Indoor airborne fungi and wheeze in the first year of life among a cohort of infants at risk for asthma

Abstract

In studies worldwide, respiratory outcomes such as cough, wheeze and asthma have been consistently linked to mold exposure. Young children spend most of their time indoors and may be particularly vulnerable. We evaluated the associations between exposure to airborne fungal levels and episodes of wheezing in a cohort of 103 infants at risk for asthma (due to maternal history of asthma), living primarily in low-income urban settings. Using a new protocol that facilitates identification of rare and slow-growing fungi, we measured the type and concentration of cultured fungi in home air samples taken early in the infant's first year of life. We also inspected the homes for visible mold, water damage and other housing and environmental conditions. All homes had measurable indoor airborne fungi and 73%, had some sign of mold, water damage, dampness or a musty odor. One or more episodes of wheeze during the first year of life were observed in 38% of infants. Multiple logistic regression showed high indoor levels of Penicillium were a significant risk factor for wheeze (OR 6.18; 95% CI: 1.34-28.46) in the first year of life after controlling for season of sampling, smoking, endotoxin levels, day care attendance and confounders. Acrodontium, a rarely reported fungal genus, was detected in 18% of study homes, and was associated with wheeze in unadjusted models (OR 2.75; 95% CI 0.99-7.61), but not after adjustment for confounders. Total fungal levels, visually observed mold, dampness, water damage or musty odors were not significantly associated with wheeze.

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

“…DIJKSTRA [29] DALES [16] DALES [32] PONSONBY [18] ZHENG [27] CHEN [25] FREEMAN [20] FREEMAN substudy [20] SPENGLER [19] PEKKANEN [33] DONG [17] DONG [22] ANTOVA [15] WARMAN [24] Summary (OR FAGBULE [34] VERHOEFF [31] LI [26] LI [35] MAIER [28] BRUNEKREEF [23] BRUNEKREEF [23] BRUNEKREEF [21] STRACHAN [37] STRACHAN [38] DIJKSTRA [29] DALES [16] SPENGLER [19] EMENIUS [36] ALPER [39] DONG [17] DONG [22] ANTOVA [15] ROSENBAUM [43] IOSSIFOVA [8] KARVONEN [42] Summary (OR LI [26] MAIER [28] BRUNEKREEF [23] BRUNEKREEF [23] CHEN [25] BIAGINI [45] IBARGOYEN-ROTETA [44] KOSKINEN substudy [47] KOSKINEN [47] LI [26] LI [35] BRUNEKREEF [21] DONG …”

“…BRUNEKREEF et al [21] reported a significantly positive association between domestic mould and persistent wheeze in 12-yrold children. BELANGER et al [53] observed an increased risk among 1-yr-old children who were genetically predisposed to allergic diseases, while a second study found no association among children in the same age range (although this may have been due to inadequate power as the study included only 103 children) [43].…”

“…GENT et al [55] and ROSENBAUM et al [43] reported an increased risk of wheeze in 1-yr-old infants, when exposed to airborne Penicillium (o1,000 and 120-1270 cfu?m -3 , respectively). A subsequent US study on infants found a positive association between exposure to airborne total fungi sampled at 3 months and wheeze at 1 yr [53].…”

“…Dust sampling from floors or mattresses using a vacuum cleaner provides a crude mixture of different particle sizes [10,83,84], but some of the dust fraction may never become airborne and might not have an effect on children's health. Hence some investigations sampled specific airborne dust fraction in domestic environments [43,46,53,55,56,61]. However, this requires considerable time and cost resources.…”

Sensitization to fungal allergens: Resolved and unresolved issues

“…are reported to be the most common indoor airborne fungi. 3,11e17 However, in the case of Cladosporium, because the indoor concentration is highly correlated with the outdoor concentration, 13 the primary source of Cladosporium is considered to be the outdoor environment. A recent environmental survey in Japan used an air sampler to investigate the profile of indoor airborne fungal spores.…”