Health Effects of Moldy Buildings – Review Articles

 

 

This page lists medical journal review articles discussing health effects associated with moldy buildings.

The Health Effects of Moldy Buildings page of the Paradigm Change site provides further information on this topic.

 

Enyiukwu, Dn. Mycotoxins in Foods and Indoor Air: Their Attendant Diseases and Modes of Injury on Biological and Human Systems. Greener Journal of Epidemiology and Public Health. 2018:6, 43-51.

Exposure to airborne toxins-carrying spores produced by several species of fungi in water damaged buildings and damp indoor environments have been linked with allergies and sick building syndromes. Contamination of cereals, grains or tubers in the field, store or transit with broad spectrum of noxious mycotoxins is well reported in literature. An understanding of their modes/mechanisms of injury in biological and human systems will help in tailoring their management in a broad scale.

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Rudert A, Portnoy J. Mold allergy: is it real and what do we do about it? Expert Rev Clin Immunol. 2017 Aug;13(8):823-835. PMID: 28453304

Fungi produce substances that contain pathogen-associated molecular patterns (pamps) and damage-associated molecular patterns (damps) which bind to pattern recognition receptors, stimulating innate immune responses in humans. they also produce allergens that induce production of specific IgE. In this review we cover both innate and adaptive immune responses to fungi. Concerns about long-term exposure to fungi have led some patients, attorneys and fungus advocates to promote fears about a condition that has been termed toxic mold syndrome. This syndrome is associated with vague symptoms and is believed to be due to exposure to mycotoxins, though this connection has not been proven.

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Borchers AT, Chang C, Eric Gershwin M. Mold and Human Health: a Reality Check. Clin Rev Allergy Immunol. 2017 Jun;52(3):305-322. PMID: 28299723

Previous reports of “toxic mold syndrome” or “toxic black mold” have been shown to be no more than media hype and mass hysteria, partly stemming from the misinterpreted concept of the “sick building syndrome.” Similarly, a causal relationship between cases of infant pulmonary hemorrhage and exposure to “black mold” has never been proven. Finally, there is no evidence of a link between autoimmune disease and mold exposure.

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Fromme H, Gareis M, Volkel W, Gottschalk C. Overall internal exposure to mycotoxins and their occurrence in occupational and residential settings–An overview. Int J Hyg Environ Health. 2016;219:143–165. PMID: 26725999 

This review aims in summarizing literature data on potentially inhalable mycotoxins occurring in dusts or air in residences and in working environments. Secondly, it gives an overview of the overall internal body burden of mycotoxins in humans in an attempt to characterize total human exposure. These data are also discussed in relation to the current toxicologically based values used for risk assessment.

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Peccia J, Kwan SE. Buildings, Beneficial Microbes, and Health. Trends Microbiol. 2016 Aug;24(8):595-597. PMID: 27397930

Bacteria and fungi in buildings exert an influence on the human microbiome through aerosol deposition, surface contact, and human and animal interactions. As the identities and functions of beneficial human microbes emerge, the consequences of building design, operation, and function must be understood to maintain the health of occupants in buildings.

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Miller JD, McMullin DR. Fungal secondary metabolites as harmful indoor air contaminants: 10 years on. Appl Microbiol Biotechnol. 2014 Dec;98(24):9953-66. PMID: 25363558

This paper summarizes the available data on the low-molecular-weight toxins reliably known from fungi common on damp building materials, the toxins that have been measured on mouldy building materials and the new understanding of the role that they play in the documented health effects of individuals living and working in damp and mouldy buildings.

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Chang CC, Ananda-Rajah M, Belcastro A, McMullan B, Reid A, Dempsey K, Athan E, Cheng AC, Slavin MA. Consensus guidelines for implementation of quality processes to prevent invasive fungal disease and enhanced surveillance measures during hospital building works, 2014. Intern Med J. 2014 Dec;44(12b):1389-97. PMID: 25482747

As the population at risk of invasive fungal infection continues to grow due to the increased burden of cancer and related factors, the need for hospitals to employ preventative measures has become increasingly important. These guidelines outline the standard quality processes hospitals need to accommodate into everyday practice and at times of healthcare-associated outbreak, including the role of antifungal stewardship programmes and best practice environmental sampling. Specific recommendations are also provided to help guide the planning and implementation of quality processes and enhanced surveillance before, during and after high-risk activities, such as hospital building works.

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Hope J. A review of the mechanism of injury and treatment approaches for illness resulting from exposure to water-damaged buildings, mold, and mycotoxins. Scientific World Journal. 2013 Apr 18;2013:767482.  PMID: 23710148

Physicians are increasingly being asked to diagnose and treat people made ill by exposure to water-damaged environments, mold, and mycotoxins. In addition to avoidance of further exposure to these environments and to items contaminated by these environments, a number of approaches have been used to help persons affected by exposure to restore their health.

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Annesi-Maesano I, Baiz N, Banerjee S, Rudnai P, Rive S, SINPHONIE Group. Indoor air quality and sources in schools and related health effects. J Toxicol Environ Health B Crit Rev. 2013;16(8):491-550. PMID: 24298914

Existing studies demonstrated that various air pollutants are found in classrooms, sometimes at elevated concentrations. Data also indicated that poor air quality may impact children’s health, in particular respiratory health, attendance, and academic performance. Air quality improvement represents an important measure for prevention of adverse health consequences in children and adults in schools.

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Hope JH, Hope BE. A review of the diagnosis and treatment of Ochratoxin A inhalational exposure associated with human illness and kidney disease including focal segmental glomerulosclerosis. J Environ Public Health. 2012;2012:835059. PMID: 22253638

Ochratoxin A (OTA) exposure via ingestion and inhalation has been described in the literature to cause kidney disease in both animals and humans. This paper reviews Ochratoxin A and its relationship to human health and kidney disease with a focus on a possible association with focal segmental glomerulosclerosis (FSGS) in humans. Prevention and treatment strategies for OTA-induced illness are also discussed, including cholestyramine, a bile-acid-binding resin used as a sequestrant to reduce the enterohepatic recirculation of OTA.

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Mendell MJ, Mirer AG, Cheung K, Tong M, Douwes J. Respiratory and allergic health effects of dampness, mold, and dampness-related agents: a review of the epidemiologic evidence. Environ Health Perspect. 2011 Jun;119(6):748-56. PMID: 21269928

The authors reviewed eligible peer-reviewed epidemiologic studies or quantitative meta-analyses, up to late 2009, on indoor dampness, mold, or other microbiologic agents and respiratory or allergic effects. Evident dampness or mold had consistent positive associations with multiple allergic and respiratory effects. Measured microbiologic agents in dust had limited suggestive associations, including both positive and negative associations for some agents. Thus, prevention and remediation of indoor dampness and mold are likely to reduce health risks, but current evidence does not support measuring specific indoor microbiologic factors to guide health-protective actions.

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Cabral João P.. Can we use indoor fungi as bioindicators of indoor air quality? Historical perspectives and open questions. The Science of the total environment. 2010;408:4285–4295. PMID: 20655574

Healthy houses and buildings, with low indoor humidity, display no appreciable indoor fungal growth, and outdoor Cladosporium dominates. On the contrary, in sick houses and buildings, high indoor humidity allows fungal growth (mainly of Penicillium and Aspergillus), with concomitant release of conidia and fragments into the atmosphere. The intoxication probably results from a chronic exposure to volatile organic compounds and mycotoxins produced by Penicillium, Aspergillus, and Stachybotrys.

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Reboux G, Bellanger AP, Roussel S, Grenouillet F, Millon L. Moulds in dwellings: health risks and involved species. Rev Mal Respir. 2010 Feb;27(2):169-79. PMID: 20206065

The lack of standardization of measurements of concentrations of fungal species, the interactions with chemical compounds (formaldehydes), organic compounds (mycotoxins, endotoxins) and between species, makes the analysis of indoor fungal contamination complicated. The time has come to establish clearly a relationship between exposure to fungi and health disorders, rather than continuing to investigate factors related to the level of indoor fungal contamination.

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Straus David C.. Molds, mycotoxins, and sick building syndrome. Toxicology and industrial health. 2009;25:617–635. PMID: 19854820

The following is a review of some of the work we have done since 2004 regarding the importance of molds and their mycotoxins in the phenomenon of sick building syndrome (SBS). We showed that the macrocyclic trichothecene mycotoxins (MTM) of Stachybotrys chartarum (SC) are easily dissociated from the surface of the organism as it grows and could therefore be consequently spread in buildings as the fungus experiences additional water events. We then showed that SC and Penicillium chrysogenum (PC) colonies remain viable long after a water source has been removed, and the MTM produced by SC remain toxic over extended periods of time. We next showed that PC when inhaled, can release in vivo, a protease allergen that can cause a significant allergic inflammatory reaction in the lungs of mice. We then showed, in a laboratory study, that the MTM of SC can become airborne attached to spores or SC particulates smaller than spores. Following that study, we next showed that the same phenomenon actually occurred in SC infested buildings where people were complaining of health problems potentially associated with SBS. Finally, we were able to demonstrate the presence of MTM in the sera of individuals who had been exposed to SC in indoor environments. This last study was done with enough mold exposed individuals to allow for the statistical significance of SC exposure to be evaluated.

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Geneva: World Health Organization; 2009. WHO Guidelines for Indoor Air Quality: Dampness and Mould. PMID: 23785740

This document provides a comprehensive review of the scientific evidence on health problems associated with building moisture and biological agents. The review concludes that the most important effects are increased prevalences of respiratory symptoms, allergies and asthma as well as perturbation of the immunological system. The most important means for avoiding adverse health effects is the prevention (or minimization) of persistent dampness and microbial growth on interior surfaces and in building structures.

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Meggs WJ. Epidemics of mold poisoning past and present. Toxicol Ind Health. 2009 Oct-Nov;25(9-10):571-6. PMID: 19808743

Throughout history, there have been a number of toxic epidemics associated with exposure to mycotoxins. This article reviews several of the more prominent epidemics, including ones related to building mold, and discusses the nature of the toxins.

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Klich MA. Health effects of Aspergillus in food and air. Toxicol Ind Health. 2009 Oct-Nov;25(9-10):657-67. PMID: 19793771

This review summarizes the health aspects of the medically important fungal genus Aspergillus. The current status of the relationship between Aspergillus in the indoor environment and health issues are discussed.

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Terr AI. Sick Building Syndrome: is mould the cause? Med Mycol. 2009;47 Suppl 1:S217-22. PMID: 19255924

There is controversy regarding the ability of indoor airborne mould spores to cause human disease through non-specific toxicity via the inhalation route. Pulmonary mycotoxicosis is an established, although rare, occupational disease of farmers who inhale enormous quantities of mycotoxins, endotoxins, and other toxic chemicals from contaminated silage. Other conditions attributed to indoor airborne mycotoxin are unproven.

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Ashcroft Carol. Toxic mould syndrome–can the link be proved? Nursing New Zealand (Wellington, N.Z. : 1995). 2009;15:22–23. PMID: 19552128

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Hodgson MJ, Dearborn DG. Literature on mycotoxins and human health at the time of the ACOEM report. Int J Occup Environ Health. 2009 Jan-Mar;15(1):115-7. PMID: 19267132

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Pestka JJ, Yike I, Dearborn DG, Ward MD, Harkema JR. Stachybotrys chartarum, trichothecene mycotoxins, and damp building-related illness: new insights into a public health enigma. Toxicol Sci. 2008 Jul;104(1):4-26. PMID: 18007011

Solving the enigma of whether Stachybotrys inhalation indeed contributes to DBRI will require studies of the pathophysiologic effects of low dose chronic exposure to well-characterized, standardized preparations of S. chartarum spores and mycelial fragments, and, coexposures with other environmental cofactors. Such studies must be linked to improved assessments of human exposure to this fungus and its bioactive constituents in indoor air using both state-of-the-art sampling/analytical methods and relevant biomarkers.

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Metts TA. Addressing environmental health Implications of mold exposure after major flooding. AAOHN J. 2008 Mar;56(3):115-20; quiz 121-2. PMID: 18389824

Extensive water damage resulting from major flooding is often associated with mold growth if materials are not quickly and thoroughly dried. Exposure to fungal contamination can lead to several infectious and noninfectious health effects impacting the respiratory system, skin, and eyes. Adverse health effects can be categorized as infections, allergic or hypersensitivity reactions, or toxic-irritant reactions. Workers and building occupants can minimize their exposure to mold by avoiding areas with excessive mold growth, using personal protective equipment, and implementing environmental controls. Occupational health professionals should encourage workers to seek health care if they experience any symptoms that may be linked to mold exposure.

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Joshi SM. The sick building syndrome. Indian J Occup Environ Med. 2008 Aug;12(2):61-4. PMID: 20040980

The sick building syndrome comprises of various nonspecific symptoms that occur in the occupants of a building. This feeling of ill health increases sickness absenteeism and causes a decrease in productivity of the workers. As this syndrome is increasingly becoming a major occupational hazard, the cause, management and prevention of this condition have been discussed in this article.

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Genuis SJ. Clinical medicine and the budding science of indoor mold exposure. Eur J Intern Med. 2007 Nov;18(7):516-23. PMID: 17967332

Many kinds of mold and their mold-associated products have the potential to disrupt human molecular biochemistry and physiology, resulting in various types of acute and chronic affliction. It is important for physicians to be aware of the pathogenesis, the manifestations, the investigations and the management of possible mold exposure. An overview of mold-related health problems and two case histories are presented for consideration.

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Portnoy JM, Kennedy K, Barnes CS. Controversies regarding dampness and mold growth in homes. Allergy Asthma Proc. 2007 May-Jun;28(3):257-8. PMID: 17619551

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Anyanwu E, Ehiri J, Kanu I. High Cholesterol Levels And Chronic Exposure To Toxigenic Molds In Damp Buildings: A High Risk For Cardiovascular Diseases And Stroke. The Internet Journal of Toxicology. 2006 Volume 3 Number 2.

Epidemiological evidence suggests a possible association between chronic exposures to toxigenic molds in damp water-damaged buildings and high levels of cholesterol abnormalities that may represent a high risk for cardiovascular diseases. Given the fact that toxigenic molds release mycotoxins that affect human health, and given the possibility that structurally, and mechanistically, mycotoxins could adversely affect cholesterol metabolism through interactions with the related enzymes and disruption of cellular supply and utilization of cholesterol, and bile acid synthesis, it is most likely that individuals exposed to chronic toxigenic molds might be at risk of neurological disorders including cardiovascular diseases and stroke.

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Lieberman A, Rea W, Curtis L. Adverse health effects of indoor mold exposure. J Allergy Clin Immunol. 2006 Sep;118(3):763; author reply 767-8. PMID: 16950304

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Bush RK, Portnoy JM, Saxon A, et al. The medical effects of mold exposure. J Allergy Clin Immunol. 2006;117:326–333. PMID: 16514772

The purpose of this position paper is to provide a state-of-the-art review of the role that molds are known to play in human disease, including asthma, allergic rhinitis, allergic bronchopulmonary aspergillosis, sinusitis, and hypersensitivity pneumonitis. In addition, other purported mold-related illnesses and the data that currently exist to support them are carefully reviewed, as are the currently available approaches for the evaluation of both patients and the environment.

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Jarvis Bruce B., Miller J. David. Mycotoxins as harmful indoor air contaminants. Applied microbiology and biotechnology. 2005;66:367–372. PMID: 15565335

Although the Penicillium and Aspergillus genera of fungi are major contaminants of both food and feed products and damp buildings, the particular species and hence the array of mycotoxins are quite different in these environments. The mycotoxins of these indoor species and less common mycotoxins from Stachybotrys and Chaetomium fungi are discussed in terms of their health effects and the need for relevant biomarkers and long-term chronic exposure studies.

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Nevalainen A, Seuri M. Of microbes and men. Indoor Air. 2005;15 Suppl 9:58-64. PMID: 15910530

Dampness and moisture phenomena in buildings, resulting microbial and chemical exposures and individual human responses are complex phenomena. While the causative links between exposing agents and health responses are still not well understood, the essential issue is to prevent the problems with good design, construction and maintenance.

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Khalili B, Montanaro MT, Bardana EJ Jr. Inhalational mold toxicity: fact or fiction? A clinical review of 50 cases. Ann Allergy Asthma Immunol. 2005 Sep;95(3):239-46. PMID: 16200814

Toxic mold syndrome or inhalational toxicity continues to cause public concern despite a lack of scientific evidence that supports its existence.

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Laumbach RJ, Kipen HM. Bioaerosols and sick building syndrome: particles, inflammation, and allergy. Curr Opin Allergy Clin Immunol. 2005 Apr;5(2):135-9. PMID: 15764903

Epidemiological studies suggest an association between bioaerosols and sick building syndrome, and toxicological studies have provided some evidence supporting biological plausibility. However, the extent to which bioaerosol exposure may explain the nonspecific symptoms of the condition is unclear. Nonspecific inflammatory responses to bioaerosols, modified by psychosocial factors such as stress, may be a promising area for continued research.

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Chang C, Gershwin ME. Mold hysteria: origin of the hoax. Clin Dev Immunol. 2005 Jun;12(2):151-8. PMID: 16050147

Over time, there appeared to be no limit to claims of building related illness, and it was “reported” that almost any kind of clinical symptom, real or imaginary, could be blamed on indoor environments.

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Institute of Medicine (US) Committee on Damp Indoor Spaces and Health. Damp Indoor Spaces and Health. Washington (DC): National Academies Press (US); 2004. PMID: 25009878

This book from the Institute of Medicine examines the health impact of exposures resulting from damp indoor environments and offers recommendations for public health interventions. A comprehensive literature review finds sufficient evidence of an association between damp indoor environments and some upper respiratory tract symptoms, coughing, wheezing, and asthma symptoms in sensitized persons.

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McGinnis Michael R.. Pathogenesis of indoor fungal diseases. Medical mycology. 2004;42:107–117. PMID: 15124863

Mold growth within homes and other buildings has been associated to varying degrees with human health problems. These problems vary from allergenic disease to toxicosis. Some important factors that may contribute to the pathogenesis of indoor mold induced disease include beta (1,3)-D-glucans, outer cell wall fungal hydrophobins, 1,8-dihydroxynaphthalene melanin, fungal volatile organic compounds, mycotoxins, and stachylysin.

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Wiszniewska M, Walusiak J, Gutarowska B, Zakowska Z, Pałczyński C. Moulds–occupational and environmental hazards. Med Pr. 2004;55(3):257-66. PMID: 15493501

This paper reviews the most common health effects of exposure to moulds. Allergens of mould may induce rhinitis or bronchial asthma, whereas occupational exposure frequently leads to hypersensitivity pneumonitis. Moulds also reveal cancerogenic and neurotoxic properties. They may cause serious infections, organic dust toxic syndrome and sick building syndrome. Methods used to evaluate exposures and decrease concentrations of spores in the house environment are also presented.

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Greenberger PA. Mold-induced hypersensitivity pneumonitis. Allergy Asthma Proc. 2004 Jul-Aug;25(4):219-23. PMID: 15510579

Mold-induced hypersensitivity pneumonitis results from macrophage- and lymphocyte-driven inflammation, which may be attributable to contaminated humidifiers or heating-ventilation systems or sources in homes, schools, or workplaces. The differential diagnosis includes mold-induced asthma, sick building syndrome, mass psychogenic illness (epidemic hysteria), unjustified fears of “toxic” molds, and conditions causing recurrent pneumonitis.

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Fung F, Clark RF. Health effects of mycotoxins: a toxicological overview. J Toxicol Clin Toxicol. 2004;42(2):217-34. PMID: 15214629

Diseases caused by fungi are spread by direct implantation or inhalation of spores. Fungi can cause adverse human health effectsto many organ systems. In addition to infection and allergy, fungi can produce mycotoxins and organic chemicals that are responsible for various toxicologic effects. We reviewed the published literature on important mycotoxins and systemic effects of mycotoxins. Further research on the health effects of inhaling mycotoxins in indoor settings is needed.

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Trout DB, Seltzer JM, Page EH, Biagini RE, Schmechel D, Lewis DM, Boudreau AY. Clinical use of immunoassays in assessing exposure to fungi and potential health effects related to fungal exposure. Ann Allergy Asthma Immunol. 2004 May;92(5):483-91; quiz 492-4, 575. PMID: 15191015

There is currently not enough scientific evidence to support the routine clinical use of immunoassays as a primary means of assessing environmental fungal exposure or health effects related to fungal exposure. Health care providers who care for persons expressing concerns about the relationship of symptoms to potential exposure to fungi are advised to use immunoassay results with care and only as an adjunct to a comprehensive approach to patient care.

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Terr AI. Are indoor molds causing a new disease? J Allergy Clin Immunol. 2004 Feb;113(2):221-6. PMID: 14722497

Recent widespread litigation has arisen out of an unproved assertion that exposure to indoor molds causes an ill-defined illness. This illness is characterized by the absence of objective evidence of disease and by the lack of a defined pathology.

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Levy Michael B., Fink Jordan N.. Toxic mold syndrome. Advances in applied microbiology. 2004;55:275–288. PMID: 15350798

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Kilburn KH. Summary of the 5th International Conference on Bioaerosols, Fungi, Bacteria, Mycotoxins, and Human Health. Arch Environ Health. 2003 Aug;58(8):538-42. PMID: 15259435

Risk assessment of bioaerosols indoors has been summarized in terms of human health effects (e.g., allergy, infection, and irritation), but neurotoxicity has been a topic of heated debate <fseif@esceng.com>. However, this debate has been resolved rather clearly by evidence presented at this conference (and at the 21st Annual International Symposium on Man and His Environment in Health and Disease, Dallas, Texas, June 2003) which showed that neurotoxicity, as well as pulmonary and immune dysfunction, can result from exposure to molds in the indoor environment.

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Small BM. Creating mold-free buildings: a key to avoiding health effects of indoor molds. Arch Environ Health. 2003 Aug;58(8):523-7. PMID: 15259432

The author identifies common causes of mold growth in buildings and summarizes key building design and construction principles essential for preventing mold contamination indoors. Physicians and healthcare workers must be made aware of conditions within buildings that can give rise to mold growth, and of resulting health problems.

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Hardin BD, Kelman BJ, Saxon A. Adverse human health effects associated with molds in the indoor environment. J Occup Environ Med. 2003 May;45(5):470-8. PMID: 12762072

Current scientific evidence does not support the proposition that human health has been adversely affected by inhaled mycotoxins in home, school, or office environments.

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Nabrdalik M, Latała A. Fungi growth in buildings. Rocz Panstw Zakl Hig. 2003;54(1):119-27. PMID: 12870304

The results of research into occurrence of fungi in buildings are hereby presented. Apart from micotoxins they have been found to produce huge amounts of conidia which can cause allergy in sensitive people. Hence, people should definitely avoid fungi in their environment.

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Chapman JA, Terr AI, Jacobs RL, Charlesworth EN, Bardana EJ Jr. Toxic mold: phantom risk vs science. Ann Allergy Asthma Immunol. 2003 Sep;91(3):222-32. PMID: 14533653

When mold-related symptoms occur, they are likely the result of transient irritation, allergy, or infection. Building-related illness due to mycotoxicosis has never been proved in the medical literature.

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Fung F, Hughson WG. Health effects of indoor fungal bioaerosol exposure. Appl Occup Environ Hyg. 2003 Jul;18(7):535-44. PMID: 12791550

Current evidence suggests that excessive moisture promotes mold growth and is associated with an increased prevalence of symptoms due to irritation, allergy, and infection. However, specific human toxicity due to inhaled fungal toxins has not been scientifically established.

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Daisey JM, Angell WJ, Apte MG. Indoor air quality, ventilation and health symptoms in schools: an analysis of existing information. Indoor Air. 2003 Mar;13(1):53-64. PMID: 12608926

We reviewed the literature on Indoor Air Quality (IAQ), ventilation, and building-related health problems in schools and identified commonly reported building-related health symptoms involving schools until 1999.

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Heller Richard M., Heller Toni W., Sasson Jack M.. Mold: “tsara’at,” Leviticus, and the history of a confusion. Perspectives in biology and medicine. 2003;46:588–591. PMID: 14593226

The noun tsara’at appears about two dozen times in the Hebrew Bible, almost exclusively in Leviticus, where it is used to describe a state of ritual defilement manifested as a scaly condition of the skin, a condition of cloth, leather, and the walls of houses. The recent identification of a specific mold (Stachybotrys sp.) that contaminates buildings and causes respiratory distress, memory loss, and rash, and the fact that mold has been present for millennia, lend support to the translation of tsara’at as “mold.”

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Bardana Emil J.. Indoor air quality and health does fungal contamination play a significant role? Immunology and allergy clinics of North America. 2003;23:291–309. PMID: 12803364

The response of individuals to indoor bioaerosols is complex and depends on age, gender, state of health, genetic makeup, and degree and time of bioaerosol exposure. When disease occurs, it more likely is related to transient annoyance or irritational reactions. Building-related disease caused by mycotoxicosis has not been proved in the medical literature.

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Lees-Haley PR. Toxic mold and mycotoxins in neurotoxicity cases: Stachybotrys, Fusarium, Trichoderma, Aspergillus, Penicillium, Cladosporium, Alternaria, Trichothecenes. Psychological reports. 2003;93:561–584. PMID: 14650691

Presented is the argument that psychologists and neuropsychologists have no scientific basis for rendering opinions about causation given the current state of the literature. The critical question is whether in a residence or office inhalation of mold spores or mold metabolites, including mycotoxins, causes neuropsychological impairment or mental and emotional disorders. There has not been sufficient research to support such conclusions.

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Bardana Emil J., Chapman Jean A., Charlesworth Ernest N., Jacobs Robert L., Terr Abba L.. Crossing over to the dark side of the mold issue: a dissenting view. Annals of allergy, asthma & immunology. 2003;91. PMID: 12952119

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No authors listed. The truth about mold. Most experts say there’s more fear than fact to “toxic mold.” But that doesn’t mean that indoor mold can’t cause health problems. Harvard health letter / from Harvard Medical School. 2003;28:1–3. PMID: 12543603

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Ammann Harriet M.. Is indoor mold contamination a threat to health? Part two. Journal of environmental health. 2003;66:47–49. PMID: 12971049

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Ammann H. Indoor mold contamination – a threat to health? J Environ Health. 2002 Jan-Feb; 64(6): 43-4. PMID: 11826627

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Assoulin-Daya Y, Leong A, Shoenfeld Y, Gershwin ME. Studies of sick building syndrome. IV. Mycotoxicosis. J Asthma. 2002 May;39(3):191-201. PMID: 12043850

Although exposure to molds can produce significant mucosal irritation, there are very few data to suggest long-term ill effects. More importantly, there is no evidence in humans that mold exposure leads to nonmucosal pathology. In fact, many of the data on toxigenic molds are derived from animal toxicity studies, and these are based primarily, on ingestion.

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Ando M. Indoor air and human health–sick house syndrome and multiple chemical sensitivity. Kokuritsu Iyakuhin Shokuhin Eisei Kenkyusho Hokoku. 2002;(120):6-38. PMID: 12638182

The number of complaints about the quality of indoor air has increased during the past two decades. These complaints have been frequent enough that the term “Sick House Syndrome or Sick Building Syndrome” and “Multiple Chemical Sensitivity” has been coined.

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Piecková E., Jesenská Z.. Microscopic fungi in dwellings and their health implications in humans. Annals of agricultural and environmental medicine : AAEM. 1999;6:1–11. PMID: 10384209

The article reviews the quantitative and qualitative incidence of microscopic filamentous fungi in dwellings, methods for their detection, mycotoxins, glucans and volatile organic compounds produced by microscopic fungi in the indoor air of homes. Characteristics and properties of the most important species of fungi in dwellings (Alternaria spp., Aspergillus spp., Cladosporium spp., Fusarium spp., Penicillium spp., Stachybotrys spp., and Wallemia spp.) and the health problems of occupants of the moldy homes are also discussed.

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Fatal fungus. Environmental health perspectives. 1998;106. PMID: 10408930

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Page E., Trout D.. Mycotoxins and building-related illness. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. 1998;40:761–764. PMID: 9777557

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Malloy CD, Marr JS. Sick-building syndrome. Lancet. 1997 Jun 28;349(9069):1913. PMID: 9235451

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Wild CP, Hall AJ. Epidemiology of Mycotoxin-Related Disease. Human and Animal Relationships, 1996, p. 213-227.

The purpose of this chapter is to review data associating specific mycotoxin exposures with human mycotoxicoses and to suggest avenues of research which could improve the understanding of mycotoxin-related disease. In particular, we discuss the possibility of improving measurements of mycotoxin exposure and discuss strategies for future epidemiological research on this topic.

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Hendry, K.M. and Cole, E.C. A review of mycotoxins in indoor air. J Toxicol Environ Health. 1993; 38: 183–198  PMID: 8433402

This paper is a review of literature on mycotoxins with emphasis on mycotoxins in indoor air. Consideration is given to specific mycotoxins identified in indoor air, indoor sources of the mycotoxins, factors affecting mycotoxin production, potential health effects indicated by animal laboratory studies, and case studies of possible human inhalation health effects of these mycotoxins.

*

Hunt SM, McKenna SP. The impact of housing quality on mental and physical health. Housing Rev. 1992;41:47–49.

 

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