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医疗环境中的空气传播食物过敏原和气源性过敏原水平:一个未被重视但可能相关的暴露源?

Airborne Food Allergen and Aeroallergen Levels in Health Care Settings: An Unaccounted for but Potentially Relevant Source of Exposure?

作者信息

Leal M, Paciência I, Farraia M, Cavaleiro Rufo J, Castro Mendes F, Delgado L, Viegas C, Moreira A

机构信息

Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.

出版信息

J Investig Allergol Clin Immunol. 2021 Oct;31(5):426-432. doi: 10.18176/jiaci.0623.

Abstract

BACKGROUND AND OBJECTIVE

Exposure to airborne allergens of biological origin is associated with the development and exacerbation of allergic asthma and rhinitis. Assessment of allergen exposure in health care facilities may improve monitoring of hygiene and surveillance of specific allergens that can cause symptoms in sensitized persons. Objective: To assess concentrations of airborne food and aeroallergens in various health care settings in Portugal.

METHODS

Dust was vacuumed from primary health care centers in Lisbon and from the emergency department, day hospital, internal medicine ward, operating room, and outpatient clinic of a university central hospital in Porto. Samples were sieved, weighed, and extracted, and concentrations of Nbos d 5, Cor a 9, Gal d 2, Ara h 3, Ara h 6, Der p 1, Fel d 1, Can f 1, Bla g 2, Alt a 1, and Phl p 5 were determined using a multiplex array for allergens (MARIA).

RESULTS

All airborne food and aeroallergens were found in at least 1 sampled area, except for Alt a 1. Levels of Der p 1 and Fel d 1 ranged from 13.0 μg/g to 971.0 μg/g and from 7.0 μg/g to 4618.8 μg/g, respectively. Higher levels of food allergens were found in the emergency department (Nbos d 5, 16 034.0 μg/g; and Cor a 9, 10 649.5 μg/g).

CONCLUSIONS

Except for the operating room, exposure levels for dust mite and cat and dog dander in health care facilities were above the values associated with sensitization and allergic asthma or rhinitis symptoms in sensitized persons.

摘要

背景与目的

接触生物源空气传播变应原与过敏性哮喘和鼻炎的发生及加重有关。评估医疗机构中的变应原暴露情况可能有助于改善卫生监测以及对可使敏感个体出现症状的特定变应原的监测。目的:评估葡萄牙不同医疗机构中空气传播食物变应原和气传变应原的浓度。

方法

从里斯本的初级保健中心以及波尔图一家大学中心医院的急诊科、日间医院、内科病房、手术室和门诊采集灰尘样本。对样本进行筛分、称重和提取,并使用变应原多重检测阵列(MARIA)测定Nbos d 5、Cor a 9、Gal d 2、Ara h 3、Ara h 6、Der p 1、Fel d 1、Can f 1、Bla g 2、Alt a 1和Phl p 5的浓度。

结果

除Alt a 1外,在至少一个采样区域均发现了所有空气传播食物变应原和气传变应原。Der p 1和Fel d 1的水平分别为13.0 μg/g至971.0 μg/g和7.0 μg/g至4618.8 μg/g。在急诊科发现了较高水平的食物变应原(Nbos d 5,16 034.0 μg/g;Cor a 9,10 649.5 μg/g)。

结论

除手术室之外,医疗机构中尘螨、猫和狗皮屑的暴露水平高于与敏感个体致敏及过敏性哮喘或鼻炎症状相关的值。

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