up of fibers from carpets and furniture, grit and sand particles, human skin scales, and food debris. This mixture is combined with allergens from domestic animals, insects, and a variety of microscopic arthropods, bacteria, algae, and fungi growing within the house and other buildings. In addition, air coming into these buildings can carry pollen and molds from outside that then become part of the dust. Because the occupants of a house are inevitably exposed to house dust, any source of foreign protein in the dust is a potential cause of sensitization. Skin testing of patients with asthma or rhinitis initially utilized extracts made from dust collected from their own house (i.e., autologous dust; Kern, 1921); now, however, commercial extracts of house dust are widely used for diagnosis and immunotherapy. In 1980 the U.S. Food and Drug Administration (FDA) estimated that at least 10 million injections of "house dust" extract were administered annually in the United States.

Until 1967, house dust allergenicity was attributed to animal dander, insects, and fungi (Spivacke and Grove, 1925; Vannier and Campbell, 1961). In that year, however, Voorhorst and his colleagues in the Netherlands observed large numbers of mites in dust samples and demonstrated that dust

TABLE 3-1 Biological Sources of Allergens in Houses



Dust mites

Dermatophagoides pteronyssinus

Dermatophagoides farinae

Euroglyphus maynei

Blomia tropicalis

Storage mites


Multiple species including

Penicillium, Aspergillus, Rhizopus, Cladosporium (growing on surfaces or wood)



Entry with incoming air, multiple species




Blattella germanica (German)

Periplanetta americana (American)

Blatta orientalis (Oriental)

Derived from outside


Crickets, flies, beetles, fleas, moths, midges


Horsehair in furniture, kapok

Food dropped by inhabitants

Domestic Animals


Cats, dogs, ferrets, skunks, horses, rabbits, pigs

Wild: mice, rats

Pets: mice, gerbils, guinea pigs

* Fungal spores may contain very little allergen and may require germination to produce significant exposure.

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