Relationship of airborne fungal spores to epidemiological data on respiratory disease: a systematic review

Abstract Exposure to fungal spores is associated with various types of respiratory health problems, and volumetric suction particle samplers have been used to estimate their concentrations in the atmosphere. This systematic review analyzes the sampling of fungal spores in outdoor air worldwide and its relationship to epidemiological data on respiratory disease. Ninety-four studies were identified that met the following inclusion criteria: They were original studies published in English or Spanish between 2010 and 2024, used active volumetric impact samplers, and identified the type of fungal spores in air. Most of the studies were conducted in Europe, with a duration of 1 to 2 years. The fungal taxa with the highest records were Alternaria sp. and Cladosporium sp. Only 13% of the studies correlated fungal spore concentrations with epidemiological variables; however, 77% of these studies concluded that there is a clear relationship between airborne fungal spore concentration and the occurrence of respiratory symptoms in the sensitized population. Therefore, this study provides an elaborate review of recent airborne fungal spore surveillance issues worldwide, attempting to include different perspectives of recent research on outdoor volumetric sampling, including epidemiological analysis.