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Indoor fungal diversity and asthma: A meta-analysis and systematic review of risk factors

Richard A. Sharpe, Nick Bearman, Christopher R. Thornton +2 more2015Journal of Allergy and Clinical ImmunologySystematic review and meta-analysis
10.1016/j.jaci.2014.07.002PubMedFree full text
Respiratory/Sinus
Indoor Mold (Stachybotrys, Aspergillus, etc.)Water-Damaged Buildings (WDB)

Abstract

Background Indoor dampness increases the risk of indoor fungal growth. A complex interaction between occupant behaviors and the built environment are thought to affect indoor fungal concentrations and species diversity, which are believed to increase the risk of having asthma, exacerbation of asthma symptoms, or both. To date, no systematic review has investigated this relationship. Objective This review aims to assess the relationship between exposure to indoor fungi identified to the genera or species level on asthma outcomes in children and adults. Methods Ten databases were systematically searched on April 18, 2013, and limited to articles published since 1990. Reference lists were independently screened by 2 reviewers, and authors were contacted to identify relevant articles. Data were extracted from included studies meeting our eligibility criteria by 2 reviewers and quality assessed by using the Newcastle-Ottawa scale designed for assessment of case-control and cohort studies. Results Cladosporium, Alternaria, Aspergillus, and Penicillium species were found to be present in higher concentrations in homes of asthmatic participants. Exposure to Penicillium, Aspergillus, and Cladosporium species were found to be associated with increased risk of reporting asthma symptoms by a limited number of studies. The presence of Cladosporium, Alternaria, Aspergillus, and Penicillium species increased the exacerbation of current asthma symptoms by 36% to 48% compared with those exposed to lower concentrations of these fungi, as shown by using random-effect estimates. Studies were of medium quality and showed medium-high heterogeneity, but evidence concerning the specific role of fungal species was limited. Conclusion Longitudinal studies assessing increased exposure to indoor fungi before the development of asthma symptoms suggests that Penicillium, Aspergillus, and Cladosporium species pose a respiratory health risk in susceptible populations. Increased exacerbation of current asthma symptoms in children and adults were associated with increased levels of Penicillium, Aspergillus, Cladosporium, and Alternaria species, although further work should consider the role of fungal diversity and increased exposure to other fungal species.

Symptom Clusters

Respiratory symptoms

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  • References (7)

    • Infant origins of childhood asthma associated with specific moldsJournal of Allergy and Clinical Immunology · 2012
    • Specific molds associated with asthma in water-damaged homesJournal of Occupational and Environmental Medicine · 2006
    • Indoor dampness and molds and development of adult-onset asthma: a population-based incident case-control studyEnvironmental Health Perspectives · 2002
    • Levels of household mold associated with respiratory symptoms in the first year of life in a cohort at risk for asthmaEnvironmental Health Perspectives · 2002
    • Can we trust cross-sectional studies when studying the risk of moisture-related problems indoor for asthma in children?International Journal of Environmental Health Research · 2011
    • Residential Dampness and Molds and the Risk of Developing Asthma: A Systematic Review and Meta-AnalysisPLoS ONE · 2012
    • Respiratory and Allergic Health Effects of Dampness, Mold, and Dampness-Related Agents: A Review of the Epidemiologic EvidenceEnvironmental Health Perspectives · 2011