Indoor Fungi And Allergic Disease

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Several hundred allergens have been characterized from fungi (molds). Such allergens can worsen allergic disease such as asthma, wheezing, hay fever, rhinitis, and eczema (skin irritation). Many molds have been associated with worsening of asthma symptoms including Alternaria, Cladosporium, Aspergillus, Penicillium, and Trichosporon.    

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Nicholas Osborne et al. Current Allergy Asthma Reports 2015;15:71.

Trichosporon and Cryptococcus have been associated with the development of hypersensitivity pneumonitis. The common mold Aspergillus causes >200,000 annual life-threatening invasive infections worldwide. Aspergillus also causes a well-characterized allergic condition called Allergic Broncho Pulmonary Aspergillosis (ABPA). ABPA is estimated to affect 4 to 13 million people in the world and cause about 100,000 deaths annually. Worldwide, at least 12 million people are affected with severe allergic fungal rhinosinusitis.

Indoor fungal levels on air, dust, and surfaces can be measured by a number of means including measuring total spore count, culture of viable spores, and use of PCR (polymerase chain reaction) to measure levels of fungal DNA. Many studies have reported that exposure to molds increases the risk of asthma and/or worsen asthma. A large European study of 31,742 children found that indoor exposure to visible mold or water damage was associated with a 39% greater risk of developing asthma (95% CI of 1.05, 1.84). A meta-analysis of 16 studies reported estimated that the presence of indoor dampness or visible mold was associated with a 1.31 to 1.50 greater risk of developing asthma.

A 2015 analysis of 8,412 children and adults in the USA reported that moldy/misty odor was associated with a significantly increased risk of new-onset asthma in children (OR 1.60, 95% CI of 1.17-2.19), asthma in adults (OR 1.61, 95 CI of 1.00-2.51), and eczema in adults (OR 1,92, 95 CI 1.39-2.63). Control of moisture, prevention/remediation of water problems and adequate ventilation are necessary to control indoor growth of mold.

 

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