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. 2000 Nov;57(11):786–792. doi: 10.1136/oem.57.11.786

Fungal and other spore counts as predictors of admissions for asthma in the Trent region

R Newson 1, D Strachan 1, J Corden 1, W Millington 1
PMCID: PMC1739878  PMID: 11024204

Abstract

OBJECTIVES—The importance of airborne fungal and other spores in provoking asthma attacks is uncertain. Panel studies have generated evidence that suggests a link between outdoor spore counts and severity of asthma. There have been no population based time series studies relating outdoor exposure to spores with incidence of attacks of asthma.
METHODS—Outcomes were hospital admissions for asthma on 2002 days during 1987-94, for children and adults in the Trent region of England. Predictors were daily counts of 25 spore taxa from volumetric traps in Derby on the same and previous day. Admissions for asthma were adjusted for weekly, seasonal, and longer term trends by log linear autoregressive models. Spore counts on 6 days of asthma epidemics were also examined.
RESULTS—When spore counts for individual taxa were analysed as quantitative variables, two positive and two negative correlations (out of a possible 100) were significant at the 5% level. When spore counts were dichotomised at the 90th percentile, one negative and eight positive correlations (out of 100) were significant at the 5% level. All significantly positive associations related to admissions among children, but none involved the total spore count. However, total spores were above the 90th percentile on four of the six epidemic days (odds ratio (OR) 9.92, 95% confidence interval (95% CI) 1.41 to 109.84), but epidemics occurred on only four of 343 days with high total moulds.
CONCLUSIONS—There was some evidence that exceptional rates of admission for asthma tend to occur on days with high total mould spore counts, but no specific taxon was consistently implicated. The predictive power was insufficient to support a public warning system.


Keywords: asthma; hospital admissions; moulds; fungi; spore counts; aeroallergens; log linear autoregression

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Selected References

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  1. Anderson H. R., Ponce de Leon A., Bland J. M., Bower J. S., Emberlin J., Strachan D. P. Air pollution, pollens, and daily admissions for asthma in London 1987-92. Thorax. 1998 Oct;53(10):842–848. doi: 10.1136/thx.53.10.842. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Beaumont F., Kauffman H. F., Sluiter H. J., De Vries K. Sequential sampling of fungal air spores inside and outside the homes of mould-sensitive, asthmatic patients: a search for a relationship to obstructive reactions. Ann Allergy. 1985 Nov;55(5):740–746. [PubMed] [Google Scholar]
  3. Beaumont F., Kauffman H. F., de Monchy J. G., Sluiter H. J., de Vries K. Volumetric aerobiological survey of conidial fungi in the North-East Netherlands. II. Comparison of aerobiological data and skin tests with mould extracts in an asthmatic population. Allergy. 1985 Apr;40(3):181–186. doi: 10.1111/j.1398-9995.1985.tb00214.x. [DOI] [PubMed] [Google Scholar]
  4. Brown H. M., Jackson F. A. Aerobiological studies based in Derby. I. A simplified automatic volumetric spore trap. Clin Allergy. 1978 Nov;8(6):589–597. doi: 10.1111/j.1365-2222.1978.tb01513.x. [DOI] [PubMed] [Google Scholar]
  5. Delfino R. J., Coate B. D., Zeiger R. S., Seltzer J. M., Street D. H., Koutrakis P. Daily asthma severity in relation to personal ozone exposure and outdoor fungal spores. Am J Respir Crit Care Med. 1996 Sep;154(3 Pt 1):633–641. doi: 10.1164/ajrccm.154.3.8810598. [DOI] [PubMed] [Google Scholar]
  6. Delfino R. J., Zeiger R. S., Seltzer J. M., Street D. H., Matteucci R. M., Anderson P. R., Koutrakis P. The effect of outdoor fungal spore concentrations on daily asthma severity. Environ Health Perspect. 1997 Jun;105(6):622–635. doi: 10.1289/ehp.97105622. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Epton M. J., Martin I. R., Graham P., Healy P. E., Smith H., Balasubramaniam R., Harvey I. C., Fountain D. W., Hedley J., Town G. I. Climate and aeroallergen levels in asthma: a 12 month prospective study. Thorax. 1997 Jun;52(6):528–534. doi: 10.1136/thx.52.6.528. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Exposure to an aeroallergen and respiratory arrest in patients with asthma. N Engl J Med. 1991 Jul 18;325(3):206–208. doi: 10.1056/NEJM199107183250313. [DOI] [PubMed] [Google Scholar]
  9. Harries M. G., Lacey J., Tee R. D., Cayley G. R., Taylor A. J. Didymella exitialis and late summer asthma. Lancet. 1985 May 11;1(8437):1063–1066. doi: 10.1016/s0140-6736(85)92368-2. [DOI] [PubMed] [Google Scholar]
  10. Hendrick D. J., Davies R. J., D'Souza M. F., Pepys J. An analysis of skin prick test reactions in 656 asthmatic patients. Thorax. 1975 Feb;30(1):2–8. doi: 10.1136/thx.30.1.2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Herxheimer H., Hyde H. A., Williams D. A. Allergic asthma caused by fungal spores. Lancet. 1966 Mar 12;1(7437):572–573. doi: 10.1016/s0140-6736(66)90765-3. [DOI] [PubMed] [Google Scholar]
  12. Horner W. E., Helbling A., Salvaggio J. E., Lehrer S. B. Fungal allergens. Clin Microbiol Rev. 1995 Apr;8(2):161–179. doi: 10.1128/cmr.8.2.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Jörres R., Nowak D., Magnussen H. The effect of ozone exposure on allergen responsiveness in subjects with asthma or rhinitis. Am J Respir Crit Care Med. 1996 Jan;153(1):56–64. doi: 10.1164/ajrccm.153.1.8542163. [DOI] [PubMed] [Google Scholar]
  14. Knox R. B. Grass pollen, thunderstorms and asthma. Clin Exp Allergy. 1993 May;23(5):354–359. doi: 10.1111/j.1365-2222.1993.tb00339.x. [DOI] [PubMed] [Google Scholar]
  15. Lehrer S. B., Hughes J. M., Altman L. C., Bousquet J., Davies R. J., Gell L., Li J., Lopez M., Malling H. J., Mathison D. A. Prevalence of basidiomycete allergy in the USA and Europe and its relationship to allergic respiratory symptoms. Allergy. 1994 Jul;49(6):460–465. doi: 10.1111/j.1398-9995.1994.tb00840.x. [DOI] [PubMed] [Google Scholar]
  16. Lehrer S. B., Hughes J. M., Altman L. C., Bousquet J., Davies R. J., Gell L., Li J., Lopez M., Malling H. J., Mathison D. A. Prevalence of basidiomycete allergy in the USA and Europe and its relationship to allergic respiratory symptoms. Allergy. 1994 Jul;49(6):460–465. doi: 10.1111/j.1398-9995.1994.tb00840.x. [DOI] [PubMed] [Google Scholar]
  17. Malling H. J. Diagnosis and immunotherapy of mould allergy. IV. Relation between asthma symptoms, spore counts and diagnostic tests. Allergy. 1986 Jul;41(5):342–350. doi: 10.1111/j.1398-9995.1986.tb00311.x. [DOI] [PubMed] [Google Scholar]
  18. Molfino N. A., Wright S. C., Katz I., Tarlo S., Silverman F., McClean P. A., Szalai J. P., Raizenne M., Slutsky A. S., Zamel N. Effect of low concentrations of ozone on inhaled allergen responses in asthmatic subjects. Lancet. 1991 Jul 27;338(8761):199–203. doi: 10.1016/0140-6736(91)90346-q. [DOI] [PubMed] [Google Scholar]
  19. Newson R., Strachan D., Archibald E., Emberlin J., Hardaker P., Collier C. Acute asthma epidemics, weather and pollen in England, 1987-1994. Eur Respir J. 1998 Mar;11(3):694–701. [PubMed] [Google Scholar]
  20. Newson R., Strachan D., Archibald E., Emberlin J., Hardaker P., Collier C. Effect of thunderstorms and airborne grass pollen on the incidence of acute asthma in England, 1990-94. Thorax. 1997 Aug;52(8):680–685. doi: 10.1136/thx.52.8.680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Packe G. E., Ayres J. G. Asthma outbreak during a thunderstorm. Lancet. 1985 Jul 27;2(8448):199–204. doi: 10.1016/s0140-6736(85)91510-7. [DOI] [PubMed] [Google Scholar]
  22. Storr J., Lenney W. School holidays and admissions with asthma. Arch Dis Child. 1989 Jan;64(1):103–107. doi: 10.1136/adc.64.1.103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Targonski P. V., Persky V. W., Ramekrishnan V. Effect of environmental molds on risk of death from asthma during the pollen season. J Allergy Clin Immunol. 1995 May;95(5 Pt 1):955–961. doi: 10.1016/s0091-6749(95)70095-1. [DOI] [PubMed] [Google Scholar]
  24. Tariq S. M., Matthews S. M., Stevens M., Hakim E. A. Sensitization to Alternaria and Cladosporium by the age of 4 years. Clin Exp Allergy. 1996 Jul;26(7):794–798. [PubMed] [Google Scholar]
  25. Verhoeff A. P., Burge H. A. Health risk assessment of fungi in home environments. Ann Allergy Asthma Immunol. 1997 Jun;78(6):544–556. doi: 10.1016/S1081-1206(10)63214-0. [DOI] [PubMed] [Google Scholar]

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