Mould in the homes of asthmatic children is associated with socioeconomic deprivation, reduced lung function and unscheduled healthcare visits

Abstract

Background: Sensitisation to thermotolerant fungi is associated with poorer lung function and presence of filamentous fungi in sputum is associated with acute asthma attacks in children. With this in mind, it is important to understand the impact that exposure to mould in the home environment could have on asthma which could have implications for clinical management

Aim: To assess whether presence of mould in the homes of asthmatic children is associated with more burdensome disease

Methods: As part of an observational cohort study, we administered questionnaires to parents of children with doctor-diagnosed asthma enquiring about home environment and number of unscheduled healthcare visits. Indices of multiple deprivation were derived from postal codes. Data on lung function, total serum IgE, fungal sensitisation and fungal culture were collected

Results: We obtained data on home environment in 115 children with asthma (median age 10 years (5-17)). 47% had reported visible mould in the home. These children were more likely to come from more socioeconomically deprived areas (55 vs 37%, p<0.05), have more frequent emergency department (54 vs 34%, p<0.05) and primary care attendances (51 vs 27%, p<0.05) due to asthma, have significantly lower FEV1 z-scores (-1.40 vs -0.55, p<0.05) and higher serum total IgE (636 vs. 286kUA/L, p<0.05). We did not find a difference in fungal sensitisation or isolation of fungi in sputum

Conclusions: In our cohort of asthmatic children, living in a home with reported mould was associated with socioeconomic deprivation, more burdensome disease; increased unscheduled healthcare visits due to asthma and poorer lung function.