Environmental management of inhalant allergens is an important part of a comprehensive allergy management program and is the one most directly controlled by the patient. One of the first tasks of a physician treating allergic patients should be to get patients to understand the importance of environmental management to the success of their allergy treatment, and to have patients begin to control their environment. This is so because the safest and most effective way to eliminate an allergic reaction is to eliminate exposure to the antigen that provokes the response.

Ignoring the environmental factor can lead to treatment failure and continued illness for the allergy patient. Environmental control can be one of the most, or one of the least, expensive parts of allergy treatment, depending on the allergens involved and the method of control used. The bedroom is generally the area of the house where the most time is spent by inhabitants. Therefore, to achieve the highest yield from effort and money spent, the first focus of environmental management should be on the bedroom.

The basic control principles for all inhalant allergens are: 1) remove the source of the allergen if possible; 2) remove accumulated allergen; and 3) prevent the return of the allergen.

There are indoor inhalant allergens—dust and dust mites, molds, and house pets and their dander—and outdoor inhalant allergens—tree, weed, and grass pollens and some molds. The techniques for managing each of these may differ, but the principles for all are the same.

This article examines the published evidence concerning environmental control measures in terms of effectiveness, cost, and ease of implementation.