Mold exposure and more asthma

Many studies have linked indoor exposure to molds (fungi), bacteria, and damp indoor conditions to higher rates and/ or worsening of allergic diseases such as asthma, eczema, and rhinitis. As reported earlier, a meta-analysis of 16 published studies reported that indoor exposure to visible molds was associated with a 29% increased risk of asthma.

Yanliang Ma et al. The link between mold sensitivity and asthma severity in a cohort of northern Chinese patients. Journal of Thoracic Disease 2015; 7(4): 585-90.

Todd Lyons et al. Mold and Alternaria skin test reactivity and asthma in children in Connecticut. Annals of Allergy Asthma and Immunology 2011 April; 06:301-7.

(R Quansah et al. Residential dampness & molds and the risk of developing asthma: A systematic review and meta-analysis. PLOS ONE Nov 2012;7:e47526.-reported in my 4/4/2014 blog).

Indoor mold exposure is not only related to higher risk for asthma and atopic disease- but allergy to mold may also increase risk of asthma and severe asthma. A Chinese study of 93 adult asthmatics measured skin prick sensitivity to common allergens including weeds, dust mites, and 6 common molds: Alternaria, Aspergillus fumigatus, Botrytis, Cladosporium, Curvularia, Neurospora, and Helminthosporium. Rates of severe asthma (and asthma severity scores) were significantly more common (higher) in patients with allergies to common molds than to patents with no allergies to common allergens or those allergic only to dust mites or weeds. Lung function was significantly lower in patients with mold allergy than with no allergies (lung function measured as FEV1 or forced expiratory air at 1 second). Blood levels of both eosinophils and immunoglobulin E (IgE) were significantly higher in patients sensitized to molds or weeds/dust mites as compared to those patients with no allergens to inhaled substances. (Both eosinophils and IgE play a critical role in the development of immediate allergy which can trigger severe asthma, anaphylactic shock or other allergic reactions).

Allergies to specific molds have also been linked to significantly higher rates of severe asthma. At least 8 published studies have linked sensitivity to the common mold Alternaria with significantly higher levels of asthma or asthma severity. A study of 126 Connecticut children reported that positive skin prick sensitivity to Alternaria was associated with a 3.4 greater risk of severe, persistent asthma as compared to children not skin sensitized to Alternaria (95% Confidence interval of 1.2- 8.6).

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