Novel Biomarkers to Assess Mold Exposure among Children with Asthma.

BACKGROUND:Household mold is a major problem in communities which face natural disasters such as hurricanes or flooding, and in homes with other sources of significant water intrusion; a biomarker for exposure to indoor mold could support public health investigations. METHODS:We analyzed serum from 132 children with asthma living in government-subsidized housing for six microbial volatile organic compounds (2-ethyl-1-hexanol, 2-heptanone, 2-hexanone, 3-methylfuran, 3-octanone, and geosmin) using GC-MS. Fewer than 10% of the samples for three compounds (2-ethyl-1-hexanol, 2-heptanone, and 2-hexanone) were quantified below the limit of detection. Associations between mold/water damage variables and microbial volatile organic compounds (mVOCs) were assessed via regression analyses, adjusting for urinary cotinine and self-reported home characteristics. RESULTS:Children with household mold (assessed by occupant report of visual mold, mold odor, or water damage) had 32% higher serum concentrations of 2-hexanone than those living in homes without reported mold or water damage. We investigated indoor tobacco use via urinary cotinine analysis of a "first morning void spot sample" (FMV) and found that children with higher urinary cotinine had significantly higher serum 2-ethyl-1-hexanol. We found that children in homes where residents reported tobacco smoking indoors had significantly higher serum 2-ethyl-1-hexanol compared with those without reported household smoke exposure. Tobacco smoke, indoor painting, gas stoves, and carpets were not confounders in the relationship between mVOCs and mold/water damage variables. CONCLUSION:2-hexanone, along with an index variable which included all detectable mVOCs in our panel, are promising biomarkers of recent mold exposure that could be used in concert with other detection methods.