cleaned with a damp cloth or oil mop. After the cleaning, the room must have its windows left open for half an hour, and then all doors and windows must be kept closed until the child is ready to occupy the room. If the child must be present in the house during cleaning time, he must wear a special mask over his mouth and nose. The best ones are made of polyethylene, which sticks to the skin, does not admit anything except air, and allows the child to talk freely. The dust clinging to it can be washed off later by dipping the mask in water.

Preparation of the bed. The mattress and springs must be cleaned and enclosed in a plastic casing (which may be bought in stores that specialize in allergy-free products). If a second bed must be used in the same room, it must be prepared in the same fashion.

Choice of the bedding material. The pillow must be made of sponge rubber, and the blankets of synthetic material (which is to be washed every four to six weeks). The bedspread must be of washable fabric that has been laundered previously. No mattress pad, quilts, comforters, or fuzzy woolen material is to be used on the bed.

The furnishings. They should be simple, not ornately carved, and should consist of a scrub-babble wooden chair, cotton curtains (instead of drapes), and roll-up window shades (instead of Venetian blinds). All toys present in the room must be made of wood, rubber, or iron (instead of stuffed toys which may contain dust, wool, and molds).

The heating. The temperature must be kept constantly at about 75°F by means of heated water and not heated air. However, if the room does have hot air heating, several layers of cheesecloth must be put on the heat outlets.

The following methods may be used to eliminate dust (as well as other inhalant allergens) from the air.

Filtration utilizes filters made from paper, glass wool, etc. The effectiveness of such a device is contingent upon the type of filter used, the rate of air exchange, and the size of the particle to be eliminated. If the size of the particle is a large one (such as that of a pollen grain which can measure from twenty to thirty microns), any simple filtering device fitted into the bedroom window will do. However, since most inhalant particles are less than five microns in size (particles of dust, fumes, smoke, mold spores, bacteria, and viruses), special material called Hepa is necessary to perform the filtration.

Electrostatic precipitation is achieved with plates charged with a high voltage and put in portable units for bedrooms, or in large units attached to the main ducts of the heating system. These plates attract inhalants and dust particles and precipitate them. The large units do their job well if radiant heat is used; however, with forced hot air heating, conventional filters have to be put in the heating ducts as well. The installation of such devices is becoming less costly each year, and the expense is tax deductible if they are installed with a doctor’s prescription.

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In summary, doctors and nurses providing contraceptive care for this age group should have detailed knowledge of the range of methods that can be offered safely. There is also a need to be aware of the hidden agenda that can lie behind a request for contraceptive advice, or problems with a method that has previously been satisfactory. The particular difficulties that some people in this age group have in asking for help must be recognized by the provision of choice within the contraceptive service, and by training doctors and nurses to be able to pick up indirect clues that the patient may be in trouble. It is particularly important that any assumptions and prejudices about age and sexuality are recognized so that appropriate care can be given to each individual patient based on their own needs rather than the preconceived ideas of the doctor.

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