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What is mold?

What are some of the health effects associated with mold?

Who’s most at risk with mold exposure?

How does mold get into my house?

Why do some people get sick from mold and others do not?

What types of materials does mold grow on?

What does Health Canada and the Canadian government say about mold?

What is mold?

Molds are simple microscopic organisms that have existed for millions of years, they can be found everywhere in our environment. There are 20,000 different types of mold. mold is neither apart of the animal or the plant family, but apart of the Fungi family. There are approximately 1.5 million species of fungi. Certain types of fungi exist naturally in soils, plants, fruits, textiles and even leather products. mold reproduce by making spores, which is very similar to the way a plant reproduces by making seeds.

Some facts about mold and fungi:

	Molds are a sub-group of fungi.

	They make up 25% of earths biomass and are always in the air we breathe.

	They are the #1 cellulose degraders on the planet.

	Differ from plants as they have no chlorophyll to produce food from sunlight.

	Different kinds of fungi are staining fungi, decaying fungi, and surface molds.

	Exposure to mold is associated with increased rates of respiratory disease.

What are some of the health effects associated with mold?

(Published by Health Canada) It is well established that fungi cause several diseases, such as systemic infections and asthma. However, cases of these diseases associated with fungal exposure in public buildings are rarely, if ever, reported, On the other hand, fungi have been raised as one of the possible causes of SBS, which is frequently reported. Symptoms of SBS (sick building syndrome) typically include:

	Asthma or shortness in breath
	Bronchitis
	Chronic colds
	Prolonged fatigue, drowsiness, and lethargy
	Reduced mental capacity, mental fatigue
	Intense and chronic body aches and pains
	Eye irritation (itching and watering eyes)
	Nasal irritation, nasal congestion
	Throat irritation
	Acute or chronic cough, wheeze
	Infant pulmonary haemorrhage
	Hoarseness, changed voice
	Skin irritation (stinging sensation, itching, dry skin)
	Headaches
	Nausea
	Changed sensation of odour or taste

Who’s most at risk with mold exposure?

That would include:

	Infants
	The elderly
	The chronically ill
	Immune-compromised individuals
	People that have a genetic predisposition

How does mold get into my house?

	InfantsThrough doorways and windows
	Through ventilation and air conditioning systems
	On people, clothing, shoes, and bags
	On construction material
	On any house hold item that’s brought into the house

Fact: Every house has mold spores in it.

Fact: Every house does not have mold growing in it.

Mold becomes a problem when it starts to colonize and grow inside a house or building. This raises the concentrations of the mold spores inside the living space to high or extreme levels, causing potentially serious health risks. mold will start growing in as little as 24-48 hours after being exposed to water or a moisture source. This means that if a house or building has had any of the following and hasn’t been dried out in 24-48 hours, it may have a mold problem:

	Roof leak
	Plumbing leak
	Sink or bathtub overflow
	Moist or leaking basement
	Grow-Op
	Building envelope flaws
	Basement flood
	Blown hot water tank
	Musty smelling areas
	Water staining
	High relative humidity
	Saturated lumber used during construction

Why do some people get sick from mold and others do not?

It is because of genetic and physiological differences. Sensitivity to mold in about 20 % of the human population is believed to be hereditary. Other factors that influence individual's resistance to mold include age and general health status. For example, infants, the elderly and those recovering from diseases may be at risk of mold exposure even at levels that would otherwise be considered "normal".

Susceptibility differences among individuals and the variability of molds in their ability to cause health problems make it difficult to determine and set permissible exposure levels for indoor molds.

What types of materials does mold grow on?

Just about anything:

	Drywall
	Glass
	Metal
	Concrete block
	Plastic
	Ceiling tiles
	Drapes
	Carpet

What does Health Canada and the Canadian government say about mold?

Residential Indoor Air Quality Guidelines for mold

Physical and chemical properties

The word "mold" is a common term referring to fungi that can grow on building materials in homes or other buildings. mold growth can influence air quality because both spores and mycelial fragments are dispersed into the air and can be inhaled. Their penetration into the bronchial tree depends on their size. The smaller particles penetrate deeper into the lungs.

Three features of mold biochemistry are of special interest in terms of human health:

	Mold cell walls contain (1->3)-ß-D-glucan, a compound with inflammatory

	Mold spores and mycelial fragments contain allergens; and

	The spores of some species contain low molecular weight chemicals that are cytotoxic or have other toxic properties (e.g. satratoxins and atranones produced by Stachybotrys chartarum).

Causes of mold growth

mold growth in a house requires the presence of nutrients, an adequate temperature, and a sufficient amount of water. The first two requirements being usually met in indoor environments, fungal growth usually results from a moisture problem (CMHC 2003). Major causes of mold growth are:

	excess humidity resulting in condensation on surfaces;

	water leakage, e.g. from a broken pipe;

	Infiltration of water from the outside, e.g. from a leaking roof or a cracked basement; and a flood.

Health effects

Health Canada has carried out two reviews of the scientific literature pertaining to the health effects of indoor molds (Health Canada 1995; 2004). The Institute national de santé publique du Québec also published a review on this subject (d'Halewyn et al. 2003). The following conclusions were drawn:

	Exposure to indoor mold is associated with an increased prevalence of asthma-related symptoms such as chronic wheezing, irritative, and non-specific symptoms; and

	In laboratory animal studies, inhalation of fungal allergens (Penicillium sp. and Aspergillus sp.) and fungal cell components [(1->3)-ß-D-glucan] resulted in an inflammatory response in the lungs of rodents, while instillation of Stachbotrys chartarum spores resulted in severe biochemical and ultrastructural changes.

These conclusions have been supported by more recent findings. In two cohort studies (Wickman et al. 2003; Jaakkola et al. 2005), significant associations were found between home dampness and the risk of developing asthma. In experimental studies, asthma-like responses were observed in mice following exposure to a typical building-associated fungus, Penicillium chrysogenum (Chung et al. 2005), and inflammatory responses were seen in rats exposed to low doses of toxins from the same species (Rand et al. 2005).

Residential Indoor Air Quality Guideline

Health Canada considers that mold growth in residential buildings may pose a health hazard. Health risks depend on exposure and, for asthma symptoms, on allergic sensitization. Therefore, Health Canada recommends:

	to control humidity and diligently repair any water damage in residences to prevent mold growth; and

	to clean thoroughly any mold growing in residential buildings

These recommendations apply regardless of the mold species found to be growing in the building.

Fungal Contamination in Public Buildings: Health Canada

Introduction

The health implications of the fungal contamination of indoor air have become an issue of increasing concern in recent years. At the request of the Government of Prince Edward Island, and with the support of the Federal-Provincial Committee on Environmental and Occupational Health, a working group was established to develop an interim guide to assist public health, occupational health, and building maintenance officials in the interpretation of fungal contamination data from public buildings with respect to health.

The Working Group has reviewed the health effects associated with fungal contamination of indoor air, reviewed existing indoor air quality guidelines, and provided guidance on procedures for the investigation and interpretation of indoor fungal contamination and for remediation and preventive maintenance of buildings.

Identifying problems in the building environment

Fungal proliferation is most often found in buildings in which there is excess moisture, often in the presence of water-damaged material. Investigators should look for areas in buildings where moisture and substrates may encourage fungal growth —for example, areas containing cellulose materials, air filters, heat exchangers, humidifiers, water sumps, perimeter heating and cooling units, wetted carpet, porous duct lining materials, etc. An attempt should be made to correlate these conditions with high-symptom areas and to designate possible hot spots of contamination.

Identification of indoor fungal amplifiers

Thorough visual inspection of a problem building, combined with some surface samples for microscopic analysis of apparent mold colonies and of deposits in HVAC systems, may obviate the need for air sampling. Where such inspections yield negative results, air sampling should be considered.

Destructive testing is necessary when certain structures of the building have to be taken apart in an attempt to locate the source of suspected contamination. During this phase, the contamination status of the building is expected to be altered by the actions taken by the investigative team, possibly through exposure of previously cryptic contaminants and redistribution of such contaminants via the HVAC system or by other means. All individuals within the building should be protected from exposure.

A key element of the report is a detailed step-wise protocol to assist professionals who may be asked to investigate a building with a potential fungal amplification problem. This protocol covers investigation of building history, visual inspection, sampling and culturing of airborne propagules and examination and culturing of materials.

Remediation Actions

Strategies for the remediation of indoor air quality problems caused by fungi are based on the elimination of conditions that promote the amplification of these potentially hazardous organisms. Remediation of fungal hazards may involve cleaning affected areas, decontaminating the HVAC systems, removing contaminated materials, repairing or replacing damaged materials or structures, and modifying the environmental conditions in the affected area. During this phase, the contamination status of the building is expected to be altered by the actions taken by the investigative team, possibly through disturbance of newly exposed heavy concentrations of contaminants and redistribution of such contaminants via the HVAC system.

The design, construction, and maintenance of public buildings should minimize conditions that allow the accumulation, amplification, and dissemination of micro-organisms in indoor air. Building maintenance personnel and building managers should be aware of the potential health problems associated with contaminated indoor air, including the importance of the proper design, installation, operation, and maintenance of HVAC systems to minimize accumulation, amplification, and dissemination of micro-organisms. Prevention of fungal contamination is one of the most desirable strategies for risk management.

References (1):CHMC 2003. Clean-up Procedures for Mold in Houses. Revised ed. Ottawa: Canada Mortgage and Housing Corporation. ISBN: 0-660-19227-6.Chung, Y. J., Coates, N. H., Viana, M. E., Copeland, L., Vesper, S. J., Selgrade, M. K., Ward, M. D. W. 2005. Dose-dependent allergic responses to an extract of Penicillium chrysogenum in BALB/c mice. Toxicology 209: 77-89.d'Halewyn, M. A., Leclerc, J. M., King, N., Bélanger, M., Legris, M. and Frenette, Y., 2002. Les risques à la santé associés à la présence de moisissures en milieu intérieur. Québec : Institut national de santé publique du Québec. 105 p. + appendices.Health Canada 1995. Fungal Contamination in Public Buildings: a Guide to Recognition and Management. Ottawa: Health Canada.Health Canada 2004. Fungal Contamination in Public Buildings: Health Effects and Investigation Methods. Ottawa: Health Canada. ISBN 0-662-37432-0. 47 p.Jaakkola, J. J. K., Hwang, B. F., Jaakkola, N. 2005. Home dampness and molds, parental atopy, and asthma in childhood: a six-year population-based cohort study. Environmental Health Perspectives. 113: 357-361.Rand, T. G., Giles, S., Flemming, J., Miller, J. D., Puniani, E. 2005. Inflammatory and cytotoxic responses in mouse lungs exposed to purified toxins from building isolated Penicillium brevicompactum Dierckx and P. chrysogenum Thom. Toxicological Sciences 87: 213-222.Wickman, M., Melen, E., Berglind, N., Lennart Nordvall, S., Almqvist, C., Kull, I., Svartengren, M., Pershagen, G. 2003. Strategies for preventing wheezing and asthma in small children. Allergy 58: 742-747.

References (2)1.Kozak, P.P., Gallup, J., Commins, L.H., and Gillman, S.A. Currently available methods for home mold surveys. II. Examples of problem homes surveyed. Ann. Allergy, 45: 167 (1980).2.Sayer, W., Shean, D.B., and Ghosseiri, J. Estimation of airborne fungal flora by the Andersen sampler versus the gravity settling culture plate. J. Allergy, 44: 214 (1969). 3.Buttner, M.P. and Stetzenbach, L.D. Monitoring airborne fungal spores in an experimental indoor environment to evaluate sampling methods and the effects of human activity on airsampling. Appl. Environ. Microbiol., 59: 219 (1993) [erratum notice: Appi. Environ.Microbiol., 59: 1694 (1993)].4. Verhoeff, A.P., van Wijnen, J.H., Brunekreef, B., Fischer, P., van Reenen-Hoekstra, ES.,and Samson, R.A. Presence of viable mold propagules in indoor air in relation to house damp and outdoor air. Allergy, 47: 83 (1992). 5.Good, I.J. The population frequencies of species and the estimation of population parameters. Biometrika, 40: 237 (1953).6.Gochenaur, S.E. Fungi of a Long Island oak—birch forest. II. Population dynamics and hydrolase patterns of the soil penicillia. Mycologia, 76: 218 (1984).7.Hyvarinen, A., Reponen, T., Husman, T., Ruuskanen, J., and Nevalainen, A. Composition of fungal flora in mold problem houses determined with four different methods. In: Indoor air ‘93, Proceedings of the 6th International Conference on Indoor Air Quality and Climate. Vol. 4. Particles, microbes, radon. P. Kalliokoski, M. Jantunen, and 0. Seppanen (eds.). Helsinki. p. 273 (1993). 8.Solomon, W.R. Assessing fungus prevalence in domestic interiors. J. Allergy Clin.Immunol., 56: 235 (1975).9.Verhoeff, A.P., van Wijnen, J.H., Boleij, J.S.M., Brunekreef, B., van Reenen-Hoekstra,E.S., and Samson, R.A. Enumeration and identification of airborne viable mold propagulesin houses: a field comparison of selected techniques. Allergy, 45: 275 1990).10.Kapyla, M. Frame fungi on insulated windows. Allergy, 40: 558 (1985).11.Muilenberg, M.L. Aeroallergen assessment by microscopy and culture. Immunol. Allergy Clin. N. Am., 9:245(1989).12.Blomquist, G., Palmgren, V., and Strom, G. Improved techniques for sampling airborne fungal particles in highly contaminated environments. Scand. J. Work Environ. Health, 10:253 (1984).13.Miller, J.D. Fungi and the building engineer. In: IAQ ‘92, Environments for people. M.Geshwiler (ed.).SHRAE, Atlanta, GA (1993).14. Smid, T., Schokkin, E., Boleij, J.S., and Heederik, D. Enumeration of viable fungi in occupational environments: a comparison of samplers and media. Am. md. Hyg. Assoc. J.,50: 235 (1989).15.Thorne, P.S., Kiekenhaefer, M.S., Whitten, P., and Donham, K.J. Comparison of bioaerosol sampling methods in barns housing swine. App!. Environ. Microbiol., 58: 2543(1992).16.Pasanen, A.L., Kalliokoski, 0., Pasanen, P., Salmi, T., and Tossavainen, A. Fungi carriedfrom farmers’ work into farm homes. Am. md. Hyg. Assoc. J., 50: 631 (1989).17.Miller, J.D. Fungi as contaminants in indoor air. Atmos. Environ., 26A: 2163 (1992).18.Burge, H.A., Chatigny, M., Feeley, J., Kreiss, K., Morey, P., Otten, J., and Petersen, K.Guidelines for assessment and sampling of saprophytic bioaerosols in the indoor environment. App!. md. Hyg., 9: 10 (1987).19. van Reenen-Hoekstra, E.S., Samson, R.A., Verhoeff, A.P., van Wijnen, J.H., and Brunekreef, B. Detection and identification of molds in Dutch houses and non-industrial working environments. Grana, 30: 418 (1991).20.Morring, K.L., Sorenson, W.G., and Attfield, M.D. Sampling for airborne fungi: a statistical comparison of media. Am. md. Hyg. Assoc. J., 44: 662 (1983).21.Littman, M.L. Growth of pathogenic fungi on a new culture medium. Tech. Bull. Reg.Med. Tech., 18: 409 (1948).

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