Variability of airborne cat allergen, Fel d1, in a public place.

Allergen exposure is a risk to develop an IgE-mediated sensitization. The amount of allergen inhaled per unit time should be related to the amount present in the air, i.e. airborne allergen. Thus, measuring allergen levels in the air would be more relevant than measuring allergen levels in dust. Allergens are present in the air in very minute quantities and usually become airborne after disturbance. Large variation of allergen levels have been found in dust. In this study, we measured variability of airborne cat allergen, Fel d1, in a public place using a high-volume air-sampler. We also studied the distribution and relationship between dust and airborne cat allergens in homes and schools. Air samples were collected at three different airflow rates, i.e. 55, 40, and 30 m3 of air per hour. The concentration of airborne Fel d1 in the community gymnastic hall varied from 1 to 10 pg/m3 within a period of 3 weeks, at airflow rates 55-30 m3/h. The coefficient of variation for repeated samplings was 14-43% (day-to-day variation) and 27-38% (within-day variation). As expected, higher levels of airborne cat allergens were found in homes with cats than in cat-free environments. There was a significant relationship between cat allergen levels in dust and air (r=0.7, P<0.01). Our study demonstrates that when measuring airborne cat allergen a large variation is observed within a day and between days. The large variability of measurement may be explained by the disturbance in the environments. We suggest, that when exposure assessment is made the environment in question should be analyzed, if possible in several occasions.

Chemical fate of arsenic and other metals in groundwater of Bangladesh: experimental measurement and chemical equilibrium model.

The presence of toxic level of inorganic arsenic in groundwater used for drinking in Bangladesh and neighboring India is unfolding as one of the worst natural disaster in the region. The purpose of this work is to ascertain the chemical fate of arsenic and other metals in groundwater of Bangladesh. A combination of techniques was used to measure 24 metals, 6 anions, Eh, pH, dissolved oxygen, conductivity, and temperature to understand the distribution of components which were then used in computational chemical equilibrium model, MINEQL+, for detailed speciation. It was found that the fate of arsenic and its speciation were inextricably linked to the formation of hydrous ferric oxide (HFO) and its kinetic. The HFO induced natural attenuation removes 50-75% of total arsenic in first 24 h through a first order kinetics. Adsorption on HFO is the predominant mode of removal of arsenic, iron, manganese, and most trace metals. The equilibrium model points to the presence of excess active sites for the removal of arsenic. MINEQL+ shows that significantly higher concentration of HFO forming iron is required to remove arsenic below maximum contamination level (MCL) of 50 microg/L than predicted by stoichiometry. The practical implication of this work is the prediction of water quality based on models.

Electrochemical measurement and speciation of inorganic arsenic in groundwater of Bangladesh.

The presence of arsenic in groundwater above the maximum permissible limit of 50 mug l(-1) has threatened the health of more than 50 million people in Bangladesh and neighboring India. We report here the development of an inexpensive anodic stripping voltammetric (ASV) technique for routine measurement and speciation of arsenic in groundwater. The measurements are validated by more expensive atomic absorption, atomic emission and other techniques. To understand the present situation in Bangladesh, we measured As(III) in 960 water samples collected from 18 districts. A random distribution of 238 samples was used to measure both As(III) and As(V). The results from the present study indicate that most toxic form of inorganic arsenic, As(III), has the broad range of 30-98%. It shows 60% of the samples have 10 mug l(-1) and 44% of the samples have 50 mug l(-1) or more As(III). The fractional distribution pattern shows significant skew towards high percent occurrence which may indicate a progressive reduction process with a single source or a single mechanism for the formation of As(III). For direct consumption, this is possibly one of the most toxic groundwater known today. Speciation distribution at groundwater pH value shows H(3)AsO(3) is the predominant species including H(2)AsO(4)(-) and H(2)AsO(4)(2-) whose distribution is significantly pH dependent. This is also supported by E(h)-pH measurements. The depth distribution for Kushtia shows most of the As(III) is located within 100-200 ft deep aquifers. Similar fractional distribution of As(III) is found in deeper aquifers and may indicate contamination by leakage from upper aquifer. This study clearly demonstrates the aquifer environment is reductive and conducive to the formation of As(III) species.

Seasonal differences of peak expiratory flow rate variability and mediators of allergic inflammation in non-atopic adolescents.

Variations in peak expiratory flow (PEF) and serum eosinophil mediators were studied in healthy adolescents. Twenty-five boys and 31 girls, 11-16 years of age (mean age 14.3 years), were selected and investigated during the birch pollen season of 1995; 45 were also investigated during the autumn of the same year. The PEF was measured twice daily and eosinophil mediators in serum and in urine were measured by radioimmunoassay (RIA) once during the birch pollen season and once in autumn. The type values of the daily PEF variation, expressed in amplitude percentage mean, were 6.4 and 3.9%, mean values were 7.35 and 6.74%, and the 95th percentiles were 18 and 14%, during the birch pollen season and autumn, respectively. The 95th percentiles were 41 and 38 microg/l for serum eosinophil cationic protein (s-ECP), 74 and 62 microg/l for serum eosinophil protein X (s-EPX), 987 and 569 microg/l for serum myeloperoxidase (s-MPO), and 165 and 104 microg/mmol for urinary eosinophil protein X/urinary creatinine (u-EPX/u-creatinine), during the birch pollen season and autumn, respectively. The levels of the eosinophil mediators decreased significantly from May (n = 56) to November (n = 45), for s-ECP from a median value of 14 microg/l to 7 microg/l (p= 0.001), for s-EPX from a median value of 28 microg/l to 20 microg/l (p= 0.001), and for the neutrophil mediator, s-MPO, from a median value of 440 g/l to 292 g/l (p< 0.001). The PEF variability decreased significantly (p= 0.037), from spring (n = 55; median 8%, 95% confidence interval [CI] 7.8-10.19) to autumn (n = 44; median 6%, 95% CI 6.1-8.9). A significant correlation was found between the levels of s-ECP and s-EPX (rs = 0.7, p< 0.001), between s-ECP and s-MPO (rs = 0.6, p< 0.001), between s-EPX and s-MPO (rs = 0.4, p< 0.005), and between s-EPX and u-EPX/u-creatinine (rs = 0.6, p< 0.0001), in the birch pollen season (n = 56) and in the autumn (n = 45). There was a positive correlation found in PEF variability between the two seasons (n = 43; rs = 0.5, p= 0.0006). No other correlation was found between PEF variability and any other parameters. The difference in the levels of eosinophil mediators between seasons in non-atopic, healthy children is unexplained. Normal limits for mediators were higher and PEF variability was almost the same as has been reported in adults. When using normal values, seasonal influences should be considered.

Environmental assessment of Dermatophagoides mite-allergen levels in Sweden should include Der m 1.

The major allergen of Dermatophagoides microceras, Der m 1, as well as the allergens of D. pteronyssinus and D. farinae, Der p 1 and Der f 1, were analyzed in the homes of 111 asthmatic children in three climatic regions in Sweden. The numbers and species of mites were determined by microscopy, and circulating IgE antibodies against mites were measured. Der f 1 was the predominant house-dust-mite (HDM) allergen, Der p 1 the least often found, and Der m 1 represented 31% of the allergen load. However, in the Linköping area, Der m 1 was the major HDM allergen (58%). Mite counts and allergen levels correlated well. Current exposure to HDM allergens at home was associated with the serum IgE antibody response to HDM in the children with no threshold level. Of the children with IgE antibodies against HDM, 67% reacted to all three mites. Mite sensitization rates were marginally increased (7%) by the addition of IgE analysis of D. microceras to the routine analysis of IgE antibodies against D. pteronyssinus and D. farinae. Thus, Der m 1 may be an important HDM allergen and should be considered when HDM exposure data are assessed in areas with a climate like that of Sweden.

Indoor allergen levels and other environmental risk factors for sensitization in Estonian homes.

The prevalence of allergic disease is low in Eastern Europe for reasons that are poorly understood. Our study aimed to investigate the levels of exposure to indoor allergens and living conditions among Estonian infants in relation to sensitization. Dust samples were collected during four winter months in 1993/94 from the homes of 197 infants participating in a prospective study of sensitization. Information about living conditions was collected through a home visit and interviewing the mothers when the children were 6 weeks old. Three dust samples were collected from each home; i.e., from the infant's mattress, bedroom floor, and living-room carpet. The levels of allergens were determined by ELISA with monoclonal antibodies. The highest allergen level in a home was regarded as the peak value. The peak geometric mean values (+/-SD) of Der p 1 and Der f 1 were 0.3 (0.07-1.4) microg/g dust, of Can f 1, 0.86 (0.23-3.12) microg/g dust, and of Fel d 1, 0.1 (0.01-0.9) microg/g dust. In 12 homes (9%), the peak value of house-dust mite (HDM) allergens exceeded 2 microg/g dust, with Der p 1 as the dominating allergen. Multivariate analyses indicated that high levels of HDM allergens were more common in apartments that were on the ground floor or first floor, that were heated with stoves, and/or that had a dampness problem. The mean allergen levels at home were similar in children sensitized to HDM (n=17, 0.29 vs 0.3 microg/ g dust), dog (n=5, 0.55 vs 1.06 microg/g dust, and cat (n=18, 0.21 vs 0.09 microg/g dust) and in children who were not sensitized to these allergens. Most of the sensitized children were exposed to relatively low allergen levels at home; i.e., below 1 microg/g dust. This level was exceeded in the homes of 4/17 mite-, 5/18 cat-, and 0/5 dog-sensitized children. The similar levels of the major indoor allergens in Estonia and in Scandinavia indicate that the large differences in atopy prevalence among children and young adults in the two regions are not due to differences in allergen exposure. No allergen threshold level for sensitization was identified.

Concentrations of cat (Fel d1), dog (Can f1) and mite (Der f1 and Der p1) allergens in the clothing and school environment of Swedish schoolchildren with and without pets at home.

To investigate whether our hypothesis that cat and dog owners bring allergens to public areas in their clothes was true or not, we studied the levels of Fel d1, Can f1, Der p1 and Der f1 in dust from the clothes and classrooms of children in a Swedish school. We also investigated the levels of allergen in different areas in the four classrooms used by the children. Thirty-one children were selected in four classes, forming three groups: cat owners, dog owners and children without a cat or dog at home. Furthermore, a group of children with asthma was included. Cat and dog allergens were detected in all 57 samples from clothes and classrooms. Mite allergen Der f1 was detected in low concentrations in 6 out of 48 and Der p1 in 5 out of 46 samples investigated. The concentrations of Can f1 were higher than those of Fel d1 in samples from clothes (geometric mean: 2676 ng/g fine dust and 444 ng/g) and classrooms (Can f1: 1092 ng/g, Fel d1: 240 ng/g). The dog owners had significantly higher concentrations of Can f1 (8434 ng/g fine dust) in their clothes than cat owners (1629 ng/g, p < 0.01), children without cat or dog (2742 ng/g, p < 0.05) and children with asthma (1518 ng/g, p < 0001). The cat owners did not have significantly higher levels of Fel d1 (1105 ng/g) in their clothes compared to the other three groups. (D: 247 ng/g, nCnD: 418 ng/g) but the levels were significantly higher than for all children without a cat at home (345 ng/g, p < 0.05). No concentrations of mite allergen and low concentrations of Fel d1 and Can f1 were found in the children's hair. There were significantly higher concentrations of Fel d1 and Can f1 in dust from curtains than in samples from floors and bookshelves (p < 0.05). There was no significant difference between the allergen concentrations in samples from curtains and from desks and chairs, including the teachers' chairs, the only upholstered furniture in the rooms. Our results support the hypothesis that cat and dog owners bring allergens to public areas in their clothes and support other studies showing that textiles and upholstered furniture function as reservoirs of cat and dog allergens. Thus, children with asthma and other allergic diseases will be exposed to cat and dog allergens at school and by contact with pet owners, even if they avoid animal allergens at home.

Mite sensitization in the Scandinavian countries and factors influencing exposure levels.

Mites are the common sources of indoor allergen and play a major role in sensitization and elicitation of allergic disease. In the Scandinavian countries, mite infestations in the home were not common in the past decades. Recent studies show that sensitization to mites among children, particularly in Sweden, is increasing. Similar trends have also been reported in Norway. Poor indoor climate, e.g., high humidity and poor ventilation as a consequence of energy-saving measures, are cited as a possible explanation of this increase. Modern furnishings, e.g., carpets and various kinds of upholstery, may also serve as reservoirs of indoor allergens. At least 2 microg of mite allergen per g of dust is considered to be a risk level for sensitization and symptoms of asthma. As compared to experience from other parts of the world, mite-allergen levels are generally low in the northern Scandinavian regions. Recent studies from Sweden and other European countries show that mite sensitization may occur below 2 microg/g dust. Various environmental adjuvant factors may affect the threshold levels of allergen. In this review, the importance of the indoor environment for the accumulation of mite allergens, sensitization to mites in the Scandinavian countries, and various environmental factors that could influence exposure levels will be discussed.

Risk levels for mite allergen: are they meaningful, where should samples be collected, and how should they be analyzed?

Indoor allergen exposure plays a major role in the development of sensitization and triggering of asthma in children. All over the world, mites are common sources of indoor allergens. Risk levels for mite-allergen exposure have been recommended. A mite-allergen level of >/=2 microg/g dust is considered a risk level for sensitization and symptoms of asthma. Data from several ongoing prospective studies of children show that mite sensitization may occur below the suggested threshold level. However, from these studies, it seems that high mite-allergen exposure increases the risk of early sensitization, whereas low exposure levels probably take a longer time to induce sensitization. Assessment of allergen exposure and consideration of allergen-elimination strategies should not be limited only to the home environment. High levels of mite allergens are also found in day-care centers, schools, and various other public places, such as bars. Thus, in addition to homes, these environments should also be considered when allergen-avoidance measures are taken. Allergen content in dust can be expressed in several units, e.g., ng/g, ng/m2, and ng/sampling, and as the total amount of allergen. At present, there is no consensus on the best way to measure and express mite-allergen levels. In this paper, aspects of threshold levels for mite sensitization, various exposure environments, and sampling, determination, and expression units of mite exposure will be discussed in brief.

Exposure to indoor allergens in early infancy and sensitization.

BACKGROUND: Indoor allergens play a major role both in sensitization and as triggers of asthma in children. The relationship between allergen exposure and sensitization to cats, dogs, and mites was studied prospectively in 100 newborn babies with a history of allergy in both parents. METHODS: Skin prick tests were done with Dermatophagoides pteronyssinus, D.farinae, and cat and dog allergens in all the children at 6 and 18 months of age and in 86 children at 5 years of age. Dust samples were collected from the homes during infancy and at 5 years. The parents of the children responded to a questionnaire focused on environmental factors that could influence indoor allergen levels. In addition, dust samples were collected from the day-care centers of the sensitized children. The allergen levels were determined by ELISA. RESULTS: The levels of the major cat allergen, Fel d 1, varied from 0.02 microg to 6.8 microg/gm (geometric mean [GM], 0.4 microg/gm) during infancy and less than 0.02 microg to 13 microg/gm dust (GM, 0.12 microg/gm) at age 5 years. Dog allergen, Can f 1, levels ranged from 0.18 microg to 590 microg/gm (GM, 3.1 microg/gm) in infancy and 0.09 microg to 13 microg/gm at age 5 years (GM, 0.6 microg/gm). Eleven children (13%) were sensitive to cats, and three were sensitive to dogs at 5 years of age. They had been exposed to similar levels of allergen as the nonsensitized children. The levels of mite allergen (Der p 1 + Der f 1) at age 1 year varied from less than 0.02 microg to 1 microg/gm dust (GM, 0.12 microg/gm) and at age 5 years from less than 0.02 microg to 3.5 microg/gm (GM, 0.05 microg/gm) dust. Only two homes contained mite allergen levels greater than 2 microg/gm dust. The levels were less than 0.3 microg/gm dust in all but one sample from the day-care centers. Only one child was sensitized to mites at age 5 years. The mite allergen level was less than 0.1 microg/gm at home, and he did not attend a day-care center. CONCLUSIONS: The findings indicate that exposure to low levels of indoor allergens in early childhood is associated with a low incidence of sensitization. However, levels well below currently suggested threshold levels may cause sensitization in children with a family history of allergy. We suggest that a fixed threshold risk level for allergic sensitization may not be appropriate in all climates.

Low-level exposure to house dust mites stimulates T-cell responses during early childhood independent of atopy.

BACKGROUND: The immune responses which underlie the expression of allergic symptoms in childhood are believed to be initiated in infancy and early childhood. The kinetics of this response have hardly been researched. OBJECTIVE: To analyse, in an environment with low house dust mite (HDM) exposure levels, the relationship between house dust mite (HDM)-specific T-cell reactivity as expressed by in vitro proliferation of blood mononuclear cells. METHODS: The study comprised a prospective analysis of patterns of allergen-specific T-cell reactivity in a cohort of 19 children, from whom blood samples were obtained in the spring during their second and third years of life. Blood mononuclear cell cultures were established in 200 microL AIM-V serum free medium. Crude house dust mite (HDM) and purified Der p 1 and Der p 2 extracts were used at optimal concentrations, i.e. 100 micrograms/mL for HDM and 30 micrograms/mL for the purified allergens. Tetanus toxoid (0.5 microgram/mL) and ovalbumin (10 micrograms/mL) served as positive controls. A clinical diagnosis of allergy was verified with skin-prick tests. Dust samples were collected from a mattress and/or carpet or sofa in homes, day care centres and day care homes. Major mite allergen levels (Der p 1/Der f 1) in dust were analysed by an enzyme linked immunosorbent assay (ELISA). RESULTS: Specific T-cell responses were seen in the majority of the children against house dust mite (crude HDM extract, Der p 1 and Der p 2). The levels of the house dust mite allergens Der p 1 and Der f 1 were low, i.e. < 0.68 microgram/g fine dust in the homes of the children and the day care centres that they were attending. This indicates that doses of mite antigen well below the suggested sensitization threshold level of 2 micrograms/g dust can induce mite-specific T-cell responses in young children. None of them showed clinical reactivity to house dust mites as indicated by negative skin-prick tests. CONCLUSIONS: The findings suggest that active immunological recognition of environmental allergens and the ensuing initiation of allergen-specific T-cell responses, is a normal part of the 'education' of the immune system in early childhood and can occur even at very low exposure levels. Priming per se does not imply clinically significant sensitivity, however.

Childhood asthma and exposure to indoor allergens: low mite levels are associated with sensitivity.

The prevalence and level of sensitivity to indoor allergens were studied in relation to current exposure at home in 124 children with perennial asthma living in three climatic zones of Sweden. The house dust mite (HDM) allergen levels were higher in the South than in the North (p < 0.001), while cat and dog allergen levels tended to be higher in the North than the South (n.s.). Thirty-four percent of the children were sensitive to the HDM Dermatophagoides pteronyssinus, as determined by IgE antibodies in vitro, 27% were sensitive to D. farinae, 57% to cat and 55% to dog. Sensitivity to HDM was significantly more prevalent in Southern, than in Central and Northern Sweden (p = 0.001) where the children were more often sensitive to pets (cat p = 0.005, dog p = 0.002). A significant association between the concentration of Der p I and Der fI in the house dust and both the prevalence of sensitivity to HDM and the IgE antibody levels against mites was found even at concentrations well below the commonly suggested risk level for sensitisation of 2 micrograms/g dust. No relationship was found between pet allergen concentration in the home dust and sensitivity to pets, possibly because of exposure outside home, e.g. in schools and meeting places for leisure activities. Similarly, there was no consistent association between the level of mite or pet allergen exposure at home and asthma severity as judged by symptom and medication score. The study indicates that there is no threshold value for sensitisation to mite allergens in asthmatic children, and therefore, dust allergen levels at home should be kept as low as possible in homes of children at risk for asthma.

Allergen avoidance in a day-care center.

The predominant sensitizing allergens in Swedish asthmatic children are furred pet animals. Poor ventilation and increased indoor humidity cause accumulation of pet allergens indoors. Indirect contacts with cats also increase pet allergen exposure. We investigated whether the concentration and the total amount of cat (Fel d I) and dog (Can f I) allergen in dust from various surfaces in a day-care center were influenced by extensive renovation, installation of a new ventilation system, ventilation of floors, and avoidance by families and personnel of direct and indirect contacts with pets. The cleaning routine in the day-care center was changed extensively after renovation. Old mattresses, pillowcases, curtains, sofas, and soft toys were removed, and new material were purchased. Dust was collected from various surfaces before and after renovation from table and chair surfaces, floors, curtains, mattresses, pillows, cushion-like toys, and sofas on five occasions during a 12-month period. Fel d I and Can f I allergen levels were determined by sandwich ELISA. The reduction in the total amount of both Fel d I and Can f I/sampling area was more pronounced than the reduction in the concentration of allergen/g of dust. After renovation, the mean cat and dog allergen concentration was decreased by six and 10 times, respectively. After 1 year, the total amount of cat allergen was lower in all areas (from 24 ng to < 1 ng/sampling area, P < 0.05). Already at the first sampling after renovation, the total amount of dog allergen had decreased more than 10 times. In a previous study, we found the median concentration of cat and dog allergen to be 10-30 times higher in ordinary day-care centers. Our present study demonstrates that children changing from a normal center to the renovated center would be exposed to much lower levels of cat and dog allergen. Combined measures such as installation of mechanical ventilation, ventilated floors, regular extensive cleaning, and, probably most important, avoidance of direct and indirect contacts with pets, should decrease cat and dog allergen exposure in day-care centers.

Mite (Der p I, Der f I), cat (Fel d I) and dog (Can f I) allergens in dust from Swedish day-care centres.

Early exposure to allergens is important for sensitization to inhalant allergens and it has been reported that there is a causal relationship between allergen exposure and bronchial asthma. We investigated the levels of major mite (Der p I/Der f I), cat (Fel d I) and dog (Can f I) allergen levels in dust collected from various locations in seven day-care centres (22 sections). The allergen levels were related to the characteristics of the day-care centres. Children and staff were questioned about contacts with animals, and cleaning personnel were asked about methods and frequency of cleaning. Mite allergen was found in nine of the 22 sections. The concentrations varied between < 16 ng/g and 106 ng/g dust (median < 16 ng/g). Mite allergen was not detected in any floor dust sample. Cat and dog allergen was detected in all centres and sections. The concentrations of dog allergen (median 4.3 micrograms/g; range < 60 ng-21 micrograms/g) were significantly higher (P < 0.05) than that of cat allergen (median 1.6 micrograms/g; range < 16 ng-22.8 micrograms/g). Higher amounts of both Fel d I and Can f I were observed on mattresses/sofas/cushion like toys and curtains than on tables/chairs and floors. The levels of cat or dog allergen on floors significantly correlated with the total number of children and staff with either a cat or a dog at home and or frequent contacts with them. Neither cleaning methods nor the frequency of cleaning influenced the allergen concentrations. The concentration of Fel d I was significantly lower (P < 0.05) in washed than in never washed curtains.(ABSTRACT TRUNCATED AT 250 WORDS)

Mite allergens in relation to home conditions and sensitization of asthmatic children from three climatic regions.

We investigated the levels of mite (Der p I and Der f I) allergen in dust from bedrooms, living rooms, kitchens, and bathrooms from 130 homes of asthmatic children in three climatic zones of Sweden. Bedroom dust samples included the child's mattress, carpets, floors, and other plain surfaces. Living-room dust samples were taken from sofas and other furniture, carpets, floors, and other plain surfaces. The allergen levels were related to home characteristics, including absolute indoor humidity (AIH), relative humidity (RH), and air changes per hour (ach). Mite allergen was detected in 62% of the homes. Levels of Der p I varied between < 16 ng and 50 micrograms/g dust, and Der f I between < 16 ng and 73 micrograms/g dust. Because we have designed a composite type of dust collection in our study, the allergen levels found tend to average down the results. Mite allergen levels were higher in homes with dampness problems, in homes with a smoker, and in homes without a basement. Homes with high absolute humidity (> or = 7 g/kg) or relative humidity (> or = 45%) and poor ventilation (< 0.5 ach) contained higher levels of mite allergens than homes with lower humidity and better ventilation. However, the number of ach measurements in homes was not high, and few homes had > 0.5 ach. Sensitization to house-dust mites was more common in southern than in northern and central Sweden. High levels of house-dust mite allergen in a temperate climate where mites are not ubiquitous are thus associated with dampness problems in homes and with tobacco smoking. Our data confirm and extend previous findings that high AIH and RH and poor ventilation increase the risk of mite infestation in homes. It seems to be important and necessary to control indoor humidity and ventilation levels, to avoid high mite allergen exposure in a temperate climate, because 34% of mite-sensitized asthmatic children were exposed to levels of mite allergen < 2 micrograms/g dust in their homes. The study also shows that mite allergen levels below the suggested threshold level (2 micrograms/g dust) are associated with mite sensitivity in children with perennial symptoms of asthma.