Buying An Allergy-Friendly House: Q and A with Dr. Stephen Lockey

If you have allergies, buying a house, new or old, is more than picking four walls, a roof, and a two-car garage. It's picking out a neighborhood that is friendly to those allergies and picking a house that is an environmentally healthy house, inside and out.

Dr. Stephen Lockey, of our Allergy & Asthma Center, is an allergist, amateur botanist, fly fisherman and… his son's baseball trainer, but not coach.

He offers some suggestions for making the house you live in, or will live in, an allergy-friendly home.

Q: Dr. Lockey, since the magic words are "location, location, location," let's begin with the neighborhood. What do you need to look for there?

Dr. Lockey: You look for things in a neighborhood which might be a detriment to you. For instance, in central Pennsylvania, living close to chicken houses, fertilizer plants, grain processors… any place producing organic dust would be a good thing to avoid.

Q: What about streams or ponds?

Dr. Lockey: If people want to keep their homes as free as possible from dampness they should build or find one in an elevated area. This is better than being close to streams or rivers because there is a higher moisture content of the air in those areas. The higher the humidity in your home the more likely it is you will encourage mold and dust mite growth.

Q: What do you consider healthy construction?

Dr. Lockey: I'm not an architect so keep in mind that that my opinions in this interview are based on my personal, clinical experience. However, as I see it, the best circumstances for anyone who is building a house is to build a house with a full basement. Every living area of the home needs to have part of the basement underneath it and there should be no living quarters or even family gathering places which are located on a cement slab. Basements should be left for storage, or perhaps some recreational activities like ping-pong, pool… if you have a young child, or perhaps soccer. But…

Q: Soccer in the basement?

Dr. Lockey: Sure. I have some good friends who have trained their children in soccer in their basements. But, the most important point is that the basement not be used as living quarters; no basement bedroom, no family room, no computer rooms and no area carpeted in the basement if you really want to have the ideal circumstances. Because, as soon as you put down carpet on cement or even if you put stuffed furniture in a basement setting you are creating an environment for dust mites. Dust mites love two primary places in our homes. They love our mattresses and they love carpet which is laid down on cement. They also love 50% humidity, and a temperature of 70 degrees. A carpeted basement gives them that. Dust mite sensitivity, incidentally, is the most common sensitivity which exists today in the allergic patient, so I feel those persons should not be living in homes where carpet is laid down on cement.

Q: If you are building a new home and looking into construction material, what should you look for in the materials?

A: Every new home will create some outgassing because of the preservatives used in woods, the preservatives and glues used in particle board and the materials used in constructing our homes today.

Q: Do you mean fumes?

Dr. Lockey: They are solvents. If a newly built home is closed up these solvents build up in the air. The house really has to be outgassed for a period of time. Anyone who has lived in a new home knows this. They have some irritation of their nose, eyes and perhaps even of their skin in the first couple of weeks that they are living in their new home. After living in the house a while and opening the windows the amount of gas decreases, the amount of outgassing becomes less and less and the problem eventually is no longer an issue.

Q: What style of home should you look for?

Dr. Lockey: Well you don't want to look for or buy a bi-level home, you don't want to look for or build a split level home and you don't want to build or look for a house that is on a cement slab.

Q: Well then what should you do about things like ventilation or humidity control?

Dr. Lockey: I think if you are looking for a house built recently you are probably going to have the insulation you need but you have to begin the process of airing out the house periodically. I feel airing out the house once per week is a good practice, especially in winter. Patients who have moderate sensitivities to animal dander, for instance, can often get by very nicely by simply airing out the house on a periodic basis.

Q: If the previous owners had a dog or a cat, is that a continuing problem?

Dr. Lockey: I'd recommend a couple of good cleanings of the house plus airing the house out following the cleanings. Routine vacuum cleanings and perhaps washing the walls initially will generally reduce the aeroallergen content of the house enough so that the patient will be able to tolerate it. We wouldn't tell an allergic person not to buy a house because there had been dogs or cats in it but we would suggest if they purchased a new house and there had been a dog or cat in It, they should do some good cleaning before moving in.

Q: Moving from the inside of the house to the outside… any tips for allergy friendly landscaping? Trees? Shrubs?

Dr. Lockey: Maybe for those considering a wooded site. If you buy a house in the woods and you are mold or dust mite sensitive, there can be problems, especially if there is a canopy of trees above and also bushes right up against the house. I generally recommend that if patients want to live in the woods, they be sure the sun is going to have access to the roof of the house for at least eight hours during the summertime. This may mean cutting back enough of the canopy so the roof can get sun exposure for this amount of time. They also need to keep their bushes trimmed back away from the house at least two feet so they can have proper ventilation of the home..

Q: In terms of heating and cooling the house, what type of system do you recommend?

Dr. Lockey: The ideal heating system is radiant and that means there is no fan moving air through ducts in your home. But you can't really centrally air condition your home without having ducts. So a radiant system is not going do the full job for you.

Q: It's expensive, too, isn't it?

Dr. Lockey: It is much more expensive to install a dual system like central air conditioning and a radiant system then it would be to install a forced air heating system which would then also serve as your air conditioning system. Under those circumstances I think it is very important to install an electrostatic air filter within the system and to be sure you have the means for cleaning that electrostatic air filter on a monthly basis.

Q: How do you do that?

Dr. Lockey: It's very simple to wash it out. Some people like to take it to the car wash. Personally, when I built my house I made sure I had a wash tub in my basement that was big enough to put the electrostatic air filter in. I had a hose attached to the faucet so I could wash my filter out on a monthly basis. You can also use a shower or tub.

Q: And do you do it every month?

Dr. Lockey: It is necessary to do it every month, otherwise, it doesn't work. If you are asking about my personal experience…there are some times it doesn't get done.

Q: Are there other suitable air filters that are available?

Dr. Lockey: There are filters that are called media type filters you can install in your heating system. Honeywell makes one and so does Spaceguard. Just change the filter approximately every six months or follow the manufacturerr's directions.

Q: Are there any problems with allergics and ceiling fans?

Dr. Lockey: Anything that moves air in the house is going to create that circulation of dust but in a clean home I have no objections to ceiling fans. If they weren't using a ceiling fan for cooling purposes they most likely would be using some type of air conditioning, and under those circumstances air is moving all the time. As long as the house is kept clean, ceiling fans are acceptable.

Q: Moving from summer to winter, can an allergic have a fireplace?

Dr. Lockey: Fireplaces are beautiful. They are lovely, charming, romantic; a source of security in case the electric doesn't work or in case the oil runs out. But they are definitely a source of indoor air pollution. There is no fireplace made I know of that is not a source of air pollution within the home. If you have asthmatics or patients who have significant allergies, they are going to have reactive symptoms upon exposure to the air pollution that comes from the fireplace. This also applies to wood and coal burning stoves. Non-vented kerosene heaters should never be used inside homes.

Q: All other things being equal, is it better for an allergic to buy an existing home or build a new one?

Dr. Lockey: It doesn't make too much difference if it has the features I mentioned. However, I generally tell my patients to be very careful about buying antique homes. What do I define as an antique home? Any home that would have a fieldstone foundation, or walls of plaster which incorporated animal dander and animal hair within the plaster or as part of the material that is used between the fieldstones. In the homes which were built in southeastern Pennsylvania in the 1700s and early 1800s, these materials were common, especially in the farm houses.

Q: Many are truly beautiful, aren't they?

Dr. Lockey: Right. Some of the farm houses are just absolutely wonderful as far as their appearances go but, if I have the opportunity, I try to tell my patients not to buy that type of home. I say this because those homes are generally thick walled and therefore they tend to gather more moisture, especially in the damp periods of the year. A lot of them also have dirt floors in the basements, are surrounded by fieldstone and are not well-drained. That dampness serves as a source of mold and mildew. In addition, it is not unusual to see the house actually built over springs. You can imagine how damp that can be.

Q: Some of these old farms have been in families for generations. More recently some of the older family members have needed to move into apartments in retirement communities or life care communities. Some are not only allergic but also more frail than many of us. How do retirement comunities stack up in terms of being allergy-friendly?

Dr. Lockey: It is particularly disconcerting to me that so many retirement homes, including the new ones, continue to build single homes and apartments for our senior citizens on cement slabs. There have been a couple of instances in my practice where I have felt that has been a major issue for the patient. Lots of times they sign contracts and obligate themselves to being in that circumstance. They are not as free to move out as they are to move into them.

Q: Speaking of both a legal and a construction issue, people often consult engineers and lawyers before they buy a house. Should they consult an allergist?

Dr. Lockey: I think if you are an allergic person and you have fallen in love with the house, one of the things you could do is to write on the contract, "…upon approval of my allergist," and you can name him or her. I am not necessarily giving you a legal viewpoint, but I am almost certain that if the allergist does not approve it, then you would probably not be held to the contract.

Q: Have you ever been consulted?

Dr. Lockey: I have been asked to go out and look at houses. On one occasion I turned the house down and on two or three other occasions I gave my approval. It doesn't turn out to be a big issue for the most part. Although I must say it's not what I thought about when I became an allergist, but it is another facet…another way…of serving my patients and their needs. It's just part of what I do.

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