Volume 118, Issue 3 , Pages 682-690, September 2006
Distribution and determinants of house dust mite allergens in Europe: The European Community Respiratory Health Survey II
Background
Several studies in European homes have described allergen levels from the house dust mite species Dermatophagoides pteronyssinus and to a lesser extent Dermatophagoides farinae, but geographic comparisons of exposure levels and risk factors have been hampered by a lack of standardized methods.
Objective
To study the distribution and determinants of the major house dust mite allergens Der p 1 and Der f 1 in 10 European countries using a common protocol.
Methods
During home visits with 3580 participants of the European Community Respiratory Health Survey II from 22 study centers, mattress dust was sampled and analyzed for Der p 1, Der f 1, and Der 2 allergen. Information on housing characteristics was obtained by both observations and interview.
Results
Der 1 and Der 2 allergens were detectable (≥0.1 μg/g) in 68% and 53% of the samples, respectively. Large differences in allergen levels between study centers were observed, and geographic patterns for Der p 1 and Der f 1 were different. Low winter temperatures reduced Der p 1 rather than Der f 1. Important risk factors for high allergen levels included an older mattress, a lower floor level of the bedroom, limited ventilation of the bedroom, and dampness for Der p 1 but not for Der f 1.
Conclusion
There are large qualitative and quantitative differences of house dust mite allergen levels in Europe, which can partly be explained by geographic and housing characteristics.
Clinical implications
Mite allergen exposure may be reduced by replacing the mattress regularly and increasing ventilation of the bedroom, particularly in winter.
Key words: House dust mites, allergens, housing, risk factors, geographic, ECRHS
Abbreviations used: ECRHS, European Community Respiratory Health Survey, GM, Geometric mean, OR, Odds ratio, rs, Spearman correlation coefficient
The coordination of ECRHS II was supported by the European Commission as part of their Quality of Life program. The following bodies funded the local studies in ECRHS II included in this article: Albacete: Fondo de Investigaciones Santarias (grant code: 97/0035-01, 99/0034-01, and 99/0034-02), Hospital Universitario de Albacete, Consejería de Sanidad; Antwerp: Fund for Scientific Research-Flanders Belgium (grant code: G.0402.00), University of Antwerp, Flemish Health Ministry; Barcelona: Spanish Respiratory Society (SEPAR), Public Health Service (grant code: R01 HL62633-01), Fondo de Investigaciones Santarias (grant code: 97/0035-01, 99/0034-01, and 99/0034-02), Interdepartmental Council of Technological Research and Innovation (CIRIT) (grant code: 1999SGR 00241), Red Respira Carlos III Health Institute; Basel: Swiss National Science Foundation, Swiss Federal Office for Education and Science, Swiss National Accident Insurance Fund, USC National Institute of Environmental Health Sciences Center grant 5P30 ES07048; Erfurt: GSF–National Research Center for Environment and Health, Deutsche Forschungsgemeinschaft (grant code FR 1526/1-1); Galdakao: Basque Health Department; Göteborg: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Grenoble: Programme Hospitalier de Recherche Clinique-DRC de Grenoble 2000 #2610, Ministry of Health, Direction de la Recherche Clinique, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, CHU de Grenoble, Comite des Maladies Respiratoires de l'Isere; Hamburg: GSF–National Reasearch Center for Environment and Health, Deutsche Forschungsgemeinschaft (grant code MA 711/4-1); Ipswich and Norwich: Asthma UK (formerly known as National Asthma Campaign); Huelva: Fondo de Investigaciones Santarias (grant code: 97/0035-01, 99/0034-01 and 99/0034-02); Oviedo: Fondo de Investigaciones Santarias (grant code: 97/0035-01, 99/0034-01, and 99/0034-02); Paris: Ministère de l'Emploi et de la Solidarité, Direction Generale de la Sante, UCB-Pharma (France), Aventis (France), Glaxo France, Programme Hospitalier de Recherche Clinique–DRC de Grenoble 2000 #2610, Ministry of Health, Direction de la Recherche Clinique, CHU de Grenoble; Pavia: Glaxo-SmithKline Italy, Italian Ministry of University and Scientific and Technological Research, Local University Funding for research 1998 and 1999 (Pavia, Italy); Reykjavik: Icelandic Research Council, Icelandic University Hospital Fund; Tartu: Estonian Science Foundation; Turin: ASL 4 Regione Piemonte (Italy), AO CTO/ICORMA Regione Piemonte (Italy), Italian Ministry of University and Scientific and Technological Research; GlaxoSmithKline Italy; Umeå: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Uppsala: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Verona: University of Verona; Italian Ministry of University and Scientific and Technological Research; GlaxoSmithKline Italy.Disclosure of potential conflict of interest: A. Soon has received grant support from the Estonian Science Foundation. The rest of the authors have declared that they have no conflict of interest.
PII: S0091-6749(06)01363-7
doi:10.1016/j.jaci.2006.04.060
© 2006 American Academy of Allergy, Asthma and Immunology. Published by Elsevier Inc. All rights reserved.
Volume 118, Issue 3 , Pages 682-690, September 2006
