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Specific mold exposure during infancy increased childhood asthma risk
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Children exposed to three specific species of molds may be more likely to develop asthma during childhood, according to recent study results.
In a substudy of the Cincinnati Childhood Allergy and Air Pollution Study, researchers collected dust samples from 289 homes where infants (mean age, 8 months) lived and analyzed them for levels of molds comprising the Environmental Relative Moldiness Index (ERMI), as well as endotoxin and various allergens. Incidence of asthma among the children was recorded at 7 years of age according to lung function and reported symptoms. The Holm method, cluster analysis and forward stepwise logistic regression were used to measure the predictive value for asthma among specific mold species, with a random forest model applied to compare the results.
At age 7 years, 24% of children in the cohort had asthma. Increased asthma risk was associated with a high ERMI value at the home during infancy (adjusted RR=1.8; 95% CI, 1.5-2.2 for a 10-unit ERMI increase), as well as parental asthma (adjusted RR=1.7; 95% CI, 1.3-2.1), upper respiratory tract infection at 1 year of age (adjusted RR=2.2; 95% CI, 1.6-3.1) and positive skin prick test responses to aeroallergens and mold at age 7 years (adjusted RR=1.5; 95% CI, 1.2-2.0), among other factors.
Among the 36 molds outlined in the ERMI, three specific group 1 species, Aspergillus ochraceus, Aspergillus unguis and Penicillium variabile, were associated with increased asthma risk (adjusted RR=2.2; 95% CI, 1.8-2.7 for a summation of levels of the three species). Group 2 mold species were not significantly associated with asthma.
“This study is unique because we have identified specific molds associated with asthma development in a prospective study, arriving at a consensus from different models,” the researchers wrote. “Expecting parents with a family history of asthma might find it prudent to correct any water and mold problems in the home. Mold assessment using the ERMI might help in identifying the high-risk homes.”
Disclosure: See the study for a full list of relevant disclosures.
Perspective
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Ruth A. Etzel, MD, PhD
Clinicians have known for many years that exposures to molds can exacerbate asthma in children with the disease. There is now a growing body of evidence that exposures to molds in infancy can also lead to the development of childhood asthma. Several birth cohort studies have provided high-quality evidence to support this association.Reponen and colleagues followed nearly 300 children living near Cincinnati from birth to aged 7 years and measured home moldiness when the children were 8 months old. They used the Environmental Relative Moldiness Index to assess the burden of mold in each child’s home. Their results demonstrated that the summation of levels of Aspergillus ochraceus, A. unguis and Penicillium variabile, three mold species commonly found in water-damaged buildings, was significantly associated with childhood asthma at aged 7 years (adjusted RR=2.2; 95% CI=1.8-2.7).
To prevent the development of asthma, infants should not live in water-damaged and moldy homes.
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