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Airborne Food Allergen and Aeroallergen Levels in Health Care Settings: An Unaccounted for 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, Lisboa, Portugal
6Comprehensive Health Research Center (CHRC), Lisboa, Portugal
7Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
*Both authors contributed equally to the work.

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

Background: 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.

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

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