Exposure to Alternaria alternata in US homes is associated with asthma symptoms

Critical reviews over the past 10 yrs have found increased respiratory and allergic health outcomes for children living in damp and mouldy environments. However, recent studies have suggested that early childhood exposure to specific mould components may actually protect children from developing allergy.We conducted a systematic review of observational studies published in English from January 1980 to July 2010. This review was conducted according to systematic guidelines for Metaanalyses of Observational Studies in Epidemiology (MOOSE). The literature was searched using a computerised bibliographic database, PubMed. In order to increase the quality of the reviewed studies, meta-analyses of the effects of visible mould exposure on allergic health outcomes were performed and we evaluated the findings according to the Bradford Hill criteria for evidence of causation.The literature search identified 1,398 peer-reviewed scientific publications, and 61 studies that fulfilled the inclusion criteria were included in this review. We observed increased risks of allergic respiratory health outcomes in children exposed to visible mould and mould spores. These findings were confirmed by the results of the meta-analysis and in line with the evaluation criteria according to Bradford Hill. Visible mould was positively associated with asthma (OR 1.49 (95% CI 1.28-1.72)), wheeze (OR 1.68 (95% CI 1.48-1.90)) and allergic rhinitis (OR 1.39 (95% CI 1.28-1.51)). However, there was a tendency of lower risk for allergic health outcomes in children exposed to mouldderived components such as (1,3)-b-D-glucan and extracellular polysaccharides.These findings suggest that home environments with visible mould and mould spore exposure increase the risk of allergic respiratory health outcomes in children. However, further investigations are needed to examine the effects of exposure to mould-derived components as the current literature is inconclusive. In order to disentangle the different effects of overall microbial exposure on children's health, research should focus on specific microbial markers in the home, in combination with new assessment techniques including molecular methods.

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“…SALO et al [70] could not find any association between dust-borne Alternaria alternata and physician-diagnosed asthma.…”

Section: Atopic Sensitisationmentioning

confidence: 85%

Association between domestic mould and mould components, and asthma and allergy in children: a systematic review

Tischer¹,

Cm²,

Heinrich³

2011

European Respiratory Journal

145

108

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“…18, 26 For Alternaria, we chose a cut point which has been associated with increased odds of asthma symptoms in the NSLAH. 27 The cut points used in the analysis were as follows: 10 μg/g for Der p 1, Der f 1, and Can f 1; 8 μg/g for Fel d 1; 8 U/g Bla g 1; 1.6 μg/g for MUP; and 7 μg/g for Alternaria.…”

Section: Discussionmentioning

confidence: 99%

Exposure to multiple indoor allergens in US homes and its relationship to asthma

Salo

Arbes

Crockett³

et al. 2008

Journal of Allergy and Clinical Immunology

184

173

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“…It has first been suggested that these microorganisms could induce an allergic response, through the production of immunoglobulin (Ig)E in response to mould allergens. Allergic sensitisation to moulds, and particularly to Alternaria alternata, has indeed been associated with asthma development and severity [64][65][66][67]. However, significant associations have also been found between exposure to moulds and respiratory symptoms among nonatopic subjects [68,69].…”

Section: Mouldsmentioning

confidence: 99%

Respiratory health and indoor air pollutants based on quantitative exposure assessments

et al. 2012

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We reviewed the main epidemiological studies that evaluate the respiratory effects of indoor air pollutants quantitatively in industrialised countries. Consistent results support short-term (aggravation) and, although more rarely, long-term (prevalence augmentation) effects on asthma, chronic bronchitis and chronic obstructive pulmonary disease (COPD) in indoor settings with poor air quality. Environmental tobacco smoke is one of the most important risks for respiratory symptoms and diseases worldwide. The evidence is also reliable for indoor nitrogen dioxide and particulate matter, which have been associated with asthma, bronchitis and COPD. Whereas formaldehyde and volatile organic compounds seem to be the main pollutants in indoor settings, relevant papers on their respiratory effects are still scarce, and limited to asthma and bronchitis. Moulds have been associated with an increased risk of asthma and COPD. Contradictory results have been found between endotoxins and asthma. The role of phthalates, persistent organic pollutants and flame retardants in respiratory diseases remains to be established. Results from rural areas of industrialised countries indicate that exposure to some indoor bio-contaminants might be protective in early life, while it is associated with adverse respiratory adverse effects in adulthood. Studies focusing on indoor air pollutants should be developed to better understand their involvement in the inception and aggravation of respiratory diseases.

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Exposure to Alternaria alternata in US homes is associated with asthma symptoms

Abstract: Background-Exposure to the fungus Alternaria alternata is a risk factor for asthma. Few studies have examined Alternaria exposures in indoor environments.

Cited by 206 publications

References 43 publications

Association between domestic mould and mould components, and asthma and allergy in children: a systematic review

Association between domestic mould and mould components, and asthma and allergy in children: a systematic review

Exposure to multiple indoor allergens in US homes and its relationship to asthma

Respiratory health and indoor air pollutants based on quantitative exposure assessments

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