title: Distribution of peanut protein in the home environment.
abstract: BACKGROUND
  To halt the increase in peanut allergy, we must determine how children become sensitized to peanut. High household peanut consumption used as an indirect marker of environmental peanut exposure is associated with the development of peanut allergy.
  
  
  OBJECTIVE
  We sought to validate a method to quantify environmental peanut exposure, to determine how peanut is transferred into the environment after peanut consumption, and to determine whether environmental peanut persists despite cleaning.
  
  
  METHODS
  After initial comparative studies among 3 ELISA kits, we validated and used the Veratox polyclonal peanut ELISA to assess peanut protein concentrations in dust and air and on household surfaces, bedding, furnishings, hand wipes, and saliva.
  
  
  RESULTS
  The Veratox polyclonal peanut ELISA had the best rate of recovery of an independent peanut standard. We demonstrated 100% sensitivity and specificity and a less than 15% coefficient of variation for intra-assay, interassay, and interoperator variability. There was high within-home correlation for peanut protein levels in dust and household surface wipes. Airborne peanut levels were lower than the limit of quantitation for the Veratox polyclonal peanut ELISA in a number of simulated scenarios, except for a brief period directly above peanuts being deshelled. Peanut protein persisted on hands and in saliva 3 hours after peanut consumption. Peanut protein was completely removed from granite tables after cleaning with detergent, and levels were reduced but still present after detergent cleaning of laminate and wooden table surfaces, pillows, and sofa covers.
  
  
  CONCLUSIONS
  Peanut spread easily around the home and might be resistant to usual cleaning methods. Peanut protein can be transferred into the environment by means of hand transfer and saliva but is unlikely to be aerosolized.
authors.affiliation: Department of Paediatric Allergy, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Brough
authors.affiliation: Department of Paediatric Allergy, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Kerry
authors.initials: K
authors.lastname: Makinson
authors.affiliation: Department of Paediatric Allergy, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Penagos
authors.affiliation: United States Department of Agriculture, Agricultural Research Service, Southern Regional Research Center, New Orleans, La.
authors.forename: Soheila J
authors.initials: SJ
authors.lastname: Maleki
authors.affiliation: United States Department of Agriculture, Agricultural Research Service, Southern Regional Research Center, New Orleans, La.
authors.forename: Hsiaopo
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Department of Public Health Science, School of Medicine, King's College London, London, United Kingdom.
authors.forename: Abdel
authors.initials: A
authors.lastname: Douiri
authors.affiliation: Department of Paediatric Allergy, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Alick C
authors.initials: AC
authors.lastname: Stephens
authors.affiliation: Department of Paediatric Allergy, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Victor
authors.initials: V
authors.lastname: Turcanu
authors.affiliation: Department of Paediatric Allergy, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. Electronic address: Gideon.lack@kcl.ac.uk.
authors.forename: Gideon
authors.initials: G
authors.lastname: Lack
mesh_terms: D000388:Air / Q000032:analysis; D000485:Allergens / Q000032:analysis*; D052179:Antigens, Plant / Q000032:analysis*; D010367:Arachis / Q000276:immunology*; D004391:Dust / Q000032:analysis*; D004781:Environmental Exposure / Q000032:analysis*; D006225:Hand; D006794:Household Articles; D006798:Housing; D006801:Humans; D007374:Interior Design and Furnishings; D010940:Plant Proteins / Q000032:analysis*; D012463:Saliva / Q000737:chemistry
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D004391:Dust; D010940:Plant Proteins
keywords: ELISA; IOM; Inhalable occupational medicine; LLQ; Lower limit of quantitation; Peanut; VPPE; Veratox polyclonal peanut ELISA; aerosolized; airborne; allergy; dust; environment; hand; saliva; sensitization; validation