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Karenzmaßnahmen bei Milbenallergie - ein Update. ALLERGO JOURNAL 2023. [DOI: 10.1007/s15007-022-5667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Home Environmental Interventions for House Dust Mite. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 6:1-7. [PMID: 29310755 DOI: 10.1016/j.jaip.2017.10.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/26/2017] [Accepted: 10/03/2017] [Indexed: 11/20/2022]
Abstract
It has been 50 years since the dust mite was first appreciated to be a major source of allergen in house dust, and by extension a key trigger of allergic respiratory disease. Since that time a number of protein allergens have been identified and characterized, mainly from mite feces, and standardized mite extracts and IgE assays have been developed. Insights into the lifecycle of dust mites and aspects of mite allergen biology have shed light on the mechanisms that lead to respiratory disease and to the development of interventions that can minimize dust mite allergen exposure. It is now clear that dust mite allergy is a key contributor to asthma in many parts of the world, and that long-term avoidance can be effective for preventing sensitization and minimizing the development and severity of respiratory disease. Here, we discuss the evidence linking dust mites with respiratory disease, outline studies that support the efficacy of home environmental interventions, and highlight practical methods that have been shown to be effective as part of a multifaceted approach to dust mite avoidance.
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Greiwe JC, Bernstein JA. Combination therapy in allergic rhinitis: What works and what does not work. Am J Rhinol Allergy 2017; 30:391-396. [PMID: 28124648 DOI: 10.2500/ajra.2016.30.4391] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Allergic rhinitis and other rhinitis subtypes are increasingly becoming some of the most prevalent and expensive medical conditions that affect the U.S. POPULATION Both direct health care costs and indirect costs significantly impact the health care system due to delays in diagnosis, lack of treatment, ineffective treatment, poor medication adherence, and associated comorbidities. Many patients who have AR turn to over-the-counter medications for relief but often find themselves dissatisfied with the results. Determining the correct diagnosis, followed by initiation of the most-effective treatment(s), is essential to provide patients with better symptomatic management and quality of life. Although there are many options, currently available combination therapies, e.g., azelastine with fluticasone and intranasal corticosteroids with nasal decongestants, offer distinct advantages for the management of complex rhinitis phenotypes. Further research is required to investigate the pathomechanisms and biomarkers for mixed rhinitis and nonallergic vasomotor rhinitis subtypes that will lead to novel targeted therapies for these conditions.
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Affiliation(s)
- Justin C Greiwe
- Bernstein Allergy Group, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA
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Bakry AI. Experimental Approach to an Efficient and Versatile Water Filtration Vacuum Cleaner. Chem Eng Technol 2017. [DOI: 10.1002/ceat.201600430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Ayman I. Bakry
- Tanta University; Mechanical Power Engineering Department; Faculty of Engineering; 31521 Tanta Egypt
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Bertelsen RJ, Faeste CK, Granum B, Egaas E, London SJ, Carlsen KH, Lødrup Carlsen KC, Løvik M. Food allergens in mattress dust in Norwegian homes - a potentially important source of allergen exposure. Clin Exp Allergy 2014; 44:142-9. [PMID: 24304208 DOI: 10.1111/cea.12231] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 09/25/2013] [Accepted: 10/24/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sensitization to food allergens and food allergic reactions are mostly caused by ingesting the allergen, but can also occur from exposure via the respiratory tract or the skin. Little is known about exposure to food allergens in the home environment. OBJECTIVE The objective of this study was firstly to describe the frequency of detection of allergens from fish, egg, milk, and peanut in mattress dust collected from homes of 13-year-old adolescents and secondly to identify home characteristics associated with the presence of food allergen contamination in dust. METHODS Food allergens were measured by dot blot analysis in mattress dust from 143 homes in Oslo, Norway. We analysed associations between home characteristics (collected by parental questionnaires and study technicians) and food allergens by multivariate regression models. RESULTS Fish allergen was detected in 46%, peanut in 41%, milk in 39%, and egg allergen in 22% of the mattress dust samples; only three samples contained none of these allergens. All four food allergens were more frequently detected in mattresses in small dwellings (< 100 m(2)) than larger dwellings (≥ 130 m(2)); 63-71% of the small dwellings (n = 24) had milk, peanut, and fish allergens in the samples compared with 33-44% of the larger dwellings (n = 95). Milk, peanut, and egg allergens were more frequently detected in homes with bedroom and kitchen on the same floor as compared with different floors, with odds ratios of 2.5 (95% confidence interval (CI): 1.1, 5.6) for milk, 2.4 (95% CI: 1.0, 6.1) for peanut, and 3.1 (95% CI: 1.3, 7.5) for egg allergens. CONCLUSIONS AND CLINICAL RELEVANCE Food allergens occurred frequently in beds in Norwegian homes, with dwelling size and proximity of kitchen and bedroom as the most important determinants. Due to the amount of time children spent in the bedroom, mattress dust may be an important source of exposure to food allergens.
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Affiliation(s)
- R J Bertelsen
- Department of Food, Water and Cosmetics, Norwegian Institute of Public Health, Oslo, Norway; Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
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Yang H, Koo TH, Hong CY, Choi IG, Jeung EB. Analysis of the effects of essential oils on airborne bacteria in a customized bio-clean room. Mol Med Rep 2012; 6:651-6. [PMID: 22751732 DOI: 10.3892/mmr.2012.972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 06/20/2012] [Indexed: 11/05/2022] Open
Abstract
Essential oils have a sedative effect on stress, and are also known to have antibiotic and anti-carcinogenic effects. These compounds have long been used as natural microbial agents, and have recently been added to a number of pharmaceutical, food and cosmetic products. Controlling the exposure to allergens and pathogens are important factors for the treatment of allergy, and potentially reducing the risk of sensitization and infection. Low humidity, at levels under 35%, may affect human comfort and health during the winter. Patients and other individuals require optimal humidification to maintain a moisturized respiratory tract necessary for protecting against bacterial infection. We designed an analytical system to examine the effects of aromatherapeutic essential oils on airborne bacteria. The antibacterial activities of essential oils were assayed using agar plate air-sampling methods. A bacterial suspension was sprayed into a bio-clean room through the upper holes using a spray gun. Free-floating airborne bacteria were collected from the bio-clean room (blank) in blood agar plates for 10 sec using an air sampler. Three different concentrations of essential oils (0.0005, 0.005 and 0.05 ppm) were then sprayed into the bio-clean room for 5 min. Free-floating airborne bacteria were collected every 10 min for 10 sec each. Treatment with 0.0005 ppm essential oils inhibited the growth of colonies; this effect appeared to persist after 60 min. Decreased bacterial colony growth was more apparent in the presence of 0.005 ppm and 0.05 ppm essential oils than 0.0005 ppm. These effects were observed after 60 min compared to the control (distilled water). These results indicate that essential oils are able to inhibit the growth of airborne bacteria.
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Affiliation(s)
- Hyun Yang
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 361-763, Republic of Korea
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Portnoy J, Kennedy K, Sublett J, Phipatanakul W, Matsui E, Barnes C, Grimes C, Miller JD, Seltzer JM, Williams PB, Bernstein JA, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, Lang DM, Nicklas RA, Oppenheimer J. Environmental assessment and exposure control: a practice parameter--furry animals. Ann Allergy Asthma Immunol 2012; 108:223.e1-15. [PMID: 22469456 DOI: 10.1016/j.anai.2012.02.015] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 02/21/2012] [Indexed: 12/20/2022]
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Portnoy J, Kennedy K, Sublett J, Phipatanakul W, Matsui E, Barnes C, Grimes C, Miller JD, Seltzer JM, Williams PB, Bernstein JA, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, Lang DM, Nicklas RA, Oppenheimer J. Environmental assessment and exposure control: a practice parameter--furry animals. Ann Allergy Asthma Immunol 2012. [PMID: 22469456 DOI: 10.1016/j.anai.2012.02.015.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2022]
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Knibbs LD, He C, Duchaine C, Morawska L. Vacuum cleaner emissions as a source of indoor exposure to airborne particles and bacteria. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2012; 46:534-42. [PMID: 22084932 DOI: 10.1021/es202946w] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Vacuuming can be a source of indoor exposure to biological and nonbiological aerosols, although there are few data that describe the magnitude of emissions from the vacuum cleaner itself. We therefore sought to quantify emission rates of particles and bacteria from a large group of vacuum cleaners and investigate their potential determinants, including temperature, dust bags, exhaust filters, price, and age. Emissions of particles between 0.009 and 20 μm and bacteria were measured from 21 vacuums. Ultrafine (<100 nm) particle emission rates ranged from 4.0 × 10(6) to 1.1 × 10(11) particles min(-1). Emission of 0.54-20 μm particles ranged from 4.0 × 10(4) to 1.2 × 10(9) particles min(-1). PM(2.5) emissions were between 2.4 × 10(-1) and 5.4 × 10(3) μg min(-1). Bacteria emissions ranged from 0 to 7.4 × 10(5) bacteria min(-1) and were poorly correlated with dust bag bacteria content and particle emissions. Large variability in emission of all parameters was observed across the 21 vacuums, which was largely not attributable to the range of determinant factors we assessed. Vacuum cleaner emissions contribute to indoor exposure to nonbiological and biological aerosols when vacuuming, and this may vary markedly depending on the vacuum used.
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Affiliation(s)
- Luke D Knibbs
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Australia
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Abstract
The prevalence of human allergy to pet danders has increased rapidly over the past six decades, as a consequence of lifestyle changes that have enhanced ambient exposure to pet allergens. This is a problem of global public health importance, as the morbidity associated with allergic diseases disproportionately affects socio-economically disadvantaged populations, particularly children. Although the public often seeks advice from veterinary health-care professionals regarding healthy pet ownership practices, including strategies for reducing residential pet dander exposure, many misconceptions persist in the public domain regarding pet dander allergy, such as the belief that certain dog and cat breeds are 'hypoallergenic' due to their hair/coat type. This review considers the epidemiology of human exposure to the major cat and dog dander allergens, Fel d 1 and Can f 1 respectively, and the sensitization mechanisms to them, including the hygiene hypothesis and the putative role of bacterial endotoxin. The literature regarding primary and secondary exposures in different ambient environments is explored including threshold effects that influence allergen sensitization and elicitation of symptoms, and environmental intervention strategies that seek to reduce allergen exposure. Pet-specific factors, including the aetiopathogenesis of the several cat and dog allergens that have been characterized to the molecular level, individual animal characteristics that influence Fel d 1 and Can f 1 shedding, and pet-directed interventions intended to reduce allergen dispersal, are discussed.
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Affiliation(s)
- Daniel O Morris
- Department of Clinical Studies - Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, PA 19104, USA.
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Koh GCH, Shek LP, Kee J, Tai BC, Wee A, Ng V, Koh D. An association between floor vacuuming and dust-mite and serum eosinophil cationic protein in young asthmatics. INDOOR AIR 2009; 19:468-473. [PMID: 19682104 DOI: 10.1111/j.1600-0668.2009.00610.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
UNLABELLED Although vacuum cleaning is recommended to reduce allergen levels and improve asthma and allergic rhinitis symptoms, some studies suggest it may increase allergen load in homes. We conducted a cross-sectional study to determine if home floor vacuuming was associated with sensitization to dust-mites and cockroaches, and serum eosinophil cationic protein (ECP), a biomarker for atopy, in 102 physician-diagnosed spirometry-confirmed asthmatics. We collected data on floor type, floor cleaning method and frequency, asthma severity, allergy medications used, serum ECP and skin prick tests (SPT) to three dust-mites [Dermatophagoides pteronyssisinus (Der p), Dermatophagoides farinae (Der f) and Blomia tropicalis (Blo t)] and two cockroaches [Periplanata americana (Per a) and Blatella germanica (Bla g)]. Those who vacuumed had increased sensitization to three dust-mites [adjusted ORs (95%CI) = Der p: 26.6 (1.8-405.2); Der f: 44.8 (3.2-620.9); Blo t: 14.1 (1.8-108.1)] but not to cockroaches, adjusted for cleaning frequency and other methods of floor cleaning. Subjects who vacuumed their floor had higher levels of serum ECP than those who did not [adjusted median difference (95%CI): 9.4 (1.1-17.7)], adjusted for use of nasal corticosteroids among those with allergic rhinitis. Vacuuming is associated with increased sensitization to dust-mite allergens and higher serum ECP. PRACTICAL IMPLICATIONS We found an association between floor vacuuming and increased sensitization to dust-mite allergens and higher levels of an atopy biomarker. Current recommendations to use vacuuming to control allergen exposure and allergic conditions may need to be reconsidered until further studies are performed.
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Affiliation(s)
- G C H Koh
- Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Krieger J, Takaro TK, Song L, Beaudet N, Edwards K. A randomized controlled trial of asthma self-management support comparing clinic-based nurses and in-home community health workers: the Seattle-King County Healthy Homes II Project. ACTA ACUST UNITED AC 2009; 163:141-9. [PMID: 19188646 DOI: 10.1001/archpediatrics.2008.532] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To compare the marginal benefit of in-home asthma self-management support provided by community health workers (CHWs) with standard asthma education from clinic-based nurses. DESIGN Randomized controlled trial. SETTING Community and public health clinics and homes. PARTICIPANTS Three hundred nine children aged 3 to 13 years with asthma living in low-income households. INTERVENTIONS All participants received nurse-provided asthma education and referrals to community resources. Some participants also received CHW-provided home environmental assessments, asthma education, social support, and asthma-control resources. OUTCOME MEASURES Asthma symptom-free days, Pediatric Asthma Caretaker Quality of Life Scale score, and use of urgent health services. RESULTS Both groups showed significant increases in caretaker quality of life (nurse-only group: 0.4 points; 95% confidence interval [CI], 0.3-0.6; nurse + CHW group: 0.6 points; 95% CI, 0.4-0.8) and number of symptom-free days (nurse only: 1.3 days; 95% CI, 0.5-2.1; nurse + CHW: 1.9 days; 95% CI, 1.1-2.8), and absolute decreases in the proportion of children who used urgent health services in the prior 3 months (nurse only: 17.6%; 95% CI, 8.1%-27.2%; nurse + CHW: 23.1%; 95% CI, 13.6%-32.6%). Quality of life improved by 0.22 more points in the nurse + CHW group (95% CI, 0.00-0.44; P = .049). The number of symptom-free days increased by 0.94 days per 2 weeks (95% CI, 0.02-1.86; P = .046), or 24.4 days per year, in the nurse + CHW group. While use of urgent health services decreased more in the nurse + CHW group, the difference between groups was not significant. CONCLUSION The addition of CHW home visits to clinic-based asthma education yielded a clinically important increase in symptom-free days and a modest improvement in caretaker quality of life.
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Affiliation(s)
- James Krieger
- University of Washington School of Medicine and School of Public Health and Community Medicine, Seattle, WA 98104, USA.
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Gore RB, Durrell B, Bishop S, Curbishley L, Woodcock A, Custovic A. High-efficiency vacuum cleaners increase personal mite allergen exposure, but only slightly. Allergy 2006; 61:119-23. [PMID: 16364166 DOI: 10.1111/j.1398-9995.2005.00946.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND High-efficiency particulate-arrest-filter vacuum cleaners are recommended to allergy sufferers although their use increases personal cat allergen exposure. We aimed to measure personal mite allergen exposure during vacuum cleaning by nasal air sampling and to compare exposures while vacuuming and emptying the vacuum cleaner bag. METHODS Five brand new high-efficiency vacuum cleaners were selected. An old, previously used vacuum cleaner with its original microfilter in situ was used as a control. Nasal air samples were taken prior to and during vacuum cleaning in 10 homes. Samples were processed by HALOgen assay. Personal mite and cat allergen exposure was measured as the dust compartments were emptied. RESULTS There was an increase in personal mite allergen exposure with vacuum cleaning, which approached significance (P = 0.058). There was no difference between the high-efficiency vacuum cleaners and the control vacuum cleaner (P = 0.141). When the dust compartments were emptied, personal mite and cat allergen exposure increased (P < 0.02). CONCLUSIONS. The increase in personal mite allergen exposure while vacuum cleaning in an area with mild to moderate mite allergen exposure is small. High-efficiency vacuum cleaners confer no benefit and cannot currently be recommended to allergy sufferers as a means of reducing personal mite allergen exposure.
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Affiliation(s)
- R B Gore
- North West Lung Centre, Wythenshawe Hospital, Manchester, UK
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Almqvist C. High allergen exposure as a risk factor for asthma and allergic disease. Clin Rev Allergy Immunol 2005; 28:25-41. [PMID: 15834167 DOI: 10.1385/criai:28:1:025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The association between pet ownership in childhood and subsequent asthma and sensitization is very controversial. Intriguing, but contradictory, reports have caused considerable uncertainty in parents who wish to avoid asthma and allergic disease in their children. This article argues that high allergen exposure is a risk factor for asthma and allergic disease. It describes dispersal of pet allergens in society and critically assesses epidemiological studies regarding how early exposure to pet allergens affects subsequent immunoglobulin E-sensitization and allergic diseases. Additionally, this article evaluates the effects of allergen exposure in already sensitized subjects with asthma. Cat and dog allergens are ubiquitous in society and may induce sensitization and allergic symptoms in predisposed individuals, regardless of pet ownership. This, in combination with selection mechanisms for pet ownership in families with a history of allergic diseases, makes it difficult to study associations between early exposure to pets and subsequent allergic disease. Nevertheless, exposure to pet allergens worsens asthma in already sensitized children. Thus, it is clear that clinicians should advise sensitized asthmatics that avoidance of exposure to indoor allergens is an important element in the treatment of allergic disease.
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Affiliation(s)
- Catarina Almqvist
- Department of Occupational and Environmental Health, Karolinska Hospital, Stockholm, Sweden.
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Huss K, Travis P, Huss RW. General principles of asthma management: environmental control. Nurs Clin North Am 2004; 38:609-20. [PMID: 14763364 DOI: 10.1016/s0029-6465(03)00100-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Environmental control is one of the major goals of asthma management. House dust mite environmental control and the reduction of other indoor environmental allergen triggers, such as animal dander, cockroaches, and mold spores, are important for individuals with asthma. Patients who have sensitivities to the allergens they produce should receive advice on environmental control reduction measures to prevent asthma symptoms. Nurses are in a key position to make proper environmental control recommendations to patients.
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Affiliation(s)
- Karen Huss
- Johns Hopkins University, School of Nursing, 525 North Wolfe Street, Room 416, Baltimore, MD 21205, USA.
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Gore RB, Durrell B, Bishop S, Curbishley L, Woodcock A, Custovic A. High-efficiency particulate arrest-filter vacuum cleaners increase personal cat allergen exposure in homes with cats. J Allergy Clin Immunol 2003; 111:784-7. [PMID: 12704358 DOI: 10.1067/mai.2003.1378] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND On the basis of experimental chamber studies, vacuum cleaners with double-thickness bags and integral high-efficiency particulate arrest (HEPA) air filters are claimed to reduce airborne allergen levels and are currently recommended to allergic patients. OBJECTIVES The objective of this study was to investigate the effect of vacuum cleaning on personal inhaled cat allergen exposure in homes with cats. METHODS Five unused new vacuum cleaners were compared with an old non-HEPA filter vacuum cleaner. Each vacuum cleaner was tested in an experimental chamber and in 5 homes with cats. Inhaled cat allergen was measured by nasal air sampling. RESULTS New vacuum cleaners failed to leak any allergen in the experimental chamber. There was a significant increase in inhaled cat allergen during vacuum cleaning in homes (F = 48.39, df = 1.4, P =.002) with no difference between the old vacuum cleaner and the unused new vacuum cleaners (5-fold and 3-fold increase compared to baseline, respectively; F = 0.005, df = 1.4, P =.95). CONCLUSIONS The use of new HEPA-filter vacuum cleaners increases inhaled cat allergen in homes with cats. The use of HEPA-filter modern vacuum cleaners to reduce pet allergen exposure in the homes of pet owners should not be justified merely on the basis of experimental chamber data.
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Affiliation(s)
- Robin B Gore
- North West Lung Centre, Wythenshawe Hospital, Manchester, UK
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Haysom IW, Sharp K. The survival and recovery of bacteria in vacuum cleaner dust. THE JOURNAL OF THE ROYAL SOCIETY FOR THE PROMOTION OF HEALTH 2003; 123:39-45. [PMID: 12722582 DOI: 10.1177/146642400312300114] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The possibility exists that environmental dust could be a source of gastro-intestinal infection in the domestic environment and that the causative microbes are collected during vacuum cleaning. This study examines the survival of total bacterial populations, Enterobacteriaceae and salmonella species in vacuum cleaner dust in vitro and in use. Total counts remain constant at around 10(6)-10(8) colony forming units (cfu) g-1 for at least 60 days. Enterobacteriaceae showed only a slight decline over the same period. Recovery of salmonellae artificially inoculated into vacuum dust was dose and time dependent: even relatively small inocula (< 100 cfu g-1) were recoverable more than one month after inoculation. Questionnaires and vacuum cleaner dust samples were received from 76 households. A significant association was found between total bacterial counts and whether the household was in a rural or urban situation and the number of people in the household. No association was found between total bacterial counts and the number of children in the household, the presence of pets, wearing shoes indoors, the makes, model and age of the vacuum cleaner, the type of dust collector or dust bag, how often the vacuum cleaner was used and the length of time between sample collection and microbiological testing. Salmonella species were isolated from vacuum cleaner dust from three of the 76 households although no factors could be identified linking the homes. This study shows that vacuum cleaners are effective collectors and reservoirs of microbial contamination and that these contaminants are able to survive for up to two months. Vacuum cleaner dust could thus be a useful indicator of environmental contamination in the home.
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Affiliation(s)
- I W Haysom
- School of Science and the Environment, Bath Spa University College, Newton Park, Newton St Loe, Bath BA2 9BN, England
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Abstract
Environmental allergen control is one of the four primary goals of good asthma management. The American Academy of Allergy, Asthma, and Immunology has published a position statement [78] that endorses the National Asthma Education and Prevention Program management guidelines [23] and recommends that every patient with persistent asthma be evaluated for environmental allergen sensitivity. Patients who have sensitivities should receive practical advice on allergen avoidance. An accumulating body of knowledge indicates that such measures, when strictly applied for a sufficient period of time, can indeed reduce asthma symptoms, need for medication, and airway hyperresponsiveness. Ongoing prospective trials in large numbers of patients are being conducted and should enhance the ability to make proper recommendations to patients.
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Affiliation(s)
- Robert K Bush
- Department of Allergy, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA.
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Custovic A, Murray CS, Gore RB, Woodcock A. Controlling indoor allergens. Ann Allergy Asthma Immunol 2002; 88:432-41; quiz 442-3, 529. [PMID: 12027062 DOI: 10.1016/s1081-1206(10)62378-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Reading of this article reinforces the reader's knowledge of the role of allergen exposure in relation to asthma and its severity, as well as the relevance of allergen avoidance in the treatment of asthma. DATA SOURCES Initial literature search for existing evidence-based guidelines, reviews, and meta-analyses was carried out, and further literature searches were performed to review individual randomized controlled trials. Evidence level was graded according to the Scottish Intercollegiate Guidelines Network recommendations. RESULTS There is good evidence for the link between mite and cockroach allergen exposure and sensitization, and between sensitization and asthma. For pet allergens, some studies found that exposure to pets in early life was associated with specific immunoglobulin E sensitization and allergic disease later in childhood, whereas others reported a protective effect. The effectiveness of allergen reduction in the treatment of asthma is suggested by studies in which the patients improve substantially when moved into the low-allergen environment of hospitals or high-altitude sanatoria. Because of limitations in the design of the most clinical of studies, we do not yet have a conclusive answer on the effectiveness of domestic aeroallergen avoidance. CONCLUSIONS Minimizing the impact of identified environmental risk factors is an important first step to reduce the severity of asthma. Although environmental control is difficult, it should be an integral part of the overall management of sensitized patients. However, what is unclear is which patients would benefit and by how much, and whether the intervention is cost-effective. These questions will be answered satisfactorily only by large randomized trials.
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Affiliation(s)
- Adnan Custovic
- North West Lung Centre, Wythenshawe Hospital, Manchester, United Kingdom.
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Gore R. Allergen avoidance: the attraction of charge. Clin Exp Allergy 2002; 32:483-5. [PMID: 11972590 DOI: 10.1046/j.0954-7894.2002.01351.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Liccardi G, Custovic A, Cazzola M, Russo M, D'Amato M, D'Amato G. Avoidance of allergens and air pollutants in respiratory allergy. Allergy 2001; 56:705-22. [PMID: 11488664 DOI: 10.1034/j.1398-9995.2001.056008705.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- G Liccardi
- Department of Chest Diseases, Division of Pneumology and Allergology, Hospital A. Cardarelli, Piazza Arenella n.7/H, 80128 Naples, Italy
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22
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Abstract
Asthma is an important and increasingly prevalent respiratory disease. Its proper diagnosis and treatment lie at the heart of improving asthma outcome. Unfortunately, asthma has many faces and is affected by many variables, many of them difficult to control. Like many chronic illnesses, asthma tends to affect the poor and less advantaged individuals in society. Heightened awareness among patients and physicians of the serious nature of the disease is needed to reduce the morbidity and mortality of asthma. Treatment clearly requires a multifaceted approach, including behavioral, environmental, social, and medical interventions, in which the National Asthma Education and Prevention Program guidelines provide a logical, step-wise, and effective approach.
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Affiliation(s)
- A W James
- Department of Medicine, Division of General Internal Medicine, University of Tennessee at Memphis, Memphis, Tennessee, USA
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23
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Arlian LG, Platts-Mills TA. The biology of dust mites and the remediation of mite allergens in allergic disease. J Allergy Clin Immunol 2001; 107:S406-13. [PMID: 11242601 DOI: 10.1067/mai.2001.113670] [Citation(s) in RCA: 206] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In most temperate humid areas of the world, house dust mites are a major source of multiple allergens in house dust. Mite allergens sensitize and induce perennial rhinitis, asthma, or atopic dermatitis in a large portion of patients with allergic disease. There is convincing evidence that avoidance of mite allergen can effectively reduce allergic symptoms. Patients can be moved to a mite allergen-free environment, or mite and mite allergen abatement can be performed to reduce exposure in existing residences. Some knowledge of the biology of house dust mites is essential to understand the basis of the recommendations for reducing mites and mite allergens in homes and to appreciate the difficulty of eliminating house dust mites and mite allergens from homes. This article reviews key aspects of the biology of dust mites, the properties of mite allergens, recommendations for reducing mite and mite allergen concentrations in homes, and practical recommendations for treatment.
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Affiliation(s)
- L G Arlian
- Department of Biological Sciences, Wright State University, Dayton, OH 45435, USA
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25
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Platts-Mills TA, Vaughan JW, Carter MC, Woodfolk JA. The role of intervention in established allergy: avoidance of indoor allergens in the treatment of chronic allergic disease. J Allergy Clin Immunol 2000; 106:787-804. [PMID: 11080699 DOI: 10.1067/mai.2000.110548] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Avoidance of exposure to indoor allergens is an important element in the treatment of allergic disease. The results of several studies provide strong evidence in support of a role for allergen avoidance; however, strategies that optimize allergen reduction in houses have not been determined. Complex issues regarding the efficacy of physical and chemical measures that target house dust mite, pet, and cockroach allergens in the home are discussed. The greatest challenge is to educate allergic patients so that they can play an important role in controlling their own disease.
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Affiliation(s)
- T A Platts-Mills
- Division of Asthma, Allergy, and Immunology, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908-1355, USA
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26
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Abstract
This article reviews information on the topics of asthma, atopic dermatitis, food allergy, and upper respiratory infections. The asthma section provides an in-depth look at sociodemographic factors contributing to asthma morbidity and the barriers to asthma control. New findings on the triggers and therapies of atopic dermatitis and new articles on formula allergy and peanut allergy are presented. Recent publications in the areas of sinusitis and upper respiratory infections are also reviewed.
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Affiliation(s)
- M R Lester
- Fairfield County Allergy, Asthma & Immunology Associates, PC, Stamford, Connecticut, USA
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27
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Affiliation(s)
- J W Vaughan
- UVA Asthma and Allergic Diseases Center, Department of Medicine, Charlottesville 22908-1355, USA
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