Asthma Prevalence and Mold Levels in US Northeastern Schools

Abstract

Asthma is among the most common chronic diseases of children in the United States (US). Mold exposures have been linked to asthma development and exacerbation. In homes, mold exposures have been quantified using the Environmental Relative Moldiness Index (ERMI) and higher home ERMI values have been linked to occupant asthma. In this analysis of the School Inner-City Asthma Study 2 (SICAS 2), we aimed to evaluate the ERMI’s applicability to measuring mold in schools compared to homes, to assess the relationship between the prevalence of asthma in schools and mold levels, and to examine the prevalence of asthma in relationship to students’ demographics and the physical characteristics of school-buildings. Northeastern US schools (n=32) and homes (n=33) were selected and the 36-ERMI molds were quantified in a dust sample from each classroom or home. School building characteristics, student demographics and asthma prevalence data were collected from the SICAS 2 study or obtained from government websites. Linear regression and mixed models were fit to assess the association of current asthma prevalence and physical characteristics of the school, make-up of the student body and the ERMI metric. Levels of outdoor Group 2 molds were significantly (p<0.01) greater in schools compared to homes and higher Group 2 levels in schools were linked to higher asthma prevalence for their students. The presence of AC in school buildings correlated significantly (p=0.02) with lower asthma prevalence. Higher mold levels in northeastern US schools were associated with an increase in students’ asthma.