哮喘联盟

   摘要
   背景：室内出现明显的霉菌与哮喘有关。然而，“教室”真菌对儿童哮喘发展的作用，以及真菌物种是否可能导致哮喘仍存在争议。全国学校调研旨在调查教室真菌孢子与学龄儿童哮喘的关系。
   方法：2011年4月至5月开展的一项横断面研究，旨在评估台湾44所学校6～15岁过敏/哮喘情况的学龄儿童。使用国际儿童哮喘和过敏症修正问卷收集个人历史资料和当前哮喘状况。使用Burkard个人空气采样器收集教室真菌孢子，并在光学显微镜下进行计数统计。三级模型被用于确定教室真菌孢子和儿童哮喘之间的复杂关系。
   结果：研究共纳入7154例患者，6346例完成调查（88.7%）。医生诊断的哮喘，当前哮喘和哮喘症状的比率在假期或周末（ASROH）分别降低11.7%，7.5%和 3.1%。总真菌数，曲霉菌属/青霉菌属和担子孢子的几何平均浓度分别为2181，49和318 spores/m3。调整个人和学校因素后，曲霉菌属/青霉菌属和担子孢子与当前哮喘和ASROH显著相关。当前的哮喘，有41%在周末报告症状解除。
   结论：教室曲霉菌属/青霉菌属和担子孢子与儿童哮喘、ASROH显著相关。政府卫生政策应该探索环境干预措施消除教室真菌孢子，降低儿童哮喘的患病率。
 

（林江涛 审校）
Chest. 2014 Mar 27. doi: 10.1378/chest.13-2129. [Epub ahead of print]

 

Current asthma in schoolchildren is related to fungal spores in classrooms.
 

Chen CH, Chao HJ, Chan CC, Chen BY, Guo YL.
 

ABSTRACT
BACKGROUND: The presence of visible mold in households is associated with asthma. However, the role of "classroom fungus" in the development of childhood asthma, as well as the fungal species that may lead to asthma, remains controversial. This nationwide school survey was conducted to investigate the correlation between fungal spores in classrooms and asthma in schoolchildren.
METHODS: From April to May 2011, a cross-sectional survey was conducted to assess allergic/asthmatic conditions in schoolchildren aged 6∼15 years old in 44 schools across Taiwan. Personal histories and current asthmatic conditions were collected using a modified International Study of Asthma and Allergies in Childhood questionnaire. Fungal spores in classroom were collected using a Burkard Personal Air Sampler and counted under light microscopy. Three-level hierarchical modeling was used to determine the complex correlation between fungal spores in classrooms and childhood asthma.
RESULTS: The survey was completed by 6346 out of 7154 parents (88.7%). The prevalences of physician-diagnosed asthma, current asthma, and asthma with symptoms reduced on holidays or weekend (ASROH) were 11.7%, 7.5%, and 3.1%, respectively. The geometric mean spore concentrations of total fungi, Aspergillus/Penicillium, and basidiospores were 2181, 49, and 318 spores/m3. Aspergillus/Penicillium and basidiospores were significantly correlated with current asthma and ASROH after adjusting for personal and school factors. Of those with current asthma, 41% reported relief of symptoms during weekends.
CONCLUSIONS: Classroom Aspergillus/Penicillium and basidiospores are significantly associated with childhood asthma and ASROH. Government health policy should explore environmental interventions for the elimination of fungal spores in classrooms to reduce the prevalence of childhood asthma.
 

Chest. 2014 Mar 27. doi: 10.1378/chest.13-2129. [Epub ahead of print]