As far back as 1924 Prof Dr Willem Storm van Leeuwen from The Netherlands suggested that inhaled mould spores could cause asthma. The types of moulds widely known to cause respiratory allergy in humans include Aspergillus, Penicillium, Cladosporium and Alternaria. The allergic responses are mainly due to the inhalation of spores rather than mycelial/hyphal fragments. Allergic reactions to each spore type differ between individuals. Mould allergens also vary in the severity of the allergic reactions they induce. More people, for example, are more sensitive to Alternaria than to Cladosporium. Alternaria also produces more severe reactions, while Cladosporium generally only produces a mild reaction. Cladosporium and in particular Cladosporium herbarum, are often the major contributors to outdoor air-spora. Due to their high concentrations they are a major cause of inhalant allergy and allergic asthma in humans. Occupational pulmonary diseases are common in cheese industry (Penicillium roquefortii), breweries (Aspergillus clavatus) and in mushroom farms (Doratomyces sp).

Alternaria is cosmopolitan and ubiquitous in nature. It is currently comprised of about 40-50 species. Alternaria is a well recognized plant disease causing agent. Species of Alternaria are commonly isolated from dead plant materials, soil, food, and indoor air. Alternaria alternata has been isolated from numerous kinds of organic materials in damp situations, including textiles, stored food, canvas, cardboard and paper, electric cables, polyurethane, jet fuel, sewage and effluents. Airborne spores of Altenaria alternata and A. tenuissima are found in very high numbers in the outdoor environment during fall.

Alternaria alternata is a well recognized allergen with airborne spores and mycelial fragments being responsible for the allergic symptoms in individuals with rhinitis or bronchial asthma. Alternaria sensitivity can also lead to severe and potentially fatal asthma. Studies have shown that up to 70 % of mould-allergic patients have skin test reactivity to Alternaria. It has also been shown that prolonged heavy exposure to A. alternata spores and mycelial fragments mimics that of other allergens such as cat dander and dust mites. Since Alternaria is a seasonal mould then this type of allergy is more prevalent in the fall. A. alternata has also been recorded as an opportunistic pathogen causing skin diseases particularly in immunocompromised patients such as the bone marrow transplant patients.

The presence of Alternaria together with other moulds such as Ulocladium spp and Phoma spp, in indoor environment is indicative of humid conditions. Alternaria alternata is not commonly isolated from indoor building materials and in most instances spores found in indoor air environment may have originated from outdoor sources. A closely related mould, Ulocladium chartarum, which is very common in indoor environment is frequently misidentified in labs as A. alternata. U. chartarum is common on wallpaper and drywall, and has been isolated from emulsion paint, polyurethane, plywood and manila fibre.

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