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ADVERSE HEALTH EFFECTS OF INDOOR MOULDS ADVERSE HEALTH EFFECTS INDOOR MOULDS Moulds and the mycotoxins they produce are a growing threat to health around the world, and tests to detect and diagnose them need to be adopted on a wide scale. Introduction n recent years, public attention has become increasingly focused on the very real problem of mould (fungi) inside both home and workplace and on the very real dangers to human health posed by such mould exposure. This position paper is presented by the American Academy of Environmental Medicine (AAEM) to describe the current knowledge of adverse health effects of indoor mould. There is considerable evidence in the medical literature validating the many different health effects reported in airborne-mould-exposed patients. Indoor airborne mould exposure frequently causes adverse human health effects with injury to and dysfunction of multiple organs and systems including: 1) respiratory, 2) nervous, 3) immune, 4) haematological systems, and 5) the skin. Indoor mould is also a common cause of life-threatening systemic infections in immuno-compromised patients. Moulds are Common in the Indoor Environment Fungi (or moulds) are ubiquitous in both indoor and outdoor environments. Moulds are frequently spread by airborne spores. Mould and mould spores require moisture and a food source like cellulose or decaying food to grow.' As mould spores swell with water and grow, they elongate, forming balloon-like protuberances (hyphae) which secrete digestive enzymes and mycotoxins. The fungus then digests the food source to support its growth. About 100,000 fungal species have already been identified; in fact, fungi are estimated to comprise an astounding 25% of the world's biomass.” Various surveys of homes in North America and Europe have reported that visible mould and/or water damage are found in 23% to 98% of all homes.** There are no official standards, at this time, for indoor airborne fungus concentrations. However, indoor fungal levels above a range of 150 to 1,000 colony-forming units per cubic metre of air (cfu/m*) are considered to be sufficient to cause human health problems.*’® Numerous reports have documented that indoor air can often be contaminated with indoor fungal spore levels well in excess 0: 1,000 cfu/m*. The most common indoor fungi generally collected are Cladosporium, Aspergillus and Penicillium. Alternaria, Stachybotrys, Rhizopus, Mucor, Wallemia, Trichoderma, yeasts, Botrytis, Epicoccum and Fusarium species are often being foun indoors as well.'*” Foreclosures, lawsuits and insurance claims due to mould problems are common. Policyholders of America reports receiving about 50 calls a week about homes with mould problems undergoing foreclosure.'* In 2002, an estimated 10,000 mould-relate cases were pending in US courts."® In 2002, the insurance industry paid out US$2 billion in mould-related claims in Texas alone.” by Luke Curtis, MS, CIH Allan Lieberman, MD Martha Stark, MD William Rea Marsha Vetter, MD, PhD © 2004 From: http://www.acnem.org/journal/ 23-1_april_2004/indoor_moulds.htm by Luke Curtis, MS, CIH Allan Lieberman, MD Martha Stark, MD William Rea Marsha Vetter, MD, PhD © 2004 Mould Related Health Symptoms are Common and Varied Many patients have been reporting multiple ill health effects from their exposures to mould. Studies of more than 1,600 patients suffering ill effects from fungus exposure were presented at one meeting in Dallas in 2003 (21st Annual Symposium of Man and His Environment, Dallas, Texas, June 2003").'*> To cite a couple of studies... Lieberman”! examined 48 mould-exposed patients who had the following health problems: 1) muscle and/or joint pain, 71%; 2) fatigue/weakness, 70%; 3) neurocognitive dysfunction, 67%; 4) sinusitis, 65%; 5) headache, 65%; 6) gastrointestinal problems, 58%; 7) shortness of breath, 54%; 8) anxiety/depression/irritability, 54%; 9) vision JUNE — JULY 2006 NEXUS +19 www.nexusmagazine.com