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Airborne food and aeroallergens levels in healthcare settings. An unaccounted but potentially relevant source of exposure?

Leal M1*, Paciência I1,2*, Farraia M1,2, Cavaleiro Rufo J1,2, Castro Mendes F1,2, Delgado L1,3, Viegas C4,5,6, Moreira A1,2,3,7

1Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
2EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
3Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal
4H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal
5NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Portugal
6Comprehensive Health Research Center (CHRC), Portugal
7Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
*contributed equally to the work

J Investig Allergol Clin Immunol 2021; Vol. 31(5)
doi: 10.18176/jiaci.0623

Background: Exposure to airborne allergens of biological origin associates with the development and exacerbation of allergic asthma and rhinitis. Assessment of allergens exposure in healthcare facilities may contribute to monitor hygiene and survey specific allergens which may cause symptoms in sensitized subjects.
Objective: To assess concentration of indoor and airborne food allergens across different healthcare settings.
Methods: Dust was vacuumed from primary health care centers in Lisbon; and emergency unit, day hospital, internal medicine ward, operating room and the outpatient clinic of a university central hospital in Porto. Samples were sieved, weighed, 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 at least in one 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. The emergency unit revealed the higher levels of food allergens, namely Nbos d 5 (16034.0 µg/g) and Cor a 9 (10649.5 µg/g).
Conclusions: With the exception of the operating room, exposure levels of dust mite, cat and dog allergens in healthcare facilities were above the values associated with sensitization and occurrence of allergic asthma or rhinitis symptoms in sensitized subjects.

Key words: Airborne food allergens, Allergic disease, Healthcare centers, Aeroallergens, Indoor exposure

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