The Mold Health Effects Controversy

Deerfield Beach, Florida
By Albert F. Robbins , D.O., MSPH-FAAEM-CIE

1)POLLUTED INDOOR AIR:
"Studies have demonstrated adverse effects-including immunotoxic, neurologic, respiratory and dermal responses-after exposure to specific toxins, bacteria, molds or their products"
                            
2)MOISTURE CONTROL IS THE KEY::
"Dampness increases the risk of microbial contamination and can cause or exacerbate the release of chemical emissions from building materials and furnitures"

3)ENVIRONMENTAL AWARENESS:
"Molds that can produce mycotoxins under the appropriate environmental and competitive conditions can and do grow indoors. Damp indoor spaces may also facilitate growth of bacteria that can have toxic and inflammatory effects."

4)EXAMINE YOUR ENVIRONMENT (home, office, school):
"There is sufficient evidence of an association between the presence of "mold" (otherwise unspecified) in a damp indoor environment and upper respiratory tract symptoms"

5)WHO IS AT RISK?:
"Exposure to fungi in indoor environments is associated with severe respiratory infections in some severely immunocompromised persons. There is sufficient evidence of an association between exposure to Aspergillus species and pulmonary aspergillosis and aspergillomas in such persons."

6)CHILDREN AT GREATER RISK:
"There is limited or suggestive evidence of an association between the presence of "mold" (otherwise unspecified) in a damp indoor environment and lower respiratory illness in otherwise -healthy children"

7)WORSE INDOORS?:
"There is sufficient evidence of an association between the presence of "mold" (otherwise unspecified) in a damp indoor environment and cough"

8)ALLERGY OF THE AIRWAYS:
"There is sufficient evidence of an association between the presence of mold and bacteria in damp indoor environments and Hypersensitivity Pneumonitis (allergic alveolitis) in susceptible people"

9)CHEMICAL HYPERSENSITIVITY:
Microorganisms can produce volatile organic compounds (VOC's) They are produced through secondary metabolism-in Penicillium and Aspergillus-around the time of sporulation, when mycotoxins also tend to be produced. VOC's produced by building materials, paints, solvents, and combustion can irritate the mucous membranes of the eyes and respiratory tract and possibly the nerve endings of the common chemical sense either alone or in concert with with other volatile and semivolatile compounds produced by microorganisms"

10)INFLAMMATION OF THE AIRWAYS AND NERVOUS SYSTEM:
"Perceived pungency can produce reflex constriction of the airways and inflammation and result in nasal stuffiness, headache, malaise, memory loss, and reduced ability to concentrate, depending on the nature of the irritant, its concentration, and individual sensitivity."

11)MULTIPLE POLLUTANTS, not just molds!: "In buildings that have moisture induced damage, people can be exposed to a complex mixture of microorganisms, organic and inorganic dust, and volatile chemicals" (Dust mites, building materials, glucans, endotoxins  and ventilation problems may also contribute-CDC)
                                                     
12)POTENTIAL HEALTH RISK OF MOISTURE DAMAGE:
"Several factors might be considered in evaluating the severity of moisture damage. Four of these include the size of the damaged area, the presence of visible signs of moisture damage, the duration of its presence, and the building material on which the damage is observed"

National Academy of Sciences, Institute of Medicine
Damp Indoor Spaces, The National Academies Press, 2004

Potential Health Effects Associated with Inhalation Exposure to Molds and Mycotoxins, US Environmental Protection Agency, March, 2001: 

"Molds produce an enormous array of potentially allergenic compounds. Each mold produces many allergens of different potencies. Inhaling or touching mold or mold spores may cause allergic reactions in sensitive individuals. Allergic reactions to mold are common-these reactions can be immediate or delayed. Repeated exposure has the potential to increase sensitivity.

Many symptoms and human health effects attributed to inhalation of mycotoxins have been reported including: mucous membrane irritation, skin rash, nausea, immune system suppression, acute or chronic liver damage, acute or chronic central nervous system damage, endocrine effects and cancer. More studies are needed to get a clear picture of the health effects related to most mycotoxins. However, it is clearly prudent to avoid exposure to molds and mycotoxins"

EPA, 2001
                                                        

Position Statement of the American College of Occupational and Environmental Medicine (ACOEM): "Scientific evidence does not support the the proposition that human health has been adversely affected by inhaled mycotoxins (from mold) in the home, school, or office environment." 

www.acoem.org

Position Statement of the American Academy of Environmental Medicine, March 1, 2008: "Exposure to significant levels of indoor mold can cause acute or chronic dysfunction or injury to all organ systems including the respiratory, neurological, cardiovascular, genitourinary, gastrointestinal, musculoskeletal, immune (through both immediate and non-IgE mechanisms) and hematological systems. In addition to the resulting more commonly considered respiratory conditions such as asthma and rhinosinusitis, exposure to mold proteins and mycotoxins has been associated with fatigue, reduced concentration, imbalance, poor memory and hemorrhagic disorders. Mold contaminated buildings may well require prompt, serious remediation since avoiding further exposure is the first step in treatment as well as a major part of disease prevention" 

www.aaem.com