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Indoor Allergens: Assessing and Controlling Adverse Health Effects
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Index
A
Absenteeism, 8
asthma, 6, 61
Acaricides, 96, 225
Acid anhydrides, 121
trimetallic anhydride, 117-123 passim
Acoustic rhinometry, 182
Acute respiratory illnesses, 83
Adverse reactions, 131
to skin tests, 11, 162, 164
African Americans
asthma prevalence, 2, 34, 44, 61, 65, 70
child sensitization, 47
Age and age differences
asthma, 59, 61, 69
dermatitis, 73
rhinitis, 72
sensitization, 47
sinusitis, 79
skin test reactivity, 163
see also Children
Air cleaning devices, 32, 116, 189, 225-226, 231
Air conditioning, see HVAC systems
Algae, 114
Allergen-free products, 24, 98
Allergic bronchopulmonary aspergillosis (ABPA), 7, 74, 110-111
Allergy shots, see Immunotherapy
Alternaria, 67, 68, 111
Altitude, and dust mites, 50, 51, 88
American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE) standards, 19, 210-211, 215, 219, 228, 229, 230
Anaphylaxis, 131
and latex, 127, 128
Animals, 99, 104-105
see also Birds;
Cat dander;
Dogs;
Pets;
Rodents
Antibiotics, 119, 121
Antibodies, see Immunoglobulin; In vitro antibody tests
Antigen-presenting cells (APC), 135-137
Antihistamines, 10
and skin test reactivity, 163
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Arthropoda, see Cockroaches;
Dust mites
Asian Americans, asthma prevalence, 70
Aspergillus fungi, 74, 75, 109, 110-111
Assessment, see Diagnosis;
Exposure assessment;
Risk assessment;
Tests and testing methods
Asthma, 6-7, 34, 57, 132, 147
allergen evaluation and control, 16, 19-20, 97-98
and allergic bronchopulmonary aspergillosis, 74
and animals, 9, 25, 36, 37, 107
and Aspergillus fumigatus, 67
attributable fractions, 59, 62-63
and bacteria, 113
and birds, 105
and bronchitis, 59, 69, 79-80
and cat dander, 68, 69, 93, 100
and chemical allergens, 27, 117, 119, 121-122, 123
and children, 6, 59, 61, 64, 67, 68, 69, 70
and cockroaches, 9, 47, 69, 92
costs, 7, 22, 34-35, 61, 84
deaths, 6, 8, 34, 64, 65-67, 70
diagnosis of, 12, 15, 16, 18, 30, 57-58, 166, 167, 175, 178, 180
and dust mites, 9, 16, 36, 67, 68, 88, 93, 199-200
epidemiological studies, 58-59
and fungi, 9, 67, 68, 74, 111, 117
and grasses, 68
historical studies, 37
hospitalization, 8, 34, 61, 64-65, 66, 68, 69
and microbes, 114
and monkeys, 105
patient education and management, 15, 19-20, 178, 233-240, 242-244
prevalence, 6, 7, 22, 34, 55, 60-61, 62-67
and quality of life, 58
and smoking, 59
Asymptomatic atopy, 42
Atopic dermatitis, 73
Atopy, 3, 42, 56
and chronic obstructive pulmonary disease, 81
Attributable fractions, 59-60
asthma, 59, 62-63
Aureobasidium, 75, 77
Australasia, asthma deaths, 64
Avoidance measures, see Control measures
Azo-dyes, 121
B
Bacteria, 29, 112-114, 213
Bedding, 24, 98
and dust mites, 9, 10, 16, 95-96
feathers in, 105
Behavior modification, see Education, of patients
Benefits systems, disability assessment, 17-18
Biocides, 115, 218, 225
Birds, 24-26, 105-106
and hypersensitivity pneumonitis, 75, 105-106
B lymphocytes, 141-142
Body plethysmography, 12
Briançon, France, 50, 51
Britain
asthma, 64
and humidifier fever, 78
sinusitis, 78
Bronchial hyperreactivity, 30-31, 57, 67, 68, 184
testing of, 179-180
Bronchiolitis, 69
Bronchitis, 3, 79-81, 83
and asthma, 59, 69, 79-80
Bronchoalveolar lavage, 181
Bronchoprovocation testing, 17, 180-181, 183
Bronchopulmonary aspergillosis, see Allergic bronchopulmonary aspergillosis
Building-related illness (BRI), 81-83, 206-207
Buildings, see Building-related illness;
Engineering control;
HVAC
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systems;
Maintenance of buildings;
Sick building syndrome
C
Carpeting, 19, 24, 38, 213-214, 223, 230
and cat dander, 101
and dust mites, 10, 16, 95, 96
and rhinitis, 37
Case control studies, 59
Cat dander, 9, 99-102
and HVAC filters, 14
lions and tigers, 105
reagents for, 11, 25, 100, 106
Cattle, 104-105
CD4+ cells, 136, 139, 147
Cell-mediated immunity, 132
and dermatitis, 73
and fungi, 26-27
testing of, 12, 53, 166, 168
Cellular processes and mechanisms, 135-144
Central heating, see Heating;
HVAC systems
Chemical allergens, 9, 27-28, 117-125
exposure assessment, 32
and in vitro testing, 30
multiple chemical sensitivity, 43
and rhinitis, 27, 119, 121
sensitization to, 27, 28, 53, 122-123
Chicago, asthma, 70
Children, 44, 47, 56, 57, 98
asthma education, 233-236
asthma onset, 67, 68
asthma prevalence, 6, 59, 61, 64, 69, 70
bronchial hyperreactivity, 180
bronchitis, 59
dermatitis, 73
dust mite sensitization, 50, 51
rhinitis, 72
Chronic obstructive pulmonary disease (COPD), 79-81
Classification of reactions, 3, 39, 40, 132
Cockroaches, 9, 91-92
Colds, 83
Competing risks, 59-60
Condensation, 211-212, 227
Conjunctivitis, 3, 132
and chemical allergens, 13, 119, 121
Construction materials, 214
Contact dermatitis, 73-74
Control measures
cat dander, 101-102
for dust mites, 9, 10, 24, 94-96, 225-226, 236-238
efficacy assessment, 17-18, 24, 44, 98
fungal and microbial infestation, 97, 114-116
household, 7, 9, 10, 98
insects, 96-97
pets and animals, 26, 96, 104, 107
pollen, 97
and quality of life, 24, 98-99
research needs, 23-24, 98
see also Education;
Engineering control;
Therapeutic interventions
Costs
analyses, 15-16, 84
asthma cases, 7, 22, 34-35, 61, 84
Cotton dust standard, 176
Cromolyn, 10
Cross-reactivity, 11, 30, 31, 91, 166, 169-170
Cultural environment
and allergy prevalence, 22, 84
and asthma, 70
Cumulative exposure, 13
Cystic fibrosis
and allergic bronchopulmonary aspergillosis, 74
Cytokines, 147, 149-150, 168
D
Daily diaries, 159-160
Dander, see Cat dander
Deaths, asthma, 6, 8, 34, 64, 65-67, 70
Deer, 105
Definition of allergy, 39
Dehumidifiers, 212, 227
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Delayed-type hypersensitivity, see Cell-mediated immunity
Dermatitis, 55, 72-74, 88
Dermatophagoides mites, 89-91
Detergents
and bacteria, 113
and dust mites, 16, 97
Development of allergies, see Genetic factors; Sensitization
Diagnosis, 10-11, 16-18
allergic bronchopulmonary aspergillosis, 74
dermatitis, 73-74
of hypersensitivity pneumonitis, 75
of rhinitis, 71-72, 166, 180
use of daily diaries, 159-160
use of physical examinations, 159
see also Asthma, diagnosis of;
In vitro antibody tests;
Medical history;
Pulmonary function tests;
Skin tests;
Tests and testing methods
Diesel fumes, 53
Diffusing-capacity testing, 12, 181-182
Disability assessment, using pulmonary function tests, 17-18
Dogs, 25, 102, 106
Double-immuno-diffusion testing, 11-12
Drugs, 10
Duct work, 207, 219-220
cleaning, 32-33, 116, 225, 231
Dust, 86-88
and asthma, 67, 88
in HVAC systems, 217-218
and rhinitis, 37, 72, 88
sampling of, 188-189, 195
Dust mites, 9, 87-88, 89-91
and birds, 105
and building climate, 10, 14, 16, 38, 88, 89, 96, 210-211
control measures, 9, 10, 24, 94-96, 225-226, 236-238
exposure and sensitization, 13, 31, 50, 51, 52, 93
research needs, 16
standardized reagents for, 111
E
Economic impacts of allergy, 7-8, 15-16, 23-24, 84-85
asthma, 6, 61
Eczema, see Dermatitis
Education
building engineers and management, 21, 244-245
of medical personnel, 15, 20-21, 240-243, 244
of patients, 15, 19-20, 44, 233-244
Electronics industry, 118-119
Electrostatic precipitation, 116
Elk, 105
Emergency medical service
asthma, 6, 7, 61
Emphysema, 79-81
Endotoxins, 29, 88
Energy efficiency, and building design, 37-38
Engineering control, 13, 18-19, 32-33, 206-209, 227-232
air cleaning, 225-226
and allergy education, 21
building design, 37-38, 207-208, 210-214
remediation, 224-227
see also HVAC systems;
Maintenance of buildings
Enzyme-linked immunosorbent assay (ELISA), 11, 167
Eosinophils, 143
Epidemiological studies, 44
acute respiratory illnesses, 83
asthma, 58-59
atopy, 42
recommendations for, 83-85
rhinitis, 71-72
sensitization, 23, 46-47, 48-49, 51, 84-85
sinusitis, 78
use of pulmonary function tests, 17, 18, 183-184
use of skin tests, 11, 47
see also Attributable fractions;
Risk assessment
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Epithelium, 134, 146
Epoxy resins, 121
Ethnic groups, see African Americans;
Mexican Americans;
Race and ethnicity
Ethylenediamine, 121
Exercise testing, 12, 179, 182
Exposure assessment, 13, 18, 185-187
personal doses, 194-196
research needs, 18, 23, 31-32, 204-205
sample analysis, 191-193
sample collection, 31-32, 94, 187-191, 204-205
Exposure levels, relation to sensitization, 5-6, 13, 23, 38, 50, 51, 93-94
Extracts, see Reagents and extracts
Eye irritation, 83
F
Farms and farmers
animal allergens, 104-105
''farmer's lung," 75, 76
Feathers, see Birds
Fibrosis, and hypersensitivity pneumonitis, 75
Ficus benjamina, 126
Field testing of control measures, 24
Filtration, see HVAC systems
Flooring, 214
Food allergies, 37
Food and Drug Administration, 169
Formaldehyde, 121-122
Fungi, 9, 11, 108-111
Aspergillus, 74, 75, 109, 110-111
and asthma, 9, 67, 68, 74, 111, 117
and building climate, 211
and carpeting, 213
research needs, 26-27, 29, 116-117
and rhinitis, 9, 72
sampling, 190, 192
see also HVAC systems, fungal and microbial infestation
G
Gas dilution, 12
Gender differences
asthma, 69
sensitization, 47
Genetic factors, 2-4, 29, 42, 151-152
asthma, 67
and childhood onset, 50, 56, 57
dermatitis, 73
Geographic location, 83-84
and asthma, 68-69
see also Inner-city areas
Grasses, 72, 97
Guidelines for the Diagnosis and Management of Asthma, 15, 241, 243
Guinea pigs, 103, 104
H
Hamsters, 104
Haptens, 119
Hay fever, see Rhinitis
Health care facilities, 7, 65, 66
HVAC standards, 215
worker allergen exposure, 119, 128, 129
Heating, 37-38
see also HVAC systems
Heredity, see Genetic factors
Histamine, 3, 39, 42, 57, 179, 180
History of allergy, 37, 38
Horses, 105
Hospitalization
for asthma, 8, 34, 61, 64-65, 66, 68, 69
for hypersensitivity pneumonitis, 75
Hours spent indoors, 2, 34
Human immunodeficiency virus (HIV), 139
Humidifiers, 109, 112, 115, 207, 212, 218-219
"humidifier fever," 77-78, 113, 114
Humidity, 24, 38
control, 19, 115, 210-211, 222, 227
and dust mites, 10, 16, 88, 89, 96
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HVAC (heating, ventilation, and air-conditioning) systems, 13-14, 18-19, 21, 32-33, 38, 207, 214-222, 229
and animal allergens, 25, 107
bird dropping contamination, 106
fungal and microbial infestation, 14, 109, 113, 115-116, 216
and hypersensitivity pneumonitis, 75, 77
improvement guidelines, 19, 230
maintenance of, 38, 207, 222, 224
in residential buildings, 228-229
Hypersensitivity, 3, 131-132
Hypersensitivity pneumonitis, 7, 12, 39, 55, 75-77
and bacteria, 113
and birds, 26
and chemical allergens, 119, 121
and fungi, 9, 26-27, 110, 117
testing of, 12, 166, 167, 170, 173, 175, 181
and thermophilic actinomycetes, 75, 77, 218
I
Identification of allergens, see Risk assessment;
Tests and testing methods
Immunoglobulin E (IgE), 3, 39, 41-42, 142
and allergic bronchopulmonary aspergillosis, 74
and dermatitis, 73
and dust mites, 88
and fungi, 11, 111, 117
in vitro testing, 11, 166-167
reaction to smoke, 52-53
and rhinitis, 71
and skin tests, 46, 160-161
Immunoglobulin G (IgG)
and allergic bronchopulmonary aspergillosis, 74
and fungi, 110-111
and hypersensitivity pneumonitis, 39, 53, 75, 77
testing of, 11-12, 53, 114, 167, 193
Immunologic hemorrhagic pneumonitis
and chemical allergens, 27, 119, 121, 124
Immunologic tests, see In vitro antibody tests;
Laboratory studies;
Reagents and extracts;
Skin tests
Immunotherapy (allergy shots), 10
Impingers, 191
Incidence of allergies, 44, 84
allergic rhinitis, 71
asthma, 61
atopic dermatitis, 73
Industrial chemicals, see Chemical allergens
Infant eczema, 73
Inflammatory-response agents, 3, 144-146
Influenza, 83
Inner-city areas, 25, 88, 92, 104, 107
and asthma, 9, 47, 69, 70, 92
Insects, 91-92, 96-97
see also Cockroaches
Insulation, 38, 221-222
Insurance systems, disability assessment for, 17-18
International Union of Immunologic Societies (IUIS), 169
Intervention, see Control measures;
Education;
Therapeutic interventions
Intradermal testing, see Skin tests
In vitro antibody tests, 11-12, 30, 161, 166-171
In vivo testing, see Skin tests
Irritating substances, and allergy development, 46
Isocyanates, 121
toluene diisocyanate, 117, 118, 119, 122
J
Japan
hypersensitivity pneumonitis, 77
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K
King Menes, 37
L
Laboratory studies, 11
see also In vitro antibody tests;
Skin tests
Laboratory workers, rodent exposure, 99, 102-103, 104
Lacquer, 121
Late respiratory systemic syndrome (LRSS), and chemical allergens, 27, 119, 124
Latex, 28-29, 127-129
Legionella pneumophila, 113
Local allergens, 83-84
Local host factors, 29, 151-152
Low-molecular-weight (LMW) chemicals, see Chemical allergens
Lung volume measurement, 12, 181
Lymphocyte transformation assay, 12, 168
M
Macrophages, 135, 136, 137, 138, 150-151
Maintenance of buildings, 33, 222-224
and allergy education, 21
Mammals, see Cat dander;
Dogs;
Pets;
Rodents
Mast cells, 3, 39, 41-42, 134, 142-143
Mattresses9, 10
Mediators, 144-146, 168
Medical devices, latex, 129
Medical history, 10-11, 29, 153-159
Medical personnel
allergen exposure, 119, 128, 129
education of, 15, 20-21, 240-243, 244
Metals, 121
Methacholine, 57, 179, 180
Mexican Americans, 70
Mice, 103-104
Microbes, 108, 114-115, 214
and building climate, 38, 210-211
and humidifier fever, 77-78
see also Bacteria;
Fungi;
HVAC systems, fungal and microbial infestation
Middle Ages, 38
Mites, see Dust mites
Moisture control, 33, 210-213
Mold, see Fungi
Monitoring, see Exposure assessment
Mucus, 146
Multiple chemical sensitivity (MCS), 43
Multiple exposure sources, see Competing risks
N
Nasal effects, see Rhinitis
Nasal lavage, 183
National Center for Health Statistics, asthma survey coding, 65
National Institute for Occupational Safety and Health, 177
Native Americans, asthma prevalence, 67, 70
Neutrophils, 143-144
New York City, asthma, 70
New Zealand, asthma deaths, 64
Nitrogen dioxide, 53
Non-IgE-mediated isocyanate asthma, and chemical allergens, 27, 124
No Observed Adverse Effect Level (NOAEL), 198-199
Nordic Committee on Building Regulations, 219
O
Occupational risks, see Farms and farmers;
Health care facilities;
Laboratory workers;
Workplaces
Offices, see Workplaces
Ouchterlony test, 11-12, 167
Outpatient care, asthma, 61
Ozone, 53
and asthma, 70-71
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P
Peak-flow measurements, 12, 18, 177-179, 184
Permissible exposure limits (PELs), 122
Pets, 9, 38, 99
see also Cat dander;
Dogs
Pharmaceutical workers, 119
Physical examinations, 159
Pigeons, and hypersensitivity pneumonitis, 75, 105-106
Plants and plant products, 28-29, 125-130
see also Grasses;
Pollen
Plating facilities, 121
Platinum, 53, 117, 118, 121
Pneumonia, 83
Pneumonitis, see Hypersensitivity pneumonitis;
Immunologic hemorrhagic pneumonitis
Pollen, 125-126, 127
and asthma, 58, 68
and carpeting, 19
historical studies, 37
and HVAC filters, 14, 216, 229
Pollution and pollutants, 35, 38, 53
and asthma, 70-71
Population studies, see Epidemiological studies
Poverty, and asthma, 70
Precipitin assays, 11-12, 114, 167, 170
Prevalence of allergies, 5, 39, 44
allergic bronchopulmonary aspergillosis, 55, 74
asthma, 6, 7, 22, 34, 55, 60-61, 62-67
bronchitis, 59
cat dander, 99
chemical exposure, 28
dermatitis, 55, 73, 74
estimation methods, 11, 22, 55, 84
hypersensitivity pneumonitis, 55
rhinitis, 5, 35, 55, 71
sensitization, 36, 39, 46-47
sinusitis, 55, 78-79
and socioeconomic status, 22, 70, 71,
work settings, 53
see also Attributable fractions;
Epidemiological studies
Primates, 105
Protozoa, 114
Psyllium, 127
Pulmonary disease anemia (PDA), 119
Pulmonary function tests, 12, 17-18, 30-31, 171-184
Q
Quality of life
and asthma, 34
impacts of control measures, 24, 98-99
R
Rabbits, 103, 104
Race and ethnicity, 84
asthma prevalence, 6, 22, 34, 61, 70
child sensitization, 47
see also African Americans
Radioallergosorbent test (RAST), 11, 165, 166-167
Rats, 103
Reagents and extracts
for animal sources, 11, 24-25, 100, 106
for fungi, 11, 111
for in vitro antibody tests, 12, 30, 168-169, 171
for skin tests, 11, 30, 163-164
Regional allergens, 83-84
Relapse prevention, 20
Research assays, 12
Reservoir sampling, 31-32, 94, 188-189, 193
Respiratory effects
adjuvant, 150-151
allergen-specific, 147-150
immune and inflammatory cells, 135-144
nonspecific defense mechanisms, 146
structural tissue and cells, 133-135
see also Acute respiratory illnesses;
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Allergic bronchopulmonary aspergillosis;
Asthma;
Bronchitis;
Hypersensitivity pneumonitis;
Immunologic hemorrhagic pneumonitis;
Late respiratory systemic syndrome;
Pulmonary function tests;
Rhinitis
Rhinitis (hay fever), 3, 5, 35, 71, 83, 132
and animals, 9, 105
and chemical allergens, 27, 119, 121
and cockroaches, 9
and dust, 37, 72, 88
and fungi, 9, 72
and grasses, 72
historical studies, 37
testing of, 71-72, 166, 180
Rhinomanometry, 12, 182
Risk assessment, 13, 38, 47, 50, 196-206
allergen identification, 23, 27, 83-84, 85
chemical allergens, 27, 122-123, 124
Rodents, 25, 102-104
Rotorods, 190-191
Rubber, see Latex
S
Sampling
analysis, 191-193
collection, 31-32, 94, 187-191, 204-205
Sauna takers disease, 77
Scratch tests, 162
Seasonal variations, 198
asthma, 68
hypersensitivity pneumonitis, 77
sensitization, 47
Sensitization, 3-5, 22-23, 29, 39, 41-42, 84-85
chemical allergens, 27, 28, 53, 122-123
and cross-reactivity, 11, 30
epidemiological studies, 23, 46-47, 48-49, 51, 84-85
prevalence, 36, 39, 46-47
prevention of, 21, 24, 26
relation to exposure levels, 5-6, 13, 23, 38, 50, 51, 93-94
testing of, 17, 45-47, 53, 201-204
and tobacco smoke, 52-53
Serial pulmonary function testing, 17, 183
Serum antibody tests, 166-167
Severity measures, 44-45
Shellac, 121
Shots, see Immunotherapy
Sick building syndrome (SBS), 81, 206-207
Sinusitis, 55, 78-79
Skin reaction, 149
see also Dermatitis;
Skin tests;
Urticaria
Skin tests, 11, 16-17, 29-30, 46-47, 160-166, 170
adverse reactions to, 11, 162, 164
smoking and reactivity, 52-53
use of house dust, 87
Slime molds, 114
Smoke and smoking, 52-53
bronchial hyperreactivity, 180
and bronchitis, 59, 69, 79
and chronic obstructive pulmonary disease, 81
Socioeconomic status
and allergy prevalence, 22, 70, 71, 84
and patient education, 20, 235-236
Sources of allergens, see Cat dander;
Chemical allergens;
Cockroaches;
Dust mites;
Exposure assessment;
Fungi;
Humidifiers;
HVAC systems;
Pets;
Risk assessment;
Rodents
Southern Building Code Congress International, 215
Spina bifida, and latex allergy, 128
Spirometry, 12, 17, 173-177, 183
Spores, see Fungi;
Slime molds
Standards and standardization
asthma survey coding, 65
chemical exposure levels, 122, 125
HVAC systems, 19, 33, 210-211, 215, 219, 228, 229, 230
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medical history data, 29, 157, 159
pulmonary function tests, 176-177, 178
reagents, 11, 12, 30, 165, 168-169
sampling and exposure assessment, 31-32, 204-205
skin test methods, 17
Steroids, 10, 74, 146, 163
Sulfur dioxide, 53
Surveys, see Epidemiological studies
Swine, 105
Symptoms, 3
relation to exposure levels, 13
T
Tannic acid, 96
Temperature, 16, 97, 210-211
Tests and testing methods
control measures efficacy, 17-18, 24, 44, 98
dust mite allergens, 89, 91, 93
environmental, 12-13
house dust allergens, 91, 92-93, 94
sensitization, 17, 45-47, 53, 201-204
see also Exposure assessment;
In vitro antibody tests;
Pulmonary function tests;
Skin tests
T helper lymphocytes and receptors, 135-141 passim, 147, 149
and asthma, 166
Therapeutic interventions
for asthma, 97-98
for dermatitis, 74
efficacy assessment, 17, 18, 44, 184
hypersensitivity pneumonitis, 75
Thermophilic actinomycetes, 114
and hypersensitivity pneumonitis, 75, 77, 218
Threshold limits, 122, 125, 198-199
Tobacco smoke, see Smoke and smoking
Toluene diisocyanate (TDI), 117, 118, 119, 122
Trimetallic anhydride (TMA), 117-123 passim
U
Upholstery, 24, 98
and dust mites, 9, 10
Urban-rural differences
asthma, 68-69
Urticaria
and latex, 127, 128
V
Vacuuming, 32, 38, 223, 230-231
and dust mite control, 10
Vapor retarders, 212
Ventilation, 13-14, 16, 19, 35, 38, 97
and animal allergens, 25
and moisture control, 33
see also HVAC systems
Veterinarians, 105
W
Water damage, 19, 212, 227
carpeting, 213-214
Wheezing, 69, 83
Workplaces, 9, 28, 54-55, 119-125 passim, 229
animals in, 99
and bacteria, 113
and humidifier fever, 77-78
and hypersensitivity pneumonitis, 77, 119
plants in, 28, 126, 129
sensitization prevalence, 53
see also Building-related illness;
Farms and farmers;
Health care facilities;
Laboratory workers;
Sick building syndrome
Z
Zoos, 105
