General Dust Mites Animals Cockroach Fungus and Molds Construction Materials
Author(s):
Lipscomb
MF ; Wilder
JA
Affiliation: Department of Pathology, University of New Mexico School of
Medicine, Albuquerque 87131-5301, USA. Title: Immune dysregulation as a cause for allergic asthma. Source: Curr Opin Pulm Med (Current opinion in pulmonary
medicine.) 1999 Jan; 5(1): 10-20
Abstract: Allergic asthma is being
increasingly understood as a disease caused by Th2-mediated immune responses to
inhaled allergens. Most individuals fail to respond to allergens with a Th2
response, and thus, allergic asthma can be considered the result of an
abnormally regulated or dysregulated immune response. The prevalence of asthma
has risen precipitously in urbanized cultures, as contrasted with third world
countries. This observation underlies the heightened efforts in the past few
years of basic and applied research efforts to gain a better understanding of
both normal and dysregulated immunity to antigens introduced via the airways.
This review focuses on recent human studies into the immune dysregulation that
results in the asthma phenotype, but also cites selected relevant papers from
research with experimental animals.
Author(s):
Pearce
N ; Douwes
J ; Beasley
R
Affiliation: Wellington Asthma Research Group, Wellington School of
Medicine, PO Box 7343, Wellington, New Zealand.
Title: Is allergen
exposure the major primary cause of asthma? Source: Thorax (Thorax.) 2000 May; 55(5):
424-31
Abstract: In recent decades a number of authors have argued that allergen exposure
is the major primary cause of asthma, and that the global increases in asthma
prevalence are due to increases in exposure to aeroallergens. We have assessed
the epidemiological evidence in support of this hypothesis. No longitudinal
studies were identified in which allergen exposure during infancy in a random
population sample has been related to asthma risk after the age of six years.
Two studies have been conducted in selected populations chosen on the basis of
a family history of asthma or allergy; one study found a non-statistically
significant association whereas the other study found no association. Many of
the identified prevalence studies in children showed negative associations
between allergen exposure and current asthma, and the weighted averages of the
population attributable risks in children were 4% for Der p 1, 11% for Fel d 1,
-4% for Bla g 2, and 6% for Can f 1. There was little change in these estimates
in studies in which children whose parents had adopted allergen avoidance
measures were excluded. Furthermore, evidence from population studies is
equivocal and provides little consistent evidence that allergen exposure is
associated with the prevalence of asthma at the population level.
Population-based cohort studies are clearly required, but currently available
evidence does not indicate that allergen exposure is a major risk factor for
the primary causation of asthma in children.
Author(s):
Halpern
MT ; Schmier
JK ; Richner
R ; Guo
C ; Togias
A
Affiliation: Exponent Inc., Alexandria, Virginia, USA. mhalpern@exponent.com
Title: Allergic
rhinitis: a potential cause of increased asthma medication use, costs, and
morbidity. Source: J Asthma (The
Journal of asthma : official journal of the Association for the Care of Asthma.)
2004 Feb; 41(1): 117-26
Abstract: Allergic rhinitis and asthma each require costly medical resource utilization, and the impact of both conditions is believed to be even greater. This retrospective cost of illness study evaluated the impact of allergic rhinitis on asthma medical care resource utilization rates and costs for patients with asthma plus allergic rhinitis vs. patients with asthma alone. Patients with one or more claims for asthma (n=27,398) were identified from a medical claims database from a large, northeastern U.S. health insurance plan (1992-1994). A subset of 9226 patients also had at least one visit for allergic rhinitis. Inpatient, professional service, major medical, and pharmaceutical (prescription medications) claims were examined. Patients with asthma and allergic rhinitis had greater medical utilization and costs than individuals with asthma only. The presence of allergic rhinitis was associated with greater frequencies and costs of prescriptions for all asthma-related medications evaluated in the study. Patients with both conditions were also more likely to receive care from medical specialists and less likely to be in managed care. Controlling for these factors, allergic rhinitis was still associated with an increase (P<0.0001) in annual costs of more than dollars 350. Allergic rhinitis in patients with asthma nearly doubles annual medical resource utilization and costs and is associated with increased utilization of asthma-related medications. Based on use of asthma medications, patients with concomitant allergic rhinitis can be regarded as having more severe asthma than do those without allergic rhinitis. Physicians should assess asthma patients for symptoms of allergic rhinitis to improve asthma treatment.
Author(s):
Liu
AH
Affiliation: Division of Pediatric Allergy & Immunology, National
Jewish Medical & Research Center, Denver, CO 80206, USA. liua@njc.org
Title: Something
old, something new: indoor endotoxin, allergens and asthma. Source: Paediatr Respir Rev (Paediatric respiratory reviews.)
2004; 5 Suppl A: S65-71
Abstract:
Endotoxin and allergen
exposure have been explored in the context of asthma for more than a century. Building
upon a pyramid of knowledge are recent observations that provide new insights
to the effect of these exposures on the development of asthma. Some of these
studies challenge some previously held concepts of the role of these exposures
in asthma inception. Indoor allergens are well established as the basis of
inflammation in sensitised asthmatics, contributing to disease severity. Then
does greater exposure to indoor allergens cause allergen sensitisation and
asthma as well? While risk of sensitisation to house dust mites generally
increases with higher levels of exposure, this does not seem to hold for cats,
where higher levels of cat allergen exposure are associated with less
sensitisation. Indeed, several recent studies suggest that early childhood
exposure to animals, as indoor pets or in farming stables, are associated with
a lower prevalence of asthma, hay fever, and inhalant allergen sensitisation.
Endotoxin in asthma provides a similar paradox. Endotoxin is a potent
immune-stimulatory component of the bacterial cell wall of all gram-negative
bacteria. As such, endotoxin is ubiquitous in our environment. Endotoxin
exposure has been well demonstrated to underlie "Monday Asthma" or
byssinosis in cotton workers, and has since emerged as a frequent cause of
asthma-like symptoms in a wide range of occupational settings. Asthmatics are
particularly sensitive to inhaled endotoxin, and inhalation induces both
immediate and sustained airflow obstruction. The paradox of endotoxin exposure
is that higher levels of exposure in early life might mitigate the development
of allergy and persistent asthma. With endotoxin exposure being significantly
higher in homes with animals and in farming households, where allergy and
asthma are less likely to develop, endotoxin and other microbial exposures in
early life may keep allergen sensitisation and asthma from developing by
promoting Th1-type immune development. These observations, consistent with the
"Hygiene Hypothesis" of allergy and asthma, are an encouraging glimpse
of the potential for early immune modulatory approaches to asthma therapy and
prevention.
Author(s):
Murray
CS ; Woodcock
A ; Custovic
A
Affiliation: North West Lung Centre, Wythenshawe Hospital, Manchester,
UK.
Title: The role of
indoor allergen exposure in the development of sensitization and asthma.
Source:
Curr Opin Allergy Clin
Immunol (Current
opinion in allergy and clinical immunology.) 2001 Oct; 1(5): 407-12
Abstract: The role of indoor allergen exposure in the development of sensitization
and asthma remains a subject of controversy. From a number of cross-sectional
and longitudinal studies we can conclude that there is a very close association
between allergen exposure and the sensitization of an individual. The
dose-response relationships seem to differ between allergens; house dust mite and
cockroach allergens appear to have a positive linear relationship, whereas cat
allergens appear to act quite differently, with maximum sensitization
developing at moderate exposure levels. Very low levels of cat allergen
exposure are likely to induce no response and very high levels are likely to
develop a form of tolerance, with a modified T helper cell type 2 response and
the production of IgG4 antibodies and but not IgE. The relationship between
indoor allergen exposure and asthma is, however, less clear. The proposed
mechanism for the development of disease is that allergen exposure causes
sensitization, and continued exposure leads to airway responsiveness and
inflammation. As yet, the evidence for allergen exposure being a primary cause
of asthma remains weak, and the results of ongoing prospective, randomized
allergen avoidance trials are awaited to clarify this issue.
Author(s):
Krieger
JW ; Song
L ; Takaro
TK ; Stout
J
Affiliation: Seattle Partners for Healthy Communities/Public Health--Seattle
and King County, WA 98104-4039, USA. james.krieger@metrokc.gov
Title: Asthma and
the home environment of low-income urban children: preliminary findings from
the Seattle-King County healthy homes project. Source: J Urban Health (Journal of urban health :
bulletin of the New York Academy of Medicine.) 2000 Mar; 77(1): 50-67
Abstract: OBJECTIVES: Childhood asthma is a growing public health concern in
low-income urban communities. Indoor exposure to asthma triggers has emerged as
an important cause of asthma exacerbations. We describe indoor environmental
conditions related to asthma triggers among a low-income urban population in
Seattle/King County, Washington, as well as caregiver knowledge and resources
related to control of these triggers. METHODS: Data are obtained from
in-person, structured, closed-end interviews with the caretakers of children
aged 4-12 years with persistent asthma living in households with incomes less
than 200% of poverty. Additional information is collected during a home
inspection. The children and their caregivers are participants in the ongoing
Seattle-King County Healthy Homes Project, a randomized controlled trial of an
intervention to empower low-income families to reduce exposure to indoor asthma
triggers. We report findings on the conditions of the homes prior to this
intervention among the first 112 enrolled households. RESULTS: A smoker was
present in 37.5% of homes. Mold was visible in 26.8% of homes, water damage was
present in 18.6% of homes, and damp conditions occurred in 64.8% of households,
while 39.6% of caregivers were aware that excessive moisture can increase
exposures to allergens. Dust-trapping reservoirs were common; 76.8% of
children's bedrooms had carpeting. Cockroach infestation in the past 3 months
was reported by 23.4% of caregivers, while 57.1% were unaware of the
association of roaches and asthma. Only 19.8% of the children had
allergy-control mattress covers. CONCLUSIONS: Many low-income urban children
with asthma in King County live in indoor environments that place them at
substantial risk of ongoing exposure to asthma triggers. Substandard housing
and lack of resources often underlie these exposures. Initiatives involving
health educators, outreach workers, medical providers, health care insurers,
housing agencies, and elected officials are needed to reduce these exposures.
Author(s):
Hirsch
T
Affiliation: Kinderklinik im Universitäts-Klinikum Carl Gustav Carus der
Technischen Universität Dresden, Germany. thhirsch@rcs.urz.tu-dresden.de
Title: Indoor
allergen exposure in west and East Germany: a cause for different prevalences
of asthma and atopy? Source: Rev Environ Health (Reviews on environmental health.) 1999 Jul-Sep;
14(3): 159-68
Abstract: West and East Germans have been living in two different political systems for 40 years. These two populations have become a classic epidemiological example for the hypothesis that lifestyle changes accompanying the industrial and economic development of modern societies are responsible for an increase in the prevalence of atopic diseases. A higher prevalence of atopic sensitization, asthma, and hay fever was found in young West Germans after the unification. It has been hypothesized that this phenomenon was at least partially due to the installation of insulating windows and central heating systems in Western homes, favoring the growth of microorganisms like mites and moulds and increasing indoor allergen exposure. This review summarizes studies that have investigated reservoir concentrations of indoor allergens in public buildings and private homes in East and West Germany. Whereas a higher prevalence of atopic sensitization in West Germans was found for nearly all tested allergens (cat, mite, pollen), allergen exposure was higher only for cat allergens, but probably not for mite and cockroach allergens or moulds. The published data do not support the view that the differences in specific sensitization are caused by differences in the exposure to specific allergens.
General Dust Mites Animals Cockroach Fungus and Molds Construction Materials
Author(s): Van
Woerden H
Affiliation: Department of Epidemiology, Statistics and Public Health,
College of Medicine, University of Wales, Heath Park, Cardiff CF14 4XN, UK.
Title:
Dust mites living in human lungs - the cause
of asthma? Source: Med Hypotheses
(Medical hypotheses.) 2004; 63(2): 193-7
Abstract:
Asthma does not have a clear
cause and may represent a cluster of diseases. We propose that asthma in house dust
mite sensitive patients may be caused by recurrent inhalation of live dust
mites which are able to live for some time in the bronchioles of the lung. To
provide themselves with a food source, the mites may purposefully excrete
proteolytic enzymes, including Der p1, which increase epithelial shedding by
freeing cells from the basement membrane. The mites then feed on the shed
respiratory epithelial cells. Consequent loss of an intact respiratory
epithelium exposes underlying tissues to dust mite protein and other allergens
triggering sensitisation to these proteins. Later, repeated infestation
provokes an allergic response which manifests itself as asthma attacks. The
evidence for this hypothesis was tested against the Bradford-Hill criteria for
causation; consistency, strength, temporal association and dose response.
Potential areas for further research were also identified. The association
between asthmatic symptoms and pulmonary acariasis was consistent across a
number of studies. Determining the strength of the association and any dose
response requires more work which is dependent on the development of better
tests for the detection of mites in sputum. There was tentative evidence of a
temporal association in the published studies identified. Biological
plausibility and experimental evidence was available for pulmonary acariasis in
primates and arsenic treatment was effective in humans. Better tests for mites
in sputum are needed, as is work to assess more modern anti-acaricidal drugs in
dust mite sensitive asthmatics.
Author(s):
Glass
EV ; Needham
GR
Affiliation: Acarine Physiology Laboratory, Department of Entomology,
The Ohio State University, Columbus, OH 43210, USA. Title: Eliminating Dermatophagoides farinae spp. (Acari:
Pyroglyphidae) and their allergens through high temperature treatment of
textiles. Source: J Med Entomol
(Journal of medical entomology.) 2004 May; 41(3): 529-32
Abstract: House dust mite allergens cause
allergy and asthma in sensitized individuals. The allergens they produce are
known to resist decay under natural household conditions and are thought to
accumulate until removed. We sought to evaluate the effects of high temperature
(96 degrees C) generated by a hard surface cleaner on live mite populations of
American house dust mites, Dermatophagoides farinae Hughes and their allergens
in carpet and mattresses. Statistically significant (P < 0.05) mite
mortality (100%) was observed in response to treatment in both textile
surfaces. Similar effects were observed on Der f1 fecal allergen. Allergen
reductions in carpet with two or five pass treatment regimes were 61.4 and
100%, respectively. These results demonstrate the potential of employing a hard
surface steam cleaner as a novel method to eliminate house dust mite
populations and their allergens in a residential setting and appeal particularly
promising as an environmental control strategy.
Author(s):
Halken
S ; Høst
A ; Niklassen
U ; Hansen
LG ; Nielsen
F ; Pedersen
S ; Osterballe
O ; Veggerby
C ; Poulsen
LK
Affiliation: Department of Pediatrics, Sønderborg Hospital, Sønderborg,
Denmark.
Title: Effect of
mattress and pillow encasings on children with asthma and house dust mite
allergy. Source: J Allergy Clin Immunol (The Journal of allergy and clinical immunology.)
2003 Jan; 111(1): 169-76
Abstract: BACKGROUND: House dust mite (HDM) allergy is a frequent cause of
allergic asthma in children. Reduction of exposure seems to be the most logical
way to treat these patients. OBJECTIVE: Our aim was to investigate whether
mattress and pillow encasings resulted in an effective long-term control of HDM
allergen levels, thereby reducing the need for asthma medication in children
with asthma and HDM allergy. METHODS: In a prospective, double-blind,
placebo-controlled study 60 children (age range, 6-15 years) with asthma and
HDM allergy were randomized to active (allergy control) or placebo mattress and
pillow encasings. After a 2-week baseline period, follow-up was performed every
3 months for 1 year. During the entire study period, the dose of inhaled
steroids was tapered off to the lowest effective dose according to well-defined
criteria. RESULTS: Fifty-two patients completed the trial, and 5 were excluded,
leaving data from 47 children (26 in the active treatment group and 21 in the
placebo group) for analysis. A significant perennial reduction in HDM allergen
concentrations was seen only for the active treatment group. Also, a
significant decrease in the dose of inhaled steroids (mean, 408 to 227
microg/d; P <.001) was found for the active treatment group only, with
significant differences between groups after 9 and 12 months. After 1 year, the
dose of inhaled steroids was reduced by at least 50% in significantly more
children in the active treatment group than in the placebo group (73% vs 24%, P
<.01). CONCLUSION: Encasing of mattresses and pillows resulted in a
significant long-term reduction in HDM allergen concentrations in mattresses
and in the need for inhaled steroids in children with asthma and HDM allergy.
Author(s):
Kronqvist
M ; Johansson
E ; Pershagen
G ; Johansson
SG ; van
Hage-Hamsten M
Affiliation: Department of Medicine, Danderyd Hospital, Stockholm,
Sweden.
Title: Increasing
prevalence of asthma over 12 years among dairy farmers on Gotland, Sweden:
storage mites remain dominant allergens. Source: Clin Exp Allergy (Clinical and experimental
allergy : journal of the British Society for Allergy and Clinical Immunology.)
1999 Jan; 29(1): 35-41
Abstract: BACKGROUND: Earlier studies from several countries have shown that
IgE-mediated allergy in rural populations is of considerable importance and
that storage mites are dominant allergens. OBJECTIVE: In an epidemiological
follow-up study among farmers on the island of Gotland, Sweden in 1996 we
wished to investigate the prevalence of respiratory allergy and to find out whether
storage mites are still important allergens in a farming environment. METHODS:
A questionnaire concerning airway symptoms, social and working conditions and
smoking habits was distributed to all Gotland farmers aged 15-65 years and was
completed by 1577 (86.7%), of whom 1015 were dairy farmers. Based on the
answers, 500 dairy farmers were invited to undergo a medical examination which
included a skin-prick test (SPT) and blood sampling for RAST analyses.
Prevalence figures (symptoms, RAST and SPT) given for the whole population (n =
1015) were based on the investigation of the 461 farmers who took part in the
examination. RESULTS: Immediate onset hypersensitivity was present in 41.7% of
the 1015 farmers studied, which is almost the same figure as in 1984 (40.0%).
The prevalence of asthma had increased significantly during the previous 12
years (5.3% vs 9.8%), as had asthma in combination with rhinoconjunctivitis
(3.7% vs 7.0%). Rhinoconjunctivitis, on the other hand, had not changed
significantly (36.5% vs 33.1%) and remained one of the most common symptoms.
The prevalence of storage mite allergy in the farming population in 1996 was
6.5% and constituted an important cause of allergic symptoms. CONCLUSION: Over
12 years, Gotland dairy farmers have developed significantly more respiratory
symptoms from the lower airways, although the proportion with atopy is
unchanged. Storage mites are still dominant allergens for developing allergic
disease.
Author(s): Wen
T ; Cai
Y ; Chen
X ; Xiang
L ; Wang
B ; Zhuang
Y
Affiliation: Medical Acarology Laboratory, Shanghai Medical University,
Shanghai 200032.
Title: [Safety
analysis of dust mite allergen for diagnosis and immunotherapy of asthma and
rhinitis] Source: Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi (Zhongguo ji sheng chong xue yu
ji sheng chong bing za zhi = Chinese journal of parasitology & parasitic
diseases.) 1999; 17(5): 274-6
Abstract: AIM: To make a retrieval investigation of safety in using
Dermatophagoides farinae extract in diagnosis and immunotherapy with patients
of asthma and rhinitis. METHODS: A questionnaire evaluation of the safety use
of D. farinae extract (SMU-Df) during diagnosis and immunotherapy of patients
from 1974 to 1995 was carried out. RESULTS: A total of 8,46,342 injections were
statistically analysed, among whom 142 systemic adverse reactions occurred
involving urticaria 0.82@10000, severe attack of asthma 0.77@10000,
anaphylactic shock 0.07@10000 (CL = 1.4-12.0/million), and angioedma
0.02@10000. The time of onset of systemic reactions of immediate type was <
30 min in 32 cases-times, and 1 h and 2 h in 6 cases-times; the time to onset
of late response type was 3 h-48 h in 23 cases-times with highest incidence of
severe asthmatic attacks. The systemic reactions occurred in 18 subjects during
skin test, in 96 cases-times during increasing dose phase, and in 14
cases-times during. Among them 6 cases were of anaphylactic shock, and none of
it after emergency treatment. The major cause of manifestation of systemic
reactions for 41 cases after immunotherapy with SMU-Df extract was due to over
dosage errors. CONCLUSION: The application of SMU-Df extract in skin test and
immunotherapy of asthma and rhinitis sensitive to mite for the past 22 years in
this country indicated that the efficacy and safety have been high.
Author(s):
van
Ree R ; Antonicelli
L ; Akkerdaas
JH ; Pajno
GB ; Barberio
G ; Corbetta
L ; Ferro
G ; Zambito
M ; Garritani
MS ; Aalberse
RC ; Bonifazi
F
Affiliation: Central Laboratory of The Netherlands Red Cross Blood
Transfusion Service, University of Amsterdam, The Netherlands.
Title: Asthma
after consumption of snails in house-dust-mite-allergic patients: a case of IgE
cross-reactivity. Source: Allergy (Allergy.)
1996 Jun; 51(6): 387-93
Abstract: A group of 28 patients from Italy was studied who had asthma after consumption of snail. All patients also had asthma and/or rhinitis caused by house-dust mite. RAST analyses confirmed the combined sensitization to snail and mite. In a few sera, IgE antibodies reactive with other foods of invertebrate origin (mussel and shrimp) were detected. RAST inhibition showed that most IgE antibodies against snail were cross-reactive with house-dust mite. In contrast, the mite RAST was not significantly inhibited by snail. This indicates that house-dust mite was the sensitizing agent. Immunoblot analyses revealed multiple bands in snail extract recognized by IgE. In contrast to what has been described for cross-reactivity between shrimp and mite, tropomyosin played only a minor role as a cross-reactive allergen in these patients. The observations in this study indicate that snail consumption can cause severe asthmatic symptoms in house-dust-mite-allergic patients. It might, therefore, be advisable to screen mite-allergic asthma patients for allergy to snail and other invertebrate animal foods.
General Dust Mites Animals Cockroach Fungus and Molds Construction Materials
Author(s): Cohn
RD ; Arbes
SJ Jr ; Yin
M ; Jaramillo
R ; Zeldin
DC
Affiliation: Constella Group Inc, Durham, North Carolina, USA.
Title: National
prevalence and exposure risk for mouse allergen in US households. Source: J Allergy Clin Immunol (The Journal of allergy and
clinical immunology.) 2004 Jun; 113(6): 1167-71
Abstract: BACKGROUND: Exposure to mouse allergen is a known
cause of asthma in occupational settings and exhibits high prevalence and
association with allergic sensitization in inner-city home environments. It has
never been characterized on a nationally representative scale. OBJECTIVE: This
study was designed to characterize mouse allergen prevalence in a
representative sample of US homes and to assess risk factors for increased
concentrations. METHODS: Allergen, questionnaire, and observational data were
analyzed from the first National Survey of Lead and Allergens in Housing, a
cross-sectional survey of 831 US housing units. Allergen levels were
characterized and related to demographic factors and household characteristics.
RESULTS: Detectable levels of mouse allergen (Mus m 1) exist in 82% of US
homes. Kitchen floor concentrations exceed 1.6 microg/g, a level associated
with increased sensitization rates, in 22% of homes. Increased concentrations
(>1.6 microg/g) were observed in high-rise apartments and mobile homes,
older homes, and low-income homes. Odds of having increased concentrations were
increased when rodent (odds ratio [OR], 3.38) or cockroach (OR, 1.81) problems
were reported and when floor mopping (OR, 2.17) was performed instead of
vacuuming. CONCLUSIONS: Household mouse allergen is widespread in many settings
at levels that might contribute to asthma morbidity. The likelihood of exposure
can be assessed by consideration of demographic and household determinants.
Author(s): Platts-Mills
TA ; Woodfolk
JA ; Erwin
EA ; Aalberse
R
Affiliation: Asthma and Allergic Disease Center, University of Virginia,
University Health Systems, Charlottesville 22908-1355, USA. tap2z@virginia.edu
Title: Mechanisms
of tolerance to inhalant allergens: the relevance of a modified Th2 response to
allergens from domestic animals. Source: Springer Semin Immunopathol (Springer seminars in
immunopathology.) 2004 Feb; 25(3-4): 271-9
Abstract:
Subjects can be
"non-allergic" because (1) they are not exposed, (2) they fail to make
an immune response, or (3) they make an immune response that does not include
IgE antibodies (Ab). The recent observation that children raised in a house
with a cat are less likely to become allergic to cat allergen than those who
only get indirect exposure provides a model to investigate the factors
controlling allergic responses. Many of these highly exposed children have made
an IgG and IgG4 Ab response to Fel d 1 without IgE Ab, i.e., a "modified
Th2 response". In countries where cats are a major cause of asthma, the
presence of a cat may decrease the risk of asthma. By contrast, in countries
with high exposure to dust mites, cats can induce specific tolerance to Fel d 1
without influencing asthma or the IgE Ab response to dust mites. Using overlapping
peptides to investigate T cell responses to Fel d 1 suggests that the structure
of the molecule plays a special role in inducing the T cell responses that can
"control" the immune response to cat allergens. This T cell response
is characterized by high levels of IL-10 production, but this is not restricted
to those who have made a modified Th2 response. The results suggest that there
are major differences in the immune response to different allergens that
profoundly affect their role in allergic disease. Dust mite and cockroach
differ from cat (and rat) allergens not only in the quantity inhaled and the
particles' sizes but also in the biochemistry of the molecule.
Author(s):
Noertjojo
K ; Dimich-Ward
H ; Obata
H ; Manfreda
J ; Chan-Yeung
M
Affiliation: Occupational and Environmental Research Unit, Respiratory
Division, Department of Medicine, University of British Columbia, Vancouver,
Canada.
Title: Exposure
and sensitization to cat dander: asthma and asthma-like symptoms among adults.
Source:
J Allergy Clin Immunol (The Journal of allergy and
clinical immunology.) 1999 Jan; 103(1) Pt 1: 60-5
Abstract: BACKGROUND: Several pets, such as cats, dogs, and rodents, are known to produce allergens. Despite the clinical and laboratory evidence that exposure to pets can cause bronchoconstriction in sensitized subjects, the results of population studies have been contradictory. OBJECTIVES: The purpose of this study was to investigate the relationship between cat ownership and the prevalence of asthma, asthma-like symptoms, and bronchitic symptoms among subjects 20 to 44 years of age in Vancouver, Canada and to determine whether sensitization is responsible for such an association. METHODS: Two thousand nine hundred ninety-nine (88%) randomly selected subjects responded to a mail questionnaire. Of these, 504 participated in laboratory examination, including allergy skin testing. RESULTS: One thousand nineteen study responders (34%) were pet owners at the time of the study (current owners). Current pet owners were found to have a higher prevalence of current asthma, asthma-like symptoms, and bronchitic symptoms compared with those without pets. Cat owners had significantly higher risk of having current asthma and asthma-like symptoms. In the subset who had allergic skin tests, we found that those who were allergic to cat dander had a significantly higher risk of current asthma than those not allergic to cat dander and not owning a cat. CONCLUSION: This study provides evidence that sensitization to cat dander is a more important risk factor for current asthma and asthma-like symptoms than cat ownership itself.
Author(s):
Perry
T ; Matsui
E ; Merriman
B ; Duong
T ; Eggleston
P
Affiliation: Department of Pediatrics, Division of Allergy and
Immunology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
Title: The
prevalence of rat allergen in inner-city homes and its relationship to
sensitization and asthma morbidity. Source: J Allergy Clin Immunol (The Journal of allergy and
clinical immunology.) 2003 Aug; 112(2): 346-52
Abstract: BACKGROUND: Rat allergen has proved to be an important cause of
IgE-mediated hypersensitivity in the occupational setting. The prevalence and
significance of rat allergen in homes has not been studied. OBJECTIVE: The
purpose of this study was to determine the prevalence of rat allergen in the
homes of inner-city children with asthma and to examine the relationship
between rat allergen exposure, sensitization, and asthma morbidity. METHODS: We
developed a new monoclonal-based ELISA to determine the prevalence of rat
allergen in dust samples from inner-city homes of the National Cooperative Inner-City
Asthma Study population. Home characteristics were evaluated to detect
variables that were associated with the presence of rat allergen. Data were
also analyzed to assess the relationship between the presence of rat allergen,
sensitization, and asthma morbidity. RESULTS: Thirty-three percent of
inner-city homes had detectable rat allergen (Rat n 1). The presence of rat
allergen was associated with reported rat and mouse infestation, as well as
evidence of mouse infestation on home inspection. Twenty-one percent of the
participants were sensitized to rat allergen; however, sensitization was not
more common when rat allergen was found in the home. The number of
hospitalizations, unscheduled medical visits, and days with slowed activity
because of asthma were significantly increased in those individuals who were
both sensitized and exposed to rat allergen. CONCLUSIONS: Rat allergen
sensitization and exposure are associated with increased asthma morbidity in
inner-city children.
Author(s):
Phipatanakul
W ; Eggleston
PA ; Wright
EC ; Wood
RA
Affiliation: Department of Pediatrics, Division of Allergy and
Immunology, Children's Hospital, Harvard University School of Medicine, Boston,
MA, USA. Corp
Author: National
Coooperative Inner-City Asthma Study
Title: Mouse
allergen. II. The relationship of mouse allergen exposure to mouse
sensitization and asthma morbidity in inner-city children with asthma.
Source:
J Allergy Clin Immunol (The Journal of allergy and
clinical immunology.) 2000 Dec; 106(6): 1075-80
Abstract: BACKGROUND: Although mouse allergen is known to cause occupational asthma in laboratory workers, its potential significance in home environments has never been studied. OBJECTIVE: This study was designed to define the prevalence of mouse sensitivity and its relationship to mouse allergen exposure and disease activity in inner-city children with asthma. METHODS: A subset of 499 subjects from the National Cooperative Inner-City Asthma Study had dust samples adequate for mouse allergen analysis, as well as valid puncture skin test (PST) results. Data were analyzed to relate mouse allergen exposure and other risk factors to mouse sensitization and asthma morbidity. RESULTS: Eighty-nine (18%) of the 499 children had a positive mouse skin test response. Children whose homes had mouse allergen levels above the median (1.60 microg/g) in the kitchen had a significantly higher rate of mouse sensitization (23% vs 11%, P =. 007). Atopy was also significantly related to mouse sensitization, with 40% of those with more than 4 positive PST responses having mouse sensitivity compared with 4% of those with no other positive PST responses (P <.0001). When atopy and exposure were considered together, 53% of those with more than 4 positive PST responses and allergen levels above the median had a positive PST response to mouse allergen compared with 22% of those with more than 4 positive PST responses and allergen levels below the median (P <.0001). The relationship among mouse allergen exposure, sensitization, and any measures of asthma morbidity was not statistically significant. CONCLUSIONS: Mouse allergen may be an important indoor allergen in inner-city children with asthma, with exposure and atopy contributing to mouse sensitization.
General Dust Mites Animals Cockroach Fungus and Molds Construction Materials
Author(s):
Wilson
NW ; Robinson
NP ; Hogan
MB
Affiliation: Department of Pediatrics, West Virginia University, School
of Medicine, Morgantown 26506-9214, USA.
Title: Cockroach
and other inhalant allergies in infantile asthma. Source: Ann Allergy Asthma Immunol (Annals of allergy, asthma &
immunology : official publication of the American College of Allergy, Asthma,
& Immunology.) 1999 Jul; 83(1): 27-30
Abstract: BACKGROUND: Infantile asthma is commonly thought to be caused by viral
respiratory infections and exposure to second-hand cigarette smoke. Allergy has
not been felt to be a major cause of infantile asthma and infants and small
children are not commonly skin tested. OBJECTIVE: To determine the frequency of
skin test reactivity in asthmatic children less than 3 years of age. METHODS:
We evaluated 196 (50 female/146 male) children with infantile asthma for
allergy. Infantile asthma was defined as three or more episodes of wheezing in
a child less than 3 years of age. A careful environmental history was obtained
on all children. All were skin tested to alternaria, cat, dog, cockroach, and
house dust mites (HDM) extracts using the prick technique with the Greer
Dermapik. RESULTS: Forty-five percent of the infants and children tested had at
least one positive skin test. 51/196 (26%) of the children were skin test
positive to cockroach, 17.3% to HDM, 13.8% to cat, 6.6% to alternaria, and 6.1%
positive to dog. For the 49 children who were less than 1 year of age, 28.5%
were positive to cockroach, 10.2% to HDM, 10.2% to cats, 4% to alternaria, and
0% to dog. CONCLUSIONS: Allergy to cockroach and other indoor allergens may be
a significant contributor to infantile asthma in a rural setting. Skin testing
children with infantile asthma may provide useful information for institution
of environmental controls measures in the child's home.
Author(s):
Arruda
LK ; Vailes
LD ; Ferriani
VP ; Santos
AB ; Pomés
A ; Chapman
MD
Affiliation: Departments of Pediatrics and Cell and Molecular Biology,
University of São Paulo School of Medicine of Ribeirão Preto, Brazil.
Title: Cockroach
allergens and asthma. Source: J Allergy Clin Immunol (The Journal of allergy and clinical immunology.)
2001 Mar; 107(3): 419-28
Abstract: Asthma and allergy are the most common diseases associated with
cockroach infestation of houses in the United States and other parts of the
world. Sensitization and exposure to cockroach allergens is associated with
increased asthma morbidity in the United States, especially among lower
socioeconomic groups, including African American and Hispanic populations.
Exposure to cockroach allergens in the first 3 months of life has been
associated with repeated wheezing and asthma. The principal domestic cockroach
species are Blattella germanica and Periplaneta americana. Both species produce
several potent allergens, including Bla g 2 (inactive aspartic proteinase), Bla
g 4 (calycin), Bla g 5 (glutathione-S-transferase), the group 1 cross-reactive
allergens Bla g 1 and Per a 1, and tropomyosin. Structural homology between
tropomyosins from cockroaches, mites, and shrimp may explain clinical cases of
the oral allergy syndrome. The 3-dimensional structures of several cockroach
allergens are known, and biologically active recombinant allergens have been
produced in high-level expression vectors. The use of recombinant cockroach
allergens should allow mechanisms of cockroach-induced asthma to be
investigated and may lead to the development of new approaches to asthma
treatment. Environmental allergen measurements of Bla g 1 and Bla g 2 have
allowed exposure levels that cause allergic sensitization to be established.
Abatement studies have shown that a sustained decrease in cockroach allergen
levels is difficult but can be accomplished by professional application of
insecticides, together with rigorous household cleaning. Cockroach asthma is an
important public health problem that affects patients who are the least likely
to be compliant with treatment with asthma medications or environmental
control. Patient education, improvements in the housing stock, and improvements
in environmental and immunologic treatment strategies are likely to be the most
successful approaches to reduce the prevalence of cockroach-induced asthma.
Author(s):
Arruda
LK ; Chapman
MD
Affiliation: Department of Pediatrics, University of São Paulo School of
Medicine of Ribeirão Preto, Brazil.
Title: The role of
cockroach allergens in asthma. Source: Curr Opin Pulm Med (Current opinion in pulmonary medicine.) 2001
Jan; 7(1): 14-9
Abstract: Cockroach allergy has been recognized as an important cause of asthma. Cockroach asthma has been described as a more severe disease, associated with perennial symptoms and high levels of total IgE. Cockroaches produce several allergens that induce sensitization, and exposure to high levels of cockroach allergens in the home is a major risk factor for symptoms in sensitized individuals. Previously identified allergens from Blattella germanica and Periplaneta americana, the most important domiciliary species, include Bla g 2 (inactive aspartic protease), Bla g 4 (calycin), Bla g 5 (glutathione-S-transferase), Bla g 6 (troponin), the Group 1 cross-reactive allergens Bla g 1 and Per a 1, Per a 3 (arylphorin), and Per a 7 (tropomyosin). Strategies for decreasing environmental exposure to cockroach have been recently investigated. The results suggest that a sustained decrease in cockroach allergen levels is difficult to accomplish, even after successful extermination of cockroach populations. Cockroach allergens have been cloned and produced as recombinant proteins in high-level expression vectors. The use of recombinant cockroach allergens should allow mechanisms of cockroach-induced asthma to be investigated and may lead to the development of new approaches to asthma treatment in the future.
General Dust Mites Animals Cockroach Fungus and Molds Construction Materials
Affiliation: Department of Industrial Hygiene and Toxicology, Finnish
Institute of Occupational Health, Helsinki, Finland.
Title: Exposure to
Aspergillus fumigatus spores induces chemokine expression in mouse macrophages.
Source:
Toxicology (Toxicology.) 2004 Aug 5;
200(2-3): 255-63
Abstract: Inhalation of fungal spores may cause inflammation and respiratory
diseases, such as bronchitis, allergic alveolitis, and asthma. Alveolar
macrophages provide the first line of defense in the respiratory tract. To
examine the cellular mechanisms involved in Aspergillus fumigatus-induced
airway inflammation, mouse macrophage cell line (RAW 264.7) cells were exposed
for 2h or 6h to graded doses of A. fumigatus spores that were either alive or
heat-killed. Furthermore, the ability of the cells to phagocytize the spores
was visualized by electron microscopy. Expression of selected cytokines and
chemokines was assessed by a real time quantitative PCR method and by
enzyme-linked immunoabsorbent assay (ELISA) after exposure. A significant
increase in mRNA expression of TNF-alpha, MIP-1alpha, MIP-1beta, and MCP-1 was
observed with a maximal induction at 6h after exposure to the highest (
[Formula: see text] ) concentration of live spores. Similar response was not
detected with heat-killed spores in the expression of chemokines and cytokines,
even though there were no differences between the phagocytosis of live and
heat-killed spores. These results suggest that exposure to live spores of A.
fumigatus can modulate the expression of proinflammatory cytokines and
chemokines in mouse macrophages and thus influence the development of
inflammatory processes in the airways.
Author(s):
Trout
DB ; Seltzer
JM ; Page
EH ; Biagini
RE ; Schmechel
D ; Lewis
DM ; Boudreau
AY
Affiliation: Division of Surveillance, Hazard Evaluations, and Field
Studies, National Institute for Occupational Safety and Health, Centers for
Disease Control and Prevention, Cincinnati, Ohio 45226-1998, USA. dtrout@cdc.gov
Title: Clinical
use of immunoassays in assessing exposure to fungi and potential health effects
related to fungal exposure. Source: Ann Allergy Asthma Immunol (Annals of allergy, asthma &
immunology : official publication of the American College of Allergy, Asthma,
& Immunology.) 2004 May; 92(5): 483-91; quiz 492-4, 575
Abstract: OBJECTIVE: To review and summarize
current evidence regarding the proper role of immunoassays in clinical
assessments of exposure to fungi and health effects related to fungal exposure.
DATA SOURCES: We reviewed relevant scientific investigations and previously
published reviews concerning this topic. STUDY SELECTION: The authors'
clinical, laboratory, and public health experiences were used to evaluate
relevant data for scientific merit. RESULTS: Testing to determine the presence
of IgE to specific fungi may be a useful component of a complete clinical
evaluation in the diagnosis of illnesses that can be caused by immediate
hypersensitivity such as allergic rhinitis and asthma. Detection of IgG to
specific fungi has been used as a marker of exposure to agents that may cause
illnesses such as hypersensitivity pneumonitis. However, the ubiquitous nature
of many fungi and the lack of specificity of fungal antigens limit the
usefulness of these types of tests in the evaluation of potential
building-related illness and fungal exposure. Specific serologic tests (such as
tests for cryptococcal antigen, coccidioidal antibody, and Histoplasma antigen)
have been shown to be useful in the diagnosis of some fungal infections, but
these are the exception not the rule. CONCLUSIONS: There is currently not
enough scientific evidence to support the routine clinical use of immunoassays
as a primary means of assessing environmental fungal exposure or health effects
related to fungal exposure. Health care providers who care for persons
expressing concerns about the relationship of symptoms to potential exposure to
fungi are advised to use immunoassay results with care and only as an adjunct
to a comprehensive approach to patient care.
Author(s):
Douwes
J ; Pearce
N
Affiliation: Centre for Public Health Research, Massey
University-Wellington Campus, Wellington, New Zealand. j.douwes@massey.ac.nz
Title:
Invited commentary: is indoor mold exposure
a risk factor for asthma? Source: Am J Epidemiol (American journal of epidemiology.) 2003 Aug 1;
158(3): 203-6
No abstract available
Author(s):
Lin
RY ; Williams
KD
Affiliation: Department of Medicine, Saint Vincents Hospital, Manhattan,
USA.
Title: Hypersensitivity
to molds in New York City in adults who have asthma. Source: Allergy Asthma Proc (Allergy and asthma proceedings
: the official journal of regional and state allergy societies.) 2003
Jan-Feb; 24(1): 13-8
Abstract: Molds have been linked epidemiologically to asthma as a key aeroallergen
in several studies. Other allergens such as cockroach have been linked to
asthma in New York City (NYC). To our knowledge, however, the pattern of mold
hypersensitivity has never been examined systematically in the NYC area. Thus,
we sought to determine the association between mold hypersensitivity and asthma
in a large group of ambulatory patients evaluated for allergic disease for the
years 1993 through 2001 at a single medical center. Serological testing for
mold-specific immunoglobulin E (IgE) as well as IgE specific for other
aeroallergens was performed and the associations between allergen-specific IgE
and the presence of asthma were examined using bivariate and multivariate
analysis. Factor analysis showed that three distinct groupings of
aeroallergen-specific IgE existed within the panel of allergens used. Group 1
consisted of cat dander and dust mites (Dermatophagoides farinae). Group 2 consisted
of tree, grass, and ragweed pollen. Group 3 consisted of the Deuteromycetes
molds, Alternaria tenuis, Aspergillus fumigatus, and Cladosporium herbarum.
Patients with asthma had a highly significant increase in the incidence of
hypersensitivity to cat/dust mites and to the molds. Multivariate analysis
showed that the presence of hypersensitivity to either A. tenuis or C. herbarum
had a significant independent association with asthma after adjustment for
cat/dust mite hypersensitivity and after adjustment for other clinical factors.
On the other hand, pollen hypersensitivity was not associated independently
with asthma. Mold hypersensitivity was strongly correlated with
hypersensitivity to cat or dust mites in patients who did not have asthma but
not in patients who did have asthma. In the NYC area, recent pollen and spore
counts show that mold spores are measurable in at least 75% of the year. Thus
it is conceivable that mold hypersensitivity plays a contributing and
independent role in initiating or perpetuating the allergic response in
patients with asthma in the New York area.
Author(s):
Gent
JF ; Ren
P ; Belanger
K ; Triche
E ; Bracken
MB ; Holford
TR ; Leaderer
BP
Affiliation: Yale Center for Perinatal, Pediatric and Environmental
Epidemiology, Department of Epidemiology and Public Health, Yale University
School of Medicine, New Haven, Connecticut 06510, USA. janneane.gent@yale.edu
Title: Levels of
household mold associated with respiratory symptoms in the first year of life
in a cohort at risk for asthma. Source: Environ Health Perspect (Environmental health
perspectives.) 2002 Dec; 110(12): A781-6
Abstract: We assessed prospectively the risk of increased incidence of respiratory
symptoms after exposure to particular fungal genera in a susceptible
population--namely, infants (n = 880) at high risk for developing asthma. Days
of wheeze or persistent cough, information on maternal allergy and asthma,
socioeconomic variables, and housing characteristics were collected over the
course of the infant's first year of life. Exposure to mold was assessed by
airborne samples collected at one time early in the infant's life. Fungi were
identified to genus level, recorded as colony-forming units per cubic meter
(CFU/m3), and then categorized into four levels: 0 (undetectable), 1-499 CFU/m3
(low), 500-999 CFU/m3 (medium), and greater than or equal to 1,000 CFU/m3
(high). Effects of mold on wheeze and persistent cough, adjusting for potential
confounding factors, were examined with Poisson regression analyses. The two
most commonly found genera were Cladosporium (in 62% of the homes) and Penicillium
(41%). Cladosporium was associated with reported mold (p < 0.02) and water
leaks (p < 0.003). Rate of persistent cough was associated with reported
mold [Rate ratio (RR) = 1.49; 95% CI, 1.18-1.88]. The highest level of
Penicillium was associated with higher rates of wheeze (RR = 2.15; 95% CI,
1.34-3.46) and persistent cough (RR = 2.06; 95% CI, 1.31-3.24) in models
controlling for maternal history of asthma and allergy, socioeconomic status,
season of mold sample, and certain housing characteristics. We conclude that
infants in this high-risk group who are exposed to high levels of Penicillium
are at significant risk for wheeze and persistent cough.
Author(s):
Zock
JP ; Jarvis
D ; Luczynska
C ; Sunyer
J ; Burney
P
Affiliation: Respiratory and Environmental Health Research Unit, IMIM,
Dr Aiguader 80, E-08003 Barcelona, Spain. Corp Author: European
Community Respiratory Health Survey
Title: Housing characteristics,
reported mold exposure, and asthma in the European Community Respiratory Health
Survey. Source: J Allergy Clin Immunol (The Journal of allergy and clinical immunology.)
2002 Aug; 110(2): 285-92
Abstract: BACKGROUND: The effects of home dampness and mold exposure on adult
asthma are not clear. OBJECTIVE: We aimed to investigate the associations
between housing characteristics related to dampness, mold exposure, and house
dust mite levels and adult asthma in 38 study centers from the European
Community Respiratory Health Survey. METHODS: Data about the present home,
heating and ventilation systems, double glazing, floor covers, recent water
damage, and mold exposure were obtained by means of an interviewer-led
questionnaire. The associations between these factors and asthma, as defined on
the basis of symptoms in the last year, and of bronchial responsiveness, as
determined with methacholine challenge, were evaluated. Odds ratios (ORs) were
obtained by using random-effects meta-analyses adjusted within study centers
for sex, age group, and smoking status. RESULTS: Fitted carpets and rugs in the
bedroom were related to fewer asthma symptoms and bronchial responsiveness (OR
range, 0.69-0.91). This effect was consistent across centers and more pronounced
among house dust mite-sensitized individuals. Reported mold exposure in the
last year was associated with asthma symptoms and bronchial responsiveness (OR
range, 1.14-1.44). This effect was homogeneous among centers and stronger in
subjects sensitized to Cladosporium species. In centers with a higher
prevalence of asthma, the prevalence of reported indoor mold exposure was also
high. This association was observed for reported mold exposure by asthmatic
subjects (Spearman r (s) = 0.46), as well as reported mold exposure by
nonasthmatic subjects (r (s) = 0.54). Reported mold exposure was highest in
older houses with recent water damage. CONCLUSION: We conclude that indoor mold
growth has an adverse effect on adult asthma.
Author(s):
Jaakkola
MS ; Nordman
H ; Piipari
R ; Uitti
J ; Laitinen
J ; Karjalainen
A ; Hahtola
P ; Jaakkola
JJ
Affiliation: Finnish Institute of Occupational Health, Helsinki,
Finland. Maritta.Jaakkola@occuphealth.fi
Title: Indoor
dampness and molds and development of adult-onset asthma: a population-based
incident case-control study. Source: Environ Health Perspect (Environmental health
perspectives.) 2002 May; 110(5): 543-7
Abstract: Previous cross-sectional and prevalent case-control studies have
suggested increased risk of asthma in adults related to dampness problems and
molds in homes. We conducted a population-based incident case-control study to
assess the effects of indoor dampness problems and molds at work and at home on
development of asthma in adults. We recruited systematically all new cases of
asthma during a 2.5-year study period (1997-2000) and randomly selected
controls from a source population consisting of adults 21-63 years old living
in the Pirkanmaa Hospital district, South Finland. The clinically diagnosed
case series consisted of 521 adults with newly diagnosed asthma and the control
series of 932 controls, after we excluded 76 (7.5%) controls with a history of
asthma. In logistic regression analysis adjusting for confounders, the risk of
asthma was related to the presence of visible mold and/or mold odor in the
workplace (odds ratio, 1.54; 95% confidence interval, 1.01-2.32) but not to
water damage or damp stains alone. We estimated the fraction of asthma
attributable to workplace mold exposure to be 35.1% (95% confidence interval,
1.0-56.9%) among the exposed. Present results provide new evidence of the
relation between workplace exposure to indoor molds and adult-onset asthma.
Author(s):
Thorn
J ; Brisman
J ; Torén
K
Affiliation: Department of Environmental Medicine, Göteborg University,
Sweden.
Title: Adult-onset
asthma is associated with self-reported mold or environmental tobacco smoke
exposures in the home. Source: Allergy (Allergy.) 2001 Apr; 56(4): 287-92
Abstract: BACKGROUND: In recent years, we have gained better knowledge about the
influence of indoor environments on respiratory symptoms and asthma. The
purpose of this study was to examine certain exposures in the home environment
and the risk of adult-onset asthma. METHODS: A nested case-referent study of
adult-onset asthma was performed in a random population sample (n = 15813),
aged 20-50 years. Cases for the study included subjects reporting
"physician-diagnosed" asthma (n= 174). The referents (n = 870) were
randomly selected from the whole population sample. The case-referent sample
was investigated with a comprehensive mailed questionnaire about exposures in
the home environment, asthma, respiratory symptoms, smoking habits, and atopy.
Odds ratios (OR) with 95% confidence intervals (CI) were calculated while
controlling for age, sex, smoking, and atopy. RESULTS: Increased adjusted OR
for asthma were associated with exposure to molds (OR 2.2, 95%, CI 1.4-3.5),
environmental tobacco smoke (OR 2.4, 95%, CI 1.4-4.1), and the presence of a
wood stove (OR 1.7, 95% CI 1.2-2.5). CONCLUSIONS: This population-based
case-referent study indicates that self-reported domestic exposures to molds or
environmental tobacco smoke can be associated with adult-onset asthma.
Author(s):
Fung
F ; Tappen
D ; Wood
G
Affiliation: Sharp Rees-Stealy Medical Group and University of
California, San Diego, San Diego, California, USA. Title: Alternaria-associated asthma. Source: Appl Occup Environ Hyg (Applied occupational and
environmental hygiene.) 2000 Dec; 15(12): 924-7
Abstract: In addition to house dust mites, there is increasing evidence that mold
allergens, especially Alternaria, are implicated in contributing to allergic
reaction, rhinitis, and asthma indoors. Situations leading to the exacerbation
of asthma in an employee were investigated and subsequent medical evaluations
were performed. An industrial hygiene study was conducted and bioaerosol
testing revealed several mold allergens were present. However, based on the
medical evaluation and testing results (skin prick test and radioallergosorbent
test [RAST]), it was concluded that Alternaria was inducing the respiratory
reaction. Alternaria was present in the drip pan of the air conditioner unit
and remedial actions were taken to remove the mold. Post-remedial bioaerosol sampling
results revealed Alternaria was no longer present in the air and the employee
returned to the office without recurrence of symptoms. Practically, several
factors should be considered prior to concluding an association between
exposure and illness. First, the employee's symptoms and signs should be
consistent with a medical diagnosis. Second, there should be either in vitro or
in vivo evidence of exposure. Third, environmental assessment should reveal
evidence of plausible biological exposure. Fourth, there should be substantial
improvement or even resolution of the illness after appropriate remediation of
the health hazard. This case study illustrates the importance of teamwork by
industrial hygienists and occupational health physicians in treatment and
prevention of occupational and environmental diseases.
Author(s):
Ross
MA ; Curtis
L ; Scheff
PA ; Hryhorczuk
DO ; Ramakrishnan
V ; Wadden
RA ; Persky
VW
Affiliation: Office of Air Quality Planning and Standards, US
Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
Title: Association
of asthma symptoms and severity with indoor bioaerosols. Source: Allergy (Allergy.) 2000 Aug; 55(8):
705-11
Abstract: BACKGROUND: In this study, repeated measurements were made of levels of
mold spores, bacteria, and dust-mite allergens over a 7-month period in the
homes of asthmatics, and relationships with measures of asthma severity were
evaluated. METHODS: A sample of 57 asthmatic individuals, living in 44 homes in
East Moline, Illinois, and nearby communities, participated in a panel study.
The homes were visited up to nine times during the study to collect air and
dust samples. Asthma severity indicators were derived from questionnaire data
and from the daily health records from the panel study. Associations between
indoor levels of mold spores, bacteria, and dust-mite allergens were tested
with several asthma severity indicators. RESULTS: There was evidence of
associations between all asthma severity measures and levels of total and
gram-negative bacteria, but mold-spore abundance was associated only with
emergency room (ER) visits for asthma. No significant associations were found
with house-dust-mite allergen and any of the asthma severity indicators, but
the levels of dust-mite allergen were low, with median concentrations of 0.18
microg/g dust Der f 1 and 0.19 microg/g dust Der p 1. CONCLUSIONS: Some
evidence was found for associations of increased concentrations of
gram-negative bacteria and mold spores with asthma severity, particularly with
ER visits. No association was found between house-dust-mite allergen and asthma
severity indicators; however, the mite-allergen levels in the study homes were
generally well below the proposed threshold level of 2 microg/g dust.
Author(s):
Taskinen
T ; Hyvärinen
A ; Meklin
T ; Husman
T ; Nevalainen
A ; Korppi
M
Affiliation: Department of Paediatrics, Kuopio University Hospital,
Finland. Taina.Taskinen@ktl.fi
Title: Asthma and
respiratory infections in school children with special reference to moisture
and mold problems in the school. Source: Acta Paediatr (Acta paediatrica (Oslo, Norway : 1992)) 1999 Dec;
88(12): 1373-9
Abstract: AIM OF THE STUDY: Initially, we performed a questionnaire study on 622
school children aged 7 to 13 y. The study was supplemented with a clinical
study including skin prick tests to 13 molds in 212 (34%) children with
doctor-diagnosed asthma or parental-reported wheezing or prolonged cough. These
children were attending one of two elementary schools, one with moisture
problems (index) school, the other being the control school. The objective of
the study was to evaluate whether exposure to moisture and sensitization to
molds are associated with respiratory manifestations in school children.
RESULTS: The prevalence of asthma was 4.8%, which was similar in the children
from both schools. The children from the index school more often had wheezing
(16% vs 6%; p <0.001) and cough (21% vs 9%: p < 0.001) symptoms than
control children. Positive skin reactions to molds were rare (2.4%), being
present in 7% of asthmatic and in 1-2% of non-asthmatic children (NS). Lower
respiratory tract infections were more common in the spring than in the fall in
children from the index school, but not in control children, and the difference
between the schools was significant in emergency visits (OR =2.0, p <0.01)
and antibiotic courses (OR = 2.1, p < 0.01). CONCLUSIONS: We found evidence
of an association between moisture or mold problems in the school building and
the occurrence of respiratory infections, repeated wheezing and prolonged cough
in school children.
Author(s):
Jaakkola
JJ ; Jaakkola
N ; Ruotsalainen
R
Affiliation: Department of Public Health, University of Helsinki,
Finland.
Title: Home
dampness and molds as determinants of respiratory symptoms and asthma in
pre-school children. Source: J Expo Anal Environ Epidemiol (Journal of exposure analysis
and environmental epidemiology.) 1993; 3 Suppl 1: 129-42
Abstract: The objective of our study was to assess the occurrence of respiratory
symptoms in relation to dampness and molds in dwellings in pre-school children.
A population-based cross-sectional study was carried out by mailing a
parent-administered questionnaire to a random sample of children in a source
population consisting of all children aged 1 to 6 years of Espoo, an
urban-suburban city (pop. 170,000) in the Helsinki metropolitan area. The study
population included a total of 2568 children whose parents filled the
questionnaire (response rate 80%). Included were questions on respiratory
health, partly modified from ATS-DLD-78-C questionnaire, and potential personal
and environmental determinants of the outcome. The determinants of interest
were histories of water damage, presence of moisture and visible molds and
perceived mold odor at home. The outcomes included persistent cough, phlegm and
wheezing, persistent nasal congestion and excretion during the past 12 months
and current asthma. The determinant-outcome relations were estimated in the
logistic regression controlling for age, gender, parents' education, single
parent or guardian, environmental tobacco smoke, gas cooking, pets and type of
day care. The occurrence of persistent cough (OR 2.17; 95% CI 1.39, 3.39),
phlegm (2.20; 1.27, 3.82), wheezing (2.62; 1.39, 4.39), nasal congestion (1.94;
1.15, 4.98), and nasal excretion (1.43; 0.95, 2.17) during the past year were
higher with the presence of any determinant, but the occurrence of asthma (OR
1.10; 0.54, 2.24) was similar compared to the reference group. Mold odor during
the past year (ORs from 2.38 to 6.87) and water damage over a year ago (ORs
from 2.54 to 8.67) had the strongest association with the respiratory symptoms.
A dose-response relation of the occurrence of the symptoms associated with the
frequency of days with mold odor was observed. There was also a compatible time
sequence between water damage taking place more than a year ago and the
occurrence of symptoms during the past year. The results provide further
evidence on the importance of home dampness and molds in the etiology of
respiratory symptoms and new information on the role of mold odor as a risk
indicator.
Author(s):
Gottlieb
SJ ; Garibaldi
E ; Hutcheson
PS ; Slavin
RG
Affiliation: Division of Allergy and Immunology, St Louis University
School of Medicine, MO 63104-1028.
Title: Occupational
asthma to the slime mold Dictyostelium discoideum. Source: J Occup Med (Journal of occupational
medicine. : official publication of the Industrial Medical Association.)
1993 Dec; 35(12): 1231-5
Abstract: Dictyostelium discoideum is a slime mold that exists in a unicellular
amoeboid form under certain nutritional conditions. In this form, it produces unique
lysosomal enzymes that are valuable in studying cell-to-cell signaling systems.
We report on a research microbiologist who developed rhinoconjunctivitis and
asthma after release of D. discoideum from a pressurized canister. Immediate
skin test reactivity was demonstrated to whole and lysed organisms.
Enzyme-linked immunosorbent assay results revealed IgE antibody against D.
discoideum whole organism, lysed organism, and lysosomal enzymes with the
strongest response being directed toward lysosomal enzymes. Pulmonary function
testing showed a decline in forced expiratory volume in 1 second and forced
expiratory flow after modified laboratory exposure to D. discoideum. This case
represents the first report of occupational rhinoconjunctivitis and asthma from
slime mild.
General Dust Mites Animals Cockroach Fungus and Molds Construction Materials
Author(s): Tuomainen
A ; Seuri
M ; Sieppi
A
Affiliation: Department of Occupational Hygiene and Toxicology, Kuopio
Regional Institute of Occupational Health, POB 93, 70701 Kuopio, Finland.
anneli.tuomainen@ttl.fi
Title: Indoor air
quality and health problems associated with damp floor coverings. Source: Int Arch Occup Environ Health (International archives of
occupational and environmental health.) 2004 Apr; 77(3): 222-6
Abstract: OBJECTIVES: To study the
relationship between a high incidence of bronchial asthma among employees
working in an office building and an indoor air problem related to the
degradation of polyvinyl chloride (PVC) floor coverings in the building. The
indoor air measurements and results of renovations are also described. METHODS:
Employees' symptoms were surveyed by a questionnaire, and the incidence of
asthma was calculated from the medical records for 1997-2000. The quality of
indoor air was assessed by microbial sampling and by investigation of the
building for possible moisture damage. Indoor air was sampled for volatile
organic compounds (VOCs) through Tenax adsorbent tubes. In situ volatile
emission measurements from the concrete floor were performed via the field and
laboratory emission cell (FLEC) method. RESULTS: In an office with
approximately 150 employees, eight new cases of asthma were found in 4 years.
In addition, the workers complained of respiratory, conjunctival and nasal
symptoms. Emissions indicating the degradation of plastic floor coverings (e.g.
2-ethyl-1-hexanol, 1-butanol) were found in the indoor air and floor material
samples. The plastic floor coverings, adhesives and the levelling layers were
carefully removed from 12 rooms. The VOCs had diffused into the underlying
concrete slabs. The concrete was warmed to remove the diffused VOCs from these
areas. After the repairs the concentrations of the VOCs indicating the
degradation of PVC, decreased, as did the prevalence of the employees' symptoms
and several asthma patients' need for medication. CONCLUSIONS: The workers in
the office building complained of several respiratory, conjunctival and dermal
symptoms. The incidence of adult-onset asthma was approximately nine-times
higher than that among Finns employed in similar work. The most probable single
cause of the indoor air problem was the degradation of the plastic floor
coverings.
Author(s):
Wieslander
G ; Norbäck
D ; Björnsson
E ; Janson
C ; Boman
G
Affiliation: Department of Occupational and Environmental Medicine,
Uppasala University, University Hospital, Sweden.
Title: Asthma and the
indoor environment: the significance of emission of formaldehyde and volatile
organic compounds from newly painted indoor surfaces. Source: Int Arch Occup Environ Health (International archives of
occupational and environmental health.) 1997; 69(2): 115-24
Abstract: As a part of the worldwide European Community Respiratory Health Survey,
possible relations between asthma and emissions from newly painted indoor
surfaces were studied. The participants (n = 562) answered a self-administered
questionnaire, with questions on symptoms and indoor exposures, including
indoor painting, during the last 12 months. The participants also underwent a
structured interview, spirometry, peak flow measurements at home (PEF),
methacholine provocation test for bronchial hyper-responsiveness (BHR), and
skin prick tests. In addition, serum concentration of eosinophilic cationic
protein (S-ECP), blood eosinophil count (B-EOS), and total immunoglobulin E
(S-IgE) were measured. Current asthma was defined as a combination of BHR and
at least one asthma-related symptom (wheezing and attacks of breathlessness).
The information gathered on indoor painting was compared with exposure
measurements of formaldehyde and volatile organic compounds (VOC) performed in
a selected sample of the dwellings (n = 62). Relations between exposures,
asthma and clinical signs were calculated by multiple linear or logistic
regression, adjusting for possible influence of age, gender and tobacco
smoking. The prevalence of asthma was increased among subjects with domestic
exposure to newly painted surfaces (OR = 1.5; 95% CI 1.0-2.4), particularly
newly painted wood details (OR = 2.3; 95% CI 1.2-4.5) and kitchen painting (OR
= 2.2; 95% CI 1.1-4.5). Moreover, blood eosinophil concentrations were
significantly elevated among subjects living in newly painted dwellings. A
significantly increased prevalence of symptoms related to asthma, but not BHR,
was observed in relation to workplace exposure to newly painted surfaces. The
indoor concentration of aliphatic compounds (C8-C11), butanols, and
2,2,4-trimethyl 1,3-pentanediol diisobutyrate (TXIB) was significantly elevated
in newly painted dwellings. The total indoor VOC was about 100 micrograms/m3
higher in dwellings painted in the last year. A significant increase in
formaldehyde concentration was observed in dwellings with newly painted wood
details. Our results indicate that exposure to chemical emissions from indoor
paint is related to asthma, and that some VOCs may cause inflammatory reactions
in the airways. To improve asthma management, and to counteract the increasing
frequency of asthma, the significance of the indoor environment should not be
neglected. Our study suggests that the contribution of emissions from paint to
indoor concentrations of formaldehyde and VOCs should be as low as possible.
Author(s):
Jaakkola
JJ ; Parise
H ; Kislitsin
V ; Lebedeva
NI ; Spengler
JD
Affiliation: Institute of Occupational Health, The University of
Birmingham, Edgbaston, Birmingham, UK. j.jaakkola@bham.ac.uk Title: Asthma, wheezing, and allergies in Russian schoolchildren
in relation to new surface materials in the home. Source: Am J Public Health (American journal of public
health.) 2004 Apr; 94(4): 560-2
Abstract: In a cross-sectional study of 5951 Russian 8-12-year-old schoolchildren,
risks of current asthma, wheezing, and allergy were related to recent
renovation and the installation of materials with potential chemical emissions.
New linoleum flooring, synthetic carpeting, particleboard, wall coverings, and
furniture and recent painting were determinants of 1 or several of these 3
health outcomes. These findings warrant further attention to the type of
materials used in interior design.
Author(s):
Dietemann-Molard
A ; Kopferschmitt-Kubler
MC ; Meyer
PD ; Tomb
R ; Pauli
G Title: Allergic
asthma due to domestic use of insulating polyurethane foam. Source: Lancet (Lancet.) 1991 Oct 12;
338(8772): 953
No abstract available.
Author(s):
Baldwin
CM ; Bell
IR ; O'Rourke
MK
Affiliation: Respiratory Sciences Center, University of Arizona, Tucson,
USA. carolb@resp-sci.arizona.edu
Title: Odor
sensitivity and respiratory complaint profiles in a community-based sample with
asthma, hay fever, and chemical odor intolerance. Source: Toxicol Ind Health (Toxicology and industrial
health.) 1999 Apr-Jun; 15(3-4): 403-9
Abstract: This is a community-based study of odor sensitivity and respiratory
complaints for persons reporting asthma (n = 14/141), hay fever (n = 72/140),
and chemical odor intolerance (CI) (n = 41/181). CI, a symptom of multiple
chemical sensitivity (MCS), was determined from self-ratings of feeling
'moderately' to 'severely' ill using the Chemical Odor Intolerance Index (CII).
Index odors included perfume, pesticide, drying paint, new carpet odor, and car
exhaust. Six additional odors [natural gas, disinfectants, chlorinated water,
room deodorizers, and environmental tobacco smoke (ETS)] were also assessed in
the health and environment survey. Asthmatics reported feeling 'frequently' to
'almost always' ill from the CII index odors of drying paint, new carpet odor,
perfume, and cleaning agents compared to nonasthmatics. People with hay fever
documented feeling 'frequently' to 'almost always' ill from pesticides, drying
paint, and car exhaust compared to individuals without hay fever. The CI cited
illness from air freshener, natural gas and chlorinated water, in addition to
the index odors of perfume, paint, pesticides, new carpeting and auto exhaust.
All three groups were significantly more likely to report feeling ill from ETS.
People with asthma were significantly more likely to report lower lung
complaints, such as wheeze and dyspnea. People with hay fever cited more chest
tightness. The CI were significantly more likely to report upper and lower
respiratory symptoms. Given this overlap in respiratory complaints, it could be
that CI may serve to amplify these traditional immune-related disorders and/or
suggest that having asthma or hay fever could make one more vulnerable to CI.
Author(s):
Krone
CA ; Klingner
TD ; Ely
JT
Affiliation: Applied Research Institute, Palmerston North, New Zealand.
Title: Polyurethanes
and childhood asthma. Source: Med Sci Monit (Medical science monitor : international medical journal
of experimental and clinical research.) 2003 Dec; 9(12): HY39-43
Abstract: BACKGROUND: Asthma is the most common chronic disease of children. Its prevalence in affluent nations has steadily and dramatically increased in recent decades. Genetic and environmental factors play a role in development of atopy and asthma. Imbalance in the immune system favoring respiratory diseases has been linked to exposure to environmental stressors (e.g, biological and chemical) very early in life. Isocyanates, used in the production of polyurethane, can elicit asthma and produce immune responses (e.g, antibodies, cytokines, etc.) typical of atopy. MATERIAL/METHODS: Numerous medical materials that directly contact human neonates are constructed of polyurethanes. A detailed survey and listing of such materials was undertaken in the neonatal unit of a large urban hospital. Representative samples of polyurethane-containing materials were tested for isocyanate residues using a semi-quantitative colorimetric method. RESULTS: Isocyanate residues were detected in wound dressings, adhesive films, oximetry sensors, etc, that directly contact neonatal skin. CONCLUSIONS: Dermal exposure to polyurethane and, thus, to isocyanates could occur early in life through contact with medical materials. In an animal model, dermal exposure to isocyanates leads to dermal sensitization and asthma. We postulate that dermal contact with polyurethane-containing medical materials may be involved in dysregulation of the neonatal immune system and could predispose infants to the development of childhood asthma.
General Dust Mites Animals Cockroach Fungus and Molds Construction Materials
Author(s):
Anderson
RC ; Anderson
JH
Affiliation: Anderson Laboratories, Inc., West Hartford, Vermont, USA.
Title: Acute
respiratory effects of diaper emissions. Source: Arch Environ Health (Archives of environmental
health.) 1999 Sep-Oct; 54(5): 353-8
Abstract: Mice were monitored with
pneumotachographs while they breathed emissions of three brands of disposable diapers
(described herein as brands A, B, and C) and one brand of cloth diapers for 1
hr. The authors used a computerized version of the ASTM-E-981 test method to
measure changes in the pattern and frequency of respiration. In response to two
brands of disposable diapers, many mice exhibited reduced mid-expiratory
airflow velocity, sensory irritation, and pulmonary irritation. During the peak
effects, brand A caused sensory irritation in 47% of the breaths and reduced
mid-expiratory airflow velocity in 17% of the breaths (n = 39 mice), whereas
the respective percentages noted for brand B were 20% and 15% of the breaths (n
= 28 mice). The effects were generally larger during repeat exposures to these
emissions, with up to 89% of breaths showing sensory irritation in response to
brand A and up to 35% of breaths showing reduced mid-expiratory airflow
velocity with brand B. A third brand of disposable diapers caused increases in
respiratory rate, tidal volume, and mid-expiratory airflow velocity. The
emissions of cloth diapers produced only slight SI and slight PI. Chemical
analysis of the emissions revealed several chemicals with documented
respiratory toxicity. The results demonstrate that some types of disposable
diapers emit mixtures of chemicals that are toxic to the respiratory tract.
Disposable diapers should be considered as one of the factors that might cause
or exacerbate asthmatic conditions.
Author(s):
Mapp
CE ; Pozzato
V ; Pavoni
V ; Gritti
G
Affiliation: Dept of Environmental Medicine and Public Health,
University of Padua, Italy.
Title: Severe asthma
and ARDS triggered by acute short-term exposure to commonly used cleaning
detergents. Source: Eur Respir J
(The European respiratory journal : official journal of the European Society
for Clinical Respiratory Physiology.) 2000 Sep; 16(3): 570-2
Abstract: This report presents a case of severe asthmatic attack and adult respiratory distress syndrome, which occurred in an asthmatic subject following acute short-term exposure to commonly used cleaning detergents. Premorbid lung conditions, i.e. asthma and airway hyperresponsiveness, might have been risk factors for illness severity but not for persistent complaints. This case report indicates that nonindustrial exposures due to household product misuse, especially to mixing cleaning agents, may cause adult respiratory distress syndrome and not only irritant-induced asthma.