title: The characteristics of indoor and outdoor fungi and their relation with allergic respiratory diseases in the southern region of Turkey.
abstract: Indoor and outdoor fungal exposure has been shown to be associated with the development of allergic respiratory diseases. The aim of the study was to investigate the types and concentrations of airborne fungi inside and outside homes and evaluate the association between fungal levels and allergic diseases in the southern region of Turkey. A total of 61 children admitted with respiratory complaints to the pediatric allergy clinic between September 2007 and November 2008 were included in this study. The air samples were obtained using the Air IDEAL volumetric air sampler longitudinally for 1 year. A comprehensive questionnaire was used for medical history and housing conditions. Skin prick test was performed to determine fungal sensitivity and spirometric indices were employed. The predominant indoor fungal species were Cladosporium (69.3 %), Penicillium (18.9 %), Aspergillus (6.5 %), and Alternaria (3.1 %). A strong correlation between indoor and outdoor fungal levels was detected for the Cladosporium species (p < 0.001, r = 0.72) throughout the year. Living in a detached home (p = 0.036) and the presence of cockroaches (p = 0.005) were associated with total indoor fungal levels. The presence of cockroaches (aOR 3.5; 95 % CI 0.95-13.10, p = 0.059) was also associated with fungal sensitization at the edge of significance. The statistical cutoff values of indoor and outdoor Cladosporium levels to predict symptomatic asthma were found to be >176 CFU/m(3) (p = 0.003, AUC 0.696; sensitivity 65.5 %; specificity 68.7 %) and >327 CFU/m(3) (p = 0.038; AUC 0.713; sensitivity 66.6 %; specificity 76.9 %), respectively. Children with respiratory symptoms are exposed to a considerable level of fungi inside and outside their homes. The prevention of fungal exposure may provide valuable intervention for respiratory diseases.
authors.affiliation: Department of Pediatric Allergy Immunology, Faculty of Medicine, Mersin University, 33343, Ciftlikkoy Kampusu, Mersin, Turkey. arikoglutugba@yahoo.com.
authors.forename: Tugba
authors.initials: T
authors.lastname: Arikoglu
authors.affiliation: Department of Pediatric Allergy Immunology, Faculty of Medicine, Mersin University, 33343, Ciftlikkoy Kampusu, Mersin, Turkey.
authors.forename: Sehra Birgul
authors.initials: SB
authors.lastname: Batmaz
authors.affiliation: Department of Microbiology, Faculty of Medicine, Mersin University, Mersin, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Coşkun
authors.affiliation: Department of Microbiology, Faculty of Medicine, Mersin University, Mersin, Turkey.
authors.forename: Feza
authors.initials: F
authors.lastname: Otag
authors.affiliation: Faculty of Medicine, Department of Biostatistics, Mersin University, Mersin, Turkey.
authors.forename: Didem Derici
authors.initials: DD
authors.lastname: Yildirim
authors.affiliation: Department of Pediatric Allergy Immunology, Faculty of Medicine, Mersin University, 33343, Ciftlikkoy Kampusu, Mersin, Turkey.
authors.forename: Semanur
authors.initials: S
authors.lastname: Kuyucu
mesh_terms: D000391:Air Microbiology / Q000592:standards*; D016902:Air Pollution, Indoor / Q000032:analysis*; D001230:Aspergillus / Q000254:growth & development / Q000276:immunology; D002648:Child; D004784:Environmental Monitoring / Q000379:methods*; D005260:Female; D005658:Fungi / Q000254:growth & development* / Q000276:immunology; D006798:Housing / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010407:Penicillium / Q000254:growth & development / Q000276:immunology; D012130:Respiratory Hypersensitivity / Q000453:epidemiology* / Q000276:immunology; D012882:Skin Tests; D014421:Turkey
keywords: Air sampling; Allergic diseases; Fungal sensitivity; House characteristics; Indoor fungi; Outdoor fungi