Clinical
The ambulatory service of Allergy and Immunology provides secondary and tertiary care to the population of Kingston and Southeastern Ontario who suffer from a variety of allergic conditions and immunologic disorders. The full spectrum of therapeutic modalities is employed. There is limited inpatient activity, with consultative services related primarily to evaluation of recognizable adverse food and drug reactions, unusual presentation of illnesses, and evaluating and testing suspected sensitivities and reactions.

Outpatient activity involves general allergy assessments, plus specialized clinics that deal with selected adverse reactivities. Such clinics are directed to high risk procedures such as food and drug testing, management of adverse reactions to vaccines, and programs for initiation of hymenoptera vaccine administration and drug desensitization. Clinical activities also include routine skin testing for aeroallergens, foods, venoms, and drugs, specific patch testing, and pulmonary function testing. Pulmonary airflow studies include methacholine and special antigen challenges. Patient education is a major component of the clinical services provided, with patients being taught about their conditions and how to manage them.

Vaccine Program
The vaccine program for immunotherapy is integral to the Allergy Services at KGH. Selected antigens are obtained commercially in bulk and are prepared under rigid specifications for testing and as vaccines for immunotherapy. Vaccines are directed against antibodies which are involved in allergic respiratory disease and anaphylactic reactions to venoms. Over 600 patients are currently undergoing immunotherapy in the Kingston region under the management of the technical and professional services of the Allergy Unit at KGH. The vaccine programs are tailored to individual patients and these are monitored over the course of each program with close follow up of each patient by the Allergy Unit and physicians administering the injections. Immunotherapy injections must be given by physicians or a trained nurse under the direction of the responsible physician.

Independent Health Facility
The Independent Health Facility license was awarded to the Allergy Unit on November 15, 1991 for methacholine challenge, an integral part of pulmonary function evaluation of patients presenting with asthma. This license recognizes expertise in administering these tests and this test system is audited on a regular basis by the College of Physicians and Surgeons for conformity to quality and standards required by the Clinical Practice Parameters of Facility Standards. The license, which cannot be transferred, requires regular use of the facility in order to be maintained.

Research
The Division of Allergy's research activities are currently directed to prevention, detection, and treatment of various respiratory diseases and adverse reactions to drugs and hymenoptera venoms. FAPC Level 4 South and the site of the old cafeteria on Dietary 3 are the settings for a large number of single centre clinical trials on new medications for the treatment of allergic respiratory conditions.

The Environmental Exposure Unit (EEU), recommended by the US FDA for determination of the onset of action and other measures of efficacy of anti-allergic treatments, was devised and operated by the Allergy Unit. The Allergy Division has been successful in obtaining funding for 22 studies in the EEU leading to 37 peer reviewed publications.

A recent study in the EEU examined factors that affect the priming response to ragweed pollen which should shed light on the allergic state. Another study evaluated different pollen collection devices used to determine pollen levels in ambient air in the controlled setting of the EEU, the results of which have been presented and submitted for publication. The Allergy Unit emphasizes collaborative initiatives with other specialty groups and researchers from other disciplines here and elsewhere. Research conducted by the Allergy Unit is presented in peer-reviewed literature, lectures, medical articles, textbooks, symposia, and seminars.