Association of Levels of Household Airborne Fungi with Wheezing Symptoms in Asthmatic Children.

摘要

Objective: To assess whether exposure to airborne Penicillium, Cladosporium, or the primary hydrophilic, mesophilic, and xerophilic fungi in the home affect asthma severity in children.;Design: Prospective cohort study.;Setting: Connecticut and Massachusetts.;Participants: Children aged 5--10 living in suburban Connecticut and Massachusetts, mainly the towns of Springfield and Worcester, with physician diagnosed asthma or active asthma symptoms and medication use for the past 12 months (n=887).;Data Collection: Each study subject had an initial home interview, where mothers or caretakers answered questions to collect information on personal characteristics, maternal and child medical history, housing characteristics, and socioeconomic factors. At this initial home interview, environmental samples were taken and the child was tested for allergies. Every day for one month following the initial home visit, mothers were asked to record daily symptoms and use of rescue medication. All data was reported during a follow-up call after the first monitoring period.;Main Outcome Measures: Number of days of wheezing and number of days of rescue medication use during the first monitoring period (expressed as standardized rates per 28-day period) and a 5-point measure of asthma severity (GINA score), which takes into consideration asthma symptom frequency and the use of rescue and maintenance medication.;Analysis: Logistic regression analysis was used to examine associations between wheeze, rescue medication use, asthma severity score and exposure to airborne household fungi.;Results: In logistic regression models adjusted for potential confounders, detectable levels of hydrophilic fungi were associated with increased risk of wheeze (odds ratio[OR] of 1.92, 95%CI 1.0--3.67) and increased risk of rescue medication use (OR 2.05, 95%CI 1.10--3.84). Exposure to mesophilic fungi over 1,000 CFU/m3 was associated with increased risk of wheeze (OR 1.79, 95% CI 1.09--2.95). Exposure to airborne fungi was not associated with asthma severity score.