Laurie Barclay, MD
Medscape Medical News

Many asthmatics are sensitive to airborne molds rather than to pollens or animal dander, according to an epidemiological survey published in the Aug. 24 issue of the British Medical Journal.

"Sensitization to molds is a powerful risk factor for severe asthma in adults," write Mahmoud Zureik, from the
National Institute of Health and Medicine Research (INSERM) in Paris, France, and colleagues. "This should be taken into account in primary prevention, management, and patients' education."

Investigators in this cross-sectional study from the European Community respiratory health survey analyzed data from 1,132 people with asthma, aged 20-44 years. The frequency of sensitization to airborne molds increased significantly with increasing asthma severity (odds ratio 2.34, 95% confidence interval 1.56 to 3.52, for severe vs. mild asthma).

There was no association between severity of asthma and sensitization to pollens or cats.

The authors suggest that fungi are more likely to exacerbate asthma than is pollen or animal dander because the small size of fungal spores may allow them to reach the lower airways; molds are present throughout the year; and most asthmatics spend more time indoors where molds are more prevalent.

"Those people with asthma who are sensitized to airborne molds should be educated to pay careful attention to symptoms and comply with treatment, particularly during the seasonal increase in mold spore counts," the authors write. "Patients should be encouraged to decrease exposure by avoiding indoor conditions that facilitate the growth of molds — for example, by better ventilation and by decreasing dampness."

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