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Association of Mold Levels in Urban Children’s Homes with Difficult-to-Control Asthma
Citation:
Vesper, S., L. Wymer, J. Kroner, J. Pongracic, E. Zoratti, F. Little, R. Wood, C. Kercsmar, R. Gruchalla, M. Gill, M. Kattan, S. Teach, S. Patel, C. Johnson, L. Bacharier, J. Gern, D. Jackson, S. Sigelman, A. Togias, A. Liu, W. Busse, AND G. Khurana Hershey. Association of Mold Levels in Urban Children’s Homes with Difficult-to-Control Asthma. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. Journal of Allergy Clinical Immunology, 149(4):1481-1485, (2022). https://doi.org/10.1016/j.jaci.2021.07.047
Impact/Purpose:
Asthma is the most common chronic illness of children in the US. Children with difficult-to-treat asthma suffer the greatest morbidity because standard treatments are unsuccessful. We sought to determine if environmental exposures are associated with difficult-to-treat asthma. We found that difficult-to-treat asthma was associated with elevated levels of the mold Mucor in the home. The presence of a window air-conditioner in the home significantly increased the likelihood of finding high levels of Mucor in the home. Therefore, eliminating the conditions that contribute to high levels of Mucor in the home might be appropriate to reducing difficult to treat asthma.
Description:
Background Mold sensitization and exposure are associated with asthma severity, but the specific species that contribute to difficult-to-control (DTC) asthma are unknown. Objective We sought to determine the association between overall and specific mold levels in the homes of urban children and DTC asthma. Methods The Asthma Phenotypes in the Inner-City study recruited participants, aged 6 to 17 years, from 8 US cities and classified each participant as having either DTC asthma or easy-to-control (ETC) asthma on the basis of treatment step level. Dust samples had been collected in each participant’s home (n = 485), and any dust remaining (n = 265 samples), after other analyses, was frozen at −20oC. The dust samples (n = 265) were analyzed using quantitative PCR to determine the concentrations of the 36 molds in the Environmental Relative Moldiness Index. Logistic regression was performed to discriminate specific mold content of dust from homes of children with DTC versus ETC asthma. Results Frozen-dust samples were available from 54% of homes of children with DTC (139 of 253) and ETC asthma (126 of 232). Only the average concentration of the mold Mucor was significantly (P < .001) greater in homes of children with DTC asthma. In homes with window air-conditioning units, the Mucor concentration contributed about a 22% increase (1.6 odds ratio; 95% CI, 1.2-2.2) in the ability to discriminate between cases of DTC and ETC asthma. Conclusions Mucor levels in the homes of urban youth were a predictor of DTC asthma, and these higher Mucor levels were more likely in homes with a window air-conditioner.
URLs/Downloads:
DOI: Association of Mold Levels in Urban Children’s Homes with Difficult-to-Control Asthma
PubMed Central Link to Manuscript