The effect of outdoor fungal spore concentrations on daily asthma severity.
The effect of outdoor fungal spore concentrations on daily asthma severity.
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室外真菌孢子浓度对每日哮喘严重程度的影响。
DOI：
10.1289/ehp.97105622
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发表时间：
1997-06
影响因子：
10.4
通讯作者：
中科院分区：
文献类型：
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作者：
哮喘严重程度的日常变化与社区空气污染物和空气过敏原的联合暴露之间的关系仍有待明确界定。我们研究了室外空气污染物、真菌和花粉对哮喘的影响。22名9-46岁的哮喘患者于1994年5月9日至7月3日在南加州的一个半农村社区（1,200英尺）进行了为期8周的随访。每日日记反应包括哮喘症状严重程度（6级）、早晨和晚上呼气峰流速（PEFR）和按需使用β受体激动剂吸入器。暴露包括24小时的真菌、花粉和直径< 10微米的颗粒物（PM10;最大值= 51微克/立方米）的室外浓度和12小时的日间个人臭氧（O3）测量值（第90百分位数= 38 ppb）。随机效应纵向回归模型控制自相关和天气。较高的温度有很强的保护作用，可能是由于在炎热干燥的时期使用空调和减少室内过敏原。控制天气，总真菌孢子浓度与所有结果相关：每增加近4，000个孢子/m3的最小值至第90百分位数，哮喘症状评分增加0.36（95% CI，0.16-0.56），吸入器使用增加0.33揿（95% CI，-0.02-0.69），夜间PEFR降低12.1 l/min（95% CI，-1.8-22.3）。通过检查某些真菌类型（例如，链格孢属、担孢子和菌丝碎片），并对16名对测试的半知真菌过敏的哮喘患者进行分层。与低水平的花粉或O3没有显著相关性，但吸入器的使用与PM10相关（0.15吸入器喷/10微克/立方米; p < 0.02）。这些发现表明，暴露于真菌孢子会对一些哮喘患者的日常呼吸状态产生不利影响。
The relationship between day-to-day changes in asthma severity and combined exposures to community air pollutants and aeroallergens remains to be clearly defined. We examined the effects of outdoor air pollutants, fungi, and pollen on asthma. Twenty-two asthmatics ages 9-46 years were followed for 8 weeks (9 May-3 July 1994) in a semirural Southern California community around the air inversion base elevation (1,200 ft). Daily diary responses included asthma symptom severity (6 levels), morning and evening peak expiratory flow rates (PEFR), and as-needed beta-agonist inhaler use. Exposures included 24-hr outdoor concentrations of fungi, pollen, and particulate matter with a diameter < 10 microns (PM10; maximum = 51 micrograms/m3) and 12-hour day-time personal ozone (O3) measurements (90th percentile = 38 ppb). Random effects longitudinal regression models controlled for autocorrelation and weather. Higher temperatures were strongly protective, probably due to air conditioning use and diminished indoor allergens during hot, dry periods. Controlling for weather, total fungal spore concentrations were associated with all outcomes: per minimum to 90th percentile increase of nearly 4,000 spores/m3, asthma symptom scores increased 0.36 (95% CI, 0.16-0.56), inhaler use increased 0.33 puffs (95% CI, -0.02-0.69), and evening PEFR decreased 12.1 l/min (95% CI, -1.8-22.3). These associations were greatly enhanced by examining certain fungal types (e.g., Alternaria, basidiospores, and hyphal fragments) and stratifying on 16 asthmatics allergic to tested deuteromycete fungi. There were no significant associations to low levels of pollen or O3, but inhaler use was associated with PM10 (0.15 inhaler puffs/10 micrograms/m3; p < 0.02). These findings suggest that exposure to fungal spores can adversely effect the daily respiratory status of some asthmatics.