Wellness Programs Should Address Allergies that Affect Performance and Safety in the Workplace

We intend the outline to provide a rationale explaining what combinations of medicines may be used to control allergies.  Use only those steps that are needed to solve the problem for you.  In general, try to use remedies toward the top of the list.  Reducing the allergic load and using protective masks for special tasks are prudent for everyone with allergic problems.  Beyond that, most people prefer to use antihistamines as their sole treatment.  Antihistamines usually will work with one or two doses of medicine per day, which is more convenient than the four times a day required for Nasalcrom®.  Some people find that antihistamines make them nervous or jittery.  Usually, it is not an antihistamine that causes this but rather a decongestant mixed with antihistamines in over-the-counter sinus or cold remedies.  Watch for the word "decongestant;" it usually means there is an adrenaline-like drug in the preparation.  If antihistamines alone are not adequate, or if they cannot be taken for some reason, the next line of defense usually is a corticosteroid nasal spray to reduce the inflammation caused by the allergic reaction.  Again, the reason is mostly the convenience of once- or twice-daily dosing.  Nasalcrom® would also be an excellent choice for a second level treatment.  For patients using both an antihistamine and a corticoid spray, Nasalcrom® really is the next best addition, despite the need to use four times a day for best effect.  Using a decongestant such as pseudoephedrine (Sudafed®) would follow as a fourth level of defense.  Treatments lower in the outline than the decongestants are usually needed only if the problem developed without warning, so that the other remedies could not be applied in time.  If you should reach the point of requiring antibiotics, it is important to use methods to open the sinuses at the same time and afterwards.  If you do not, the bacteria causing sinusitis may be destroyed as planned, but may be replaced with a fungal or yeast infection, which is even more difficult to treat. Using a saline solution to rinse mucous out of the nose often helps symptoms greatly.  The recipe is 2 tsp salt, 1 tsp baking soda, and 1 quart (~900 mL) water.  You can buy a salt solution in a spray bottle and then refill the bottle.

 

Author:  Sanford S. Leffingwell, M.D., MPH is a board certified specialist in occupational medicine, with degrees from Harvard University, University of Colorado School of Medicine and The Johns Hopkins School of Hygiene and Public Health.  He can be reached at ssl@hlmconsultants.com. www.HLMConsultants.com