Associations between household airborne culturable fungi and allergies and airway illnesses in childhood in Shanghai, China

Abstract

Associations of household airborne fungi with allergies in childhood were inconsistent in the epidemiologic studies. During 2013–2014, we conducted a case-control study (phase two), which was nested in a cross-sectional study (phase one) during 2011–2012 in Shanghai, China. We inspected indoor air quality of 454 residences for 5–10 years old children. We defined cases as those children who were reported illnesses in the questionnaire of phase one or phase two and defined controls as those children who were not reported illnesses in both phases. A total of 436 living rooms and 445 bedrooms had valid data of household airborne fungi, and their mean concentrations were 301 cfu/m3 and 310 cfu/m3, respectively. In the multiple logistic regression analyses with adjusting for potential confounders, most associations of 16 studied illnesses with airborne fungi concentration were not statistically significant. Taking children in the 1st quartile that was stratified according to airborne fungi concentration in the living room as reference, only children in the 3rd quartile were significantly associated with a higher odd of lifetime-ever ear infections (adjusted OR, 95% CI 3.05, 1.29–7.21), and children in the 4th quartile were significantly associated with a higher odd of lifetime-ever wheeze (2.72, 1.28–5.75); but children in the 3rd quartile (0.33, 0.17–0.68) and in the 4th quartile (0.47, 0.23–0.97) were significantly associated with a lower odd of rhinitis in the past 12 months prior to the home inspection. Our results indicate that exposures to indoor airborne fungi in low concentrations seemingly have no significant impacts on the risks of most allergic and airway illnesses in childhood. Since families with sick participants might pay more attention to improve indoor air quality, effects of “avoidance behavior” on associations between indoor pollutants and childhood health should be considered in the data analysis and design of the nested case-control study.

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Acknowledgments

We thank all of the parents and children who took part in this study and others who provided assistance for our home inspection. We also thank Prof. Yinping Zhang in the Tsinghua University, Prof. Baizhan Li in the Chongqing University, and Associate Prof. Zhuohui Zhao in the Fudan University for their guidance and helps on the CCHH project in Shanghai, China.

Funding

This work is financially supported by the National Key Research and Development Program of China (2017YFC0702700), research start-up fund for new faculty of Chongqing university of Science and Technology (182001002), and special fund for Postdoctoral Fellow in Chongqing (13201907).

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Correspondence to Chen Huang.

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The questionnaire and proposal for the CCHH study was approved by the ethical committee from the School of Public Health, Fudan University.

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Liu, W., Cai, J., Sun, C. et al. Associations between household airborne culturable fungi and allergies and airway illnesses in childhood in Shanghai, China. Environ Sci Pollut Res (2020). https://doi.org/10.1007/s11356-020-09717-w

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Keywords

  • Airborne fungi
  • Asthma
  • Childhood
  • Case-control study
  • Residence
  • Threshold