Original articleMechanisms of allergic and immune diseaseA comparison of subject room dust with home vacuum dust for evaluation of dust-borne aeroallergens
Introduction
Domestic allergen exposures remain at the top of the list of controllable factors related to asthma in children.1 Measurement of allergen proteins in house dust has been very useful in identifying environmental agents that are at the root of human allergic disease and function to trigger asthma attacks. From the beginning of allergen measurements in house dust,2 there has been discussion as to the best collection methods and which collection protocols are most representative of human exposure. The most accurate method, however, is still not known.[3], [4] In light of the need for frequent monitoring to adequately assess exposure and gauge potential reductions that might lead to asthma symptom reduction, the practicality of patient-collected dust samples for allergen testing has been proposed.
The measurement of allergen reservoir levels is an important aspect of effective allergen trigger control. The cost effectiveness of allergen reduction and thereby the utility of allergen measurements has been demonstrated previously.5 In 1 study of improved asthma as a result of environmental control, within the intervention group there was a significant relationship between the reduction of dust aeroallergens and asthma symptom improvement.6 Allergen measurements were repeated every 6 months, and results from aeroallergen testing were used as part of motivational education and modeled behavioral changes to reduce aeroallergen exposures. Even though it has not been possible to consistently demonstrate the effectiveness of isolated allergen trigger control strategies,7 numerous studies have shown targeted interventions involving multiple control strategies to be effective in reducing asthma symptoms and health care use.[6], [8], [9], [10]
In this work, we aim to determine the relationship between allergen content in dust collected by a field worker according to a specific protocol and samples a patient could take from their home vacuum. We hypothesize that a dust sample collected from the home vacuum unit of a family, assuming the unit is used regularly and only in the home, would be a good proxy for that collected by a trained investigator.
Section snippets
Home selection and characteristics
Homes in this study were a subset of homes that participated in the Kansas City Safe and Healthy Homes Program. Homes participating in this program had at least 1 child with asthma resident for a minimum of 4 days per week. Asthma severity ranged from mild to severe. Homes in the program were assessed by environmental health professionals before and after a series of targeted interventions designed to improve the indoor air quality of the home. Homeowners received a new vacuum cleaner at the
Results
The Healthy Homes Demonstration project screened a total of 1,473 families for enrollment, of which 382 families were enrolled and 302 families completed the study. Reasons for not enrolling in the study included failure to complete enrollment information, income greater than 80% of median family income (Department of Housing and Urban Development stipulation for participation), and plans to relocate during the time of the study. Reasons for not completing the study included repeated failure to
Discussion
Early reviews on home allergen measurement used polyclonal antibodies and expressed results per square meter.12 Subsequent discussion as to practical methods for dust sampling has been extensive.13 A continuously operating filter device worn on the collar or a particle retaining device worn in the nose constitutes the gold standard of exposure monitoring. In light of the reduced practicality of these devices, measurement of allergens from vacuum-collected house dust has become the most commonly
Acknowledgment
The authors wish to acknowledge the Center for Environmental Health at Children's Mercy Hospital for their assistance with the completion of this study, including Kevin Kennedy, MS, Ryan Allenbrand, MFS, Minati Dhar, PhD, Erica Forrest, MS, RRT, Luke Gard, Jennifer Lowry, MD, Mubeen Mohammed, MS, Anita Didonna, and Tanisha Webb, RRT.
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2013, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :For homeowners to collect samples for measurement of dust mite allergen levels, simple and inexpensive methods of sampling are needed. It appears that a single sample from a vacuum cleaner is sufficient to represent overall exposure to mite allergens in the home.239 In 1 study, 4 different devices were used to collect dust samples from carpets.
Association of tobacco smoke exposure and atopic sensitization
2013, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :Similarly, mold levels varied, with the maximum detected levels of A alternata, P chrysogenum, A fumigatus, and C herbarum at 66, 42, 102, and 93 μg/g of dust, respectively. These allergens were undetectable in some homes and previously reported.12 No significant difference was seen in dust allergen levels from homes of cases vs controls for any allergen tested.
Disclosures: Authors have nothing to disclose.
Funding Sources: Funded by Children's Mercy Hospital and by a Healthy Homes Demonstration Project Award from Housing and Urban Development.