Original Articles: Asthma, Lower Airway DiseasesHousehold airborne Penicillium associated with peak expiratory flow variability in asthmatic children
Section snippets
INTRODUCTION
For epidemiologic studies that evaluate asthma, peak expiratory flow (PEF) monitoring permits multiple measurements each day for a prolonged period and thus can measure day to day variations in lung function. Previous studies1, 2, 3, 4, 5, 6 have demonstrated associations between fungal exposure and respiratory symptoms in asthmatic patients.
It has been suggested that PEF variability (PEFV) better reflects the dynamic nature of asthma and may help avert impending asthma exacerbations.7, 8, 9
METHODS
The study population consisted of 322 children with physician-diagnosed asthma. These children were enrolled in a cross-sectional study that involved a 2-week trial of in-home PEF monitoring as a part of a larger study of 466 children that evaluated environmental determinants of childhood asthma severity.5, 10 Homes were located in Connecticut and Western Massachusetts. Of the 322 individuals in the present study, 307 (95%) met our age criterion of 6 to 12 years and the American Thoracic
RESULTS
Study children participated in the 2-week PEF monitoring period for a mean (SD) of 6 (3) days. More than half (65%) of the individuals participated for 3 to 8 days; 11% contributed fewer than 3 days of data, 23% had 9 to 13 days, and less than 1% (0.9%) had a full 14 days of data. Unadjusted associations between personal characteristics and PEF measurements are given in Table 1. Girls, children with allergies, and children whose only medication was short-acting inhalers had significantly
DISCUSSION
To our knowledge, this study is the largest to evaluate the association between directly measured indoor home fungi and PEFV. Our data suggest that exposure to Penicillium is associated with PEFV in asthmatic children. Exposure to indoor fungal allergens is important because of both the high percentage of time spent indoors14 and data suggesting the importance of fungal antigens across a variety of allergic diseases, including chronic rhinosinusitis,15 atopic conjunctivitis,16 and atopic
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Disclosures: Authors have nothing to disclose.
Funding Sources: This work was supported by grants ES07456 and ES05410 from the National Institute of Environmental Health Sciences, National Institutes of Health.