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 (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 ≥ 95^(th) 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 ≥ 95^(th) 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.
Highlights
Allergic diseases such as allergic conjunctivitis, rhinitis, and asthma are non-communicable diseases that affect individuals worldwide (Bachert et al, 2006; Reid and Gamble, 2009; Lunn and Craig, 2011; Henriksen et al, 2015)
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, respectively
Cladosporium was correlated with acute conjunctivitis in females at a concentration ≥ 95th percentile with RR = 2.90
Summary
Allergic diseases such as allergic conjunctivitis, rhinitis, and asthma are non-communicable diseases that affect individuals worldwide (Bachert et al, 2006; Reid and Gamble, 2009; Lunn and Craig, 2011; Henriksen et al, 2015). In addition to reducing quality of life, these diseases affect health care use and expenditure. To assess the health impact of ambient bioaerosols, one monitoring station is typically used as the primary source of exposure data (Dales et al, 2000; Lierl and Hornung, 2003; Atkinson et al, 2006; Harley et al, 2009; Raphoz et al, 2010; Chen et al, 2014a). Kallawicha et al, Aerosol and Air Quality Research, 18: 2077–2085, 2018 measured at only one or a few monitoring stations cannot be generalized to larger scale areas because of spatiotemporal variation in bioaerosol distributions. We successfully developed land-use regression (LUR) models to estimate the ambient bioaerosol levels in the Greater Taipei Area (Kallawicha et al, 2015a, b). The data were used to investigate the associations between exposure to ambient bioaerosols and allergic skin diseases, the results revealing positive relationships (Kallawicha et al, 2016)
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