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1. Strong Scents and Cleaning Products
“Cough is a common symptom for patients with IPF, and there is data that these individuals develop hypersensitive cough reflexes,” says Nirav G. Shah, MD, clinical chief of pulmonary, critical care, and sleep medicine at the University of Maryland Medical Center in Baltimore. “This results in exacerbations of cough with exposure to fumes and scents that may not bother other people.”
“Not everyone is affected by fumes or scents, but some people are,” says Amy Hajari Case, MD, chief medical officer for the Pulmonary Fibrosis Foundation and director of the interstitial lung disease program and pulmonary and critical care research department at Piedmont Healthcare in Atlanta. “For those who are sensitive, this can lead to symptoms such as coughing, wheezing, or even chest tightness as a result,” she says.
Unfortunately, scents are found in a huge range of products, including:
- Soap
- Shampoo and conditioner
- Hand and body lotions
- Deodorants
- Cologne or perfumes
- Air fresheners
- Scented laundry detergents
- Fabric softeners
- Cleaning products.
“In general, we advise patients with lung diseases to avoid perfumes, strong scents, fumes, and other environmental exposures, as they may worsen cough symptoms and even result in increased breathlessness,” says Dr. Shah. “We also advise against using scented candles, air fresheners, and strong cleaners, such as bleach, as it may exacerbate symptoms.”
- Identify Your Triggers You may not be sensitive to all scents and odors, so try to identify and avoid those that act as triggers.
- Go Fragrance-Free Opt for scent-free personal and household products, as this will reduce your exposure to harmful chemicals.
- Avoid Aerosols Avoid or at least cut back on your use of aerosol sprays, including air fresheners, hairspray, and spray deodorants, as inhaling fine particles and chemical fumes can worsen symptoms.
- Seek Safer Products Use safer products for household cleaning, preferably those without VOCs. Read product labels, and look for products certified by Safer Choice, Green Seal, or EcoLogo programs.
- Never Mix Products Avoid using bleach or ammonia for cleaning and never combine cleaning products; some of them, like bleach and ammonia, can create toxic and even fatal gases when mixed together.
- Simplify Try using simple nontoxic items like vinegar and baking soda, or mild soap, for cleaning.
- Wear Protective Gear If you must use cleaning products that contain VOCs, limit exposure by wearing protective gear, including gloves and an N-95 mask, and make sure the room is well ventilated to reduce the amount of fumes you inhale.
2. Smoke and Allergens
“An air purifier with a HEPA filter can help reduce smoke, dust, pollen, and airborne pathogens such as bacteria and viruses,” says Dr. Hajari Case. She recommends avoiding air purifiers that produce ozone, a potential respiratory irritant.
- Stop Smoking If you currently smoke, it is important to consider quitting. Refrain from using e-cigarettes or vaping products.
- Avoid Secondhand Smoke Do not allow others to smoke in your home or car. Keep a distance from smokers.
- Avoid Burning Wood Avoid wood burning fireplaces and wood stoves. If you have one in your house, make sure that it is well ventilated.
- Keep Pollen Outside If you have pollen allergies, learn which type affects you and during which seasons. Keep windows closed and use air-conditioning when pollen counts are high, and use an air filter. Consider removing your shoes when you enter your home, to avoid tracking pollen around the house.
- Remove Animal Dander Dander can stick to carpets, clothing, and furniture, so make sure to keep those things clean if you have a pet. Wash your hands after touching animals, including your own pets. If dander is a problem, you might consider getting a pet that doesn’t shed or sheds minimally.
- Control Dust Mites Dust mites live in mattresses, bedding, carpets, curtains, and on dusty furniture, so it is important to keep those items clean. Wash bedding in hot water every week, cover mattresses and pillows with special mite-proof cases, and keep household dust at a minimum.
- Prevent Mold Keeping your house dry (relative humidity in the 30 to 50 percent range) is important for preventing mold. Use an exhaust fan in the bathroom when the shower is running, or keep a window open. Use a dehumidifier, if needed. When cleaning mold, use a mask and gloves, especially if you are using a strong cleaning agent. Keep windows or doors open when using any cleaning products, and if mold is extensive, consider getting it professionally cleaned.
3. Gastroesophageal Reflux Disease (GERD)
“GERD is a common trigger for coughing,” says Hajari Case. “Air quality and other environmental factors may impact GERD, and keeping the indoor climate comfortable can help with symptoms.”
She recommends having a fan running during the summer to keep the air moving and maintain a comfortably cool indoor temperature. “In the winter, humidity is often lower, and having a heater running can dry indoor air even more,” she says. “If you choose to use a humidifier, be sure to keep it clean by changing the water daily, cleaning it regularly, and replacing filters per the manufacturer’s instructions to avoid mold growth in the unit.”
Lifestyle modifications can also help control GERD symptoms. “We highly recommend interventions such as elevating the head of the bed with bed risers or cinder blocks — not pillows, because we often roll off of them in the middle of the night,” Shah says, “and not eating or drinking anything except for water for two to three hours prior to bedtime so that everything in your stomach can move to the small intestine and result in less reflux.”
With regard to temperature and humidity, a relative humidity level of 40 to 50 percent is recommended because dry air can irritate airways and cause coughing, while overly humid environments can make it harder to breathe, he points out. “In cold, dry environments, such as the wintertime, a mask or face covering can help humidify the air and make breathing a little easier,” he says.
4. Respiratory Infections
Respiratory Infections are a common trigger for IPF flare-ups and can have serious consequences for people with chronic lung diseases. While infections can’t always be prevented, there are many ways to protect yourself and minimize the risk.
- Get Vaccinated The American Lung Association emphasizes that staying up to date on recommended vaccines is a crucial step in preventing respiratory infections. This includes vaccines for influenza, COVID-19, respiratory syncytial virus, and pneumonia. Encourage your family and friends to keep their own vaccinations up to date to lower the risk of transmitting a virus to you.
- Practice Good Hand Hygiene Wash your hands frequently with soap and water for at least 20 seconds. If soap and water isn’t available, use a hand sanitizer that is at least 60 percent alcohol. Sanitize your hands after touching anything that other people have touched, such as doorknobs or keypads.
- Don’t Touch Your Face Avoid touching your face, particularly your nose and mouth, especially if you haven’t washed your hands.
- Don’t Share Personal Equipment Do not share masks or any sort of inhaler with others.
- Mask Up Wear a mask if you are in a large group of people, especially in an indoor setting and during the winter, when respiratory viruses are circulating at their peak.
- Clean Surfaces Frequently clean and disinfect heavily used surfaces in your home, such as countertops and doorknobs.
- Limit Contact With Sick People Avoid as best you can, or at least limit, contact with people, especially children, who are sick with a respiratory virus. Wear a mask when with them.
- Avoid Potential Exposure Stay away from or limit your time in crowded places, such as shopping malls, especially during cold and flu season.
The Takeaway
- Hidden triggers within the home can cause IPF symptom flare-ups, but steps can be taken to minimize their danger.
- Scented products, including perfumes, air fresheners, and personal care products can be irritants for people with IPF, causing their symptoms to worsen. Some cleaning supplies and household products may release chemicals that are linked to respiratory illnesses.
- It is important to be tested if you suspect you have allergies, in order to identify the trigger and minimize contact with it.
- GERD is a suspected cause of IPF, and if left untreated, it may trigger symptom flare-ups.
- Getting vaccinated for respiratory illnesses such as influenza, COVID-19, and pneumonia is a crucial preventive measure for people with IPF.
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