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- Pollen -
11/20/05 re: Allergen-free areas in the USA Where in the USA do the lowest allergen levels exist? Or, in other words, where is the best place for someone to live, and suffer the least, from allergies (ex - the most common allergens)?
There is no geographic area in the continental USA completely free of aeroallergens. If one is considering a move from the large populated areas on the East or West coast or the Midwest, perhaps the lowest levels of pollens and molds would be in relatively isolated areas at high altitudes in the Southwest such as the northern New Mexico area, provided that there is not a lot of local artificial irrigation of lawns and farm crops that would enhance plant growth. The relatively low relative humidity in such areas would also retard the growth of dust mites, the source of the major indoor aeroallergen. However, conditions such as asthma certainly can be found in residents of such higher altitude “desert” areas, albeit at lower frequency. A partial reason for such symptoms is that some atopic individuals develop allergies to pollens of some of the local “desert” plants after several years of exposure.
7/15/02 re: Allergic reaction to roses I have an employee who is allergic to roses - allergy can become severe at times. We try to keep roses out of the patients' rooms that she would enter. One day she had a severe reaction just from the particles of the roses being on the bed. I am trying to write a policy to ban roses in our hospital, but would appreciate your information to document the ban. Some parents bring roses in even when we have told them about this employee's allergy. As you may already know, allergic respiratory reactions to plants are usually triggered by the pollen of such plants. To my knowledge, allergic respiratory reactions to roses must be quite rare and I have never seen a documented case. I could also not find description of such cases in a Medline medical literature search. The reason is that rose pollen is heavy and sticky, designed for pollination by sticking to the bodies of insects feeding on rose nectar. It is not wind-dispersed. This contrasts with the light, fluffy pollen of grasses and most weeds, which are readily disseminated in the air by the wind (and can be inhaled by individuals allergic to such pollen). What has been called "rose fever" by some is an allergic respiratory reaction to the pollen of grasses and some trees which pollinate at the same time as roses in the latter part of the spring.
Therefore, it would be most unusual for someone to exhibit a true allergic respiratory reaction to the fragrance of roses brought into a room. There have been occasional case reports of contact sensitivity to the fragrances obtained from plants and placed in perfumes but this is generally manifest as a rash (see enclosed abstract). Some individuals are convinced that they have allergic respiratory reactions to fragrances but the cause is not clear. Indeed, in one study , individuals claiming allergic respiratory reactions to fragrances of plant origin were exposed in a blinded manner to a similar odor due to a synthetic fragrance with no structural resemblance to the plant fragrance. Such individuals exhibited their "typical" reactions.
To help answer your questions, I consulted an expert in the nature of plant allergens. I have not yet received a response, but will send it to you if and when it arrives.
Am J Contact Dermat 1997 Dec;8(4):239-42
Is it really fragrance-free?
Scheinman PL.
Department of Medical and Surgical Dermatology, New England Medical Center Hospital, Boston, MA 02111, USA.
BACKGROUND: Fragrance allergy is the most common cause of cosmetic contact dermatitis. Many occult sources of fragrance exist. Those which cause the most concern are some "fragrance-free" products that contain fragrance raw ingredients. Thus, the very patients requiring fragrance-free items may be exposed to potential perfume allergens or cross-reactors in seemingly safe products. Additionally, medications dermatologists recommend, both prescription and over-the-counter, sometimes contain fragrance.
OBJECTIVE: This report describes a patient with chronic hand dermatitis sensitized to multiple fragrance ingredients including rose oil, present in the "fragrance-free" soap she used. Additionally, the tar soaks recommended to her also contained fragrance.
CONCLUSION: It is no longer sufficient to recommend the use of products labeled fragrance-free to fragrance-sensitive patients. These patients must be educated to read labels and look for plant extracts that are potential perfume sensitizers and cross-reactors. Rose oil, which has been felt to be a rare sensitizer, may be a more common allergen than previously recognized, perhaps because of its existence in a popular "fragrance-free" soap and, conceivably, in many "all-natural" products. Further testing with rose oil should be conducted in the future. Finally, manufacturers need to be more forthright in the labeling of their products
7/6/01 re: How to do pollen counting and measure mite levels in carpets Can I get information how to measure pollen (pollen count) and also the methods to detect house mites in carpets? 1) Pollen counting: Accurate pollen counting requires specialized training and some specialized equipment. The types of pollen in your geographic area will determine the pollen identification training you will need. I suggest that you contact the National Allergy Bureau, the pollen reporting service of the AAAAI. You can access this at the National Allergy Bureau section of the homepage of the web site of the AAAAI (www.aaaai.org). To get additional information, you can also call the AAAAI Executive Office at 414-272-6071 and ask for the staff person connected with the National Allergy Bureau to obtain information about getting training (if you are located in the USA). 2) Mite allergen levels: Are generally assessed by an ELISA immunologic technique in extracts of scraping from the surface of carpets. This requires specialized training. Some commercial labs in the USA are beginning to offer this assay service for a fee. I have enclosed abstracts of 2 recent articles which describe use of such assays.
Allergy 1998;53(48 Suppl):84-7
Risk levels for mite allergen: are they meaningful, where should samples be collected, and how should they be analyzed?
Munir AK.
Department of Health and Environment, University Hospital, Linkoping, Sweden.Indoor allergen exposure plays a major role in the development of sensitization and triggering of asthma in children. All over the world, mites are common sources of indoor allergens. Risk levels for mite-allergen exposure have been recommended. A mite-allergen level of >/=2 microg/g dust is considered a risk level for sensitization and symptoms of asthma. Data from several ongoing prospective studies of children show that mite sensitization may occur below the suggested threshold level. However, from these studies, it seems that high mite-allergen exposure increases the risk of early sensitization, whereas low exposure levels probably take a longer time to induce sensitization. Assessment of allergen exposure and consideration of allergen-elimination strategies should not be limited only to the home environment. High levels of mite allergens are also found in day-care centers, schools, and various other public places, such as bars. Thus, in addition to homes, these environments should also be considered when allergen-avoidance measures are taken. Allergen content in dust can be expressed in several units, e.g., ng/g, ng/m2, and ng/sampling, and as the total amount of allergen. At present, there is no consensus on the best way to measure and express mite-allergen levels. In this paper, aspects of threshold levels for mite sensitization, various exposure environments, and sampling, determination, and expression units of mite exposure will be discussed in brief.
Ann Allergy Asthma Immunol. 2001 May;86(5):489-91
Allergenic materials in the house dust of allergy clinic patients.
Barnes C, Tuck J, Simon S, Pacheco F, Hu F, Portnoy J.
Section of Allergy/Immunology, The Children's Mercy Hospital, Kansas City, MO 64108, USA.Introduction: Environmental agents including animal, fungal, tree, and weed antigens are known to cause allergic rhinitis and asthma. The following study was performed to measure the antigen concentration of several of these in house dust of children seen in an allergy clinic. Comparisons are made between household allergen levels of children seen for asthma and children seen for other reasons.
Methods: Dust samples were solicited from patients in a pediatric allergy specialty clinic and other individuals associated with the clinic. Persons submitting dust were asked to complete a questionnaire describing their house. Samples were extracted, centrifuged, and filtered for sterility. Samples were stored in 50% glycerol at -20 degrees C. Specific antigens for Alternaria, Cladosporium, Aspergillus, Candida, Dermatophagoides farinae, cat, dog, oak, fescue, ragweed, plantain, and cockroach were measured using inhibition assays developed with whole antigen extract. Allergens Der p1, Der f 1, Alt a 1, and Alt a 70 kD were measured using double monoclonal antibody assays.
Results: Significant concentrations of whole antigen from cat, dog, oak, Alternaria, and Cladosporium were detected. Between 0.1 and 18 microg of Der f1 and Der p1 per gram of dust were also measured. Alt a 1 and Alt a 70 kD levels varied between 3.0 and 1000 U/g of dust. Significant positive correlation’s were observed in levels of dust mite and Alternaria allergen for patients with an evaluation of asthma.
Conclusions: We found measurable levels of fungal antigens (Alternaria, Cladosporium), mite antigens, and animal antigens (dog and cat) in the majority of dust samples in this self-selected set of allergy clinic patients. Specific allergens Alt a 1, Alt a 70kD, and Der p 1 were significantly higher in the homes of asthmatic patients when compared with patients seen for reasons other than asthma. These studies support the hypothesis that fungal allergen exposure is an important component in the pathogenesis of the clinical condition known as asthma.
4/10/00 re: Planting gardens outside of school rooms I am a school nurse teacher at an elementary school gr, K-6, population 300. A parent and teacher received a grant to develop a flowering garden outside the school. The garden will serve to integrate into the curriculum science, math, English and to enhance the learning environment. A parent wrote a letter to the administration stating the garden would compromise students and the air quality. She stated pollen would be increased and exposures to bees higher. We do not have screens on the windows so closing them would compromise air quality (per the parent)! Do you have any data to support the parent concerns? Are there any contraindications to the use of a garden around schools? I have also contacted our Health Department, DEM, our school physician, an exterminator company and allergy physician in our area. My response to your questions depends on what is growing in the garden. Most ornamental plants (flower, shrubs) and vegetables have heavy pollen which requires insects to carry out pollination. However, most trees, grasses and weeds are wind-pollinated with light, fluffy pollen and therefore present more a potential problem if they enter through open classroom windows. Therefore, judicious choice of plantings and garden maintenance to keep out weeds should prevent most inhalant problems. The question of increased exposure to stinging insects is more difficult to resolve. As noted above, ornamental plants are pollinated by insects including the hymenoptera (bees, hornets wasps). The latter are attracted to particular plants, a fact that can be used in making planting choices (consult your horticulturist). Honey bees tend to be non-aggressive unless disturbed while yellow jackets (a type of hornet) can be more aggressive. Unfortunately, there are no reliable repellents for hymenoptera. Keeping known hymenoptera-sensitive children away from the garden may be prudent.
