Despite an increasing body of knowledge regarding the role of indoor allergen exposure, particularly to mammals, as a cause of asthma, much remains to be learned. The relationship between exposure to indoor pets and the increasing morbidity and mortality of asthma requires further clarification.

Research Agenda Item: Determine the relationship between exposure to indoor pets and the incidence, prevalence, and severity of asthma.

In addition, rodents that infest inner-city dwellings need to be examined as potential risk factors for asthma among individuals exposed to these potent allergens.

Research Agenda Item: Explore the possibility that exposure to rodent populations in inner-city areas may be a risk factor for asthma.

For many allergens, the size of airborne particles and their distribution in the air have not been elucidated and should be studied. Reservoirs of animal and avian allergen exposure and their dissemination through ventilation systems of offices, apartments, and other large buildings likewise require investigation.

Research Agenda Item: Investigate the potential role of mammalian- and avian-allergen- contaminated ventilation systems in the development of allergic disease among inhabitants of apartments, offices, and other large buildings.

Although control measures may reduce airborne concentrations of mammalian and avian allergens, the ability of these approaches to influence symptoms in sensitized patients or to prevent the sensitization of naive individuals requires clarification and study. The use of personal monitoring systems should be useful in making these determinations.

Research Agenda Item: Evaluate the effectiveness of environmental control measures on patient symptoms. This should include assessments of preventing sensitization in the naive individual as well as symptom reduction in those already sensitized.

The epidemiology, diagnostic techniques, and even pathogenesis of hypersensitivity pneumonitis from avian proteins are poorly characterized and require further elucidation. In addition, the risk factors and natural history of the disease are poorly understood and the effects of allergen avoidance remain controversial in the ultimate prognosis of the disease. All of these issues require clarification through further research.



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