Outdoor Alternaria and Cladosporium spores and acute asthma

Yulia Olsen; Elias Arildskov; Stefan Nygaard Hansen; Marianne Pedersen; Shyamali C Dharmage; Mathilde Kloster; Torben Sigsgaard

doi:10.1111/cea.14397

Outdoor Alternaria and Cladosporium spores and acute asthma

Yulia Olsen^*, Elias Arildskov, Stefan Nygaard Hansen, Marianne Pedersen, Shyamali C Dharmage, Mathilde Kloster, Torben Sigsgaard

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

2 Citations (Scopus)

Abstract

BACKGROUND: Outdoor Alternaria and Cladosporium spores are ubiquitous. Few studies have assessed their impact on asthma hospitalizations providing conflicting results, mainly focused on vulnerable paediatric populations. We aimed to study the impact of outdoor Alternaria and Cladosporium concentrations on acute hospitalizations in the Capital Region of Denmark.

METHODS: This is a bi-directional case-crossover study with 26 years of national registry data at individual level on acute asthma hospitalizations and daily average data on Alternaria and Cladosporium, pollen (Artemisia, Poaceae), maximal temperature, and air pollution. Conditional logistic regression models were applied to assess the associations. Concentration quartiles at lag 0 were used for categorizing the exposure.

RESULTS: For lags 0-2, the odds of hospitalization were significantly higher for both Alternaria and Cladosporium at concentration quartile 2-4 compared with quartile 1. When stratified for age and sex, odds of hospitalization at Alternaria quartiles 2-4 were significantly higher in males below 40 years at lag 0-2, and at lag 0 in females (18-30 years), while quartiles 2-4 of Cladosporium concentrations were associated with significantly higher odds in boys (0-17 years) at lag 1-3, males (18-39 years) at lag 0-1, females (18-39 years) at lag 1-2, males (40-64 years) at lag 0-2, females (40-64 years) at lag 0 and 2, in seniors (65+ years) male at lag 1-2 and female at lag 0-1. The effect of Alternaria varied significantly depending on the level of Cladosporium (p < .0001).

CONCLUSION: Ambient Alternaria and Cladosporium spores can induce asthma hospitalizations. Males are more susceptible to both genera. Males and females under age 40 years are more susceptible to Alternaria.

Original language	English
Journal	Clinical and Experimental Allergy
Volume	53
Issue	12
Pages (from-to)	1256-1267
Number of pages	12
ISSN	0954-7894
DOIs	https://doi.org/10.1111/cea.14397
Publication status	Published - Dec 2023

Keywords

aeroallergen
asthma
case-crossover design
hospitalization
outdoor fungi

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10.1111/cea.14397Licence: CC BY-NC

Clin Experimental Allergy - 2023 - Olsen - Outdoor Alternaria and Cladosporium spores and acute asthmaFinal published version, 3.21 MBLicence: CC BY-NC

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@article{11fde9ca14854b08aef0578841efaef6,

title = "Outdoor Alternaria and Cladosporium spores and acute asthma",

abstract = "BACKGROUND: Outdoor Alternaria and Cladosporium spores are ubiquitous. Few studies have assessed their impact on asthma hospitalizations providing conflicting results, mainly focused on vulnerable paediatric populations. We aimed to study the impact of outdoor Alternaria and Cladosporium concentrations on acute hospitalizations in the Capital Region of Denmark.METHODS: This is a bi-directional case-crossover study with 26 years of national registry data at individual level on acute asthma hospitalizations and daily average data on Alternaria and Cladosporium, pollen (Artemisia, Poaceae), maximal temperature, and air pollution. Conditional logistic regression models were applied to assess the associations. Concentration quartiles at lag 0 were used for categorizing the exposure.RESULTS: For lags 0-2, the odds of hospitalization were significantly higher for both Alternaria and Cladosporium at concentration quartile 2-4 compared with quartile 1. When stratified for age and sex, odds of hospitalization at Alternaria quartiles 2-4 were significantly higher in males below 40 years at lag 0-2, and at lag 0 in females (18-30 years), while quartiles 2-4 of Cladosporium concentrations were associated with significantly higher odds in boys (0-17 years) at lag 1-3, males (18-39 years) at lag 0-1, females (18-39 years) at lag 1-2, males (40-64 years) at lag 0-2, females (40-64 years) at lag 0 and 2, in seniors (65+ years) male at lag 1-2 and female at lag 0-1. The effect of Alternaria varied significantly depending on the level of Cladosporium (p < .0001).CONCLUSION: Ambient Alternaria and Cladosporium spores can induce asthma hospitalizations. Males are more susceptible to both genera. Males and females under age 40 years are more susceptible to Alternaria.",

keywords = "aeroallergen, asthma, case-crossover design, hospitalization, outdoor fungi",

author = "Yulia Olsen and Elias Arildskov and Hansen, {Stefan Nygaard} and Marianne Pedersen and Dharmage, {Shyamali C} and Mathilde Kloster and Torben Sigsgaard",

note = "{\textcopyright} 2023 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.",

year = "2023",

month = dec,

doi = "10.1111/cea.14397",

language = "English",

volume = "53",

pages = "1256--1267",

journal = "Clinical and Experimental Allergy",

issn = "0954-7894",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "12",

}

TY - JOUR

T1 - Outdoor Alternaria and Cladosporium spores and acute asthma

AU - Olsen, Yulia

AU - Arildskov, Elias

AU - Hansen, Stefan Nygaard

AU - Pedersen, Marianne

AU - Dharmage, Shyamali C

AU - Kloster, Mathilde

AU - Sigsgaard, Torben

PY - 2023/12

Y1 - 2023/12

N2 - BACKGROUND: Outdoor Alternaria and Cladosporium spores are ubiquitous. Few studies have assessed their impact on asthma hospitalizations providing conflicting results, mainly focused on vulnerable paediatric populations. We aimed to study the impact of outdoor Alternaria and Cladosporium concentrations on acute hospitalizations in the Capital Region of Denmark.METHODS: This is a bi-directional case-crossover study with 26 years of national registry data at individual level on acute asthma hospitalizations and daily average data on Alternaria and Cladosporium, pollen (Artemisia, Poaceae), maximal temperature, and air pollution. Conditional logistic regression models were applied to assess the associations. Concentration quartiles at lag 0 were used for categorizing the exposure.RESULTS: For lags 0-2, the odds of hospitalization were significantly higher for both Alternaria and Cladosporium at concentration quartile 2-4 compared with quartile 1. When stratified for age and sex, odds of hospitalization at Alternaria quartiles 2-4 were significantly higher in males below 40 years at lag 0-2, and at lag 0 in females (18-30 years), while quartiles 2-4 of Cladosporium concentrations were associated with significantly higher odds in boys (0-17 years) at lag 1-3, males (18-39 years) at lag 0-1, females (18-39 years) at lag 1-2, males (40-64 years) at lag 0-2, females (40-64 years) at lag 0 and 2, in seniors (65+ years) male at lag 1-2 and female at lag 0-1. The effect of Alternaria varied significantly depending on the level of Cladosporium (p < .0001).CONCLUSION: Ambient Alternaria and Cladosporium spores can induce asthma hospitalizations. Males are more susceptible to both genera. Males and females under age 40 years are more susceptible to Alternaria.

AB - BACKGROUND: Outdoor Alternaria and Cladosporium spores are ubiquitous. Few studies have assessed their impact on asthma hospitalizations providing conflicting results, mainly focused on vulnerable paediatric populations. We aimed to study the impact of outdoor Alternaria and Cladosporium concentrations on acute hospitalizations in the Capital Region of Denmark.METHODS: This is a bi-directional case-crossover study with 26 years of national registry data at individual level on acute asthma hospitalizations and daily average data on Alternaria and Cladosporium, pollen (Artemisia, Poaceae), maximal temperature, and air pollution. Conditional logistic regression models were applied to assess the associations. Concentration quartiles at lag 0 were used for categorizing the exposure.RESULTS: For lags 0-2, the odds of hospitalization were significantly higher for both Alternaria and Cladosporium at concentration quartile 2-4 compared with quartile 1. When stratified for age and sex, odds of hospitalization at Alternaria quartiles 2-4 were significantly higher in males below 40 years at lag 0-2, and at lag 0 in females (18-30 years), while quartiles 2-4 of Cladosporium concentrations were associated with significantly higher odds in boys (0-17 years) at lag 1-3, males (18-39 years) at lag 0-1, females (18-39 years) at lag 1-2, males (40-64 years) at lag 0-2, females (40-64 years) at lag 0 and 2, in seniors (65+ years) male at lag 1-2 and female at lag 0-1. The effect of Alternaria varied significantly depending on the level of Cladosporium (p < .0001).CONCLUSION: Ambient Alternaria and Cladosporium spores can induce asthma hospitalizations. Males are more susceptible to both genera. Males and females under age 40 years are more susceptible to Alternaria.

KW - aeroallergen

KW - asthma

KW - case-crossover design

KW - hospitalization

KW - outdoor fungi

U2 - 10.1111/cea.14397

DO - 10.1111/cea.14397

M3 - Journal article

C2 - 37748858

SN - 0954-7894

VL - 53

SP - 1256

EP - 1267

JO - Clinical and Experimental Allergy

JF - Clinical and Experimental Allergy

IS - 12

ER -

Outdoor Alternaria and Cladosporium spores and acute asthma

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