| 英文摘要 |
Our aeroallergens monitoring database was the first dataset conducted in Taiwan to finish overall daily fungal spores year round. The seasonal distribution of fungal spores was first been well demonstration through time series daily data. Large day to day variation also been demonstrated in our database, and further indicated the intermittent sampling strategy in outdoor air might leading the misclassification of exposure. In southern Taiwan, the predominant fungal spore is Cladosporium, which contributed to 70% of total counts of spores and mostly with higher concentrations in winter season. It means total fungal spores are dramatically higher in winter season in southern Taiwan. This finding provided a very good support for our previous environmental measurements conducting in indoor environments, which also show the same patterns. Relative humidity in the air favor for three dominant fungal spores, Cladosporium, Ascospores, and Periconia, that comprised about 89% total spore counts. Our results also suggest Ascospores, Botrytis and Basidiospores were more hydrophilic for the spore counts will significantly increase after rainfall days. The growth and release of Ascospores, second dominant spore, was increasing in hotter and humid days. Moreover, Ascospores was significantly associated with increasing temperature and rainfall. This finding suggests a warmer and humid weather might at least contribute large increase of Ascospores in the air. The health implications need for further discussion and research.
Our study has analyzed, using generalized addictive models with Poisson regression model, the associations between the levels of daily fungal spores and frequencies of daily hospital admission in a major teaching hospital from 1 January to 31 December in 2002 in southern Taiwan. Time-series analysis, having filtered the seasonal trends and adjusted for the day-of the week cycles, weather factors, and air pollutants, was conducted to determine the influence of ambient spores on asthma hospital admissions.
The strongest association was observed at a time-lag of 2 days for effect of ambient Cladosporium concentrations on the number of clinical visits for childhood asthma (0-14 years old), and at a time-lag of 3 days for asthmatic visits by adults and the elderly. Children appeared to be more sensitive to the day-to-day changes of ambient Cladosporium spore counts; about 8.9% increase in childhood asthma visits with per 1000 spores/m3 increase in airborne levels. In contrast, only about 1.4% to 2.7% increases in the number of visits to asthmatic clinics by populations of 15-39, 40-64, and those above 65 years old.
Our study attempted to assess the burden of illness, namely fungus-induced asthma, in the population of southern Taiwan. The concentrations of airborne Cladosporium spore counts alone appeared to account for a significant proportion of clinical asthma visit, and childhood asthmatics seemed to be more sensitive to changes of daily fungal spores than the rest of the general population across different age groups. The effect of exposure to ambient fungal spores on the increasing number of visits remain even after controlling for the levels of different air pollutants and number of clinical visits for respiratory infectious diseases.
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