Club cell protein (CC16) in serum as an effect marker for small airway epithelial damage caused by diesel exhaust and blasting fumes in potash mining.

OBJECTIVE: The effect marker club cell protein (CC16) is secreted by the epithelium of the small respiratory tract into its lumen and passes into the blood. Increased amounts of CC16 in serum are observed during acute epithelial lung injury due to air pollutants. CC16 in serum was determined as part of this cross-sectional study in underground potash miners on acute and chronic health effects from exposures to diesel exhaust and blasting fumes. METHODS: Nitrogen oxides, carbon monoxide, and diesel particulate matter were measured in 672 workers at a German potash mining site on a person-by-person basis over an early shift or midday shift, together with CC16 serum concentrations before and after the respective shift. CC16 concentrations and CC16 shift-differences were evaluated with respect to personal exposure measurements and other quantitative variables by Spearman rank correlation coefficients. CC16 shift-differences were modeled using multiple linear regression. Above-ground workers as reference group were compared to the exposed underground workers. RESULTS: Serum concentrations of CC16 were influenced by personal characteristics such as age, smoking status, and renal function. Moreover, they showed a circadian rhythm. While no statistically significant effects of work-related exposure on CC16 concentrations were seen in never smokers, such effects were evident in current smokers. CONCLUSION: The small airways of current smokers appeared to be vulnerable to the combination of measured work-related exposures and individual exposure to smoking. Therefore, as health protection of smokers exposed to diesel exhaust and blasting fumes, smoking cessation is strongly recommended.

Physiological responses, self-reported health effects, and cognitive performance during exposure to carbon dioxide at 20 000 ppm.

In this study, 24 subjects (20-58 years) were exposed to carbon dioxide (CO2 ) at 770 ppm and 20 000 ppm in an exposure laboratory for 4-h, including 2 × 15 min of cycling to investigate the effects on acid-base balance, physiological responses, cognitive performance and acute health. Capillary blood analysis, heart rate, respiratory rate, divided attention, flexibility, and sustained attention from the Test Battery for Attentional Performance (TAP), critical flicker fusion frequency (CFF), and self-reported symptoms were measured before, during, and after the 4-h exposure. Blood pH decreased and partial pressure of carbon dioxide (pCO2 ) increased significantly when exposed to 20 000 ppm CO2 compared to 770 ppm. However, the values remained within the normal range. In addition, respiratory rate increased slightly but significantly at 20 000 ppm CO2 . No significant changes in heart rate, CFF, task performance or acute health were found. In sum, the findings suggest that the observed changes in acid-base balance and ventilation can be classified as physiological adaptation responses. Impairment of cognitive performance is not expected from exposure to 20 000 ppm CO2 , neither as direct effect on central nervous system function nor as a distraction related to perception of health effects.

Skin symptoms in veterinary assistant staff and veterinarians: A cross-sectional study.

BACKGROUND: Veterinary assistants and veterinarians are at an increased risk of developing an occupational skin disease, for example, irritant/allergic contact dermatitis, contact urticaria and hand eczema (HE). OBJECTIVES: We aimed to investigate the prevalence of skin problems and the influence of predisposing factors especially among veterinary assistants. METHODS: We conducted a cross-sectional study among veterinary assistant staff (n = 103) and veterinarians (n = 19). A questionnaire, specific IgE determination and photographs of hands were evaluated for skin symptoms. Logistic regression models assessed predisposing factors. RESULTS: Over 50% (n = 62/122) of our study population reported hand eczema (HE) in the last 12 months (1-year prevalence). Twenty-seven subjects reported redness and contact urticaria directly after animal contact, 35 had a positive history of allergic contact dermatitis. HE was associated with (i) increased frequency of hand washing (11-15 times per day; OR 4.15, confidence interval [CI] 95% 1.18-14.6, p = 0.027, univariate model) and (ii) unprotected contact to fluids and tensides >5 times per day (OR 4.56, CI 95% 1.53-13.6, multivariate model). CONCLUSIONS: We observed a high prevalence of self-reported HE among staff in veterinary practices. Excessive hand washing, unprotected contact with irritants and long-term glove use should be avoided.

Self-Reported Survey on Allergy Symptoms Among First-Year Students in Veterinary Medicine: A Preamble to the AllergoVet Cohort Study.

Practical work in veterinary medicine provides exposure to various allergens which could increase the risk of sensitization. With the ongoing prospective "AllergoVet" study, we are investigating patterns of allergic symptoms and sensitization among veterinary students. Here, we report the results of the introductory self-reported survey on the presence of allergies in the first-year students of veterinary medicine, who had begun their studies in the years 2013-2016. The survey included 553 students who answered a questionnaire (63% response rate, 83% female ratio). The median age was 20 years (IQR: 19-22 years). About half of the responders indicated an interest in participating in the prospective study ("candidates"). Those who were uninterested in participating were termed "noncandidates". A doctor's diagnosis of any kind of atopic disease was reported by every fourth student. Hay fever was reported by 71 (13%) and allergic asthma by 38 (6.9%) students. The prevalence of hay fever in "candidates" (n = 294) and "noncandidates" (n = 259) was 13.5% and 12.2%, respectively. Allergic asthma was reported by 9.9% of "candidates" and 3.5% of "noncandidates", the difference being significant (p = 0.003). We conclude that the prevalence of self-reported allergic symptoms in the first-year students of veterinary medicine is similar to that in the general population. Pre-existing allergic asthma may have increased the motivation for the enrolment into the longitudinal "AllergoVet-study".

Ethyl acrylate: influence of sex or atopy on perceptual ratings and eye blink frequency.

Occupational exposure limits (OELs) are derived for protection from health hazards, assuming that exposed subjects are healthy adult workers. Whether differences in susceptibility to sensory irritation effects from airborne chemicals have to be taken into account is currently under discussion. Thus, we chose atopics as a healthy but possibly susceptible subpopulation that can be identified with a clinical test. To investigate the influence of sex or atopy on sensitivity to airborne chemicals, 22 subjects were exposed for 4 h to ethyl acrylate at three concentrations: 0.05 ppm (odor threshold; sham), 5 ppm (constant), and varying exposure between 0 and 10 ppm. Odor intensity decreased and eye irritation ratings increased in a dose-dependent manner, reflecting the time course of the exposure scenarios. The reports of moderate-to-strong eye irritation were verified by significant increases in eye blink frequency. Our results show that women reported subjective eye irritation to an increasing degree. However, these sex-related differences in ratings could not be verified by objective assessment of eye blink frequency. Atopic subjects reported higher odor intensity than non-atopic subjects, but only during the sham (odorous but not irritating) exposure condition. Differences in ratings on annoyance, and eye or nose irritation were not found. Furthermore, the study revealed that atopic subjects might belong to a group of subjects with frequent eye blink activity. Although the relative increase in blink rates was more pronounced in non-atopic subjects, atopic subjects had significant higher blink rates at the end of the exposure to varying ethyl acrylate concentrations. Our results do not support that atopy enhances chemosensory effects if only the increase of blink rates and not the absolute height are considered as adverse effect. Nevertheless, the results indicate that individuals with frequent eye blink activity should be distinguished from those with normal eye blink activity while investigating blink rates as objective parameter of eye irritation.

Methodological Implications and Repeatability of Nasal Nitric Oxide: Relevance for Challenge Studies.

There is an interest in assessing changes in nasal NO (nNO) levels as an effect marker of upper airways. In this study, we examined methodologic influences on short and long term repeatability of nNO levels assessed by a portable electrochemical analyzer. Nine atopic and eighteen healthy subjects were exposed for 4 h to ethyl acrylate concentration of 0.05 ppm (sham) and mean concentrations of 5 ppm (either constant 5 ppm or variable 0 to 10 ppm). Sampling of nNO was performed by using passive aspiration during both breath-holding (634 ppb) or calm tidal breathing (364 ppb, p < 0.0001). The intra-session (between-session) repeatability in terms of coefficient of variation was 16.4% (18.5%) using the tidal-breathing and 8.6% (13.0%) using the breath-holding method, respectively. Atopic subjects demonstrated a significant increase in nNO (breath-holding mean 16%, tidal-breathing mean 32%) after applying a constant ethyl acrylate concentration (5 ppm). Our findings suggest that the less elaborate tidal-breathing method might be sufficient to detect significant changes at a group level. Given a lower coefficient of variation of breath-holding we assume there is an advantage of that approach at an individual level. Further research is needed to validate the usefulness of nNO in the evaluation of irritative, non-allergic responses.

Effects of Exposure to Carbon Dioxide in Potash Miners.

Potash miners can become exposed to carbon dioxide (CO2) during the blasting of basalt intrusions or loading and transporting the blasted salt. In a cross-shift study, we compared physiological effects of acute exposure to elevated CO2 concentrations in miners after long-term exposure to evaluate the possible health risks. A group of 119 miners was assessed by clinical examination, lung function tests, and blood gas content directly before and after the shift. A cumulative CO2 exposure was measured using personal monitors. The miners were categorized as low (<0.1 vol.%, n = 83), medium (<0.5 vol.%, n = 26), and high (>0.5 vol.%, n = 10) CO2 exposed subjects. We found no significant differences among the three groups. Lung function testing revealed no conspicuous findings, and chronic health effects were not observed in the miners either. In conclusion, no significant adverse effects could be found in potash miners exposed to elevated CO2 concentrations. Therefore, the mining authorities allow potash mining operations for 4 h at ambient CO2 up to 1.0 vol.% and for 2 h at CO2 not exceeding 1.5 vol.% per shift.

Analysis of inflammatory markers and metals in nasal lavage fluid of welders.

Welding fumes may produce adverse health effects in the respiratory tract. To assess the relationship between exposure to welding fumes and inflammation in the upper airways, 190 male welders were examined from the WELDOX study (median age 40 yr, 54.7% smokers, and 32.9% atopics). Inhalable welding fumes were collected in the breathing zone of welders during a single shift. Chromium (Cr), nickel (Ni), manganese (Mn), and iron (Fe) were measured in the welding-fume samples and in postshift nasal lavage fluid (NALF). In addition, the numbers of particles and inflammatory biomarkers, including total and differential cell counts, interleukin (IL)-8, leukotriene (LT) B4, 8-isoprostane (8-iso-PGF2α), tissue inhibitor of metalloproteinase-1 (TIMP-1), and immunoreactive matrix metalloproteinase (MMP)-9, were determined. Metal concentrations in NALF correlated with airborne concentrations. No significant association was found between airborne metal concentrations and biomarkers of inflammation in NALF, whereas increasing metal concentrations in NALF resulted in increased concentrations of total protein, IL-8, MMP-9, and TIMP-1. LTB4 and 8-iso PGF2α were elevated at higher concentrations of Cr or Ni in NALF. The same was true for Fe, although the effects were less pronounced and of borderline significance. In conclusion, our results showed a significant association between the concentrations of metals and soluble inflammatory markers in the NALF of welders. The noninvasive collection of NALF is applicable in field studies, where it may serve as a suitable matrix to simultaneously assess biomarkers of exposure and effect in the upper respiratory tract in workers who are occupationally exposed to airborne hazardous substances.

Exposure assessment of potash miners at elevated CO2 levels.

PURPOSE: In a potash mine in the center of Germany, stationary measurements 40 cm above ground level have revealed occasional increases in the carbon dioxide (CO2) levels that exceed the 0.5 vol.% German occupational exposure limit (OEL). This study, therefore, aimed to examine the individual exposures of potash miners to CO2 at their underground workplaces. METHODS: 119 miners were equipped with personal CO2 detectors to log the individual CO2 exposures during underground work. We decided to use electrochemical monitors due to their compactness and minimal mass. Furthermore, generated CO2 measurements with precipitated overshooting and false positive CO2 values were studied using diverse CO2 test gases and different fumigation times. RESULTS: The personal detectors showed short-term CO2 peak exposures at very high concentrations in a limited number of workers. Twenty-two threshold limit value violations were observed according to the present OEL, and the personal CO2 monitoring allowed categorization into three exposure groups, low (n = 83), moderate (n = 26) and high burdens (n = 10) of CO2. CONCLUSIONS: The electrochemical sensors used have numerous properties that can potentially influence the assessment of exposures. The current findings suggest that assessing similar exposure scenarios, with respect to elevated and strongly fluctuating CO2 concentrations, the behavior of electrochemical sensors should be taken into consideration.

Animal exposure, sensitization, and allergic symptoms in first-year veterinary medicine students.

The AllergoVet study longitudinally examines the influence of animal exposure on the development of sensitization and allergic diseases among veterinary medicine students. In this group, contact to animals usually existed long before the study began. Therefore, the aim of this analysis was to investigate lifelong animal species-specific exposure and the prevalence of sensitizations and allergic symptoms already existing before the start of the study. Questionnaire data, including exposure history, were summarized to determine the duration and intensity of animal-related exposure as well as the prevalence of allergic symptoms to animals. Serologically, specific IgE was determined against ubiquitous inhalant allergens (atopy screen sx1) and against animal allergens using ImmunoCAP. The association between animal-specific sensitization, allergic symptoms, and exposure was analyzed using Fisher's exact test or Cochran-Armitage trend test. All study participants (n = 313) had previous contact with animals, with dogs mentioned most frequently (91.1%) followed by cats (89.5%) and horses (72.2%). Sensitization to ubiquitous allergens (positive sx1 value) was detected in 38.4% of subjects. Approximately 11%, 7%, and 5% were sensitized to cats, dogs, and horses, respectively. Only a small proportion of these sensitizations were associated with self-reported symptoms (41% for cat, 9% for dog, and 13% for horse). While no significant association between animal-specific exposure and sensitization was found for cats and horses, a clear trend emerged for dogs. With increasing duration of exposure to dogs, the number of dog-specific sensitizations decreased significantly (p = 0.0069). Furthermore, a decreasing trend in sx1 sensitization was noted with increasing cat (p = 0.0288) and dog (p = 0.0107) exposure. None of the subjects who grew up on a farm (n = 40) had any sensitization to animals. The sensitization prevalence determined among first-year students in veterinary medicine roughly corresponds to that in the general population. Most animal sensitizations were not clinically relevant. In this collective, a protective effect of increasing exposure to animals in childhood and adolescence was found on sensitization, which was particularly pronounced during contact with dogs.

Relationship of pulmonary function response to ozone exposure and capsaicin cough sensitivity.

CONTEXT: Challenge studies in humans have shown considerable interindividual variability in pulmonary impairment across ozone exposure. OBJECTIVE: Since previous results suggested effect modulation by neural mechanism, we investigated sensory C-fiber reactivity in relationship to ozone-triggered response pattern. METHODS: Cough reflex thresholds reflecting C-fiber sensitivity were evaluated by capsaicin single breath dose-response method. Capsaicin concentrations triggering, respectively, two and five or more coughs (C2, C5) were recorded. Sixteen healthy subjects were randomly exposed in an intermittent exercise protocol to ozone concentrations of 240 and 40 ppb (sham exposure). Ozone responsiveness was defined by a decrease in forced expiratory volume in 1 s (FEV(1)) of more than 5%. RESULTS: Based on a dichotomous classification, subjects with enhanced reactivity to ozone had lower cough thresholds than non-responders (C2, p = 0.035; C5, p = 0.086). Over all, we could demonstrate relationships between capsaicin sensitivity and ozone-triggered changes in FEV(1), peak expiratory flow and maximal expiratory flow at 50% vital capacity but not in specific airway resistance. CONCLUSION: Our results suggest that capsaicin challenge tests might be useful to characterize subjects with enhanced pulmonary function response towards inhalant irritants.

Reproducibility of sensitivity to capsaicin assessed by single breath inhalation methodology.

The hallmark of sensory hyperreactivity is an enhanced capsaicin induced cough reflex. The cough reflex can be modified by activation of nociceptive (capsaicin-sensitive) nerve terminals. The aim of our study was to assess the influence of exposure to CO(2) concentrations up to 2.0 vol% on capsaicin induced cough reflex on four different occasions. Sixteen healthy volunteers were exposed to CO(2) concentrations of 0.5, 1.0, and 2.0 vol% for 4 h and to clean air in a repeated measures cross-over design. After exposure the capsaicin induced cough reflex was assessed by the single breath dose-response method according to ERS 2007 guidelines. After blank solutions, capsaicin doses (n=12, range 0.49 to 1000 µM) were administrated from a nebulizer combined with a provocation system (Masterscope, software APS version 5.02). Doses were doubled every minute and the concentration causing five or more coughs (C5) was fixed as the end point. The inter-individual C5 capsaicin responsiveness reflected a representative range (0.95-1000 µM). On an intra-individual basis, a good reproducibility could be demonstrated for four tests within 3 weeks. There was no influence of CO(2) challenge on the cough reflex. The first capsaicin test demonstrated a lower C5 threshold independent of the CO(2) concentration applied. In conclusion, assessing the capsaicin cough reflex by single breath inhalation is reliable. However, the at cough sensitivity might be overestimated at the first test occasion. Exposure to CO(2) in concentrations of up to 2.0 vol% has no effect on sensory reactivity.

Comment on 'Limitations in evaluating COVID-19 protective face masks using open circuit spirometry systems: respiratory measurement mask introduces bias in breathing pressure and perceived respiratory effort'.

We comment on the paper by Seibt and coworkers (Seibtet al2023) which investigates whether wearing an additional respiratory measurement mask during open-circuit spirometry assessments (respirometry mask) shows any effect on breathing pressure and perceived respiratory effort when wearing protective face masks commonly worn during the COVID-19 pandemic.

Indoor air quality - An overview of methods for measuring odor detection thresholds of single substances.

Odor evaluation is an important topic in the field of indoor air quality. Odor detection threshold (ODT) values are used to derive limit values like odor guide values or odor activity value. However, ODT values for the same substance available in compilations or published before 2003 rarely have an accuracy of less than three orders of magnitude. Stimulus preparation, including analytical verification, stimulus presentation, as well as selection and training of test subjects have been identified as major sources of variability. ODT values obtained by validated standardized methods are now considered objective, reliable, and reproducible. They exhibit a variability of one or two orders of magnitude and are lower than traditionally assumed and reported.This review presents the essential criteria for a well-performed ODT determination. It is intended to assist health and safety professionals in assessing whether the methodological approach of a study was appropriate for determining a valid and reliable ODT value.

ATS/ ERS spirometry quality criteria in real life. Results of two occupational field studies.

Spirometry is a widely used test and the American Thoracic Society and the European Respiratory Society (ATS/ERS) provide standardised recommendations. However, detailed information on test quality is often incomplete in publications. In light of the 2005 ATS/ERS recommendations, we investigated the acceptability and repeatability criteria of spirometry performed under occupational field conditions in 242 practicing welders (WELDOX study, median age 41.5 years, all male) and 312 first-year veterinary students (AllergoVet study, median age 20.0 years, 84.3% female). At least three acceptable or usable measurements could be identified for 233 welders and 305 students. The repeatability for welders was 96.1% for the forced expiratory volume in the first second (FEV1) and 97.0% for forced vital capacity (FVC). The corresponding results for students were 95.7% and 95.4%, respectively. The overall repeatability of test sessions at the 150-mL level was 90.5% (219/242) for welders and 90.1% (281/312) for students. Spirometry can be performed with reliable quality in an occupational field setting.

Influence of face masks on the subjective impairment at different physical workloads.

To quantify the subjective and cognitive impairment caused by wearing face masks at work, 20 men and 20 women (median age 47 years, range 19-65) were tested under different ergometer workloads while wearing surgical mask, community mask, FFP2 respirator or no mask in a randomized and partially double-blinded design. Masks were worn also at the workplace for four hours. Subjective impairment was recorded by questionnaires. Cognitive performance was tested before and after the workplace examination. Subjective feeling of heat, humidity, and difficult breathing increased with rising physical exertion and wearing time for all three mask types, most notably for FFP2. Even when blinded, participants with FFP2 reported difficult breathing already at rest. During physical exertion, individuals with low tolerance to discomfort reported significantly stronger impairment (OR 1.14, 95% CI 1.02-1.27). Regarding light work, older subjects (OR 0.95, 95% CI 0.92-0.98) and women (OR 0.84, 95% CI 0.72-0.99) showed significantly lower and atopic subjects stronger impairment (OR 1.16, 95% CI 1.06-1.27). No significant influence of mask wearing was detected on cognitive performance. Wearing a mask had no effect on cognitive performance, but led to discomfort which increased with physical exertion and wearing time. Individuals who tolerate discomfort poorly felt more impaired by wearing a mask during physical exertion.

Effects of wearing different face masks on cardiopulmonary performance at rest and exercise in a partially double-blinded randomized cross-over study.

The use of face masks became mandatory during SARS-CoV-2 pandemic. Wearing masks may lead to complaints about laboured breathing and stress. The influence of different masks on cardiopulmonary performance was investigated in a partially double-blinded randomized cross-over design. Forty subjects (19-65 years) underwent body plethysmography, ergometry, cardiopulmonary exercise test and a 4-h wearing period without a mask, with a surgical mask (SM), a community mask (CM), and an FFP2 respirator (FFP2). Cardiopulmonary, physical, capnometric, and blood gas related parameters were recorded. Breathing resistance and work of breathing were significantly increased while wearing a mask. During exercise the increase in minute ventilation tended to be lower and breathing time was significantly longer with mask than without mask. Wearing a mask caused significant minimal decreases in blood oxygen pressure, oxygen saturation, an initial increase in blood and inspiratory carbon dioxide pressure, and a higher perceived physical exertion and temperature and humidity behind the mask under very heavy exercise. All effects were stronger when wearing an FFP2. Wearing face masks at rest and under exercise, changed breathing patterns in the sense of physiological compensation without representing a health risk. Wearing a mask for 4-h during light work had no effect on blood gases.

Symptoms, spirometry, and serum antibody concentrations among compost workers exposed to organic dust.

Work-related symptoms and diseases of 190 currently exposed compost workers, 59 former compost workers, and 38 nonexposed control subjects were investigated in a cross-sectional study. Using a standardized questionnaire, participants were asked for work-related symptoms, exposures to bioaerosols, atopic diseases, and smoking habits. The subjects underwent a physical examination and a lung function test. In addition, total immunoglobulin (Ig) E, IgE specific to environmental allergens and moulds, and IgG specific to molds and actinomycetes were quantified. Compared to controls, compost workers suffered more often from cough and irritation of the eyes in terms of mucosal membrane irritation (MMI). Former compost workers reported similar work-related complaints, but most MMI symptoms had improved after termination of bioaerosol exposure. In contrast, cough and dyspnea persisted, indicating a chronic process. Lung function parameters of compost workers were within the reference ranges. Nevertheless, forced vital capacity (FVC) was significantly lower than for controls. Specific IgE to environmental allergens and molds was positive in 25.3% and 7.4%, respectively, of currently exposed compost workers. There were no marked differences in IgE and IgG concentrations among the three groups. Compost workers suffered with a higher frequency from cough and MMI symptoms. The findings that MMI symptoms improved in former compost workers after leaving the job confirmed the association with bioaerosol exposure. Further, the reduced FVC may be produced by this exposure. There was no higher frequency of mold sensitization in the group of compost workers compared to controls, which may be an indication of a healthy worker survivor effect.

Impact of different welding techniques on biological effect markers in exhaled breath condensate of 58 mild steel welders.

Total mass and composition of welding fumes are predominantly dependent on the welding technique and welding wire applied. The objective of this study was to investigate the impact of welding techniques on biological effect markers in exhaled breath condensate (EBC) of 58 healthy welders. The welding techniques applied were gas metal arc welding with solid wire (GMAW) (n=29) or flux cored wire (FCAW) (n=29). Welding fume particles were collected with personal samplers in the breathing zone inside the helmets. Levels of leukotriene B(4) (LTB(4)), prostaglandin E(2) (PGE(2)), and 8-isoprostane (8-iso-PGF(2α)) were measured with immunoassay kits and the EBC pH was measured after deaeration. Significantly higher 8-iso-PGF(2α) concentrations and a less acid pH were detected in EBC of welders using the FCAW than in EBC of welders using the GMAW technique. The lowest LTB(4) concentrations were measured in nonsmoking welders applying a solid wire. No significant influences were found in EBC concentrations of PGE(2) based upon smoking status or type of welding technique. This study suggests an enhanced irritative effect in the lower airways of mild steel welders due to the application of FCAW compared to GMAW, most likely associated with a higher emission of welding fumes.

Animal Allergens, Endotoxin, and ß-(1,3)-Glucan in Small Animal Practices: Exposure Levels at Work and in Homes of Veterinary Staff.

OBJECTIVES: In veterinary settings, high exposures to animal allergens and microbial agents can be expected. However, occupational exposure levels are largely unknown. The objective of this study was to estimate the allergen, endotoxin, and ß-(1,3)-glucan concentrations in small animal practices and in the homes of practice employees. METHODS: Dust samples were collected using electrostatic dust fall collectors in diverse rooms of 36 small animal practices, as well as in employees' homes. Major animal allergens (Fel d 1, Can f 1, Ory c 3, Cav p 1, Equ c 1, Bos d 2), domestic mite (DM) allergens, and ß-(1,3)-glucan levels were measured using enzyme immunoassays. Endotoxin was determined using the Limulus amoebocyte lysate assay. Influences on exposure levels were analyzed using multilevel models. RESULTS: The levels of Can f 1, Fel d 1, Ory c 3, and Cav p 1 were up to 30 times higher in practices compared with homes without animals, but significantly lower compared with the homes with the respective pet. Although horses were not treated in the practices, Equ c 1 was found in 87.5% of samples, with the highest concentrations measured in changing rooms. DM levels were significantly lower in practices than in all private homes, and endotoxin levels were similar to those in homes with pets. In the practice itself, exposure levels were significantly influenced by animal presence, type of the room, and area per employee; whereas, room volume and diverse cleaning measures had mostly no effect. CONCLUSIONS: Exposure to animal allergens is high in veterinary practices, but it does not reach levels of households with pets. Domestic mite allergen and endotoxin exposure seem to be low for workers in veterinary practices. The high Equ c 1 detection rate strongly indicates dispersal of allergens, most likely through clothing and hair.