Health Effects and Symptoms Associated with Mold Exposure
When
moisture problems occur and mold growth results, building occupants may
begin to report odors and a variety of health problems, such as
headaches, breathing difficulties, skin irritation, allergic
reactions, and aggravation of asthma symptoms; all of these symptoms
could potentially be associated with mold exposure.
All
molds have the potential to cause health effects. Molds produce
allergens, irritants, and in some cases, toxins that may cause
reactions in humans. The types and severity of symptoms depend, in
part, on the types of mold present, the extent of an individual's
exposure, the ages of the individuals, and their existing sensitivities
or allergies.
Potential Health Effects Associated with Inhalation Exposure to Molds and Mycotoxins
Allergic Reactions (e.g., rhinitis and dermatitis or skin rash); Asthma;
Hypersensitivity Pneumonitis; Other Immunologic Effects
Research on mold and health effects is ongoing. This
list is not intended to be all-inclusive.
The
health effects listed above are well documented in humans. Evidence for
other health effects in humans is less substantial and is primarily
based on case reports or occupational studies.
Specific reactions to mold growth can
include the following:
- Allergic Reactions
Inhaling or touching mold or mold spores may cause allergic reactions
in sensitive individuals. Allergic reactions to mold are common - these
reactions can be immediate or delayed. Allergic responses include hay
fever-type symptoms, such as sneezing, runny nose, red eyes, and skin
rash (dermatitis). Mold spores and fragments can produce allergic
reactions in sensitive individuals regardless of whether the mold is
dead or alive. Repeated or single exposure to mold or mold spores may
cause previously non-sensitive individuals to become sensitive.
Repeated exposure has the potential to increase sensitivity.
- Asthma
Molds can trigger asthma attacks in persons who are allergic (sensitized) to molds. The irritants produced by molds may
also worsen asthma in non-allergic (non-sensitized) people.
- Hypersensitivity Pneumonitis
Hypersensitivity pneumonitis may develop following either short-term (acute) or long-term (chronic) exposure to molds.
The disease resembles bacterial pneumonia and is uncommon.
- Irritant Effects
Mold exposure can cause irritation of the eyes, skin, nose, throat, and lungs, and sometimes can create a burning sensation
in these areas.
- Opportunistic Infections
People with weakened immune systems (i.e., immune-compromised or immune-suppressed individuals) may be more vulnerable to
infections by molds (as well as more vulnerable than healthy persons to mold toxins). Aspergillus fumigatus,
for example, has been known to infect the lungs of immune-compromised individuals. These individuals inhale the
mold spores which then start growing in their lungs. Trichoderma has also been known to infect immune-compromised
children.
Healthy individuals are usually not vulnerable to opportunistic infections from airborne mold exposure. However, molds can
cause common skin diseases, such as athlete's foot, as well as other infections such as yeast infections.
Toxic Molds
Some molds, such as Aspergillus versicolor and Stachybotrys atra (chartarum),
are known to produce potent toxins under certain circumstances.
Although some mycotoxins are well known to affect humans and have been
shown to be responsible for human health effects, for many mycotoxins,
little information is available, and in some cases research is
ongoing. For example, some strains of Stachybotrys atra can produce one or more potent toxins. In addition, preliminary reports from an investigation of an outbreak of
pulmonary hemorrhage in infants suggested an association between pulmonary hemorrhage and exposure to Stachybotrys chartarum.
Review of the evidence of this association at CDC resulted in an a
published clarification stating that such an association was not
established. Research on the possible causes of pulmonary hemorrhage in
infants continues. Consult the Centers for Disease Control and
Prevention (CDC) for more information on pulmonary hemorrhage in
infants.
Mold Toxins (Mycotoxins)
Molds
can produce toxic substances called mycotoxins. Some mycotoxins cling
to the surface of mold spores; others may be found within spores. More
than 200 mycotoxins have been identified from common molds, and many
more remain to be identified. Some of the molds that are known to
produce mycotoxins are commonly found in moisture-damaged buildings.
Exposure pathways for mycotoxins can include inhalation, ingestion, or
skin contact. Although some mycotoxins are well known to affect humans
and have been shown to be responsible for human health effects, for
many mycotoxins, little information is available.
Aflatoxin B1 is perhaps the most well known and studied mycotoxin. It can be produced by the molds Aspergillus flavus and Aspergillus
parasiticus and is one of the most potent carcinogens known. Ingestion of aflatoxin B1 can cause liver cancer. There is also some evidence that
inhalation of aflatoxin B1 can cause lung cancer. Aflatoxin B1 has been found on contaminated grains, peanuts, and other human and animal
foodstuffs. However, Aspergillus flavus and Aspergillus parasiticus are not commonly found on building materials or in indoor environments.
Much
of the information on the human health effects of inhalation exposure
to mycotoxins comes from studies done in the workplace and some case
studies or case reports.
Many symptoms and human health effects attributed to inhalation of
mycotoxins have been reported including: mucous membrane irritation,
skin rash, nausea, immune system suppression, acute or chronic liver
damage, acute or chronic central nervous system damage, endocrine
effects, and cancer. More studies are needed to get a clear picture of
the health effects related to most mycotoxins. However, it is clearly
prudent to avoid exposure to molds and mycotoxins.
Some molds can produce several toxins, and some molds
produce mycotoxins only under certain environmental conditions. The
presence of mold in a building does not necessarily mean that
mycotoxins are present or that they are present in large quantities.
Note: Information on ingestion exposure, for both humans and animals, is more abundant -- wide range of health effects has been
reported following ingestion of moldy foods including liver damage, nervous system damage, and immunological effects.
Microbial Volatile Organic Compounds (mVOCs)
Some
compounds produced by molds are volatile and are released directly into
the air. These are known as microbial volatile organic compounds
(mVOCs). Because these compounds often have strong and/or unpleasant
odors, they can be the source of odors associated with molds. Exposure
to mVOCs from molds has been linked to symptoms such as headaches,
nasal irritation, dizziness, fatigue, and nausea. Research on MVOCs is
still in the early phase.
Glucans or Fungal Cell Wall Components (also known as ß-(1-->3)-D-
Glucans)
Glucans
are small pieces of the cell walls of molds which may cause
inflammatory lung and airway reactions. These glucans can affect the
immune system when inhaled. Exposure to very high levels of glucans or
dust mixtures including glucans may cause a flu-like illness known as
Organic Dust Toxic Syndrome (ODTS). This illness has been primarily
noted in agricultural and manufacturing settings.
Spores
Mold spores are microscopic (2-10 um)
and are naturally present in both indoor and outdoor air. Molds
reproduce by means of spores. Some molds have spores that are easily
disturbed and waft into the air and settle repeatedly with each
disturbance. Other molds have sticky spores that will cling to surfaces
and are dislodged by brushing against them or by other direct contact.
Spores may remain able to grow for years after they are produced. In
addition, whether or not the spores are alive, the allergens in and on
them may remain allergenic for years.