AFRS is disproportionately identified in patients of low socioeconomic status living in warm, humid climates, and is expected to be due to environmental fungal species.

The study was done to check that either micro-geographic differences in fungal exposure contribute to the pathogenesis of AFRS or not, and to compare home fungal exposure of patients with AFRS to normative data and controls.

70 patients were included in the study. Patients with AFRS were compared to a control population with chronic rhinosinusitis with CRSwNP and comorbid atopy. Comprehensive demographics, SNOT-22 questionnaires, and endoscopy scores were compiled. A home fungal assessment was completed for each patient, along with detailed questions related to the home condition.

Patients with AFRS were more likely to be younger, African American, from a lower income bracket, and less likely to own their home.

The study concluded that there were no differences in total home fungal exposure levels between those with AFRS and atopic CRSwNP, despite differences in socioeconomic status. This suggests that absolute fungal levels may not be the primary driver in the development of AFRS, or that the fungal detection strategies utilized were not representative of patients’ overall fungal exposure.