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Sensitisation to airborne moulds and severity of asthma: cross sectional study from European Community respiratory health survey

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7361.411 (Published 24 August 2002) Cite this as: BMJ 2002;325:411
  1. Mahmoud Zureik (zureik{at}vjf.inserm.fr), epidemiological researchera,
  2. Catherine Neukirch, senior physician in allergologya,
  3. Bénédicte Leynaert, epidemiological researchera,
  4. Renata Liard, epidemiologista,
  5. Jean Bousquet, professorb,
  6. Françoise Neukirch, senior epidemiological researcher aa,
  7. European Community Respiratory Health Survey.
  1. a National Institute of Health and Medical Research (INSERM), Unit 408 Epidémiologie, Faculté de Médecine Xavier Bichat, BP 416, 75870 Paris CEDEX 18, France
  2. b National Institute of Health and Medical Research (INSERM), Unit U454 Hôpital Arnaud de Villeneuve, 34295 Montpellier Cedex 05, France
  1. Correspondence to: Mahmoud Zureik
  • Accepted 4 April 2002

Abstract

Objective: To assess whether the severity of asthma is associated with sensitisation to airborne moulds rather than to other seasonal or perennial allergens.

Design: Multicentre epidemiological survey in 30 centres.

Setting: European Community respiratory health survey.

Participants: 1132 adults aged 20-44 years with current asthma and with skin prick test results.

Main outcome measure: Severity of asthma according to score based on forced expiratory volume in one second, number of asthma attacks, hospital admissions for breathing problems, and use of corticosteroids in past 12 months.

Results: The frequency of sensitisation to moulds (Alternaria alternata or Cladosporium herbarum, or both) increased significantly with increasing asthma severity (odds ratio 2.34 (95% confidence interval 1.56 to 3.52) for either for severe v mild asthma). This association existed in all of the study areas (gathered into regions), although there were differences in the frequency of sensitisation. There was no association between asthma severity and sensitisation to pollens or cats. Sensitisation to Dermatophagoides pteronyssinus was also positively associated with severity. In multivariable logistic regressions including sensitisation to moulds, pollens, D pteronyssinus, and cats simultaneously, the odds ratios for sensitisation to moulds were 1.48 (0.97 to 2.26) for moderate v mild asthma and 2.16 (1.37 to 3.35) for severe v mild asthma (P<0.001 for trend).

Conclusions: Sensitisation to moulds is a powerful risk factor for severe asthma in adults. This should be taken into account in primary prevention, management, and patients' education.

Footnotes

  • Funding Australia: Allen & Hanbury, Australia; Belgium: Belgian Science Policy Office, National Fund for Scientific Research; France: Ministère de la Santé, Glaxo France, Institut Pneumologique d'Aquitaine, Contrat de Plan Etat-Région Languedoc-Roussillon, CNMATS, CNMRT (90MR/10, 91AF/6), Ministre délégué de la santé, RNSP, Ministère de l'Environnement (No 96115-EN96D4); Germany: GSF, Bundesminister für Forschung und Technologie, Bonn; Greece: Greek Secretary General of Research and Technology, Fisons, Astra, Boehringer-Ingelheim; India: Bombay Hospital Trust; Italy: Ministero dell'Univesità e della Ricerca Scientifica e Tecnologica, CNR, Regione Veneto Grant RSF No 381/05.93; New Zealand: Asthma Foundation of New Zealand, Lotteries Grant Board, Health Research Council of New Zealand; Norway: Norwegian Research Council project No 101422/310; Portugal: Glaxo Farmacêutica Lda, Sandoz Portugesa; Spain: Ministero Sanidad y Consumo FIS (grants 91/0016060/OOE-05E, 92/0319, 93/0393), Hospital General de Albacete, Hospital General Juan Ramón Jiménenz, Consejeria de Sanidad Principado de Asturias; Sweden: Swedish Medical Research Council, Swedish Heart Lung Foundation, Swedish Association against Asthma and Allergy, Swedish Society of Medicine, Astra, Glaxo-Wellcome, Boehringer-Ingelheim; Switzerland: Swiss National Science Foundation Grant 4026-28099; United Kingdom: National Asthma Campaign, British Lung Foundation, Department of Health, South Thames Regional Health Authority; United States: US Department of Health, Education and Welfare Public Health Service Grant No 2 S07 RR05521-28.

  • Competing interests None declared.

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