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Associations between outdoor fungal spores and childhood and adolescent asthma hospitalizations
Tham, Rachel Vicendese, Don Dharmage, S. C. Hyndman, Rob J. Newbigin, E. Lewis, Emma O'Sullivan, Molly Lowe, Adrian J. Taylor, Philip Bardin, Philip
Tham, Rachel
Vicendese, Don
Dharmage, S. C.
Hyndman, Rob J.
Newbigin, E.
Lewis, Emma
O'Sullivan, Molly
Lowe, Adrian J.
Taylor, Philip
Bardin, Philip
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.
Keywords
Outdoor fungi, asthma, hospitalization, child, adolescent, case-crossover design
Date
2017
Type
Journal article
Journal
Journal of Allergy and Clinical Immunology
Book
Volume
139
Issue
4
Page Range
1140-1147
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled