Outdoor fungi and child asthma health service attendances |
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Authors: | Rachel Tham Shyamali C Dharmage Philip E Taylor Constance H Katelaris Don Vicendese Michael J Abramson Bircan Erbas |
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Institution: | 1. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, , Melbourne, Vic., Australia;2. Centre for Cellular and Molecular Biology, School of Life and Environmental Sciences, Deakin University, , Burwood, Vic., Australia;3. Department of Medicine, Immunology and Allergy, Campbelltown Hospital, , Campbelltown, NSW, Australia;4. School of Public Health, La Trobe University, , Bundoora, Vic., Australia;5. Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, , Melbourne, Vic., Australia |
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Abstract: | Asthma is a significant global public health issue. Severe asthma exacerbations can be triggered by environmental factors and require medical care from health services. Although it is known that fungal exposure may lead to allergic sensitization, little is understood about its impact on asthma exacerbations. This review aims to examine whether outdoor fungi play a significant role in child asthma exacerbations. Systematic search of seven electronic databases and hand searching for peer‐reviewed studies published in English, up to 31 August 2013. Inclusion criteria were study population aged <18 yr, diagnosis of asthma, attended a health service; outdoor fungi exposure was reported. Quality and risk of bias assessments were conducted. Due to significant heterogeneity, meta‐analysis was not conducted. Of the 1896 articles found, 15 were eligible. Findings were not consistent, possibly due to methodological variations in exposure classifications, statistical methods and inclusion of confounders. Cross‐sectional studies found no or weak associations. All but one time series studies indicated an association that varied between fungal species. Increasing evidence indicates that asthmatic children are susceptible to asthma exacerbations when exposed to outdoor fungal spores. There is limited understanding of the contributions of different fungal species. Research is needed to investigate interactions of outdoor fungi with pollen, air pollutants and respiratory viruses. |
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Keywords: | aeroallergen asthma child emergency department fungi health services hospital mould systematic review |
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