Effects of house dust mite avoidance measures on Der p 1 concentrations and clinical condition of mild adult house dust mite-allergic asthmatic patients, using no inhaled steroids

BACKGROUND

Exposure to house dust mite (HDM) allergens often results in worsening of asthma. Therefore, avoidance of exposure to HDM allergens is often proposed. Unfortunately, the most effective and feasible avoidance strategy is still not completely assessed. Consequently, we investigated the effects of a combined HDM avoidance strategy on HDM allergen concentrations and clinical condition of allergic, mild asthmatic, patients using no inhaled steroids.

METHODS

Asthmatic patients, allergic to HDM, using no inhaled corticosteroids, were randomly allocated to an active (n = 76) or a placebo allergen-avoidance group (n = 81). Avoidance measures consisted of applying Acarosan(R) (placebo: water) to the living room and bedroom floors, and the use of HDM-impermeable covers for mattresses and bedding (placebo: cotton covers for mattresses only). Effects on allergen concentrations (Der p 1), FEV1, bronchial hyperresponsiveness, peak flow parameters and asthma symptom scores were studied during 20 weeks and controlled for the allergic status of the patients.

RESULTS

The active covers reduced Der p 1 concentrations to 9.4% (P = 0.0001), and were always significant lower than in the placebo group (P = 0.0002). Acarosan(R) resulted in slight but significant decreases (twofold, P = 0.0001), both on living room and bedroom floors, but concentrations were never significantly lower than the placebo group. Although the combined avoidance strategy resulted in a considerable reduction in allergen load in the active group, no differences were seen between the two groups in any of the clinical parameters during the follow-up period in this group of allergic asthmatics, using no inhaled corticosteroids. Corrections for the allergic status did not alter these results.

CONCLUSIONS

The combined avoidance strategy was effective in reducing HDM allergen concentration. This was especially achieved by the allergen-impermeable covers, while the effects of Acarosan(R) were only marginal. However, this allergen reduction was not reflected in a convincing improvement in clinical condition in this group of mild allergic asthmatics, using no inhaled steroids. Perhaps, a longer follow-up period would have resulted in more pronounced effects.

[Studies on appropriate methods for dust scrubbing from dust-laden gas in shaft kilns of small-sized cement plants]

OBJECTIVE

To study an appropriate method for dust scrubbing from dust-laden gas in the shaft kilns of small-sized cement plants.

METHODS

Characteristics of dust-laden gas, including its temperature, dew point, dust concentration, diameters of dust particles and their distribution, as well as fractional dust collection efficiencies of the dust precipitator settling chamber, cyclone, impinging scrubber, impinging-spray scrubber, were measured according to the National Standards for Measurement of Particulate in Exhaust Gas Emitted from the Stationary Pollution Sources and Sampling Methods of Gaseous Pollutants (GB/T16157 - 1996), with a WY-1 In-stack 7-Stage Cascade Impactor for fractional dust collection.

RESULTS

The fractional dust collection efficiency of the settling chamber for the particles greater than 12 microm was 72%, while that of the cyclone for the particles of 2 microm, 5 microm and 10 microm were 40.0%, 72.5% and 88.9%, respectively, and that of impinging scrubber was 55.0%, 91.0% and 98.9%, respectively; and that of impinging-spray scrubber were 96.0%, 99.2% and 99.6%, respectively. Results showed that 81% of the dust (by weight) from the shaft kilns were greater than 10 microm, so the settling chamber was effective for the removal of this fraction of dust. But dust particles behind the settling chamber were finer, and about 59% - 69% of them were less than 2 microm in diameters. In that case, the cyclone, impinging scrubber and impinging-spray scrubber could give an overall collection efficiency of 54%, 57% and 96%, respectively. Based on this, the following combination of dust collectors were adopted to meet the national standards for exhaust emission: a settling chamber plus an electrostatic precipitator, a settling chamber plus an impinging-spray scrubber and a settling chamber plus an impinging scrubber. The cement plants could select appropriate dust collectors according to their technical and economical conditions.

CONCLUSION

Based on the results of the studies, appropriate dust collectors used to treat dust-laden gas from shaft kilns to meet the national standards for exhaust emission were recommended.

Primary prevention of childhood lead exposure: A randomized trial of dust control

BACKGROUND

Dust control is recommended as one of the primary strategies to prevent or control children's exposure to residential lead hazards, but the effect of dust control on children's blood lead levels is poorly understood.

OBJECTIVE

To determine the effectiveness of dust control in preventing children's exposure to lead, as measured by blood lead levels, during their peak age of susceptibility.

DESIGN

A randomized, controlled trial.

SETTING

Rochester, NY.

PARTICIPANTS

A total of 275 urban children were randomized at 6 months of age, of whom 246 (90%) were available for the 24-month-old follow-up visit.

INTERVENTIONS

Children and their families were randomly assigned to an intervention group (n = 140), which received cleaning equipment and up to eight visits by a dust control advisor, or a control group (n = 135).

OUTCOME MEASURES

Geometric mean blood lead levels and prevalence of elevated blood lead levels (ie, >10 microg/dL, 15 microg/dL, and 20 microg/dL).

RESULTS

At baseline, children's geometric mean blood lead levels were 2.9 microg/dL (95% confidence interval [CI] = 2.7, 3.1); there were no significant differences in characteristics or lead exposure by group assignment, with the exception of water lead levels. For children in the intervention group, the mean number of visits by a dust control advisor during the 18-month study period was 6.2; 51 (36%) had 4 to 7 visits, and 69 (49%) had 8 visits. At 24 months of age, the geometric mean blood lead was 7.3 microg/dL (95% CI = 6.6, 8.2) for the intervention group and 7.8 microg/dL (95% CI = 6.9, 8. 7) for the control group. The percentage of children with a 24-month blood lead >/=10 microg/dL, >/=15 microg/dL, and >/=20 microg/dL was 31% versus 36%, 12% versus 14%, and 5% versus 7% in the intervention and control groups, respectively.

CONCLUSIONS

We conclude that dust control, as performed by families and in the absence of lead hazard controls to reduce ongoing contamination from lead-based paint, is not effective in the primary prevention of childhood lead exposure.

Growth performance, carcass characteristics, and the incidence of ascites in broilers in response to feed restriction and litter oiling

The effect of feed restriction and the application of canola oil to broiler straw litter to contain respirable dust on growth performance, carcass traits, and the incidence of ascites was evaluated with 800 male broilers studied in two 6-wk periods. Two pens of birds were feed restricted. Two pens of birds received feed ad libitum for the 6-wk trial. One restricted and one ad libitum pen received biweekly addition of canola oil to the litter. At 6 wk of age, 30 birds from each pen were killed for determination of breast muscle, fat pad, and heart weights. All birds were scored for the incidence of ascites at processing. A cross sectional image of each heart was digitally recorded and, using image analysis, the right ventricular area (RVA), left ventricular area (LVA), and total heart area (HA) were determined. The right ventricular wall was removed and its weight was expressed as a percentage of total heart weight (PRVW). The 40-d BW was significantly greater in the ad libitum birds (2.07 kg) than in the feed-restricted birds (1.86 kg). The right ventricular weight (RVW) (1.69 and 1.92 g) and the RVA (0.35 and 0.40 cm2) were also significantly different between the two feeding treatments. The ascites score was significantly correlated to the RVW (r = 0.50) and RVA (r = 0.52). The RVA was also correlated to the RVW (r = 0.63). Oiling the litter did not result in differences in carcass characteristics. Litter oiling significantly reduced the RVA of the ad libitum birds (0.36 cm2) compared to the ad libitum birds that did not have oiled litter (0.44 cm2). Feed restriction reduced the incidence of ascites, but also reduced gain. Litter oiling in the feed-restricted groups reduced the RVA, but did not reduce mortality.

The effect of dust lead control on blood lead in toddlers: a randomized trial

BACKGROUND

Contaminated household dust is believed to be a major source of exposure for most children with elevated blood lead levels. To determine if a vigorous dust clean-up effort would reduce this exposure we conducted a randomized controlled field trial.

METHODS

We randomized 113 urban children between the ages of 6 and 36 months: 56 children to a lead dust intervention composed of maternal education and biweekly assistance with household cleaning and 57 children to a control group. Household cleaning was done by two trained lay workers who focused their efforts on wet mopping of floors, damp-sponging of walls and horizontal surfaces, and vacuuming with a high-efficiency particle accumulating vacuum. Household dust lead levels, child blood lead levels, and maternal knowledge of lead poisoning and sources of exposure were measured before and after the intervention.

RESULTS

Ninety-nine children were successfully followed for 12 +/- 3 months: 46 children in the lead group and 53 children in the control group. Age and blood lead were similar in the two groups at baseline and averaged 20 months and 12.0 micrograms/dL, respectively. Blood lead fell 17% in the intervention group and did not change among controls. Household dust and dust lead measures also fell significantly in the intervention group. Children in homes cleaned 20 or more times throughout the year had an average blood lead reduction of 34%.

CONCLUSIONS

Regular home cleaning, accompanied by maternal education, is a safe and partially effective intervention that should be recommended for the large majority of lead-exposed children for whom, unfortunately, removal to lead-safe housing is not an option.

Dustiness of chopped straw as affected by lignosulfonate as a dust suppressant

Many sources add to the concentration of bioaerosols in livestock buildings, and source control is the number one priority for keeping a low concentration. Straw is a common but dusty bedding material in livestock buildings and the present study is focused on the dustiness of chopped straw (barley) as affected by lignosulfonate (LS) as a dust suppressant. A LS-solution was aerosolized in a spray chamber fitted to an existing bedding chopper to allow the chopped straw to adsorb the LS-solution. The dustiness of straw treated with LS was compared to non-treated straw. As storage conditions may affect dustiness, the study included treated straw kept for 4 weeks in sealed plastic bags. Dustiness of the chopped straw was measured in terms of the potential of the straw to emit bioaerosols in a rotating drum. The LS-treated straw proved low in dustiness compared to the non-treated straw. The dustiness with respect to the mass of dust was reduced by at least a factor of 6, and for fungi and endotoxin the factors of reduction were 4 and 3, respectively. Dustiness of LS-treated straw kept in plastic bags was reduced by a factor of 2 for mass of dust and by a factor of 4 for endotoxin, but dustiness for fungi was increased by a factor of 3. It is concluded that lignosulfonate has potential as a dust suppressant for chopped straw.

[Sawdust in autopsies: production, spreading, and contamination]

Airborne infections are well known in clinical medicine (transport of bacteria by aerosols). During autopsies floating, respirable kinds of bone dust are produced, depending on the type of saw. Experiments were carried out with oscillating saws (without/with exhauster) and manual saws (autopsy of cranial cavity). The intention was to characterize and quantify the sawdust produced by the different saws. Furthermore, we wanted to find out whether bacteria are transported by these aerosols. Bone dust was collected with adhesive microscopic slides. Alizarin red was used for solid histochemistry of bone particles. Quantification was carried out by an eyepiece micrometer. Airborne particles and bacteria were identified macroscopically per unit of time. The oscillating saw without exhauster produced sawdust in large quantities. This dust was respirable and had suspension power for hours. There was a remarkable reduction of sawdust by an integrated exhauster. Spreading of particles carrying bacteria/saccharomycetes was seen over 6-8 m. There is a very low risk of an airborne infection when utilizing a manual saw (production of particles similar to chippings, absence of suspended sawdust). It is necessary to take every precaution against airborne infections by wearing breathing masks and safety goggles when using an oscillating saw.

New concepts in air abrasion

There is no doubt that air abrasion is going to be part of the millennial shift in dentistry away from traditional treatment modalities. With the change in incidence and morphology of caries as a result of the hardening effect of fluoride on enamel, this ability to remove only decayed areas and permanently seal the less susceptible areas becomes increasingly desirable.

Effect of interventions on children's blood lead levels

Trail, Canada, has been the site of an active lead/zinc smelter for nearly a century. Since 1991, the Trail Community Lead Task Force has carried out blood lead screening, case management, education programs targeted at early childhood groups and the general community, community dust abatement, exposure pathways studies, and remedial trials. From 1989 through 1996, average blood lead levels of children tested for the first time declined at an average rate of 0.6 microg/dl/year, while blood lead levels in Canadian children not living near point sources appeared to be leveling off following the phase-out of leaded gasoline. Since there was no concurrent improvement in local environmental conditions during this time, it is possible that the continuing decline in Trail blood lead levels has been at least partly due to community-wide intervention programs. One year follow-up of children whose families received in-home educational visits, as well as assistance with home-based dust control measures, found that these specific interventions produced average blood lead changes of +0.5- -4.0 microg/dl, with statistically significant declines in 3 years out of 5. Education and dust control, particularly actions targeted toward higher risk children, appear to have served as effective and appropriate interim remedial measures while major source control measures have been implemented at the smelter site.

Dust control for material handling operations: a systematic approach

Material handling operations are used widely in industry. Often they produce unacceptable levels of dust. This article proposes a systematic approach to dust control for material handling operations. It focuses on the appropriate dust control technologies for the wide range of material handling operations. Both dust collection and dust suppression systems are considered. Comparisons are made between competing technologies using available information. Relevant literature resources are compiled and synthesized to provide the reader with the most recent design and operational information. Important areas requiring further research and development work are identified.

Positive human health effects of dust suppression with canola oil in swine barns

A crossover trial was conducted to evaluate the acute human health effects of a dust control technology in a swine confinement facility. Twenty lifetime nonsmoking male subjects, with no evidence of allergy or asthma and no previous swine barn exposure, participated in the study, which included a laboratory session (baseline), 5-h exposure in a swine room sprinkled with canola oil (treatment) and 5-h exposure in a traditional swine room (control). Mean values of inhalable dust concentrations and endotoxin levels in the control room were significantly greater than those observed in the treatment room. Mean shift changes in FEV1 from preexposure to end of exposure were 1.1% (standard error, 0.63%) on baseline day, -1.9% (0.63%) on treatment day, and -9.9% (1.12%) on control day; the differences in the shift changes were statistically significant. Mean value of methacholine concentration that reduced the FEV1 by 20% (PC20) in bronchoprovocation tests on baseline day was significantly different from that on treatment day (p = 0.04) and that on control day (p < 0.001). Significant increases were also observed in white blood cell counts and nasal lavage cell counts on the control day in comparison with the other two days. Blood neutrophil counts after control room exposure were twice those observed on baseline and after exposure to the treatment room. Significant differences were also observed in IL-1 beta, IL-6, and IL-8 nasal lavage cytokines and in IL-6 serum cytokine. These results suggest that the canola oil dust control method is effective in improving indoor air quality in swine barns and reducing acute health effects in naive healthy subjects.

The link between silica dust levels, risk assessments, and regulations

Improvements in workplace health among silica exposed workers followed demonstrations of the severity of the risk of silicosis and means of controlling high dust levels on the job. Current ambient environmental analyses include either an adoption of air quality goals for reducing emissions of criteria pollutants or the conduct of risk assessments to determine if regulatory procedures are needed. Although silica has been regulated as a workplace hazard for most of the 20th century, only recently has it been considered for ambient control, and most of the thrust for this action has evolved from environmental regulatory work in California, where both state initiative (Proposition 65) and legislative law (Air Toxics Hot Spots Information and Assessment Act; Assembly Bill number 2588) have required risk assessments for silica dust emissions as carcinogens.

Improved nasal clearance among pulp-mill workers after the reduction of lime dust

OBJECTIVES

The purpose of this study was to investigate nasal symptoms and function among workers exposed to lime dust and to determine if a reconstruction of the workplace improved the worker's nasal health.

METHODS

In 1992, pulp-mill workers (N = 15) exposed to lime dust and an equal number of matched unexposed referents were examined by questionnaires, nasal peak expiratory flow, the saccharin test, nasal lavage, and a clinical examination of the upper airways. The study was repeated one year later, after the pulp mill had been rebuilt. Dust levels were measured on both occasions with stationary and personal samplings.

RESULTS

In 1992 the total dust level was 1.2 mg.m-3. The saccharin test showed a significantly increased nasal transit time for the exposed workers in comparison with that of the unexposed referents (difference 3.5 min, 95% confidence interval 0.1-6.9 min). One year later the dust levels had decreased to 0.1 mg. m-3, and the difference in nasal transit time had decreased (difference- 0.8 min, 95% confidence interval -4.8-3.3 min).

CONCLUSIONS

Workers exposed to lime dust have an impaired mucociliary function. This impairment is probably due to the alkalinity of the lime. When dust levels are reduced, mucociliary function improves; therefore renovating a workplace to reduce dust levels has a positive effect.

The respiratory effects of reduction of mite allergen in the bedrooms of asthmatic children--a double-blind controlled trial

BACKGROUND

Inhalation of house dust mite (HDM) allergen may provoke attacks of asthma.

OBJECTIVE

We investigated whether a double-blind placebo-controlled community-based study aimed at reducing the HDM allergens in the bedrooms of HDM sensitive asthmatic children using the best methods available would prove beneficial to the children's health.

METHODS

The children (mean age 9.9 years, 34 boys) were recruited by a questionnaire submitted to 7386 families in a geographically-defined area of the UK. Subjects were chosen to take part in the double-blind placebo-controlled trial if they were asthmatic, skin sensitive to mites, and had mite allergen in their mattresses. Seventy children were randomly allocated to groups. In the active group, the children's bedrooms were treated with an acaricide (Acarosan) and the mattresses, pillows and duvets were encased in exclusion covers. The control group received placebo treatments.

RESULTS

Forty-nine complete data sets were obtained. Applying bedding covers and Acarosan led to a median reduction of 480 ng (100%) in mite allergen on the mattress vs 215 ng (53%) reduction in placebo-treated group by 6 weeks. No evidence was found that the acaricide reduced mite allergen level. A change in bronchial reactivity to histamine was observed in the children after 6 weeks. This was not associated with any change in thrice-daily records of peak expiratory flow rate. By 24 weeks, the actively-treated children had improved forced expiratory volume in 1s (FEV1) and fewer required bronchodilator therapy or reported asthmatic symptoms than did the controls.

CONCLUSIONS

The results suggest that mite removal procedures may modestly improve mite-sensitive asthmatics and could perhaps be of value in exceptionally mite-sensitive and/or highly mite-exposed individuals whose response to the attempted removal should be measured.

A combined approach to reduce mite allergen in the bedroom

BACKGROUND

Asthma is a common chronic disease of childhood. House dust mite (HDM) are known to be a major source of allergen affecting atopic asthmatics. No single control method has been demonstrated to consistently reduce asthma.

OBJECTIVE

We investigated the effect of a combination of two methods of HDM allergen control on HDM allergen content in the bedding and carpets of asthmatic children.

METHODS

This was a double-blind placebo-controlled trial treating the bedrooms of 56 mite-sensitive asthmatic children. The carpet and the mattress, duvet and pillows (bedding) in the bedroom of children of the active group were treated with the acaricide Acarosan (benzyl benzoate). The bedding was then encased in vapour permeable waterproof fabric (Intervent--cotton coated with polyurethane) for 24 weeks. The carpet and bedding of the control group were treated with placebo and the bedding encased in cotton covers for 24 weeks. Dust samples were collected from all these items in a standard manner at regular intervals and Der p I content analysed.

RESULTS

The group with active treatment had a median reduction of 480 ng (100%) in mite allergen from the mattress vs 215 ng (53%) reduction in placebo-treated group by 6 weeks. The Der p I content of the active group's bedding was always less than the placebo group after treatment (P < 0.01). The acaricide applied to the carpets or inside the mattress covers was ineffective in reducing allergen content.

CONCLUSION

This study confirms the effectiveness of encasing covers in reducing the mite allergen exposure but indicates there is no further advantage in applying acaricide simultaneously.

Atopy and reaction to nail dust inhalation

Inhalation of nail dust is a chronic problem facing podiatric physicians. This problem is compounded in physicians who develop allergic reactions to nail dust. This article defines atopy, reviews the characteristics of nail dust, and suggests methods to reduce the potential hazard that nail dust presents to the podiatric physicians and their employees.

Processing of samples

The Good Laboratory Practice (GLP) Processing Program at Texas A&M University provides a service that encompasses research and pilot scale processing of raw agricultural commodities while conforming to the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA), 40 CFR, Part 160. A general overview of a typical processing study is presented to include preliminary discussions with the study director, sample and protocol receipt, sample processing, fraction shipment, and processing report disposition. Atypical situations are also introduced to stress the need for improved communication and organization within the agrochemical industry. Examples of processed fractions are presented to clarify better the role of the processor in the chemical registration process. To describe the versatility required within this segment of the registration process, a new processing procedure is introduced.

Measurements of the effectiveness of dust extraction systems of hand sanders used on wood

An investigation has been made of the production of dust by hand sanders when used without dust extraction, with integral dust extraction and with external dust extraction. The apparatus used for the measurement was designed to carry out sanding in a repeatable manner, simulating normal working practice. The geometry of the wood sanded affects the dust concentration critically, whereas the effects of the sandpaper grade and of the filtration efficiency of the collection system are small. Belt sanders produce high dust levels in all situations, but they are very efficient in removing wood, which means that they need to be used for only a short period. The integral systems of orbital sanders give good dust control on flat wood but not on edges. The high air extraction rate of external systems results in much better dust control during the sanding of edges, though the performance of the two extraction systems on flat wood is broadly similar. The size distribution of the dust clouds produced by the sanding is relatively constant, but that produced by rotary sanders tends to be coarser than that produced by orbital sanders, consistent with the smoother finish given by the latter. The electric charge on the dust produced by sanding is high.