Investigation of allergic sensitisation in areas of Hungary

with different level of ragweed pollution

Páldy A1 Bobvos J1., Nékám K2., Bitay Zs3., Csajbók V4., Kelemen A5., Major T6.

1 National Institute of Environmental Health, 2Hospital of Brothers of Mercy, Budapest, 3Bács-Kiskun County Dispensary Kecskemét,

4Józsa András Hospital, Nyíregyháza, Szabolcs-Szatmár Bereg County 5Heves County Dispnesary Eger, 6HRCh Hospital of Cardio-pulmonary patients Mosdós

Aim

To investigate the pattern of sensitisation of allergic patients in areas with different level of ragweed pollution

Sampling sites and patients: Kecskemét, Nyíregyháza, Eger

50-50 adult allergic patients Mosdós: 22 allergic patients Study: questionnaire survey

Specific IgE measurement by using a common panel

Cladosporium herbarum Cladosporium herbarum Alternaria alternata Alternaria alternataHámszövet keverék mix of cutaneous tissueMacska hámszövet cat cutaneous tissueKutya hámszövet dog cutaneous tissueKutya szőr dog hairMacska szőr cat hairHázipor keverék (H1, D1, D2, I6) mix of housedustCsótány cocroachDermatophagoides pteronyssinus (poratka) Dermatophagoides pteronyssinus (poratka)Dermatophagoiedes farinae (liszt atka) Dermatophagoiedes farinae (liszt atka)Lepidoglyphus destructor Lepidoglyphus destructorTyrophagus putresentiae Tyrophagus putresentiaeFű keverék (G2,G3,G5,G6,G8,G10,G12,G13,G14,G15,G16)grass mixCsenkesz faj Fescue (Festuca)Kukorica maizeGyom keverék (W6, W9, W10, W12, W20) weed mixLándzsás útifű plantain (Plantago)Fehér libatop Goose-foot family(chenopodiaceae)Aranyvessző golden rodnagy csalán nettle family (Urticaceae)Fekete üröm Mugwort (Artemisia)Szőrös disznóparéj Amaranth (Amaranthus)Juh sóska Sorrel (Rumex)Közönséges falgyom Common pellitory (Parietaria erecta)Ürömlevelű parlagfű ragweed (Ambrosia)Fa keverék (T1, T2,T 3, T4, T7, T11, T12, T14)mix of trees)Juhar Maple (Acer)Hamvas éger Alder (Alnus)Nyírfa Birch (Betula)Mogyoró Hazel (Corylus)Platán Plane (Platanus)Fűz Willow (Salix)Magas kőris Ash (Fraxinus)Élelmiszer keverék (F1,F2,F4,F5,F8, F75, F76,F77,F78,F79,F81)mix of food)Tojásfehérje egg white Tehéntej cow milkBúzaliszt flour of cornRozs ryeTojássárgája egg yellowKazein (marha) caseineÉlelmiszer keverék (F13, F14, F16, F17, F26, F45, F48, F83)mix of food)Földimogyoró peanutSzójabab soybeenDió nutMogyoró hazel nutSzezámmag sesam seedMustár mustardLatex Latex

Examined allergens in children and adult population with symptoms of allergy,

Hungary, 2006

Results

Evaluation of the questionnaire Description of sensitisation Demonstration of the association of

ragweed sensitisation and answers to the questions

Distribution of answers to the questionnaire I.

In Eger and Kecskemét the rate of breast fed patients was higher In Eger and Nyíregyháza the rate of complaints due to feather allergy was high The rate of smokers and rate of mould in flats was the highest in Kecskemét

Sampling site: M - E - K - NY

4321

cou

nt

60

50

40

30

20

10

0

Do you have

allergic symptoms

Feather

Breast-fed

Ever smoked

Mold

Number of sample

Distribution of answers to the questionnaire II.

The leading complaints are housedust mite and pollen allergy – highest in Eger, Allergic skin symptoms and pet allergy – highest in Kecskemét.

Sampling site: M - E - K - NY

4321

cou

nt

60

50

40

30

20

10

0

Dust allergy

Pollen allergy

Food allergy

Allergic skin

symptoms

Pet allergy

Drog allergy

Insect bite

Number of

sample

Distribution of polysensitisation acc. to the questionnaire

Rate of polysensitized patients -highest in Eger, lowest in Nyiregyhaza

Sampling site: M - E - K - NY

4321

Co

un

t

60

50

40

30

20

10

0

Multiple allergy

7

6

5

4

3

2

1

0

Animal hair allergy

Cow hair allergy was reported in Mosdós and KecskemétRate of patients reporting dog hair allergy is high in each site

Sampling site: M - E - K - NY

4321

Su

m

70

60

50

40

30

20

10

0

Cow

Pig

Poultry

Cat

Dog

Type of house and allergic complains

Sampling site: M - E - K - NY

4321

cou

nt

60

50

40

30

20

10

0

Type of house

Other

Housing

district (H)

Block

of f lats (B)

Attached

house (A)

Family

hause (F)

Missing

In Mosdós, majority of patients live in family houses, In Eger and Nyíregyháza the majority of them live in housing district (panel building).

The type of house does not affect the allergic complaints. House dust mite allergy is the most frequent in block houses, drug allergy and skin symptoms – in family houses, pet hair – in panel buildings.

Type of house: F - A - B - H

4321

Su

m

100

90

80

70

60

50

40

30

20

10

0

Insect bite

Drug allergy

Pet allergy

Allergic

skin symptoms

Food allergy

Pollen allergy

Dust allergy

Allergic symptoms and breast feeding

Multiple allergy

76543210

Co

un

t

100

90

80

70

60

50

40

30

20

10

0

Breast fed

Yes

No

Multiallergic symptoms are less frequent among non breast fed patients.

Rate of pollen and mite alleric symptoms are less frequent among breast fed patients.

Breast fed

10M

ea

n

100.0

90.0

80.0

70.0

60.0

50.0

40.0

30.0

20.0

10.0

0.0

Insect bite

Drog allergy

Pet allergy

Allergic

skin symptoms

Food allergy

Pollen allergy

Dust allergy

X

X

X

X

X

X

X

X

X

X

X

X

x

egg yellowcaseinsoybeennut

pea nutgoose featheregg white

cat hairdog cutaneous tissue

cow milkHazel

Cat cutaneous tissueSesam seedLatex

Dog hairSorrrel

AshAlternaria alternataMustard

CocroachRye

AmaranthPlaneWilllow

Golden rodflour mite

grasshousedust mite

HazelMaizeMugworth

UrticaPlantago

MapleCorn wheet

BirchGoose-foot

AshFescue (Festuca)

Common pellitoryRagweed

Cladosporium herbarum

0,0 5,0 10,0 15,0 20,0 25,0 30,0 35,0 40,0

Percentage of sensitisation in the total sample

The most frequently detectable outdoor allergen IgEs by sites

0,0 20,0 40,0 60,0 80,0

Eger

Nyíegyháza

Mosdós

Kecskemét

The most frequently detectable food allergen and animal IgE levels (%) by sites

0,0 10,0 20,0 30,0 40,0 50,0 60,0 70,0

cat cutaneous tissuedog cutaneous tissue

dog hair

goose feather

cocroach

dust mite

flour mite

corn wheet

rye

sesam seed

mustard

latex

%

Eger

NyíegyházaMosdós

Kecskemét

Frequency of sensitisation in Eger

Corn flour

Ash

PlantagoUrtica

CocroachMaize

BirchGoose feather

Plane

Flour mite

Dog hairAmaranth

Golden rodSorrel

RAGWEED

Common pellitory

Cat cutaneous tissue

Sesam seedRye

Willow

Hazel

Alternaria

Housedust mite

Mugwort

Mustard

Goosefoot

Maple

Fescue

0,0 10,0 20,0 30,0 40,0 50,0 60,0 70,0

%

Frequency of sensitization in Kecskemét

Golden rod

Mugwort

Alder

Maple

Latex

Hazel

Urtica

Plane

Sesam seed

RAGWEED

Corn flour

Willow

Sorrel

Ash

Fescue

Mustard

Amaranth

Rye

Birch

0,0 10,0 20,0 30,0 40,0 50,0 60,0

%

Frequency of sensitisation in Nyíregyháza

UrticaGoosefoot

Alder

BirchFescue

PlantagoMugwort

WillowMustaed

Alternaria

Housedust miteGolden rosAmaranth

Corn flourCocroach

Cat cutaneous tissue

Rye

Common pellitory

MapleGoose feather

PlaneSorrrel

Flour miteAsh

Sesam seed

Dog hair

Hazel

MaizeRAGWEED

0,0 10,0 20,0 30,0 40,0 50,0 60,0

%

Frequency of sensitisation in Mosdós

FescueBirch

AlderHazel

MaizeMugwort

PlantagoGolden rod

PlaneAsh

Willow

UrticaRyeCommon pellitory

Sorrel

AlternariaLatex

Flour miteGoosefoot

Cat cutaneous tissue

RAGWEED

Housedust mite

Dog hair

Maple

Amaranth

0,0 10,0 20,0 30,0 40,0 50,0 60,0 70,0 80,0

%

Prevalence of pollen and dust mite allergy complaints in relation to ragweed sensitised patients

Sampling site: M - E - K - NY

4321

N o

f W

1

30

20

10

0

Pollen allergy

No

Yes

In general 33% of patients have IgE against house dust mite - in more than 50% in Nyíregyháza.

In Eger and Kecskemét complaints do not correlate with ragweed IgE positivity

Sampling site: M - E - K - NY

4321

N o

f W

1

100

90

80

70

60

50

40

30

20

10

0

Dust allergy

Yes

No

Detectable anti - ragweed IgE in breast fed and smoking patients

Sampling site: M - E - K - NY

4321

N o

f W

1

30

20

10

0

Breast-fed

No

Yes

In Kecskemét and in Nyíregyháza rate of ragweed IgE pozitivity is higher among non breast fed patients.

In Kecskemét rate of smoking patients is higher among ragweed positive patients

Sampling site: M - E - K - NY

4321N

of

W1

30

20

10

0

Ever smoking

No

Yes

The project was founded by:

National

Research and Development Program - socio-health research

NKFP -1B/022/04. 2005-2006