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Respiratory symptoms in relation to indoor exposure to mite and cat allergens and endotoxins

¹ GSF - National Research Centre for Environment and Health, Institute of Epidemiology, Neuherberg, Germany. ² Chair of Epidemiology, Institute of Medical Data Management, Biometrics and Epidemiology, Ludwig-Maximilians-University of Munich, Munich, Germany. ³ Centre for Pneumology and Thoracic Surgery, Pulmonary Research Institute at Grosshansdorf Hospital, Grosshansdorf, Germany. ⁴ Institute of Clinical Immunology, Friedrich-Schiller-University of Jena, Jena, Germany. ⁵ Institute of Occupational, Social and Environmental Medicine, Friedrich-Schiller-University of Jena, Erfurt, Germany

CORRESPONDENCE: U. Gehring, GSF - National Research Centre for Environment and Health, Institute of Epidemiology, Geb 56, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany. Fax: 49 8931873380

Keywords: allergens, cat, endotoxins, house dust, mite, respiratory symptoms

Received: November 15, 2000
Accepted March 30, 2001

This study was supported by the Federal Ministry for Education, Science, Research, and Technology, Grant No. 01 EE 93016.

The authors investigated the relationship between respiratory symptoms in adults and exposure to mite and cat allergens, the role of endotoxins in house dust, the effects of mixtures of several allergens, and interactions between allergen exposure and allergic sensitization.

Within a nested case-control study, 405 subjects aged 25–50 yrs from two German cities answered a standardized questionnaire. Allergen-specific immunoglobulin-E was measured. Dust samples were taken from the subjects' homes to determine exposure to mite (Dermatophagoides pteronyssinus antigen 1 Der p 1) and (D. farinae antigen 1 Der f 1) and cat (cat antigen d1 Fel d 1) allergen and endotoxin content in settled house dust.

Exposure to Der f 1 and Der p 1 plus Der f 1 >10 µg·g^–1 of mattress dust, respectively, increased the risk of wheeze and breathlessness (odds ratios (OR): 4.04, 95% confidence interval (CI): 1.53–10.64, OR: 2.78, 95% CI: 1.06–7.28). Fel d 1 >8 µg·g^–1 was positively associated with cough at night (OR: 2.74, 95% CI: 1.22–6.17), noteworthy also in the nonsensitized subjects. Subjects exposed to elevated concentrations of more than one allergen had an up to seven-fold increase in the risk of respiratory symptoms, compared to nonexposed subjects. Sensitized subjects exposed to elevated concentrations of Der f 1 or Fel d 1 were found to have the highest risk of asthma attacks and respiratory symptoms. No statistically significant association was found between exposure to endotoxins and respiratory health.

Indoor exposure to Dermatophagoides farinae antigen 1 and cat antigen d1 is a risk factor for respiratory symptoms in adults, and for cat antigen d 1 even in nonsensitized subjects. The risk is increased if subjects are exposed to a mixture of allergens or if they are sensitized in addition to high exposure.