Epidemiologic aspects of allergic aspergillosis

The incidence of allergic bronchopulmonary aspergillosis (ABA) seems much less in the United States than in Great Britain. The suggestion that there are differences in the atmospheric burden of A. fumigatus prompted the authors to evaluate skin reactivity to A. fumigatus in their clinic population. Immediate skin reactivity was found significantly less than to Alternaria, a common Midwest mold. Because of the association of A. fumigatus with decaying vegetation, compost piles in the St. Louis area were cultured. Hot or working piles were extremely rich in A. fumigatus while cold or finished piles were devoid of this organism. A group of nonatopic organic farmers showed no serum precipitating antibody to A. fumigatus. It is suggested that active asthmatics with immediate skin reactivity to A. fumigatus avoid exposure to working compost piles.