Kraiwuth Kallawicha1,2, Ying-Chih Chuang1, Shih-Chun Candice Lung3, Chang-Fu Wu4,5,6, Bor-Cheng Han1, Yi-Fang Ting1, Hsing 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

Received: January 25, 2018
Revised: May 30, 2018
Accepted: May 30, 2018
Download Citation: ||  

  • Download: PDF

Cite this article:
Kallawicha, K., Chuang, Y.C., Lung, S.C.C., Wu, C.F., Han, B.C., Ting, Y.F. and Chao, H.J. (2018). Outpatient Visits for Allergic Diseases are Associated with Exposure to Ambient Fungal Spores in the Greater Taipei Area. Aerosol Air Qual. Res. 18: 2077-2085.


  • 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.


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 (viz., 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 the 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 critical determinants of allergic diseases. In addition, using LUR models to assess exposure to ambient bioaerosols is feasible.

Keywords: Bioaerosols; Acute conjunctivitis; Allergic rhinitis; Asthma; Land use regression (LUR).


Share this article with your colleagues 


Subscribe to our Newsletter 

Aerosol and Air Quality Research has published over 2,000 peer-reviewed articles. Enter your email address to receive latest updates and research articles to your inbox every second week.

77st percentile
Powered by
   SCImago Journal & Country Rank

2022 Impact Factor: 4.0
5-Year Impact Factor: 3.4

Aerosol and Air Quality Research partners with Publons

CLOCKSS system has permission to ingest, preserve, and serve this Archival Unit
CLOCKSS system has permission to ingest, preserve, and serve this Archival Unit

Aerosol and Air Quality Research (AAQR) is an independently-run non-profit journal that promotes submissions of high-quality research and strives to be one of the leading aerosol and air quality open-access journals in the world. We use cookies on this website to personalize content to improve your user experience and analyze our traffic. By using this site you agree to its use of cookies.