An evaluation of mattress encasings and high efficiency particulate filters on asthma control in the tropics. (65/1985)

The effect of two allergen avoidance modalities, Allergy Control Covers (ACC) and High Efficiency Particulate Filters (HEPA) on asthma control in children were evaluated. This was an open study involving 24 dust mite sensitive asthmatic children. Following a 4 week run-in period, the subjects were randomly allocated to use mattresses fitted with ACC (n = 6), HEPA filters in their bedrooms (n = 12) or act as controls (n = 6) for a study duration of 4 months. Measurements of the major Dermatophagoides spp. mite allergens, Der p 1 and Der f 1, levels in dust samples obtained from mattresses were made at baseline, 1, 2 and 4 months post implementation. Daily symptom scores including morning and evening peak flow readings, and monthly spirometry and exercise bronchoprovocation tests were carried out Our results showed that dust mite allergen levels in mattresses fell at 1 and 2 months post implementation in the ACC group (p<0.05). In contrast, no decrease in allergen levels was seen in the HEPA and control group. At the end of the 16 weeks, only the ACC group showed improvement in FEV1 and reduction in diurnal peak expiratory flow rate (p<0.05). Improvement in mean symptom scores was also observed for both the ACC and HEPA groups, but not the control groups (p<0.05). Although the numbers in this study were small, the results Indicate that the effectiveness on mite exposure barrier covers was short-lived, and the improvement in asthma control though documented was not obvious.  (+info)

Healthy adults demonstrate less skin reactivity to commercial extracts of commonly ingested food than to D. farinae. (66/1985)

The aim of this study is to determine the skin reactivity of healthy Oriental adults to commercial extracts of commonly ingested food and the house dust mite D. farinae, a common local aeroallergen. D. farinae and 18 food extracts were skin prick tested on adults without any personal history of atopic diseases and food allergy. The extracts of food not consumed by any subject on religious or personal grounds were not tested for that individual. A total of 103 healthy adults who fulfilled the selection criteria were skin prick tested. There were 35 males and 68 females. Their mean age was 29 years (SD +/- 7.5) with a range of 19 to 49 years. Sixty-eight percent were Chinese, 12.6% Malay, 12.6% Indian and 6.8% other Oriental races. Fifty-four (52.4%) were positive for D. farinae while only 12 (11.7%) were positive for at least one food extract The food extract that gave the most number of positive reactions was shellfish mix (5/102, 4.9%). A family history of atopy did not have any significant correlation with the results of skin test. It was concluded that healthy adults demonstrate less skin reactivity to extracts of commonly ingested food than to D. farinae.  (+info)

Culture of Blomia tropicalis and IgE immunoblot characterization of its allergenicity. (67/1985)

Blomia tropicalis is an important triggering factor for allergic diseases such as asthma, rhinitis and atopic dermatitis in tropical and subtropical regions, which climate favours the growth of this species. Our previous mite fauna study revealed that Blomia tropicalis is the most dominant species present in Singapore house dust The main objective of this study is to establish a mass culture of Blomia tropicalis for further characterization of the antigenic and molecular properties of this mite. Approximately one gram of mites could be obtained for every 300-gram of culture medium by culturing under natural condition with a mean annual temperature of 30 degrees C and a mean relative humidity of 80%, and harvested by modified Tullgren funnel. Allergen characterization by IgE immunoblot analysis with crude mite extracts showed some IgE reactivity differences between Blomia tropicalis mite extract from Singapore and Colombia. The possible reasons for these findings are the quality and source of the mite protein extracts used, or selective differences in the population under evaluation. Further, the atopic sera tested showed differences in the pattern and Intensity of IgE immunoblot reactivity to crude extracts of Blomia tropicalis and Dermatophagoides pteronyssinus, the other highly prevalent mite in Singapore. These data support the existence of species-specific allergens. In conclusion, we have been successful in setting up B. tropicalis mass cultures and have prepared extracts of high allergenicity.  (+info)

The size of airborne dust particles precipitating bronchospasm in house dust sensitive children. (68/1985)

We have assessed the effect of house-cleaning procedures on changes in airborne dust and bacteria counts and correlated these with respiratory function tests in 14 children with bronchial asthma who were known to have developed attacks at home, and who had positive skin tests to house dust and the house-dust mite. We have demonstrated that after cleaning procedures a positive and statistically significant correlation exists between the increase in the numbers of small particles, 2 mum. and less in diameter, in the environment, and reduction in mean peak flow. This indicates that particles of this size penetrate the bronchial tree and are the causative factor in the genesis of bronchospasm.  (+info)

Lung function decline in 4-monthly repeated spirometric measurements: due to silt aerosol exposure or decreasing effort? (69/1985)

BACKGROUND: Workers on dredgers and lighters on rivers are exposed to the inhalation of aerosols and dusts. OBJECTIVE: The aim of this study was to investigate effects of river silt aerosol and dust exposure on the respiratory health of dredging employees. METHODS: Six examinations were performed over a period of 2 years at 4-monthly intervals in 54 seamen with higher silt aerosol exposure and 36 controls of the same employer. RESULTS: No significant differences could be observed between the groups at any time of the study but there was an unexpected significant decrease in the age-corrected expiratory vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)) and midexpiratory flow rate (MMEF(25/75)) over the six series in both groups. This may indicate a loss of effort of the participants in re-examinations since biological and technical influences were highly unlikely to be the cause of these findings. CONCLUSIONS: Ignoring this possible decline of effort in frequently repeated measurements may result in overestimating potential effects of occupational exposure.  (+info)

Lung function, biological monitoring, and biological effect monitoring of gemstone cutters exposed to beryls. (70/1985)

OBJECTIVES: Gemstone cutters are potentially exposed to various carcinogenic and fibrogenic metals such as chromium, nickel, aluminium, and beryllium, as well as to lead. Increased beryllium concentrations had been reported in the air of workplaces of beryl cutters in Idar-Oberstein, Germany. The aim of the survey was to study the excretion of beryllium in cutters and grinders with occupational exposure to beryls--for example, aquamarines and emeralds--to examine the prevalence of beryllium sensitisation with the beryllium lymphocyte transformation test (BeLT), to examine the prevalence of lung disease induced by beryllium, to describe the internal load of the respective metals relative to work process, and to screen for genotoxic effects in this particular profession. METHODS: In a cross sectional investigation, 57 out of 100 gemstone cutters working in 12 factories in Idar-Oberstein with occupational exposure to beryls underwent medical examinations, a chest radiograph, lung function testing (spirometry, airway resistance with the interrupter technique), and biological monitoring, including measurements of aluminium, chromium, and nickel in urine as well as lead in blood. Beryllium in urine was measured with a newly developed direct electrothermal atomic absorption spectroscopy technique with a measurement limit of 0.06 microgram/l. Also, cytogenetic tests (rates of micronuclei and sister chromatid exchange), and a BeLT were performed. Airborne concentrations of beryllium were measured in three factories. As no adequate local control group was available, the cutters were categorised into those with an exposure to beryls of > 4 hours/week (group A) and < or = 4 hours/week (group B). RESULTS: Clinical, radiological, or spirometric abnormalities indicating pneumoconiosis were detected in none of the gemstone cutters. Metal concentrations in biological material were far below the respective biological limit values, and beryllium in urine was only measurable in subjects of group A. Cytogenetic investigations showed normal values which were independent of the duration of beryllium exposure. In one subject, the BeLT was positive. Beryllium stimulation indices were significantly higher in subjects with detectable beryllium in the urine than in those with beryllium concentrations below the detection limit (p < 0.05). In one factory, two out of four measurements of airborne beryllium concentrations were well above the German threshold limit value of 2 micrograms/m3 (twofold and 10-fold), and all gemstone cutters working in this factory had measurable beryllium concentrations in urine. CONCLUSION: No adverse clinical health effects were found in this cross sectional investigation of gemstone cutters working with beryls. However, an improvement in workplace hygiene is recommended, accompanied by biological monitoring of beryllium in urine.  (+info)

Socioeconomic predictors of high allergen levels in homes in the greater Boston area. (71/1985)

In the United States, childhood asthma morbidity and prevalence rates are the highest in less affluent urban minority communities. More than 80% of childhood asthmatics are allergic to one or more inhalant allergens. We evaluated whether socioeconomic status was associated with a differential in the levels and types of indoor home allergens. Dust samples for an ELISA allergen assay were collected from the homes of 499 families as part of a metropolitan Boston, Massachusetts, longitudinal birth cohort study of home allergens and asthma in children with a parental history of asthma or allergy. The proportion of homes with maximum home allergen levels in the highest category was 42% for dust mite allergen (> or = 10 microg/g Der p 1 or Der f 1), 13% for cockroach allergen (> or = 2 U/g Bla g 1 or Bla g 2), 26% for cat allergen (> or = 8 microg/g Fel d 1), and 20% for dog allergen (> or = 10 microg/g Can f 1). Homes in the high-poverty area (> 20% of the population below the poverty level) were more likely to have high cockroach allergen levels than homes in the low-poverty area [51 vs. 3%; OR, 33; 95% confidence interval (CI), 12-90], but less likely to have high levels of dust mite allergen (16 vs. 53%; OR, 0.2; CI, 0.1-0.4). Lower family income, less maternal education, and race/ethnicity (black or Hispanic vs. white) were also associated with a lower risk of high dust mite levels and a greater risk of high cockroach allergen levels. Within a single U.S. metropolitan area we found marked between-community differences in the types of allergens present in the home, but not necessarily in the overall burden of allergen exposure.  (+info)

Exposure-response relations for self reported asthma and rhinitis in bakers. (72/1985)

OBJECTIVES: To explore relations between two estimates of exposure to inhalable flour dust, and the incidence rates (IRs) of asthma and rhinitis in bakers. METHODS: This was a retrospective cohort study among 2923 bakers. A posted questionnaire registered the disease and work history. For every year, each baker was assigned an estimate of the exposure concentration to inhalable flour dust derived from reported job-tasks and dust measurements. Exposure at onset of disease was expressed as current dust exposure concentration, and as cumulative dose of exposure to dust. A multiple Poisson regression analysis assessed the impacts of the exposure estimates on the IRs of asthma and rhinitis. RESULTS: IRs of asthma and rhinitis increased by dust concentration at onset of disease. The IR of asthma for the bakers with highest exposure (dough makers) was 7. 3/1000 person-years in men and 6.5 in women and for rhinitis 43.4 and 38.5, respectively. There was a significant association between the dust concentration at onset of disease and the risk for asthma or rhinitis, but not of the cumulative exposure. CONCLUSION: The risk of asthma seemed to be increased at inhalable dust concentrations >/=3 mg/m(3) (dough making or bread forming), whereas the risk of rhinitis was increased at all concentrations >/=1 mg/m(3), indicating an increased risk in all bakery job-tasks. The risks seemed to be less dependent on the cumulative exposure dust than the inhalable dust concentrations.  (+info)