allergy
Minimizing the risks of latex allergy: the effectiveness of written information.

Carrozzi FM, Katelaris CH, Burke TV, Widmer RP.

Institute of Immunology and Allergy Research, Westmead Hospital, Sydney, New South Wales.

BACKGROUND: Latex allergy has been identified as an occupational risk for the dental profession. This study assessed whether identified latex-allergic dental personnel changed their practices after receiving verbal and written information about the management of latex allergy. METHODS: A survey conducted at the 1998 Australian Dental Association Congress identified 157 dental personnel with clinical latex allergy, or at high risk from latex exposure. The workplace implications were then explained to them by a consultant allergist. Four weeks later, follow up written information on latex allergy was mailed out. The information sheet outlined possible symptoms and cross-reactions, implications for the workplace, hand care advice and management strategies to reduce latex exposure in the workplace. After six weeks, a questionnaire, designed to assess whether appropriate steps to reduce latex exposure had been taken, was mailed out. RESULTS: Seventy per cent of the questionnaires were returned. All respondents felt the information was easy to understand and informative. While 50 per cent of respondents indicated that they had changed to powder-free or non-latex gloves, only five respondents were fully compliant with all instructions. CONCLUSION: Compliance with instructions regarding minimizing exposure to latex in a group of latex-allergic dental personnel was poor.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12405464&dopt=Abstract allergy medicine



allergy
Rising prevalence of allergy to peanut in children: Data from 2 sequential cohorts.

Grundy J, Matthews S, Bateman B, Dean T, Arshad SH.

David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, United Kingdom.

BACKGROUND: Allergy to peanut is common. However, it is not known whether the prevalence of sensitization and clinical allergy to peanut is increasing. OBJECTIVE: We sought to determine any change in the prevalence of peanut sensitization and reactivity in early childhood in 2 sequential cohorts in the same geographic area 6 years apart. METHODS: Of 2878 children born between September 1, 1994, and August 31, 1996, living on the Isle of Wight, 1273 completed questionnaires, and 1246 had skin prick tests at the age of 3 to 4 years. Those with positive skin prick test responses to peanut were subjected to oral peanut challenges, unless there was a history of immediate systemic reaction. These data were compared with information on sensitization and clinical allergy to peanut available from a previous cohort born in 1989 in the same geographic area. RESULTS: There was a 2-fold increase in reported peanut allergy (0.5 % [6/1218] to 1.0 % [13/1273]), but the difference was nonsignificant (P =.2). Peanut sensitization increased 3-fold, with 41 (3.3 %) of 1246 children sensitized in 1994 to 1996 compared with 11 (1.1 %) of 981 sensitized 6 years ago (P =.001). Of 41 sensitized children in the current study, 10 reported a convincing clinical reaction to peanut, and 8 had positive oral challenge results, giving an overall estimate of peanut allergy of 1.5% (18/1246). CONCLUSIONS: Sensitization to peanut had increased between 1989 and 1994 to 1996. There was a strong but statistically nonsignificant trend for increase in reported peanut allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12417889&dopt=Abstract allergy medicine



allergy
[The prevalence of positive allergy skin tests among children with asthma in the Ashkelon Region, Israel]

[Article in Hebrew]

Bibi H, Shoseyov D, Kerjner N, Zeldin Y, Armoni M, Ohali M, Schlesinger M.

Department of Pediatrics, Barzilai Medical Center, Ashkelon, Israel.

BACKGROUND: Asthma is the most common chronic disease amongst children. OBJECTIVE: To find the prevalence of positive allergy skin tests amongst children having asthma attending the asthma clinic in Barzilai Medical Center in Ashkelon Israel. STUDY DESIGN: Retrospective study. All medical files of the asthmatic children attending the asthma clinic in Barzilai Medical Center in Ashkelon, Israel, were reviewed. Data regarding their clinical status, past medical history, socioeconomic and familial medical history were collected. RESULTS: One thousand three hundred and fifty three medical files including all the information necessary for the study were reviewed. Amongst the children 1,238 lived in urban areas and towns and 115 lived in rural areas. It was found that most of the children have positive allergy skin tests for house dust mite and mold. Among the urban children 86.2% were found to have positive allergy skin tests for house dust mite compared with 48% of the rural children (P < 0.02). Positive allergy skin tests for mold were found among 63.1% of the urban children compared with 44% of the rural children (p < 0.04). Positive allergy skin tests for most allergens were found to be more prevalent amongst the children living in urban areas compared with the children living in rural areas. The positive allergy skin tess are not related to parental smoking habits or house pets amongst these findings. CONCLUSION: Most of the children living in the Ashkelon region and positive allergy skin tests for house dust mite. This tendency is more common among the children living in urban areas as compared with children living in rural areas. The reason for this difference has to be studied.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12420590&dopt=Abstract allergy medicine



allergy
The association between contact allergy and hand eczema in 2 cross-sectional surveys 8 years apart.

Nielsen NH, Linneberg A, Menne T, Madsen F, Frolund L, Dirksen A, Jorgensen T.

Departments of Dermatology, Gentofte and Bispebjerg Hospital, Hellerup, Denmark.

Hand eczema is a recurrent chronic skin disease related to contact allergy and atopic dermatitis. When possible, efforts should be redoubled to eliminate provoking factors. Our objective was to assess changes in the prevalence of self-reported hand eczema and to evaluate the association between contact allergy and hand eczema among adult Danes before and after nickel exposure regulation in Denmark. In 1990 and 1998, random samples of 15-41-year-old persons were examined in 2 cross-sectional studies of the general population in Copenhagen, Denmark. The studies included questionnaires, patch and prick testing. From 1990 to 1998 the prevalence of a history of hand eczema increased significantly. This increase did not appear to be fully explained by changes in the prevalence of flexural eczema, prick test reactivity, patch test reactivity, and nickel allergy. In 1990, nickel allergy and allergic nickel contact dermatitis were significantly associated with a history of hand eczema among women. In 1998, these associations were not found. It can be concluded that, from 1990 to 1998, the prevalence of a history of hand eczema rose significantly. It was indicated that it might be possible to prevent the hand eczema related to nickel allergy by exposure regulation, public education or both.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12423403&dopt=Abstract allergy medicine



allergy
Characterization of cytokines present in pediatric otitis media with effusion: comparison of allergy positive and negative.

Jang CH, Kim YH.

Department of Otolaryngology, Wonkwang Medical School, Iksan 570-711, South Korea. chul wonkwang.ac.kr

To investigate the possible relationship between allergy and otitis media with effusion (OME), we investigated the cytokine level in the middle ear effusion (MEE)s of children with persistent OME. Interleukin (IL)-2, IL-4, IL-6 and tumor necrosis factor (TNF)-alpha in the MEEs were measured by devised sensitive sandwich enzyme-linked immunosorbent assay (ELISA) and compared allergy positive group with allergy negative group. The mean levels of IL-4, IL-6 and TNF-alpha in MEE were significantly higher in allergy positive group than allergy negative group (P<0.05). Elevation of Th-2-driven cytokines (IL-4, IL-6) and TNF-alpha in MEEs may be a contributing factor in the persistence of OME with allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12363420&dopt=Abstract allergy medicine



allergy
History of penicillin allergy and referral for skin testing: evaluation of a pediatric penicillin allergy testing program.

Langley JM, Halperin SA, Bortolussi R.

joanne.langley dal.ca

INTRODUCTION: Penicillin allergy, commonly reported in children, leads to use of more expensive, broad-spectrum drugs. The results and effectiveness of a skin testing program for immediate hypersensitivity to penicillin in children were studied. METHODS: Children seen at the IWK Health Centre in Halifax between 1986 and 2000 with a history of suspected penicillin allergy were referred by their family physician or pediatrician. Two-stage skin testing (scratch, intradermal) of benzylpenicilloyl-polylysin and penicillin G sodium, with histamine and saline as positive and negative controls, was carried out. If the test results were negative, an oral challenge was conducted and the child observed for 60 minutes. If no adverse reaction was noted, a letter was sent to the referring physician and to Health Records at the IWK Health Centre, indicating that warning labels should be removed from the chart. RESULTS: Of 72 children tested, 32% described their past cutaneous eruption as hives and 68% had other rashes; 96% of rashes were generalized. The mean age at the time of the suspected penicillin allergy was 4.4 years; it was 7.4 years at the time of testing. There was no positive response to the scratch testing, but 4% of children had a positive response to intradermal testing. No adverse responses to oral challenge were observed. Letters confirming negative status were not received in 4% (3 of 69) cases, resulting in ongoing avoidance of penicillins and falsely labelling of the child as penicillin allergic. CONCLUSIONS: In this referral setting, true penicillin allergy was uncommon, suggesting that many children are incorrectly labelled as penicillin-allergic. Communication of test results to family and care providers and health records administration must be effective if testing is to affect prescribing behaviour.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12375719&dopt=Abstract allergy medicine



allergy
Total and allergen-specific immunoglobulin A levels in saliva in relation to the development of allergy in infants up to 2 years of age.

Bottcher MF, Haggstrom P, Bjorksten B, Jenmalm MC.

Department of Molecular and Clinical Medicine, Division of Paediatrics, and Clinical Research Centre, Faculty of Health Sciences, Linkoping University, Sweden. malfa kfc.liu.se

BACKGROUND: The association between salivary IgA levels and development of allergy is controversial and the employed methodology has been questioned. OBJECTIVE: The aim of the study was to relate the levels of total IgA, SIgA and allergen-specific IgA antibodies in saliva to the development of allergy in infants during the first 2 years of life. METHODS: Saliva samples from 80 infants participating in a prospective study regarding the development of allergy were collected at 3 or 6, and 12 and 24 months of age. Total IgA, SIgA and Fel d 1 and beta-lactoglobulin specific IgA levels were analysed with ELISA. RESULTS: The levels of total IgA and SIgA increased with age. The number of samples with detectable IgA to Fel d 1 tended to increase with age, whereas the opposite was observed for IgA to beta-lactoglobulin. Infants who developed allergy tended to have higher levels of total IgA, and allergen-specific IgA was more commonly detected than in non-allergic children. In contrast, non-allergic children tended to have higher levels of SIgA. Furthermore, the levels of SIgA were higher in sensitized infants with no allergic symptoms than in sensitized children with symptoms. Infants with allergic parents had lower SIgA levels than infants without. Direct exposure to cat and cow's milk did not influence the levels of allergen-specific IgA levels, nor was there any association between breast-feeding and IgA production. CONCLUSION: The kinetics of food and inhalant allergen-specific IgA in saliva during the first 2 years of life is similar to what has earlier been shown for IgG in serum. Development of allergy tended to be associated with high levels of total and allergen-specific IgA antibodies, but low levels of SIgA. Furthermore, high levels of SIgA seemed to protect sensitized children from developing allergic symptoms during the first 2 years of life, supporting a possible protective role of SIgA against development of allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12220466&dopt=Abstract allergy medicine