Q:

5/8/2012  
What are the recommendations / standards for PPE when mixing antigens? It is our understanding that a hood is not needed however our staff is wondering if they need to wear gowns, masks, gloves, etc? Thanks very much!

A:

Thank you for your inquiry.

There is no mandate for the wearing of gowns, masks, gloves, et cetera, while preparing allergy extracts.

There are some excellent documents that are available for you in establishing standards related to the preparation, storage, and administration of allergy extracts. There is an excellent Allergy Parameter available to you free of charge online. The reference is:

Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter, third update. Journal of Allergy and Clinical Immunology, September 2011; Volume 127 (1), Supplement, page S1-S55.

In addition, there is a brief summation of the standards, which includes a section on aseptic technique, entitled: Physician's Instruction Guide for the Preparation of Allergen Extracts." It is also available to you free of charge in Word format online. You can obtain this document by simply "Googling" "sterility requirements for the preparation of allergy extracts." The first entry will be entitled, "Allergen Immunotherapy Extract Preparation Guidelines."

In addition, if you are working in a hospital, there are a set of guidelines that may apply to you as well. You can find these entries by simply entering "797" into the search box on our Academy "Ask the Expert" website. They are:

1. Posted 4/13/2012 - Laminar flow hood for preparation of allergy extracts
2. Posted 8/5/2011 - Expiration of allergy extracts
3. Posted 6/9/2011 - Allergy guidelines for vial preparation - Part II
4. Posted 2/7/2011 - Both this website and the Joint Council have received inquiries about new regulations for the preparation of allergy extracts, in particular their expiration dates. We hope this release from the Joint Council helps clarify this issue.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology