More than 50 million Americans, one out of five, suffer from hay fever, asthma, and other allergic diseases. Many of these conditions are caused by exposure to allergens in indoor environments such as the house, work, and school--where we spend as much as 98 percent of our time.

Developed by medical, public health, and engineering professionals working together, this unique volume summarizes what is known about indoor allergens, how they affect human health, the magnitude of their effect on various populations, and how they can be controlled. The book addresses controversies, recommends research directions, and suggests how to assist and educate allergy patients, as well as professionals.

Indoor Allergens presents a wealth of information about common indoor allergens and their varying effects, from significant hay fever to life-threatening asthma. The volume discusses sources of allergens, from fungi and dust mites to allergenic chemicals, plants, and animals, and examines practical measures for their control.

Indoor Allergens discusses how the human airway and immune system respond to inhaled allergens and assesses patient testing methods, covering the importance of the patient's medical history and outlining procedures and approaches to interpretation for skin tests, in vitro diagnostic tests, and tests of patients' pulmonary function.

This comprehensive and practical volume will be important to allergists and other health care providers; public health professionals; specialists in building design, construction, and maintenance; faculty and students in public health; and interested allergy patients.

Contents

• Committee On The Health Effects Of Indoor Allergens
• Preface
• Acknowledgments
• Executive Summary
  • Introduction
  • Magnitude Of The Problem
  • Agents, Sources, And Source Controls
  • Mechanisms Of Immune Function
  • Medical Testing Methods
  • Assessing Exposure And Risk
  • Engineering Control Strategies
  • The Role Of Education
  • Recommendations And Research Agenda
• 1. Introduction
  • Allergens And The Indoor Environment
  • Concepts and Definitions
  • Scope And Organization Of The Report
• 2. Magnitude and Dimensions of Sensitization and Disease Caused by Indoor Allergens
  • Immunologic Sensitization
  • Diseases
  • Conclusions and Recommendations
• 3. Agents, Sources, Source Controls, and Diseases
  • Dust Mite, Cockroach, And Other Arthropoda
  • Mammals And Birds
  • Microbial Allergens
  • Chemicals
  • Plants And Plant Products
  • Conclusions And Recommendations
• 4. Mechanisms of Immune Function
  • Response Of Airway Cells And Tissues To Indoor Allergens
  • Mediators
  • Generation Of Immune Response And Host Defense To Indoor Allergens
  • Conclusions And Recommendations
• 5. Medical Testing Methods
  • Medical History And Diagnosis
  • Skin Tests
  • In Vitro Diagnostic Tests
  • Pulmonary Function Tests
• 6. Assessing Exposure and Risk
  • Exposure Assessment
  • Risk Assessment
  • Conclusions And Recommendations
• 7. Engineering Control Strategies
  • Principles And Strategies
  • Summary Of Practical Control Strategies
  • Conclusions And Recommendations
• 8. The Role of Education
  • Educating Patients And The General Public
  • Educating Health Care Providers
  • Conclusions And Recommendations
• References
• Acronyms
• Glossary
• Committee and Staff Biographies

This project was supported by funds from the Environmental Protection Agency, National Institute of Environmental Health Sciences, National Institute of Allergy and Infectious Diseases, National Heart, Lung, and Blood Institute, and Agency for Toxic Substances and Disease Registry.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education.