Home exposure to moisture and mold is associated with poorer asthma control in children: CHAMPIASTHMA study

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.