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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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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Indoor Allergens: Assessing and Controlling Adverse Health Effects 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