Abstract
BackgroundThe bed is commonly regarded as the main site of house dust mite exposure; however this has not been directly established by continuous measurements. The objective of this study was to determine the pattern of personal exposure to mite aeroallergen over 24 hours.Methods12 adults each collected 9 sequential samples (8 during the day, mean 115 mins, and one overnight, mean 514 mins) over 24 hours using a portable air-pump (2L/min) connected to an IOM filter located on the shoulder during the day and on the bed head overnight. Samples were analysed for mite allergen Der p 1 by ELISA. Location and activity were recorded. A mixed model analysis was performed to determine exposure as a function of 14 categories of activity.ResultsPersonal aeroallergen exposure differed widely over time, both within and between subjects. The highest average exposure (1117 pg/m3, 95% CI: 289-4314) occurred on public transport and the lowest overnight in bed (45 pg/m3, 95% CI: 17-17), which contributed only 9.8% (95% CI: 4.4%-15.1%) of total daily exposure. Aeroallergens were not related to bed reservoirs.ConclusionThe study challenges the current paradigm that the bed is the main site of HDM exposure and instead suggests most exposure occurs in association with domestic activity and proximity to other people. Effective mite interventions, designed to improve asthma outcomes, need to first identify and then address the multiple sources of aeroallergen exposure.
Highlights
House Dust Mite (HDM) allergy is a significant risk factor for asthma in many countries and high exposure to the allergens contributes to airway inflammation [1] and asthma exacerbations [2]
The presumption about the dominance of beds is based on the high HDM allergen concentrations in bed dust compared to other sites in houses, the proportion of life spent in bed and the physical proximity between the bedding and the occupant [3]
This study aimed to model the pattern of HDM aeroallergen exposure throughout the day and night and determine its relationship to people’s activities
Summary
House Dust Mite (HDM) allergy is a significant risk factor for asthma in many countries and high exposure to the allergens contributes to airway inflammation [1] and asthma exacerbations [2]. This study aimed to model the pattern of HDM aeroallergen exposure throughout the day and night and determine its relationship to people’s activities. The bed is commonly regarded as the main site of house dust mite exposure; this has not been directly established by continuous measurements. The objective of this study was to determine the pattern of personal exposure to mite aeroallergen over 24 hours. Conclusion: The study challenges the current paradigm that the bed is the main site of HDM exposure and instead suggests most exposure occurs in association with domestic activity and proximity to other people.
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