***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Previous studies of how parental  atopy and exposure to dampness and molds contribute to the risk of asthma  have been mainly cross-sectional or prevalent case – control studies , where selection and information bias and temporality constitute problems . We assessed longitudinally the independent and joint effects of  parental atopy and exposure to molds in dwellings on the development of asthma in childhood . We conducted a population -based , 6-year prospect i ve cohort study of 1,984 children 1–7 years of age at the baseline in 1991 ( follow-up rate , 77 % ) . The study population included 1,916 children without asthma at baseline and complete outcome information . The data collection included a baseline and follow-up survey . The outcome of interest was development of asthma during the study period . The studied determinants were parental allergic diseases and four indicators of exposure at baseline : histories of water damage , presence of moisture and visible molds , and perceived mold odor in the home . A total of 138 ( 7.2 % ) children developed asthma during the study period , result ing in an incidence rate of 125 cases per 10,000 person-years [ 95 % confidence interval ( CI ) , 104–146 ] . In Poisson regression adjusting for confounding , parental atopy [ adjusted incidence rate ratio ( IRR ) 1.52 ; 95 % CI , 1.08–2.13 ] and the presence of mold odor in the home reported at baseline ( adjusted IRR 2.44 ; 95 % CI , 1.07–5.60 ) were independent determinants of asthma incidence , but no apparent interaction was observed . The results of this cohort study with assessment of exposure before the onset of asthma strengthen the evidence on the independent effects of parental atopy and exposure to molds on the development of asthma We assessed prospect ively the risk of increased incidence of respiratory symptoms after exposure to particular fungal genera in a susceptible population --namely , infants ( n = 880 ) at high risk for developing asthma . Days of wheeze or persistent cough , information on maternal allergy and asthma , socioeconomic variables , and housing characteristics were collected over the course of the infant 's first year of life . Exposure to mold was assessed by airborne sample s collected at one time early in the infant 's life . Fungi were identified to genus level , recorded as colony-forming units per cubic meter ( CFU/m3 ) , and then categorized into four levels : 0 ( undetectable ) , 1 - 499 CFU/m3 ( low ) , 500 - 999 CFU/m3 ( medium ) , and greater than or equal to 1,000 CFU/m3 ( high ) . Effects of mold on wheeze and persistent cough , adjusting for potential confounding factors , were examined with Poisson regression analyses . The two most commonly found genera were Cladosporium ( in 62 % of the homes ) and Penicillium ( 41 % ) . Cladosporium was associated with reported mold ( p < 0.02 ) and water leaks ( p < 0.003 ) . Rate of persistent cough was associated with reported mold [ Rate ratio ( RR ) = 1.49 ; 95 % CI , 1.18 - 1.88 ] . The highest level of Penicillium was associated with higher rates of wheeze ( RR = 2.15 ; 95 % CI , 1.34 - 3.46 ) and persistent cough ( RR = 2.06 ; 95 % CI , 1.31 - 3.24 ) in models controlling for maternal history of asthma and allergy , socioeconomic status , season of mold sample , and certain housing characteristics . We conclude that infants in this high-risk group who are exposed to high levels of Penicillium are at significant risk for wheeze and persistent cough BACKGROUND Although sensitization to fungal allergens is prevalent in inner-city children with asthma , the relationship between fungal exposure and morbidity is poorly understood . OBJECTIVE We examined relationships between fungal sensitization , exposure , and asthma morbidity in inner-city children . METHODS Participants were 5 to 11 years old and enrolled in the Inner-City Asthma Study . This report includes the subset of children with at least 1 positive skin test ( PST ) response to a fungal allergen extract ;  for these children , indoor and outdoor airborne culturable fungi levels were measured at baseline and throughout the 2-year study . Asthma morbidity measures were collected prospect ively . The primary outcome was symptom days per 2 weeks . RESULTS At baseline , children with a PST response to a fungal allergen extract had significantly more symptom days compared with those without a PST response to any fungal allergen extract ( 6.3 vs 5.7 days per 2 weeks , P = .04 ) . During the study , increases in total fungal exposure and indoor Penicillium species exposure were associated with increases in symptom days and asthma-related unscheduled visits . Indoor exposures to total fungi and to Penicillium species were associated with significant increases in unscheduled visits , even after controlling for outdoor fungal levels . Adverse effects associated with exposure to a specific fungus were stronger among children with PST responses to that fungal allergen extract compared with those seen in children with negative skin test responses . CONCLUSION Outdoor fungal exposure is primarily associated with increased asthma symptoms and increased risk of exacerbations in this population Previous cross-sectional and prevalent case-control studies have suggested increased risk of asthma in adults related to dampness problems and molds in homes . We conducted a population -based incident case-control study to assess the effects of indoor dampness problems and molds at work and at home on development of asthma in adults . We recruited systematic ally all new cases of asthma during a 2.5-year study period ( 1997 - 2000 ) and r and omly selected controls from a source population consisting of adults 21 - 63 years old living in the Pirkanmaa Hospital district , South Finl and . The clinical ly diagnosed case series consisted of 521 adults with newly diagnosed asthma and the control series of 932 controls , after we excluded 76 ( 7.5 % ) controls with a history of asthma . In logistic regression analysis adjusting for confounders , the risk of asthma was related to the presence of visible mold and /or mold odor in the workplace ( odds ratio , 1.54 ; 95 % confidence interval , 1.01 - 2.32 ) but not to water damage or damp stains alone . We estimated the fraction of asthma attributable to workplace mold exposure to be 35.1 % ( 95 % confidence interval , 1.0 - 56.9 % ) among the exposed . Present results provide new evidence of the relation between workplace exposure to indoor molds and adult-onset asthma Higher values of the environmental relative moldiness index ( ERMI ) , a DNA-based method for quantifying indoor molds , have been associated with asthma in children . In this study , settled dust sample s were collected from the homes of adults with asthma , rhinitis , or both conditions ( n=139 homes ) in Northern California . The ERMI values for these sample s were compared to those from dust collected in homes from the same geographic region r and omly selected as part of the 2006 American Healthy Home Survey ( n=44 ) . The median ERMI value in homes of adult with airway disease ( 6 ) was significantly greater than median ERMI value ( 2 ) in the r and omly selected homes ( p<0.0001 ) . In this study in Northern California , the homes of adults with asthma had ERMI values consistent with a heavier burden of indoor mold than that measured in other homes from the same region This study was undertaken to examine the seasonal variations of domestic Der p 1 , Der p 2 , and endotoxin on mattress and airborne fungal concentrations in homes of asthmatic and nonasthmatic children in southern Taiwan , where temperature and relative humidity are usually high throughout the year . A group of asthmatic children ( 10 - 12 years old ) were selected r and omly based on a citywide question naire survey . The nonasthmatic children were chosen to be in the comparison group by matching in age , gender , and proximity of residence . Environmental sampling of domestic microbes was conducted once a month for a year . Twelve calendar months were grouped into spring , summer , fall , and winter according to weather data ( mainly average temperature and humidity ) from the Central Weather Bureau . Dust sample s from a child 's mattress and airborne sample s from a child 's bedroom were collected and analyzed for allergens of Der p 1 and Der p 2 , endotoxin , and fungi respectively . Results show that about 65 % of children 's mattresses in our region have Der p 1 levels greater than 2 microg/g . It is also apparent that most airborne fungal concentrations found in homes of either asthmatic or nonasthmatic children are higher than the recommended levels of concern . The predominant genera are Cladosporium , Aspergillus , Penicillium , Alternaria , and yeast . In addition , seasonal effects seem to be a critical factor for the concentrations and distributions of domestic endotoxin in these study homes . The implication of long-term exposure to these high levels of environmental microbes and how their effects vary with seasons remain to be further characterized BACKGROUND Atopy is known to be important for childhood asthma , but this is to our knowledge the first study on its relation with development of asthma in adulthood . OBJECTIVES We addressed the role of atopy , measured as total IgE and Phadiatop , and of specific IgE antibodies to mites and molds in development of adult-onset asthma . METHODS A population -based incident case-control study was conducted in the Pirkanmaa District in Southern Finl and . All new clinical ly diagnosed cases of asthma 21 - 63 years of age were recruited 1997 - 2000 in the study district . A r and om sample of the source population formed the controls . A total of 485 cases and 665 controls provided a serum sample . Diagnosis of asthma was based on demonstration of reversibility in lung function investigations . Subjects with previous asthma were excluded .  Phadiatop score and IgE antibodies were analyzed with the UniCAP system . RESULTS The adjusted odds ratio of asthma increased with total IgE and Phadiatop score in a dose-dependent pattern . IgE antibodies to house dust mite and storage mite were significantly related to an increased risk of asthma . Among molds , increased risk of asthma was seen in relation to IgE antibodies to Aspergillus fumigatus and Cladosporium herbarum . Population attributable fraction due to sensitization to common aeroallergens was 30 % ( 95 % CI , 23 - 41 ) . CONCLUSION Atopy is a strong determinant of asthma in adulthood . Specific IgE antibodies to mites and some molds are significantly related to increased risk of adult-onset asthma . A considerable fraction of adult asthma could be prevented by measures to reduce atopy Many studies report that damp housing conditions are associated with respiratory symptoms . Less is known about mechanisms and possible effect modifiers . Studies of dampness in relation to allergic sensitization and eczema  are scarce BACKGROUND Data for trends in prevalence of asthma , allergic rhinoconjunctivitis , and eczema over time are scarce . We repeated the International Study of Asthma and Allergies in Childhood ( ISAAC ) at least 5 years after Phase One , to examine changes in the prevalence of symptoms of these disorders . METHODS For the ISAAC Phase Three study , between 2002 and 2003 , we did a  cross-sectional question naire survey of 193,404 children aged 6 - 7 years from 66 centres in 37 countries , and 304,679 children aged 13 - 14 years from 106 centres in 56 countries , chosen from a r and om sample of schools in a defined geographical area . FINDINGS Phase Three was completed a mean of 7 years after Phase One . Most centres showed a change in prevalence of 1 or more SE for at least one disorder , with increases being twice as common as decreases , and increases being more common in the 6 - 7 year age-group than in the 13 - 14 year age-group , and at most levels of mean prevalence . An exception was asthma symptoms in the older age-group , in which decreases were more common at high prevalence . For both age-groups , more centres showed increases in all three disorders more often than showing decreases , but most centres had mixed changes . INTERPRETATION The rise in prevalence of symptoms in many centres is concerning , but the absence of increases in prevalence of asthma symptoms for centres with existing high prevalence in the older age-group is reassuring . The divergent trends in prevalence of symptoms of allergic diseases form the basis for further research into the causes of such disorders Airborne fungi were collected during the summer and winter seasons . A N6 And ersen sample r was used inside and outside the homes of 46 asthmatic children , 20 atopic children , and 26 nonatopic control children in the Taipei area . In addition , host and house characteristics were obtained by question naire . The indoor fungus concentrations of asthmatic and control groups were higher than those in atopic groups in summer , but there were no differences in total fungus concentrations among three groups in winter . Concentration differences among these three groups also occurred for Cladosporium and Penicillium in summer and for Aspergillus , Cladosporium , Penicillium , and ye 
    Output:
    
RESULTS Cladosporium , Alternaria , Aspergillus , and Penicillium species were found to be present in higher concentrations in homes of asthmatic participants .
Exposure to Penicillium , Aspergillus , and Cladosporium species were found to be associated with increased risk of reporting asthma symptoms by a limited number of studies .