Tokelau: a unique low allergen environment at sea level.

BACKGROUND: Previous studies have shown that children in Tokelau have a lower prevalence of asthma and atopy compared to Tokelauan children resident in New Zealand. We hypothesized that the low asthma and atopy prevalence in Tokelau may be associated with low indoor allergen levels. METHODS: Dust was collected from bedding and floors of 76 homes and four public buildings in Tokelau and from the homes of 30 Tokelauan families in Wellington, New Zealand. Dust samples were analysed for Der p 1, Der f 1, Can f 1, Fel d 1, Bla g 2 and Blo t 5 by ELISA, and for endotoxin by a kinetic amoebocyte lysate assay. RESULTS: Der p 1 levels were over 1000-fold lower in Tokelau compared to New Zealand, geometric mean levels were 0.04 and 47.0 microg/g in beds and 0.04 and 44.7 microg/g on floors, respectively. Can f 1 and Fel d 1 levels were also significantly lower in Tokelau. Bed endotoxin levels were significantly higher in Tokelau, geometric mean: 26 736 EU (endotoxin units)/g, compared to 5181 EU/g in New Zealand. Floor endotoxin levels were similar between the two countries. CONCLUSION: The very low indoor allergen levels in homes in Tokelau compared to much higher levels in New Zealand homes provides a logical explanation for the lower prevalence of asthma and atopy in Tokelau, compared to New Zealand.

Open houses and closed rooms: Tokelau housing in New Zealand.

The migrant Tokelau community in New Zealand, through the Wellington Tokelau Association, is playing an active role in partnership with the Wellington School of Medicine to develop a research program to help improve the health of its people. The relationship between crowded homes and health was investigated in six focus groups. While cultural patterns were an essential part of Tokelau hospitality, the decision to "double up" households was often the result of "rational" economic decision making in relation to household expenditures such as rent and food. The implication for public health practitioners is that while overcrowding may be a health hazard for residents, the most effective solutions by the community are higher household income and more flexible housing designs that accommodate multifamily households.

[Transient immunosuppression after abdominal surgical intervention]. / Immunodepressione transitoria dopo intervento chirurgico addominale.

Transient immunodepression appears a few hours after surgery and usually regresses spontaneously within 15-20 days. In this study, cellular and humoral immunity parameter values were compared prior to and 24 h, 7 days and 14 days after laparotomic and laparoscopic cholecystectomy (12 patients and 25 patients respectively) operated at the University of Turin's First Surgical Clinic, to look for differences in the immunological effects of these two types of surgery. The following parameters were determined: IgG, IgA, IgM, C3, C4, granulocytes (CD11c), lymphocytes, B lymphocytes (CD19, CD19-CD15), T lymphocytes (CD3), T helper cells (CD3-CD4), T suppressor cells (CD3-CD8), CD4/CD8 ratio, NK cells (CD16), monocytes (CD14, CD11c-CD14), IL-2 receptor expression (CD25), HLA-DR expression (total HLA-DR, HLA-CD3), total cytotoxic activity (CD57), T cell cytotoxic activity (CD8-CD57), and NK cell cytotoxic activity (CD16-CD57). Granulocytes increased significantly (p < 0.05) in both groups. The increase was more marked in the laparotomy group and still evident on the 7th and 14th days. Total T cells, T helpers and NK cells fell after 24 h (p < 0.05) in this group only. These results suggest that laparoscopy is associated with less substantial immunological changes than laparotomy.