title: Current asthma in schoolchildren is related to fungal spores in classrooms.
abstract: BACKGROUND
  The presence of visible mold in households is associated with asthma. However, the role of "classroom fungus" in the development of childhood asthma, as well as the fungal species that may lead to asthma, remains controversial. This nationwide school survey was conducted to investigate the correlation between fungal spores in classrooms and asthma in schoolchildren.
  
  
  METHODS
  From April to May 2011, a cross-sectional survey was conducted to assess allergic/asthmatic conditions in schoolchildren aged 6 to 15 years old in 44 schools across Taiwan. Personal histories and current asthmatic conditions were collected using a modified International Study of Asthma and Allergies in Childhood questionnaire. Fungal spores in classroom were collected using a Burkard Personal Air Sampler and counted under light microscopy. Three-level hierarchical modeling was used to determine the complex correlation between fungal spores in classrooms and childhood asthma.
  
  
  RESULTS
  The survey was completed by 6,346 out of 7,154 parents (88.7%). The prevalences of physician-diagnosed asthma, current asthma, and asthma with symptoms reduced on holidays or weekends (ASROH) were 11.7%, 7.5%, and 3.1%, respectively. The geometric mean spore concentrations of total fungi, Aspergillus/Penicillium, and basidiospores were 2,181, 49, and 318 spores/m3. Aspergillus/Penicillium and basidiospores were significantly correlated with current asthma and ASROH after adjusting for personal and school factors. Of those with current asthma, 41% reported relief of symptoms during weekends.
  
  
  CONCLUSIONS
  Classroom Aspergillus/Penicillium and basidiospores are significantly associated with childhood asthma and ASROH. Government health policy should explore environmental interventions for the elimination of fungal spores in classrooms to reduce the prevalence of childhood asthma.
authors.affiliation: Department of Environmental and Occupational Medicineqs, National Taiwan University College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
authors.forename: Chi-Hsien
authors.initials: CH
authors.lastname: Chen
authors.affiliation: School of Public Health, Taipei Medical University, Taipei, Taiwan.
authors.forename: H Jasmine
authors.initials: HJ
authors.lastname: Chao
authors.affiliation: Department of Environmental and Occupational Medicineqs, National Taiwan University College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan.
authors.forename: Chang-Chuan
authors.initials: CC
authors.lastname: Chan
authors.affiliation: Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan.
authors.forename: Bing-Yu
authors.initials: BY
authors.lastname: Chen
authors.affiliation: Department of Environmental and Occupational Medicineqs, National Taiwan University College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan. Electronic address: leonguo@ntu.edu.tw.
authors.forename: Yue Leon
authors.initials: YL
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D012574:Schools; D013172:Spores, Fungal; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology