Current asthma and respiratory symptoms among pupils in relation to dietary factors and allergens in the school environment

The aim was to study asthma and allergy in relation to diet and the school environment. Pupils (5-14 years) in eight schools received a questionnaire, 1014 participated (68%). Settled dust was collected on ALK-filters and analyzed for allergens from cat (Fel d 1), dog (Can f 1), horse (Equ cx), house dust mites (Der p 1, Der f 1), and cockroach (Bla g 1) by ELISA. In total, 6.8% reported cat allergy, 4.8% dog allergy, 7.7% doctor's diagnosed asthma and 5.9% current asthma, and 7.8% reported wheeze. Current asthma was less common among those consuming more fresh milk (P < 0.05) and fish (P < 0.01). Poly-unsaturated fatty acids was associated with more wheeze (P < 0.05), olive oil was associated with less doctors' diagnosed asthma (P < 0.05). Totally, 74% of the classrooms had mean CO(2) <1000 ppm. The median concentration per gram dust was 860 ng/g Fel d 1, 750 ng/g Can f 1 and 954 U/g Equ cx. Horse allergen was associated with more wheeze (P < 0.05), daytime breathlessness (P < 0.05), current asthma (P < 0.05) and atopic sensitization (P < 0.05). Dog allergen was associated with wheeze (P < 0.05) and daytime breathlessness (P < 0.05). The associations between allergens and respiratory symptoms were more pronounced among those consuming margarine, not consuming butter, and with a low intake of milk. In conclusion, cat, dog and horse allergens in schools could be a risk factor for asthma and atopic sensitization, and dietary factors may interact with the allergen exposure. PRACTICAL IMPLICATIONS: Previous school studies performed by us in mid-Sweden, showed that most classrooms did not fulfill the ventilation standards. In this study, most of the classrooms fulfilled the ventilation standard, but despite that had widespread allergen contamination. Most previous studies have focused on cat allergen, but our study has shown that also dog and horse allergens can be risk factors for asthma and allergy in schools. As allergens are transported from other environments, mainly the home environment, the main prevention should be to minimize transfer of allergens. This could be achieved by reducing contacts with furry pets and horses, or using different clothes at home and at school (e.g. school uniforms). Increased cleaning in the schools may reduce allergen levels, but the efficiency of this measure must be evaluated in further intervention studies. Finally, our study supports the view that dietary habits among pupils should not be neglected and interaction between dietary factors and indoor allergen exposure needs to be further investigated.     

Mite and pet allergen exposure in hotels in Uberlândia, Midwestern Brazil

Mite allergens are involved in airway sensitization and allergic diseases. We evaluated the exposure to house dust-mite (Der p 1 and Der f 1) and pet (Fel d 1 and Can f 1) allergens in hotels in Uberlandia, Midwestern Brazil. A total of 140 dust samples were collected from bedding (n = 98) and carpet (n = 42) of bedrooms in 20 hotels enrolled for this study. Geometric mean (GM) levels of Der f 1 (11.30 microg/g of dust; 95% CI: 8.34-15.30 microg/g) were significantly higher than Der p 1 (0.15 microg/g of dust; 95% CI: 0.13-0.18 microg/g) in bedding dust samples (P < 0.001), regardless of the hotel classes. Der f 1 levels were significantly higher in bedding (11.30 microg/g of dust; 95% CI: 8.34-15.30 microg/g) than carpet (6.32 microg/g of dust; 95% CI: 4.31-9.26 microg/g) dust samples (P < 0.05). High levels of Der f 1 (>10 microg/g of dust) were found in 58%, 76%, and 69% of dust samples from Simple, Economical, and Tourist/Superior hotels, respectively, while GM levels of Fel d 1 (0.11 microg/g of dust; 95% CI: 0.09-0.14 microg/g) and Can f 1 (0.30 microg/g of dust; 95% CI: 0.20-0.44 microg/g) were relatively low. These results indicate that Der f 1 is the predominant allergen in hotels in Uberlandia, especially in bedding dust samples, regardless of the hotel classes and could represent an important risk factor for exacerbation of allergic symptoms in previously mite-sensitized guests. PRACTICAL IMPLICATIONS: Mites and pets are important sources of indoor allergens. Most people spend the greatest part of their time indoors. Hotels can constitute an important allergen reservoir of the indoor environment and could represent an important risk for exacerbation of allergic symptoms in previously sensitized guests. Thus, hotels should also be included for planning indoor allergen avoidance as part of a global management strategy, especially in patients with respiratory allergy.     

House dust mites (Der p 1, Der f 1), cat (Fel d 1) and cockroach (Bla g 2) allergens in indoor work-places (offices and archives)

BACKGROUND: Exposure to indoor allergens has already been shown to occur in many public places, including workplaces, in several countries. Aim of this study was to measure the levels of house dust mites, cat and cockroach allergens in indoor workplaces (offices and archives) in Italy and to evaluate the possible relationships between allergen levels and building characteristics, type of ventilation, indoor relative humidity and temperature. METHODS: Der f 1 and Der p 1, Fel d 1, Bla g 2 were measured by ELISA in dust samples collected from floors or upholstered seats of 160 workplaces. RESULTS: Detectable Der p 1 levels were found in 86 (54%) workplaces Der f 1 in 87 (55%), Fel d 1 in 86 (54%) and Bla g 2 in 3 (1.9%). Der p 1 allergen concentrations expressed per weight were higher than the proposed sensitization thresholds in 7 samples, Der f 1 in 5, Fel d 1 in 6 and Bla g 2 in 3. The highest allergen levels were detected in samples from upholstered seats. A significant correlation was found between Der f 1 level on floors, expressed per surface, and indoor temperature (r = 0.39; P < 0.01). CONCLUSIONS: In our study we found that upholstered seats in workplaces in Italy may constitute a significant reservoir both of house dust mites and cat allergens. Exposure to these allergens in workplaces may represent a risk factor for elicitation of symptoms and/or induction/maintenance of inflammation in allergic individuals and might also constitute a risk factor for sensitization.     

Mouse and cockroach allergens in the dust and air in northeastern United States inner-city public high schools

Considering that high school students spend a large proportion of their waking hours in the school environment, this could be an important location for exposure to indoor allergens. We have investigated the levels of mouse and cockroach allergens in the settled dust and air from 11 schools in a major northeastern US city. Settled dust samples were vacuumed from 87 classrooms, three times throughout the school year. Two separate air samples (flow = 2.5 lpm) were collected by 53 students over a 5-day period from both their school and their home. Mouse allergen (MUP) in the dust varied greatly between schools with geometric means ranging from 0.21 to 133 microg/g. Mouse allergen was detectable in 81% of the samples collected. Cockroach allergen (Bla g 2) ranged from below limit of detection (<0.003 microg/g) to 1.1 microg/g. Cockroach allergen was detected (>0.003 microg/g) in 71% of the dust samples. Bla g 2 was detected in 22% of airborne samples from the schools. By comparison, mouse allergen was only detected in 5%. These results indicate that the school may be an important location for exposure to allergens from mice and cockroaches and is an indoor environment that should be considered in an overall allergen intervention strategy. PRACTICAL IMPLICATIONS: To date, cockroach and mouse allergen intervention strategies have been mainly focused on the home environment. Considering that children spend a significant amount of time in schools, some studies have assessed cockroach allergen levels in schools. This study provides a clearer picture of the distribution and variability of not only cockroach allergen, but also mouse allergen in the school environment. In addition, this study describes limitations of personal air sampling in a student population. Our results suggest that although cockroach and mouse allergens are commonly recovered in classroom dust samples of inner city schools, cockroach allergens are recovered in the personal air samples with a greater frequency relative to mouse allergens.     

Asthma and respiratory symptoms in hospital workers related to dampness and biological contaminants

Abstract The National Institute for Occupational Safety and Health investigated respiratory symptoms and asthma in relation to damp indoor environments in employees of two hospitals. A cluster of six work‐related asthma cases from one hospital department, whose symptoms arose during a time of significant water incursions, led us to conduct a survey of respiratory health in 1171/1834 employees working in the sentinel cases hospital and a nearby hospital without known indoor environmental concerns. We carried out observational assessment of dampness, air, chair, and floor dust sampling for biological contaminants, and investigation of exposure‐response associations for about 500 participants. Many participants with post‐hire onset asthma reported diagnosis dates in a period of water incursions and renovations. Post‐hire asthma and work‐related lower respiratory symptoms were positively associated with the dampness score. Work‐related lower respiratory symptoms showed monotonically increasing odds ratios with ergosterol, a marker of fungal biomass. Other fungal and bacterial indices, particle counts, cat allergen and latex allergen were associated with respiratory symptoms. Our data imply new‐onset of asthma in relation to water damage, and indicate that work‐related respiratory symptoms in hospital workers may be associated with diverse biological contaminants.     

Social factors, allergen, endotoxin, and dust mass in mattress

Indoor environment has been associated with allergic disease. Further, it has been observed that the prevalences of allergic sensitization are different in different social groups. We therefore investigated the association between socioeconomic status (SES) and indoor bio-contaminants. House dust samples were collected from parents' and infants' mattress from 2166 families in Munich (62.2%) and Leipzig (37.8%), Germany. Major mite allergen Der p 1 and Der f 1, cat allergen Fel d 1, and endotoxin were extracted and quantified. Parental educational level and family equivalent income were used independently as socioeconomic indicators. Indoor endotoxin, mite allergen Der p 1, and the amount of sampled dust were not associated with the social factors. Mite allergen Der f 1 was slightly associated by family SES but without a consistent pattern. In families who are not cat owners, however, a negative association between the amount of cat allergen and family SES were observed. The observed negative association between cat allergen loads and concentrations in mattress and family SES in non-cat owners' homes indicated that community is an important source of cat allergen exposure. PRACTICAL IMPLICATIONS: The study indicated that community is a major source of cat allergen exposure especially in communities of low SES.     

Allergens and endotoxin in settled dust from day-care centers and schools in Oslo, Norway

Allergy to indoor allergens can cause frequent and severe health problems in children. Because little is known about the content of allergens in the indoor environments in Norway, we wanted to assess the levels of cat, dog and mite allergens in schools and day-care centers in Oslo. Allergen levels in dust samples from 155 classrooms and 81 day-care units were measured using commercially available enzyme-linked immunosorbent assay (ELISA) kits. Additionally, we measured the levels of endotoxin in 31 day-care units, using the limulus amebocyte lysate test. Most of the dust samples contained detectable amounts of cat and dog allergens. In mattress and floor dust (day-care centers), and curtain and floor dust (schools) the median Fel d 1 levels were 0.17, 0.002, 0.02 and 0.079 microg/m2, while the median Can f 1 levels were 1.7, 0.03, 0.1 and 0.69 microg/m2, respectively. Levels of cat and dog allergens in school floor dust were associated with the number of pupils with animals at home. In contrast, <1% of the samples had measurable levels of the mite allergen Der p 1. Moreover, the levels of endotoxin tended to be higher in dust from floors (1.4 ng/m2) compared with that from mattresses (0.9 ng/m2). PRACTICAL IMPLICATIONS: To reduce allergen exposure, allergic individuals should be placed in the classes/rooms with the fewest pet owners. Moreover, mattresses in day-care centers are major reservoirs of cat and dog allergens and should be cleaned frequently.     

Predicted risk of childhood allergy, asthma, and reported symptoms using measured phthalate exposure in dust and urine

The associated risk of phthalate exposure, both parent compounds in the home and their metabolites in urine, to childhood allergic and respiratory morbidity, after adjusting for exposures of indoor pollutants, especially bioaerosols, was comprehensively assessed. Levels of five phthalates in settled dust from the homes of 101 children (3-9 years old) were measured, along with their corresponding urinary metabolites. Other environmental risk factors, including indoor CO2, PM2.5, formaldehyde, 1,3-β-D-glucan, endotoxin, allergen and fungal levels, were concomitantly examined. Subject's health status was verified by pediatricians, and parents recorded observed daily symptoms of their children for the week that the home investigation visit took place. Significantly increased level of benzylbutyl phthalate, in settled dust, was associated with test case subjects (allergic or asthmatic children). Higher levels of dibutyl phthalate and its metabolites, mono-n-butyl phthalate, and mono-2-ethylhexyl phthalate were found to be the potential risk factors for the health outcomes of interest. Similarly, indoor fungal exposure remained a significant risk factor, especially for reported respiratory symptoms. The relative contribution from exposure to phthalates and indoor biocontaminants in childhood allergic and respiratory morbidity is, for the first time, quantitatively assessed and characterized. PRACTICAL IMPLICATIONS: For asthmatic and allergic children living in subtropical and highly developed environments like homes in Taiwan, controlling environmental exposure of phthalates may be viewed as equally important as avoiding indoor microbial burdens, for the management of allergy-related diseases. It is also recognized that multidisciplinary efforts will be critical in realizing the true underlying mechanisms associated with these observations.     

Home and day‐care microenvironment exposure to Blomia tropicalis allergens and their associations with salivary eosinophilic cationic protein (ECP) among preschool children in Singapore

To date, exposure studies linking dust‐mite allergens with asthma and allergic morbidities have typically relied on sampling from representative locations in the home for exposure assessment. We determine the effects of differing microenvironments allergen exposures on asthma and asthma severity among 25 case and 31 control preschool children in Singapore. Blo t 5 allergen levels in various niches from the children's home and day‐care microenvironments as well as their Blo t 5 time‐weighted concentrations were determined. Eosinophilic cationic protein (ECP) levels from the children's saliva as markers for airway inflammation were obtained. Salivary ECP levels were higher in children with asthma than those without and the strength of association increased with higher salivary ECP levels. Although there was no relationship between time‐weighted Blo t 5 concentrations with salivary ECP levels among the controls, a positive statistically significant relationship was noted among cases, demonstrating the effects of cumulative exposure on asthma severity. Avoidance measures to reduce Blo t 5 allergen exposure should include all microenvironments that asthmatic children are exposed throughout the day.     

Viruses as the causative agent related to 'dampness' and the missing link between allergen exposure and onset of allergic disease

Asthma and asthma-like symptoms occur more often among people living in humid indoor climates. It has been postulated that the higher concentration of allergens in these environments is the cause for the increase in the number of affected people. However, poor correlations between allergen concentration and symptoms indicate a missing link between allergen exposure and onset of asthma. Respiratory viruses have been identified in up to 85% cases of asthma or exacerbations of asthma. The missing link between respiratory diseases and humid indoor climates could therefore be attributed to viruses. The infectious effectiveness of respiratory viruses depends strongly on the environment where the viruses are spread. For respiratory viruses, survival and infectivity are dependent on temperature and relative humidity. A direct link between virus-induced inflammation and the asthmatogenic process has been proposed. Therefore, a more effective spreading of viral infections in damp indoor climates is likely to represent the main cause for the increased prevalence of asthma in these environments. Moreover, the incidence of viral infections is higher in patients with asthma compared with that in control subjects. Therefore, a humid indoor climate could also represent a higher risk for persons already sensitized to one or more allergens. PRACTICAL IMPLICATIONS: In epidemiological studies where the relationship between moisture in the indoor climate, respiratory symptoms and exposure to allergens is investigated it will be necessary to analyze the role of respiratory viruses in relation to respiratory symptoms. Today, the necessary techniques to address the presence of viruses [e.g. polymerase chain reaction (PCR), antibodies] are highly sensitive. In order to further our understanding of why the frequency of asthma and atopic diseases is still increasing, it is mandatory to implement these methods.     

Domestic exposure to fungal allergenic particles determined by halogen immunoassay using subject's serum versus particles carrying three non‐fungal allergens determined by allergen‐specific HIA

Studies that estimate indoor aeroallergen exposure typically measure a pre‐selected limited range of allergens. In this study, inhalable aeroallergen particles were quantified using the halogen immunoassay (HIA) to determine the contribution of fungal and non‐fungal aeroallergens to total allergen exposure. Bioaerosols from 39 homes of fungal‐allergic subjects were sampled using inhalable fraction samplers and immunostained by HIA using resident subject's immunoglobulin E (IgE) to detect allergen‐laden particles. Fungal aerosols as well as particles carrying mite, cat, and cockroach allergens were identified and enumerated by HIA. Reservoir dust‐mite (Der p 1), cat (Fel d 1), and cockroach (Bla g 1) allergen concentrations were quantified by ELISA. Fungal particles that bound subject's IgE in the HIA were 1.7 (bedroom)‐ and 1.4 (living room)‐fold more concentrated than Der p 1, Fel d 1, and Bla g 1 allergen particles combined. Predominant fungal conidia that bound IgE were derived from common environmental genera including Cladosporium and other fungi that produce amerospores. Airborne mite, cat, and cockroach allergen particle counts were not associated with reservoir concentrations determined by ELISA. This study demonstrates that inhalable fungal aerosols are the predominant aeroallergen sources in Sydney homes and should be considered in future exposure assessments.     

A comparative study of asthma, pollen, cat and dog allergy among pupils and allergen levels in schools in Taiyuan city, China, and Uppsala, Sweden

We compared the school environment, asthma and allergy in 10 schools in Taiyuan, China, with eight schools in Uppsala, Sweden. In total 2193 pupils (mean age 13 years) participated. Chinese pupils had more respiratory symptoms, particularly daytime breathlessness after exercise (29.8% vs. 7.1%; P < 0.001), while cat allergy (1.2% vs. 6.6%; P < 0.001) and dog allergy (1.3% vs. 4.0%; P < 0.01) was less common. Cumulative incidence of asthma (1.8% vs. 9.5%; P < 0.001) and doctor's diagnosed asthma (1.2% vs. 9.0%; P < 0.001) were less common in China, indicating an under-diagnosis of asthma. Chinese classrooms were colder (mean 14.7 vs. 21.4 degrees C), more humid (mean 42% vs. 31% RH) and had higher CO2-levels (mean 2211 vs. 761 ppm). Levels of cat (Fel d1), dog (Can f1) allergens were low in settled dust from China (< 200 ng/g dust), but high in airborne dust on Petri-dishes (GM 16.8 ng/m2/day for Fel d1 and 17.7 for Can f1). The Swedish settled dust contained cat, dog and horse allergens in high levels (median 1300 ng/g, 1650 ng/g, 1250 U/g dust, respectively). In conclusion, there were large differences in the school environment, and in respiratory symptom and allergy. Allergen measurements in settled dust only may largely underestimate the classroom exposure. Practical Implications There is a need to improve the school environment, both in China and Sweden. The Swedish schools contained high levels of cat, dog and horse allergens and more amounts of open shelves and textiles that can accumulate dust and allergens. The air measurements indicated that Chinese schools may contain significant amounts of cat and dog allergen, and analysis of settled dust only may not reflect the true allergen exposure. Since the Chinese schools had no mechanical ventilation, they could not fulfill the ventilation standard in winter, and hence there is a need for improving the ventilation. The great discrepancy between respiratory symptoms and reports on asthma, and the high prevalence of attacks of breathlessness without wheeze, may have implication for future questionnaire studies on asthma in China.     

Quantitative measurement of airborne cockroach allergen in New York City apartments

We designed and tested a sampling and analysis system for quantitative measurement of airborne cockroach allergen with sufficient sensitivity for residential exposure assessment. Integrated 1-week airborne particle samples were collected at 10-15 LPM in 19 New York City apartments in which an asthmatic child who was allergic to cockroach allergen resided. Four simultaneous air samples were collected in each home: at heights of 0.3 and 1 m in the child's bedroom and in the kitchen. Extracts of air samples were analyzed by ELISA for the cockroach allergen Bla g2, modified by amplifying the colorimetric signal generated via use of AMPLI-Q detection system (DAKO Corporation, Carpinteria, CA, USA). Settled dust samples were quantified by conventional ELISA. Of the homes where cockroach allergen was detected in settled dust, Bla g2 also was detected in 87% and 93% of air samples in the bedroom and kitchen, respectively. Airborne Bla g2 levels were highly correlated within and between the bedroom and kitchen locations (P < 0.001). Expressed as picogram per cubic meter, the room average geometric mean for Bla g2 concentrations was 1.9 pg/m3 (95% CI 0.63, 4.57) and 3.8 pg/m3 (95% CI 1.35, 9.25) in bedrooms and kitchens, respectively. This method offers an attractive supplement to settled dust sampling for cockroach allergen exposure health studies. PRACTICAL IMPLICATIONS: Until now, cockroach allergen exposures have usually been assessed by collection and analysis of settled dust, on the assumption that airborne cockroach allergen cannot be reliably measured. In this study, a sensitive and quantitative method for measuring indoor airborne exposures to cockroach allergens involving a 7-day integrated total suspended particulate (TSP) sample collected at approximately 10-15 l/min was developed. Investigators are now empowered with an alternative exposure assessment method to supplement their studies and the understanding of allergen aerodynamics in the homes of children with asthma. We report airborne cockroach allergen in apartments, suggesting an ongoing burden of inhalation exposure.     

Indoor environmental quality in a 'low allergen' school and three standard primary schools in Western Australia

To investigate indoor environmental quality in classrooms, assessments were undertaken in a 'low allergen' school and three standard primary schools in Western Australia. Dust allergens, air pollutants and physical parameters were monitored in the four schools at four times (summer school term, autumn holiday, winter school term and winter holiday) in 2002. The levels of particulate matter (PM(10)) and volatile organic compounds were similar between the four primary schools. Although slightly decreased levels of dust-mite and cat allergens were observed in the 'low allergen' school, the reductions were not statistically significant and the allergen levels in all schools were much lower than the recommended sensitizing thresholds. However, significantly lower levels of relative humidity and formaldehyde level during summer-term were recorded in the 'low allergen' school. In conclusion, the evidence here suggests that the 'low allergen' school did not significantly improve the indoor environmental quality in classrooms. Practical Implications School is an important environment for children in terms of exposure to pollutants and allergens. By assessing the levels of key pollutants and allergens in a low allergen school and three standard primary schools in Western Australia, this study provides useful information for implementation of healthy building design that can improve the indoor environment in schools.     

Mould Allergy in Schoolchildren in Relation to Airborne Fungi and Residential Characteristics in Homes and Schools in Northern Norway

Abstract During winter, airborne microfungi were collected from the homes and schools of 19 children sensitized to house dust mites (HDM) and 19 non-atopic control children in the community of Sør-Varanger, northern Norway. The samples were cultivated and microfungal growth was identified microscopically. Indoor humidity, temperature, carbon dioxide (CO₂), allergic symptoms and sensitization were registered. Symptom data and information concerning sociodemographic and housing conditions were obtained using a questionnaire. Penicillium was the most common microfungus in both homes and schools, followed by different yeasts, Aspergillus, Cladosporium and Mucor. The number of infected homes was equal in the HDM-sensitized and in the control group, but the mean aerospore counts were higher in the HDM-sensitized than in the control group. The lowest aerospore counts were found in the schools. High airborne spore counts appeared to be related to high indoor humidity. Only four children were sensitized to fungi, and these children were also sensitized to other allergens, such as animal dander and pollen, and suffered from asthma, allergic rhinoconjuncitivits (AR) and atopic dermatitis (AD). Three of these four children also had high counts of aerospores in their homes. However, no consistent association between mould growth and sensitization to moulds could be observed. The health implications of indoor fungal exposure may be multifactorial.     

House dust-mite allergen and cat allergen variability within carpeted living room floors in domestic dwellings

Exposure to allergens from house dust-mites (Der p 1) and domestic cats (Fel d 1) is associated with symptom severity in atopic subjects with asthma and rhinitis. Assessment of allergen exposure in the domestic environment is normally determined by measurement from a single floor site. We determined the variability of these allergens and protein throughout the whole living room floor area. Dust samples were collected from 1 m2 areas from 16 carpeted living room floors in Wellington, New Zealand, and analyzed for concentrations of Der p 1 and Fel d 1. Mean coefficients of variation for Der p 1 and Fel d 1 were 53.1% (range: 28.5-136.8) and 65.6% (range: 28.5-131.0), respectively. This study has demonstrated a large variation of house dust-mite and cat allergens within living room floors and thus assessment of a single sampling site may not be representative of an individual's exposure risk. House dust-mite and cat allergen levels from the center of the room, in front of a couch or chair, or from a corner of the room are similar to mean levels from the whole room. These sites may thus be representative of the whole living room floor in large-scale epidemiological studies.     

House dust-mite allergen and cat allergen variability within carpeted living room floors in domestic dwellings

Exposure to allergens from house dust-mites (Der p 1) and domestic cats (Fel d 1) is associated with symptom severity in atopic subjects with asthma and rhinitis. Assessment of allergen exposure in the domestic environment is normally determined by measurement from a single floor site. We determined the variability of these allergens and protein throughout the whole living room floor area. Dust samples were collected from 1 m2 areas from 16 carpeted living room floors in Wellington, New Zealand, and analyzed for concentrations of Der p 1 and Fel d 1. Mean coefficients of variation for Der p 1 and Fel d 1 were 53.1% (range: 28.5-136.8) and 65.6% (range: 28.5-131), respectively. This study has demonstrated a large variation of house dust-mite and cat allergens within living room floors and thus a single sampling site may not be representative for assessment of an individual's exposure risk. House dust-mite and cat allergen levels from the center of the room, in front of a couch or chair, or from a corner of the room are similar to mean levels from the whole room, these sites may thus be representative of the whole living room floor in large-scale epidemiological studies.     

Associations between selected allergens,phthalates, nicotine,polycyclic aromatic hydrocarbons,and bedroom ventilation and clinically confirmed asthma,rhinoconjunctivitis, and atopic dermatitis in preschool children

Previous studies, often using data from questionnaires, have reported associations between various characteristics of indoor environments and allergic disease. The aim of this study has been to investigate possible associations between objectively assessed indoor environmental factors and clinically confirmed asthma, rhinoconjunctivitis, and atopic dermatitis. The study is a cross‐sectional case–control study of 500 children aged 3–5 years from Odense, Denmark. The 200 cases had at least two parentally reported allergic diseases, while the 300 controls were randomly selected from 2835 participating families. A single physician conducted clinical examinations of all 500 children. Children from the initially random control group with clinically confirmed allergic disease were subsequently excluded from the control group and admitted in the case group, leaving 242 in the healthy control group. For most children, specific IgE's against various allergens were determined. In parallel, dust samples were collected and air change rates were measured in the children's bedrooms. The dust samples were analyzed for phthalate esters, polycyclic aromatic hydrocarbons (PAH), nicotine, and various allergens. Among children diagnosed with asthma, concentrations of nicotine were higher (P < 0.05) and cat allergens were lower (P < 0.05) compared with the healthy controls; air change rates were lower for those sensitized (specific IgE+) compared with those not sensitized (specific IgE?, P < 0.05); and dust mite allergens were higher for specific IgE+ cases compared with healthy controls (P < 0.05). When disease status was based solely on questionnaire responses (as opposed to physician diagnosis), significant associations were found between di(2‐ethylhexyl) phthalate (DEHP) and dog allergens in dust and current wheeze.     

Exposure to microbial components and allergens in population studies: a comparison of two house dust collection methods applied by participants and fieldworkers

Dust collection by study participants instead of fieldworkers would be a practical and cost-effective alternative in large-scale population studies estimating exposure to indoor allergens and microbial agents. We aimed to compare dust weights and biological agent levels in house dust samples taken by study participants with nylon socks, with those in samples taken by fieldworkers using the sampling nozzle of the Allergology Laboratory Copenhagen (ALK). In homes of 216 children, parents and fieldworkers collected house dust within the same year. Dust samples were analyzed for levels of allergens, endotoxin, (1-->3)-beta-D-glucans and fungal extracellular polysaccharides (EPS). Socks appeared to yield less dust from mattresses at relatively low dust amounts and more dust at high dust amounts than ALK samples. Correlations between the methods ranged from 0.47-0.64 for microbial agents and 0.64-0.87 for mite and pet allergens. Cat allergen levels were two-fold lower and endotoxin levels three-fold higher in socks than in ALK samples. Levels of allergens and microbial agents in sock samples taken by study participants are moderately to highly correlated to levels in ALK samples taken by fieldworkers. Absolute levels may differ, probably because of differences in the method rather than in the person who performed the sampling. Practical Implications Dust collection by participants is a reliable and practical option for allergen and microbial agent exposure assessment. Absolute levels of biological agents are not (always) comparable between studies using different dust collection methods, even when expressed per gram dust, because of potential differences in particle-size constitution of the collected dust.     

Distribution variations of multi allergens at asthmatic children's homes

Increasing asthma prevalence is evident in many countries and childhood asthma has also become one of the most common chronic diseases in children. Exposure to indoor allergens has been be attributed to a significant increase in asthma occurrence. Meanwhile, allergen distribution varies widely among different countries. This brief investigation reports the distribution of common indoor allergens, such as mite (Dermatophagoides pteronyssinus, Der p 1 and Der p 2), cat (Felis domesticus, Fel d 1), and German cockroach allergens (Blattella germanica, Bla g 1) at different sites of asthmatic children in Taiwan. Approximately 40 asthmatic children's homes participated in this study and the cohort was followed prospectively for approximately 6 months, starting in December until the following May. Dust samples were collected from each child's mattress, and bedroom and living room floors. All samples were analyzed with monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA). Statistical difference of Der p 1 concen trations is observed among those on the mattress, bedroom and living room floor, except for in May. Seasonal variation in Der p 1 levels on the mattress and bedroom floor is also significant (P < 0.025 and 0.001, respectively). Distributional variation seems to be significant for most allergens among sites within homes in most seasons. Therefore, if only one sample is to be taken, the month of May would be a more ideal choice of study period, and detailed sampling across sites appears to be necessary should the true environmental exposure of allergens be desired.