Monitoring forced expiratory volume in 1 second (FEV1) is a valuable component to determine asthma control 1 Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol. 2007; 120: S94-S138 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar , 2 Nair S.J. Daigle K.L. DeCuir P. Lapin C.D. Schramm C.M. The influence of pulmonary function testing on the management of asthma in children. J Pediatr. 2005; 147: 797-801 Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar and indicate the risk of future exacerbation [3] Fuhlbrigge A.L. Kitch B.T. Paltiel A.D. et al. FEV1 is associated with risk of asthma attacks in a pediatric population. J Allergy Clin Immunol. 2001; 107: 61-67 Abstract Full Text PDF PubMed Scopus (221) Google Scholar in children. However, use of spirometry by patients outside health care facilities is limited by accessibility, staffing, time, and cost.

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Desktop dust has been studied as a source of food allergen, but not as a source of potential aeroallergen exposure. Thirty-six wiped samples from desktop surfaces were collected from preschools and schools. Samples were analyzed for detectable levels of common aeroallergens including Alternaria, cockroach, dog, dust mite, cat, mouse, and rat allergens by immunoassay. Mouse allergen was the most prevalent, detectable in 97.2% of samples. Cat allergen was detectable in 80.6% of samples, and dog allergen was detectable in 77.8% of samples. Other allergens were not as prevalent. Mouse was the only allergen that was highly correlated with settled floor dust collected from the same rooms (r = 0.721, P < 0.001). This is the first study to detect aeroallergens on desktop surfaces by using moist wipes. Allergens for mouse, cat, and dog were highly detectable in wipes with mouse desktop surface levels correlating with levels in vacuumed floor dust.

RationaleWe evaluated the performance of a compact ion capture device (cICD) for the sampling of a set of airborne allergens and endotoxin in school classrooms as part of a larger study of the relation of allergen exposure to asthma in an inner city school system. Since smaller particles penetrate deeper in the lungs, we determined size distribution of captured particles.MethodsSamples were collected over 4 days in 3 rooms at 3 time intervals. Multiplex assays for allergens (MARIA™) and Endotoxin were by Indoor Biotechnologies. Size distributions of particles collected were measured directly on the electrodes of the cICDs with a Bruker dimension ICON AFM system with sub-nm resolution. Imaging was done in tapping mode with super harp silicon probes.ResultsMeans and standard deviations over all locations in fg/liter of air were Feld 1 (1.7+/-1.7); Can f1 (0.7+/-0.5), Mus m1 (1.9+/-1.3) and endotoxin (28+/-7). Seven other allergens were undetectable. There was 100% qualitative agreement with parallel determinations made by a reference method using a full size ion capture device and measurements as μg/gram of dust. AFM measurements on the cICD showed particles captured down to less than 200nm. The particles were distributed uniformly across the surface and consistent in size.ConclusionsThe cICD is an extremely inexpensive, quiet, compact and simple device that can be unobtrusively deployed in critical locations without sacrificing performance. The ability to capture particles in a size range that is lower than currently used methods provides the opportunity to determine the fraction most significant for asthma provocation. RationaleWe evaluated the performance of a compact ion capture device (cICD) for the sampling of a set of airborne allergens and endotoxin in school classrooms as part of a larger study of the relation of allergen exposure to asthma in an inner city school system. Since smaller particles penetrate deeper in the lungs, we determined size distribution of captured particles. We evaluated the performance of a compact ion capture device (cICD) for the sampling of a set of airborne allergens and endotoxin in school classrooms as part of a larger study of the relation of allergen exposure to asthma in an inner city school system. Since smaller particles penetrate deeper in the lungs, we determined size distribution of captured particles. MethodsSamples were collected over 4 days in 3 rooms at 3 time intervals. Multiplex assays for allergens (MARIA™) and Endotoxin were by Indoor Biotechnologies. Size distributions of particles collected were measured directly on the electrodes of the cICDs with a Bruker dimension ICON AFM system with sub-nm resolution. Imaging was done in tapping mode with super harp silicon probes. Samples were collected over 4 days in 3 rooms at 3 time intervals. Multiplex assays for allergens (MARIA™) and Endotoxin were by Indoor Biotechnologies. Size distributions of particles collected were measured directly on the electrodes of the cICDs with a Bruker dimension ICON AFM system with sub-nm resolution. Imaging was done in tapping mode with super harp silicon probes. ResultsMeans and standard deviations over all locations in fg/liter of air were Feld 1 (1.7+/-1.7); Can f1 (0.7+/-0.5), Mus m1 (1.9+/-1.3) and endotoxin (28+/-7). Seven other allergens were undetectable. There was 100% qualitative agreement with parallel determinations made by a reference method using a full size ion capture device and measurements as μg/gram of dust. AFM measurements on the cICD showed particles captured down to less than 200nm. The particles were distributed uniformly across the surface and consistent in size. Means and standard deviations over all locations in fg/liter of air were Feld 1 (1.7+/-1.7); Can f1 (0.7+/-0.5), Mus m1 (1.9+/-1.3) and endotoxin (28+/-7). Seven other allergens were undetectable. There was 100% qualitative agreement with parallel determinations made by a reference method using a full size ion capture device and measurements as μg/gram of dust. AFM measurements on the cICD showed particles captured down to less than 200nm. The particles were distributed uniformly across the surface and consistent in size. ConclusionsThe cICD is an extremely inexpensive, quiet, compact and simple device that can be unobtrusively deployed in critical locations without sacrificing performance. The ability to capture particles in a size range that is lower than currently used methods provides the opportunity to determine the fraction most significant for asthma provocation. The cICD is an extremely inexpensive, quiet, compact and simple device that can be unobtrusively deployed in critical locations without sacrificing performance. The ability to capture particles in a size range that is lower than currently used methods provides the opportunity to determine the fraction most significant for asthma provocation.

BackgroundStudents spend a large portion of their day in classrooms which may be a source of mold exposure. We examined the diversity and concentrations of molds in inner-city schools and described differences between classrooms within the same school.MethodsClassroom airborne mold spores, collected over a 2day period, were measured twice during the school year by direct microscopy.ResultsThere were 180 classroom air samples collected from 12 schools. Mold was present in 100% of classrooms. Classrooms within the same school had differing mold levels and mold diversity scores. The total mold per classroom was 176.64.2 spores/m3 (geometric meanstandard deviation) and ranged from 11.2 to 16,288.5 spores/m3. Mold diversity scores for classroom samples ranged from 1 to 19 (7.7 +/- 3.5). The classroom accounted for the majority of variance (62%) in the total mold count, and for the majority of variance (56%) in the mold diversity score versus the school. The species with the highest concentrations and found most commonly included Cladosporium (29.3 +/- 4.2 spores/m3), Penicillium/Aspergillus (15.0 +/- 5.4 spores/m3), smut spores (12.6 +/- 4.0 spores/m3), and basidiospores (6.6 +/- 7.1 spores/m3).ConclusionsOur study found that the school is a source of mold exposure, but particularly the classroom microenvironment varies in quantity of spores and species among classrooms within the same school. We also verified that visible mold may be a predictor for higher mold spore counts. Further studies are needed to determine the clinical significance of mold exposure relative to asthma morbidity in sensitized and non-sensitized asthmatic children.

RationaleThere is a paucity of information about mouse allergen exposure in classrooms/schools of children with asthma and its effect on asthma morbidity.MethodsThe School Inner City Asthma Study (SICAS) examines urban classroom allergen exposures and asthma morbidity in students with asthma. Allergen sensitization data is collected at baseline. Classroom mouse allergen (Mus m 1) levels, linked to enrolled students, are collected during the academic year and analyzed by MARIA™ technology. Asthma morbidity outcome measures are obtained every 3 months during the year.ResultsClassroom mouse allergen levels and skin testing data were available for analysis in 257 enrolled students from 29 schools. Of these students, 27% (N=70) were sensitized to mouse. For those sensitized to mouse, we found a significant dose-response relationship between classroom mouse allergen levels and asthma symptom days with higher levels of mouse allergen leading to significantly more asthma symptoms (Rate Ratio=1.27, 95% CI=1.05-1.53), p=0.01. Specifically, sensitized children in classrooms at the 90th percentile of observed mouse allergen levels (12.8 μg/g) had 4.0 asthma symptom days in a 2-week period compared to children at the 10th percentile (0.07 μg/g) who had 2.3 asthma symptom days. In contrast, within the non-sensitized population, there was no relationship between mouse allergen levels and asthma symptom days (RR=1.04, 95% CI=0.9-1.21), p=0.59. Minimal mouse allergen levels were found in homes of enrolled students.ConclusionsStudents sensitized to mouse allergen and exposed to higher levels of classroom mouse allergen have more asthma symptom days, suggesting that classroom specific exposure to mouse allergen is important. RationaleThere is a paucity of information about mouse allergen exposure in classrooms/schools of children with asthma and its effect on asthma morbidity. There is a paucity of information about mouse allergen exposure in classrooms/schools of children with asthma and its effect on asthma morbidity. MethodsThe School Inner City Asthma Study (SICAS) examines urban classroom allergen exposures and asthma morbidity in students with asthma. Allergen sensitization data is collected at baseline. Classroom mouse allergen (Mus m 1) levels, linked to enrolled students, are collected during the academic year and analyzed by MARIA™ technology. Asthma morbidity outcome measures are obtained every 3 months during the year. The School Inner City Asthma Study (SICAS) examines urban classroom allergen exposures and asthma morbidity in students with asthma. Allergen sensitization data is collected at baseline. Classroom mouse allergen (Mus m 1) levels, linked to enrolled students, are collected during the academic year and analyzed by MARIA™ technology. Asthma morbidity outcome measures are obtained every 3 months during the year. ResultsClassroom mouse allergen levels and skin testing data were available for analysis in 257 enrolled students from 29 schools. Of these students, 27% (N=70) were sensitized to mouse. For those sensitized to mouse, we found a significant dose-response relationship between classroom mouse allergen levels and asthma symptom days with higher levels of mouse allergen leading to significantly more asthma symptoms (Rate Ratio=1.27, 95% CI=1.05-1.53), p=0.01. Specifically, sensitized children in classrooms at the 90th percentile of observed mouse allergen levels (12.8 μg/g) had 4.0 asthma symptom days in a 2-week period compared to children at the 10th percentile (0.07 μg/g) who had 2.3 asthma symptom days. In contrast, within the non-sensitized population, there was no relationship between mouse allergen levels and asthma symptom days (RR=1.04, 95% CI=0.9-1.21), p=0.59. Minimal mouse allergen levels were found in homes of enrolled students. Classroom mouse allergen levels and skin testing data were available for analysis in 257 enrolled students from 29 schools. Of these students, 27% (N=70) were sensitized to mouse. For those sensitized to mouse, we found a significant dose-response relationship between classroom mouse allergen levels and asthma symptom days with higher levels of mouse allergen leading to significantly more asthma symptoms (Rate Ratio=1.27, 95% CI=1.05-1.53), p=0.01. Specifically, sensitized children in classrooms at the 90th percentile of observed mouse allergen levels (12.8 μg/g) had 4.0 asthma symptom days in a 2-week period compared to children at the 10th percentile (0.07 μg/g) who had 2.3 asthma symptom days. In contrast, within the non-sensitized population, there was no relationship between mouse allergen levels and asthma symptom days (RR=1.04, 95% CI=0.9-1.21), p=0.59. Minimal mouse allergen levels were found in homes of enrolled students. ConclusionsStudents sensitized to mouse allergen and exposed to higher levels of classroom mouse allergen have more asthma symptom days, suggesting that classroom specific exposure to mouse allergen is important. Students sensitized to mouse allergen and exposed to higher levels of classroom mouse allergen have more asthma symptom days, suggesting that classroom specific exposure to mouse allergen is important.

Background: Endotoxins are stimulators of the immune system and, despite their potential to protect against allergy, have been associated with early wheezing and asthma morbidity.Objective: To compare inner-city school endotoxin exposure with home endotoxin exposure in children with asthma.Methods: Students with asthma were recruited from 12 urban elementary schools. Settled and airborne dust samples, linked to enrolled students, were collected from school classrooms, gymnasiums, and cafeterias twice during the academic year. For comparison, settled dust was collected once from the bedrooms of students with asthma.Results: Two hundred twenty-nine school settled dust samples and 118 bedroom settled dust samples were collected and analyzed for endotoxin. The median endotoxin concentration for school samples was 13.4 EU/mg (range, 0.7-360.7 EU/mg) and for home samples was 7.0 EU/mg (range = LLOD-843.0 EU/mg). The median concentration within each individual school varied from 6.6 EU/mg to 24.0 EU/mg. One hundred four students with asthma had matched classroom and bedroom endotoxin exposure measurements performed in the same season and demonstrated significantly higher concentrations of endotoxin in the students' classrooms (mean log value, 1.13 vs 0.99, P = .04). The median of the classrooms was 12.5 EU/mg compared with their bedrooms, with a median of 7.0 EU/mg. Within the school environment, no significant difference was seen between the fall and spring samples (mean log value 1.14 vs 1.09; P = .35).Conclusion: Inner-city children with asthma were exposed to higher concentrations of endotoxin in their classrooms as compared with their bedrooms. Further studies are needed to evaluate school endotoxin exposure as a factor in asthma morbidity. (C) 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

To cite this article: Permaul P, Hoffman E, Fu C, Sheehan W, Baxi S, Gaffin J, Lane J, Bailey A, King E, Chapman M, Gold D, Phipatanakul W. Allergens in urban schools and homes of children with asthma. Pediatr Allergy Immunol 2012: 23: 543–549.AbstractBackground: Most studies of indoor allergens have focused on the home environment. However, schools may be an important site of allergen exposure for children with asthma. We compared school allergen exposure to home exposure in a cohort of children with asthma. Correlations between settled dust and airborne allergen levels in classrooms were examined.Methods: Settled dust and airborne samples from 12 inner‐city schools were analyzed for indoor allergens using multiplex array technology (MARIA). School samples were linked to students with asthma enrolled in the School Inner‐City Asthma Study (SICAS). Settled dust samples from students’ bedrooms were analyzed similarly.Results: From schools, 229 settled dust and 197 airborne samples were obtained. From homes, 118 settled dust samples were obtained. Linear mixed regression models of log‐transformed variables showed significantly higher settled dust levels of mouse, cat and dog allergens in schools than homes (545% higher for Mus m 1, estimated absolute difference 0.55 μg/g, p < 0.0001; 198% higher for Fel d 1, estimated absolute difference 0.13 μg/g, p = 0.0033; and 144% higher for Can f 1, estimated absolute difference 0.05 μg/g, p = 0.0008). Airborne and settled dust Mus m 1 levels in classrooms were moderately correlated (r = 0.48; p < 0.0001). There were undetectable to very low levels of cockroach and dust mite allergens in both homes and schools.Conclusion: Mouse allergen levels in schools were substantial. In general, cat and dog allergen levels were low, but detectable, and were higher in schools. Aerosolization of mouse allergen in classrooms may be a significant exposure for students. Further studies are needed to evaluate the effect of indoor allergen exposure in schools on asthma morbidity in students with asthma.