October 20, 2000

Summary of Presentation on Mold

By Peter H. Wald, MD, MPH
Board-Certified, Occupational Medicine, Medical Toxicology, Internal Medicine
Principal, WorkCare
www.WorkCare.com

Presented September 7, 2000
Oak Avenue Middle School, Temple City

Background On Services Provided To La Rosa Elementary

On September 1, 2000 , La Rosa Elementary School in Temple City contacted Dr. Peter P. Greaney, M.D., of WorkCare to provide medical consulting services regarding a mold species found in one of its classrooms.  Dr. Greaney, a board-certified physician in occupational medicine and specialist in toxicology, is President/CEO of WorkCare, a national provider of occupational health consulting services. 

La Rosa Elementary retained Dr. Greaney to provide clinical guidance in assessing the public health risks related to the discovered mold.  Following are highlights of Dr. Greaney's presentation, which was delivered on September 7 at a community meeting called by the Temple City Unified School District (District).

Fungi and Mold:  A Definition

Fungi are microscopic organisms that are part of our everyday world.  Fungi can be categorized into several species, including mold, mildew and mushrooms.  Certain forms of fungi have proven to be beneficial to humans.  Beer, bread and penicillin are all products made from fungi.

Mold is a species of fungi that lives in virtually any indoor or outdoor environment in which there is moisture, an area to grow and a source of food (organic material).  They are commonly found in buildings, with the most common types being Cladosporium, Penicillium, Aspergillus, and Alternaria. Molds reproduce by making spores, which are tiny, lightweight fragments that may become airborne.  Generally speaking, people are exposed to molds everyday without adverse health effects.   

Health Risks Associated With Mold

Although molds are a natural part of our environment, exposure to certain types of airborne mold spores can cause allergic reactions, asthma episodes and other respiratory problems.  In addition, exposure to high spore levels can cause the development of an allergy to the mold. Health impacts from mold/mildew occur when individuals are exposed to large doses of mycotoxins, which are by-products produced from the molds. 

However, adverse health effects from exposure to mycotoxins differ from person to person.  While some people may be highly sensitive to mycotoxins and experience adverse health effects, other people exposed to the same dosage of the mold will be unaffected.  The mere presence of mold found indoors does not indicate a public health risk.

Groups at Higher Risk

Certain population groups have a greater health risk when exposed to mold.  These people include infants and children, elderly, immune compromised patients, pregnant women and individuals with respiratory conditions.

Toxic Molds

Certain types of mold are considered toxic and require immediate risk management decisions.  These species include Stachybotrys chartarum, Aspergillus versicolor, A. flavus, A. fumigatus and Fusarium moniliforme. 

Though, not all species of mold are toxic, standard public health practices include removal from exposure through clean up or remediation, combined with public education on the potential for harm.  This prudent approach suggests that the discovery of excess molds found indoors—regardless of type—should be handled in a consistent manner.

What is Stachybotrys Chartarum?

Stachybotrys chartarum is a greenish black mold that has been found in environments with high moisture content.  Growth occurs when there is moisture from water damage, excessive humidity, water leaks, condensation and flooding.  Stachybotrys chartarum may produce mycotoxins and is a relatively uncommon mold. 

Because Stachybotrys chartarum's spores do not easily become airborne, contamination of indoor air by this mold is uncommon.  The specimen of this mold found on the tissue box in Room 7 was gummy, indicating that the mold had not sporulated. 

Health Effects of Stachybotrys Chartarum

Although no lethal cases have been reported, Stachybotrys chartarum has the potential to cause symptoms such as coughing, wheezing, runny nose, irritated eyes or throat, skin rash or diarrhea. A causal link between Stachybotrys chartarum and the development of idiopathic pulmonary hemorrhage among infants has not been conclusively proven. 

Laboratory Tests for Stachybotrys Chartarum

Only a few physicians have used an antibody test for Stachybotrys chartarum.  Such tests have not always indicated positive results when exposure to Stachybotrys chartarum had been proven. Antibodies developed by a person exposed to the mold can only document that exposure has occurred.  Since exposure to fungi routinely occurs in both outdoor and indoor environments, this information is of limited value.  It is possible that a positive test result may be an earlier encounter with Stachybotrys chartarum.

Remediation Efforts

The District has taken aggressive measures to protect the public health of students, teachers and administrators at La Rosa Elementary.  The District has hired an environmental consulting company to conduct invasive testing, visual inspections and air quality monitoring.  Following the findings from the consultant's report, the District hired the Janus Company to carry out extensive mold remediation efforts.

Summary Of Presentation

For parents and teachers concerned about health risks caused by molds, it is important to recognize that we are not dealing with a mysterious substance.  Fungi have been around forever, and those in the medical, environmental and health community have adopted well-established protocols for managing public health issues associated with mold exposure.  The District has utilized these resources to remedy the situation.

Although no test currently exists that proves an association between Stachybotrys chartarum and particular health symptoms, we encourage people with persistent health problems to consult their physician if they believe their illness is caused by exposure to mold. 

This page relates to the Osh.Net Newsletter Article of October 20, 2000 "Summary of Presentation on Mold"

For more information relating to this article click below:

Q & A Fact Sheet on Mold & Antibody Testing for Exposure

Links to Useful Indoor Air Quality Related Web Sites