Air and Surface Quantification of Peanut Ara h 2 Concentrations in Common Public Settings
Sunday, March 6, 2016: 4:45 PM
Concourse Foyer (Convention Center)
Jay Jin, MD PhD, John W. Yunginger, MD FAAAAI, Nancy L. Ott, MD FAAAAI
Rationale: Peanut avoidance is paramount to management of peanut allergy.  Clinicians often make avoidance recommendations without direct evidence of the amount of peanut exposure that occur in environments such as restaurants and commercial airplanes.  We quantified aerosolized and surface levels of Ara h2 in common public locations.

Methods: Air samples were collected using personal breathing zone (PBZ) samplers (5-L/min) for 1-hour or large sampler (15-L/min) for 15-min onto Teflon membranes.  Surfaces were wiped with Teflon membranes.  Peanut proteins were extracted in phosphate buffered saline and Ara h2 quantified by ELISA (Indoor Biotechnologies; limit of detection 0.5ng/mL).

Results: During active shelling of peanuts, 1.4ng/mL of Ara h2 was detected in a large sampler collection.  No Ara h2 was detected in PBZ samples from restaurants with unshelled peanuts in the eating area.  Table surface samples from these restaurants had an average of 41.1ng/mL of Ara h2.  In restaurants without peanuts in the eating area, 0.77ng/mL of Ara h2 was detected on table surfaces.  Tray tables of airplanes had an average of 13.5ng/mL of Ara h2 on peanut-free flights and 175.3ng/mL of Ara h2 after the mid-flight service with peanuts.  Library tables averaged 0.75ng/mL.  A frozen yogurt shop toppings counter had 11,126.7ng/mL whereas a table had 6.2ng/mL.

Conclusions: Peanut exposure in public settings is most likely to occur by contact with surfaces harboring allergens rather than by inhalation, even in peanut-rich environments.  Recognizing likely modes of exposure and places where peanut allergen concentrations are highest can help clinicians provide evidence-driven avoidance recommendations to peanut allergic individuals.