Bla g 1 Allergen Levels in Zagreb Area Household Dust
Cockroach allergy is a health problem in many parts of the world. In urban environments, indoor exposure to cockroach allergens involves a risk of asthma. The aim of this study was to measure the mass fraction of Bla g 1, a major allergen of the German cockroach (Blatella germanica) in 30 house samples, collected at random from Zagreb area households, Croatia. Dust samples were collected on cellulose filters by vacuuming living rooms floors. After extraction, Bla g 1 was detected using the commercial enzyme-linked immunosorbent assay (ELISA). Only four of the thirty households had detectable Bla g 1 levels, and only in one was its concentration higher than 2.0 U g-1, the threshold associated with sensitisation. The Bla g 1 ELISA proved highly sensitive, with the detection limit of 0.12 U g-1. The within- and between-assay imprecision was 8.9 % and 14.4 %, respectively, and accuracy 85 % to 120 %. Low Bla g 1 levels in the household dust support previously reported low prevalence of skin sensitisation to B. germanica among Zagreb residents. Further monitoring should reveal if there are differences in cockroach allergen exposure and sensitisation between households from other geographic areas in Croatia.
Der p 1 is the main allergen of house dust mite Dermatophagoides pteronyssinus, which has routinely been detected in residential dust. However, the procedure for extracting Der p 1 from reservoir dust has not been well defi ned. The aim of this study was to compare Der p 1 mass fractions in dust extracts prepared using the following extraction buffers: phosphate (pH 7.4), borate (pH 8.0), and ammonium bicarbonate (pH 8.0), all with 0.05 % Tween 20. Twenty-eight dust samples were divided into three aliquots and each portion was extracted with one of the three buffers at room temperature. Der p 1 mass fractions were measured in a total of 84 dust extracts using the enzyme immunoassay (range: 0.1 μg g-1 to 7.53 μg g-1). Statistical methods including intraclass correlation showed a high agreement between Der p 1 mass fractions irrespective of the extracting medium. Our results suggest that all three buffers are suitable for the extraction of mite allergens and routine Der p 1 analysis in dust.
Pyroglyphid Mites as a Source of Work-Related Allergens
Pyroglyphid mites are primarily associated with allergen exposure at home; hence the name house dust mites. However, we have found numerous studies reporting pyroglyhid mite levels in public and occupational settings. This review presents the findings of house dust mite allergens (family Pyroglyphidae, species Dermatophagoides) as potential work-related risk factors and proposes occupations at risk of house dust mite-related diseases. Pyroglyphid mites or their allergens are found in various workplaces, but clinically relevant exposures have been observed in hotels, cinemas, schools, day-care centres, libraries, public transportation (buses, trains, taxies, and airplanes), fishing-boats, submarines, poultry farms, and churches. Here we propose a classification of occupational risk as low (occasional exposure to mite allergen levels up to 2 μg g-1), moderate (exposure between 2 μg g-1 and 10 μg g-1), and high (exposure >10 μg g-1). The classification of risk should include factors relevant for indoor mite population (climate, building characteristics, and cleaning schedule). To avoid development or aggravation of allergies associated with exposure to house dust mites at work, occupational physicians should assess exposure risk at work, propose proper protection, provide vocational guidance to persons at risk and conduct pre-employment and periodic examinations to diagnose new allergy cases. Protection at work should aim to control dust mite levels at work. Measures may include proper interior design and regular cleaning and building maintenance.
Prema podacima iz Registra profesionalnih bolesti Hrvatskoga zavoda za zaštitu zdravlja i sigurnost na radu, u posljednjih deset godina (2008. ‒ 2017.) prijavljeno je samo 20 slučajeva profesionalne astme od ukupno 2234 prijavljene profesionalne bolesti. To upućuje na značajne nedostatke u prepoznavanju toga poremećaja u našoj radnoj populaciji. Cilj ovoga rada bio je opisati standardnu metodu praćenja vršnog ekspiratornog protoka zraka (eng. peak expiratory flow, PEF) i predložiti praktičnu smjernicu za korištenje te dijagnostičke metode u ambulantama medicine rada i sporta. Praćenje vršnog ekspiratornog protoka zraka (PEF-monitoring) jednostavna je, jeftina, neinvazivna i pouzdana metoda za utvrđivanje funkcije dišnog sustava u stvarnim uvjetima rada i radnog okoliša. Sadašnje smjernice preporučuju PEF-monitoring kao inicijalnu dijagnostičku metodu prilikom sumnje na profesionalnu astmu. Pozitivan test upozorava na povezanost promjene plućne funkcije s radnom izloženošću i važan je dio dijagnostičkoga procesa utvrđivanja profesionalne astme. Najveći je nedostatak te metode da se tim testom ne može utvrditi uzrok astme, tj. on ne razlikuje profesionalnu astmu od astme pogoršane na radu, nema standardizirane metode za interpretaciju rezultata, a mjerenja provode sami radnici pa su moguće namjerne i nenamjerne manipulacije rezultatima mjerenja. U radu je predložena praktična smjernica za primjenu te metode u ambulantama medicine rada i sporta, s preporukama protokola mjerenja PEF-a, prikaza rezultata mjerenja i njihove interpretacije u sklopu dijagnosticiranja profesionalne astme.
Determination of mite Allergens in House Dust Using the Enzyme Immunoassay
The aim of this study was to determine the level of two major mite allergens Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1) in 30 urban homes in Zagreb, Croatia, using the enzyme immunoassay with two monoclonal antibodies which has been established as the reference method for indoor allergen analysis. Dust samples were taken by vacuuming a carpeted area and collected on cellulose filters. The ranges of Der p 1 and Der f 1 were (0.1-12.5) μg g-1 (median 0.32 μg g-1) and (0.1-31.2) μg g-1 (median 0.35 μg g-1), respectively. Der p 1 and Der f 1 (>2 μg g-1) associated with increased risk of sensitization to mite allergens were found in approximately 16% homes for each allergen. The sum of allergen (Der p 1 + Der f 1) exceeded the lower threshold in 27% of homes. Analytical evaluation of the ELISA assay showed satisfactory results for precision (intra-assay CV <6.9%, inter-assay CV<13.3%), accuracy (91% to 93%), and sensitivity (2 ng mL-1).
The ELISA assay for the measurement of dust mite allergens demonstrated very good analytical characteristics for routine laboratory use, and will provide the essential basis for our future studies of various indoor allergens.
Determination of Biogenic Amines and Endotoxin in Squid, Musky Octopus, Norway Lobster, and Mussel Stored at Room Temperature
Little research has been published on the indicators of spoilage in Mediterranean molluscan shellfish and crustaceans. Thus is why we studied changes in the concentrations of endotoxin and four biogenic amines (histamine, putrescine, tyramine and cadaverine) in European common squid (Loligo subulata, Lamarck, 1798), musky octopus (Eledone moschata, Lamarck, 1798), Norway lobster (Nephrops norvegicus, Linnaeus, 1758), and mussel (Mytilus galloprovincialis, Lamarck, 1819) from the Adriatic Sea stored at room temperature for 24 h. Endotoxin load in fresh squid, Norway lobster, and mussel (<1 EU mg-1) indicated good microbiological quality of raw samples. Biogenic amine index (as the sum of histamine, putrescine, tyramine, and cadaverine) correlated well with endotoxin load in squid (r=0.978, p<0.001) and musky octopus (r=0.874, p<0.01). A good correlation was also found between endotoxin and putrescine in Norway lobster (r=0.777, p<0.05). The highest endotoxin load was found in decomposed mussels and was associated with histamine alone. In conclusion, increase in biogenic amine levels is species-specific. Endotoxin analysis could be used for rapid assessment of microbiological quality of cephalopods and shellfish.
The CD14 receptor is expressed on the surfaces of monocytes, macrophages, and, to a lesser extent, of activated granulocytes and B lymphocytes (mCD14). It also exists in soluble form in the serum (sCD14), in which it binds microbial compounds and indoor allergens. The objectives of this study were to see whether serum sCD14 concentrations could be used as a marker of atopic disorders and to estimate the effects of environmental factors (tobacco smoke exposure, childhood residence in urban or rural areas, and having a pet) on sCD14 and IgE values. Mass fraction of sCD14 and total IgE were determined in the sera of atopic (N=53) and non-atopic (N=35) participants using the standard enzyme-linked immunosorbent assay. Exposure to pets and environmental tobacco smoke was estimated based on the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC). Median sCD14 concentration was significantly lower in atopic than in non-atopic girls (3.49 vs. 3.83 μg mL-1; p<0.010). The number of smokers at home positively correlated with the sCD14 level in atopics, and urban atopics had significantly lower sCD14 levels than rural atopics (3.47 vs. 3.92 μg mL-1, p=0.028). Median total IgE concentration was significantly lower in atopic pet owners than in atopics with no pets (161 vs. 252 kIU L-1; p=0.021). In conclusion, while sex and environmental factors might be involved in sCD14 expression, particularly in atopics, we found no correlation between sCD14 and total IgE concentrations. The usefulness of sCD14 as a marker of atopic disorders should be investigated further, particularly in relation to the severity of allergic disorders.
Frizeri su prepoznati kao zanimanje koje uključuje značajne zdravstvene rizike, ponajviše za kožu. Od 2010. do 2012. provodio se EU-ov projekt SafeHair s ciljem razvoja zdravstvenih standarda i standarda mjera zaštite na radu za sprečavanje profesionalnih kožnih bolesti u frizerstvu, u kojem su sudjelovali i suradnici iz Hrvatske. Cilj je ovog rada utvrditi trenutačno stanje zaštite kože na radu hrvatskih frizera. Prikupljanje podataka provedeno je ispunjavanjem EvaHair upitnika, koji je sastavljen u sklopu projekta SafeHair. Analizirano je ukupno 213 upitnika. Među ispitanicima je bilo 133 (64 %) vlasnika salona, 46 (22 %) zaposlenika te 31 (14 %) frizerski učenik. Trideset šest (17 %) ispitanika potvrdilo je da je u protekle tri godine u njihovu salonu bilo slučajeva kožnih tegoba, a gotovo svi ispitanici (98 %) smatraju da je prevencija profesionalnih kožnih bolesti vrlo važna. Utvrđen je velik udio (40 % do 50 %) neodgovorenih pitanja o provođenju procjene opasnosti. Rukavice se najviše koriste prilikom tretiranja kose kemikalijama (88 %), a rijetko se koriste prilikom pranja kose (13 %). Iako su dostupne većini ispitanika (95 %), njih 32 % iskazalo je da ima problema s nošenjem rukavica, većinom zato što ograničavaju osjet opipa. Frizeri s >30 godina radnog staža značajno češće koriste rukavice pri pranju i šišanju kose u usporedbi s frizerima s <30 godina radnog staža (P<0,05). Obuka frizera o zaštiti kože češće je zastupljena (39 %) od obuke o zaštiti dišnih putova (15 %) te mišića i zglobova (18 %). Najviše ispitanika iskazalo je potrebu za pomoći pri korištenju zakona i informiranju o proizvodima (57 %) te obavljanju procjene opasnosti (49 %). Rezultati upućuju na potrebu daljnjeg rada na edukaciji frizera o zdravstvenim rizicima njihova radnog mjesta te o mjerama zaštite na radu i njihovoj implementaciji. Edukaciju iz područja zaštite na radu te primjenu mjera zaštite na radu potrebno je provoditi tijekom redovitog školovanja i u obliku trajne edukacije frizera.
Occupational diseases (ODs) often have a chronic, progressive course, resulting in reduced work capacity and quality of life, prolonged sick leaves, unemployment, early retirements, and disability claims. The aim of this retrospective study was to see how diagnosed ODs affected the employment of 95 Croatian workers between 2005 and 2014. To do that, we reviewed archived data and made a telephone survey. The lowest age at which an OD was diagnosed was 20 years in women and 22 in men, while the shortest duration of work before OD diagnosis was one year for both genders. The most common ODs were overuse syndromes on the arms, carpal tunnel syndrome in particular, diagnosed mostly in textile and office workers. Of the 95 participants, 12 lost their jobs since the OD diagnosis, 46 retired, and 37 continued to work. Significantly more participants became unemployed after OD diagnosis in the period 2010-2014 than 2005-2009 (9 out of 43, 21 %, vs. 3 out of 52, 6 %, P<0.05). Only five participants were included in an occupational rehabilitation programme. Our findings warn against the deterioration in care for workers diagnosed with OD in Croatia.
Exhaled Breath Condensate pH in Adult Croatian Population Without Respiratory Disorders: How Healthy a Population Should Be to Provide Normative Data?
The aim of this study was to obtain preliminary exhaled breath condensate (EBC) pH values for healthy adult Croatian subjects, and to evaluate criteria for defining respiratory health of population providing normal EBC pH values in epidemiologic studies. In 109 adults without a history of lower airway symptoms (AS), four groups were described by narrowing the definition of "health" down to 1) without lower AS; 2) without lower and upper AS; 3) without AS, with normal FEV1 and bronchial normoreactivity; 4) without AS, with normal FEV1, bronchial normoreactivity, normal total IgE, and with negative skin prick test. Median EBC pH values did not differ between the groups (7.72, 7.73, 7.73, 7.73), but as health criteria got stricter, we observed a slight, nonsignificant increase in minimal pH values (6.95, 7.10, 7.20, 7.37). Median EBC pH values with interquartile range in the total sample (7.72; 7.63 to 7.76) were within the range previously reported by other authors. They did not differ regarding sex, smoking habit and atopic status, and were not associated with age, FEV1 or total IgE. The non-significant trend in EBC pH observed with stricter criteria of respiratory health and atopic status indicates the need for further research on criteria for defining healthy population in a larger sample.