A leading authority on asthma and allergies puts dust mites and mould on the top of his list as major problems in Bermuda.

American Dr. John O'Loughlin, Chief of Allergy and Immunology at the Lahey Clinic in Burlington, Massachusetts, travels to Bermuda three or four times a year to see patients for Dr. Ewart Brown rather than having those patients incurring expenses by travelling to the United States.

The affiliation between Dr. Brown's office and the Lahey Clinic started three years ago.

"The patients I do see have asthma and other allergies to environmental things such as pollen, mites and mould,'' said Dr. O'Loughlin in a recent telephone interview from his office.

"I go down there on Thursday, Friday and Saturday to see patients. I would say three to four times a year. I'm planning to come back in February.

"The most prevalent offenders, from what I see from my skin testing, is dust mites and mould. After that, equally in second place would be animals and pollen, such as tree and grass pollen.'' Added Dr. O'Loughlin: "There is also a fair amount of sensitivity in children to cockroaches, but that could be anywhere. Any place that has a warm, humid climate can be a problem and they can aggravate and be a very big cause of asthma, particularly in children. You don't even have to see them, but their droppings can sensitise a youngster who is on the floor.

"The major thrust in any treatment of asthma or allergy is the avoidance of that particular culprit.

"All of the drugs we have up here they have down there in Bermuda. There is plenty to work with and they should be able to be helped tremendously with the medication that's available.'' Dr. O'Loughlin has been at the Lahey Clinic in the Allergy and Immunology Department for 31 years and has been chairman of that department for the last 10 years. He is constantly upgrading his skills and was recently in Seattle for the American College of Allergy, Asthma and Immunology annual meeting. He is also a past president of the American Association of Certified Allergists.

"You have to keep up with the latest changes, and there have been tremendous changes in the treatment of asthma,'' said the doctor.

"Today, if someone has asthma on a regular basis, the foundation of treatment is anti-inflammatory drugs, such as the cortisone spray. When I started 30 years ago there was just combination drugs which, if you increased the drug to two or three from one, you had to increase all the components of it which gave a lot of side effects.

"Today we have the luxury, if you will, of having drugs which you inhale right down to where the action is in the lungs, which are extremely effective if used properly.'' Cigarette smoke and animal dander, particularly cats, are two major irritants for asthmatics.

"If they have a parent who smokes it is bad for someone who may eventually develop asthma,'' the doctor revealed.

"Also they should not have animals if they can. Cats are worse than dogs and of the two animals the one more likely to cause asthma and other allergy symptoms is the cat.

"The saliva and the dander both have proteins in them that can cause asthma and other allergy symptoms. Fortunately there are treatments you can give if someone has to have an animal. Immunotherapy therapy can be used.'' He added: "The thing with allergies is that if you are severely allergic to something, if you can go without it you should avoid it. I tell people `if you're allergic to cats and don't have one then don't get one.

"But if they already have one and they are part of the family, then they should try to get them off the bed and out of the bedroom and into an area that is not a sleeping area. If the patient does have asthma in particular they should consider allergic injections. They do work.'' Dr. O'Loughlin noted that eczema was part of an allergic person's genetics and if that person had two parents with an allergy they would be more likely to develop eczema, asthma or hay fever. But he says asthma and eczema are not related.

"Some people who have asthma potential sometimes will have eczema or when people get stressed their eczema will worsen. It seems to be worse when people have a baby, get married or have domestic problems.

"Up here (US) it's worse in the summer when people perspire a lot as opposed to the winter when the skin is dry. That somewhat holds true for asthma, about 50 per cent of asthma is allergy related but a lot of it is not. Some people only wheeze when they exercise.

"You have wheezing only when people get infections, sometimes. You can get wheezing when someone is exposed to a chemical irritant. The asthma patients have what we call twitchly lungs, they are susceptible to exposure to cigarette smoke or exercise which is in a category of its own.

"You can have absolutely no wheezing but with exercise.'' Night crawler: A dust mite, seen in this magnified image, lives in your bedding, eating dead skin that flakes off your body overnight.

HEALTH HTH