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Review
. 2025 Mar;155(3):714-725.
doi: 10.1016/j.jaci.2024.11.027. Epub 2024 Nov 27.

Indoor bioaerosols and asthma: Overview, implications, and mitigation strategies

Karen C Dannemiller  1 , Laura A Conrad  2 , Sarah R Haines  3 , Yvonne J Huang  4 , Linsey C Marr  5 , Jeffrey A Siegel  3 , Sumaiya Hassan  3 , Jon C King  6 , Aaron J Prussin 2nd  5 , Austin Shamblin  7 , Matthew S Perzanowski  8
Affiliations
Review

Indoor bioaerosols and asthma: Overview, implications, and mitigation strategies

Karen C Dannemiller et al. J Allergy Clin Immunol. 2025 Mar.

Abstract

Aerosolized particles with a biological origin are called bioaerosols. Bioaerosols from plants, animals, fungi, bacteria, and viruses are an important class of environmental exposures that are clinically relevant to asthma. However, there are important differences in the pathways by which various bioaerosols affect asthma. Additionally, differences in individual susceptibility to different bioaerosols affect exposure reduction and mitigation strategies. Strategies to reduce exposures to potential triggers of asthma are routinely considered as part of standard clinical care and asthma management guidelines. Ventilation standards in buildings may reduce bioaerosol exposure for everyone, but they are not necessarily designed specifically to protect patients with asthma. Direct measurement of a bioaerosol is not generally necessary for practical applications where the relevant source of the bioaerosol has been identified. Different types of bioaerosols can be controlled with similar strategies that prioritize source control (eg, reducing resuspension, integrated pest management, controlling moisture), and these can be supplemented by enhancing air filtration. The goal of this review is to summarize the latest information on bioaerosols, including allergens, fungi, bacteria, and viruses, that have been associated with adverse asthma outcomes and to discuss mitigation options.

Keywords: Allergic sensitization; cat; dog; moisture; mold; particulate matter; pests; pet; respiratory illness; ventilation.

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Conflict of interest statement

Disclosure statement Funding was received from the US Department of Housing and Urban Development (grant OHHHU0057-20), the National Science Foundation (grant 1942501), and the National Institute of Environmental Health Sciences (grant P30 ES009089). The work that provided the basis for this publication was supported by funding under an award with the US Department of Housing and Urban Development. The substance and findings of the work are dedicated to the public. The author and publisher are solely responsible for the accuracy of the statements and interpretations contained in this publication. Such interpretations do not necessarily reflect the views of the US government. Disclosure of potential conflict of interest: K. C. Dannemiller has over the past 5 years received honoraria and/or travel support for speaking at university seminars and academic conferences. K. C. Dannemiller and J. C. King have submitted a patent application related to development of a new mold detection strategy. S. R. Haines has over the past 5 years received honoraria and/or travel support for speaking at an event/webinars. Y. J. Huang has over the past 5 years received honoraria and/or travel support for speaking at professional society meetings and academic conferences; received consultant fees/stock options as a scientific advisor for Alveolus Bio; and has received support for investigator-initiated research studies from Regeneron and Sanofi. J. C. King has received travel support for speaking at an academic conference. L. C. Marr has over the past 5 years received honoraria and/or travel support for speaking at an event/webinars. A. Shamblin has received travel support for attending an academic conference. J. A. Siegel reports receipt of honoraria and/or travel support for speaking at an event/webinars; donations of air cleaners to support his research program; and receipt of consulting fees for expert witness reports and testimony, with sources including air-cleaning and HVAC equipment manufacturers, testing/measurement equipment manufacturers, Canadian and US government agencies and nongovernmental organizations, and law firms. The rest of the authors declare that they have no relevant conflicts of interest.

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