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Indoor Allergens: Assessing and Controlling Adverse Health Effects
anhydride and isocyanates). Primarily, however, the report focuses on airborne allergenic agents of biological origin.
In-depth consideration of multiple chemical sensitivity (MCS) reactions was excluded from the scope of this report because of a lack of data showing immune mechanisms. As stated in a recent NRC report (NRC, 1992a, p. 138), "there is insufficient evidence to ascribe an immune etiology to this disorder." For information on the topic of MCS the reader is directed to the recently published proceedings of a workshop and compilation of individually authored papers (NRC, 1992b).
The remaining seven chapters of this volume present the committee's findings, conclusions, and recommendations on several aspects of the problem of indoor allergens. Chapter 2 discusses the magnitude and dimensions of allergen-caused disease, and Chapter 3 presents a detailed discussion of allergen sources and their distribution. Chapter 4 describes the mechanisms of immune function. A discussion of test methods, with particular attention to their applicability, reliability, and interpretation appears in Chapter 5. Chapter 6 discusses the assessment of exposure and risk. The report concludes with an examination in Chapter 7 of engineering control strategies and the role of education in Chapter 8.
In preparing this report, the committee identified and developed a list of research agenda items and 15 priority recommendations. The recommendations focus primarily on the need to improve awareness and education, and as such are also relatively inexpensive and easy to implement compared to the research agenda items. The research agenda focuses on the longer term, more expensive, and more technical aspects of fundamental research and data collection.
Although cost-benefit analyses were beyond the scope of the committee's charge in conducting this study the committee's findings have been separated into recommendations and research agenda items, as described above, based on relative ease of implementation and estimations of associated costs. Policy development and further priority setting, however, should be based on investigations of the probable costs and benefits of the various strategies for prevention and control. The cost analyses should include both direct and indirect costs (i.e., medical costs as well as lost work), and benefits should include a full assessment of the effects on improving the quality of life and on reducing morbidity and mortality.
All of the committee's recommendations and research agenda items are compiled in the Executive Summary. In the body of the report they are presented in their individually relevant chapters and chapter sections.