Pet shop workers: exposure, sensitization, and work-related symptoms.

BACKGROUND: Allergy to laboratory animals is a well-known occupational hazard. The aim was to investigate the frequency of allergic sensitization and respiratory symptoms among pet shop staff and to document their work environment. METHODS: Subjects (n = 59) from 24 pet shops were investigated with a questionnaire and lung function tests and skin prick tests against a panel of common inhalant and pet shop allergens. Blood samples were taken for immunoglobulin E (IgE) and IgE antibodies against Phadiatop and specific pet shop allergens. Personal airborne rodent allergen (n = 40) and endotoxin exposure (n = 40) was measured during work. Airborne rodent allergens were also collected using petri dishes at work (n = 40) and at home (n = 45). RESULTS: Fifty-three percent reported nasal symptoms, 34% eye symptoms, and 22% had experienced symptoms indicating asthma. However, only four workers (7%) were previously diagnosed with asthma. One-third reported respiratory symptoms at work, mostly against rodents, birds, insects, and hay, and 29% were sensitized to work-related allergens, mainly rodents and fodder insects, e.g., Zophobas. Atopy and total IgE > 100 kU/l increased prevalence of pet shop sensitization [prevalence ratio (PR) 17 and 5.5, respectively], and atopy increased work-related symptoms (PR 3.2). Endotoxin levels were similar between shops with and without rodents. Exposure to animals outside of work was extensive. CONCLUSIONS: A third of the pet shop workers reported airway symptoms at work or were sensitized, sometimes to unusual pet shop allergens, especially among atopics. The findings stress the importance of improving the knowledge of health risks and allergen avoidance measures among pet shop staff.

Optimized methods for fungal alpha-amylase airborne exposure assessment in bakeries and mills.

BACKGROUND: In order to enable reproducible and comparable exposure measurements of fungal alpha-amylase (alpha-amylase) in different laboratories and countries, the entire procedure from sampling of airborne dust to measuring extracted samples (including standards and the used enzyme) immunoassays must be standardized. The aim of this study was to establish optimal elution and assay conditions. METHODS: A parallel sampler was used for simultaneous collection of 10 samples of inhalable dust in bakeries and mills in Germany, England, the Netherlands and Spain. Three enzyme-immunoassays (EIAs) for detection of fungal alpha-amylase based on monoclonal antibodies or polyclonal antibodies were used for the measurement of the parallel-sampled filters (n=432) extracted using several methods. The results were analysed by regression analysis of variance. Additional filters (n=54) were extracted and analysed using two EIAs to investigate the storage stability of the extracts. RESULTS: Although alpha-amylase concentrations correlated well (r> or =0.88), differences were found between the EIAs in the sensitivity and nominal values (up to a mean factor 5.8). The best elution medium for airborne filters (phosphate-buffered saline 'PBS' with 0.05% Tween-20) led to 1.2 to two times higher alpha-amylase allergen yields than extraction in PBS only, while higher Tween-20 concentrations decreased the extracted alpha-amylase yield. During storage of frozen dust/filter extracts for 3-4 months at -20 degrees C, a loss of approximately 40% of measurable alpha-amylase was observed, which could be partially prevented by addition of 0.1% casein to the medium directly after extraction. CONCLUSION: Although the effects of only a few of many possible causes of variation were investigated, for these factors a clear choice could be made with regard to optimal elution conditions and the use of validated EIAs with calibrated standards, thus making significant progress towards a completely standardized procedure for airborne alpha-amylase measurements.

An amplified sandwich EIA for the measurement of soy aeroallergens.

BACKGROUND: Soy hull low-molecular-weight (SHLMW) allergens were responsible for the soy asthma epidemics in Barcelona, with one 7.5 kDa protein (Gly m 1) being the main IgE-binding component. The aims of this study were to develop a sensitive sandwich enzyme immunoassay (EIA) using rabbit polyclonal antibodies to measure low levels of SHLMW allergens, and to compare this method with the previously described human IgE EIA-inhibition technique. METHODS: IgG was isolated from serum of rabbits immunized with a chromatographically purified SHLMW extract (SHLMWE). Antibody-binding profiles were compared with those of human IgE anti-soy protein antibodies by Western blot analysis. An amplified sandwich EIA was developed using the purified SHLMWE as a calibration standard. Results were expressed in nanograms per millilitre. To compare the two assays, 54 air samples were analysed by both methods. RESULTS: SDS-PAGE of the SHLMWE revealed four bands of 6, 8, 15 and 17 kDa. Gly m 1 in the SHLMWE was identified by fingerprinting. The detection limit of the assay was 40 pg/mL. The two methods correlated well (r=0.89; P<0.001). The allergen concentration was detected in all 54 (100%) samples by the sandwich EIA but in only 37 (68.5%) by the EIA inhibition. CONCLUSIONS: The amplified sandwich EIA for SHLMW components has a high sensitivity and appeared to be a useful tool for the measurement of airborne SHLMW allergens, even at relatively low concentrations. Moreover, the method uses rabbit antibodies at high dilutions and does not require human sera, with limited availability and quantitative and qualitative pool-to-pool variability.

Human hair is a potential source of cat allergen contamination of ambient air.

BACKGROUND: We have previously shown that airborne cat allergen levels are significantly lower in school classes using special school clothing or in classes with no pet owners. However, cat allergen is present and the levels are in fact two- to threefold higher on cat owners' than noncat owners' school clothing which is used, washed and stored at school only. This suggests that allergen is transferred to schools by routes other than clothing. AIM: To analyse levels of cat allergen (Fel d 1) in hair from cat owners and noncat owners among children and adults. METHODS: Samples of unwashed hair (> or =1 day prior to sampling) from adults and children with (n = 22) or without (n = 22) cats at home were collected at a hairdresser. In addition, samples of newly washed hair (adults only, n = 11) were collected. The hair sample was extracted and analysed for Fel d 1 content with ELISA. RESULTS: The geometric mean levels were more than two orders of magnitude higher in unwashed hair from cat owners, compared with noncat owners (P < 0.0001) and more than 10-fold higher in newly washed hair from adults. The allergen contamination of unwashed hair among noncat owners appeared higher in children than in adults (P = 0.045). CONCLUSIONS: Hair may be an important source for transfer and deposition of cat allergen in schools and may explain why cat allergen is found in environments with strict allergen avoidance measures. Although it may be unrealistic to apply allergen avoidance strategies against this allergen source, it is important to be aware of it.

Allergen avoidance does not alter airborne cat allergen levels in classrooms.

BACKGROUND: Some schools in Sweden offer allergen avoidance classrooms for allergic children with severe asthma. However, the measures commonly used to achieve a reduction in allergen levels have not been properly evaluated. The aim of the present prospective study was to study whether the levels of airborne cat allergen are altered after introducing feasible intervention measures in classrooms, without interfering with peoples' freedom of choice regarding pet ownership. METHODS: Twenty-five classes, including five established allergy prevention classrooms participated in the study during a school year. After one term, six classes underwent a number of intervention measures recommended by the Swedish National Institute of Public Health. Curtains, upholstery and plants were removed, bookshelves were replaced with cupboards and regular cleaning was increased. Airborne dust was collected weekly (32 weeks) using duplicate Petri dishes (n = 1574) and on six occasions using two personal air samplers in each class (n = 264). RESULTS: Airborne cat allergen levels were showing a similar variability throughout the whole study in all classes. Despite extensive measures in order to reduce allergen exposure, cat allergen levels were unaltered in the six classes after intervention. Allergen levels were not significantly lower in the established allergy prevention classes, compared with the other classes. Cat allergen levels differed, however, significantly between classes with few and many cat owners (P < 0.05). CONCLUSIONS: We conclude that the recommended allergen avoidance measures used in this study did not reduce airborne cat allergen. It seems plausible that measures that fail to reduce allergen levels also fail to influence health status in allergic children but this remains to be shown.

Evaluation of Petri dish sampling for assessment of cat allergen in airborne dust.

BACKGROUND: Dust reservoir sampling is the most commonly used method for assessment of indirect allergen exposure. Because assessment of personal exposure using person-carried pumps is time-consuming and expensive we evaluated the Petri dish sampling method for measurement of airborne cat allergen in classrooms. METHODS: Petri dish sampling was evaluated in three study parts. Part I: by comparison between Petri dish sampling and personal air sampling in 44 classrooms with many (> or = 20%) and few (< or = 10%) cat owners and by additional Petri dish sampling in 40 pet-free homes. Part II: by sampling with duplicate Petri dishes in 28 classrooms. Part III: by sampling in three classrooms at four sampling heights during different sampling times. All samples were analyzed for cat allergen (Fel d 1) content with a monoclonal antibody two-site ELISA (enzyme linked immunosorbent assay), using signal amplification when necessary. RESULTS: There was a significant correlation between Petri dish sampling and personal air sampling (r = 0.66; P < 0.0001). Levels were five-fold higher in classes with many cat owners than in classes with few cat owners, regardless of method. A corresponding difference was found in the homes. Duplicate sample values were in fair agreement (Bland-Altman test) and were correlated (r = 0.77; P < 0.0001). Cumulative levels collected weekly in one Petri dish were lower than using five daily Petri dishes, regardless of sampling height. CONCLUSIONS: Petri dish sampling can be useful as an alternative method to personal air sampling of airborne allergens.

Nasal air sampling used for the assessment of occupational allergen exposure and the efficacy of respiratory protection.

BACKGROUND: Occupational exposure to rodent allergens may cause laboratory animal allergy. Personal exposure to occupational allergens is measured by collecting airborne dust on filters using person-carried pumps. This technique cannot be used to evaluate personal protective respiratory equipment. Recently developed intranasal air samplers collect inhaled particles by impaction on adhesive strips within the samplers. OBJECTIVE: The aims were to compare rodent aeroallergen exposure assessment using nasal air samplers with personal air sampling, and to evaluate the efficacy of using respiratory protection during rodent work using nasal air samplers. METHODS: Aeroallergen exposure was assessed during rodent work using both nasal air samplers and personal air samplers. The efficacy of respiratory protection (P2 facemasks and fresh-air helmets) was studied in subject pairs working side by side, one person with protection, the other without. Right nostril samples were laminated with protein-binding membrane and immunostained for rat urinary allergen-containing particles. Left nostril samples and air samples were eluted in buffer and analysed in amplified ELISAs for rat (RUA) and mouse (MUA) urinary allergen content (detection limit 10 pg/mL). Allergen collection efficacy of the nasal air samplers was tested at high and low exposure levels and at different flow rates using static sampling. RESULTS: P2 facemasks decreased the amount of inhaled allergen by about 90%, and verylittle allergen was inhaled using fresh-air helmets. Allergen levels in air and nasal samples correlated well (r(s) was about 0.8 for both RUA and MUA). The number of RUA-positive particles and nasal allergen levels measured in ELISA also correlated significantly (r(s) = 0.8). Collection efficacy of the nasal air sampler was better during high exposure (cleaning cages, median 73% of allergenic particles collected), than during low exposure (undisturbed room, 49% of particles). CONCLUSION: Nasal air sampling is a relevant and sensitive complement to personal air sampling and enables evaluation of personal respiratory protection equipment. Use of P2 facemasks and fresh-air helmets may substantially reduce occupational exposure to inhaled allergens.

Comparison of four allergen-sampling methods in conventional and allergy prevention classrooms.

BACKGROUND: Several allergen-sampling methods are used to assess level of personal or indirect exposure to cat in homes, schools and other public buildings and working environments. OBJECTIVE: To compare four different allergen-sampling methods (dust collectors, Petri dishes, person-carried pumps and intranasal samplers) by simultaneous sampling in classrooms and to compare the cat allergen levels between conventional classrooms and allergy prevention classrooms. Another aim was to relate the results to self-reported frequency of allergy and asthma symptoms among the children, to their perception of the school environment. METHODS: Among all compulsory schools (n = 257) in the Stockholm suburban area, 35 classrooms (five with implemented allergy prevention measures, seven with additional cleaning and 23 with normal cleaning routines) were chosen for allergen-sampling. Dust collectors (two models), Petri dishes, person-carried pumps and intranasal samplers were used simultaneously. All children (n = 829) received a self-administered questionnaire which included questions about home and school environment, allergic disease, asthma symptoms and pet contact. RESULTS: The correlation between sampling methods was generally poor.Furthermore, there was no significant difference in allergen levels between allergy prevention and allergen avoidance classes compared to conventional classes. Median levels were generally, but not significantly, lower in classes with few cat owners, compared to classes with many cat owners. Children in allergy prevention classes were more satisfied with the indoor air quality and cleaning than children attending classes with fewer or no allergy prevention measures (P < 0.0001). Nine per cent of all children reported allergic symptoms while at school. CONCLUSION: The lack of correlation between sampling methods used simultaneously demonstrates the difficulty in assessing allergen levels in schools and similar environments. The implemented intervention measures (allergy prevention/allergen avoidance) did not influence cat allergen levels at school.

Working with male rodents may increase risk of allergy to laboratory animals.

BACKGROUND: Our aim was to study the risk of laboratory animal allergy (LAA) among research staff working in laboratories separate from the animal confinement area. The roles of atopy and exposure intensity in LAA were studied with special regard to exposure to male rodents, who excrete higher levels of urinary allergens than female rodents. METHODS: Eighty rodent-exposed subjects gave blood samples for the analysis of total IgE, Phadiatop, and specific IgE against rat (RUA) and mouse urinary allergens (MUA), and answered questionnaires. Air samples were collected for RUA and MUA aeroallergen measurement in both laboratories and animal confinement facilities. RESULTS: Twenty percent of the subjects had IgE >0.35 kU/l to RUA and/or MUA, and 32% had experienced animal work-related symptoms, although 90% of aeroallergen samples from the research department laboratories were below the detection limit (<0.26 ng RUA per m(3) and <0.8 ng MUA per m(3)). Atopy (positive Phadiatop), total IgE >100 kU/l, other allergies (especially to other animals), or more than 4 years of exposure significantly increased laboratory animal sensitization and symptoms. Working with mainly male rodents gave odds ratios (95% CI) of 3.8 (0.97-15) for sensitization and 4.4 (1.4-14) for symptoms. Subjects with both exposure to mainly male rodents and atopy or elevated total IgE had a 10-fold higher frequency of sensitization than exposed subjects with neither risk factor. CONCLUSION: A majority of subjects with a combination of exposure to mainly male rodents and atopy or elevated total IgE developed sensitization to and symptoms from laboratory animals. Current low exposure seems to maintain the presence of specific IgE. Further measures must be undertaken to provide a safe workplace for laboratory animal workers.

Worsening of asthma in children allergic to cats, after indirect exposure to cat at school.

Exposure to cat allergen at school might exacerbate symptoms in asthmatic children with cat allergy. To study this, we identified 410 children, 6-12 yr of age, who were being treated for asthma (inhaled steroids and beta-agonists), were allergic to cats, and had no cat at home. Peak expiratory flow (PEF), asthma symptoms, medication, fever and/or sore throat, and contact with furred pets were recorded twice daily during the last week of summer holidays and the second and third weeks of school. The number of cat owners in each class was recorded. Ninety-two children with asthma reported no contact with furred pets. Among these, children who attended classes with > 18% (median value) cat owners reported significantly decreased PEF, more days with asthma symptoms, and increased use of medication after school started. Those in classes with < or = 18% cat owners reported no change. Children in classes with many cat owners ran a 9-fold increased risk of exacerbated asthma after school start compared with children in classes with few cat owners, after adjusting for age, sex, and fever and/or sore throat. Thus, asthma symptoms, PEF, and the use of asthma medication in children with cat allergy may be affected by indirect cat exposure at school.

Evaluation of individually ventilated cage systems for laboratory rodents: occupational health aspects.

New ventilated caging systems for laboratory animals were compared with conventional caging regarding allergen distribution, ergonomic suitability, cage environment and animal welfare. This paper presents occupational health evaluations. Mice were placed in individually ventilated cage (IVC) systems, a ventilated cabinet, and in cages on open shelves (conventional husbandry). The IVC systems were studied at negative and positive airflow. Aeroallergens were sampled on filters (n = 204, including controls) in undisturbed rooms and during cage changing. Concentrations of mouse urinary allergen (Mus m 1) in filter eluates were measured using sandwich ELISA. An ergonomic evaluation was performed with measurement of traction forces. Staff exposure during cage changing was high in all systems, range 116-4430 ng Mus m 1/m3. In undisturbed animal rooms, allergen levels were orders of magnitude higher when using conventional caging compared with ventilated systems; P < 0.001. At positive pressure both IVCs leaked allergen (median Mus m 1 concentration was < 0.08 ng/m3 at negative, but 6.5 ng/m3 (IVC1) and 0.8 ng/m3 (IVC2S) at positive pressure). The IVC systems had ergonomic disadvantages compared with the conventional husbandry and the ventilated cabinet, for instance with cages in unsuitable working heights. Ventilated husbandry solutions reduce levels of airborne allergen substantially at negative pressure, but are ergonomically less suitable. To prevent allergen exposure during cage changing, we propose that this procedure should be performed under ventilated conditions. Producers and users must cooperate in optimizing animal caging systems for both animals and staff.

Evaluation of individually ventilated cage systems for laboratory rodents: cage environment and animal health aspects.

The use of individually ventilated cage (IVC) systems has become an attractive housing regime of laboratory rodents. The benefits of IVC systems are, reportedly, a high degree of containment combined with relative ease of handling, and a high degree of protection from allergenes. In the present study we tested whether two IVC systems (BioZone VentiRack, IVC1 and Techniplast SealSafe, IVC2S), in which we held mature male NMRI mice, were constructed to maintain a constant differential pressure, positive or negative, during a prolonged period of time. We also measured ammonia (NH3) concentrations after about 2 weeks of use, and CO2 build-up during a 60 min simulated power failure situation. In addition, animal weight development and bite-wound frequency were recorded (Renström et al. 2000). From the present study it is concluded that the IVC1 air handling system provides a more uniform and balanced differential pressure than the IVC2S. Both systems effectively scavenge NH3 when bedding material is not soaked by urine. Although the IVCs are dependent on the continual function of the fans to work properly, it seems unlikely that CO2 concentrations increase to hazardous levels, as a result of a one hour power failure, with the type of cages used in this study. Differences in weight development and bite-wound occurrence were noted between the two IVC systems. Causes for these differences could not be established and need more investigation.

Comparison of methods to assess airborne rat and mouse allergen levels. I. Analysis of air samples.

Airborne laboratory-animal allergens can be measured by several methods, but little is known about the effects of important differences in methodology. Therefore, methods used in research projects in The Netherlands, the UK, and Sweden were compared. Seventy-four sets of three parallel inhalable dust samples were taken by a single operator in animal facilities in the three countries, and analyzed in parallel by the three institutes for rat and mouse urinary allergen. Rat-allergen levels measured by RAST inhibition (UK) were 3000 and 1700 times higher than levels measured by enzyme immunoassay (EIA)-sandwich methods with polyclonal rabbit (The Netherlands) or monoclonal mouse (Sweden) antibodies, while the difference between the two EIA-sandwich methods was much smaller: a factor of 2.2. For mouse allergen, an inhibition radioimmunoassay (RIA) with rabbit antimouse antibodies (UK) gave 4.6 and 5.9 times higher concentrations than sandwich EIAs with rabbit polyclonal antibodies (Sweden and The Netherlands), while the difference between the two sandwich EIAs was, on average, 1.6-fold. Thus, although levels of rat and mouse aeroallergens are significantly correlated, the assay type gives large differences in absolute concentrations, and interlaboratory technical differences affect even the same assay type. Conversion factors can aid comparison between studies, and, in the long term, assay standardization is desirable.

Comparison of methods to assess airborne rat and mouse allergen levels. II. Factors influencing antigen detection.

Potential factors influencing antigen detection in immunoassays for measuring rat or mouse aeroallergen (i.e., assay setup, antigen specificities, standard extracts used, and antigen decay) were investigated in a three-country study (the UK, The Netherlands, Sweden). An inhibition enzyme immunoassay (EIA) setup gave nominal rat urinary allergen (RUA) sample values seven times higher than a sandwich EIA setup utilizing identical antibodies and standards. In immunoblotting experiments, pooled patient serum and polyclonal rabbit antibodies partly detected different rat antigens; monoclonal antibody specificity could not be determined. Immunoblot detection of mouse urinary antigens (MUA) by the polyclonal rabbit antibodies from all laboratories was similar. In both the RUA and the MUA assays, urinary antigen standards were detected with similar potency, except purified Rat n 1, which was an inefficient inhibitor in the RUA RAST inhibition. In the sandwich EIA RUA assays, a rat room-dust extract was detected with 700800-fold less sensitivity than rat urine, whereas in the RAST RUA assay, dust inhibited equally with rat urine. Simulated decay did not decrease the potency of urinary antigen in any assay. Thus, assay setup and choice of detection antibodies strongly influence the nominal allergen levels. We recommend the use of standardized and characterized antibodies and standard extracts in sandwich EIAs to measure airborne rodent urinary allergens.

Exposure-response relationships for work-related sensitization in workers exposed to rat urinary allergens: results from a pooled study.

BACKGROUND: Recent studies in a few industries have shown that the likelihood of IgE-mediated sensitization increases with increasing exposure. The shape of the exposure-response relationships and modification by age, sex, and smoking habit has hardly been studied. OBJECTIVE: The purpose of this study was to determine exposure sensitization relationships for rat sensitization and to evaluate the influence of atopy, smoking habits, and sex. METHODS: Data from 3 cross-sectional studies in The Netherlands, the United Kingdom, and Sweden were used and involved 1062 animal laboratory workers. Selection criteria were harmonized, and this resulted in a study population of 650 animal laboratory workers (60.6% female) with less than 4 years of exposure. Air allergen levels were assessed previously and converted on the basis of an interlaboratory allergen analysis comparison. Available sera were analyzed for the presence of specific antibodies against common allergens (house dust mite, cat, dog, and grass and birch pollen) and work-related allergens (rat and mouse urinary proteins). Questionnaire items on work-related respiratory symptoms, hours worked with rats per week, job performed, smoking habits, and sex were used in this analysis RESULTS: The prevalence of work-related sensitization to rat urinary allergens (IgE >0.7 KU/L) was 9.7 % (n = 63). Thirty-six of the sensitized workers had work-related symptoms (asthma or rhinitis). Two hundred forty-eight workers (38.2%) were atopic (defined as specific IgE to 1 of the common allergens). The sensitization rate increased with increasing air allergen exposure. Atopic workers exposed to low levels of allergen had a more than 3-fold increased sensitization risk compared with nonexposed atopic workers. For atopic subjects, the risk increased little with increasing exposure, whereas for nonatopic subjects, a steadily increasing risk was observed. Smoking and sex did not modify the sensitization risk. CONCLUSION: Rat urinary allergen-sensitization risk increased with increasing exposure intensity. Workers who were atopic had a clearly elevated sensitization risk at low allergen exposure levels.

A new amplified monoclonal rat allergen assay used for evaluation of ventilation improvements in animal rooms.

BACKGROUND: Available methods for the measurement of airborne laboratory animal allergens are not standardized and are often insufficiently sensitive for measurements in laboratories or in undisturbed animal rooms. Although low, the levels may be clinically relevant, because many scientists not involved in cleaning out cages or handling animals have rodent allergies. OBJECTIVE: The purpose of this study was to develop a sensitive monoclonal assay to determine airborne rat allergen and test it in the evaluation of a sliding curtain system installed in refurbished rat rooms, with perforated, transparent polycarbonate screens, behind which were the cage racks. METHODS: Monoclonal antibodies were produced against male rat urine by immunization in mice and fusion with mouse cell line Sp2/0. A novel biotinylated phenol compound was synthesized for immunoassay signal amplification in conjunction with horseradish peroxidase. Air filter samples were collected at a rate of 2 L/min, and allergen content in the filter eluates was determined. RESULTS: Two monoclonal antibodies were produced and used in a sandwich ELISA, which bound alpha2u-globulin (Rat n 1.02). The assay detection limit was 3.2 pg/ml, about tenfold increased sensitivity compared with the unamplified assay. Allergen levels were lower in rooms when curtains were closed (median, 0.2 ng/m3) than behind the curtains (0.9 ng/m3, p = 0.01) or if the curtains were open (0.9 ng/m3, p = 0.001). However, allergen levels during cage cleaning, when curtains were drawn apart, were high (18 ng/m3). CONCLUSION: We have developed a method for measurement of airborne rat allergen that can be standardized, measures an important allergen, and is sufficiently sensitive to measure low allergen levels with personal samplers.

Comparison of a radioallergosorbent (RAST) inhibition method and a monoclonal enzyme linked immunosorbent assay (ELISA) for aeroallergen measurement.

BACKGROUND: Mouse and rat urinary proteins are potent occupational allergens for exposed personnel. Methods of measuring airborne allergens differ greatly, and reported levels of allergens vary considerably between laboratories. OBJECTIVES: To compare the values obtained using two different methods of allergen detection. METHODS: Air samples were collected in rat rooms in Sweden and the United Kingdom at 2 L/min on to polytetrafluoroethylene (PTFE) filters and extracted in buffer containing 0.5% v/v Tween 20. Airborne rat urinary allergen (RUA) was measured in all samples by both RAST inhibition using a polyclonal human serum pool (UK) and a two monoclonal antibody sandwich ELISA employing antibodies specific for Rat n 1.02 (alpha2u-globulin) (Sweden). RESULTS: The two methods gave values which were correlated (r2 log values = 0.72, P<0.0001), but differed by several orders of magnitude (median [range] ratio of RAST inhibition/ELISA = 316 [7-26(80)]. There was a systematic bias: as the absolute values increased, the difference in the measurements increased. The rat urine standards used were antigenically similar. CONCLUSIONS: A large contrast in RUA values obtained from the two assays was observed in this study. This may be primarily due to methodological differences, but variations in antibody specificities or composition of allergenic epitopes in the air samples may contribute. The results demonstrate that standardization of methods and antibodies is necessary before interlaboratory comparisons can be made.

Test-retest reliability of ankle injury risk factors.

Ligamentous instability, ankle muscle weakness, foot-ankle alignment, and generalized joint laxity may be predisposing factors for ankle ligament injuries. The purpose of this study was to examine the reliability of these risk factors before and after the season in healthy individuals and to determine if any significant differences developed during the athletic season (range, 12 to 16 weeks). Twenty-one healthy college-aged athletes were tested for generalized joint laxity, anatomic alignment of the foot and ankle, ligamentous stability, and isokinetic strength of the ankle muscles. This study showed that generalized joint laxity, ankle ligamentous stability, and ankle strength measurements demonstrated high correlation coefficients (r > 0.75). The high correlation coefficients suggested reliable measures. Some of the range of motion measurements had lower correlation coefficients, which suggested more variability in these measurements. After establishing the reliability in 24 of the 28 measurements with standardized methods, further work is underway to evaluate the role of these factors in inversion ankle sprains.

A prospective study of ankle injury risk factors.

Many factors are thought to cause ankle ligament injuries. The purpose of this study was to examine injury risk factors prospectively and determine if an abnormality in any one or a combination of factors identifies an individual, or an ankle, at risk for subsequent inversion ankle injury. We examined 145 college-aged athletes before the athletic season and measured generalized joint laxity, anatomic foot and ankle alignment, ankle ligament stability, and isokinetic strength. These athletes were monitored throughout the season. Fifteen athletes incurred inversion ankle injuries. Statistical analyses were performed using both within-group (uninjured versus injured groups) data and within-subject (injured versus uninjured ankles) data. No significant differences were found between the injured (N = 15) and uninjured (N = 130) groups in any of the parameters measured. However, the eversion-to-inversion strength ratio was significantly greater for the injured group compared with the uninjured group. Analysis of the within-subject data demonstrated that plantar flexion strength and the ratio of dorsiflexion to plantar flexion strength was significantly different for the injured ankle compared with the contralateral uninjured ankle. Individuals with a muscle strength imbalance as measured by an elevated eversion-to-inversion ratio exhibited a higher incidence of inversion ankle sprains. Ankles with greater plantar flexion strength and a smaller dorsiflexion-to-plantar flexion ratio also had a higher incidence of inversion ankle sprains.

Allergic sensitization is associated with increased bronchial responsiveness: a prospective study of allergy to laboratory animals.

The purpose of this prospective study was to investigate the extent of change in bronchial responsiveness and the prognostic value of methacholine provocation in early sensitization to laboratory animals. Thirty eight laboratory technicians were studied during training (before first exposure) and after having been exposed to laboratory animals for a median 18 (range 5-33) months. On both occasions they were subjected to spirometry, bronchial methacholine challenge, skin-prick tests and blood sampling, and responded to questionnaires. Nine (24%) developed laboratory animal allergy (LAA), defined as animal work-related symptoms (n = 8), or specific immunoglobulin E (IgE) (n = 7) or both. In the LAA group, bronchial responsiveness was normal before employment, but had increased significantly at follow-up compared to technicians who had not developed LAA. Six of the nine LAA subjects had a more than threefold increase in bronchial responsiveness, and three of these reported chest symptoms. Spirometric values were not different between the groups prior to exposure or at follow-up, and had no prognostic value. However, a pre-employment level of total IgE > 100 kU.L-1 predicted the development of LAA (relative risk 2.8). Thus, early LAA was associated with increased bronchial responsiveness in most subjects. In contrast to total IgE, the level of pre-employment bronchial responsiveness or lung function did not influence the magnitude of change in responsiveness, nor predict sensitization.