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Home exposure to moisture and mold is associated with poorer asthma control in children: CHAMPIASTHMA study
Margaux Sauvere1, Stéphanie Lejeune1,2, Flore Chagnon1,3
1Pediatric Pulmonology and Allergy Department, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire (CHU) Lille, Lille, France.
Background:
Deleterious indoor environment is a risk factor for poor asthma control in children.
Objective:
We assessed the association between exposure to moisture and/or mold (EMM) and asthma control in children.
Methods:
The CHAMPIASTHMA study is a multicenter cross-sectional observational study. Children with recurrent wheeze/asthma aged 1 to 17 years were stratified by EMM, as assessed by a standardized questionnaire administered to their parents. The primary outcome was asthma control according to Global Initiative on Asthma guidelines. Secondary outcomes were: control according to asthma control test or pediatric asthma control test score, exacerbations (unscheduled visits, oral corticosteroid receipt, and hospitalization), asthma treatment step, and mold sensitization. Clinical trial registration: NCT04918394.
Results:
Four hundred twenty-four patients were included, among whom 146 (34%) noted EMM. Patients with EMM more frequently had disease that was not controlled according to Global Initiative on Asthma guidelines (64 [45%] vs 90 [33%]; P = .03), and had lower asthma control test scores (22 [19-25] vs 24 [21-25]; P = .02), more frequent unscheduled visits (65 [45%] vs 86 [32%]; P = .02), and a trend for higher oral corticosteroids receipt in the past year (53 [37%] vs 74 [27%]; P = .09). There was no difference in asthma treatment step and hospitalization for exacerbations. Forty-two (12%) of 341 children were sensitized to molds, with no difference between the EMM and non-EMM groups (P = .85).
Conclusion:
The CHAMPIASTHMA study highlights that EMM is associated with poorer disease control and asthma outcomes in children. The search for EMM during scheduled visits should be systematic, especially in cases of uncontrolled asthma.
Insights
Exposure to moisture and/or mold (EMM) in indoor environments is linked to worse asthma control in children. Healthcare providers should systematically check for EMM in children with uncontrolled asthma.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Allergy and Immunology
Background:
- Indoor environmental quality is a significant factor influencing childhood asthma control.
- Poorly controlled asthma in children is often associated with detrimental indoor environments.
Purpose of the Study:
- To investigate the association between exposure to moisture and/or mold (EMM) and the level of asthma control in pediatric patients.
- To evaluate the impact of EMM on various asthma-related outcomes in children.
Main Methods:
- The CHAMPIASTHMA study employed a multicenter, cross-sectional observational design.
- Asthma control was assessed using Global Initiative on Asthma guidelines and validated asthma control tests.
- Exposure to moisture and/or mold (EMM) was determined via a parent-administered questionnaire for children aged 1-17 years with recurrent wheeze or asthma.
Main Results:
- Children with EMM exhibited significantly poorer asthma control as per Global Initiative on Asthma guidelines (45% vs 33%, P=.03).
- Patients exposed to EMM reported lower Asthma Control Test scores (22 vs 24, P=.02) and experienced more frequent unscheduled visits (45% vs 32%, P=.02).
- A trend towards higher oral corticosteroid use was observed in children with EMM (37% vs 27%, P=.09), though hospitalization rates and asthma treatment steps did not differ.
Conclusions:
- Exposure to moisture and/or mold (EMM) is demonstrably associated with diminished asthma control and adverse outcomes in children.
- Routine screening for EMM during clinical visits is recommended, particularly for children presenting with uncontrolled asthma symptoms.
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