Controlling Asthma & Allergy Triggers Through Source Identification
Allergens or irritants such as mold, smoke, dust, dust mite, cat & cockroach allergen or pollen can cause the airways to become inflamed and narrow.
Washington 9/18/2013 01:25 PM GMT
Washington, DC –Asthma is the most common chronic disease affecting more than 35 million people, including 6 million children. Each year, the prevalent disease causes more than 5 million emergency room visits and 500,000 hospitalizations.
According to EPA “Americans spend up to 90 percent of their time indoors. Indoor allergens and irritants play a significant role in triggering asthma attacks. Triggers are things that can cause asthma symptoms, an episode or attack or make asthma worse. If you have asthma, you may react to just one trigger or you may find that several things act as triggers. Be sure to work with a doctor to identify triggers and develop a treatment plan that includes ways to reduce exposures to your asthma triggers.”
Allergens or irritants such as mold, smoke, dust, dust mite, cat & cockroach allergen or pollen can cause the airways to become inflamed and narrow. If one parent has asthma, chances are one in three that each child will have asthma. If both parents have asthma, it is much more likely (7 in 10) that their children will have asthma. Symptoms may include wheezing, coughing, pain or tightness in the chest and shortness of breath. Not all asthma attacks are the same. In severe attacks, the airways can close so much that not enough oxygen gets to vital organs. This condition is a medical emergency.
The assessment of allergens in a house dust sample is an essential step for allergen-avoidance and provides information essential for allergen-reducing measures, in addition to managing the indoor environment from a health and hygiene point of view.
Some of the most common allergens in this category include but are not limited to:
- Dust mite (Der p 1, Der f 1P)
- Cockroach (Bla g 2)
- Cat (Fel d 1)
- Dog (Can f 1)
Exposure to these substances, even in small amounts, can trigger allergenic symptoms/disorders. Common symptoms of a house dust allergy include, but are not limited to, sneezing, itchy or watery eyes, nasal congestion and a runny nose. These signs appear as a result of production of immunoglobulin E (IgE) antibodies in a sensitive individual upon the exposure of dust allergens. In fact, IgE binds to mast cells in the mucosa in eye conjunctiva, nose, throat, and bronchi, and trigger a release of histamine. Histamine causes dilation of vessels in mucosa, and secretion of mucus from mucous glands, resulting in mucosal swelling and mucus secretion, which gives allergenic symptoms.
Successful management of allergies due to house dust is a two-fold approach (i.e. clinical diagnosis of the allergy sufferer and environmental monitoring of the dwelling). The clinical evaluation of a patient includes symptom history, blood tests, IgE levels, evaluation of suspected allergens (skin prick or patch test), etc. where as environmental monitoring reveals the identification and quantification of allergen load in house dust.
Culture (Bioaerosols) or non-culture (spore trap analysis) based methods and Polymerase Chain Reaction (PCR) are often used for enumerating allergens of the indoor environment. However, enzyme immunoassay (ELISA) of air or dust samples has been the gold standard for assessing indoor allergens. ELISA kits have been used for analyzing indoor allergens in house dust for years, although it is costly, time consuming and allergen specific.
Immunological assay for the determination of indoor allergens is available which evaluates five to eight most common allergens/sample in house dust. The immunological assay simultaneously measures HouseDust Allergens (HDA) such as mite allergens Der p 1, Der f 1 and Mite Group 2, animal allergens of cat (Fel d 1), dog (Can f 1), rat (Rat n 1) and mouse (Mus n 1) as well as cockroach (Bla g 2). Immunological assay provides improved performance (increased sensitivity, accuracy and precision) in a high throughput system with substantial time and cost savings. Concentration of identified allergens from indoor dust is reported as μg/gram.
Indoor environmental screening of the home or work environment is important for individuals with allergies, chronic sinusitis, rhinitis, emphysema, asthma, atopic dermatitis, immune deficiencies, etc. In keeping with the National Heart, Lung and Blood Institute (NHLBI) 1997 recommendations, it is desirable to identify and remove common allergens (e.g. molds) and modify the home or office to reduce the level of ubiquitous (common) allergens. Before one can remove allergens and/or pollutants effectively, it is essential to understand if they exist and in what quantity.
Environmental bulk/dust samples are acceptable for House Dust Allergen (HDA) analysis. Dust samples from the indoor environment are collected in a dust sock (duct collection filter), which is attached to the hose of a vacuum cleaner, against the flow of the air. The suspect area is vacuumed. Then, the dust sock, containing the collected dust, is carefully removed and mailed to the laboratory in a clean and unused zip lock bag along with the completed chain of custody.
Advantage of HDA:
- Multiple allergen tests (up to 5 – allergens) in one environmental sample. Significantly reduces the sample collection time.
- More sensitive in comparison to other methods.
- Use of Universal Allergen Standard generates superior data.
- Statistically superior results with less variation
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