MEDICAL IMPACT OF ARTHROPOD ALLERGENS

Abstract:
In the European Union and the USA allergens of arthropods comprise a rising health problem. Atopic diseases resulting from insect or mite exposure cost several hundreds of millions British pounds per European country per year. This article is devoted to major sources of inhalant arthropod allergens, the cause of their rising abundance and resulting morbidity, and possibilities for effective management. For this review, literature was collected from the time period 1900-present. Arthropod allergens are involved in three different atopic diseases: allergic asthma, allergic rhinitis and atopic eczema. About 40% of the human population has a hereditary predisposition to develop atopic allergies. The atopic diseases show a rising trend in both prevalence and severity. Nowadays, 2-27% (Scandinavia) to 80% (the Netherlands, United Kingdom) of atopic patients are sensitized to one or more allergens derived from arthropods. In the United States up to 70% of asthmatics have a cockroach allergy. Major arthropods producing relevant allergens include house dust mites, storage mites and cockroaches. Arthropod allergen exposure indoors has increased due to changes in building construction, household management and facility management. Pesticides may be used to diminish pest populations producing inhalant allergens, but diminishing medical symptoms or preventing sensitization is only possible when the remaining allergens are removed by cleaning. The prevention of atopic disease demands avoidance in both the domestic and the occupational domain. Responsibility for the prevention and management of arthropod derived disease in the domestic environment is shared between the householder and owner of the dwelling. Health professionals have an advising and therapeutic role. In the occupational domain. architect, facility manager, work manager and employee share responsibility for prevention and care. In the domestic and occupational domains different multidisciplinary Task Groups should be formed to solve the problem of arthropod allergens. Pest exterminators have a (public) health task in both domains