Abstract
Of the four modes of treating human allergic disease, avoidance or separation of the allergic patient from the allergen source is most effective and least expensive. The clinical immunology laboratory has established efficient and inexpensive “reservoir” dust sampling and processing procedures to obtain a surface dust specimen that reflects the allergen burden of the environment. Following extraction, allergens are quantified by reproducible, validated immunoenzymetric assays for the quantification of “indicator” aeroallergen levels in home, school, and work environments. In this paper, the strategies and methods for collecting and processing dust samples are discussed, and assays are reviewed for quantifying indoor aeroallergen exposure from dust mites (Der p 1 and 2, Der f 1 and 2), animals (cat: Fel d 1; dog: Can f 1; mouse: Mus m 1; rat: Rat n 1), and insects (cockroach: Bla g 1 and 2). Accurate quantification of the levels of allergen in indoor environments facilitates avoidance therapy by identifying environmental risk factors for asthma and allergy exacerbation and allowing the allergic patient to monitor the effectiveness of environmental remediation actions.
Similar content being viewed by others
References and Recommended Reading
Platts-Mills TA: Allergen avoidance. J Allergy Clin Immunol 2004, 113:388–391. A strong case is made for the utility of allergen avoidance programs in the management of asthma and allergies. Six studies are summarized that show improvement in primary outcomes with avoidance practices such as physical barriers, carpet treatments, and heat treatments.
Eggleston PA, Creticos PS, Lockey R, et al.: Environmental allergen avoidance in allergic asthma (position statement). J Allergy Clin Immunol 1999, 103:203–205.
National Academy of Sciences, Institute of Medicine: Clearing the Air: Asthma and Indoor Air Exposures. Washington, DC: National Academy Press; 2000:438.
Arshad SH: Indoor allergen exposure in the development of allergy and asthma (review). Curr Allergy Asthma Rep 2003, 3:115–120. This paper is a useful review of the factors, including allergen exposure, that lead to allergen sensitization.
Platts-Mills TAE, Vervlot D, Thomas WR, et al.: Indoor allergens and asthma. Third International Workshop. J Allergy Clin Immunol 1997, 100(Suppl):S1-S24.
Spieksma FT, Dieges PH: The history of the finding of house dust mite. J Allergy Clin Immunol 2004, 113:573–576. This paper provides a historical perspective on the identification of the genus Dermatophagoides.
Thomas WR, Smith WA, Hales BL: The allergenic specificities of the house dust mite. Chang Gung Med J 2004, 27:563–569. The principal unique and cross-reactive allergen specificities produced by house dust mites are discussed.
Dryer AL, Chandler MJ, Hamilton RG: Dust mite allergen removal from feathers by commercial processing. Ann Allergy Asthma Immunol 2002, 88:576–577.
Platts-Mills TA: Allergens derived from arthropods and domestic animals. In Indoor Air Quality Handbook. Edited by Spengler JD, Samet JM, McCarthy JF. New York: McGraw-Hill; 2001:43:1–12.
Leitermann K, Ohman JL: Cat allergen I. Biochemical, antigenic and allergenic properties. J Allergy Clin Immunol 1984, 74:147–152.
Wood RA, Chapman MD, Adkinson NF Jr, et al.: The effect of cat removal on allergen content in household dust samples. J Allergy Clin Immunol 1989, 83:730–734.
de Groot H, Goei KGH, Van Swieten P, et al.: Affinity purification of a major and a minor allergen from dog extract: serologic activity of affinity purification Can f 1 and of Can f 1 depleted extract. J Allergy Clin Immunol 1991, 87:1056–1065.
Platts-Mills TA, Sporik R, Ingram JM, Honsinger R: Dog and cat allergens and asthma among school children in Los Alamos, New Mexico, USA, altitude 7200 feet. Int Arch Allergy Immunol 1995, 107:301–303.
Matsui EC, Simons E, Rand C, et al.: Airborne mouse allergen in the homes of inner-city children with asthma. J Allergy Clin Immunol 2005, 115:358–363. Discusses the quantity of Mus m 1 levels in homes of inner-city patients with asthma in relationship to their skin test reactivity.
Perry T, Matsui E, Merriman B, et al.: The prevalence of rat allergen in inner-city homes and its relationship to sensitization and asthma morbidity. J Allergy Clin Immunol 2003, 112:346–352.
Cohn RD, Arbes SJ Jr, Yin M, et al.: National prevalence and exposure risk for mouse allergen in US households. J Allergy Clin Immunol 2004, 113:1167–1171.
Matsui EC, Wood RA, Rand C, et al.: Cockroach allergen exposure and sensitization in suburban middle class children. J Allergy Clin Immunol 2003, 112:87–92.
Arbes SR Jr, Sever M, Mehta J, et al.: Abatement of cockroach allergens (Bla g 1 and Bla g 2) in low-income urban housing: moth 12 continuation results. J Allergy Clin Immunol 2004, 113:109–114.
Bollinger ME, Wolf B, Schwindt C, Hamilton RG: Contamination of nebulizer equipment with cockroach allergen. Ann Allergy Asthma Immunol 2004, 92:475–477.
Sarpong SB, Hamilton RG, Eggleston PA, Adkinson NF Jr:Socieoeconomic status and race as risk factors for cockroach allergen exposure and sensitization in asthmatic children. J Allergy Clin Immunol 1996, 97:1393–1401.
Wood RA, Eggleston PA, Lind P, et al.: Antigenic analysis of household dust samples. Am Rev Respir Dis 1988, 137:358–366.
Portnoy JM, Kennedy K, Barnes C: Sampling for indoor fungi: what the clinician needs to know. Curr Opin Otolaryngol Head Neck Surg 2005, 13:165–170.
Rao CY, Cox-Ganser JM, Chew GL, et al.: Use of surrogate markers of biological agents in air and settle dust samples to evaluate a water-damaged hospital. Indoor Air 2005, 15:89–97.
Huss K, Naumann PL, Mason PJ, et al.: Asthma severity, atopic status, allergen exposure and quality of life in elderly persons. Ann Allergy Asthma Immunol 2001, 86:524–530.
McArthur B: Dermal measurement and wipe sampling methods: a review. Appl Occup Environ Hyg 1982, 7:599–606. This is an excellent historical overview of the advantages and limitations of available methods that have been used to sample the environment for toxins and allergens.
Mitakakis TZ, Mahmic A, Deduc GD, Tovey ER: Comparison of vacuuming procedures for reservoir dust mite allergen on carpeted floors. J Allergy Clin Immunol 2002, 109:122–124.
Lewis RD, Breysse PN, Lees PSJ, et al.: Factors that affect the retention of dust mite allergen on carpet. Am Ind Hyg Assoc J 1998, 59:606–613.
Hamilton RG, Eggleston PA: Environmental allergen analyses. Methods 1997, 13:53–60.
Lioy PJ, Freeman NCG, Millette JR: Dust: a metric for use in residential and building exposure assessment and source characterization. Environ Health Perspect 2002, 110:969–983.
Hamilton RG, Rosenberg J, Bronzert C, Adkinson NF Jr: Effect of heat, freezing, pH and carpet additives on allergen immunoreactivity in house dust specimens (abstract). J Allergy Clin Immunol 1991, 87:190.
Sercombe JK, Liu Brennan D, Garcia ML, Tovey ER: Evaluation of home allergen sampling devices. Allergy 2005, 60:515–520.
Pate AD, Hamilton RG, Ashley PJ, et al.: Proficiency testing of allergen measurements in residential dust. J Allergy Clin Immunol 2005, In press. This study makes the case for requiring long-term internal and external proficiency testing programs to ensure the quality of allergen measurements. The importance is emphasized, given that environmental allergen measurements are not regulated analyses under current federal guidelines.
Luczynska CL, Karla-Arruda L, Platts-Mills TAE, et al.: A two-site monoclonal antibody ELISA for the quantification of the major Dermatophagoides spp. allergens, Der p 1 and Der f 1. J Immunol Methods 1989, 118:227–235.
Tsay A, Williams L, Mitchell EB, Chapman MD: A rapid test for detection of mite allergens in homes. Clin Exp Allergy 2002, 32:1596–1601.
Marks GB, Tovey ER, Peat JK, et al.: Variability and repeatability of house dust mite allergen measurement: implications for study design and interpretation. Clin Exp Allergy 1995, 25:1190–1197.
Amr S, Bollinger MB, Meyers M, et al.: Environmental allergens and asthma in urban elementary schools. Ann Allergy Asthma Immunol 2003, 90:34–40.
Christiansen SC, Martin SB, Schleicher NC, et al.: Exposure and sensitization to environmental allergen of predominantly Hispanic children with asthma in San Diego’s inner city. J Allergy Clin Immunol 1996, 98:288–294.
Huss K, Adkinson NF, Eggleston P, et al.: House dust mite and cockroach exposure are strong risk factors for positive allergy skin tests in the Childhood Asthma Management Program. J Allergy Clin Immunol 2001, 107:48–54.
Tranter DC: Indoor allergens in settled school dust: a review of findings and significant factors. Clin Exp Allergy 2005, 35:126–136. This paper is a comprehensive review of indoor allergen concentrations in schools, reported by investigators in different parts of the world and during different seasons. It is an excellent and comprehensive overview of the subject of aeroallergens in schools.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hamilton, R.G. Assessment of indoor allergen exposure. Curr Allergy Asthma Rep 5, 394–401 (2005). https://doi.org/10.1007/s11882-005-0013-0
Issue Date:
DOI: https://doi.org/10.1007/s11882-005-0013-0