title: High environmental relative moldiness index during infancy as a predictor of asthma at 7 years of age.
abstract: BACKGROUND
  Mold exposures may contribute to the development of asthma, but previous studies have lacked a standardized approach to quantifying exposures.
  
  
  OBJECTIVE
  To determine whether mold exposures at the ages of 1 and/or 7 years were associated with asthma at the age of 7 years.
  
  
  METHODS
  This study followed up a high-risk birth cohort from infancy to 7 years of age. Mold was assessed by a DNA-based analysis for the 36 molds that make up the Environmental Relative Moldiness Index (ERMI) at the ages of 1 and 7 years. At the age of 7 years, children were evaluated for allergic sensitization and asthma based on symptom history, spirometry, exhaled nitric oxide, and airway reversibility. A questionnaire was administered to the parent regarding the child's asthma symptoms and other potential cofactors.
  
  
  RESULTS
  At the age of 7 years, 31 of 176 children (18%) were found to be asthmatic. Children living in a high ERMI value (≥5.2) home at 1 year of age had more than twice the risk of developing asthma than those in low ERMI value homes (<5.2) (adjusted odds ratio [aOR], 2.6; 95% confidence interval [CI], 1.10-6.26). Of the other covariates, only parental asthma (aOR, 4.0; 95% CI, 1.69-9.62) and allergic sensitization to house dust mite (aOR, 4.1; 95% CI, 1.55-11.07) were risk factors for asthma development. In contrast, air-conditioning at home reduced the risk of asthma development (aOR, 0.3; 95% CI, 0.14-0.83). A high ERMI value at 7 years of age was not associated with asthma at 7 years of age.
  
  
  CONCLUSIONS
  Early exposure to molds as measured by ERMI at 1 year of age, but not 7 years of age, significantly increased the risk for asthma at 7 years of age.
authors.affiliation: Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio 45267-0056, USA. Tiina.Reponen@uc.edu
authors.forename: Tiina
authors.initials: T
authors.lastname: Reponen
authors.forename: Stephen
authors.initials: S
authors.lastname: Vesper
authors.forename: Linda
authors.initials: L
authors.lastname: Levin
authors.forename: Elisabet
authors.initials: E
authors.lastname: Johansson
authors.forename: Patrick
authors.initials: P
authors.lastname: Ryan
authors.forename: Jeffery
authors.initials: J
authors.lastname: Burkle
authors.forename: Sergey A
authors.initials: SA
authors.lastname: Grinshpun
authors.forename: Shu
authors.initials: S
authors.lastname: Zheng
authors.forename: David I
authors.initials: DI
authors.lastname: Bernstein
authors.forename: James
authors.initials: J
authors.lastname: Lockey
authors.forename: Manuel
authors.initials: M
authors.lastname: Villareal
authors.forename: Gurjit K
authors.initials: GK
authors.lastname: Khurana Hershey
authors.forename: Grace
authors.initials: G
authors.lastname: LeMasters
mesh_terms: D017668:Age of Onset; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004271:DNA, Fungal / Q000032:analysis*; D004781:Environmental Exposure / Q000009:adverse effects; D005500:Follow-Up Studies; D005658:Fungi / Q000235:genetics* / Q000254:growth & development / Q000276:immunology; D006801:Humans; D007223:Infant; D008487:Medical History Taking; D011379:Prognosis; D012306:Risk; D013147:Spirometry; D011795:Surveys and Questionnaires
chemical_list: D004271:DNA, Fungal