Strachan D P, Flannigan B, McCabe E M, McGarry F
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine.
Thorax. 1990 May;45(5):382-7. doi: 10.1136/thx.45.5.382.
A population survey of 1000 7 year old children found a significant excess of wheeze among children whose homes were reported to be mouldy (odds ratio 3.70, 95% confidence limits 2.22, 6.15). The airborne mould flora was quantified by repeated volumetric sampling during the winter in three rooms of the homes of 88 children. All of these had previously completed spirometric tests before and after a six minute free running exercise challenge. Total airborne mould counts varied from 0 to 41,000 colony forming units (CFU)/m3, but were generally in the range 50-1500 CFU/m3, much lower than the concentrations found outdoors in summer. The principal types of fungi identified are all known to be common out of doors, and most were found on at least one occasion in most of the homes. Median and geometric mean total mould counts were not related to reports of visible mould in the home, or to a history of wheeze in the index child. The heterogeneous group of non-sporing fungi (mycelia sterilia) were the only airborne fungi present at significantly higher concentrations in the homes of wheezy children (geometric mean 2.1 v 0.7 CFU/m3. A non-significant increase in total mould counts was observed in the homes of children with a 10% or greater decline in FEV1 after exercise (geometric mean 354 v 253 CFU/m3). Questionnaire reports of mould in the home may be a poor indicator of exposure to airborne spores. The total burden of inhaled mould spores from indoor sources is probably not an important determinant of wheeze among children in the general population. Although the association with mycelia sterilia could be a chance finding, these non-sporing isolates may include a potent source of allergen.
一项针对1000名7岁儿童的人口调查发现,据报告家中有霉菌的儿童出现喘息的比例显著过高(优势比3.70,95%置信区间2.22,6.15)。通过在冬季对88名儿童家中的三个房间进行重复的体积采样,对空气中的霉菌菌群进行了量化。所有这些儿童此前都在六分钟自由跑步运动激发试验前后完成了肺活量测试。空气中霉菌总数从0到41000菌落形成单位(CFU)/立方米不等,但一般在50 - 1500 CFU/立方米范围内,远低于夏季在户外发现的浓度。鉴定出的主要真菌类型在户外都很常见,并且在大多数家庭中至少有一次被发现。霉菌总数的中位数和几何平均数与家中可见霉菌的报告或指标儿童的喘息病史无关。非产孢真菌(不育菌丝体)这一异质组是喘息儿童家中唯一存在浓度显著更高的空气传播真菌(几何平均数2.1对0.7 CFU/立方米)。在运动后第一秒用力呼气量(FEV1)下降10%或更多的儿童家中,观察到霉菌总数有非显著增加(几何平均数354对253 CFU/立方米)。关于家中霉菌的问卷调查报告可能不是接触空气传播孢子的良好指标。来自室内来源的吸入霉菌孢子的总负担可能不是普通人群中儿童喘息的重要决定因素。尽管与不育菌丝体的关联可能是偶然发现,但这些非产孢分离株可能包括一种强效过敏原来源。