Am. J. Respir. Crit. Care Med., Volume 164, Number 1, July 2001, 65-71

Current Indoor Allergen Levels of Fungi and Cats, But Not House Dust Mites, Influence Allergy and Asthma in Adults with High Dust Mite Exposure

SHYAMALI DHARMAGE, MICHAEL BAILEY, JOAN RAVEN, TERESA MITAKAKIS, ANNA CHENG, DAVID GUEST, JENNIFER ROLLAND, ANDREW FORBES, FRANCIS THIEN, MICHAEL ABRAMSON, and E. HAYDN WALTERS

Departments of Epidemiology and Preventive Medicine, Respiratory Medicine, Pathology and Immunology, and Allergy, Asthma and Clinical Immunology, Monash Medical School and The Alfred Hospital, Prahran, Melbourne, and School of Botany, The University of Melbourne, Parkville, Australia

We assessed the influence of current indoor levels of fungi, house dust mite allergen (Der p 1), and cat allergen (Fel d 1) on sensitization and asthma in adults. A total of 485 adults answered a questionnaire and had skin prick tests and lung function tests. Dust and air samples were collected from their bedrooms. The dust was analyzed for Der p 1, Fel d 1, and fungal biomass (ergosterol). Fungal propagules were measured in air samples. Current asthma was defined as having wheezed during the past 12 mo plus bronchial hyperreactivity (BHR) to methacholine. High exposure to total airborne fungi was associated with increased BHR, but perhaps paradoxically with a lower risk of being sensitized to fungi. Ergosterol levels in floor dust were a risk factor both for being sensitized to fungi and having wheezed within the last year. High Fel d 1 levels in floor dust were found to increase the risk of being sensitized to cats and in beds to increase the risk of current asthma. Although Der p 1 levels in homes were high, people exposed to high Der p 1 levels in floor dust were less likely to be sensitized to house dust mites or to have wheezed within the past year. Current indoor levels of fungi and Fel d 1, but not Der p 1, influenced sensitization and asthma in adults with high dust mite exposure.

Keywords: asthma; allergy; indoor environment; indoor allergens; house dust mites; fungi; ergosterol; cat

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