The prevalence of contact allergy in the general population has traditionally been investigated through population-based epidemiological studies. A different approach is the combination of clinical epidemiological (CE) data and the World Health Organization-defined drug utilization research (DUR) method. The CE-DUR method was applied in Denmark to estimate the prevalence of contact allergy in the general population and compare it with the prevalence estimates from the Glostrup allergy studies. Contact allergy prevalence estimates ranging from very liberal ('worst case') to conservative ('best case') assumptions were based on patch test reading data in combination with an estimate of the number of persons eligible for patch testing each year based on sales data of the 'standard series'. The estimated 10-year prevalence of contact allergy ranged between 7.3% and 12.9% for adult Danes older than 18 years. The 10-year prevalence of contact allergy measured by CE-DUR was slightly lower than previous prevalence estimates from the Glostrup allergy studies. This could probably be explained by a decrease in nickel allergy. The CE-DUR approach holds the potential of being an efficient and easy monitoring method of contact allergy prevalence.
p-Phenylenediamine (PPD) is an important allergen; 5.0% of patients tested positive to PPD when patch-tested, according to the North American Contact Dermatitis Group. Hair dyes are the main source of exposure.
To assess the significance of PPD allergy at the Ottawa Patch Test Clinic.
We assessed the epidemiology of PPD allergies and determined the cross-reactivity with other para-amino compounds. Charts of patients visiting the Ottawa Patch Test Clinic between May 1997 and July 2009 were reviewed.
One hundred thirty-four patients were found to have a contact allergy to PPD; 75.4% were female, 24.6% were male, 13.4% were hairdressers, 18.7% had a history of atopy, 90.3% were sensitized by hair dye, 2.2% were sensitized by henna tattoos, and 7.5% were sensitized by other sources. Positive patch-test reactions to textile dyes were seen in 24.6%, 7.5% reacted to benzocaine, 6.0% reacted to sulfa drugs, 1.5% reacted to isopropyl-para-phenylenediamine, and 1.5% reacted to para-aminobenzoic acid.
PPD is an important source of allergic contact allergy. Our results show a significant relationship of PPD with other related para-amino compounds.
Severe facial and scalp dermatitis following the use of permanent hair dyes has been reported in several cases. Para-phenylenediamine (PPD) is known as a potent contact allergen, and PPD is allowed in hair dye at a concentration of 6%. Hair dye reactions are usually diagnosed by the patients themselves, and adverse reactions to hair dye may not necessarily be recorded by the health care system, unless the reactions are especially severe. Based on this assumption, we suspected that hair dye dermatitis was occurring more frequently than reported in the literature. Consumer complaint-based data were obtained by advertising for persons with adverse reactions to hair dye. Among those responding to the advertisement, 55 cases of severe, acute allergic contact dermatitis were identified. The main symptoms were severe oedema of the face, scalp and ears, and clinically this was often mistaken for angio-oedema. The 55 cases comprised a total of 75 visits to the health service and 5 admissions to hospital. 18 persons had sick leave, which supports the impression of very severe dermatitis reactions. 60% were treated with antihistamine, while 52% were treated with corticosteroids. 29% of the cases were patch tested and all were found positive to PPD. Our data presented here clearly show that PPD and its derivatives in hair dye at the present concentrations presents a significant health risk for the population. Furthermore, the severe acute allergic skin reactions are often misdiagnosed in the health care system. The frequency of allergic contact dermatitis resulting from hair dye is likely to be underestimated. New methods to survey the frequency of adverse reactions should be considered.
This paper presents an analysis of airborne biogenic particles (1 mkm-1 mm) found in the snow in several cities of the Russian Far East during 2010-2013. The most common was vegetational terraneous detritus (fragments of tree and grass leaves) followed by animal hair, small insects and their fragments, microorganisms of aeroplankton, and equivocal biological garbage. Specific components were found in samples from locations close to bodies of water such as fragments of algae and mollusc shells and, marine invertebrates (needles of sea urchins and shell debris of arthropods). In most locations across the Far East (Vladivostok, Khabarovsk, Blagoveshchensk, and Ussuriysk), the content of biogenic particles collected in the winter did not exceed 10% of the total particulate matter, with the exception of Birobidzhan and the nature reserve Bastak, where it made up to 20%. Most of all biogenic compounds should be allergic: hair, fragments of tree and grass leaves, insects, and microorganisms.
Cites: Ann Allergy Asthma Immunol. 1995 Oct;75(4):325-307583847
Exposure to fragrance chemicals causes various eye and airway symptoms. Individuals with perfume contact allergy report these symptoms more frequently than individuals with nickel allergy or no contact allergies. However, the associations between contact allergy and respiratory symptoms elicited by airborne chemicals other than perfumes are unclear. The study aimed to investigate the association between eye and airway symptoms elicited by airborne chemicals (other than perfumes) and contact allergy in a population-based sample. A questionnaire on respiratory symptoms was posted, in 2002, to 1189 individuals who participated in 1997/1998 in a Danish population-based study of allergic diseases. Questions about eye and airway symptoms elicited by different airborne chemicals and airborne proteins were included in the questionnaire. Data from the questionnaire were compared with data on patch testing and prick testing. Having at least 1 positive patch test (adjusted odds ratio 1.7, 95% CI 1.2-2.5) was associated with the symptoms, and the odds ratio increased with the number of positive patch tests (P-value for test for trend
BACKGROUND: The overall aim of this study was to investigate how airborne house dust particles may contribute to an allergic immune response, and thereby also to asthma and allergic diseases. MATERIAL AND METHODS: Using transmission electron microscopy, we quantified and characterized airborne house dust particles, with regard to elemental and size distribution. Furthermore, an immunogold labelling technique was used to study whether some common allergens were present on the surface of airborne house dust particles. Finally, a mouse model was used to study the adjuvant activity of airborne house dust on the IgE antibody response. RESULTS: A vast majority of the airborne particles samples from homes in Oslo were found to be less than 2.5 microns in diameter, thus they are liable to penetrate deep into the respiratory tree. This PM2.5 fraction contained, in addition to sulphur aerosols and silicates, many soot particles, most of them being less than 1 micron in diameter. These soot particles were found to carry allergens on their surface. We also found that diesel exhaust particles, which is probably a main soot component of airborne house dust, absorbed several wellknown allergens in vitro. Furthermore, the airborne house dust particles were found to elicit a local lymph node response, and to have an adjuvant activity on the production of IgE antibodies to ovalbumin as a model allergen. INTERPRETATION: These results show that indoor suspended particulate matter contains a lot of potential allergen carriers, i.e. soot particles (carbon aggregates), most of them being less that 1 micron in diameter and thereby able to transport allergens deep into the airways. In addition, our results indicate that suspended particulate matter may have an adjuvant effect on the production of IgE to common environmental allergens, and also may provoke a local inflammatory response.
Existing studies of the association between air pollution, aeroallergens and emergency department (ED) visits have generally examined the effects of a few pollutants or aeroallergens on individual conditions such as asthma or chronic obstructive pulmonary disease. In this study, we considered a wide variety of respiratory and cardiac conditions and an extensive set of pollutants and aeroallergens, and utilized prospectively collected information on possible effect modifiers which would not normally be available from purely administrative data. The association between air pollution, aeroallergens and cardiorespiratory ED visits (n = 19,821) was examined for the period 1992 to 1996 using generalized additive models. ED visit, air pollution and aeroallergen time series were prefiltered using LOESS smoothers to minimize temporal confounding, and a parsimonious model was constructed to control for confounding by weather and day of week. Multipollutant and multi-aeroallergen models were constructed using stepwise procedures and sensitivity analyses were conducted by season, diagnosis, and selected individual characteristics or effect modifiers. In single-pollutant models, positive effects of all pollutants but NO2 and COH were observed on asthma visits, and positive effects on all respiratory diagnosis groups were observed for O3, SO2, PM10, PM2.5, and SO4(2-). Among cardiac conditions, only dysrhythmia visits were positively associated with all measures of particulate matter. In the final year-round multipollutant models, a 20.9% increase in cardiac ED visits was attributed to the combination of O3 (16.0%, 95% CI 2.8-30.9) and SO2 (4.9%, 95%CI 1.7-8.2) at the mean concentration of each pollutant. In the final multipollutant model for respiratory visits, O3 accounted for 3.9% of visits (95% CI 0.8-7.2), and SO2 for 3.7% (95% CI 1.5-6.0), whereas a weak, negative association was observed with NO2. In multi-aeroallergen models of warm season asthma ED visits, Ascomycetes, Alternaria and small round fungal spores accounted for 4.5% (95% CI 1.8-7.4), 4.7% (95% CI 1.0-8.6) and 3.0% (95% CI 0.8-5.1), respectively, of visits at their mean concentrations, and these effects were not sensitive to adjustment for air pollution effects. In conclusion, we observed a significant influence of the air pollution mix on cardiac and respiratory ED visits. Although in single-pollutant models, positive associations were noted between ED visits and some measures of particulate matter, in multipollutant models, pollutant gases, particularly ozone, exhibited more consistent effects. Aeroallergens were also significantly associated with warm season asthma ED visits.
BACKGROUND: Particulate air pollution has been much discussed in Norway during the last few years. Coarse particles from asphalt are likely to have quite different properties than the far smaller particles from diesel exhaust. MATERIALS AND METHODS: On the basis of data from the literature and our own research, we discuss the health problem of different types of particles with a focus on allergy and respiratory symptoms. RESULTS: Diesel exhaust particles have well-documented adverse effects in relation to allergic airway disease. They increase symptoms load in already allergic individuals and also seem to contribute to the increased prevalence of allergy. PM10 is today measured on the basis of weight, not on number. Diesel exhaust particles are much smaller than road surface particles; hence PM10 measurements reflect road surface dust pollution more than exhaust particles. INTERPRETATION: Focus should now be given to diesel exhaust particles in order to reduce the adverse health effects of particulate air pollution in Norwegian cities.
Comment In: Tidsskr Nor Laegeforen. 2002 Aug 10;122(18):176612362683
Allergy to indoor allergens can cause frequent and severe health problems in children. Because little is known about the content of allergens in the indoor environments in Norway, we wanted to assess the levels of cat, dog and mite allergens in schools and day-care centers in Oslo. Allergen levels in dust samples from 155 classrooms and 81 day-care units were measured using commercially available enzyme-linked immunosorbent assay (ELISA) kits. Additionally, we measured the levels of endotoxin in 31 day-care units, using the limulus amebocyte lysate test. Most of the dust samples contained detectable amounts of cat and dog allergens. In mattress and floor dust (day-care centers), and curtain and floor dust (schools) the median Fel d 1 levels were 0.17, 0.002, 0.02 and 0.079 microg/m2, while the median Can f 1 levels were 1.7, 0.03, 0.1 and 0.69 microg/m2, respectively. Levels of cat and dog allergens in school floor dust were associated with the number of pupils with animals at home. In contrast,