Custovic A, Fletcher A, Pickering C A, Francis H C, Green R, Smith A, Chapman M, Woodcock A
North West Lung Centre, Wythenshawe Hospital, Manchester, UK.
Clin Exp Allergy. 1998 Jan;28(1):53-9. doi: 10.1046/j.1365-2222.1998.00183.x.
Exposure and sensitization to indoor allergens is a major cause of asthma.
This study investigated the levels of house dust mite, cat, dog and cockroach allergens in the dust and air in hospitals and the effects of regular vacuum cleaning on allergen levels in hospital chairs.
Der p 1, Fel d 1, Can f 1 and Bla g 2 were measured in the dust collected by vacuuming upholstered chairs and a 1 m2 area of carpet and mattress in 14 hospitals. Air samples were collected using an air sampler (flow rate 60 L/min) on 10 separate days for 4 h in the outpatient department in one of the hospitals during busy clinics when patients were waiting for their appointments. In addition, dust samples were collected on four occasions, at 4-weekly intervals, from 36 fabric covered chairs in the outpatient area of a busy chest clinic by vacuuming each chair for 2 min. During the intervening weeks, 18 of the chairs (active group) were each cleaned by vacuuming for 1 min, three times per week. Der p 1, Fel d 1, Can f 1 and Bla g 2 were assayed using monoclonal antibody-based ELISA.
In total, 83 carpets, 69 mattresses and 42 upholstered chairs were sampled. The levels of dust mite allergen Der p 1 and cockroach allergen Bla g 2 found in the hospital setting were low. High levels of Fel d 1 (GM 22.9 microg/g, range 4.5-58) and Can f 1 (GM 21.6 microg/g, range 4-63) were found in upholstered chairs. Airborne Can f 1 was detected on every occasion (range 0.12-0.56 ng/m3), whilst detectable airborne Fel d 1 was found on 7 out of the 10 sampling days (range 0.09-0.22 ng/m3). Der p 1 and Bla g 2 were below the detection limit in all airborne samples. Following repeated vacuuming the mean cat and dog allergen levels decreased significantly (P<0.001) and were almost fivefold lower in the vacuumed chairs compared with the control group.
Low levels of mite allergen are unlikely to be of any clinical significance to mite-sensitive asthmatic patients. However, upholstered chairs in hospitals constitute a significant reservoir of cat and dog allergen. Inhalation of airborne allergen in patients attending their hospital appointment may exacerbate asthma in those highly allergic to cats or dogs. These results question the wisdom of introducing soft furnishings and carpets into hospitals. Three-times weekly vacuuming significantly reduces allergen levels in upholstered chairs.
接触室内过敏原并对其致敏是哮喘的主要病因。
本研究调查了医院灰尘和空气中屋尘螨、猫、狗及蟑螂过敏原的水平，以及定期真空清洁对医院座椅过敏原水平的影响。
在14家医院，通过用吸尘器抽吸软垫座椅、1平方米面积的地毯和床垫来收集灰尘，检测其中的Der p 1、Fel d 1、Can f 1和Bla g 2。在一家医院的门诊部，于繁忙门诊时段患者候诊时，使用空气采样器（流速60升/分钟）在10个不同日期采集4小时的空气样本。此外，在一家繁忙胸科门诊的门诊区域，每隔4周对36把织物覆盖的椅子进行4次灰尘样本采集，每次用吸尘器抽吸每把椅子2分钟。在间隔的几周内，对18把椅子（实验组）每周进行3次真空清洁，每次1分钟。使用基于单克隆抗体的ELISA法检测Der p 1、Fel d 1、Can f 1和Bla g 2。
总共采样了83块地毯、69个床垫和42把软垫座椅。在医院环境中发现的屋尘螨过敏原Der p 1和蟑螂过敏原Bla g 2水平较低。在软垫座椅中发现高水平的Fel d 1（几何均值22.9微克/克，范围4.5 - 58）和Can f 1（几何均值21.6微克/克，范围4 - 63）。每次均检测到空气中的Can f 1（范围0.12 - 0.56纳克/立方米），而在10个采样日中的7天检测到可检测到的空气中的Fel d 1（范围0.09 - 0.22纳克/立方米）。在所有空气样本中，Der p 1和Bla g 2低于检测限。经过反复真空清洁后，猫和狗过敏原的平均水平显著降低（P<0.001），与对照组相比，经过真空清洁的椅子中的过敏原水平降低了近五倍。
低水平的螨过敏原对螨敏感的哮喘患者可能没有任何临床意义。然而，医院中的软垫座椅是猫和狗过敏原的重要储存源。前来医院就诊的患者吸入空气中的过敏原可能会使对猫或狗高度过敏的患者哮喘加重。这些结果对在医院引入软装和地毯的做法是否明智提出了质疑。每周三次的真空清洁可显著降低软垫座椅中的过敏原水平。
