Health Effects
Toxic mold can cause a wide variety of health effects. The health problems experienced by each person are different due to several factors, including age, genetics, health prior to exposure, amount of exposure, extent of contamination, types of molds and mycotoxins involved, other contaminants such as bacteria, etc.
Contamination in water-damaged buildings is a very complex situation that can result in multi-system health problems.
There are thousands of articles, studies, books and papers written on this topic. We will provide a brief overview of some of the key statements and conclusions that are presented in the literature.
From a 2020 paper confirming that health effects caused by exposure to mold in water-damaged buildings are sometimes irreversible
The Roles of Autoimmunity and Biotoxicosis in Sick Building Syndrome as a “Starting Point” for Irreversible Dampness and Mold Hypersensitivity Syndrome
"Persistent or cumulative exposure to DM (dampness microbiota) may make SBS (sick building syndrome) potentially life-threatening and lead to irreversible dampness and mold hypersensitivity syndrome (DMHS)."
"The impact of DM and mycotoxins on the initiation of SBS and further deterioration of many bodily functions has become already established even if water damage has been removed."
"Many indoor air mycotoxins are neurotoxic. They have multiple actions on the cell: they may increase the production of reactive oxygen species (ROS), may deplete ATP synthesis, may alter mitochondrial membrane potential and facilitate the release of mitochondrial proteins into the cytosol. Exposure to mycotoxins activates inflammasome machinery in the cell. This will promote the production of the pro-inflammatory IL-1β cytokine, the marker of the activation of innate immunity. When IL-1β cytokine binds to its cognate receptor, IL-1R1, intracellular signal transduction will follow. This mechanism will lead to a vicious cycle of inflammation."
This report includes a discussion about the importance of using the correct procedures for sampling and testing. For example, it explains why air sampling is inaccurate and ineffective. Here is an excerpt of that discussion:
"Air sampling completely ignore the fact that toxigenic indoor microbes, such as Stachybotrys, emit toxins as liquid vesicles (micro vesicles, exoms) in which the concentrations of toxins are more than 1000-fold higher than the emissions coming from the same microbial particle (spores, hyphae fragments)."
Article in the Chicago Sun Times (December 24, 2018)
Millions of People Suffering from Mold Toxicity Go Undiagnosed
Toxic mold exposure is on the rise, and most people aren’t even aware they’re at risk, according to experts.
“There are millions of people suffering from mold toxicity that don’t know it because it’s going majorly undiagnosed,” said Dr. Neil Nathan, a Board Certified Family Physician and author of the book “Toxic” (Victory Belt Publishing).
“If more medical professionals got educated about mold toxicity and its effects on the human body, there would be fewer cases of misdiagnosis. They came out with studies in 2017 that showed mold can be a direct link to Alzheimer’s and other kinds of dementia, and once these patients get treatment for mold, their symptoms improved. Cognitive impairment is a big factor with mold. So is muscle and joint pain and lethargy, which can be misdiagnosed as chronic fatigue, the list goes on.”
Nathan said many doctors need to consider a person’s environment when assessing their symptoms.
“These illnesses are increasing and if we do not grasp this, take it seriously and monitor our exposure, all of us are going to be sick,” Nathan said.
Report from Finland (2017)
Severe Sequelae to Mold-Related Illness as Demonstrated in Two Finnish Cohorts
The following statements in a 2017 research paper in Finland provide a good summary of this situation and how it is harming patients and keeping them from getting proper medical care:
"Mold-related illness should not be viewed as a so-called medically unexplained syndrome, as has been claimed. In our opinion, providing these patients with cognitive or behavioral therapy is medically unethical—it represents a denial that mold-exposed individuals are suffering from a somatic illness. Moreover, cognitive/behavioral therapy is not effective.
We can assume that providing the mold-exposed patient with only psychotherapy in combination with high dosages of corticosteroids while he/she continues to live or work in a hazardous environment is inappropriate “medication;” in fact, it will aggravate their risks of suffering severe morbidity and even dying.
On the basis of the present data, we think that it is irresponsible to claim that indoor molds cause only transient irritation symptoms and pose only a 1.5-fold risk for the development of asthma. Even though more and more knowledge is available on the mechanisms underpinning the health hazards associated with moldy environments, mold-related disease is still called a “non-disease,” or “somatoform disorder,” with some physicians trying to label it as a “fashionable” disorder, or stating that its sufferers are exhibiting hysteria.
Mold-related illness is a somatic disorder; the symptoms are physical, not psychosocial problems, although this has been claimed for almost 20 years. In most cases, later it can become a psychosocial problem as patients suffer mental distress from their failure to convince physicians that they are ill.
Our data show that occupying a contaminated building for even 2–3 years (either a home or a school) can seriously impair the well-being of potentially healthy individuals, even to the extent of loss of life. Therefore, any attempt by governmental/medical authorities to deny the serious effects of toxic molds on human health should be combatted."
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The following is one example of a list of health problems that can be caused by molds and mycotoxins:
From Dr. Harriet Ammann (Senior Toxicologist)
Is Indoor Mold Contamination a Threat to Health? Part One (2003)
Health effects from exposures to molds in indoor environments can result from allergy, infection, mucous membrane and sensory irritation and toxicity alone, or in combination.
Mycotoxins are nearly all cytotoxic, disrupting various cellular structures such as membranes, and interfering with vital cellular processes such as protein, RNA and DNA synthesis.
- Vascular system (increased vascular fragility, hemorrhage into body tissues, or from lung, e.g., aflatoxin, satratoxin, roridins).
- Digestive system (diarrhea, vomiting, intestinal hemorrhage, liver effects, i.e., necrosis, fibrosis: aflatoxin; caustic effects on mucous membranes: T-2 toxin; anorexia: vomitoxin.
- Respiratory system: respiratory distress, bleeding from lungs e.g., trichothecenes.
- Nervous system, tremors, incoordination, depression, headache, e.g., tremorgens, trichothecenes.
- Cutaneous system: rash, burning sensation sloughing of skin, photosensitization, e.g., trichothecenes.
- Urinary system, nephrotoxicity, e.g. ochratoxin, citrinin.
- Reproductive system; infertility, changes in reproductive cycles, e.g. T-2 toxin, zearalenone
- Immune system: changes or suppression: many mycotoxins.
From the 2009 World Health Organization Report--Guidelines for Indoor Air Quality: Dampness and Mould
WHO 2009 Report
Indoor air pollution--such as from dampness and mould, chemicals and other biological agents--is a major cause of morbidity and mortality worldwide.
From the Executive Summary :
Exposure to microbial contaminants is clinically associated with respiratory symptoms, allergies, asthma and immunological reactions.
Toxicological evidence obtained in vivo and in vitro supports
these findings, showing the occurrence of diverse inflammatory and toxic responses after exposure to microorganisms isolated from damp buildings, including their spores, metabolites and components.
From Chapter 2 :
Mycotoxins, or fungal toxins, are low-relative-molecular-mass biomolecules produced by fungi, some of which are toxic to animals and human beings. Mycotoxins are known
to interfere with RNA synthesis and may cause DNA damage.
From a report on Neurotoxic Effects
The Validity of the Environmental Neurotoxic Effects of Toxigenic Molds and Mycotoxins
"Exposure to mycotoxin may occur via enteric, inhalation, or direct contact to skin and mucosa. Acute and chronic disorders, irritation, systemic reactions, and even cancer may develop after the exposure to these toxins."
"Symptoms include respiratory complaints that involve the nose and lungs; eye symptoms, and mucous membrane irritation. The major presentations are headache, general debilitating pains, nose bleeding, fevers with body temperatures up to 40 degrees C (104 degrees F), cough, memory loss, depression, mood swings, sleep disturbances, anxiety, chronic fatigue, vertigo/dizziness, and in some cases, seizures."
"Mycotic demyelinating optic neuritis is a neurological disorder of the visual system caused by mycotoxins released by indoor toxic molds."
"Other neurobehavioral manifestations in the mold-exposed individuals are abnormal decrease in steady balance, reaction time, blink-reflex latency, color discrimination, visual fields, and grip, compared to control. Hence, most exposed patients have reduced cognitive functioning in multiple domains, with memory and executive functions the most commonly affected areas."
From a Wire Service Canada article (January 27, 2010)
B.C. Company Fights Back Against Sick Building Syndrome
"William Fisk from Lawrence Berkeley National Laboratory in California established a baseline for quantifying benefits from improved IAQ and demonstrated the economic impacts of increased productivity. Findings are showing that improvement in IAQ can: Reduce SBS symptoms by 20 to 50 percent, with estimated savings of $10 to $100 billion; Reduce asthma by 8 to 25 percent, with estimated savings of $1 to $4 billion; Reduce other respiratory illnesses by 23 to 76 percent, with estimated savings of $6 to $14 billion; Improve office worker productivity by 0.5 to 5 percent, with estimated savings of $20 to $200 billion."
From the ACGIH book titled "Bioaerosols: Assessment and Control"
Be sure to check out the list of symptoms on
page 24-3 of this book.
To purchase the book from ACGIH, go to:
www.acgih.org
From a November 2012 Alert by NIOSH (National Institute of Occupational Safety and Health)
Preventing Occupational Respiratory Disease from Exposures Caused by Dampness in Office Buildings, Schools, and Other Nonindustrial Buildings
Occupants within damp office buildings, schools, and other nonindustrial buildings may develop respiratory symptoms and disease.
NIOSH has estimated that 29% to 33% of new-onset adult asthma is attributable to work-related exposures and 23% of existing adult asthma is exacerbated by work. If occupants develop asthma or asthma exacerbation while working in damp buildings, medical treatment may not be effective if the occupant continues to be exposed. An occupant in damp buildings with allergic asthma may experience symptoms after exposure to very low levels of a
sensitizing agent that may still be present after remediation; in such cases, an occupant may require relocation to another area.
From Dr. Ruth Etzel (2006)
What the Primary Care Pediatrician Should Know About Syndromes Associated with Exposures to Mycotoxins
"Mycotoxins can have protean manifestations; the symptoms depend on the specific toxin or mixture of toxins, the age, sex, and diet of the child, the dose, and whether exposure is by ingestion, inhalation, skin and mucosal exposure, or a combination of two or more of these routes. The most well-characterized presentations among infants and children are summarized in Table 2 under four headings: vomiting illness, bone marrow failure, acute pulmonary hemorrhage, and recurrent episodes of apnea and/or pneumonia."
From the 1999 Bulletin of the World Health Organization
Toxic Effects of Mycotoxins in Humans
"Exposure to mycotoxins is mostly by ingestion, but also occurs by the dermal and inhalation routes."
"Mycotoxicoses often remain unrecognized by medical professionals, except when large numbers of people are involved."
"Aflatoxins are acutely toxic, immunosuppressive, mutagenic, teratogenic and carcinogenic compounds."
From a 1989 U.S. EPA Report for Congress on Indoor Air Pollution
U.S. EPA Report for Congress on Indoor Air Quality. Volume II: Assessment and Control of Indoor Air Pollution. August 1989.
Health effects from indoor air pollution cover the range of acute and chronic effects, and include eye, nose, and throat irritation, respiratory effects, neurotoxicity, kidney and liver effects, heart functions, allergic and infectious diseases, developmental effects, mutagenicity, and carcinogenicity.
From the 1989 Massachusetts Special Legislative Commission on Indoor Air Pollution
The Commonwealth of Massachusetts, Special Legislative Commission on Indoor Air Pollution: Indoor Air Pollution in Massachusetts
The Commission's efforts confirm the seriousness of the indoor air pollution health threat, which worsened with the energy conservation efforts of the 1970s. More insulation and tighter construction led to lower ventilation rates and build-up of contaminants. Many 'sick' buildings have been identified where occupants suffer severe or recurring discomforts such as headaches, dizziness, fatigue, eye irritation, and respiratory problems. Other conditions attributable to indoor air contaminants include: cancer; bronchitis; pneumonia; heart, circulatory and respiratory problems; impaired vision; skin rash; chemical sensitivity; birth defects; and mental, nervous and immunological disorders.
From Jack Thrasher, Ph.D. Toxicologist (2009)
Biocontaminants and Complexity of Damp Indoor Spaces: More Than What Meets the Eyes
Exposure of occupants mainly results from inhalation and, to a lesser extent, skin absorption and ingestion. Molds produce mycotoxins during rapid growth. At low concentrations, they cause mycotoxicosis in humans and animals. The mycotoxins causing disease include aflatoxins, ochratoxin A, trichothecenes, citreviridins, fumonisins and gliotoxins. Mycotoxins can regulate the immune system up or down as well as inhibit synthesis of protein, RNA and DNA. Moreover, they can form DNA adducts, protein adducts and cause oxidative stress as well as mitochondrial directed apoptosis.
Toxic encephalopathy involves multiple symptoms, including loss of balance, recent memory decline, headaches, lightheadedness, spaciness/disorientation, insomnia, loss of coordination.
From the 2008 Report of the U.S. Government Accountability Office (GAO)
Indoor Mold: Better Coordination of Research on Health Effects and More Consistent Guidance Would Improve Federal Efforts
"Mold may affect human health through a number of routes and mechanisms. While inhalation is generally the most common route of exposure for mold in indoor environments, exposure can also occur through ingestion (for example, hand-to-mouth contact) and contact with the skin. The roles of these routes of exposure in causing illness are unclear. Once exposure occurs, health effects may arise through several potential mechanisms, including allergic (or immune-mediated), infectious, and toxic. It is not always possible to determine which of these mechanisms is associated with a specific health outcome."
From a 2004 U.S. Army Textbook
Medical Management of Biological Casualties Handbook
"Exposure causes skin pain, pruritis, redness, vesiculation, necrosis, and sloughing of the epidermis. Effects on the airway include nose and throat pain, nasal discharge, itching and sneezing, cough, dyspnea, wheezing, chest pain, and hemoptysis. Toxin also produces similar effects after ingestion or eye contact. Severe intoxication results in prostration, weakness, ataxia, collapse, shock, and death."
From a 1999 study by the Mayo Clinic
Mayo Clinic Study Implicates Fungus as Cause of Chronic Sinusitis
"Mayo Clinic researchers say they have found the cause of most chronic sinus infections--an immune system response to fungus."
"An estimated 37 million people in the United States suffer from chronic sinusitis, an inflammation of the membranes of the nose and sinus cavity. Its incidence has been increasing steadily over the last decade."
From a 2007 study by Berkeley Labs and the EPA
Berkeley Lab, EPA studies Confirm Large Public Health and Economic Impact of Dampness and Mold
"Of the 21.8 million people reported to have asthma in the U.S., approximately 4.6 million cases are estimated to be attributable to dampness and mold exposure in the home,” says the study. In addition, this paper estimates that “the national annual cost of asthma that is attributable to dampness and mold exposure in the home is $3.5 billion."
From a 2007 study by Brown University
Brown Study Finds Link Between Depression and Household Mold
"A groundbreaking public health study, led by Brown University epidemiologist Edmond Shenassa, has found a connection between damp, moldy homes and depression."
From a 2004 paper on the effects of toxic mold on the neurological and immune systems
Molds and Mycotoxins: Effects on the Neurological and Immune Systems in Humans
Forgacs noted in 1962 that mold mycotoxicosis was called "the neglected disease." The manifestations and disorders in humans caused by molds and mycotoxins continues to be overlooked or unnoticed by many physicians. Each year studies continue to be published throughout the world medical and scientific literature elucidating and explaining the pathological processes and biomechanisms by which exposure to molds and mycotoxins cause sickness in humans.
Campbell et al. (2003) studied 119 patients with symptoms of neurotoxicity with documented measured exposure to molds. These patients complained of fatigue, memory loss, cognitive function loss, headaches, tremors, numbness and tingling, blurred vision, tinnitus, and muscle weakness. Ninety-nine of these patients had abnormal clinical neurological examinations, abnormal findings on neurophysiological testing, and elevated antibodies to neuronal antigens.
Campbell et al.
(2003) concluded their observations on changes in
nerve conduction velocities and the presence of neural antigen autoantibodies
as follows: "The increased latency for motor and sensory nerves
observed in the 55 patients with mixed neuropathy is suggestive of a
demyelinating process (Busby et al., 2003}." This was accompanied by
a decrease in velocities for the median, ulnar, and peronoal nerves while
the tibial nerve had a decrease in the amplitude. All three sensory nerves
(median, ulnar, and superficial peroneal) exhibited increased latencies
and decreased amplitudes. Thus the polyneuropathy observed in these
patients appeared to be a demyelinating process with decreased number
and size of fibers (decreased amplitude) and chronic involvement of the
nerve (decreased velocities) (Busby et al., 2003; Steck et al., 1987).
The motor neuropathies (17 patients) had decreases in latencies (peroneal and tibial nerves), decreased amplitudes (median and peroneal nerves), and decreased velocities (median, ulnar, peroneal, and tibial nerves). This appeared to be a diffuse neuropathy and may involve some demyelination (Berger et al., 2003). Finally, the sensory neuropathies (27 patients) had increased latencies for all three nerves, with that of the superficial peroneal being not significant. The increased latencies and the decreased amplitude of the superficial peroneal suggested demyelination was occurring (Reindl et al, 1999; Willison and Yuki, 2002).
From a 2005 paper on neurotoxicity caused by Stachybotrys chartarum
Studies conducted on students who were exposed to poor IAQ due to fungal contamination, demonstrated acoustic mycotic neuroma. Initial symptoms associated with this condition included sensorineural hearing loss, tinnitus, and unsteadiness. This condition is associated with hearing loss and tumor development in nerve tissues associated with hearing and this tumorous tissue must be removed through surgical techniques. In addition, these individuals had other symptoms associated with neurological damage from SBS conditions, such as headaches, memory loss, and lack of concentration, fatigue, sleep disturbance, facial swelling, rashes, nosebleeds, diarrhea, abdominal pains and respiratory problems.
From a 2012 paper on the effects of toxic mold on 6-year-old children
The results of this study draw attention to the harmful effect of early postnatal exposure to indoor molds on children's cognitive development and provide additional evidence on the role of environmental determinants in human cognitive development.