Mattress encasings and mite allergen levels in the Prevention and Incidence of Asthma and Mite Allergy study

BACKGROUND: Reduction of allergen exposure from birth may reduce sensitization and subsequent allergic disease. OBJECTIVE: To measure the influence of mite allergen-impermeable mattress encasings and cotton placebo encasings on the amount of dust and mite allergen in beds. METHODS: A total of 810 children with allergic mothers took part in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Allergen-impermeable and placebo mattress encasings were applied to the childrens' and the parents' beds before birth. Dust samples were taken from the beds of children and their parents before birth and 3 and 12 months after birth. Extracts of dust samples were analysed for mite allergens (Der p 1 and Der f 1). RESULTS: Active mattress encasings were significantly more effective in reducing dust and mite allergen levels than placebo encasings. Mite allergen levels were low in general and the treatment effect was modest. Twelve months after birth, mattresses with active mattress encasings had about half the amount of Der 1 (Der p 1 + Der f 1)/m2, compared to mattresses with placebo encasings, for the child's and the parental mattress. CONCLUSION: This study shows that mite-impermeable mattress encasings have a significant but modest effect on dust and mite allergen levels of mattresses with low initial mite allergen levels, compared to placebo.     

House dust mite allergens on different types of mattresses

Beds and especially mattresses are important breeding grounds for house dust mites. We investigated whether supposed differences in the microclimate on water, spring and foam mattresses were reflected in the occurrence of house dust mite major allergens (Der fI, Der mI, and Der pI) in mattress dust. Fifty-one mattresses that had been in use for 8-25 months were sampled. Median concentration of total major allergens was 0.5 microgram/g dust (range 0-45) with little difference between the three major allergens and between the three types of mattresses. Occurrence of mattresses with concentrations above and below the proposed risk level (2 micrograms/g) was similar in the mattress groups. However, the allergen concentration was above risk level in 56%, if washable underblankets were not applied, compared with only 21% in the group with such underblankets. In conclusion, mattresses tend to accumulate allergen rather rapidly. Neither heated water mattresses, spring nor foam mattresses seem to be of any advantage for mite allergics, whereas underblankets made of synthetic fibres in a cotton or synthetic cover, commonly used in Denmark, might play a beneficial role in reducing allergen exposure.     

Levels of house-dust-mite allergen in homes of nonallergic people in Pavia, Italy

BACKGROUND: HDM distribution varies between geographic areas and may be affected by housing characteristics. We quantified Der p 1 and Der f 1 and assessed the relationships between their levels and housing characteristics in homes of nonallergic subjects. METHODS: Der f 1 and Der p 1 were measured by ELISA in dust samples from living-room floors and mattresses of 44 homes of nonallergic subjects in Pavia. Information about household characteristics was obtained by questionnaire. RESULTS: Der p 1 and Der f 1 concentrations (microg/g dust, median) were 0.34 and 7.8 on mattresses, and 0.15 and 0.83 on living-room floors. Higher Der f 1 levels on mattresses were associated with synthetic pillows (P<0.05), and (only when expressed as microg/m2) with bedding washing temperature of < or = 60 degrees C (P<0.05). Der f 1 levels were higher on the living-room floors of homes located on lower (< or =first) floors (P<0.05). Good correlations were found between Der p 1 and Der f 1 expressed as microg/g dust and microg/m2 on both mattresses and living-room floors. CONCLUSIONS: In homes of nonallergic subjects in northern Italy, Der f 1 exceeded the threshold for sensitization in a high proportion of mattress samples.     

Concentrations of domestic mite and pet allergens and endotoxin in Palestine

BACKGROUND: A few studies have compared indoor allergens and endotoxin levels between urban and rural settings as important determinants for asthma and atopy in children. However, no study was done in the Middle East or investigated refugee camps. METHODS: As part of a nested case-control study in Ramallah in 2001, we measured house dust mite and pet allergens, as well as endotoxin in dust collected from 110 children's mattresses and living room floors. RESULTS: Geometric mean (GM) concentrations of Dermatophagoides pteronyssinus (Der p1) antigen were 4.48 microg/g in mattress dust and 1.23 microg/g floor dust. The highest Der p1 levels were seen in refugee camps. Concentrations of Dermatophagoides farinae antigen (Der f1) were much lower (<0.08 microg/g dust). Concentrations of cat allergen (Fel d1) were highest in villages, and those of dog allergen (Can f1) were highest in mattresses from cities and in floor dust from refugee camps. GM of endotoxin levels were 25.7 EU/mg in mattress dust and 49 EU/mg dust in floor dust. CONCLUSIONS: Concentrations of Der p1 were high compared to Western European countries, but were lower compared to UK and Australia. Levels of pet allergens were lower than in Western Europe. Endotoxin levels were higher compared to developed countries. Indoor environmental factors such as dampness seemed to be important determinants for allergen and endotoxin, but living habits such as lack of mattress cover appeared unimportant.     

House-dust-mite allergen (Der p 1) levels in university colleges

Background In coastal Australia, mean house-dust-mite allergen concentration is 20-40 times higher in homes than in public buildings. Allergen concentrations in university colleges, which share some eharacteristics of both homes and public buildings, are not known. The study aimed to compare bed mite-allergen concentration in colleges with local homes.
Methods Mattress dust was collected from three colleges (n = 60 m each) and local homes (N=68) during summer, Der p 1 was measured by ELISA. Information was collected on the floor plan of the colleges, cleaning practices, age of building, and orientation of room.
Results Most college mattresses (94%) had Der p 1 concentrations less than the mean of homes in the same climate. The geometric means of Der p 1 m the mattresses of the colleges were as follows: A, 8.9 pg Der p 1/g fme dust (95% CI 6.9,11.5); B, 1.9 (1.5,2.3); and C, 1.5 (1.2,2.0), compared to homes, 22,5 (17.6, 28.7). The percentages of college mattresses with less than 2 jig/ g were 7%, 48%, and 58%, respectively, compared to 4% for homes. Higher Der p 1 concentrations were weakly associated with age of building in college A, and orientation in college B, Der p 1 concentrations were independent of floor level and age of mattress.
Conclusions These findings indicate that low allergen concentrations are achievable without extreme hygiene and cleaning measures in a climate which supports mite proliferation in homes.     

Allergen-avoidance measures in homes of house-dust-mite-allergic asthmatic patients: effects of acaricides and mattress encasings

This double-blind, placebo-controlled study investigated whether the application of an acaricide (Acarosan®) on mattresses and on textile floor coverings in living rooms and bedrooms can contribute to improvement in lung function and airway hyperresponsiveness in 40 adult asthmatic patients sensitized to house-dust mite. In a second group of 19 patients who refused chemical intervention, the clinical effects of application of allergen-impermeable mattress encasings were studied. In all three treatment groups, Der p 1 levels in mattress dust were statistically significantly decreased after 12 months. However, this decrease was much greater in the group who received mattress encasings (final mean level 430 ng/g) than in groups with acaricide- or placebo-treated mattresses (final mean levels 1730 and 2100 ng/g, respectively). Treatment of textile floors with either Acarosan or placebo chemical caused a statistically significant decrease in the level of the house-dust-mite allergen Der p 1 in floor dust. In the group with mattress encasings, no significant changes of floor dust Der p 1 were found. Airway hyperresponsiveness (as measured by the PC²⁰ histamine) improved significantly in the mattress cover group after 6 months. The Acarosan group also showed a small but statistically significant improvement after 12 months.     

Household characteristics and mite allergen levels in Manchester,UK

BACKGROUND: Mite allergen levels vary enormously between different homes in the same geographical area. No large scale studies of mite levels in Manchester homes has been conducted to identify factors associated with higher levels. OBJECTIVES: To quantify exposure to mite allergens and to identify characteristics associated with higher Der p 1 levels in a large sample of homes in Manchester, UK. METHODS: Der p 1 was measured in dust from the living room floor, sofa, bedroom floor and mattress in 564 homes. Data on household characteristics were collected by administering a questionnaire. Univariate and multivariate analyses were performed to identify household characteristics associated with higher mite allergen levels. RESULTS: Der p 1 levels were highest in the mattress (GM 1.19 microg/g, 95% CI 0.98-1.45, P < 0.001). Two-thirds of homes contained Der p 1 levels > 2 microg/g in at least one dust reservoir, and 40.3% contained Der p 1 greater than 10 microg/g. There was a large range in Der p 1 levels between homes (> 10(3)-fold). Damp and condensation were common findings in homes. In the multivariate analyses, factors associated with higher Der p 1 levels in more than one dust reservoir were older homes, older living room carpets, damp, condensation and mixed glazing. Older mattresses were associated with higher mite allergen levels in the mattress where the age of the mattress was recorded. Twenty-four homes contained no detectable mite allergen, six of which reported damp. CONCLUSIONS: Mite allergen levels are high enough in two of every three homes to be associated with an increase in the risk of sensitization to mite. Factors such as older homes, carpets and mattresses, damp and condensation are associated with higher mite allergen. However, mite allergen levels are occasionally unpredictably very low in homes with risk factors for high levels.     

Allergens in house-dust samples in Germany: results of an East-West German comparison

The background of this study is the finding of several studies that the frequency of respiratory allergies was significantly higher in the former West Germany than the former East Germany. The present study investigated the levels of allergens of house-dust mite (Der p 1 and Der f 1), cat (Fel d 1), and cockroach (Bla g 2) in the household dust of 201 homes in Hamburg (West Germany) and 204 homes in Erfurt (East Germany), and examined the factors that affect these levels. The characteristics of homes were assessed by a questionnaire. The allergen levels were studied in dust from living rooms (LR), bedrooms (BR), and mattresses (MA). We detected in samples from Hamburg significantly higher allergen concentrations than in Erfurt: three times higher Der p 1, five times higher Der f 1, and three times higher Fel d 1. For Bla g 2, no comparison was possible because the concentrations were below the detection limit in 93% of the samples. Most of the differences could be explained by differences in housing and living characteristics between both cities. The mean ratio of Der p 1 levels in mattress dust between Hamburg and Erfurt decreased from 4.1 to 1.54 (NS) after adjustment for season, building material, age of the house, story of the dwelling, type of heating, age of carpet/mattress, presence of dogs, and indoor climate (temperature, humidity). The mean ratio of Der f 1 levels decreased from 6.9 to 2.78 (P<0.05) after adjustment for these factors. The mean ratio for Fel d 1 in mattress dust decreased fom 4.03 to 1.65 (P<0.05) after adjustment for season, building material, story of dwelling, size of dwelling, ventilation, cleaning routines, and pets. A similar reduction was seen for floor dust (LR plus BR). Our results indicate that the differences between the concentrations of mite and cat allergens found in Hamburg and Erfurt are explicable mainly, but not completely, by different building characteristics (age of houses, building material, story, and size of the dwelling) which affected the indoor climate, as well as by differences in other individual living habits (keeping of pets, age of carpets or mattresses, and cleaning routines).     

Allergens, Der p 1, Der f 1, Fel d 1 and Can f 1, in newly bought mattresses for infants

BACKGROUND: To avoid allergen exposure of newborn babies, the use of a new mattress for the baby bed may be recommended. However, it is not certain that new mattresses are always free of allergens. OBJECTIVE: In the present study the allergen content of new infant mattresses was investigated. METHODS: Dust samples were vacuumed from 90 new mattresses for infant beds bought in 50 different Dutch shops, and the concentrations of Der p 1, Der f 1, Fel d 1 and Can f 1 were determined by radioimmunoassays. RESULTS: Most mattresses contained some allergen and often the allergen concentrations were surprisingly high. Only 15 of the 90 mattresses contained no detectable amounts of any of the four allergens. The highest concentration found for each allergen was 3.1, 46.5, 20.2 and 95.7 microg/g of dust, respectively. However, the total amount of allergen in a mattress was still rather low because the new mattresses contained only modest amounts of dust. Baby mattresses more often contained an increased allergen load than the larger, standard-sized, infant mattresses. This may be caused by differences in manufacturing procedure. Also, mattresses that were sold without a plastic encasement more often contained an increased allergen load. CONCLUSIONS: It is advisable to buy a mattress that is wrapped in plastic, but it may still contain a substantial amount of allergen. Thorough vacuuming of a newly bought mattress before it is installed on a child's bed, is also advisable. After instalment, regular vacuuming of the mattress and washing of the bed linen as well as measures to eliminate allergen reservoirs in other parts of the house are important, because our observations indicate that mattresses easily pick up allergens from the environment.     

Distribution of dust-mite allergens (Lep d 2, Der p 1, Der f 1, Der 2) in pig-farming environments and sensitization of the respective farmers

BACKGROUND: The aim of the present study was to determine the distribution of mite allergens in pig-farming environments in comparison to urban homes and the relationship between exposure to mite allergens and sensitization to the respective allergens in 100 pig farmers with work-related respiratory symptoms. METHODS: The concentration of storage mite (Lep d 2) and house-dust-mite (Der p 1, Der f 1, and Der 2) allergens in dust collected from five different sampling sites (floor, wall, grain mill, transit area between confinement house and farmer's kitchen, and farmers' mattresses) was studied in relationship to the respective sensitization rates. Allergen concentrations in the mattresses were compared to those determined in mattresses from 22 urban dwellers. RESULTS: Median concentrations of Der p 1 and Der 2 in the mattresses of the farmers were significantly higher than in the urban dwellers' samples (53.4 microg/g dust vs 1.05 microg/g dust, P=0.001; 19.6 microg/g dust vs 2.2 microg/g dust, P<0.0001, respectively). Allergen concentrations in the transit areas were strongly related to bedroom exposure. In a multiple logistic regression model, a weak but significant relationship between Der p 1 exposure and sensitization to Der p 1 was found. Despite these findings, the prevalence of sensitization to mite allergens in the farmers (18%) was comparable to the prevalence in the general population. CONCLUSIONS: Allergen exposure at the workplace is strongly related to the concentration of allergens in farmers' beds. Exposure to domestic mite allergens should be taken into account when assessing occupational exposure to allergens and the respiratory health of farmers.     

House dust mites and their allergens at selected locations in the homes of house dust mite-allergic patients

BACKGROUND: Knowledge of the occurrence of house dust mites (HDM) and their allergens in domestic locations is important when planning intervention. OBJECTIVE: The aim of this study was to describe the distribution of HDMs and their allergens before intervention in multiple locations in the homes of newly diagnosed HDM-allergic patients with a known high Der 1 concentration in their mattress dust. METHODS: Dust was collected from ten locations in the homes of eight HDM-allergic patients. Dust was analysed for allergen content with ELISAs for Der f 1, Der p 1 and Der m 1; and HDM were counted. Total allergen concentrations ( micro g Der 1/g dust) were expressed as the sum of Der f 1, Der p 1 and Der m 1. RESULTS: On mattresses the median concentration was 86 micro g Der 1/g dust (range 30-288) and 188 mites/g dust (range 12-1910). Der 1 exceeded 10 micro g/g dust in mattresses (8/8), duvets/pillows (3/8), a bedroom carpet (1/1), a living room carpet (1/6), upholstered furniture (2/8) and a curtain (1/5). Uncarpeted floors, upholstered furniture, bookshelves and walls had significantly lower Der 1 concentration than the mattresses. The relative contribution of Der p 1, Der f 1 or Der m 1 to Der 1 was related to homes, rather than to the location. Der m 1 only occurred in minute amounts. CONCLUSION: For HDM intervention, our results indicate that priority should be given to the removal of allergens from mattresses, and in addition from carpets, duvets/pillows and upholstered furniture. Dust from walls, uncarpeted floors, bookshelves and curtains appear to contribute insignificantly to the domestic HDM allergen load.     

Effect of mattress encasings on atopic dermatitis outcome measures in a double-blind,placebo-controlled study: the Dutch mite avoidance study

BACKGROUND: House dust mite (HDM) allergen might induce and maintain atopic dermatitis (AD). Reduction of allergen load by applying encasings might improve the clinical symptoms of AD. OBJECTIVE: We sought to investigate, in a randomized, double-blind, placebo-controlled study, whether reducing HDM allergen levels by using mattress, duvet, and pillow encasings for 12 months will result in improvement in AD symptoms. METHODS: Patients with AD (8-50 years old and allergic to HDM), having a Leicester sign score (a dermatitis score) of at least 1% extent and a severity score of 6 points or greater, were randomly allocated to an active (n = 45) or a placebo allergen-avoidance group (n = 41). Avoidance measures consisted of applying HDM-impermeable encasings for mattresses, pillows, and duvets for the active treatment group and cotton encasings for the placebo group. Effect on allergen concentrations (Der p 1 and Der p 1 plus Der f 1), Leicester sign score extent and severity, visual analogue scale scores for itching and sleeplessness, intradermal test results, atopy patch test results, total serum IgE levels, anti-Der p 1-specific IgE levels, and total blood eosinophil counts were studied. RESULTS: The active encasings reduced the Der p 1 allergen concentration in the mattress after 12 months with a factor 2.1 (P =.007) and the Der p 1 plus Der f 1 allergen concentration with a factor of 2.5 (P =.005); no significant change in allergen concentrations in mattresses was seen in the placebo group. Although the decrease in allergen load was significant, no differences in treatment-induced changes were seen between the placebo and active groups. CONCLUSIONS: Use of HDM-impermeable encasings resulted in a significant decrease in Der p 1 and Der p 1 plus Der f 1 allergen concentrations. However, this reduction in allergen load did not result in significant changes in clinical parameters between the groups. Reduction of allergens in other environments (work, school, and outdoors) might be equally important in improving symptoms of AD.     

Mite antigen in house dust: relationship with different housing characteristics in the Netherlands

As part of a case-controlled study on the relationship between home dampness and respiratory symptoms of children, the concentration of the major allergen of Dermato-phagoides pteronyssinus (Der p I) in floor dust and mattress dust in 516 dwellings in the Netherlands was measured. A checklist, completed by the investigators, was used to obtain information on home and occupant characteristics, which may have an impact on the Der p I concentration in house dust. The geometric mean mite antigen concentrations were 2370 ng Der p I/g floor dust for the living room, 2201 ng Der p I/g floor dust for the bedroom and 5075 ng Der p I/g mattress dust. In 86% of the houses the maximum concentration was higher than 2000 ng Der p I/g dust, that is regarded as representing a risk for genetically predisposed individuals for the development of specific IgE to house dust mite allergen. In 55% of the houses the maximum concentration exceeded 10000 ng Der p I/g dust, regarded as a risk factor for acute attacks of asthma for mite allergic patients. The Der p I concentrations in dust from carpeted floors were six to 14 times higher than in dust from floors with a smooth floor covering. Higher Der p I concentrations in floor dust were also significantly associated with increasing age of the dwelling and of the floor covering, with an increasing number of occupants, and with the absence of floor insulation. For mattress dust, the age of the mattress, the presence of an outer cavity wall and mechanical ventilation were important factors. Older mattresses had higher levels, and mattress dust from bedrooms with solid brick outer walls had higher levels than that from bedrooms with outer cavity walls. Mattresses in homes with continuous mechanical ventilation had almost twice lower levels than mattresses in homes with natural ventilation. There was a tendency towards higher Der p I concentrations in dust in homes with reported or observed signs of dampness. The Der p I concentrations in dust from carpeted bedroom floors and mattresses were positively associated with the average relative humidity in the bedroom over a period of 3–6 weeks in a subset of the homes where relative humidity was measured. Similar results were obtained using the concentrations of Der p I in ng/m² instead of ng/g dust. The results obtained in this study are of importance for planning and evaluating allergen avoidance measures advised to mite allergic patients.     

Natural variation in mite antigen density in house dust and relationship to residential factors

To investigate the year-to-year variation of mite antigen density (Der p I, Der f1) in dust from mattresses and the relevance of residential factors for antigen load, information derived from an epidemiologic study including two surveys carried out in the households of a cohort of elementary school children (n= 1291) was analysed. When considering residences with measurements taken in both years in question (n= 1050), rank-correlation indicated a predominance of stability for both antigens (Der p I: r_s= 0-82, p=0.0001; Der f I: r_s=0.72, P= 0.0001), Using multiple regression analyses, significant associations between antigen concentrations and a variety of residential factors were found. Use of a blanket of animal hair, use of a cover or underblanket, wet spots in the bedroom, higher relative humidity and a low storey level were significantly associated with increased concentrations of Der p I, whereas inverse relationships between this antigen and room temperature, number of persons per m² as well as use of underfloor heating were seen. Regarding Der f I, older mattresses, use of a cover or underblanket, higher weight of sampled dust, high educational level and higher ratio of inhabitants per m² were significantly associated with increased concentrations of the antigen. On the other hand, lower Der f I concentrations were found when interior sprung mattresses were used and when the mattress was ‘treated regularly’. In conclusion, two measurements, 1 year apart from each other, show that stability of mite antigen concentrations predominated. Our data suggest that allergic patients should be advised against living in lower storeys and damp homes and to use a newer or encased mattress and to give preference to a residence with underfloor heating.     

Predictors of high house dust mite allergen concentrations in residential homes in Sydney

BACKGROUND: In parts of coastal Australia, house dust mite allergen concentrations in homes are often very high with at least 80% of homes in Sydney exceeding concentrations of 10 microg of allergen per gram of fine dust. In this study, we report the relation between characteristics of the home environment and house dust mite allergen concentrations at three sites in Sydney homes. METHODS: A total of 616 families were recruited as part of the Childhood Asthma Prevention Study (CAPS). Information about the home environment and structural aspects of the home was collected using a questionnaire. Samples of dust were collected from the parents' bed, the bedroom floor and the living room floor and assayed for Der p 1. RESULTS: A total of 68% of participants' beds, 65% of bedroom floors and 56% of living room floors had Der p 1 concentrations above 10 microg/g, with the highest concentrations of allergen in the bed. The most significant predictor of high Der p 1 concentrations in the bed and floors was the age of the home. We also found that beds with mattresses over two years old and with woollen or synthetic blankets or synthetic quilts had higher Der p 1 concentrations. Carpeted floors had higher Der p 1 concentrations than hard floors. CONCLUSION: The finding that high Der p 1 allergen concentrations in homes with carpets and older mattresses indicates that control strategies directed at these sources are likely to be effective in reducing exposure. Alternatives such as the use of house dust mite impermeable mattress encasings on older mattresses may also be effective in reducing exposure.     

Repeated measurements of mite and pet allergen levels in house dust over a time period of 8 years

BACKGROUND: Studies of the association between indoor allergen exposure and the development of allergic diseases have often measured allergen exposure at one point in time. OBJECTIVE: We investigated the variability of house dust mite (Der p 1, Der f 1) and cat (Fel d 1) allergen in Dutch homes over a period of 8 years. METHODS: Data were obtained in the Dutch PIAMA birth cohort study. Dust from the child's mattress, the parents' mattress and the living room floor was collected at four points in time, when the child was 3 months, 4, 6 and 8 years old. Dust samples were analysed for Der p 1, Der f 1 and Fel d 1 by sandwich enzyme immuno assay. RESULTS: Mite allergen concentrations for the child's mattress, the parents' mattress and the living room floor were moderately correlated between time-points. Agreement was better for cat allergen. For Der p 1 and Der f 1 on the child's mattress, the within-home variance was close to or smaller than the between-home variance in most cases. For Fel d 1, the within-home variance was almost always smaller than the between-home variance. Results were similar for allergen levels expressed per gram of dust and allergen levels expressed per square metre of the sampled surface. Variance ratios were smaller when samples were taken at shorter time intervals than at longer time intervals. CONCLUSION: Over a period of 4 years, mite and cat allergens measured in house dust are sufficiently stable to use single measurements with confidence in epidemiological studies. The within-home variance was larger when samples were taken 8 years apart so that over such long periods, repetition of sampling is recommended.     

Measurement of Dermatophagoides mite allergens on bedding and human skin surfaces

BACKGROUND: The level of the Dermatophagoides mite group 1 (Der 1) allergens in reservoir dust has been used as an index of exposure in most studies. However, the mite allergen level in reservoir dust cannot directly reflect the personal exposure level. OBJECTIVE: We sought to develop a new method for quantifying the Der 1 allergens on bedding and human skin surfaces as an index of exposure to mite allergens. METHODS: Samples were obtained with a small adhesive tape from the forearm skin of 30 healthy volunteers and from their regularly used mattresses. The level of Der 1 allergens collected onto the adhesive tape was measured by a newly developed sensitive fluorometric ELISA for Der p 1 and Der f 1. RESULTS: The Der 1 allergens could be detected in all the samples from bedding surfaces and in 28 of the 30 samples from skin surfaces. The Der 1 levels by adhesive tape sampling from the mattresses correlated with those by reservoir dust sampling. The sampling of the skin and bedding surface with adhesive tape correlated, but skin sampling did not correlate with reservoir sampling. CONCLUSION: The Der 1 allergens on bedding surfaces and on human skin surfaces could be quantified with a very simple sampling technique. The system developed in this study will provide a new tool for the assessment of mite allergen exposure in daily life.     

The influence of air conditioning, humidity, temperature and other household characteristics on mite allergen concentrations in the northeastern United States

BACKGROUND: Information about the influence of housing and occupant characteristics on mite allergen concentrations is crucial to determine which methods could be used to decrease exposure of susceptible subjects. OBJECTIVES: To identify housing and occupant characteristics that are associated with mite allergen concentrations in house dust collected from living rooms and mattresses. METHODS: We collected dust samples from 750 homes in the northeastern US. The influence of various characteristics on concentrations of mite allergens (Der p 1 and Der f 1) was studied using multiple linear regression analysis. RESULTS: Some characteristics, like absence of air conditioners, the presence of mold or mildew, and a lower temperature were consistently associated with higher concentrations of both mite allergens in dust from all sampling locations. However, none of these factors changed Der p 1 or Der f 1 concentrations by more than a factor of 2. People of white ethnic background had roughly two times higher mite allergen concentrations, while family income, family size, and education level only marginally influenced mite allergen concentrations. CONCLUSIONS: Various housing characteristics have some influence on mite allergen concentrations, and could possibly be used to decrease exposure of susceptible subjects. However, only a limited percentage of the variation in mite allergen concentrations was explained by these characteristics.     

Der p I concentrations in mattress surface and floor dust collected from infants' bedrooms

Background Allergen exposure in early childhood is thought to be important for sensitization and subsequent development of asthma. Not much is known, however, about exposure of young children to allergens in the home. Objectives This study was designed to document dust mite allergen exposure in young children, and to determine wheither infants from atopic mothers (=‘high-risk’ infants) are exposed to lower concentrations of house dust mite alkrgen than infants from non-atopic parents (=‘low-risk’ infants). Methods Dust samples were taken in the homes of 104 infants (48 ‘high-risk’ and 56 ‘low-risk’ infants, selected by questionnaire) aged 3–15 months, from floors in different rooms and from the child's mattress surface. Results The majority of the infants were found to be exposed to Der p I concentrations of more than 2000 ng/g in dust collected from the surface of their mattresses. Lower Der p I concentrations were found in mattress surface dust from the beds of infants from atopic mothers than of infants from non-atopic parents. Also, lower Der p I concentrations were found in floor dust from the homes of infants from atopic mothers, Infant beds equipped with new mattresses, new blankets and top plastic sheeting had significantly lower Der p I concentrations than beds equipped with used mattresses and blankets, without top plastic sheeting. Conclusions Young children in the Netherlands are exposed to significant concentrations of Der p I in mattress surface dust. Allergic parents appear to provide their children with environments somewhat less rich in mite allergen than non-allergic parents.     

Microbial exposure of rural school children, as assessed by levels of N-acetyl-muramic acid in mattress dust, and its association with respiratory health

BACKGROUND: Endotoxin exposure has been shown to be associated with a decreased prevalence of atopic sensitization and symptoms. Yet endotoxin represents only a part of the indoor microbial exposure. Muramic acid, a constituent of peptidoglycan, is present in gram-negative and gram-positive bacteria in the environment and may therefore serve as an additional marker of microbial exposure. OBJECTIVE: To study the factors determining the level of indoor exposure to muramic acid/peptidoglycan, as well as its potential association with respiratory health. METHODS: In 553 farm and nonfarm school children from Austria, Switzerland, and Germany, mattress dust muramic acid concentrations were determined, and health was assessed by using IgE measurements and questionnaire information. RESULTS: The muramic acid concentration was found to be significantly higher in dust from farm children's mattresses than in dust from nonfarm children's mattresses (157 vs 131 ng/mg). Children with higher mattress dust muramic acid concentrations had a significantly lower prevalence of wheezing (odds ratio of highest vs lowest tertile of muramic acid concentration, 0.3; 95% CI, 0.1-0.9), regardless of farming status and endotoxin exposure. The association for asthma was similar, and no association was found with atopic sensitization. CONCLUSION: Next to endotoxin, muramic acid provides us with an independent marker of microbial exposure. Unlike endotoxin, muramic acid was inversely associated with wheezing rather than with atopic sensitization.