Mite control: what are the DISADVANTAGES?

The expense will prevent you from spending money on other things which may be important to you.

The sheer amount of work involved will prevent you from doing other things which may be important.

When either of these things means that in practice you simply cannot do the things we recommend, you may wrongly get a sense of guilt. If you are already under stress for other reasons, as many of us are, this could make depression or anxiety worse. THAT IS NOT THE OBJECT OF OUR INFORMATION ON MITE CONTROL.

Just realise that many of the things we recommend are simply not practical propositions for many people. Heart-wrenching it may be, but this is what real life is like for real people.

A very few people take house dust mite control so seriously that they become socially crippled by their extreme efforts to do the right thing. Their whole lives become dominated by an obsession with cleanliness and they might, for example, not go out or may keep other people out of their houses and spend endless time cleaning the house to an extent which is simply not normal. If you think this may be happening, please do go and have a chat with your doctor or specialist.

Most importantly, there is clear evidence that mite control measures simply don't work well enough in asthma to show clear benefit in controlled clinical trials, in which people following anti-mite instructions are compared with others. This may be because the anti-mite instructions are truly useless, though I don't believe that in the case of the better instructions. It may also be because the trials were not done well enough (clearly true for quite a few of the trials). But it does mean that you must not expect spectacular benefit, and probably does mean that you will notice no benefit unless you do the right things rather than the wrong things and are exceptionally thorough. If that is beyond you, as it may be for excellent reasons, it may well be best not to bother. Alternatively, you could do those things which are not too expensive or troublesome, knowing that there is doubt about the benefit but aiming to pick up any long-term benefit which modest measures might possibly achieve.

Remember, the cure must not be worse than the disease.

In fact it must not be worse than the benefit you would miss out on by not doing house dust mite control.

Remember that for the vast majority of people the results of house dust mite control will be incomplete. In fact we don't have an even remotely accurate idea of how much or little benefit ordinary people are likely to achieve in real life. Our advice is often based on experiments in which research workers helped carefully selected people to achieve their results. The rest of the time it is often based on the opinions of doctors who believe in house dust mite control. However well-meaning we doctors are, we are not always right, especially when we judge from day-to-day experience rather than careful scientific research. There are many pitfalls in drawing conclusions from our daily experience. The fact that an expert means well may mean that he or she runs ahead of the evidence and ends up giving advice later found to be misleading.

Having said that, here is my own opinion, based on my own experience. Don't expect miracles from mite control measures, at least not if you cannot be very thorough. Patients do often think they benefit, but in general, for most people who cannot reorganise the furnishing of their whole house, the benefits may not be large. This however does not necessarily mean that they are not worthwhile.

We are not trying to be negative about mite control all of a sudden. But you have a right to understand both sides of the argument.

Where do people go wrong with mite control?

Distressingly often, people with asthma or other allergies find out (or just suspect) that they are allergic to house dust mites, but then do precisely the wrong things.

This does not help. It wastes money and effort. Disillusionment is the result.

Here are some mistakes people have often made before they come to see us:

Help!

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