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Environmental Factor, September 2012

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Infants exposed to specific molds have higher asthma risk

By Amanda Harper

Tiina Reponen, Ph.D.

Reponen was first author on a study last year (see story) that laid the foundation for her work with the three specific molds linked to asthma development. (Photo courtesy of UC)

Grace LeMasters, Ph.D.

Veteran grantee LeMasters is also a member of the National Advisory Environmental Health Sciences Council, which meets three times a year at NIEHS. A study by her group published earlier this year (see story) examined the role of secondhand smoke in boys and girls with asthma. (Photo courtesy of UC)

In the U.S., one in ten children suffers from asthma, but the potential environmental factors contributing to the disease are not well known. In a new study, partially funded by an NIEHS grant, Cincinnati-based researchers report new evidence that exposure to three types of mold during infancy may have a direct link to asthma development during childhood.

These forms of mold — Aspergillus ochraceus, Aspergillus unguis, and Penicillium variabile — are typically found growing in water-damaged homes, putting a spotlight on the importance of mold remediation for public health.

Lead author Tiina Reponen, Ph.D., and colleagues report these findings in the August 2012 issue of the Journal of Allergy and Clinical Immunology, the official scientific publication of the American Academy of Allergy, Asthma and Immunology.

Exposure in infancy linked to asthma at age 7

In a long-term population study of nearly 300 infants, researchers from the University of Cincinnati (UC), U.S. Environmental Protection Agency (EPA), and Cincinnati Children’s Hospital Medical Center assessed allergy development and the respiratory health of children, annually, for the first four years of life, and then again at age 7 — an early age for objective diagnosis of asthma in children. The team also monitored home allergens and mold. All infants enrolled in the study were born to at least one parent with allergies.

They found that 25 percent of children whose parents had allergies were asthmatic by age 7. Among the multiple indoor contaminants assessed, only mold exposure during infancy emerged as a risk factor for asthma at age 7.

“Previous scientific studies have linked mold to worsening asthma symptoms, but the relevant mold species and their concentrations were unknown, making it difficult for public health officials to develop tools to effectively address the underlying source of the problem,” explains Reponen, who is a professor in the UC College of Medicine’s environmental health department.

The UC-based team used the Environmental Relative Moldiness Index (ERMI), a DNA-based mold level analysis tool, to determine that exposure to Aspergillus ochraceus, Aspergillus unguis, and Penicillium variabile was linked to asthma development in the high-risk study population. The ERMI tool was developed by the EPA to combine analysis results from 36 different types of mold into one index that describes a home’s cumulative mold burden.

“This is strong evidence that indoor mold contributed to asthma development and this stresses the urgent need for remediating water damage in homes, particularly in lower income, urban areas where this is a common issue,” says Reponen. “Therapeutics for asthma may be more efficient if targeted toward specific mold species.”

Children included in this study were part of the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), a long-term population-based study of more than 700 children from the Greater Cincinnati area. CCAAPS looked at the effects of environmental particles on childhood respiratory health and allergy development. Participants were identified, during infancy, as being at high risk to develop allergies, based on family medical history.

Co-authors of the study include UC environmental faculty members James Lockey, M.D., David Bernstein, M.D., Linda Levin, Ph.D., Sergey Grinshpun, Ph.D., Manuel Villareal, M.D., Shu Zheng, Ph.D., and Grace LeMasters, Ph.D., principal investigator of CCAAPS. Stephen Vesper, Ph.D., of the EPA, Gurjit Khurana Hershey, M.D., Ph.D., and Patrick Ryan, Ph.D., of Cincinnati Children’s Hospital Medical Center, also contributed to this study.

In addition to NIEHS funding, the study was also supported in part by grants from the U.S. Department of Housing and Urban Development and EPA, through its Office of Research and Development.

Citation: Reponen T, Lockey J, Bernstein DI, Vesper SJ, Levin L, Khurana Hershey GK, Zheng S, Ryan P, Grinshpun SA, Villareal M, Lemasters G. 2012. Infant origins of childhood asthma associated with specific molds. J Allergy Clin Immunol; doi: 10.1016/j.jaci.2012.05.030 [Online 11 July 2012].

(Amanda Harper is a public information officer in the Office of Public Relations and Communications at the UC Academic Health Center. For more information about this study, contact Harper by phone at 513-558-4657 or by email at

Aspergillus unguis, Penicillium variabile, and Aspergillus ochraceus molds

Shown above are the molds Aspergillus unguis, left, Penicillium variabile, right, and Aspergillus ochraceus, top. (Photo courtesy of U.S. Environmental Protection Agency)

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