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Medical Edge Newspaper Column from Mayo Clinic

BEST TREATMENT AGAINST MOLD: ELIMINATE IT AT THE SOURCE

DEAR MAYO CLINIC: Is there any new information regarding the health risks of living in a “sick house” that contains toxic mold such as penicillium, aspergillus or stachybotrys?

ANSWER: The best source is a recent and comprehensive review of already-available information called “Damp Indoor Spaces and Health,” a report published in 2004 by the National Academies’ Institute of Medicine. Researchers and practitioners in the field consider this report to be the gold standard on what is known and unknown, likely and unlikely, about the health effects of household mold.

IOM’s committee of experts found “sufficient evidence to conclude that the presence of mold (is associated) with cough, wheeze, asthma symptoms in sensitized asthmatic persons, and hypersensitivity pneumonitis (a relatively rare immune-mediated condition) in susceptible persons.” It also found limited evidence that mold can cause lower respiratory-tract illness in otherwise healthy children.

But the committee found inadequate or insufficient evidence to support sometimes-fanciful claims — many of which, I’d note, tend to get more than their due from the news media and the Internet — that mold causes a variety of other health problems such as gastrointestinal tract disorders, fatigue, neuropsychiatric symptoms (memory loss, for instance), pulmonary hemorrhage and cancer.

Mold has been present since the very beginnings of life on earth. Humans, the rest of the animal kingdom and all other living things have evolved so as to peacefully coexist with mold. But just as some people are allergic to pollen, grass and cats, certain individuals suffer adverse effects — usually, hay fever-like symptoms — from mold.

To put this incidence in perspective, consider 100 randomly selected people. On average, seven will have asthma, four will have asthma that is triggered by some allergen, and one or two will specifically have a mold sensitivity.

Given that most people can be exposed to mold and remain symptom-free, medical professionals tend to regard the terms “toxic mold” and “sick house” as misleading. You mention three common mold varieties, but there are thousands of mold types, and while some may produce toxins, this occurs under exceptional circumstances.

In any case, virtually all types of indoor mold are managed similarly from a medical point of view. In modest amounts, such as on a shower curtain, we consider mold to be harmless. In large quantities — resulting, say, from excessive humidity, poor ventilation or water leaks — residents should remove or, better yet, prevent the mold formation in the first place. Rather than dismissing a house as sick, we should pay attention to what its particular problems are and what to do about them.

The best treatment for people sensitive to mold is to eliminate it at the source. Already-existing mold can be removed with commercial products, soap and water, or a weak bleach solution. But to prevent the recurrence of heavy outbreaks of indoor mold, the key is to eradicate the warm, damp and humid conditions under which it thrives. Appropriate home repair and maintenance actions include the use of an air-conditioner or dehumidifier, assurance of adequate ventilation (with the aid of exhaust fans), correction of any plumbing problems, the addition of mold inhibitors to paints, and numerous others.

In the meantime, short-term asthma or allergy symptoms, whether from mold or other allergens, can be relieved in several conventional ways — through the selective use of asthma medications, or with allergy medications such as antihistamines, decongestants and intranasal corticosteroids. Allergy shots, on the other hand, have not been very effective against mold allergy. Yet even if they were, removal and prevention of mold would still be a far better long-term strategy, not only for the patient but also for his or her home.

— James T. Li, M.D., Allergic Diseases, Mayo Clinic, Rochester, Minn.

Additional Resources:
Information on Mold
Appointment Information
More Information on Mold
Allergy Proof Your House

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.