can face masks cause allergic rhinitis

https://www.fda.gov/consumers/consumer-updates/rinsing-your-sinuses-neti-pots-safe. I hope this answers your query. So can medicines for depression. Esmaeilzadeh H, Goodarzian M, Abbasi A, Alamdari M, Mortazavi N. Health Sci Rep. 2023 Apr 19;6(4):e1226. Complementary Therapies in Medicine. eCollection 2022 Dec. Pneumo News. Our pediatric otolaryngologists provide compassionate and comprehensive care for children with common and rare ear, nose, and throat conditions. Allergens; Allergic rhinitis; Face mask; Pollen. You may experience symptoms during times when hormones are in flux, including: Nonallergic rhinitis may also result from using nonprescription drugs, like cocaine. Does mask usage worsen symptoms in patients with rhinosinusitis balloon sinuplasty amid the COVID-19 pandemic? 1. (2022). The study found that there was no difference in symptoms between pre-pandemic patients and those who wore masks throughout the pandemic. The .gov means its official. That's caused by your body overreacting to things like pollen or mold. You can learn more about how we ensure our content is accurate and current by reading our. The most effective way to treat an allergy is with allergy shots, or immunotherapy. Chronic rhinitis may be caused by allergy or a variety of other factors. Wearing makeup under your mask is also not advised. Irritants like strong odors, smoke, and weather changes can trigger nasal (nose) symptoms. Mayo Clinic. 2021 Nov;165(5):609-610. doi: 10.1177/01945998211000419. Nonallergic rhinitis - vasomotor defined. India, 8600 Rockville Pike 2023 Apr 14;28:165-199. doi: 10.1016/j.jtos.2023.04.006. 5. For the 10% to 20% of the population who suffer from allergic rhinitis (seasonal allergies), continuing to mask even after California's mask order has been lifted may be a good thing. Nonallergic rhinitis symptoms often come and go year-round. Wearing your mask during the summer months may make it feel more difficult to breathe. 2020 Sep 1;41(5):363-371. doi: 10.2500/aap.2020.41.200046. Ramirez AV, et al. Most people manage symptoms with self-care measures, changes to their environment and medicine. U.S. Food & Drug Administration. Fouladi Dehaghi B, Ghodrati-Torbati A, Teimori G, Ibrahimi Ghavamabadi L, Jamshidnezhad A. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen) Allergy. Sinuses are cavities around nasal passages. (2021). Besides making you miserable, hay fever can affect how well you perform at work or school and can generally interfere with your life. Itchy, stuffy, or runny nose. As a result, your nose can produce thick boogers along with mucus which can cause a stuffy nose. Chronic rhinitis can occur due to seasonal allergies whenever the pollen youre allergic to is in the area, whether for days, weeks, months, or years, depending on the allergen. Learn more about the. Always see your healthcare provider for a diagnosis. Sore throat from mucus dripping down the throat (postnasal drip). 2020 Dec;10(2):020311. doi: 10.7189/jogh.10.020311. What Type of Face Mask Is Appropriate for Everyone-Mask-Wearing Policy amidst COVID-19 Pandemic? The authors stated that patient reports of worsening sinus symptoms with mask usage is likely to be perceived discomfort rather than a physical exacerbation. Most often, the diagnosis is made by your healthcare provider based on an in-depth history and physical exam. April 19, 2022. Allergic rhinitis. Any advice? Symptoms of vasomotor rhinitis include: Stuffy nose. Epub 2020 May 18. This substance is called an allergen. To learn more about how to safely use a neti pot, follow these steps. Australia, 15 If symptoms . It may come and go over time. At Night: Your nighttime skin routine is even more important in the fight against maskitis, says Dr. I tried over the counter (OTC) nasal allergy sprays but they irritate me. Meanwhile, you can use the following medicine to help you with these symptoms. Unable to load your collection due to an error, Unable to load your delegates due to an error. In those cases where avoiding the trigger is impossible, you can put measures in place to ease symptoms, try over-the-counter medications or get a prescription from a healthcare provider. Allergic rhinitis is caused when allergens in the air trigger the release of histamine in the body. How do I include my pets in my familys emergency planning for COVID-19? Comparative Mask Protection against Inhaling Wildfire Smoke, Allergenic Bioaerosols, and Infectious Particles. Symptoms of hay fever include: Nasal stuffiness (congestion), sneezing and runny nose. Allergic rhinitis is a diagnosis associated with a group of symptoms affecting the nose. Treatment Effect of Phototherapy with Low-Level Energy in Patients with Allergic Rhinitis: A Single-Arm Observational Study. https://www.uptodate.com/contents/search. Wear a mask when mowing the lawn, doing garden work, or cleaning the house. This allergy is usually worse during humid and rainy weather. Take extra steps when pollen counts are high Seasonal allergy signs and symptoms can flare up when there's a lot of pollen in the air. When a harmless substance such as dust, mold, or pollen is encountered by a person who is allergic to that substance, the immune system may over react by producing antibodies that "attack" the allergen. Hay fever/rhinitis. (2018). Online ahead of print. Preventive measures for avoiding allergic rhinitis include: Avoiding areas where there is heavy dust, mites, or molds, Avoiding what you know you are allergic to, Controls in your environment, such as air conditioning during pollen season. Nasal irrigation, also called nasal lavage, involves using a saltwater solution to rinse the nasal passages. Allergies to grasses and weeds tend to occur in the summer and fall. But getting the right treatment might offer relief. All rights reserved. Some of the most common causes of rhinitis are pollen, dust mites, mold, cockroach waste, animal dander, fumes and odors, hormonal changes, and smoke. Children (Basel). Our houses are the one place most people arent wearing a mask, and more patients are seeking treatment for allergies to animals, dust, and mold. Nurses with intermittent allergic rhinitis showed a significant improvement in overall symptoms burden after wearing face mask, but no change in specific ophthalmic symptomatology regardless of the type of face mask used. The most common are acute rhinitis, which is usually caused by a viral illness, allergic or seasonal rhinitis, and nonallergic or year-round rhinitis. Our website services, content, and products are for informational purposes only. American Academy of Allergy, Asthma & Immunology. An official website of the United States government. Advertising revenue supports our not-for-profit mission. But they say people need to keep their masks clean and remove them properly. You can lower your risk by avoiding triggers known to cause rhinitis. 2020 Oct 6;173(7):542-555. doi: 10.7326/M20-3213. privacy practices. Unlike allergic rhinitis (or hay fever), the symptoms are of an unknown cause. Masking and sinus issues: Whats the link? 2020 Nov-Dec;8(10):3590-3593. doi: 10.1016/j.jaip.2020.08.035. In other words, the discomfort of the mask itself often gets confused with sinus discomfort when the two arent related. Clinical practice guideline: allergic rhinitis. Consult over 3M existing patients and increase your online brand presence. Using a humidifier at home or at work may ease symptoms. The medications mentioned above are to symptomatically treat the issue and not allow it to further progress into sinusitis which invariably does happen when care is not adequately taken. The primary causes of this type of rhinitis are allergies to dust mites, mold, animal dander and cockroach debris. This histamine release results in allergic rhinitis symptoms. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). At your appointment, be prepared to tell the doctor how long youve had these symptoms and what treatments youve already tried. Wu WW, et al. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Bookshelf Haven't gotten relief from home remedies or medicines you bought at a store without a prescription. The review also noted that the American Academy of Allergy Asthma & Immunology (AAAAI) has linked climate change to an increase in the intensity and duration of pollen season. Symptoms can also occur when you eat a food that you are allergic to. https://www.uptodate.com/contents/search. Click here for an email preview. Many people especially children get used to hay fever symptoms, so they might not seek treatment until the symptoms become severe. Irritant rhinitis (IR) is defined as an inflammatory and/or irritative response of the nasal mucosa due to causes attributable to non-allergic stimuli, eg, a physical or chemical stimulus. Rhinitis, or inflammation of the inner lining of the nose, becomes chronic when it lasts more than 12 weeks. Congestion. Nonallergic rhinitis. People with asthma are at a higher risk for rhinitis. The impact of the COVID-19 pandemic on otolaryngologic emergency department visits at two major NYC hospital systems. Mucus flows from the front of the nose and drains down the back of the throat. This content does not have an Arabic version. If youre not sure whats causing your symptoms, a doctor can perform an allergy test called an allergen-specific immunoglobulin E (IgE) antibody test. Dr. Davis says the first step for mask use and sensitive skin is after you've washed and patted your face dry, apply hypoallergenic moisturizer that's identified as face moisturizer. Duonase nasal spray (Fluticasone + Azelastine) two puffs in each nostril two times a day for one month. doi: 10.1111/j.1398-9995.2007.01620.x. If you choose to use a neti pot for nasal irrigation, be certain that you use distilled, sterile, previously boiled and cooled, or filtered water to prevent dangerous infections. Materials and methods: 2015;152:S143. Emily McCobb, V00, VG02, director of Cummings Schools Shelter Medicine Program, responds, Irina F. Dragan, DG15, assistant professor of periodontology at Tufts University School of Dental Medicine, fills us in. Try different masks to find one that is comfortable, fits well, and is easy to breathe through. Social distancing and masking can also reduce the spread of viral URIs, which is another trigger for sinus infections. Conclusions: This saltier saline may help draw fluid out of the nasal membranes. In fact, masks can protect against triggers of sinus infections, like airborne allergens and viruses. Here are eight air purifiers we recommend for dust and allergies. Gross. Climate change can contribute to increased pollen and warmer temperatures. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Make sure youre also drinking enough water and other caffeine-free liquids to encourage mucus drainage from the nose and reduce inflammation. If your symptoms dont go away, you may want to see a doctor for a diagnosis and treatment. (2021). De Corso E, et al. These may include a runny nose, itchy eyes, congestion, sneezing and sinus pressure. and Intl. Postnasal drip can make you feel like you have something stuck in your throat and cause you to cough. / (2018). If this isnt possible, certain medications may help with your symptoms, including OTC and prescription nasal sprays and decongestants. Still, many people still report discomfort with masks. Unlike allergic rhinitis, symptoms of vasomotor rhinitis usually occur year-round. These symptoms occur when you breathe in something you are allergic to, such as dust, animal dander, or pollen. Wearing a face mask gives me an itchy, runny nose. Epub 2021 Mar 9. The nurses scored their overall allergic, MeSH Unauthorized use of these marks is strictly prohibited. How can I avoid this? Keep in mind that theres no evidence that wearing a mask makes you [sicker]. Rhinitis 2020: A practice parameter update. A 2018 review noted that sinus issues can be triggered by changes in: A 2020 review noted that 12 out of 17 locations on multiple continents showed an increase in pollen load over time, and that this increase was significantly associated with an increase in maximum temperatures. Otolaryngol Neck Surg. Not Sure You Have COVID-19? How to tell the difference, Mayo Clinic Minute: Tips to deal with 2023 spring pollen and allergies, Mayo Clinic Minute: How to get hay fever relief from fall allergies, Mayo Clinic Q and A:Springtime allergies, Mayo Clinic Minute: How to manage hay fever allergy symptoms, Mayo Clinic Minute: How to get spring allergy relief, Runny nose with thin, watery discharge; no fever, Runny nose with watery or thick yellow discharge; body aches; low-grade fever, 1 to 3 days after exposure to a cold virus, Runny nose and nasal stuffiness (congestion), Watery, itchy, red eyes (allergic conjunctivitis), Mucus that runs down the back of your throat (postnasal drip), Swollen, bruised-appearing skin under the eyes (allergic shiners), Extreme tiredness (fatigue), often due to poor sleep, Tree pollen, which is common in early spring, Grass pollen, which is common in late spring and summer, Dust mites and cockroach droppings, which are present year-round, Dander from pets, which can be bothersome year-round but might cause worse symptoms in winter, when houses are closed up, Spores from indoor and outdoor fungi and molds, which can be both seasonal and year-round, You can't find relief from your hay fever symptoms, Allergy medications don't provide relief or cause annoying side effects, You have another condition that can worsen hay fever symptoms, such as nasal polyps, asthma or frequent sinus infections, Having a condition called atopic dermatitis or eczema, which makes your skin irritated and itchy, Having a blood relative, such as a parent or sibling, with allergies or asthma, Living or working in an environment that constantly exposes you to allergens such as animal dander or dust mites, Being exposed to smoke and strong odors that irritate the lining of the nose, Having a mother who smoked during your first year of life. the unsubscribe link in the e-mail. The exact cause of nonallergic rhinitis is unknown. Immunol Allergy Clin North Am. Allergic rhinitis: Clinical manifestations, epidemiology, and diagnosis. Of 301 nurses, the minority typically use only 1 type of mask, either a surgical mask (n= 47) or an N95 mask (n= 39), whereas most (n= 215), for the purposes of this study, used 2 types of face mask (surgical mask and N95) for 1 week each for a total of 2 weeks. What Can Cause a Constant, Clear-Fluid Runny Nose? International Forum of Allergy & Rhinology. You can upload files and images in the next step. What can be done for allergic rhinitis? Allergic rhinitis is a common problem that may be linked to asthma. We avoid using tertiary references. The triggers can include some: Health care providers often first make sure a person's symptoms aren't caused by allergies. 2018;75:446452. The triggers can include some: Dust, fumes and other irritants in the air. https://www.cdc.gov/antibiotic-use/colds.html. See additional information. information and will only use or disclose that information as set forth in our notice of Levocetirizine 5mg, Montelukast 10 mg Read full, Is a person with previous pneumonia attack more prone to Covid-19? Nurse categorization of allergic rhinitis symptom severity. Please help. 17. Using masks to alleviate allergy symptoms can require a bit of "trial and error," said Dr. Purvi Parikh, an allergist and immunologist at N.Y.U. National Library of Medicine doi: 10.1016/j.bja.2020.05.008. Treatments involve a combination of medications and lifestyle changes. The reasons are plenty depending on the situation. The following can increase your risk of developing hay fever: Problems that may go along with hay fever include: There's no way to avoid getting hay fever. 2023 Healthline Media LLC. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. structural problems that affect the nasal passages, including a deviated septum, other medical conditions, including GERD, asthma, or. Rhinitis is a reaction that happens in the eyes, nose, and throat when allergens in the air trigger histamine to be released in the body. Her writing can be seen in Business Insider, Insider, Lonely Planet, Fodors Travel, and others. You can also try using a humidifier to keep the nasal passages lubricated and healthy. They often occur in groups, like grapes on a stem. Invest Educ Enferm. Results: Medications known as antihistamines can help treat the underlying cause of allergic rhinitis. privacy practices. An allergen can be anything that causes an allergic reaction. The interior nasal tissues may bleed when you attempt to remove the crust. We're sorry. Nicole Aaronson, MD, MBA, CPE, FACS, FAAP. and transmitted securely. Itchy mouth or skin. If you suspect you might have COVID-19, immediately quarantine and get tested. Accessed April 13, 2022. Facial pain: sinus or not? 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/allergy-testing. You must be signed in to continue. And using decongestant nose spray or drops too often can cause a type of nonallergic rhinitis called rhinitis medicamentosa. Non-allergic rhinitis. Conclusions: This study observed that the use of face masks reduced both nasal and ocular allergic rhinitis symptoms in individuals with pollen allergy. Even before COVID-19 caused everyone to start wearing masks, some patients with seasonal allergies used masks on days with extremely high pollen counts or when doing yardwork. official website and that any information you provide is encrypted Researchers say COVID-19 face masks are helping people with outdoor allergies because they filter out pollen. The Score for Allergic Rhinitis Study in Turkey, 2020. Try not to overuse nasal decongestants, as this can actually worsen your symptoms. Nicole Aaronson, MD, MBA, CPE, FACS, FAAP, Fever isnt a typical symptom of allergies. It can also be found in rotting logs, hay, and mulch. "Then do a vinegar soak with a washcloth and lay it across your face for about 15 minutes in the areas that . -. Sujan Gogu, an osteopathic physician board certified in family medicine, sports medicine, and pain medicine, says sinus infections can happen from a number of summer-related sources, including: In most parts of the [United States], pollen increases during the summer. -, Portnoy J., Kennedy K., Sublett J., Phipatanakul W., Matsui E., Barnes C., et al. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Both allergic and nonallergic rhinitis share many of the same symptoms, but there are a few key differences. When working in situations where outdoor mold may be present, wearing a face mask can drastically reduce your exposure to the allergen. When I wear a face mask my nose itches and runs. The can cause wheezing, itching, runny nose, watery or itchy eyes, and other symptoms. 2. Your nose has the job of conditioning that air before it reaches the sensitive tissue of your lungs. Coughing. Allergic rhinitis, or hay fever, is swelling inside your nose caused by an allergen. It sounds like you have a sensitive nose. Irritants like strong odors, smoke, and weather changes can trigger nasal (nose) symptoms. 2008;63:8160. This leads to swelling and congestion. Diminished sense of smell. A Lot of What We Know About Seasonal Allergies Is Based on Studies in Children. Common allergens that can lead to chronic rhinitis may include: Pollen can be especially challenging at certain times of the year. All rights reserved. Keywords: Allergens; Allergic rhinitis; Face mask; Pollen. 8600 Rockville Pike You may feel that you need to blow your nose all the time but find that little mucus comes out. Pollen given off by trees, grass, and weeds, Certain medicines and overuse of topical nose sprays. While symptoms may be similar, other viruses can cause a cold as well. Douglas T. Johnston, DO, FAAAAI, FACAAI, is an allergist/clinical immunologist at Carolina Asthma & Allergy Center in Charlotte, North Carolina, and Assistant Professor at Edward Via School of Osteopathic Medicine in Spartanburg, South Carolina. A surgeon can correct structural problems of the nose or sinuses with surgery. Gevorgyan A, et al. With climate change, this has had a huge impact as our summers have changed, he adds. American Academy of Allergy, Asthma & Immunology. That symptom is linked with allergies such as hay fever. It may be helpful to rinse your nasal passages with a saline (salt water) solution to clean out your nose and nasal cavities (nasal irrigation). 2022 Nov 1;19(21):14274. doi: 10.3390/ijerph192114274. Keywords: Face masks vs. COVID-19: a systematic review. 2012;108(223):e115. Larger, controlled trials are needed to confirm its effectiveness. The effect of face mask usage on the medical treatment of allergic rhinitis. New masking guidelines are in effect starting April 24. Ipratropium (nasal route). Nonallergic rhinitis can affect children and adults. Authors Effect of perennial dust mites allergy on symptom severity of autumn allergic rhinitis in adults. https://www.uptodate.com/contents/search. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The masks people have been wearing to help prevent the spread of COVID-19 are also good at filtering out pollen and other allergens floating in the air. On. Am J Otolaryngol. Left untreated, vasomotor rhinitis may cause persistently blocked nasal passages or a constantly runny nose. Like I said earlier, it is all about the tolerance level of the body to handle the situation, and the reasons causing stuffiness in your nose can actually be a relieving factor for another person. In some cases, people can experience rhinitis with no known cause. Bethesda, MD 20894, Web Policies Occup Environ Med. Careers. Managing a sinus infection? Please enable it to take advantage of the complete set of features! https://www.aaaai.org/Tools-for-the-Public/Allergy,-Asthma-Immunology-Glossary/Nonallergic-Rhinitis-Vasomotor-Defined. (2020). Hay fever is caused by an allergic response to a harmless outdoor or indoor substance the body identifies as harmful (allergen). If you are wearing a surgical mask, dehydration in the nose can be possible. AskMayoExpert. In both conditions, precautionary measures are the key to keep the problems at the bare minimum level. Chronic nonallergic rhinitis. Are Wheezing and Shortness of Breath a Complication of Postnasal Drip? For people with allergic rhinitis or allergic asthma, who develop symptoms after breathing in allergens, masks can be really helpful. Treatment of allergic rhinitis. My mother has been suffering from severe cold, cough, and catarrh for years now. But experts do know that nonallergic rhinitis happens when blood vessels in the nose expand. Viral URIs are often confused with sinus infections and inappropriately treated with antibiotics. This study observed that the use of face masks reduced both nasal and ocular allergic rhinitis symptoms in individuals with pollen allergy. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. This happens because the congestion isnt caused by mucus buildup but because the nasal passages are swollen. Is rinsing your sinuses with neti pots safe? information is beneficial, we may combine your email and website usage information with He has lectured at national and international medical conferences and has publications in several medical journals, including Clinical Immunology, World Allergy Organization Journal, Journal of Allergy, Asthma, and Immunology, The Journal of the American Medical Association, and the New England Journal of Medicine., 1235 South Clark Street Suite 305, Arlington, VA 22202, Asthma and Allergy Foundation of America 2023. Ask your health query to a doctor online? But there are several other causes unrelated to allergies, including: Nonallergic rhinitis can also occur without the presence of a known allergen or infection. 2022 Oct 25;7(6):1704-1711. doi: 10.1002/lio2.935. She notes that many of her patients have reported they will likely wear masks more in the future for better symptomatic control. Also, I would need to know how frequently you get them. On the other hand, Crosby hasnt noticed an increase in summer sinus issues in her region. Other over-the-counter (OTC) and prescription medications may help reduce inflammation in the nasal passages. Likely, they result from triggers that irritate your nose. While the rate of participants who defined their nasal symptoms as severe-moderate in the pre-pandemic period was 92% (46 patients), this rate decreased to 56% (28 patients) during the pandemic when they used face masks. information submitted for this request. Hay fever is caused by an allergic response to a harmless outdoor or indoor substance the body identifies as harmful (allergen). You may opt-out of email communications at any time by clicking on In some cases, further testing helps confirm your diagnosis. Of course, face masks dont protect your eyes. Accessed Dec. 19, 2020. Its more common in women and people assigned female at birth. Antihistamines can relieve symptoms due to allergic rhinitis but wont work for nonallergic rhinitis. Many people dealing with allergies also have skin conditions like eczema or acne that can be made worse by wearing a mask for a prolonged time. Safe ritual nasal rinsing. Allergy Asthma Proc. American College of Allergy, Asthma & Immunology. Its not known exactly why the blood vessels in the nose dilate, but the reaction may be triggered by: For some people, doctors cant identify the specific cause of nonallergic rhinitis. 2022 May-Jun;43(3):103364. doi: 10.1016/j.amjoto.2021.103364. However, unlike allergies (allergic rhinitis), vasomotor rhinitis doesnt result from exposure to allergens, like pollen, mold, pet dander, etc. Vol. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2020 Nov-Dec;8 (10):3590-3593. doi: 10.1016/j.jaip.2020.08.035. Accessed April 15, 2022. https://acaai.org/allergies/management-treatment/allergy-immunotherapy/allergy-shots/. American College of Allergy, Asthma & Immunology. The site is secure. Instead of being seasonal as is the case with seasonal allergies symptoms flare up whenever you're exposed to a trigger. The following includes common questions about chronic rhinitis. include protected health information. Only wear the same mask for a couple of hours. How masks might prevent or improve sinus issues, Allergic rhinitis is not the same as sinusitis, ncbi.nlm.nih.gov/pmc/articles/PMC6325651/, sciencedirect.com/science/article/abs/pii/S2213219820308679?via%3Dihub, sciencedirect.com/science/article/pii/S0196070921002246?via%3Dihub, journals.sagepub.com/doi/10.1177/01945998211000419, ncbi.nlm.nih.gov/pmc/articles/PMC7369820/, Is It a Sinus Infection or COVID-19? Accessed April 14, 2022. Research shows that sinus issues arent worsened by masks. HHS Vulnerability Disclosure, Help Allergies to weeds, grass, trees, or mold often cause seasonal allergic rhinitis. We do not endorse non-Cleveland Clinic products or services. Cleveland Clinic is a non-profit academic medical center. Doctors typically recommend surgery as a last resort if several other treatment options dont work. Rarely, vasomotor rhinitis causes a foul-smelling crust to form inside your nose. Talk to your doctor about your symptoms. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/outdoor-allergens-ttr. Allergic and nonallergic rhinitis (including vasomotor rhinitis) affects up to half of the population in industrialized countries. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/indoor-allergens-ttr. The broken bridge between recommendations and implementation in Lebanon. 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