Gale and Ira Drukier Institute for Children's Health

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Association between fungal spore exposure in inner-city schools and asthma morbidity.

TitleAssociation between fungal spore exposure in inner-city schools and asthma morbidity.
Publication TypeJournal Article
Year of Publication2019
AuthorsBaxi SN, Sheehan WJ, Sordillo JE, Muilenberg ML, Rogers CA, Gaffin JM, Permaul P, Lai PS, Louisias M, Petty CR, Fu C, Gold DR, Phipatanakul W
JournalAnn Allergy Asthma Immunol
Date Published2019 Mar 20

BACKGROUND: Home fungus exposures may be associated with development or worsening of asthma. Little is known about the effects of school/classroom fungus exposures on asthma morbidity in students.

OBJECTIVE: To evaluate the association of school-based fungus exposures on asthma symptoms in both fungus-sensitized and nonsensitized students with asthma.

METHODS: In this prospective study, 280 children with asthma from 37 inner-city schools were phenotypically characterized at baseline and followed-up for 1 year. Fungal spores were collected by using a Burkard air sampler twice during the school year. Clinical outcomes were evaluated throughout the school year and linked to classroom-specific airborne spore sampling. The primary outcome was days with asthma symptoms per 2-week period.

RESULTS: Fungal spores were present in all classroom samples. The geometric mean of the total fungi was 316.9 spores/m and ranged from 15.0 to 59,345.7 spores/m. There was variability in total fungus quantity between schools and classrooms within the same school. Mitospores were the most commonly detected fungal grouping. Investigation of the individual mitospores revealed that exposure to Alternaria was significantly associated with asthma symptom days in students sensitized to Alternaria (OR = 3.61, CI = 1.34-9.76, P = .01), but not in children not sensitized to Alternaria (OR = 1.04, CI = 0.72-1.49, P = .85). Students sensitized to Alternaria and exposed to high levels (≥75th percentile exposure) had 3.2 more symptom days per 2-week period as compared with students sensitized but exposed to lower levels.

CONCLUSION: Children with asthma who are sensitized to Alternaria and exposed to this fungus in their classroom may have significantly more days with asthma symptoms than those who were sensitized and not exposed.

CLINICAL TRIAL REGISTRATION: Clinicaltrials.govNCT01756391.

Alternate JournalAnn. Allergy Asthma Immunol.
PubMed ID30904580
Grant ListU01 AI110397 / AI / NIAID NIH HHS / United States
R01 HL137192 / HL / NHLBI NIH HHS / United States
K23 AI123517 / AI / NIAID NIH HHS / United States
K23 AI106945 / AI / NIAID NIH HHS / United States
R01 ES030100 / ES / NIEHS NIH HHS / United States
K24 AI106822 / AI / NIAID NIH HHS / United States