Associations between outdoor fungal spores and childhood and adolescent asthma hospitalizations

Journal article

Tham, Rachel, Vicendese, Don, Dharmage, S. C., Hyndman, Rob J., Newbigin, E., Lewis, Emma, O'Sullivan, Molly, Lowe, Adrian J., Taylor, Philip, Bardin, Philip, Tang, Mimi L. K., Abramson, Michael J. and Erbas, B.. (2017). Associations between outdoor fungal spores and childhood and adolescent asthma hospitalizations. Journal of Allergy and Clinical Immunology. 139(4), pp. 1140 - 1147. https://doi.org/10.1016/j.jaci.2016.06.046
AuthorsTham, Rachel, Vicendese, Don, Dharmage, S. C., Hyndman, Rob J., Newbigin, E., Lewis, Emma, O'Sullivan, Molly, Lowe, Adrian J., Taylor, Philip, Bardin, Philip, Tang, Mimi L. K., Abramson, Michael J. and Erbas, B.
Abstract

Background
Childhood asthma is a significant public health problem and severe exacerbations can result in diminished quality of life and hospitalization.
Objective
We sought to examine the contribution of outdoor fungi to childhood and adolescent asthma hospitalizations.
Methods
The Melbourne Air Pollen Children and Adolescent study is a case-crossover study of 644 children and adolescents (aged 2-17 years) hospitalized for asthma. The Melbourne Air Pollen Children and Adolescent study collected individual data on human rhinovirus infection and sensitization to Alternaria and Cladosporium and daily counts of ambient concentrations of fungal spores, pollen, and air pollutants. Conditional logistic regression models were used to assess associations with increases in spore counts while controlling for potential confounding and testing interactions.
Results
Exposure to Alternaria (adjusted odds ratio [aOR], 1.07; 95% CI, 1.03-1.11), Leptosphaeria (aOR, 1.05; 95% CI, 1.02-1.07), Coprinus (aOR, 1.04; 95% CI, 1.01-1.07), Drechslera (aOR, 1.03; 95% CI, 1.00-1.05), and total spores (aOR, 1.05; 95% CI, 1.01-1.09) was significantly associated with child asthma hospitalizations independent of human rhinovirus infection. There were significant lagged effects up to 3 days with Alternaria, Leptosphaeria, Cladosporium, Sporormiella, Coprinus, and Drechslera. Some of these associations were significantly greater in participants with Cladosporium sensitization.
Conclusions
Exposures to several outdoor fungal spore taxa, including some not reported in previous research, are associated with the risk of child and adolescent asthma hospitalization, particularly in individuals sensitized to Cladosporium. We need further studies to examine cross-reactivity causing asthma exacerbations. Identifying sensitization to multiple fungal allergens in children with asthma could support the design and implementation of more effective strategies to prevent asthma exacerbations.

KeywordsOutdoor fungi; asthma; hospitalization; child; adolescent; case-crossover design
Year2017
JournalJournal of Allergy and Clinical Immunology
Journal citation139 (4), pp. 1140 - 1147
PublisherElsevier - Mosby
ISSN0091-6749
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jaci.2016.06.046
Scopus EID2-s2.0-84994806230
Page range1140 - 1147
Research GroupMary MacKillop Institute for Health Research
Publisher's version
File Access Level
Controlled
Place of publicationUnited States of America
EditorsC. Akdis and Z. Ballas
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