Application of the personal aeroallergen sampler to assess personal exposures to Japanese cedar and cypress pollens

Exposome mapping in chronic respiratory diseases: the added value of digital technology

PURPOSE OF REVIEW

The development and progression of chronic respiratory diseases are impacted by a complex interplay between genetic, microbial, and environmental factors. Here we specifically summarize the effects of environmental exposure on asthma, allergic rhinitis, and chronic rhinosinusitis. We furthermore discuss how digital health technology may aid in the assessment of the environmental exposure of patients and how it may be of added value for them.

RECENT FINDINGS

It is well established that one gets allergic symptoms if sensitized and exposed to the same allergen. Viruses, bacteria, pollutants, irritants, and lifestyle-related factors modify the risk of getting sensitized and develop symptoms or may induce symptoms themselves. Understanding these processes and how the various factors interact with each other and the human body require big data and advanced statistics. Mobile health technology enables integration of multiple sources of data of the patients' exposome and link these to patient outcomes. Such technologies may contribute to the increased understanding of the development of chronic respiratory disease.

SUMMARY

Implementation of digital technologies in clinical practice may in future guide the development of preventive strategies to tackle chronic respiratory diseases and eventually improve outcomes of the patient.

An integrated system for automated measurement of airborne pollen based on electrostatic enrichment and image analysis with machine vision

Here we describe an automated and compact pollen detection system that integrates enrichment, in-situ detection and self-cleaning modules. The system can achieve continuous capture and enrichment of pollen grains in air samples by electrostatic adsorption. The captured pollen grains are imaged with a digital camera, and an automated image analysis based on machine vision is performed, which enables a quantification of the number of pollen particles as well as a preliminary classification into two types of pollen grains. In order to optimize and evaluate the system performance, we developed a testing approach that utilizes an airflow containing a precisely metered amount of pollen particles surrounded by a sheath flow to achieve the generation and lossless transmission of standard gas samples. We studied various factors affecting the pollen capture efficiency, including the applied voltage, air flow rate and humidity. Under optimized conditions, the system was successfully used in the measurement of airborne pollen particles within a wide range of concentrations, spanning 3 orders of magnitude.

Monitoring techniques for pollen allergy risk assessment

Understanding airborne pollen allergens trends is of great importance for the high prevalence and the socio-economic impact that pollen-related respiratory diseases have on a global scale. Pursuing this aim, aeropalynology evolved as a broad and complex field, that requires multidisciplinary knowledge covering the molecular identity of pollen allergens, the nature of allergen-bearing particles (pollen grains, pollen sub-particles, and small airborne particles), and the distribution of their sources. To estimate the health hazard that urban vegetation and atmospheric pollen concentrations pose to allergic subjects, it is pivotal to develop efficient and rapid monitoring systems and reliable allergic risk indices. Here, we review different pollen allergens monitoring approaches, classifying them into I) vegetation-based, II) pollen-based, and III) allergen-based, and underlining their advantages and limits. Finally, we discuss the outstanding issues and directions for future research that will further clarify our understanding of pollen aeroallergens dynamics and allergen avoidance strategies.

A new portable sampler to monitor pollen at street level in the environment of patients

Allergic rhinitis caused by pollen exposure is one of the most common allergic diseases. Therefore monitoring pollen levels in ambient air is an important tool in research and health care. Most European monitoring stations collect airborne pollen at rooftop levels for measurements in the larger surrounding of the sampling station, and not in the direct environment of sensitized subjects. Here we present the development and evaluation of a portable pollen sampler, called "Pollensniffer", that was designed to collect pollen in the immediate environment of allergic subjects. Validation of the Pollensniffer against the standard volumetric pollen sampler showed for most pollen types high correlations between the number of pollen collected by those two devices (Spearman's Correlation Coefficient > 0.8); the Pollensniffer appeared to collect on average 5.8 times more pollen per hour than the static sampler. Pollen monitoring was performed using this Pollensniffer at street level at 3 different locations in the city of Leiden during 22 weeks in 2017 and 21 weeks in 2018, during three 15-min periods a day and at one day in the week. The results showed that the pollen levels for birch and grass pollen can significantly differ from location to location and per time of day. Furthermore, the Pollensniffer measurements at street level showed that birch and grass pollen grains were detected 1 1/2 and 2-3 weeks, respectively, before detection at rooftop level. The street measurements show that allergic subjects can encounter varying pollen levels throughout the city and that they can be exposed to grass and birch pollen and may experience hay fever symptoms, even before the sampler at rooftop level registers these pollen.

Bioaerosol Sampling: Classical Approaches, Advances, and Perspectives

Bioaerosol sampling is an essential and integral part of any bioaerosol investigation. Since bioaerosols are very diverse in terms of their sizes, species, biological properties, and requirements for their detection and quantification, bioaerosol sampling is an active, yet challenging research area. This paper was inspired by the discussions during the 2018 International Aerosol Conference (IAC) (St. Louis, MO) regarding the need to summarize the current state of the art in bioaerosol research, including bioaerosol sampling, and the need to develop a more standardized set of guidelines for protocols used in bioaerosol research. The manuscript is a combination of literature review and perspectives: it discusses the main bioaerosol sampling techniques and then overviews the latest technical developments in each area; the overview is followed by the discussion of the emerging trends and developments in the field, including personal sampling, application of passive samplers, and advances toward improving bioaerosol detection limits as well as the emerging challenges such as collection of viruses and collection of unbiased samples for bioaerosol sequencing. The paper also discusses some of the practical aspects of bioaerosol sampling with particular focus on sampling aspects that could lead to bioaerosol determination bias. The manuscript concludes by suggesting several goals for bioaerosol sampling and development community to work towards and describes some of the grand bioaerosol challenges discussed at the IAC 2018.

Relationships among indoor, outdoor, and personal airborne Japanese cedar pollen counts

Japanese cedar pollinosis (JCP) is an important illness caused by the inhalation of airborne allergenic cedar pollens, which are dispersed in the early spring throughout the Japanese islands. However, associations between pollen exposures and the prevalence or severity of allergic symptoms are largely unknown, due to a lack of understanding regarding personal pollen exposures in relation to indoor and outdoor concentrations. This study aims to examine the relationships among indoor, outdoor, and personal airborne Japanese cedar pollen counts. We conducted a 4-year monitoring campaign to quantify indoor, outdoor, and personal airborne cedar pollen counts, where the personal passive settling sampler that has been previously validated against a volumetric sampler was used to count airborne pollen grains. A total of 256 sets of indoor, outdoor, and personal samples (768 samples) were collected from 9 subjects. Medians of the seasonally-integrated indoor-to-outdoor, personal-to-outdoor, and personal-to-indoor ratios of airborne pollen counts measured for 9 subjects were 0.08, 0.10, and 1.19, respectively. A greater correlation was observed between the personal and indoor counts (r = 0.89) than between the personal and outdoor counts (r = 0.71), suggesting a potential inaccuracy in the use of outdoor counts as a basis for estimating personal exposures. The personal pollen counts differed substantially among the human subjects (49% geometric coefficient of variation), in part due to the variability in the indoor counts that have been found as major determinants of the personal pollen counts. The findings of this study highlight the need for pollen monitoring in proximity to human subjects to better understand the relationships between pollen exposures and the prevalence or severity of pollen allergy.