TY - JOUR
T1 - Associations between outdoor fungal spores and childhood and adolescent asthma hospitalizations
AU - Tham, Rachel
AU - Vicendese, Don
AU - Dharmage, Shyamali C.
AU - Hyndman, Rob J.
AU - Newbigin, Ed
AU - Lewis, Emma
AU - O'Sullivan, Molly
AU - Lowe, Adrian J.
AU - Taylor, Philip
AU - Bardin, Philip
AU - Tang, Mimi L K
AU - Abramson, Michael J.
AU - Erbas, Bircan
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
KW - Adolescent
KW - Asthma
KW - Case-crossover design
KW - Child
KW - Hospitalization
KW - Outdoor fungi
UR - http://www.scopus.com/inward/record.url?scp=84994806230&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2016.06.046
DO - 10.1016/j.jaci.2016.06.046
M3 - Article
AN - SCOPUS:84994806230
VL - 139
SP - 1140
EP - 1147
JO - The Journal of Allergy and Clinical Immunology
JF - The Journal of Allergy and Clinical Immunology
SN - 0091-6749
IS - 4
ER -
