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Introduction

Most people are aware that outdoor air pollution can damage their health but many not know  that indoor air pollution can also have significant effects. EPA studies of human exposure to air pollutants indicate that indoor air levels of many pollutants may be 2-5 times, and occasionally, more that 100 times higher than outdoor levels. 
These levels of indoor air pollutants are of particular concern because it is estimated that most people spend as 90% of their time indoors.
             
Over the past several decades, our exposure to indoor air pollutants is believed to have increased due to a variety of factors, including the construction of more tightly sealed buildings, reduced ventilation rates to save energy, the use of synthetic building materials and furnishings, and the use of chemically formulated personal care products, pesticides, and household cleaners.
   
In recent years, comparative risk studies performed by EPA and its Science Advisory Board (SAB) have consistently ranked indoor air pollution among the five environmental risks to public health. EPA, in close cooperation with other Federal agencies and the private sector, is actively involved in a concerted effort to better understand indoor air 
pollution  and to reduce people's exposure to air pollutants in offices, homes and other indoor environments where people live, work, and play.
        
Approximately 70,000 species of fungi (molds, yeasts, mildews) have been identified, and some estimates suggest that the total number of species present in the environment exceed one million. 
While nearly all fungi can cause allergies in humans, only about 100 species appear to be potentially pathogenic (disease causing) to humans. Exposure to various fungi may result in adverse health effects including allergies responses (hay fever, allergic rhinitis, skin and upper respiratory tract irritation, hypersensitivity Pneumonitis) and infection diseases (athlete's foot, yeast infections, histoplasmosis, aspergillosis). many of the symptoms associated with exposure to pathogenic molds appear to primarily affect immunocompromised individuals such as infants, the elderly, HIV positive persons, and those with AIDS.

Fungi are ubiquitous in the environment, that is, they are found everywhere. Fungi generally breakdown organic matter, such as cellulose, and either absorb or eat the nutrition. The "earthly" odors fungi produce are called VOCs (volatile organic compounds), some of which are known to cause irritation and upper respiratory tract problems, as well as certain cancers where exposures occur over extended durations. Because fungi are everywhere in the outdoor environment, they are usually found indoors as well.

Types of fungi frequently found both in outdoor and indoor air include Cladosporium, Penicillum, and Alternaria species. Several pathogenic species of fungi are found on occasion in indoor air, and may include Aspergillus niger, Aspergillus fumigatus, Aspergillus flavus, and stachybotrys atra. All fungi are of health concern whether they are viable (able to grow) or non-viable (essentially dead).

For fungi to grow or flourish, several key elements are necessary, including:

  1. The presence of spores ( everywhere in the environment!);
  2. Water availability (both in materials and in the air);
  3. Food Sources (such as wood, paper, drywall, leaves...);
  4. Appropriate temperature (various requirements depending on species);
  5. Presence of competing organisms (bacteria or other fungal species);
  6. Light (varying requirements depending on species); and
  7. pH of material.

Modifying or eliminating one or more of the above elements can minimize or even prevent the growth and proliferation of fungi.

Because fungi can present a potential health risk, caution must be exercised when cleaning up visible sources, or whenever conditions exist that may promote fungi growth, as growths are not always visible to the naked eye. Areas affected with fungi growth should be isolated to prevent the spread of spores during clean-up, as they typically become airborne quite easily. Professionals should always be consulted when dealing with the investigation, identification, and remediation of fungi and their sources.

Note: Due to common mold contamination problem and  importance of mold health hazards ENVIRONMENTAL C&R offers full service indoor air quality control for mold assessment and mold remediation. Mold assessment includes mold inspection mold testing such as mold air sampling, mold surface sampling and mold bulk sampling. , mold remediation includes toxic mold removal, black mold removal, toxic mold clean up and black mold clean up for existing commercial and residential properties in Orange County and Los Angeles areas. From mold assessment (mold inspection and toxic mold testing) to complete mold remediation (mold removal and mold decontamination) Environmental C & R offers our customers peace of mind and complete indoor environmental health.

 
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Health Effects

Can mold make me and my family sick?

Mold can affect the health of people who are exposed to it. People are mainly exposed to mold by breathing spores or other tiny fragments. People can also be exposed through skin contact with mold contaminants (for example, by touching moldy surfaces) and by swallowing it.

The type and severity of health effects that mold may produce are usually difficult to predict. The risks can vary greatly from one location to another, over time, and from person to person.

What symptoms might I see?

The most common health problems caused by indoor mold are allergy symptoms. Although other and more serious problems can occur, people exposed to mold commonly report problems such as:

  • nasal and sinus congestion
  • cough
  • wheeze/breathing difficulties
  • sore throat
  • skin and eye irritation
  • upper respiratory infections (including sinus)
  • trigger Asthma
  • respiratory illness
  • shortness breath
  • chest tightness

Are the risks greater for some people?

There is wide variability in how different people are affected by indoor mold. However, the long term presence of indoor mold growth may eventually become unhealthy for anyone. The following types of people may be affected more severely and sooner than others:

  • infants and children
  • elderly people
  • individuals with respiratory conditions or sensitivities such as allergies and asthma
  • persons having weakened immune systems (for example, people with HIV infection, chemotherapy patients, organ transplant recipients)

Those with special health concerns should consult a medical professional if they feel their health is affected by indoor mold.

Note: Due to common mold contamination problem and  importance of mold health hazards ENVIRONMENTAL C&R offers full service indoor air quality control for mold assessment and mold remediation. Mold assessment includes mold inspection mold testing such as mold air sampling, mold surface sampling and mold bulk sampling. , mold remediation includes toxic mold removal, black mold removal, toxic mold clean up and black mold clean up for existing commercial and residential properties in Orange County and Los Angeles areas. From mold assessment (mold inspection and toxic mold testing) to complete mold remediation (mold removal and mold decontamination) Environmental C & R offers our customers peace of mind and complete indoor environmental health.
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Heart Problems
Fungal Endocarditis: a Disease of the Heart

Pathogenic fungi cause disease by parasitizing their plant, animal or human host. In humans, some of these fungi are normally present on, or in, our bodies and only cause a problem when the bodily defenses that control them are weakened or damaged. For example, Candida albicans, a yeast which normally lives harmlessly on our skin and mucus membranes, can, in certain conditions, grow out of control and cause the mouth disease "thrush" or other "yeast infections".

A specific disease or set of symptoms can sometimes be caused by one of several different potential pathogens (disease-causing organisms). Sore throats can be caused by both bacteria and viruses. Endocarditis is a heart disease that can be caused by either bacteria or fungi.

Endocarditis is an inflammation of the heart muscle, the heart’s valves, or the lining of the heart’s chambers. The disease can be caused by many different pathogens, among them the filamentous fungus, Aspergillus fumigatus, and the yeast, Candida albicans. The symptoms are very general, and typical of many physical problems. Only a physician can make an accurate diagnosis. The symptoms can include fever, weakness, chest pain, unexplained weight loss, aches, a heart murmur, blood in the urine or abnormal urine color, and straight, narrow red lines of broken blood vessels under the nails. A variety of tests, possibly including blood culture, a complete blood count (CBC) or a CT ("cat") scan of the chest, can be used to diagnose this disease. Some cases are "culture-negative", meaning no fungus or bacterium can be found.

Aspergillus fumigatus and Candida albicans are opportunistic pathogens. They exploit weaknesses or lapses in the body’s defense mechanisms. Our skin is an important defense against pathogens. These fungi enter the body through wounds, such as surgical incisions, the insertion of catheters (tubes) into already existing wounds, or the sharing of contaminated needles by drug users.

As organisms, Aspergillus fumigatus and Candida albicans do not resemble one another at all. Aspergillus fumigatus is a member of a large genus of filamentous fungi. Most Aspergillus are harmless, although other species have caused allergic reactions, since many produce huge amounts of air-borne spores, called conidia, in wet or humid rooms. We often breathe in the spores in such rooms, but Aspergillus fumigatus does not cause infections when inhaled.

Candida albicans belongs to the group of fungi called yeasts. It is a very distant relative of a yeast in another genus, Saccharomyces cerevisiae, used in making bread. Candida albicans does not produce air-borne spores. It spreads to new places by being carried there.

The treatment of fungal Endocarditis can require surgery to remove colonies of fungi from the heart, and anti-fungal drug therapy for 6-8 weeks. 

Note: Due to common mold contamination problem and  importance of mold health hazards ENVIRONMENTAL C&R offers full service indoor air quality control for mold assessment and mold remediation. Mold assessment includes mold inspection mold testing such as mold air sampling, mold surface sampling and mold bulk sampling. , mold remediation includes toxic mold removal, black mold removal, toxic mold clean up and black mold clean up for existing commercial and residential properties in Orange County and Los Angeles areas. From mold assessment (mold inspection and toxic mold testing) to complete mold remediation (mold removal and mold decontamination) Environmental C & R offers our customers peace of mind and complete indoor environmental health.
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Questions and Answers

From: Centers for Disease Control

Q: I heard about toxic molds that grow in homes and other buildings. Should I be concerned about a serious health risk to me and my family?

A: The hazards presented by molds that may contain mycotoxins should be considered the same as other common molds which can grow in your house. There is always a little mold everywhere - in the air and on many surfaces. There are very few case reports that toxic molds (those containing certain mycotoxins) inside homes can cause unique or rare, health conditions such as pulmonary hemorrhage or memory loss. These case reports are rare, and a causal link between the presence of the toxic mold and these conditions has not been proven. A common-sense approach should be used for any mold contamination existing inside buildings and homes. The common health concerns from molds include hay-fever like allergic symptoms. Certain individuals with chronic respiratory disease (chronic obstructive pulmonary disorder, asthma) may experience difficulty breathing. Individuals with immune suppression may be at increased risk for infection from molds. If you or your family members have these conditions, a qualified medical clinician should be consulted for diagnosis and treatment. For the most part, one should take routine measures to prevent mold growth in the home.

Q: How common is mold, including Stachybotrys chartarum (also known by its synonym Stachybotrys atra) in buildings?

A: Molds are very common in buildings and homes and will grow anywhere indoors where there is moisture. The most common indoor molds are Cladosporium, Penicillum, Aspergillus, and Alternaria. We do not have accurate information about how often Stachybotrys chartarum is found in buildings and homes. While it is less common than other mold species it is not rare.

Q: How do molds get in the indoor environment and how do they grow?

A: Molds naturally grow in the indoor environment. Mold spores may also enter your house through open doorways, windows, heating, ventilation, and air conditioning systems. Spores in the air outside also attach themselves to people and animals, making clothing, shoes, bags, and pets, convenient vehicles for carrying mold indoors.

When mold spores drop on places where there is excessive moisture, such as where leakage may have occurred in roofs, pipes, walls, plant pots, or where there has been flooding, they will grow. Many building materials provide suitable nutrients that courage mold to grow. Wet cellulose materials, including paper and paper products, cardboard, ceiling tiles, wood, and wood products, are particularly conducive for the growth of some molds. Other materials such as dust, paints, wallpaper, insulation materials, drywall, carpet, fabric, and upholstery, commonly support mold growth.

Q: What is Stachybotrys chartarum (stachybotrys atra)?

A: Stachybotrys chartarum (also known by its synonym Stachybotrys atra) is a greenish-black mold. It can grow on material with a high cellulose and low nitrogen content, such as fiberboard, gypsum board, paper, dust, and lint. Growth occurs when there is moisture from water damage, excessive humidity, water leaks, condensation, water infiltration, or flooding. Constant moisture is required for its growth. It is not necessary, however, to determine what type of mold you may have. All molds should be treated the same with respect to potential health risks and removal.

Q: Are there any circumstances where people should vacate a home or other building because of mold?

A: These decisions have to be made individually. If you believe you are ill because of exposure to mold in a building, you should consult your physician to determine the appropriate action to take.

Q: Who are the people who are most at risk for health problems associated with exposure to mold?

A: People with allergies may be more sensitive to molds. People with immune suppression or underlying lung disease are more susceptible to fungal infections.

Q: How do you know if you have a mold problem?

A: Large mold infestations can usually be seen or smelled.

Q: Does Stachybotrys chartarum (Stachybotrys atra) cause acute idiopathic pulmonary hemorrhage among infants.?

A: To date, a possible association between acute idiopathic pulmonary hemorrhage among infants and Stachybotrys chartarum (Stachybotrys atra) has not been proved. Further studies are needed to determine what causes acute idiopathic hemorrhage.

Q: What if my child has acute idiopathic pulmonary hemorrhage?

A: Parents should ensure that their children get proper medical treatment

Q: What are the potential health effects of mold in buildings and homes?

A: Mold exposure does not always present a health problem indoors. However some people are sensitive to molds. These people may experience symptoms such as nasal stuffiness, eye irritation, or wheezing when exposed to molds. Some people may have more severe reactions to molds. Severe reactions may occur among workers exposed to large amounts of molds in occupational settings, such as farmers working around moldy hay. Severe reactions may include fever and shortness of breath. People with chronic illnesses, such as obstructive lung disease, may develop mold infections in their lungs.

Q: How do you get the molds out of buildings, including homes, schools, and places of employment?

A: In most cases mold can be removed by a thorough cleaning with bleach and water. If you have an extensive amount of mold and you do not think you can manage the cleanup on your own, you may want to contact a professional who has experience in cleaning mold in buildings and homes.

Q: What should people to do if they determine they have Stachybotrys chartarum (Stachybotrys atra) in their buildings or homes?

A: Mold growing in homes and buildings, whether it is Stachybotrys chartarum (Stachybotrys atra) or other molds, indicates that there is a problem with water or moisture. This is the first problem that needs to be addressed. Mold can be cleaned off surfaces with a weak bleach solution. Mold under carpets typically requires that the carpets be removed. Once mold starts to grow in insulation or wallboard the only way to deal with the problem is by removal and replacement. We do not believe that one needs to take any different precautions with Stachybotrys chartarum (Stachybotrys atra), than with other molds. In areas where flooding has occurred, prompt cleaning of walls and other flood-damaged items with water mixed with chlorine bleach, diluted 10 parts water to 1 part bleach, is necessary to prevent mold growth. Never mix bleach with ammonia. Moldy items should be discarded.

Q: How do you keep mold out of buildings and homes?

A: As part of routine building maintenance, buildings should be inspected for evidence of water damage and visible mold. The conditions causing mold (such as water leaks, condensation, infiltration, or flooding) should be corrected to prevent mold from growing.

Specific Recommendations:

  • Use air conditioner or a dehumidifier during humid months.
  • Be sure home has adequate ventilation, including exhaust fans in kitchen and bathrooms
  • Use mold inhibitors which can be added to paints.
  • Clean bathroom with mold killing products.
  • Do not carpet bathrooms.
  • Remove and replace flooded carpets.

In summary:
Stachybotrys chartarum (Stachybotrys atra) and other molds may cause health symptoms that are nonspecific. At present there is no test that proves an association between Stachybotrys chartarum (Stachybotrys atra) and particular health symptoms. Individuals with persistent symptoms should see their physician. However, if Stachybotrys chartarum (stachybotrys atra) or other molds are found in a building, prudent practice recommends that they be removed. Use the simplest and most expedient method that properly and safely removes mold.

Note: Due to common mold contamination problem and  importance of mold health hazards ENVIRONMENTAL C&R offers full service indoor air quality control for mold assessment and mold remediation. Mold assessment includes mold inspection mold testing such as mold air sampling, mold surface sampling and mold bulk sampling. , mold remediation includes toxic mold removal, black mold removal, toxic mold clean up and black mold clean up for existing commercial and residential properties in Orange County and Los Angeles areas. From mold assessment (mold inspection and toxic mold testing) to complete mold remediation (mold removal and mold decontamination) Environmental C & R offers our customers peace of mind and complete indoor environmental health.
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