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Outpatient Visits for Allergic Diseases are Associated with Exposure to Ambient Fungal Spores in the Greater Taipei Area

Category: Air Pollution and Health Effects

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DOI: 10.4209/aaqr.2018.01.0028
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Kraiwuth Kallawicha1,2, Ying-Chih Chuang1, Shih-Chun Candice Lung3, Chang-Fu Wu4,5,6, Bor-Cheng Han1, Yi-Fang Ting1, H. Jasmine Chao 1

  • 1 School of Public Health, Taipei Medical University, Taipei 11031, Taiwan
  • 2 Environmental Toxicology Program, Chulabhorn Graduate Institute, Bangkok 10210, Thailand
  • 3 Research Center for Environmental Changes, Academia Sinica, Taipei 11529, Taiwan
  • 4 Department of Public Health, National Taiwan University, Taipei 10055, Taiwan
  • 5 Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei 10055, Taiwan
  • 6 Institute of Environmental Health, National Taiwan University, Taipei 10055, Taiwan

Highlights

Validated LUR models were used to assess bioaerosol exposure levels.
Total fungal spores were associated with acute conjunctivitis and asthma.
Cladosporium was correlated with acute conjunctivitis in females.
Basidiospores were associated with allergic rhinitis in males.
Meteorological parameters were also associated with outpatient visits.


Abstract

Allergic diseases are prevalent worldwide, and may result from exposure to various substances. Exposure to ambient bioaerosols is a potential risk factor for allergic diseases; however, accurate exposure assessment is challenging due to the limited number of outdoor monitoring stations. In this study, the relationships between ambient bioaerosol exposure and allergic diseases (i.e., acute conjunctivitis, allergic rhinitis, and asthma) were evaluated using validated land-use regression (LUR) models to estimate the exposure levels. Data on the daily outpatient visits were retrieved from the Taiwan National Health Insurance Research Database. The total fungal spore count was associated with acute conjunctivitis in males at the second and third quartiles with relative risks (RRs) of 1.75 (95% confidence interval [CI] = 1.24, 2.48) and 1.32 (95% CI = 1.03, 1.70), respectively. It was also associated with asthma in both sexes when concentration ≥ 95th percentile with RRs = 3.06 (95% CI = 1.89, 4.95) in males and 1.73 (95% CI = 1.08, 2.76) in females. Cladosporium was correlated with acute conjunctivitis in females at a concentration ≥ 95th percentile with RR = 2.90 (95% CI = 1.40, 6.04). Basidiospores were associated with allergic rhinitis in males at the third and fourth quartiles with RRs = 1.88 (95% CI = 1.44, 2.45) and 1.49 (95% CI = 1.20, 1.84), respectively. Meteorological parameters including relative humidity and rainfall were also crucial factors associated with the number of outpatient visits. Our results revealed that ambient fungal spores are crucial determinants of allergic diseases. In addition, the use of LUR models is feasible for assessing the exposure of ambient bioaerosols.

Keywords

Bioaerosols Acute conjunctivitis Allergic rhinitis Asthma Land use regression (LUR)


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