(1219) Investigating the Relationship Between Home Mold Exposure and Chronic Rhinosinusitis Subtype

Introduction: Mold exposure is linked to inflammation in various airway diseases and is a potential inciting factor in chronic rhinosinusitis (CRS). Environmental fungi can interact with the microbiome to affect immune responses and enhance disease. The link between mold and CRS is known in allergic fungal CRS. However, the impact of mold exposure on other CRS phenotypes and disease burden is unknown. This study compares home mold exposure with varying CRS phenotypes and evaluates the relationship with disease burden.

Methods: This IRB-approved pilot prospective cohort study from September 2023-January 2024 recruited subjects who underwent sinus surgery for CRS. Patients received mold growth plates, a hygrometer to measure humidity and temperature, and questions about the home environment (i.e. air conditioner, water damage, previous mold, etc). Mold growth was coded as yes/no and ordinally. Preop disease burden was analyzed with Sinonasal Outcomes Test (SNOT-22) and Lund-Kennedy endoscopic (LKE) scores, clinically important difference was 9 and 1.2 points, respectively. Descriptive analysis compared CRSsNP to CRSwNP.

Results: Recruited subjects (n = 19) had mean age 47 (sd = 15), 58% males, 79% White, 33% Black, and 47% Hispanic. Mold growth was seen in all CRSsNP (n = 3) and 81% of CRSwNP (n = 16), although concerning (5-8 colonies) and hazardous (9+ colonies) mold were only seen in CRSwNP. Preop SNOT-22 score was clinically significantly worse in no mold growth (78 ± 14) compared to mold (37 ± 18). Preop LKE was lower in mold exposed = 5.6 ± 3.3, compared to no mold = 7 ± 5.2. CRSsNP mold group had a higher preop SNOT-22 compared to mold-exposed CRSwNP. Water damage and prior home mold were associated with mold growth.

Conclusions: CRSsNP have a higher rate of mold growth in this pilot study as compared to CRSwNP, but CRSwNP had more severe mold exposure. Those with home mold growth have a lower SNOT-22 and LKE compared to no mold growth. This pilot study indicates that mold exposure may relate to CRS phenotypes and disease burden in different ways, warranting further investigation in a prospective powered study.