Exposure and Allergy to Dust Mites in General and Working Environment in Croatia

U radu dan je pregled najvažnijih zdravstvenih učinaka izloženosti prašinskim grinjama u općem i radnom okolišu. Prikazani su rezultati istraživanja razine izloženosti i učestalosti alergije na piroglifidne i nepiroglifidne grinje u Hrvatskoj, koja se u Institutu za medicinska istraživanja i medicinu rada provode posljednjih 10 godina. Razine alergena piroglifidnih grinja te vrste grinja utvrđene su u uzorcima podne kućne prašine skupljene iz dnevnih i spavaćih soba ispitanih regija u Hrvatskoj te u nekoliko uzoraka industrijskih prašina. Utvrđena je učestalost alergije na piroglifidne grinje u općoj urbanoj populaciji kontinentalne regije od oko 20%, uz značajnu izloženost tim grinjama u općem unutarnjem okolišu iste regije (srednja razina Der p 1: 0,85 µg/g prašine). Značajno više razine izloženosti piroglifidnim grinjama utvrđene su u priobalnoj regiji (srednja razina Der p 1: 4,5 µg/g prašine), ali uz značajno manju učestalost alergije na ove grinje u općoj odrasloj populaciji ove regije koja iznosi oko 5 %. Akarološke analize uzoraka prašine te statističke analize pokazale su da utvrðena velika učestalost alergije na nepiroglifidne grinje u općoj i radnoj populaciji kontinentalnog dijela Hrvatske nije odraz izloženosti ovim grinjama u okolišu, nego je najvećim dijelom odraz križne reaktivnosti izmeðu piroglifidnih i nepiroglifidnih grinja te nespecifično pozitivnih kožnih reakcija u prick testu, osobito na T. putrescentiae. Dosadašnja istraživanja nisu pokazala da su piroglifidne grinje profesionalni alergeni u industrijskoj preradi papira, duhana i ribe.This paper gives a review of the most important impacts of exposure to dust mites in general and working environment on human health. The Institute for Medical Research and Occupational Health in Zagreb, Croatia, has been investigating the frequency and exposure levels of allergies to pyroglyphid and nonpyroglyphid mites in Croatia for the last 10 years. Investigations were performed in general urban and rural population from the inland and coastal Croatia, and several industrial inland populations occupationally exposed to organic dusts. Mite species and levels of pyroglyphid mites allergens (Der p 1, Der f 1) were established in house dust samples taken from the floors of bedrooms and living rooms and in several industrial dust samples. The frequency of allergies to pyroglyphid mites in general urban population of inland Croatia is about 20 %, with significant general indoor exposure to these mites (median value for Der p 1: 0.85 µg/g of dust). General adult population of the coastal region had a significantly higher exposure to pyroglyphid mites (median value for Der p 1: 4.5 µg/g of dust), yet showed a significantly lower frequency of allergies to these mites (about 5 %). New studies are necessary to investigate possible genetic and environmental factors involved in the mechanisms which protect coastal population from the development of mite allergy. Acarological and statistical analyses have shown that the high frequency of sensitisation to non-pyroglyphid mites found in the general and working populations of the inland region is not related to environmental exposure to these mites, but to the cross-reactivity between pyroglyphid and non-pyroglyphid mites and to false positive skin reactions in prick testing, particularly to T. putrescentiae. So far, results do not indicate that pyroglyphid mites are occupational allergens in paper-recycling, fish-processing and tobacco-processing