Associations between outdoor fungal spores and childhood and adolescent asthma hospitalisations.

Tham, Rachel, Vicendese, Don, Dharmage, Shyamail C., Hyndman, Rob J, Newbigin, Ed, Lewis, Emma, O'Sullivan, Molly, Lowe, Adrian J, Taylor, Philip, Bardin, Philip, Tang, Mimi L K, Abramson, Michael J and Erbas, Bircan 2017, Associations between outdoor fungal spores and childhood and adolescent asthma hospitalisations., Journal of allergy and clinical immunology, vol. 139, no. 4, pp. 1140-1147, doi: 10.1016/j.jaci.2016.06.046.

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Title Associations between outdoor fungal spores and childhood and adolescent asthma hospitalisations.
Author(s) Tham, Rachel
Vicendese, Don
Dharmage, Shyamail C.
Hyndman, Rob J
Newbigin, Ed
Lewis, Emma
O'Sullivan, Molly
Lowe, Adrian J
Taylor, PhilipORCID iD for Taylor, Philip
Bardin, Philip
Tang, Mimi L K
Abramson, Michael J
Erbas, Bircan
Journal name Journal of allergy and clinical immunology
Volume number 139
Issue number 4
Start page 1140
End page 1147
Total pages 12
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2017-04
ISSN 1097-6825
Keyword(s) adolescent
case-crossover design
outdoor fungi
Summary BACKGROUND: Childhood asthma is a significant public health problem and severe exacerbations can result in diminished quality of life and hospitalisation. OBJECTIVE: To examine the contribution of outdoor fungi to childhood and adolescent asthma hospitalisations. METHODS: The Melbourne Air Pollen Children and Adolescent (MAPCAH) study is a case-crossover study of 644 children and adolescents (aged 2-17 years) hospitalised for asthma. MAPCAH collected individual data on human rhinovirus (HRV) infection and sensitisation to Alternaria and Cladosporium; and daily counts of ambient concentrations of fungal spores, pollen and air pollutants. Conditional logistic regression models were used to assess associations with increases in spore counts while controlling for potential confounding and testing interactions. RESULTS: Exposure to Alternaria (aOR=1.07, 95%CI 1.03-1.11), Leptosphaeria (aOR=1.05, 95%CI 1.02-1.07), Coprinus (aOR=1.04, 95%CI 1.01-1.07), Drechslera (aOR=1.03, 95%CI1.00-1.05) and total spores (aOR=1.05, 95%CI 1.01-1.09) were significantly associated with child asthma hospitalisations independent of HRV infection. There were significant lagged effects up to 3-days with Alternaria, Leptosphaeria, Cladosporium, Sporormiella, Coprinus, and Drechslera. Some of these associations were significantly greater in participants with Cladosporium sensitisation. CONCLUSION: Exposures to several outdoor fungal spore taxa, including some not reported in previous research, are associated with the risk of child and adolescent asthma hospitalisation, particularly in individuals sensitised to Cladosporium. We need further studies to examine cross-reactivity causing asthma exacerbations. Identifying sensitisation to multiple fungal allergens in asthmatic children could support the design and implementation of more effective strategies to prevent asthma exacerbations.
Language eng
DOI 10.1016/j.jaci.2016.06.046
Field of Research 110203 Respiratory Diseases
110799 Immunology not elsewhere classified
Socio Economic Objective 970106 Expanding Knowledge in the Biological Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Elsevier
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