Association of mold levels in urban children's homes with difficult-to-control asthma

Stephen Vesper; Larry Wymer; John Kroner; Jacqueline A. Pongracic; Edward M. Zoratti; Frédéric F. Little; Robert A. Wood; Carolyn M. Kercsmar; Rebecca S. Gruchalla; Michelle A. Gill; Meyer Kattan; Stephen J. Teach; Shilpa Patel; Christine C. Johnson; Leonard B. Bacharier; James E. Gern; Daniel J. Jackson; Steven M. Sigelman; Alkis Togias; Andrew H. Liu; William W. Busse; Gurjit K. Khurana Hershey

doi:10.1016/j.jaci.2021.07.047

Association of mold levels in urban children's homes with difficult-to-control asthma

Stephen Vesper^*, Larry Wymer, John Kroner, Jacqueline A. Pongracic, Edward M. Zoratti, Frédéric F. Little, Robert A. Wood, Carolyn M. Kercsmar, Rebecca S. Gruchalla, Michelle A. Gill, Meyer Kattan, Stephen J. Teach, Shilpa Patel, Christine C. Johnson, Leonard B. Bacharier, James E. Gern, Daniel J. Jackson, Steven M. Sigelman, Alkis Togias, Andrew H. LiuWilliam W. Busse, Gurjit K. Khurana Hershey

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

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 −20^oC. 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.

Original language	English (US)
Pages (from-to)	1481-1485
Number of pages	5
Journal	Journal of Allergy and Clinical Immunology
Volume	149
Issue number	4
DOIs	https://doi.org/10.1016/j.jaci.2021.07.047
State	Published - Apr 2022

Funding

This project has been funded in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under contract numbers HHSN272200900052C and HHSN272201000052I, and 1UM1AI114271-01. The US Environmental Protection Agency (EPA) through its Office of Research and Development collaborated in the research described here. It has been subjected to the agency's peer review and has been approved as an EPA publication. Mention of trade names or commercial products does not constitute endorsement or recommendation by the EPA for use. The findings and the conclusions in this report are those of the authors and do not necessarily represent the views of the US EPA. This project has been funded in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health , Department of Health and Human Services , under contract numbers HHSN272200900052C and HHSN272201000052I, and 1UM1AI114271-01. The US Environmental Protection Agency (EPA) through its Office of Research and Development collaborated in the research described here. It has been subjected to the agency’s peer review and has been approved as an EPA publication. Mention of trade names or commercial products does not constitute endorsement or recommendation by the EPA for use. The findings and the conclusions in this report are those of the authors and do not necessarily represent the views of the US EPA.

Keywords

APIC
Mucor
US cities
air-conditioner
child
mold

ASJC Scopus subject areas

Immunology and Allergy
Immunology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jaci.2021.07.047

Cite this

Vesper, S., Wymer, L., Kroner, J., Pongracic, J. A., Zoratti, E. M., Little, F. F., Wood, R. A., Kercsmar, C. M., Gruchalla, R. S., Gill, M. A., Kattan, M., Teach, S. J., Patel, S., Johnson, C. C., Bacharier, L. B., Gern, J. E., Jackson, D. J., Sigelman, S. M., Togias, A., ... Khurana Hershey, G. K. (2022). Association of mold levels in urban children's homes with difficult-to-control asthma. Journal of Allergy and Clinical Immunology, 149(4), 1481-1485. https://doi.org/10.1016/j.jaci.2021.07.047

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title = "Association of mold levels in urban children's homes with difficult-to-control asthma",

abstract = "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.",

keywords = "APIC, Mucor, US cities, air-conditioner, child, mold",

author = "Stephen Vesper and Larry Wymer and John Kroner and Pongracic, {Jacqueline A.} and Zoratti, {Edward M.} and Little, {Fr{\'e}d{\'e}ric F.} and Wood, {Robert A.} and Kercsmar, {Carolyn M.} and Gruchalla, {Rebecca S.} and Gill, {Michelle A.} and Meyer Kattan and Teach, {Stephen J.} and Shilpa Patel and Johnson, {Christine C.} and Bacharier, {Leonard B.} and Gern, {James E.} and Jackson, {Daniel J.} and Sigelman, {Steven M.} and Alkis Togias and Liu, {Andrew H.} and Busse, {William W.} and {Khurana Hershey}, {Gurjit K.}",

note = "Funding Information: This project has been funded in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under contract numbers HHSN272200900052C and HHSN272201000052I, and 1UM1AI114271-01. The US Environmental Protection Agency (EPA) through its Office of Research and Development collaborated in the research described here. It has been subjected to the agency's peer review and has been approved as an EPA publication. Mention of trade names or commercial products does not constitute endorsement or recommendation by the EPA for use. The findings and the conclusions in this report are those of the authors and do not necessarily represent the views of the US EPA. Funding Information: This project has been funded in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health , Department of Health and Human Services , under contract numbers HHSN272200900052C and HHSN272201000052I, and 1UM1AI114271-01. The US Environmental Protection Agency (EPA) through its Office of Research and Development collaborated in the research described here. It has been subjected to the agency{\textquoteright}s peer review and has been approved as an EPA publication. Mention of trade names or commercial products does not constitute endorsement or recommendation by the EPA for use. The findings and the conclusions in this report are those of the authors and do not necessarily represent the views of the US EPA. Publisher Copyright: {\textcopyright} 2021 American Academy of Allergy, Asthma & Immunology",

year = "2022",

month = apr,

doi = "10.1016/j.jaci.2021.07.047",

language = "English (US)",

volume = "149",

pages = "1481--1485",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Elsevier Inc.",

number = "4",

}

Vesper, S, Wymer, L, Kroner, J, Pongracic, JA, Zoratti, EM, Little, FF, Wood, RA, Kercsmar, CM, Gruchalla, RS, Gill, MA, Kattan, M, Teach, SJ, Patel, S, Johnson, CC, Bacharier, LB, Gern, JE, Jackson, DJ, Sigelman, SM, Togias, A, Liu, AH, Busse, WW & Khurana Hershey, GK 2022, 'Association of mold levels in urban children's homes with difficult-to-control asthma', Journal of Allergy and Clinical Immunology, vol. 149, no. 4, pp. 1481-1485. https://doi.org/10.1016/j.jaci.2021.07.047

TY - JOUR

T1 - Association of mold levels in urban children's homes with difficult-to-control asthma

AU - Vesper, Stephen

AU - Wymer, Larry

AU - Kroner, John

AU - Pongracic, Jacqueline A.

AU - Zoratti, Edward M.

AU - Little, Frédéric F.

AU - Wood, Robert A.

AU - Kercsmar, Carolyn M.

AU - Gruchalla, Rebecca S.

AU - Gill, Michelle A.

AU - Kattan, Meyer

AU - Teach, Stephen J.

AU - Patel, Shilpa

AU - Johnson, Christine C.

AU - Bacharier, Leonard B.

AU - Gern, James E.

AU - Jackson, Daniel J.

AU - Sigelman, Steven M.

AU - Togias, Alkis

AU - Liu, Andrew H.

AU - Busse, William W.

AU - Khurana Hershey, Gurjit K.

N1 - Funding Information: This project has been funded in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under contract numbers HHSN272200900052C and HHSN272201000052I, and 1UM1AI114271-01. The US Environmental Protection Agency (EPA) through its Office of Research and Development collaborated in the research described here. It has been subjected to the agency's peer review and has been approved as an EPA publication. Mention of trade names or commercial products does not constitute endorsement or recommendation by the EPA for use. The findings and the conclusions in this report are those of the authors and do not necessarily represent the views of the US EPA. Funding Information: This project has been funded in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health , Department of Health and Human Services , under contract numbers HHSN272200900052C and HHSN272201000052I, and 1UM1AI114271-01. The US Environmental Protection Agency (EPA) through its Office of Research and Development collaborated in the research described here. It has been subjected to the agency’s peer review and has been approved as an EPA publication. Mention of trade names or commercial products does not constitute endorsement or recommendation by the EPA for use. The findings and the conclusions in this report are those of the authors and do not necessarily represent the views of the US EPA. Publisher Copyright: © 2021 American Academy of Allergy, Asthma & Immunology

PY - 2022/4

Y1 - 2022/4

N2 - 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.

AB - 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.

KW - APIC

KW - Mucor

KW - US cities

KW - air-conditioner

KW - child

KW - mold

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SN - 0091-6749

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EP - 1485

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

IS - 4

ER -

Association of mold levels in urban children's homes with difficult-to-control asthma

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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