title: Do indoor chemicals promote development of airway allergy?
abstract: Allergic asthma has increased worldwide in the industrialized countries. This review evaluates whether the major groups of indoor chemical exposures possess allergy-promoting (adjuvant) effects; formaldehyde was excluded, because of the size of the literature. Volatile organic compounds (VOCs) are used as an example of gases and vapors. The precipitation of asthmatic symptoms by VOC exposures is probably because of VOC levels considerably above typical indoor levels, or VOCs may be a surrogate for exposure to allergens, combustion products or dampness. Indoor particles possessed adjuvant effects in animal studies and allergy-promoting effects in humans. Quaternary ammonium compounds may possess adjuvant effects in animal studies and promoted sensitization in humans in occupational settings. The use of cleaning agents, anionic and non-ionic surfactants are not considered to possess an important adjuvant effect in the general population. Regarding phthalate exposures, results from animal and epidemiological studies were found to be discordant. There is little evidence that the indoor chemicals evaluated possess important adjuvant effects. If buildings are kept clean, dry and free of combustion products, the important question may be would it be profitable to look for lifestyle factors and non-chemical indoor exposures in order to abate airway allergy?
  
  
  CONCLUSIONS
  Indoor chemicals (pollutants) have been accused to promote development of airway allergy by adjuvant effects. In this review, we evaluated the scientific literature and found little support for the supposition that indoor chemicals possess important adjuvant effects. This rises the question: would it be profitable for abatement of airway allergy to look for non-chemical indoor exposures, including lifestyle factors, and exposures to allergens, microorganisms, including vira, and their interactions?
authors.affiliation: National Institute of Occupational Health Denmark, Copenhagen, Denmark. gdn@ami.dk
authors.forename: G D
authors.initials: GD
authors.lastname: Nielsen
authors.forename: S T
authors.initials: ST
authors.lastname: Larsen
authors.forename: O
authors.initials: O
authors.lastname: Olsen
authors.forename: M
authors.initials: M
authors.lastname: Løvik
authors.forename: L K
authors.initials: LK
authors.lastname: Poulsen
authors.forename: C
authors.initials: C
authors.lastname: Glue
authors.forename: P
authors.initials: P
authors.lastname: Wolkoff
mesh_terms: D000276:Adjuvants, Immunologic / Q000633:toxicity; D000393:Air Pollutants / Q000633:toxicity*; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D000485:Allergens / Q000633:toxicity; D000818:Animals; D004391:Dust; D004781:Environmental Exposure / Q000009:adverse effects; D006241:Haptens / Q000633:toxicity; D006801:Humans; D007509:Irritants / Q000633:toxicity; D009930:Organic Chemicals / Q000633:toxicity; D000644:Quaternary Ammonium Compounds / Q000633:toxicity; D012130:Respiratory Hypersensitivity / Q000453:epidemiology / Q000209:etiology*; D013501:Surface-Active Agents / Q000633:toxicity; D014835:Volatilization
chemical_list: D000276:Adjuvants, Immunologic; D000393:Air Pollutants; D000485:Allergens; D004391:Dust; D006241:Haptens; D007509:Irritants; D009930:Organic Chemicals; D000644:Quaternary Ammonium Compounds; D013501:Surface-Active Agents