Health Effects of Moldy Buildings – Sick Building Syndrome

 

 

This page lists medical journal articles discussing the relationship between sick building syndrome and moldy buildings.

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

 

Kishi R, Yoshino H, Araki A, Saijo Y, Azuma K, Kawai T, Yamato H, Osawa H, Shibata E, Tanaka M, Masuchi A, Minatoya M, Ait Bamai Y. New Scientific Evidence-based Public Health Guidelines and Practical Manual for Prevention of Sick House Syndrome. Nihon Eiseigaku Zasshi. 2018;73(2):116-129. PMID: 29848862

Recently, we have published a book containing evidence-based public health guidelines and a practical manual for the prevention of sick house syndrome. It is an almost completely revised version of the 2009 version. The coauthors are 13 specialists in environmental epidemiology, exposure sciences, architecture, and risk communication. Since the 1970s, health problems caused by indoor chemicals, biological pollution, poor temperature control, humidity, and others in office buildings have been recognized as sick building syndrome (SBS) in Western countries, but in Japan it was not until the 1990s that people living in new or renovated homes started to describe a variety of nonspecific subjective symptoms such as eye, nose, and throat irritation, headache, and general fatigue. These symptoms resembled SBS and were designated “sick house syndrome (SHS).” To determine the strategy for prevention of SHS, we conducted a nationwide epidemiological study in six cities from 2003-2013 by randomly sampling 5,709 newly built houses. As a result 1,479 residents in 425 households agreed to environmental monitoring for indoor aldehydes and volatile organic compounds (VOCs). After adjustment for possible risk factors, some VOCs and formaldehyde were dose-dependently shown to be significant risk factors. We also studied the dampness of the houses, fungi, allergies, and others.

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Rand TG, Chang CT, McMullin DR, Miller JD. Inflammation-associated gene expression in RAW 264.7 macrophages induced by toxins from fungi common on damp building materials. Toxicol In Vitro. 2017 Sep;43:16-20. PMID: 28535995

This investigation adds to a body of evidence supporting the role of low molecular weight compounds from damp building materials as pathogen associated molecular patterns (PAMPs). Along with fungal glucan and chitin, these compounds contribute to the non-allergy based respiratory outcomes for people living and working in damp buildings.

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Tuuminen T, Rinne KS. Severe Sequelae to Mold-Related Illness as Demonstrated in Two Finnish Cohorts. Front Immunol. 2017 Apr 3;8:382. PMID: 28421079

This paper describes two cohorts suffering severe sequelae to mold-related illness. One cohort is a nine-member family with pets that moved into a new house, which soon proved to be infested with pathogenic molds. The other cohort consists of 30 teachers and 50 students from a mold-infested school building. The first cohort experienced a plethora of mucosal irritation, neurological, skin, allergic, and other symptoms, with all family members ultimately developing a multiple chemical syndrome. In the second cohort, we detected a greatly elevated prevalence of autoimmune conditions and malignancies. The authors recommend that future studies should combine data from, e.g., cancer, autoimmune, and endocrine disorder registers and neurological and mental health or neuropsychological registers with mold-exposed individuals being monitored for prolonged follow-up times.

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Norbäck D, Hashim JH, Cai GH, Hashim Z, Ali F, Bloom E, Larsson L.  Rhinitis, Ocular, Throat and Dermal Symptoms, Headache and Tiredness among Students in Schools from Johor Bahru, Malaysia: Associations with Fungal DNA and Mycotoxins in Classroom Dust. PLoS One. 2016 Feb 1; 11(2):e0147996. MIDI: 26829324

This study looked at associations between levels of five fungal DNA sequences, two mycotoxins (sterigmatocystin and verrucarol) and cat allergen (Fel d 1) levels in schools and rhinitis and other weekly SBS symptoms in the students. Fungal DNA was measured by quantitative PCR and cat allergen by ELISA. Pupils (N = 462) from eight randomly selected schools in Johor Bahru, Malaysia participated (96%). Weekly nasal symptoms (rhinitis), ocular, throat, dermal symptoms, headache and tiredness were common. Total fungal DNA in swab samples was associated with rhinitis (p = 0.02), ocular symptoms (p = 0.009) and tiredness (p = 0.001). There were positive associations between Aspergillus versicolor DNA in Petri dish samples, ocular symptoms (p = 0.02) and tiredness (p = 0.001). The level of the mycotoxin verrucarol (produced by Stachybotrys chartarum) in swab samples was positively associated with tiredness (p = 0.04). Streptomyces DNA in swab samples (p = 0.03) and Petri dish samples (p = 0.03) were negatively associated with tiredness. In conclusion, total fungal contamination, measured as total fungal DNA) in the classrooms, Aspergillus versicolor and verrucarol can be risk factors for rhinitis and SBS symptoms among students in the tropical country Malaysia.

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Lu C, Deng Q, Li Y, Sundell J, Norbäck D. Outdoor air pollution, meteorological conditions and indoor factors in dwellings in relation to sick building syndrome (SBS) among adults in China. Sci Total Environ. 2016 Aug 1;560-561:186-96. PMID: 27101454

We studied associations between outdoor air pollution, meteorological parameters and selected indoor exposure and building characteristics at home and weekly SBS symptoms in a standardized questionnaire study among 3485 randomly selected adults in China. Outdoor factors included particulate matters with diameter <10μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), outdoor temperature (T), relative air humidity (RH), and wind speed (WS) during last three months. Indoor mold/dampness, air pollution from redecoration and poorer ventilation conditions in dwellings can be risk factors for SBS symptoms in an adult Chinese population, especially among females.

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Lukcso D, Guidotti TL, Franklin DE, Burt A. Indoor environmental and air quality characteristics, building-related health symptoms, and worker productivity in a federal government building complex. Arch Environ Occup Health. 2016;71(2):85-101. PMID: 25258108

Building Health Sciences, Inc. (BHS), investigated environmental conditions by many modalities in 71 discreet areas of 12 buildings in a government building complex that had experienced persistent occupant complaints despite correction of deficiencies following a prior survey. Four environmental factors were consistently associated with group-level building-related health complaints: physical comfort/discomfort, odor, job stress, and glare. Low relative humidity was significantly associated with lower respiratory and “sick building syndrome”-type symptoms. We concluded from the experience of this study that building-related health complaints should be investigated at the work-area level and not at a building-wide level.

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Takaoka M, Suzuki K, Norbäck D. Sick Building Syndrome Among Junior High School Students in Japan in Relation to the Home and School Environment. Glob J Health Sci. 2015 Jun 12;8(2):165-77. PMID: 26383200

The aim of this study is to investigate associations between SBS and the home, school environment and personal factors among Japanese junior high school students. The prevalence of SBS symptoms was high and associated with both home and school environment. Window pane condensation and floor dampness at home can increase the risk for SBS symptoms in students. Moreover, high relative air humidity at school may increase the risk for SBS.

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Thrasher JD, Hooper DH, Taber J. Family of Six, Their Health and the Death of a 16 Month Old Male from Pulmonary Hemorrhage: Identification of Mycotoxins and Mold in the Home and Lungs, Liver and Brain of Deceased Infant. Global Journal of Medical Research. 2014; 14 (5-K).

The health of a family of six residing in a water-damaged home is presented. The parents and two boys developed RADS/asthma and had multiple symptoms including nose bleeds.The newborn fraternal twins experienced respiratory illness that required hospital treatments. The infant girl survived while her brother was found face down, blue in color, lifeless with oral and nasal blood discharge. Aspergillus versicolor was identified by PCR-DNA analysis in the lungs and brain of the deceased child. Aflatoxin was detected in his lungs, while monocyclic trichothecenes were identified in the lungs, liver and brain.

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Wang J, Li B, Yang Q, Yu W, Wang H, Norback D, Sundell J. Odors and sensations of humidity and dryness in relation to sick building syndrome and home environment in Chongqing, China. PLoS One. 2013 Aug 26;8(8):e72385. PMID: 23991107

The prevalence of perceptions of odors and sensations of air humidity and sick building syndrome symptoms in domestic environments were studied using responses to a questionnaire on the home environment. Parents of 4530 1-8 year old children from randomly selected kindergartens in Chongqing, China participated. Adults’ perceptions of odors and sensations of humid air and dry air are related to factors of the home environment and SBS symptoms are related to odor perceptions.

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Sahlberg B, Gunnbjörnsdottir M, Soon A, Jogi R, Gislason T, Wieslander G, Janson C, Norback D. Airborne molds and bacteria, microbial volatile organic compounds (MVOC), plasticizers and formaldehyde in dwellings in three North European cities in relation to sick building syndrome (SBS). Sci Total Environ. 2013 Feb 1;444-40. PMID: 23280302

As a follow-up of the European Community Respiratory Health Survey (ECRHS II), indoor measurements were performed in homes in three North European cities. The aim was to examine whether volatile organic compounds of possible microbial origin (MVOCs), and airborne levels of bacteria, molds, formaldehyde, and two plasticizers in dwellings were associated with the prevalence of SBS, and to study associations between MVOCs and reports on dampness and mold. In total 30.8% reported any SBS (20% mucosal, 10% general, and 8% dermal symptoms) and 41% of the homes had a history of dampness and molds There were positive associations between any SBS and levels of 2-pentanol (P=0.002), 2-hexanone (P=0.0002), 2-pentylfuran (P=0.009), 1-octen-3-ol (P=0.002), formaldehyde(P=0.05), and 2,2,4-trimethyl-1,3-pentanediol monoisobutyrate (Texanol) (P=0.05). 1-octen-3-ol (P=0.009) and 3-methylfuran (P=0.002) were associated with mucosal symptoms. In dwellings with dampness and molds, the levels of total bacteria (P=0.02), total mold (P=0.04), viable mold (P=0.02), 3-methylfuran (P=0.008) and ethyl-isobutyrate (P=0.02) were higher.

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Piecková E. Adverse health effects of indoor moulds. Arh Hig Rada Toksikol. 2012 Dec;63(4):545-9. PMID: 23334050

Indoor humidity is strongly associated with the symptoms of sick building syndrome SBS). Fungal metabolites that may induce ill health in susceptible occupants comprise beta-D-glucan, mycotoxins, and volatile organic compounds as known irritants and/or immunomodulators. Chronic low-level exposure to a mixture of fungal toxicants and other indoor stressors may have synergistic effects and lead to severe neuroendocrineimmune changes.

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Thrasher JD, Gray MR, Kilburn KH, Dennis DP, Yu A. A water-damaged home and health of occupants: a case study. J Environ Public Health. 2012;2012:312836. PMID: 22220187

A family of five and pet dog who rented a water-damaged home and developed multiple health problems. The home was analyzed for species of mold and bacteria. The health of the family is discussed in relation to the most recent published literature regarding microbial contamination and toxic by-products present in water-damaged buildings.

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Straus DC. The possible role of fungal contamination in sick building syndrome. Front Biosci (Elite Ed). 2011 Jan 1;3:562-80. PMID: 21196335

The following is a review of some of the work that we have done since 2007 regarding the importance of molds in the phenomenon of sick building syndrome (SBS). In these studies we first examined mold contamination in air handling units (AHU). In a series of three papers, we examined growth and mycotoxin production by Chaetomium globosum (CG). In these studies we showed that CG produces two potent mycotoxins, chaetoglobosin A (Ch-A) and chaetoglobosin C (Ch-C) when grown on building material. In another study, we showed that mycotoxins can be detected in body fluids and human tissues from patients exposed to mycotoxin producing molds, and we showed which human tissues or fluids were the most likely to give positive results for detection of these compounds. Finally, we showed that the macrocyclic trichothecene mycotoxins (MTM) produced by Stachybotrys chartarum (SC) are detectable in experimental animals soon after exposure and we described the dynamics of MTM tissue loading.

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Sahlberg B, Wieslander G, Norbäck D. Sick building syndrome in relation to domestic exposure in Sweden–a cohort study from 1991 to 2001. Scand J Public Health. 2010 May;38(3):232-8. PMID: 19850651

A random sample of 1,000 people of the general population in Sweden (1991) was sent a self administered questionnaire. A follow-up questionnaire was sent in 2001. An increased risk for onset of any skin symptoms, mucosal symptoms, or general symptoms was found for those who had dampness or moulds in the dwelling during follow-up. In addition, people living in damp dwellings had a lower remission of general symptoms and skin symptoms.

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Simons E, Hwang SA, Fitzgerald EF, Kielb C, Lin S. The impact of school building conditions on student absenteeism in Upstate New York. Am J Public Health. 2010 Sep;100(9):1679-86. PMID: 20634471

We investigated Upstate New York school building conditions and examined the associations between school absenteeism and building condition problems. After adjustment for confounders, student absenteeism was associated with visible mold, humidity, poor ventilation, vermin, 6 or more individual building condition problems, and building system or structural problems related to these conditions. Schools in lower socioeconomic districts and schools attended by younger students showed the strongest associations between poor building conditions and absenteeism.

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Al-Ahmad M, Manno M, Ng V, Ribeiro M, Liss GM, Tarlo SM.  Symptoms after mould exposure including Stachybotrys chartarum, and comparison with darkroom disease. Allergy. 2010 Feb;65(2):245-55. PMID: 19796210

Thirty-two patients presented with symptoms attributed to mould exposures. Exposure identification for 25 patients had reported Stachybotrys chartarum as well as other mould (Aspergillus, Penicillium), 88% at work. Cough, shortness of breath and chest tightness (at presentation) were reported in 79%, 70% and 64%, respectively, and persisted >6 weeks in 91%. The mould-exposed group more commonly reported they were bothered when walking in a room with carpets, complained of a chemical or metallic taste in their mouth, and had problems in concentration when compared with a control physiotherapist group (P < 0.005). Although only a minority with health concerns from indoor mould exposure had demonstrable mould-allergy, a significant proportion had asthma-like symptoms. Other symptoms were also common and persistent after the initial implicated exposure.

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Takigawa T, Wang BL, Sakano N, Wang DH, Ogino K, Kishi R. A longitudinal study of environmental risk factors for subjective symptoms associated with sick building syndrome in new dwellings. Sci Total Environ. 2009 Sep 15;407(19):5223-8. PMID: 19608217

This study was performed to explore possible environmental risk factors, including indoor chemicals, mold, and dust mite allergens, which could cause sick building syndrome (SBS)-type symptoms in new houses. The study was conducted in 2004 and 2005 and the final study population consisted of 86 men and 84 women residing in Okayama, Japan. Increases in benzene and in Aspergillus contributed to the occurrence of SBS in the logistic regression model.

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Saijo Y, Yoshida T, Kishi R. Dampness, biological factors and sick house syndrome. Nihon Eiseigaku Zasshi. 2009 May;64(3):665-71. PMID: 19502762

Sick house syndrome is caused by not only chemicals but also dampness and biological factors. Many European and North American studies have shown that dampness associated with condensation, visible mold, moldy odor, and water-induced damage among others affects residents’ health. Recent Japanese studies have also shown a similar significant relationship.

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Nakayama K, Morimoto K. Risk factor for lifestyle and way of living for symptoms of sick building syndrome: epidemiological survey in Japan. Nihon Eiseigaku Zasshi. 2009 May;64(3):689-98. PMID: 19502765

A questionnaire included items on symptoms of SBS and lifestyle, and an indoor environmental survey (i.e., mold, mites, and volatile organic compounds (VOC)) was conducted in family rooms of dwellings in Japan (Sapporo, Fukushima, Nagoya, Osaka, Okayama, and Kitakyusyu), from 2004 to 2007. Mites, molds, VOCs, renovation, moldiness, stuffiness, feeling of having insufficient sleeping hours, carpet use, benzin, thinner, and coating materials, increase the risk of developing symptoms of SBS, whereas modification of lifestyle and ways of living factors might alleviate them.

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Kilburn KH. Neurobehavioral and pulmonary impairment in 105 adults with indoor exposure to molds compared to 100 exposed to chemicals. Toxicol Ind Health. 2009 Oct-Nov;25(9-10):681-92. PMID: 19793776

Patients exposed at home to molds and mycotoxins and those exposed to chemicals (CE) have many similar symptoms of eye, nose, and throat irritation and poor memory, concentration, and other neurobehavioral dysfunctions. People exposed to mold had a total of 6.1 abnormalities and those exposed to chemicals had 7.1 compared to 1.2 abnormalities in referents. Compared to referents, the exposed groups had balance decreased, longer reaction times, and blink reflex latentcies lengthened. Also, color discrimination errors were increased and visual field performances and grip strengths were reduced. The cognitive and memory performance measures were abnormal in both exposed groups. Culture Fair scores, digit symbol substitution, immediate and delayed verbal recall, picture completion, and information were reduced. Times for peg-placement and trail making A and B were increased. One difference was that chemically exposed patients had excess fingertip number writing errors, but the mold-exposed did not. Mood State scores and symptom frequencies were greater in both exposed groups than in referents. Vital capacities were reduced in both groups. Neurobehavioral and pulmonary impairments associated with exposures to indoor molds and mycotoxins were not different from those with various chemical exposures.

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Takeda M, Saijo Y, Yuasa M, Kanazawa A, Araki A, Kishi R. Relationship between sick building syndrome and indoor environmental factors in newly built Japanese dwellings. Int Arch Occup Environ Health. 2009 Apr;82(5):583-93. PMID: 19205722

Dampness, formaldehyde, and alpha-pinene were significantly related to sick building syndrome symptoms in newly built dwellings.

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Hooper DG, Bolton VE, Guilford FT, Straus DC. Mycotoxin detection in human samples from patients exposed to environmental molds. Int J Mol Sci. 2009 Apr 1;10(4):1465-75. PMID: 19468319

The goal of this study was to determine if selected mycotoxins (trichothecenes, aflatoxins, and ochratoxins) could be extracted and identified in human tissue and body fluids from patients exposed to toxin producing molds in their environment. The data suggest that mycotoxins can be detected in body fluids and human tissue from patients exposed to mycotoxin producing molds in the environment, and demonstrate which human tissues or fluids are the most likely to yield positive results.

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Seki A, Takigawa T, Kishi R, Sakabe K, Torii S, Tanaka M, Yoshimura T, Morimoto K, Katoh T, Kira S, Aizawa Y. Review of sick house syndrome. Nihon Eiseigaku Zasshi. 2007 Sep;62(4):939-48. PMID: 17969320

‘Sick house syndrome’ (SHS) is a health issue that closely resembles sick building syndrome (SBS) that had occurred in European countries. The aim of this review is to clarify the characteristics of SHS by reviewing previous reports rigorously.

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Sun Y, Sundell J, Zhang Y. Validity of building characteristics and dorm dampness obtained in a self-administrated questionnaire. Sci Total Environ. 2007 Nov 15;387(1-3):276-82. PMID: 17692898

A self-administrated questionnaire used in a cross-sectional study on associations between environmental factors and allergies was validated by building inspections and physical measurements. Dampness problems reported by occupants were associated with health effects (case status), while such problems observed by inspectors were not.

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Nakayama K, Morimoto K. Relationship between, lifestyle, mold and sick building syndromes in newly built dwellings in Japan. Int J Immunopathol Pharmacol. 2007 Apr-Jun;20(2 Suppl 2):35-43. PMID: 17903355

To investigate the relationships among Sick Building Syndrome (SBS) symptoms, we conducted a questionnaire and an indoor environment mold survey in a sample of newly built dwellings in Japan. Results suggest that the presence of Penicillium sp. in females and Alternaria alternata in males increases the risk of SBS, whereas sufficient sleep, moderate alcohol consumption for males, and fewer working hours for females might alleviate SBS symptoms.

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Shoemaker RC, House DE. Sick building syndrome (SBS) and exposure to water-damaged buildings: time series study, clinical trial and mechanisms. Neurotoxicol Teratol. 2006 Sep-Oct;28(5):573-88. PMID: 17010568

Studies have demonstrated that the indoor air of water damaged buildings often contains a complex mixture of fungi, mycotoxins, bacteria, endotoxins, antigens, lipopolysaccharides, and biologically produced volatile compounds. A case-series study with medical assessments at five time points was conducted to characterize sick building syndrome after a double-blinded, placebo-controlled clinical trial conducted among a group of study participants investigated the efficacy of cholestyramine (CSM) therapy. The results from the time series study supported the general study hypothesis that exposure to the indoor air of WDBs is associated with SBS. Results from the clinical trial on CSM efficacy indicated highly significant improvement in group-mean number of symptoms and VCS scores relative to baseline in the 7 participants randomly assigned to receive 2 weeks of CSM therapy, but no improvement in the 6 participants assigned placebo therapy during that time interval. However, those 6 participants also showed a highly significant improvement in group-mean number of symptoms and VCS scores relative to baseline following a subsequent 2-week period of CSM therapy.

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Saijo Y, Sata F, Mizuno S, Yamaguchi K, Sunagawa H, Kishi R. Indoor airborne mold spores in newly built dwellings. Environ Health Prev Med. 2005 May;10(3):157-61. PMID: 21432155

This study looked at the relationships between sick building syndrome and mold in newly-built dwellings. Cladosporium was dominant in the Japanese newly-built dwellings studied, and Cladosporium and Ulocladium were probably associated with the residents’ symptoms in these newly-built dwellings.

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Ebbehøj NE, Meyer HW, Würtz H, Suadicani P, Valbjørn O, Sigsgaard T, Gyntelberg F; Members of a Working Group under the Danish Mold in Buildings program (DAMIB). Molds in floor dust, building-related symptoms, and lung function among male and female schoolteachers. Indoor Air. 2005;15 Suppl 10:7-16. PMID: 15926939

Five hundred and twenty-two teachers from 15 public schools, eight ‘water-damaged’ schools, and seven ‘non-damaged’ schools with no visible water damage were included in a cross-sectional design. Women’s reports of symptoms from mucous membranes and skin and general symptoms were positively associated with mold exposure. Odds ratio for ‘difficult to concentrate’ after adjustment for confounders was 11.2 (1.4-90.1, 95% CI) at high levels of mold exposure. None of the lung function tests performed in this study were associated with mold exposure, to the ‘water damaged’ vs. ‘non-damaged’ classification, or to the symptoms reported. IL-8 and ECP were not associated either.

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Meyer HW, Würtz H, Suadicani P, Valbjørn O, Sigsgaard T, Gyntelberg F; Members of a Working Group under the Danish Mold in Buildings program (DAMIB). Molds in floor dust and building-related symptoms among adolescent school children: a problem for boys only? Indoor Air. 2005;15 Suppl 10:17-24. PMID: 15926940

In this cross-sectional epidemiological study of adolescent school children, we found independent significant positive associations between building-related symptoms and viable molds in floor dust in boys and non-menstruating girls. In contrast, no such associations were seen among menstruating girls. The identification of these two susceptible groups adds further support the relevance of minimizing sources of dust and mold exposure.

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Shoemaker RC, House DE. A time-series study of sick building syndrome: chronic, biotoxin-associated illness from exposure to water-damaged buildings. Neurotoxicol Teratol. 2005 Jan-Feb;27(1):29-46. PMID: 15681119

The current study assessed the hypothesis that exposure to the indoor environments of water damaged buildings with visible microbial colonization was associated with illness. The study used a cross-sectional design with assessments at five time points, and the interventions of cholestyramine (CSM) therapy, exposure avoidance following therapy, and re-exposure to the buildings after illness resolution. The results indicated that CSM was an effective therapeutic agent, that VCS was a sensitive and specific indicator of neurologic function, and that illness involved systemic and hypothalamic processes.

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Schwab CJ, Straus DC. The roles of Penicillium and Aspergillus in sick building syndrome. Adv Appl Microbiol. 2004;55:215-38. PMID: 15350796

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Vesper SJ, Vesper MJ. Possible role of fungal hemolysins in sick building syndrome. Adv Appl Microbiol. 2004;55:191-213. PMID: 15350795

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Reijula K. Moisture-problem buildings with molds causing work-related diseases. Adv Appl Microbiol. 2004;55:175-89. PMID: 15350794

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Meyer HW, Würtz H, Suadicani P, Valbjørn O, Sigsgaard T, Gyntelberg F; Members of a Working Group under the Danish Mould in Buildings program (DAMIB). Molds in floor dust and building-related symptoms in adolescent school children. Indoor Air. 2004 Feb;14(1):65-72. PMID: 14756847

This stratified cross-sectional epidemiological study included 1053 school children aged 13-17 years. We did not find a positive association between building-related symptoms and extent of moisture and mold growth in the school buildings. Five of eight building-related symptoms were significantly and positively associated with the concentration of colony forming units of molds in floor dust: eye irritation, throat irritation, headache, concentration problems, and dizziness.

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Saijo Y, Kishi R, Sata F, Katakura Y, Urashima Y, Hatakeyama A, Kobayashi S, Jin K, Kurahashi N, Kondo T, Gong YY, Umemura T. Symptoms in relation to chemicals and dampness in newly built dwellings. Int Arch Occup Environ Health. 2004 Oct;77(7):461-70. PMID: 15558298

The aim of this study was to clarify whether symptoms in residents living in newly built dwellings were related to chemicals and dampness. Condensation on window panes and/or walls was related to all symptoms, and mold growth was related to all symptoms except skin, throat and respiratory and general symptoms.

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Kilburn KH. Role of molds and mycotoxins in being sick in buildings: neurobehavioral and pulmonary impairment. Adv Appl Microbiol. 2004;55:339-59. PMID: 15350801

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Johanning E. Indoor moisture and mold-related health problems. Eur Ann Allergy Clin Immunol. 2004 May;36(5):182-5. PMID: 15206571

Moisture, microbial and in particular mold related indoor exposure and health problems in homes, offices, and public buildings (Kindergartens, schools, library, and hospitals) have been gaining recognition as one of the most common indoor environmental health issues. Proper recognition of microbial related health problems and the differential diagnosis of sick building syndrome (SBS) or building related illness (BRI) are important for early and effective exposure intervention, treatment, referral and prevention of more serious illness.

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Lee TG. Health symptoms caused by molds in a courthouse. Arch Environ Health. 2003 Jul;58(7):442-6. PMID: 15143857

A majority of occupants of a newly renovated historic courthouse in Calgary, Alberta, Canada, reported multiple (3 or more) health-related symptoms, and several reported more than 10 persistent symptoms. Most required at least 1 day outside of the building to recover from their symptoms. Molds that produce mycotoxins, such as Stachybotrys chartarum and Emericella nidulans, were identified in the building, along with fungal organisms of the genera Aspergillus, Penicillium, Streptomyces, Cladosporium, Chaetomium, Rhizopus/Mucor, Alternaria, Ulocladium, and Basidiomycetes.

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Straus DC, Cooley JD, Wong WC, Jumper CA. Studies on the role of fungi in Sick Building Syndrome. Arch Environ Health. 2003 Aug;58(8):475-8. PMID: 15259426

The authors describe 2 case studies, and other experimentation, that have investigated the role of fungi in the occurrence of Sick Building Syndrome.

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Kilburn KH. Indoor mold exposure associated with neurobehavioral and pulmonary impairment: a preliminary report. Arch Environ Health. 2003 Jul;58(7):390-8. PMID: 15143851

Sixty-five consecutive outpatients exposed to mold in their respective homes in Arizona, California, and Texas were compared with 202 community subjects who had no known mold or chemical exposures. The mold-exposed group exhibited decreased function for balance, reaction time, blink-reflex latency, color discrimination, visual fields, and grip, compared with referents. The exposed group’s scores were reduced for the following tests: digit-symbol substitution, peg placement, trail making, verbal recall, and picture completion. Twenty-one of 26 functions tested were abnormal. Airway obstructions were found, and vital capacities were reduced. Mood state scores and symptom frequencies were elevated. The author concluded that indoor mold exposures were associated with neurobehavioral and pulmonary impairments that likely resulted from the presence of mycotoxins, such as trichothecenes.

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Rea WJ, Didriksen N, Simon TR, Pan Y, Fenyves EJ, Griffiths B. Effects of toxic exposure to molds and mycotoxins in building-related illnesses. Arch Environ Health. 2003 Jul;58(7):399-405. PMID: 15143852

The authors studied 100 patients who had been exposed to toxic molds in their homes. Abnormalities in T and B cells, and subsets, were found in more than 80% of the patients. Respiratory signs (e.g., rhinorrhea, sinus tenderness, wheezing) were found in 64% of all patients, and physical signs and symptoms of neurological dysfunction (e.g., inability to stand on the toes or to walk a straight line with eyes closed, as well as short-term memory loss) were identified in 70% of all patients. Objective abnormal autonomic nervous system tests were positive in all 100 patients tested. Brain scans, conducted using triple-head single photon emission computed tomography, were abnormal in 26 (86%) of 30 (subgroup of the 100) patients tested. Objective neuropsychological evaluations of 46 of the patients who exhibited symptoms of neurological impairment showed typical abnormalities in short-term memory, executive function/judgment, concentration, and hand/eye coordination.

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Santilli J. Health effects of mold exposure in public schools. Curr Allergy Asthma Rep. 2002 Nov;2(6):460-7. PMID: 12359116

This paper profiles the impact of mold exposure on the health of students, teachers, and staff in two public elementary schools in Connecticut, and explains how the air quality in each school was tested, and how the health of teachers and students was assessed.

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Wilson SC, Straus DC. The presence of fungi associated with sick building syndrome in North American zoological institutions. J Zoo Wildl Med. 2002 Dec;33(4):322-7. PMID: 12564528

A total of 110 sites from five zoological institutions were examined to determine whether fungi associated with sick building syndrome (SBS) were prevalent in the exhibits or night-time holding facilities and to investigate whether the presence of these organisms was associated with declining breeding rates or increases in morbidity and mortality (or both). A Fisher exact test analysis showed a significant nonrandom association between high levels of P. chrysogenum and sites with records of poor animal health.

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Saijo Y, Reiko K, Sata F, Katakura Y, Urashima Y, Hatakeyama A, Mukaihara N, Kobayashi S, Jin K, Iikura Y. Symptoms of sick house syndrome and contributory factors; study of general dwellings in Hokkaido. Nihon Koshu Eisei Zasshi. 2002 Nov;49(11):1169-83. PMID: 12508471

The results of this study suggest that symptoms of sick house syndrome are associated with high humidity such as condensation on windows and mold growth, odors from furniture and use of aromatics.

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Ochmański W, Barabasz W. Microbiological threat from buildings and rooms and its influence on human health (sick building syndrome). Przegl Lek. 2000;57(7-8):419-23. PMID: 11109318

In buildings we can observe many different strains of bacteria, over 400 species of mould fungi, many strains of fungus causing the rotting of wood and wood like materials, many species of algae, aphids, and other types of growths and seed plants and also over 30 types of mites especially those seen in house dust. Research which was begun by Prof. Julian Aleksandrowicz and Prof. Bolesław Smyk in 1970 and 1971 showed that the so called “leukaemia houses” of leukaemia victims had an abundance of toxinogenic fungus in them, particularly the most potent fungus which turned out to be Aspergillus flavus. Toxinogenic funguses are abundant in many living spaces and cellars in older and also in new housing. Mycotoxins have been shown to be very toxic and harmful and it is no wonder that many inhabitants of these living spaces are constantly ill, mainly upper respiratory tract infections, lethargy, constant headaches, nausea and a general ill feeling. Inhabiting these living spaces for a considerable period may lead to cancer.

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Dunn, J.R. and Hayes, M.V. Social inequality, population health, and housing: a study of two Vancouver neighborhoods. Soc Sci Med. 2000; 51: 563–587. PMID: 10868671

The data for this study were obtained through a mailed survey of residents in the Mount Pleasant (n = 322) and Sunset (n = 206) neighborhoods of Vancouver, Canada. They suggest that, in concert with commonly used measures of socioeconomic status, both material and meaningful dimensions of housing and home are associated with health status.

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Johanning E., Landsbergis P., Gareis M., Yang C. S., Olmsted E.. Clinical experience and results of a Sentinel Health Investigation related to indoor fungal exposure. Environmental health perspectives. 1999;107 Suppl 3:489–494. PMID: 10346997

This is a review of exposure conditions, clinical presentation, and morbidity of children and adults with indoor fungal exposure such as toxic Stachybotrys chartarum. Primarily disorders of the respiratory system, skin, mucous membranes, and central nervous system were reported. Some enumeration and functional laboratory abnormalities, mainly of the lymphatic blood cells, were observed, although no statistically significant differences were found. IgE or IgG fungi-specific antibodies, used as exposure markers, were positive in less than 25% of all tested cases. In an evaluation of a symptomatic girl 11 years of age (sentinel case investigation) living in an apartment with verified toxigenic fungi (i.e., S. chartarum), several health indicators showed improvement after exposure cessation.

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Sudakin DL. Toxigenic fungi in a water-damaged building: an intervention study. Am J Ind Med. 1998 Aug;34(2):183-90. PMID: 9651629

In an investigation of health complaints among employees of a water-damaged office building, the environment showed evidence of fungal contamination with the isolation of Stachybotrys chartarum in one of five bulk samples tested for fungal growth. A health survey of building occupants revealed a high prevalence of multiple symptoms, with the predominance of neurobehavioral and upper respiratory tract complaints. The majority of symptoms were significantly less prevalent after relocation from the water-damaged environment.

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Hodgson MJ, Morey P, Leung WY, Morrow L, Miller D, Jarvis BB, Robbins H, Halsey JF, Storey E. Building-associated pulmonary disease from exposure to Stachybotrys chartarum and Aspergillus versicolor. J Occup Environ Med. 1998 Mar;40(3):241-9. PMID: 9531095

The authors present an outbreak of disease associated with exposure to Stachybotrys chartarum and Aspergillus species. A courthouse and two associated office buildings had generated discomfort among employees for two years since initial occupancy. An initial evaluation of 14 individuals identified three with potential asthma and three with symptoms consistent with interstitial lung disease. This outbreak represents a likely human response to inhaled fungal toxins in indoor environments.

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Cooley J. D., Wong W. C., Jumper C. A., Straus D. C.. Correlation between the prevalence of certain fungi and sick building syndrome. Occupational and environmental medicine. 1998;55:579–584. PMID: 9861178

This was a 22-month study in the United States of 48 schools (in which there had been concerns about health and indoor air quality (IAQ). The study results suggest that propagules of Penicillium and Stachybotrys species may be associated with sick building syndrome.

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Passon TJ Jr, Brown JW, Mante S. New and emerging pathogens, Part 6. Sick-building syndrome and building-related illness. MLO Med Lab Obs. 1996 Jul;28(7):84-6, 88, 90 passim; quiz 98-9. PMID: 10162473

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Packer, C.N., Stewart-Brown, S., and Fowle, S.E. Damp housing and adult health: results from a lifestyle study in Worcester, England. J Epidemiol Community Health. 1994; 48: 555–559. PMID: 7830009

The study involved an analysis of responses gathered in a cross sectional, postal questionnaire survey of a randomly selected sample of 5347 residents of Worcester. Altogether 2353 people aged 16 to 64 years responded to the survey (adjusted response 52%). Nine per cent of respondents lived in housing which they reported to be damp. Rates were highest among young women. People who lived in damp housing were more likely to report long standing illness, disability, or infirmity; the increased prevalence could not be attributed to any particular medical condition. Perceived ill health, as measured by the sleep, energy, and social isolation dimensions of the Nottingham Health Profile, was also more common in this group. These associations could not be explained by lifestyle factors; the relationship proved strongest among people in non-manual social classes living in owner occupied housing. The prevalence of ill health increased as the severity of dampness increased.

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Smoragiewicz W, Cossette B, Boutard A, Krzystyniak K. Trichothecene mycotoxins in the dust of ventilation systems in office buildings. Int Arch Occup Environ Health. 1993;65(2):113-7. PMID: 8253508

Analysis of trichothecene mycotoxins in dust samples from ventilation systems of office buildings was applied as a rapid and inexpensive method for the detection of mycotoxins. Dust samples from three different office spaces of the Montreal urban area, reportedly affected by the “sick buildings syndrome”, were analysed by thin-layer chromatography (TLC). The dust samples contained at least four trichothecenes: T-2 toxin, diacetoxyscirpenol, roridine A and T-2 tetraol.

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

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Hyndman, S.J. Housing dampness and health amongst British Bengalis in east London. Soc Sci Med. 1990; 30: 131–141. PMID: 2305276

The paper describes a survey that was undertaken to investigate the possible associations between damp public sector housing in London (U.K.) and the health of British Bengali tenants. The results show that there are significant relationships between reported and measured damp, cold and mould in the home and various aspects of reported health.

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Platt, S.D., Martin, C.J., Hunt, S.M., and Lewis, C.W. Damp housing, mould growth, and symptomatic health state. BMJ. 1989; 298: 1673–1678. PMID: 2503174

This was a survey of public housing residents in Glasgow, Edinburgh and London. Damp was found in 184 (30.8%) dwellings and actual mould growth in 274 (45.9%). Adult respondents living in damp and mouldy dwellings were likely to report more symptoms overall, including nausea and vomiting, blocked nose, breathlessness, backache, fainting, and bad nerves, than respondents in dry dwellings. Children living in damp and mouldy dwellings had a greater prevalence of respiratory symptoms (wheeze, sore throat, runny nose) and headaches and fever compared with those living in dry dwellings. The mean number of symptoms was higher in damp and mouldy houses and positively associated with increasing severity of dampness and mould (dose response relation).

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Martin, C.J., Platt, S.D., and Hunt, S.M. Housing conditions and ill health. Br Med J (Clin Res Ed). 1987; 294: 1125–1127. PMID: 3107723

A preliminary study was carried out of a random sample of council owned residences in a deprived area of Edinburgh. No conclusive effects of damp on the health of adults were identified. Nevertheless, children living in damp houses, especially where fungal mould was present, had higher rates of respiratory symptoms, which were unrelated to smoking in the household, and higher rates of symptoms of infection and stress.

 

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