Could a 1911 Farmhouse have healthier indoor air than a new home Part 3

Part 3
We’ve talked alot about the history and events that led us to the indoor air quality problems that we currently face. Today, we are going to focus on building materials and mold.
In 1979, the use of plaster, for walls and ceilings, was discontinued. Plaster does not support the growth of mold or bacteria. In its place gypsum board was substituted. To this day it is still in use. Gypsum board is really nothing more than thick cellulose paper.
You may have already guessed the connection. Yes – mold exists in nature to DEGRADE cellulose into basic organic matter. Trees, leaves, limbs, all reduced to basic organic molecules by these tiny organisms. Add to this that most of these home building products are left outside for weeks and sometimes months, on site, before they are installed into homes being built in subdivisions. It has been noted that many of these gypsum board pieces already have black mold growing on them as they were being installed. Now we have homes that have very little fresh air exchange AND we have enclosed fungi on material that they naturally reduce in the forest. All we need is to add the magic ingredient – water. It does not have to be a water intrusion, as in a roof leak or bathtub overflow. It can be in the simple form of humidity. Humidity that stays consistently above 50 RH allows fungi to form reservoirs of growth. By the way, Atlanta averages 68%RH during the year.
Lets add a couple more ingredients that assist in making our homes a potentially hazardous environment. In the 1960’s carpeting our homes became big business. Schools followed the trend. In the 1980’s we went from having one parent home to no one home. Family members now work at least one full time job each and in many instances have a part time position, as well. Dust and dirt are being ground into our carpets, surface dust collects on shelves and ceiling fans. Family members are too tired to keep up the cleaning schedule of our grandparents. What is attached to the dirt and dust? Fungi spores. Our research has demonstrated that our carpets, uncleaned and uncared for are major breeding grounds for fungi. And all we had to add was what? Water – relative humidity above 50%. Now we have two hazards working against us – gypsum board and carpeting in homes with high humidity or water intrusion. It doesn’t end there either. We have HVAC systems that run almost constantly in the summer months. The filters that would keep out contamination are, in many cases not the right size or the correct capacity to be very useful. Fungi pass through the filters and land on areas inside the HVAC where bacteria have already colonized. Mycotoxins and endotoxins are produced and passed into the living area. And what else comes in with the microbiological contaminants? Remember the dust and dirt in the carpets and surface dust? Much of that came in through the HVAC and was spread all through the home by air motion. Look in almost any home or business and see fungi growing on the dust that has accumulated on supply and return vents. Here is an area that does not need to be a hazard. With the correct filter type, preferably a MERV 8 rating, contaminants will be kept out of the HVAC system. In addition, if one is to employ a dehumidifier in their home and basement, humidity can be controlled to the 50%RH recommended levels. This is important to keep the fungi from growing, but also to keep dust mites from proliferating. Dust mites are commonly found in carpeting and live on human skin scales that have fallen to the carpet. Dust mites are considered a major trigger for Asthma. Another good reason to use a dehumidifier in the summer months is to save money on electrical costs. Before one degree of temperature is reduced by the HVAC, it must first remove the humidity from the air. Most air conditioning units spend the majority of their time removing the humidity rather than cooling. With the use of a dehumidifier, the water in the air is removed efficiently to allow the air conditioning to do only one thing – cool the air. This will also allow you to keep your temperature at a higher level in the home, as it is the humidity that creates the uncomfortable feeling of warmth.
So we have identified three areas of concern: gypsum board (especially in basements), carpeting and surface dust, HVAC systems. These are not the only concerns – far from it, but these are the areas where we must concern ourselves with the growth of mold.

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Could a 1911 farmhouse have healthier air than a new home Part 2

Part 2 — Mystery in Philadelphia – politics and death
During the 1973 Israeli – Egyptian war in the Golan Heights, England and the US sided with Israel. This provoked a drastic response from the Arab OPEC nations. They placed an embargo on oil bound for England and the US. Oil prices jumped and shortages became the new reality. Here in the US we were advised by our government that we would need to begin conserving energy. Among other things, this meant tightening our windows and doors to fill drafty leaks. We were asked to put an insulating blanket around our water heaters. The president asked us to lower our heat in the winter and raise our thermostats in the summer. Of all of the measures, though, the one that would quickly cost the lives of American citizens was asking everyone to lower their water heaters by 10 °F from the then accepted 170°F. In 1976, the politics of oil was about to kill 29 Americans and sicken 221 more in Philadelphia, Pa.
During an American Legion Convention, in Philadelphia, suddenly, elderly veterans began arriving at local hospitals with a severe pneumonia. Then the deaths began, one followed by another and another and another. The physicians involved had no idea what was accelerating the pneumonia in such a rapid manner. Whatever the agent was, it was extremely virulent and NEW. It was thought to be bacterial or viral, but it was not being isolated or identified. How do you treat something you have never seen before? Worse, the pneumonia accelerated much more rapidly than anything previously seen. The story spread just as rapidly as the pneumonia. Soon the entire country was gripped by a panic. Was this the “killer virus” we had been promised was coming in our time? Parents kept children home from school. People began wearing surgical masks so as not to breathe in a potentially fatal organism. Some just stopped coming out of their homes. The stories could be seen every night on the national news.
Finally, the outbreak subsided. No one knew why it had begun and no one had any idea why it ended. Among the casualties – the hotel that housed the veterans and their families. It went unoccupied and eventually filed for bankruptcy. In the following years, a maintenance worker, at a hospital, several hundred miles away would die from the very same pneumonia. This time, a physician at the hospital decided to track the maintenance worker’s steps before he had become sick. The agent of the pneumonia was isolated. It proved to be a bacterium. It was eventually named Legionella pneumonphila, for the members of the American Legion in Philadelphia, who had died from it. The physician, additionally, was able to determine how the worker had contracted the bacterium. It appears that the Legionella was growing rapidly in a cooling tower on top of the hospital. The tower was leaking warm water and steam was rising from puddles it created. The worker inhaled the bacteria in large quantities from the rising steam. The bacteria then was released into the deep recesses of the worker’s lungs. As the general population had not been exposed to this bacteria previously, it had damaging and fatal effects on its victims.
Why 1976? Why at the American Legion Convention? Why at that hospital?
The answer was in the lowering of the water heaters by 10 degrees F. Currently water heaters are set at 140°F. This is much lower than in the early 1970’s. Bacteria are killed in water heaters at the higher temperatures of the 1970’s. With the lower temperature most of the bacteria are still killed, except for Legionella. The Legionella proliferate and are dispersed into the deep recesses of the lung by the mist produced in bathroom showers. At the American Legion Convention, the victims were killed by merely taking a shower in their bathrooms. The worker at the hospital was killed because he had no protective mask , which would have filtered out the bacteria.
Since the original outbreak, it is now recognized that Legionella is ubiquitous in fresh water. It is probably in every home and workplace’s water supplies. Although, the solution would be to either raise the temperature in water heaters back to 170°F or to treat cooling towers with bactericides, the US government has chosen to take no action, which has led to thousands of deaths since the original outbreak. Legionella is most often contracted in home showers, grocery store misters in the produce area and in hot tubs that have not been treated with bactericides. In every case the bacteria is transmitted through steam or misting. Fortunately, the pneumonia responds very well to erythromycin, if caught early enough.
People most at risk are those with compromised immune systems, smokers, elderly, and males that are overweight and smoke.
Tomorrow part 3 – mold in homes

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Could a 1911 Farmhouse have healthier indoor air than a new home ?

A Multi-Part Series

Part 1  Overview

As so many issues in life, there are several answers to that simple question.

Most farm homes in 1911 were heated with wood stoves and lit with kerosene lanterns and candles.  Electric power plants were in their infancy.  By 1930, it is estimated that only 10-25 percent of rural America had electricity.  Heating and air conditioning was also not readily available in the early 20th century.  Rural homes relied on wood stoves   although some were able to install steam radiators in each room.  Air conditioning was not readily available until the 1950’s.

This is not just the history of the 20th century for me personally.  I grew up in a farm house that was constructed in 1929.  As a child in the 1950’s my parents were still converting from kerosene lamps to electricity in our barns.  The heating (to this day) was, and is, by steam radiators.

Homes built in the early 20th century were constructed with “real” wood and plaster.  They also were painted with lead paint.   Homes today are constructed with particle board and gypsum board.  The difference;  gypsum board is the “food of the gods” for fungi, and particle board, when wet, becomes a feast for fungi and bacteria, as it falls apart and bulges.  As we know, lead paint is no longer legal for use, although lead paint in older buildings is a current issue for children’s learning health. 

Water quality and outside air quality is an issue that differs dramatically over the last 100 years.   Plastics and non degradable products many of which pose a carcinogenic risk, pollute our environment in the 21st century, especially with the weakening of environmental laws during the last 10 years.  The use of fossil fuels was, and is, a problem air pollutant, directly related to Asthma.

Microbiologically, the fauna and flora of the country has not changed much in 100 years.  What has changed is what we find inside the building envelope.  Interestingly, health care officials in the 19th century recognized that the indoor air was critical in the health of children.  More about the history in Part 2 and how that relates to today.

Tomorrow, Part 2

What political decisions in the 1970’s and 1980’s determined current indoor air quality?  Fungi in the indoor air.

Have a great day,  Rick

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Mold: Action by State and Federal Agencies

There are no mandated actions specific to molds and indoor air quality required by any state or federal agencies. The U.S. EPA Indoor Air Quality website states, “Standards or Threshold Limit Values (TLVs) for airborne concentrations of mold, or mold spores, have not been set. Currently, there are no EPA regulations or standards for airborne mold contaminants.”
 
No ‘mandates’ do not equal no action

In response to public concern, some state and federal agencies have made available a variety of documents related to mold and indoor air quality. The majority of these publications focus on commercial building and school building infestation and remediation. However, there are a few publications available which are geared specifically toward the general public and residential exposure. Although, every effort was made to ensure that this list is all inclusive, it is possible that at the time of publication some documents may not have been discovered.
 
State Government: California

In response to increasing queries with regard to mold toxicity, the California Department of Health Services Indoor Air Quality Program has developed a website that includes a variety of documents related to this issue. Included in the selection is a document specific to residential exposure titled Mold In My Home: What Do I Do? 
 
The Occupational Health Branch of California Department of Health Services (OHB) is mandated to review new and emerging occupational hazards and propose new regulations to the California Division of Occupational Safety and Health (Cal OSHA). As a result of a proposal by the OHB, Cal OSHA is looking at adding molds  to the sanitation standard for office buildings and workspaces. OHB has created a “Molds in the Indoor Workplace” handout which addresses these concerns. 
  
Federal Government

The U.S. EPA has published recommendations on the cleanup of mold and control of moisture as part of its informational package titled “IAQ Tools for Schools.” Federal guidelines regarding mold remediation are anticipated in a subsequent publication, “Mold Remediation in Schools and Commercial Buildings.” EPA staff states that the guidelines are practical and thorough and focus on commercial buildings (including multi-family dwellings) and schools. Staff also asserts that the guidelines have applicability to residential infestation as the underlying principles for remediation are the same. The document is anticipated to be available online at the U.S. EPA website by the third week in March 2001.
 
Federal OSHA refers to molds as a potential indoor air quality concern in the OSHA Technical Manual, Section III, Chapter 2. This document suggests guidelines to employers on how to respond to employee complaints regarding indoor air quality, including recommendations for increasing indoor air quality and removal of offending organisms. Molds are one of several air contaminants mentioned as possible causes of building-related illnesses. According to Ira Wainless, an industrial hygienist with OSHA, there are no plans for further action with regard to mold as an indoor air contaminant at this time.
 
Nationwide: State and Local governments

Several state and local agencies and universities across the United States have begun to address the issue of mold as an indoor air contaminant through the publication of articles and informational pamphlets discussing health effects, prevention, and remediation of indoor molds. Nationwide, agencies and universities offering informational materials include: Kansas Department of Health and Environment; Kansas State University; Minnesota Department of Health; Montana State University; New Jersey Department of Health and Senior Services, Public Employees Occupational Safety and Health Program; New York City Department of Health, Bureau of Environmental & Occupational Disease Epidemiology; North Carolina State University; Texas Department of Health; and Washington State Department of Health. The Canadian government has also conducted research regarding mold and indoor air quality.
 
Why are molds not on the Proposition 65 list of chemical contaminants? Proposition 65 requires that the Governor publish a list of chemicals that are known to the State of California to cause birth defects, reproductive harm, or cancer. Given that toxic molds are not classified as chemicals, they do not currently qualify for inclusion on the list.

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Setting Mold Exposure Limits

Unfortunately, due to the variances in personal sensitivities and the vast array of molds (by some estimates over 100,000) it has been impossible to set exposure limits for molds that can be applied to all humans. Research regarding exposure limits and the effects of  ingesting molds are readily available. However, due to the limitations of currently available science, few studies exist regarding the exposure limits and effects of inhaled molds on individuals, this is due primarily to the absence of biomarkers specific to molds.

Biomarkers are chemicals in the body which have a particular molecular feature that make it possible to measure if an individual has been exposed to disease causing organisms as well as the progress of disease or the effects of treatment. At present time there are no known biomarkers that can prove that an individual has been exposed to molds. Therefore, traditional means of proving the correlation between exposure and symptoms is impossible. The lack of biomarkers limits our ability to genuinely link indoor mold exposure to specific illnesses. New York City Department of Health Guidelines explains: “Susceptibility varies with the genetic predisposition, age, state of health, and concurrent exposures. For this reason, and because measurements of exposure are not standardized and biological markers of exposure are largely unknown, it is not possible to determine ‘safe’ or ‘unsafe’ levels of exposure for people in general.”
 
Regarding infant exposure, the American Academy of Pediatrics Committee on Environmental Health in April 1998 stated that physicians should make every effort to ensure that infants less than one year of age avoid chronically moldy, water-damaged environments.
 
Several population-based studies make the correlation between mold exposure via inhalation and health effects. A comprehensive review of available literature relating to the health effects of mold performed by the Federal-Provincial Working Group on Mycology Air Quality in Public Buildings (a Canadian Government sponsored group) showed that such studies “have consistently detected an association between respiratory symptoms and home dampness and mould growth, but causality in these studies has not been established. Until the magnitude of population risk is known, it would be prudent, based on current evidence, to remediate indoor sources conducive to fungal growth.”
 
All resources reviewed agree that those most at risk for adverse health effects related to mold exposure are infants, the elderly, the chronically ill, severely immuno-compromised individuals such as those undergoing chemotherapy, individuals who have had organ or one marrow transplants, and persons with HIV/AIDS.

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Toxic Molds & Indoor Air Quality

While there are no state or federal statues or regulations regarding mold exposure and indoor air quality, molds are increasingly being suspected as the cause of a variety of illnesses related to inhalation exposure. McNeel and Kreutzer explain that in the 1970s and 1980s mold contamination was identified as the primary cause for poor air quality in only 5% of more than 500 National Institute for Occupational Safety and Health (NIOSH) indoor air quality investigations. From 1986 to 1996, however, molds were the primary source of contamination 35-50% of the time. They note, “This change has been attributed at least partially to a paradigm shift from chemical contaminant-based investigations to an interdisciplinary approach combining evaluation of physical, chemical and microbial constituents of indoor air environments.” In other words, until recently, we didn’t look for molds.
 
According to Chris Gerber, an environmental consultant with nationally recognized testing and consulting firm Restoration Consultants, 70-80% of mold problems investigated by his employer in the past five to seven years have been in newly constructed buildings and newly constructed residences. Mr. Gerber attributes this high incidence of growth primarily to poor construction practices, the use of substandard materials, and increased air tightness of new construction techniques. He explains that increased air-tightness of newly constructed residences and office buildings can allow moisture to become trapped in exterior walls, creating an environment conducive to mold growth. Gerber further explains that in buildings with mod problems, centralized heating and air-conditioning systems can pick up contaminants and re-circulate them throughout the building thus potentially spreading the infestation.
 
Jed Waldman, Chief of the California Department of Health Services Indoor Air Quality Program, suggests that regardless of construction practices, certain climate related events, such as flooding and the La Niña experienced two years ago (which left most of California very cold and very wet), can cause even the most carefully constructed building to support mold growth. With regard to indoor air quality, molds have been implicated in office buildings, schools, and residences as contributing to the cause of illness in humans:

Sick Building Syndrome (SBS)

Although not attributed exclusively to molds, this is a term “used to describe situations in which building occupants experience acute health and comfort effects that appear to be linked to time spent in a building” because all other probable causes have been ruled out. Symptoms include headaches; eye, nose, and throat irritation; dry cough; dry or itchy skin; dizziness and nausea; difficulty in concentrating; fatigue; and sensitivity to orors.
 
Sick building syndrome is attributed to inadequate ventilation, chemical contaminants from indoor and outdoor sources, and biological contaminants such as molds, bacteria, pollens, and viruses. In the paper, Sick-Building Syndrome and Building Related Illnesses, Theodore Passon, James W. Brown, and Seth Mante explain how increased air tightness of buildings in the 1970s, as a means of reducing energy consumption, has created environmental conditions conducive to the “proliferation of microorganisms [including mold] in indoor environments.” Once growth has occurred, harmful organisms can be spread by improperly designed and maintained ventilation systems.
 
Poor Indoor Air Quality in Schools

A 1998 survey of literature published on indoor air quality, ventilation and health symptoms in schools performed by Lawrence Berkeley National Laboratory states that health problems in schools related to indoor air quality are very similar to those symptoms reportedly experienced as sick building syndrome.  The survey also revealed that microbiological pollutants, along with volatile organic compounds, CO, and CO2, were some of the most commonly measured air pollutants in schools, adding that fungal spores, bacteria, and allergens may be of particular concern. The surgery cites water damage leading to mold contamination as the second most frequently reported building-related problem.
 
The United States government’s General Accounting Office reports that nationwide one in five schools reports having indoor air quality problems. Consequences of poor indoor air quality in schools include: increasing risk of long and short-term health problems in teachers and students; a negative impact on students’ ability to learn due to physical symptoms; reduced productivity of teachers; destruction of school equipment, including text books; and negative publicity for the school resulting in strained relationships among teachers, parents, and administrators.
 
Illness related to residential exposure

Molds are believed to be one possible cause of certain severe adverse health impacts in children and adults in their homes. A few extreme examples include:

1. A Foresthill, California, couple, after realizing remediation was too expensive, recently burned their home to the ground. The family claims that exposure to mold infestation caused respiratory problems, nose bleeds, rashes, and other illnesses in family members. They believe, in their case, that rebuilding is less costly than remediation.

2. Residents of four low-income housing apartment complexes in the Hunters Point section of San Francisco, California, blame toxic molds for a myriad of illnesses including rashes, hacking coughs, respiratory problems, headaches, nosebleeds, and high blood pressure. Statewide, similar claims have occurred in other complexes.

3.  A Dripping Springs, Texas, couple’s 11,500 square-foot home was quarantined after molds were alleged to have caused stomach problems, diarrhea, vomiting, severe respiratory scarring and other maladies in their son, as well as severe memory loss in the husband, untimately resulting in his ability to work.

Is climate an issue?

While molds are commonly thought to grow only a warm, moist, dark environments, recent research has shown that mold can grow even in day climates. Since 1991, the U.S. EPA has been conducting research to determine what environmental conditions permit mold infestation. The focus of the investigation has been on material properties, climate conditions, and microorganism interactions. According to the executive summary, “One of the most significant technical results from this project is that the effect of relative humidity is indirect and that very small amounts of moisture, well below those commonly cited, will permit growth.” Therefore, while dry climates may experience a reduced incidence of mold growth, they are not immune to infestation.

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About Mold

What Type Of Organism Is Mold?

Molds are the most typical form of fungus found on earth. They comprise approximately 25% of the earth’s biomass. Fungi also include yeasts and mushrooms. Molds are ubiquitous on our planet and are essential decomposers of organic substances necessary for sustaining plant and animal life. Molds are made up of masses of filament-like cells called hyphae. Under the appropriate conditions, the hyphae will grow into long intertwining strings that form the main body of the fungus, or the mycelium. It is the mass of mycelium that is visible to the human eye. Molds reproduce via spores. Molds can also spread if a fragment of broken hyphae is transplanted to an area with adequate moisture and organic matter for food.

What causes mold to grow?
 
Molds are incredibly resilient and adaptable. Molds gain the nutrients they need through the decomposition of organic matter. Most molds found in indoor air are saprotropic, meaning they gather their food from dead moist organic matter such as wood, paper, paint, fabric, plant soil, dust, and cooked or raw foods. However, molds can also grow on the surface of damp inorganic matter such as glass and bare concrete covered by an invisible biofilm (an extremely thin layer of organic matter). In short, all mold needs to germinate and grow is a readily available food source, undisturbed water, and time. Some molds can germinate in as little as four to 12 hours. Left undisturbed, mod can grow and spread in 24 to 72 hours. Peter Kozak, et al. state, in their paper on health effects of molds, “Endogenous mold problems generally occur after prolonged or repeated water damage to a variety of organic materials.” They further explain that mold spores can be brought into the home from outside. Outdoor factors that seem to affect indoor mold spore concentrations include marked shade, increased levels of available organic debris, and “natural or basically uncared for property.”
 
Floods, leaking pipes, leaking windows, and leaking roofs are all potential sources of moisture that can lead to mold infestation. Increased ambient humidity as a result of inadequate ventilation or improper drying of flooded areas can also lead to mold growth. Lifestyle choices such as overpopulating a residence, keeping a house closed up without running an air conditioner or dehumidifier, the presence of multiple indoor houseplants (especially if over watered and without adequate ventilation), and poor housecleaning habits can also lead to mold growth.
 
What are the reproductive properties of molds?
 
Molds reproduce through the production of spores. The environment in which a given mold may grow prolifically is very likely different from the environment necessary for spore production. Once the spores are formed they are released into the air to be carried elsewhere for germination and growth. Mold spores can survive for many years in dry or hot environments, requiring only moisture and available organic matter to allow them to germinate.

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Mold Threats

Molds can elicit a variety of health responses in humans. The severity of the impact depends upon the type and amount of mold present as well as the susceptibility and sensitivity of the individual experiencing mold exposure. Humans are exposed to molds via ingestion, inhalation, and skin contact with mold or mold infested material. Although molds are living, multiplying organisms, they do not have to be alive to cause adverse health effects. Below is a list of mold components known to elicit a response in humans. Selected health effects of mold exposure are discussed in a later section of this paper.

Volatile Organic Compounds
 
In the paper “Fungi & Indoor Air Quality” Sandra McNeel and R. Kreutzer state that “molds produce a large number of volatile organic compounds. These chemicals are responsible for the musty odors produced by growing molds.” Volatile organic compounds also provide the odor in cheese, and the “off” taste of mold infested foods. Exposure to high levels of volatile organic compounds, from any source, such as industrial work places, can irritate the mucous membranes and affect the central nervous system, producing such symptoms as headaches, attention deficit, inability to concentrate, and dizziness.
 
According to McNeel, at present the specific contribution of mold volatile organic compounds to building-related health problems has not been studied. Also, mold  volatile organic compounds are likely responsible for only a small fraction of total volatile organic compounds indoors.
 
Allergens
 
Due to the presence of allergens on spores, all molds studied to date have the potential to cause an allergic reaction in susceptible humans. Allergic reactions are believed to be the most common exposure reaction to molds. These reactions can range from mild, transitory responses, like runny eyes, runny nose, and throat irritation, coughing, and sneezing; to severe, chronic illnesses such as sinusitis and asthma.
 
Mycotoxins
 
Some molds are capable of producing mycotoxins, natural organic compounds that are capable of initiating a toxic response in vertebrates. Molds known to potentially produce mycotoxins and which have been isolated in infestations causing adverse health effects include certain species of Acremonium, Alternaria, Aspergillus, Chaetomium, Cladosporium, Fusarium, Paecilomyces, Penicillium, Stachybotrys, and Trichoderma. This list is not all-inclusive.*
 
While a certain type of mold or mold strain type may have the genetic potential for producing mycotoxins, specific environmental conditions are believed to be needed for the mycotoxins to be produced. In other words, although a given mold might have the potential to produce mycotoxins, it will not produce them if the appropriate environmental conditions are not present. Currently, the specific conditions that cause mycotoxin production are not fully understood. The United States Environmental Protection Agency (U.S. EPA) recognizes that mycotoxins have a tendency to concentrate in fungal spores and that there is limited information currently available regarding the processes involved in fungal spore release. As a result, the agency is currently conducting research on Stachybotrys chartarum in an effort to determine “the environmental conditions required for sporulation, emission, aerosolization, dissemination and transport of [Stachybotrys] into the air.”

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Potential Health Effects of Mold

Certain health effects, such as those related to allergic reactions like irritation of the eyes, nose, and throat, dermatitis, exacerbation of asthma, and respiratory distress, have been proven to be associated with mold exposure. Other reported effects such as fever, flu-like symptoms, fatigue, respiratory dysfunction (including coughing up blood), excessive and regular nose bleeds, dizziness, headaches, diarrhea, vomiting, liver damage, and impaired or altered immune function have been identified in persons who have been exposed to mold via inhalation, however, limitations in existing science hinder the ability of researchers to conclusively cite mold exposure as the cause of these health effects. 

Similarly, while kidney damage, infertility, reproductive cycle disruption, and neurotoxicity have been reported in animals exposed to molds under laboratory conditions, no evidence of these effects has been noted in humans. The extent to which an individual may be affected depends upon his or her state of health, susceptibility to disease, the organism with which he or she came in contact, and the duration and severity of exposure. Some people experience temporary effects that disappear when they vacate infested areas. In others, the effects of exposure may be long-term or permanent. Selected incidence of injury related to mold exposure will be discussed in a later section of this paper.

Systemic infections caused by molds are not common. Normal, healthy individuals can resist systemic infection from airborne molds. Those at risk for systemic fungal infection are severely immunocompromised individuals such as those undergoing chemotherapy, individuals who have had organ or bone marrow transplants, and persons with HIV/AIDS.

A National Academy of Sciences report titled Clearing the Air: Asthma and Indoor Air Exposures determined there was sufficient evidence to show an association between mold exposure and the aggravation of asthma in individuals who are sensitized to the disease. However, researchers report inadequate or insufficient evidence to determine whether or not an association exists regarding mold exposure and the development of asthma. An outbreak of Stachybotrys chartarum in Cleveland, Ohio, in 1994 was believed by some to have caused pulmonary hemorrhage in infants. Sixteen of the infants died. A Center for Disease Control sponsored a review of the cases concluded that the scientific evidence provided did not warrant the conclusion that inhaled mold was the cause of the illnesses in the infants. However, the panel also stated that further research was warranted, as the study design for the original research appeared to be faulty.

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How is Mold Remediated?

No State or Federal statues or regulations exist with regard to removing mold. The New York City Department of Health was the first government entity to produce guidelines on mold. The document, “Guidelines on Assessment and Remediation of Fungi in Indoor Environments,” has been cited by many as useful in planning mold cleanup procedures primarily because it was the only document available. However, some believe that the New York City guidelines are too arbitrary and focus too much on the size of visible mold when determining appropriate cleanup methods.

For example, Jim Holland, of Remediation Consultants, states that the New York City guidelines do not take into consideration hidden molds which may be revealed when walls are opened. Thus, he claims, the guidelines can actually increase the risk of spreading the mold throughout the building as they do not require containment of small areas of infestation during the cleanup process.

Recommendations regarding mold remediation in commercial and school buildings are offered by a variety of federal, state, and private organizations and are not standardized. The soon-to-be-available U.S. EPA guidelines are widely anticipated and many hope they will clear the air with regard to differing schools of thought regarding mold cleanup in commercial and school buildings. However, there are certain aspects of mold cleanup which are agreed upon by all.

  • Persons with respiratory problems, a compromised immune system, or fragile health, should not participate in cleanup operations.
  • The source of moisture must be stopped and all areas infested with mold thoroughly cleaned. If thorough cleaning is not possible due to the nature of the material (porous versus semi- and non-porous), all contaminated areas should be removed.
  • Cleanup crews should be properly attired. Mold should not be allowed to touch bare skin. Eyes and lungs should be protected from aerosol exposure.
  • All efforts should be made to contain the infestation, while still allowing adequate ventilation for the cleanup crew during the cleanup process, in an effort to avoid spreading mold to other areas.

Experts consulted agree that a common sense approach should be taken when assessing mold growth. For example, it is generally believed that small amounts of growth, like those commonly found on shower walls, pose no immediate health risk to most individuals. The California Department of Health Services information sheet, “Mold in My Home: What Do I Do?” contains guidelines for cleanup of large areas of mold that mirror those for commercial buildings and schools: persons with fragile health should not be involved in mold cleanup, wear protective gear, keep the area of infestation isolated, and maintain adequate ventilation for cleanup crew in area being cleaned.

Residents are also cautioned to work over short time spans with rest periods in locations with access to fresh air, and to air out their home well after cleanup. This document also encourages residents to start the cleanup process with a small test patch. If the resident experiences any adverse health effects while cleaning the test area, it is advised that they consider hiring a professional to complete the job.

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