Health Effects of Stachybotrys – Review Articles

 

 

This page lists medical journal review articles discussing health effects associated with Stachybotrys exposures.

The Health Effects of Stachybotrys Chartarum page of the Paradigm Change site provides further information on the effects of this toxic mold.

 

Yike Iwona, Dearborn Dorr. Guest editorial–novel insights into the pathology of Stachybotrys chartarum. Mycopathologia. 2011;172:1–3. PMID: 21505872 

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Straus DC. Molds, mycotoxins, and sick building syndrome. Toxicol Ind Health. 2009 Oct-Nov;25(9-10):617-35. 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). In these studies 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.

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Pestka James J., Yike Iwona, Dearborn Dorr G., Ward Marsha D., Harkema Jack R.. Stachybotrys chartarum, trichothecene mycotoxins, and damp building-related illness: new insights into a public health enigma. Toxicological sciences : an official journal of the Society of Toxicology. 2008;104:4–26. PMID: 18007011 

Damp building-related illnesses (DBRI) include a myriad of respiratory, immunologic, and neurologic symptoms that are sometimes etiologically linked to aberrant indoor growth of the toxic black mold, Stachybotrys chartarum. Macrocyclic trichothecene mycotoxins, produced by one chemotype of this fungus, are potent translational inhibitors and stress kinase activators that appear to be a critical underlying cause for a number of adverse effects. Notably, these toxins form covalent protein adducts in vitro and in vivo and, furthermore, cause neurotoxicity and inflammation in the nose and brain of the mouse. A second S. chartarum chemotype has recently been shown to produce atranones-mycotoxins that can induce pulmonary inflammation. Other biologically active products of this fungus that might contribute to pathophysiologic effects include proteinases, hemolysins, beta-glucan, and spirocyclic drimanes.

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Lai K. M.. Hazard identification, dose-response and environmental characteristics of stachybotryotoxins and other health-related products from Stachybotrys. Environmental technology. 2006;27:329–335. PMID: 16548213 

An extensive growth of Stachybotrys in water-damaged buildings is of great public health concern. It is inconclusive whether Stachybotrys is responsible for the reported health effects on the occupants in these contaminated environments. However, based on the veterinary, occupational and laboratory toxicity studies, it is reasonable to project that Stachybotrys can cause adverse health responses once the toxic level of the corresponding agents reached the target systems.

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Hossain MA, Ahmed MS, Ghannoum MA. Attributes of Stachybotrys chartarum and its association with human disease. J Allergy Clin Immunol. 2004 Feb;113(2):200-8; quiz 209. PMID: 14767429

This review summarizes available information on the pathogenic attributes of S. chartarum and calls for well-controlled objective studies.

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Hintikka Eeva-Liisa L.. The role of Stachybotrys in the phenomenon known as sick building syndrome. Advances in applied microbiology. 2004;55:155–173. PMID: 15350793 

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Jarvis Bruce B.. Stachybotrys chartarum: a fungus for our time. Phytochemistry. 2003;64:53–60. PMID: 12946405

Stachybotrys chartarum, a fungus found in damp buildings and sometimes ascribed a role in building-related illnesses, produces a variety of secondary metabolites including trichothecenes, triprenylated phenolics, and a new class of diterpenoids called atranones. A related fungus, Memnoniella echinata also produces trichothecenes and the triprenylated phenolics.

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Revankar Sanjay G.. Clinical implications of mycotoxins and Stachybotrys. The American journal of the medical sciences. 2003;325:262–274. PMID: 12792245

This review summarizes what is known regarding health effects of mycotoxins in general and specifically examines the evidence for the role of indoor exposure to the fungi of the genus Stachybotrys as a cause of disease in humans. The risk of health effects from ingestion seems much more widespread than from indoor airborne exposure, although the latter has received considerably more media attention.

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Miller J. David, Rand Thomas G., Jarvis Bruce B.. Stachybotrys chartarum: cause of human disease or media darling? Medical mycology. 2003;41:271–291. PMID: 12964721

It is generally accepted that living or working in mouldy environments is associated with building related asthma, exacerbating asthma in mould-sensitive asthmatics and increased rates of upper respiratory disease. There is limited evidence that severe lung damage can occur from building exposure to S. chartarum but possibly only under conditions of exposure that approach those associated with handling contaminated straw. There is no positive evidence in the literature to account for putative neurological damage resulting from exposure to this mould.

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Musmand Jon. Does Stachybotrys actually cause adverse effects? Annals of allergy, asthma & immunology. 2003;90. PMID: 12602681 

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Etzel Ruth A.. Stachybotrys. Current opinion in pediatrics. 2003;15:103–106. PMID: 12544280

Epidemiologic evidence has demonstrated an association between acute pulmonary hemorrhage in infants and exposure to Stachybotrys and other fungi in water-damaged home environments. In recent years, advances in understanding of this association have occurred in six major areas: animal models, biologic mechanism of lung injury, dose-response relationship, isolation from diseased patients, detection methods, and intervention. The association demonstrates strength, consistency, coherence, and specificity.

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Kuhn D. M., Ghannoum M. A.. Indoor mold, toxigenic fungi, and Stachybotrys chartarum: infectious disease perspective. Clinical microbiology reviews. 2003;16:144–172. PMID: 12525430 

Recently, there have been reports of severe illness as a result of indoor mold exposure, particularly due to Stachybotrys chartarum. Here, we review the evidence regarding indoor mold exposure and mycotoxicosis, with an emphasis on S. chartarum. We also examine possible end-organ effects, including pulmonary, immunologic, neurologic, and oncologic disorders. We discuss the Cleveland infant idiopathic pulmonary hemorrhage reports in detail, since they provided important impetus for concerns about Stachybotrys.

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Sudakin Daniel L.. Trichothecenes in the environment: relevance to human health. Toxicology letters. 2003;143:97–107. PMID: 12749813

The toxicodynamic properties of trichothecenes include inhibition of protein synthesis and immunomodulatory effects. Very little information is available relating to their toxicokinetics and toxicodynamics in humans. While there is general agreement that the diet represents an important source of human exposure to trichothecenes, risk assessment from non-dietary routes of exposure is complicated by the limited epidemiological data that are currently available.

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Black mold and human illness. Texas medicine. 2002;98:53–56.

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Page E. H., Trout D. B.. The role of Stachybotrys mycotoxins in building-related illness. AIHAJ : a journal for the science of occupational and environmental health and safety. 2001;62:644–648. PMID: 11669391

A literature review indicates that currently there is inadequate evidence supporting a causal relationship between symptoms or illness among building occupants and exposure to mycotoxins. Research involving the identification and isolation of specific fungal toxins in the environment and in humans is needed before a more definitive link between health outcomes and mycotoxins can be made.

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Terr A. I.. Stachybotrys: relevance to human disease. Annals of allergy, asthma & immunology. 2001;87:57–63. PMID: 11770686

The current public concern for adverse health effects from inhalation of Stachybotrys spores in water-damaged buildings is not supported by published reports in the medical literature.

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Mahmoudi M., Gershwin M. E.. Sick building syndrome. III. Stachybotrys chartarum. The Journal of asthma. 2000;37:191–198. PMID: 10805208

The presence of Stachybotrys in a building does not necessarily imply a cause-and-effect relationship with illness, but should alert physicians and healthcare professionals to do more vigorous environmental testing. Guidelines are presented herein for intervention measures in the maintenance of heating, ventilation, and air-conditioning systems.

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Sudakin D. L.. Stachybotrys chartarum: current knowledge of its role in disease. MedGenMed : Medscape general medicine. 2000;2. PMID: 11104457

Although the hazards associated with exposure to some mycotoxins have been well studied, the health risks from environmental exposure to Stachybotrys remain poorly defined.

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Bitnun A., Nosal R. M.. Stachybotrys chartarum (atra) contamination of the indoor environment: Health implications. Paediatrics & child health. 1999;4:125–129. PMID: 20212975 

A variety of respiratory, dermatological, eye and constitutional symptoms have been associated with heavy and prolonged exposure to S chartarum. S chartarum has also been potentially implicated as a rare cause of idiopathic pulmonary hemorrhage in infants. Buildings found to be heavily contaminated with molds, particularly S chartarum, should undergo thorough cleaning and repair to remove the offending agent(s), and prevent further water damage and mold overgrowth.

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Fung F., Clark R., Williams S.. Stachybotrys, a mycotoxin-producing fungus of increasing toxicologic importance. Journal of toxicology. Clinical toxicology. 1998;36:79–86. PMID: 9541050

A critical review of papers, reports, and studies on Stachybotrys mycotoxins revealed only descriptive reports of suspected animal and human poisoning secondary to consumption of mold-contaminated food products. No studies of good toxicologic and epidemiologic designs answer whether airborne mycotoxins produced by Stachybotrys could produce specific human toxicity.

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Fung F., Clark R., Williams S.. Stachybotrys: still under investigation. Journal of toxicology. Clinical toxicology. 1998;36:633–634. PMID: 9776971

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Johanning E.. Stachybotrys revisited. Journal of toxicology. Clinical toxicology. 1998;36:629–631. PMID: 9776970

 

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