|The Facts About
There has been a dramatic
increase nationwide in concern about mold and health effects. The term
"mold" describes more than a million species of microscopic fungi which
grow on wet organic matter. When excess moisture is present mold problems
can spread and proliferate rapidly. Mold spores are everywhere, including
the indoor environment. Under favorable conditions, spores germinate and
mold colonies grow and multiply.
What Are the Health Concerns with
Molds can produce a variety of allergenic
substances, odorous chemicals, and toxic metabolites. When it multiplies
and spreads indoors, high levels of mold can cause a spectrum of health
effects to include Hearing loss, Vomiting, Memory loss, and Asthmatic
lungs. Excess moisture is the underlying cause of indoor mold problems.
The key to prevention and correction is moisture control. The best way to
identify a mold problem is by visual inspection and following odors. If
mold (any type) can be seen or smelled, a mold problem exists.
Mold in the News
Fifty percent [50%] of homes contain problem molds.
A new medical study attributes nearly 100% of chronic sinus infections to
mold. A 300% increase in the asthma rate over the past 20 years has been
linked to molds, as reported in USA WEEKEND, Dec. 3-5,
A 1994 Harvard University School of Public Health
study of 10,000 homes in the United States and Canada found half had
conditions of water damage and mold associated with a 50 to 100%
increase in respiratory symptoms.
Last year Dr. David Sherris at the Mayo Clinic performed a study of
210 patients with chronic sinus infections and found that most had
allergic fungal sinusitis. The prevailing medical opinion has been that
mold accounted for 6 to 7 percent of all chronic sinusitis. [The Mayo
Clinic study] found that it was 93 percent-the exact reverse. [Newsweek,
Most homeowners believe that as long as they do not see visible signs
of mold, that is, patches of green, blue, or black discoloration on
surfaces, their environment is free of contamination. What they don't
realize, however, is that large accumulations of [hidden or concealed]
mold may be growing in areas that they cannot see, like remote attic or
basement spaces, or wall cavities. Left to multiply, these infestations
may produce enough organic compounds to cause allergic reactions,
sickness and, in extreme cases, death (a possibility with infants), wrote
Edward R. Lipinski in HOME CLINIC: The Battle Against Mold and
Mildew, NEW YORK TIMES, Sept. 12, 1999.
All molds have the potential to cause health effects. Molds can
produce allergens that can trigger allergic reactions or even asthma
attacks in people allergic to mold. Others are known to produce potent
toxins and/or irritants. Potential health concerns are an important
reason to prevent mold growth and to remediate/clean up any existing
indoor mold growth, noted the U.S. Environmental Protection Agency,
Because the effects of toxic mold (Stachybotrys) are similar to
Alzheimer's Disease [in such ways as the loss of memory and ability to
think logically], it is possible that relatives and friends of toxic mold
victims think that their relative's memory losses and mental diminishment
is a sign of advancing age, or of the onset of Alzheimer's disease.
Medical researchers strongly believe that environmental factors help
trigger what is ultimately a genetic condition. [USA Weekend, Aug. 31-
Sept. 2, 2001, p. 6]
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The following mold resources will help you understand the health and
environmental issues with indoor molds, controls, prevention, and
Molds, Toxic Molds, and Indoor Air Quality
My Home: What Do I Do?
California Research Bureau Reports Molds, Toxic Molds,
and Indoor Air Quality
Minnesota Department of Health - Mold in Homes
Investigating Mold in Minnesota Public Schools
WHAT EVERY HOMEOWNER SHOULD KNOW ABOUT MOLD
Recent Mold Legislation
Mold Legislation 1
Legislation 2 | Mold Legislation
Not so long ago, the only image that word created was of something
fuzzy growing on a forgotten leftover, somewhere deep in the recesses
of your refrigerator. More recently, however, mold has acquired a more
foreboding image, that of an infestation that can threaten your home
and your health. Both images are correct, actually, because there are
many different kinds of mold. And for all the talk it's generating now
among homeowners, insurers and health-care providers, mold has been
That's because, according to the U.S. Environmental Protection Agency,
mold spores constantly travel through the indoor and outdoor air. If
these spores are exposed to moisture, they can grow, digesting whatever
they're on, to reproduce. Outdoors, this process plays a key role in
the breakdown of leaves, wood and other plant debris. "In the forest,
it's nature's recycling plan," says Lloyd Osgood, a senior
microbiologist who analyzes mold for Environmental Laboratory Services
in North Syracuse. Indoors, however, mold growth can damage any number
of surfaces, particularly those with cellulose in them, including
drywall and carpeting. Also, some molds have been linked to respiratory
problems, particularly for those who suffer from allergies or asthma or
who have a compromised immune system.
But you could have mold and not experience any effects on your health.
Susan Anagnost, a wood-products biologist at the State University of
New York College of Environmental Science and Forestry, says there is a
great deal of ongoing research studying mold. Anagnost says much of the
research examines three categories associated with the inhalation of
molds: allergens, infections and toxins. Many homeowners have heard of
one type of mold in particular, stachybotrys (pronounced
STACK-ee-BOT-ris). Although it's not the most common type of mold and
requires a longer exposure to water than other molds, it is among the
most toxic and has been linked to memory and hearing loss as well as
bleeding in the lungs. Stachybotrys was also the type of mold in a
well-publicized case where a Texas homeowner won a $32 million judgment
in 2001 against Farmers Insurance Group, that has since been reduced to
$4 million. Locally, in 2001 the Onondaga County Health Department
confirmed stachybotrys in at least two condominiums at Village Green,
near Baldwinsville, although random testing of more units ruled out a
larger problem, says Gary Sauda, the department's director of
Stachybotrys forced Mary E. Hamilton from her condominium at 736
Village Blvd. S. in October 2001. Hamilton, 75, who had lived at
Village Green since 1986, is suing the Hartford Insurance Co. and the
Village Green Homeowners' Association. The homeowners' association, her
suit claims, failed to correct defective cedar siding and roofing
materials that led to a moisture problem that allowed the infestation
of mold to grow inside her wall cavities, and the insurance company
refused to cover the cost of cleaning up the mold. Hamilton, who lived
with her daughter for more than a year, moved back to the condominium
in early December 2002. "I needed to get back in my own home," she
says. "After you live on your own for 24 years, you need your own
space." Hamilton says she's spent approximately $45,000 over the last
14 months to deal with the mold, an amount that includes having the
mold infestation cleaned. Hamilton says her expenses are likely to
increase, because many items in her garage still need to be evaluated
and cleaned, if possible.
Bob Krell, president of IAQ Technologies, Inc., a Syracuse indoor air
quality company, performed Hamilton's "remediation," the industry's
term for cleaning a mold infestation. In Hamilton's case, the mold was
growing inside a wall. Krell built a containment structure around the
repair area to limit airborne spores and removed the infested
materials, including drywall, insulation and carpeting. Often, sight
and smell are the first signs that mold may be present, although mold
also can grow undetected inside a wall or in areas where access is
limited, such as a crawl space. Hamilton's first clues, she says, were
on her bedroom carpet, where she found water and some orange spots.
Later, there was a strong musty odor. She also experienced respiratory
problems, including itchy eyes, a runny nose and a sore throat. "As
long as I was gone, I didn't have those symptoms," Hamilton says. "The
minute I would come back home, they did too."
Dealing with mold depends on how much mold there is and where it's
located. If you have a large area, or mold that's inaccessible, you
should hire an experienced indoor air quality consultant or a
remediation specialist to investigate. Krell and Osgood also say the
underlying cause of the mold must be addressed, or it will return.
Because mold spores germinate where there is excessive moisture, look
for the cause of the moisture and correct it. Proper ventilation is
crucial because it keeps air moving and controls your home's moisture
levels. Ventilation should be to the outside and not to areas where
moisture can collect and mold can grow. Osgood frequently finds mold on
the underside of roofs, in attic crawl spaces. "Be sure the vent pipes
from the bathroom go through the roof and out of the crawl space,"
Osgood says. "Otherwise, you can grow orchids up there."
Mold on the web
- Use high-efficiency furnace filters, which are designed to trap
more pollutants, and be sure they fit properly. Expect to pay more
(up to $12 each) for such filters than for ordinary fiberglass
- Use a vacuum cleaner with True HEPA filtration.
- Have your air conditioner and furnace serviced regularly and
consider a germicidal air purifier.
- Do a visual inspection of your home's exterior. Clean your
gutters and unclog your downspouts.
- Check your landscaping to be sure that water drains away from
There are dozens of resources to help homeowners and renters prevent or
clean up mold in their homes. Here is a partial listing of some sources
accessible via the Internet:
The Environmental Protection Agency. The
agency has a Web site devoted to mold, and it contains a handbook called
"Mold, Moisture and Your
Home." For those without access to the Internet, the agency has a
toll-free phone number with operators who can answer questions about
The National Association of Homebuilders. Its research center
also has a site devoted to mold.
The Centers for Disease Control and Prevention. The agency asked
the National Academy of Sciences' Institute of Medicine to review all
evidence of health
effects linked to mold. A study is expected in 2003.
The Indoor Air Quality Association, the group that certified
professionals who are trained to eradicate
mold from buildings.
The Policy Holders of America. A consumer group established to
help homeowners get mold claims reimbursed if their homeowner's policies
The Insurance Information Institute. A Web site of the insurance
industry that has information about mold
claims from the industry's point of view.
The National Association of Realtors. Mold is becoming an issue in home buying
and selling. This organization has several pages on mold, including a
American Society of Home Inspectors. This organization of home
inspectors offers mold control tips at
its Web site.
Office of Air and Radiation
Office of Research and Development
Office of Radiation and Indoor Air (6609J)
The term "sick building syndrome" (SBS) is used to describe situations
in which building occupants experience acute health and comfort effects
that appear to be linked to time spent in a building, but no specific
illness or cause can be identified. The complaints may be localized in a
particular room or zone, or may be widespread throughout the building. In
contrast, the term "building related illness" (BRI) is used when symptoms
of diagnosable illness are identified and can be attributed directly to
airborne building contaminants.
A 1984 World Health Organization Committee report suggested that up to
30 percent of new and remodeled buildings worldwide may be the subject of
excessive complaints related to indoor air quality (IAQ). Often this
condition is temporary, but some buildings have long-term problems.
Frequently, problems result when a building is operated or maintained in
a manner that is inconsistent with its original design or prescribed
operating procedures. Sometimes indoor air problems are a result of poor
building design or occupant activities.
Indicators of SBS include:
- Building occupants complain of symptoms associated with acute
discomfort, e.g., headache; eye, nose, or throat irritation; dry
cough; dry or itchy skin; dizziness and nausea; difficulty in
concentrating; fatigue; and sensitivity to odors.
- The cause of the symptoms is not known.
- Most of the complainants report relief soon after leaving the
Indicators of BRI include:
- Building occupants complain of symptoms such as cough; chest
tightness; fever, chills; and muscle aches
- The symptoms can be clinically defined and have clearly
- Complainants may require prolonged recovery times after leaving
It is important to note that complaints may result from other
causes. These may include an illness contracted outside the building,
acute sensitivity (e.g., allergies), job related stress or
dissatisfaction, and other psychosocial factors. Nevertheless, studies
show that symptoms may be caused or exacerbated by indoor air quality
Causes of Sick Building Syndrome
The following have been cited causes of or contributing factors to
sick building syndrome:
Inadequate ventilation: In the early and mid 1900's, building
ventilation standards called for approximately 15 cubic feet per minute
(cfm) of outside air for each building occupant, primarily to dilute
and remove body odors. As a result of the 1973 oil embargo, however,
national energy conservation measures called for a reduction in the
amount of outdoor air provided for ventilation to 5 cfm per occupant.
In many cases these reduced outdoor air ventilation rates were found to
be inadequate to maintain the health and comfort of building occupants.
Inadequate ventilation, which may also occur if heating, ventilating,
and air conditioning (HVAC) systems do not effectively distribute air
to people in the building, is thought to be an important factor in SBS.
In an effort to achieve acceptable IAQ while minimizing energy
consumption, the American Society of Heating, Refrigerating and
Air-Conditioning Engineers (ASHRAE) recently revised its ventilation
standard to provide a minimum of 15 cfm of outdoor air per person (20
cfm/person in office spaces). Up to 60 cfm/person may be required in
some spaces (such as smoking lounges) depending on the activities that
normally occur in that space (see ASHRAE Standard 62-1989).
Chemical contaminants from indoor sources: Most indoor air
pollution comes from sources inside the building. For example,
adhesives, carpeting, upholstery, manufactured wood products, copy
machines, pesticides, and cleaning agents may emit volatile organic
compounds (VOCs), including formaldehyde. Environmental tobacco smoke
contributes high levels of VOCs, other toxic compounds, and respirable
particulate matter. Research shows that some VOCs can cause chronic and
acute health effects at high concentrations, and some are known
carcinogens. Low to moderate levels of multiple VOCs may also produce
acute reactions. Combustion products such as carbon monoxide, nitrogen
dioxide, as well as respirable particles, can come from unvented
kerosene and gas space heaters, woodstoves, fireplaces and gas
Chemical contaminants from outdoor sources: The outdoor air
that enters a building can be a source of indoor air pollution. For
example, pollutants from motor vehicle exhausts; plumbing vents, and
building exhausts (e.g., bathrooms and kitchens) can enter the building
through poorly located air intake vents, windows, and other openings.
In addition, combustion products can enter a building from a nearby
Biological contaminants: Bacteria, molds, pollen, and viruses
are types of biological contaminants. These contaminants may breed in
stagnant water that has accumulated in ducts, humidifiers and drain
pans, or where water has collected on ceiling tiles, carpeting, or
insulation. Sometimes insects or bird droppings can be a source of
biological contaminants. Physical symptoms related to biological
contamination include cough, chest tightness, fever, chills, muscle
aches, and allergic responses such as mucous membrane irritation and
upper respiratory congestion. One indoor bacterium, Legionella, has
caused both Legionnaire's Disease and Pontiac Fever.
These elements may act in combination, and may supplement other
complaints such as inadequate temperature, humidity, or lighting. Even
after a building investigation, however, the specific causes of the
complaints may remain unknown.
A Word About Radon and
SBS and BRI are associated with acute or
immediate health problems; radon and asbestos cause long-term
diseases which occur years after exposure, and are therefore not
considered to be among the causes of sick buildings. This is not
to say that the latter are not serious health risks; both should
be included in any comprehensive evaluation of a building's
Building Investigation Procedures
The goal of a building investigation is to identify and solve indoor
air quality complaints in a way that prevents them from recurring and
which avoids the creation of other problems. To achieve this goal, it is
necessary for the investigator(s) to discover whether a complaint is
actually related to indoor air quality, identify the cause of the
complaint, and determine the most appropriate corrective actions.
An indoor air quality investigation procedure is best
characterized as a cycle of information gathering, hypothesis
formation, and hypothesis testing. It generally begins with a
walkthrough inspection of the problem area to provide information about
the four basic factors that influence indoor air quality:
- the occupants
- the HVAC system
- possible pollutant pathways
- possible contaminant sources.
Preparation for a walkthrough should include documenting
easily obtainable information about the history of the building and
of the complaints; identifying known HVAC zones and complaint areas;
notifying occupants of the upcoming investigation; and, identifying
key individuals needed for information and access. The walkthrough
itself entails visual inspection of critical building areas and
consultation with occupants and staff.
The initial walkthrough should allow the investigator to
develop some possible explanations for the complaint. At this point,
the investigator may have sufficient information to formulate a
hypothesis, test the hypothesis, and see if the problem is solved. If
it is, steps should be taken to ensure that it does not recur.
However, if insufficient information is obtained from the walk
through to construct a hypothesis, or if initial tests fail to reveal
the problem, the investigator should move on to collect additional
information to allow formulation of additional hypotheses. The
process of formulating hypotheses, testing them, and evaluating them
continues until the problem is solved.
Although air sampling for contaminants might seem to be the
logical response to occupant complaints, it seldom provides
information about possible causes. While certain basic measurements,
e.g., temperature, relative humidity, CO2, and air movement, can
provide a useful "snapshot" of current building conditions, sampling
for specific pollutant concentrations is often not required to solve
the problem and can even be misleading. Contaminant concentration
levels rarely exceed existing standards and guidelines even when
occupants continue to report health complaints. Air sampling should
not be undertaken until considerable information on the factors
listed above has been collected, and any sampling strategy should be
based on a comprehensive understanding of how the building operates
and the nature of the complaints.
Solutions to Sick Building Syndrome
Solutions to sick building syndrome usually include combinations of
Pollutant source removal or modification is an effective
approach to resolving an IAQ problem when sources are known and control
is feasible. Examples include routine maintenance of HVAC systems,
e.g., periodic cleaning or replacement of filters; replacement of
water-stained ceiling tile and carpeting; institution of smoking
restrictions; venting contaminant source emissions to the outdoors;
storage and use of paints, adhesives, solvents, and pesticides in well
ventilated areas, and use of these pollutant sources during periods of
non-occupancy; and allowing time for building materials in new or
remodeled areas to off-gas pollutants before occupancy. Several of
these options may be exercised at one time.
Increasing ventilation rates and air distribution often can
be a cost effective means of reducing indoor pollutant levels. HVAC
systems should be designed, at a minimum, to meet ventilation standards
in local building codes; however, many systems are not operated or
maintained to ensure that these design ventilation rates are provided.
In many buildings, IAQ can be improved by operating the HVAC system to
at least its design standard, and to ASHRAE Standard 62-1989 if
possible. When there are strong pollutant sources, local exhaust
ventilation may be appropriate to exhaust contaminated air directly
from the building. Local exhaust ventilation is particularly
recommended to remove pollutants that accumulate in specific areas such
as rest rooms, copy rooms, and printing facilities. (For a more
detailed discussion of ventilation, read Indoor Air Facts No. 3R,
Ventilation and Air Quality in Office Buildings.)
Air cleaning can be a useful adjunct to source control and
ventilation but has certain limitations. Particle control devices such
as the typical furnace filter are inexpensive but do not effectively
capture small particles; high performance air filters capture the
smaller, respirable particles but are relatively expensive to install
and operate. Mechanical filters do not remove gaseous pollutants. Some
specific gaseous pollutants may be removed by adsorbent beds, but these
devices can be expensive and require frequent replacement of the
adsorbent material. In sum, air cleaners can be useful, but have
Education and communication are important elements in both
remedial and preventive indoor air quality management programs. When
building occupants, management, and maintenance personnel fully
communicate and understand the causes and consequences of IAQ problems,
they can work more effectively together to prevent problems from
occurring, or to solve them if they do.
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