following peer reviewed research on this page provides readers
with key findings that are highly relevant to understanding
the potential impact of mold on human health. Victims of mold
exposures will recognize the symptoms that can be so debilitating.
In the school setting teachers are often ongoing victims of
this exposure returning year after year while the student
may go on to other rooms and schools.
of the most compelling, recent studies on mold are featured
here - revealing these biotoxins to be far more harmful than
the minor allergen doctors previously understood them
to be. (see
FUNGALBIONICS for more) Please see our Internet
Links page on this site for more studies like these. We are
honored to have the support of a number of these researchers,
who truly care about school children and the staff who suffer
in mold-ridden schools.
Guidance for Clinicians on the Recognition and
Management of Health Effects Related to Mold Exposure and
|Healthy Schools and Achievement
Healthy Building News
Date: Friday, October 15, 2004 1:22 AM
Subject: HBN News - The Healthy and High Performing School
AN INSIDE LOOK AT EMERGING MARKET AND POLITICAL TRENDS
Healthy Building News
The Healthy and High Performing School
by Stephen Boese and Claire Barnett 
October 15, 2004
The Healthy Schools Network, Inc. is a national not-for-profit
organization centered on children's environmental health,
and dedicated to assuring every child and school employee
an environmentally safe and healthy school.
The Healthy Building News asked its leaders to discuss the
impact of an important new report on how school buildings
affect student health and achievement.
In the Spring of 2004, Healthy Schools Network, Inc. (HSN)
 released The Healthy and High Performance School report
that for the first time tied together the peer-reviewed international
sciences documenting the connection between school indoor
environmental quality (IEQ) and student health and achievement.
 The resulting work and its policy translation for legislators
strengthens the call for healthy buildings and moves the call
into the school facility sector-- the largest volume of all
While on the road doing Healthy High Performance School workshops
last spring, it was surprising how little awareness the local
architectural and engineering professionals had of children's
environmental health issues, and how eager they were to hear
more. School buildings should be built for their primary occupants--kids,
who breathe more air per pound of body weight than adults
and spend hours on the floor, not built to meet an abstract
notion of what adults like to see.
The paper finds that schools are, on average, in very poor
physical condition, even though schools that are poorly designed
and/or poorly maintained increase children's and all building
occupant exposure to environmental health threats. Threats
include poor indoor air pollution, growing mold, diesel fumes,
lead, mercury, pesticides, and a variety of toxic substances,
not to mention the safety hazards associated with poor engineering
or shoddy construction controls. Environmental or occupational
health standards do not consider this unique vulnerability
of children. Children are required by law to attend school
even if the school makes them sick and/or detracts for learning.
HSN has successfully advocated for New York State and major
federal advances towards improving indoor environmental quality
at school, and now chairs a Schools Work Group at US EPA.
Like other states, New York State is engaged in a legal battle
concerning state government's responsibility to equitably
fund a "sound basic education" for all students. The HSN science
paper shows the Court and the Legislature that school environments
have a substantial impact on student health and learning.
Therefore it is essential that schools the state and schools
be held accountable to provide a well designed and well maintained
Healthy and High Performance learning environment as part
of any resolution to this educational funding and equity debate.
HHPS standards effectively and efficiently provide a well-designed
learning environment for children that promote student health,
attendance and achievement and save money for localities.
Careful materials selection can have an important long-term
and short-term impact on IEQ, not only be reducing direct
off-gassing emissions but also by reducing the need for toxic
cleaning and maintenance products. Over the long term, careful
material selection will also help us avoid the systemic problems
that plague our schools today. This trend is also helping
to build markets for healthier building materials and fixtures,
free of PCB's, mercury, lead, formaldehyde and other pollutants.
The Healthy Building Network has reported for example, that
High Performance Schools are an important factor behind skyrocketing
sales of linoleum as an alternative to vinyl flooring. 
HEALTHY BUILDING NEWS SOURCES
 Claire Barnett is the Executive Director of the Healthy
Schools Network, Inc.; Stephen Boese is HSN's State Director
for New York
 Science-Based Recommendations to Prevent of Reduce Potential
Exposures to Biological, Chemical and Physical Agents in Schools,
Derek G. Shendell, D.Env, MPH; Claire Barnett, MBA and Stephen
Boese, MSW, available from Healthy Schools Network and at
A manuscript concisely summarizing the completed science
report and its 300+ references has been accepted for publication
in the peer-reviewed Journal of School Health and is in press
for December 2004. This paper will also be presented at the
APHA 2004 Annual Meeting, on November 9, 2004 in Washington,
 Forbo Flooring, which controls more than 80 percent of
the US linoleum market, reports that driven by orders from
schools and health care facilities, linoleum sales growth
has outpaced growth in the overall floor covering market by
substantially more than double during the last five years.
This document contains hotlinks: if you can't see them, check
out our web version at http://www.healthybuilding.net.
from NewsSlice, an online news service operated by Healthy
Schools Network, Inc. to promote healthier students, personnel,
school facilities, and communities-- topics at the intersection
of health, environment, building sciences, and education.
Send your announcements, news clips, or articles for posting
To subscribe to NewsSlice, go to http://www.healthyschools.org/newsslice.html
and complete the subscription form.
|Institute of Medicine, National Academy of Sciences: Damp
Indoor Spaces and Health (2004)
ON THIS IOM REPORT, AUGUST 2004, THE CDC AND NIOSH ARE CURRENTLY
REVISING THEIR PUBLIC INFORMATION ABOUT DAMP BUILDINGS, MOLD
AND HEALTH. THIS IS A LONG AWAITED CHANGE AND WE SHALL SHORTLY
SEE THE IMPORTANT GOVERNMENTAL INFORMATION THAT WILL CONCLUSIVELY
STATE THAT MOLD IS A DANGER AND CAN CAUSE NON-ALLERGENIC, SERIOUS
PULMONARY DAMAGE. THIS IS A BEGINNING.
Damp Indoor Spaces
and Health (2004)
Board on Health Promotion and Disease Prevention (HPDP), Institute
of Medicine (IOM)
This study was supported by a contract between the National
Academy of Sciences and Centers for Disease Control and Prevention
The findings of the IOM, commissioned by the Center for Disease
Control (CDC), a two year (2001-2003), conservative but compelling
review of selected mold studies through 2003, are available
online in draft form, with the final copy in hardcover and as
a pdf file, for sale through the National Academy of Sciences
(see above). The IOM findings conclusively support that damp
buildings are unhealthy for humans - and that dampness produces
molds and bacteria that can cause allergenic and non-allergenic
responses, some of them initiating new (respiratory) disease
and exacerbating other (respiratory) disease, without ruling
out more extensive organ and neurological damage. The IOM
findings include the strong recommendation for further, extensive
mold research, especially in these areas.
|Peer Reviewed Published Scientific Information on Mold (2003):
18 Original Studies
a scientific view, this 2003 compilation of 18 original research
reports on mold is available, adding much to the Institute of
Medicine (IOM) report (see below).
of Environmental Health: Monograph on Molds and Mycotoxins
Kaye H. Kilburn, M.D., Editor
associated with exposures to indoor mold growth real, or the
results of a conspiracy fueled by media hype and greedy lawyers?
This book is a compilation of 18 current, scientific, peer reviewed
papers presented in 2003 — a veritable mountain of evidence
that many mold-exposed people are indeed sick, with significant
brain function impairment. The published investigations collected
here are based on measurements of single patients and groups,
studied systematically. Physiological functions and brain scans
(single photon emission computed tomography (SPECT) and quantitative
electroencephalograms) were abnormal. Mechanisms of mold damage
to brain cells resemble those for Gulf War Syndrome, chemical
intolerance, and exposure to chlorine, ammonia, or hydrogen
sulfide (“rotten egg”) gases. Clear evidence of brain impairment
in several hundred people controverts questions and charges
of malingering and secondary gain.
are invariably to mixtures of molds. Attempts to define exposure
in terms of specific molds and toxins, or by searching for biomarkers
in body fluids, are inconclusive. Often homes and other buildings
are poorly designed, so that rather than “breathing” they collect
moisture. Cold temperatures and air conditioning condense this
moisture on indoor surfaces, between walls, and in ductwork.
Molds grow opportunistically on wet paper, such as the cellulose
present in drywall, on wooden studs and floors, carpets and
pads, wallpaper, and other organic materials. Because much of
the physiological damage suffered by victims of mold-related
illnesses is irreversible, avoidance of mold is the key. Buildings
must be designed to prevent mold growth.
summarize the preliminary conclusions from studies of several
hundred patients. Evidence is presented for severe neurobehavioral
impairment, nasal sinus and lung dysfunctions, and immunological
disturbance. Integrating these findings and developing treatments
are works in progress as are identifying the molds toxic chemicals.
Introduction: Mold Conference Objectives and Summary
Kaye H. Kilburn, William J. Rea
Indoor Mold Exposure Associated with Neurobehavioral and
Pulmonary Impairment: A Preliminary Report
Kaye H. Kilburn
Effects of Toxic Exposure to Molds and Mycotoxins in
William J. Rea, Nancy Didriksen, Theodore R. Simon, Yaqin
Pan, Ervin J. Fenyves, Bertie Griffiths
Use of Functional Brain Imaging in the Evaluation of
Exposure to Mycotoxins and Toxins Encountered in Desert
Theodore R. Simon, William J. Rea
Mixed Mold Mycotoxicosis: Immunological Changes in Humans
Following Exposure in Water-Damaged Buildings
Michael R. Gray, Jack D. Thrasher, B. Robert Crago, Roberta
A. Madison, Linda Arnold,
Andrew W. Campbell, Aristo Vojdani
Psychological, Neuropsychological, and Electrocortical
Effects of Mixed Mold Exposure
B. Robert Crago, Michael R. Gray, Lonnie A. Nelson, Marilyn
Davis, Linda Arnold, Jack D. Thrasher
Neural Autoantibodies and Neurophysiologic Abnormalities in
Patients Exposed to Molds in Water-Damaged Buildings
Andrew W. Campbell, Jack D. Thrasher, Roberta A. Madison,
Aristo Vojdani, Michael R. Gray, Al Johnson
Antibodies to Molds and Satratoxin in Individuals Exposed
in Water-Damaged Buildings
Aristo Vojdani, Jack D. Thrasher, Roberta A. Madison,
Michael R. Gray, Gunnar Heuser, Andrew W. Campbell
Chronic Sinusitis: Defective T-Cells Responding to
Superantigens, Treated by Reduction of Fungi in the Nose
Donald P. Dennis
Health Symptoms Caused by Molds in a Courthouse
Tang G. Lee
Studies on the Role of Fungi in Sick Building Syndrome
David C. Straus, J. Danny Cooley, Wing C. Wong, Cynthia A. Jumper
Analysis for Mycotoxins: The Chemist¹s Perspective
Bruce B. Jarvis
Organophosphorus Ester-Induced Chronic Neurotoxicity
Mohamed B. Abou-Donia
Atmospheric Transport of Mold Spores in Clouds of Desert Dust
Eugene A. Shinn, Dale W. Griffin, Douglas B. Seba
The Way We Build Now
Geoffrey H. Hutton
Proactive Approaches for Mold-Free Interior Environments
Katherine Warsco, Patricia F. Lindsey
Creating Mold-Free Buildings: A Key to Avoiding Health
Effects of Indoor Molds
Bruce M. Small
Lipoic Acid as a Potential First Agent for Protection from
Mycotoxins and Treatment of Mycotoxicosis
Sherry A. Rogers
Treatment of Cancer with Mushroom Products
Jean A. Monro
Summary of the 5th International Conference on Bioaerosols,
Fungi, Bacteria, Mycotoxins, and Human Health
Kaye H. Kilburn
is available from Dr. K.H. Kilburn
PO Box 5374, Pasadena, CA 91117
or from Heldref Publications
1319 18th St NW, Washington DC, 20036-1802
|Dr. Kaye Kilburn
H. Kilburn M.D.,is a Ralph Edgington Professor of Medicine,
USC (University of Southern California) Keck School of Medicine.
For more information, visit Dr. Kilburn's website at: http://www.neuro-test.com.
new book: Endangered
Brains just released!
of Environmental Health: Monograph on Molds and Mycotoxins
Kaye H. Kilburn, M.D., Editor
Health. 2003 Jul;58(7):390-8.
mold exposure associated with neurobehavioral and pulmonary
impairment: a preliminary report.
University of Southern California, Keck School of Medicine,
Environmental Sciences Laboratory, Alhambra, California 91803,
Recently, patients who have been exposed indoors to mixed molds,
spores, and mycotoxins have reported asthma, airway irritation
and bleeding, dizziness, and impaired memory and concentration,
all of which suggest the presence of pulmonary and neurobehavioral
problems. The author evaluated whether such patients had measurable
pulmonary and neurobehavioral impairments by comparing consecutive
cases in a series vs. a referent group. Sixty-five consecutive
outpatients exposed to mold in their respective homes in Arizona,
California, and Texas were compared with 202 community subjects
who had no known mold or chemical exposures. Balance, choice
reaction time, color discrimination, blink reflex, visual fields,
grip, hearing, problem-solving, verbal recall, perceptual motor
speed, and memory were measured. Medical histories, mood states,
and symptom frequencies were recorded with checklists, and spirometry
was used to measure various pulmonary volumes and flows. Neurobehavioral
comparisons were made after individual measurements were adjusted
for age, educational attainment, and sex. Significant differences
between groups were assessed by analysis of variance; a p value
of less than 0.05 was used for all statistical tests. The mold-exposed
group exhibited decreased function for balance, reaction time,
blink-reflex latency, color discrimination, visual fields, and
grip, compared with referents. The exposed group's scores were
reduced for the following tests: digit-symbol substitution,
peg placement, trail making, verbal recall, and picture completion.
Twenty-one of 26 functions tested were abnormal. Airway obstructions
were found, and vital capacities were reduced. Mood state scores
and symptom frequencies were elevated. The author concluded
that indoor mold exposures were associated with neurobehavioral
and pulmonary impairments that likely resulted from the presence
of mycotoxins, such as trichothecenes.
Eur J Public Health. 2004 Mar;12(1):36-42.
FAQ page for info re: Dr. Kaye
|Dr. Richard Shoemaker
Shoemaker, M.D., graduate of Duke University School
of Medicine, is a family practitioner in Pokomoke, MD, whose
interests in biology led him to study and treat patients exposed
to a variety of toxins - including mold and Lyme Disease. Dr.
Shoemaker's website is located at www.chronicneurotoxins.com.
He is an author of a number of books on biotoxin poisoning and
related illnesses. Click here to learn about Dr. Shoemaker's
Medicine, one that explains his philosophy on toxin-related
illnesses - Dr. Shoemaker calls it "the primer on mold". A new
book, Mold Warriors, will be available very soon. For
further publications by Dr. Shoemaker, see Books
in VEGF, MMP9 and leptin correlate with acute and chronic illness
symptoms and visual contrast sensitivity in patients from water
damaged buildings: Indicators of complex physiologic disturbances
in Sick Building Syndrome
Ritchie C. Shoemaker¹, Dennis House¹
for Research on Biotoxin Associated Illnesses, Pocomoke, Md
A 5-step repetitive exposure protocol provides a mechanism to
document causation of illness in symptomatic patients exposed
to in door environments of water-damaged buildings (WDB). By
demonstrating benefits of treatment with cholestyramine (CSM)
of affected patients, with stability off medication away from
exposure and then documenting changes in symptoms and biomarkers
prospectively with re-exposure, followed by correction with
re-treatment, we have previously shown that the physiologic
disturbances underlying illness in Sick Building Syndrome are
identical to those of a chronic biotoxin associated illness.
We present data here to support use of leptin, vascular endothelial
growth factor (VEGF) and matrix metalloproteinase-9 (MMP9) as
biochemical markers for both acute and chronic illness adjunctive
to recording of symptoms and visual contrast sensitivity (VCS).
We again present data on unique genotypes of HLA DR, analyzed
by PCR, previously reported to be associated with a genetic
basis of susceptibility to neurotoxic illness caused by exposure
to resident indoor toxigenic fungi. The unique grouping of symptoms
found in these patients, including fatigue, neurologic, respiratory
and rheumatologic symptoms match changes of biomarkers with
treatment and re-exposure.
26 consecutive patients exposed to buildings with growth of
identified toxigenic fungi attending a private clinic for diagnosis
and treatment of chronic fatiguing illness refractory to all
prior modalities of therapy agreed to participate in an IRB
approved, multiple intervention, longitudinal clinical treatment
trial using CSM to assess the effect of exposure, treatment,
re-exposure and re-treatment on multiple simultaneously measured
clinical and laboratory parameters. Each patient provided informed
consent. Exposure to tobacco smoke, IgE, pulmonary function
testing results before and after interventions and HLA DR genotypes
Each affected patient showed clinical improvement following
treatment with CSM and was stable off drug, away from exposure
to the known affected building. Each patient relapsed within
3 days of re-exposure to the contaminated building off CSM,
with improvement following re-treatment. Change in clinical
course was paralleled by symptoms, VCS, leptin, MMP9 and VEGF.
Improvement in PFT testing was noted. HLA DR genotypes previously
noted to confer susceptibility were again demonstrated. Tobacco
smoke was not a relevant clinical parameter. Symptom rosters
showed multiple organ system illness, with fatigue, chronic
pain and cognitive problems most commonly identified.
Use of symptoms, VCS, leptin, VEGF and MMP9 gives the treating
physician biomarkers useful in case identification and assessment
of efficacy of therapy. Changes in biomarkers suggest pathophysiologic
abnormalities acquired following exposure to water damaged buildings.
These biomarkers change hyperacutely in each step, with clinical
stability in chronic conditions. The direct physiologic effects
of toxic elements from indoor buildings can be assessed clinically
and used in prospective studies that can assign causation. A
double blinded, placebo controlled clinical trial designed to
further define these results is underway.
released by permission of Dr. R. Shoemaker
Identifying markers for chronic illness in pediatric patients
exposed to water damaged buildings: Linkage disequilibrium of
HLA DR, MSH, MMP9 and autoantibodies
Ritchie C. Shoemaker¹, Courtney Holt¹, Dennis House¹, HK Hudnell²
for Research on Biotoxin Associated Illnesses , Pocomoke, Md;
²US EPA NHEERL, Research Triangle Park, NC
No studies have previously identified biomarkers adequate to
create a case definition of illness associated with exposure
to water damaged buildings (WDB) in pediatric patients. Previous
work from this facility has presented a case definition of illness
in adults that includes exposure, symptoms and absence of confounders,
together with biomarkers HLA DR genotypes of the immune response
genes; deficiency of the hypothalamic immunomodulatory hormone,
alpha melanocyte stimulating hormone (MSH); excess pro-inflammatory
cytokine responses, represented by matrix metalloproteinase-9
(MMP9), deficits in visual contrast and pituitary hormone dysregulation.
We have seen an increased incidence of antibodies to gliadin,
cardiolipin and myelin basic protein in adults with chronic
illness following exposure to WDB. Here we present data supporting
a pediatric case definition using multiple biomarkers from 66
patients with illness following exposure to WDB.
Patients under age 19 coming for treatment of chronic illness
at a specialized medical clinic provided informed consent for
evaluation and blood testing prior to initiation of definitive
therapy for presumptive chronic, biotoxin associated illness.
Symptoms were recorded and blood was sent to national high complexity
labs for analysis of HLA DR genotype, MSH, MMP9, anticardiolipins
(ACLA), antigliadins (AGA) and myelin basic protein (MBP) antibodies.
Lab parameters were compared to in-house registries of control
patients and published registries. Following treatment and confirmation
of diagnosis, cases were then analyzed by biomarker to identify
unique diagnostic features.
Control populations have markedly different HLA DR genotype
distributions from cases, with relative risks for illness identified
for the same genotypes as reported previously in adults. Affected
patients had lower levels of MSH and MMP9 than controls. Marked
increase in incidence of antibodies to antigliadin IgG, anticardiolipin
IgM and myelin basic protein antibodies was found in affected
patients compared to controls. Taken together, the combination
of potential for exposure, absence of confounding diagnoses,
presence of distinctive groupings of symptoms, including fatigue
and cognitive problems identified over 85% of cases. Adding
HLA DR, MSH deficiency, AGA-IgG and ACLA-IgM increased the case
detection rate to 100%. For patients with MMP9 over 400, HLA
DR and MSH deficiency alone identified all cases.
Specific genetic, physiologic and neurotoxicologic factors can
be identified in pediatric patients that identify cases of chronic
illness due to exposure to WDB. Physiologic mechanisms associated
with increased production of particular autoantibodies will
require further study.
|10/04 Mayo Clinic Common Airborne Fungi Cause Chronic Stuffy
Mayo Clinic Released: Wed 06-Oct-2004, 15:00 ET
Common Airborne Fungi Cause Chronic Stuffy Nose
A team led by Mayo Clinic researchers has determined that over-
reactive immune responses to airborne fungi could cause the
stuffy noses and airway inflammation among sufferers of chronic
rhinosinusitis. These findings could one day lead to a new,
"It's time to recognize there is a greater sensitivity to airborne
fungi in some patients, and therefore we need to remove or reduce
the fungal exposure," says lead investigator Hirohito Kita,
In today's electronic edition of theJournalofAllergyandClinicalImmunologyhttp://www2.us.elsevierhealth.com/scripts/om.dll/serve?action=searchDB&searchDBfor=home&id=ai,
the Mayo Clinic researchers and a colleague from the University
of Utah conclude that certain species of airborne fungus produce
spores and by-products, that when inhaled, prompt irregular
and damaging immune responses. The responses, in turn, produce
the congestion and inflammation. Chronic rhinosinusitis costs
society about $5.6 billion a year. And that doesn't include
an estimated $70 million in annual lost work days, as well as
a diminished quality of life.
Implications of Research "The fungi we're talking about are
very common," Dr. Kita. "They are airborne fungi found anywhere
in the United States. Now that we know the role of the fungi,
we can work toward reducing the potential role of the fungi
through such treatments as nasal irrigations (flushing with
water) that clear the fungi, or prescription of antifungal medicines
taken by mouth."
Preliminary results show that the irrigation treatment relieves
symptoms. Larger, multicenter studies are needed before this
treatment can move into general use. But the results are encouraging
because they support the idea that reducing fungal exposure
in sensitive individuals could offer a new treatment option
to sufferers worldwide.
Background Chronic rhinosinusitis is one of the most common
chronic illnesses in the United States. Its symptoms include
persistent stuffy nose, thick mucus production and loss of smell.
Though chronic rhinosinusitis causes significant discomfort
and health problems, it is not well understood. Viruses, bacteria
and allergic reactions all have been researched and debated
as potential mechanisms driving the responses. The immune system
mounts different kinds of responses for different invaders --
a bacterium gets attacked by a different cell or system than
an allergy-prompting particle, for example. That's why it's
critical to identify the key mechanisms in the immune response
to chronic rhinosinusitis, allowing researchers to design treatments
to relieve the distressing symptoms.
The Mayo Clinic work is the first to provide data for the role
of airborne fungi in chronic rhinosinusitis and to show that
several immune system branches appear to collaborate in response
to the fungi -- resulting in an abnormally enhanced response
that causes troublesome inflammation and congestion. The research
team's data show that specific cells in 90 percent of chronic
rhinosinusitis patients produce an enhanced immune-system response
to one fungus in particular, Alternaria. Another kind of common
fungus, Cladosporium, also provoked an abnormally enhanced immune
Mayo Clinic scientists previously used antifungal therapies
to treat patients with chronic sinusitis, which marked a new
clinical approach. These new findings serve to further support
this perspective and will prompt additional research.
The Investigation Researchers tested blood from 18 patients
with chronic rhinosinusitis and 15 healthy persons to evaluate
how specific immune system cells responded to common airborne
fungi. The immune systems of those with chronic rhinosinusitis
reacted more robustly than those of healthy individuals. In
fact, when exposed to Alternaria, one branch of the immune system's
response was five times greater in the chronic rhinosinusitis
patients than in the healthy volunteers.
The research team investigated the body's responses to this
fungal exposure by measuring components within the two branches
of the adaptive immune system. The adaptive immune system takes
several days to mount a response to foreign invaders. The two
branches of the adaptive immune system are: 1) a cell-directed
branch that involves special cells known as T lymphocytes and
2) the humoral branch, which works primarily through cells known
as B lymphocytes. Research Team Members and Support
In addition to Dr. Kita, the Mayo Clinic research team includes
Seung-Heon Shin, M.D.; Jens Ponikau, M.D.; David Sherris, M.D.;
David Congdon, M.D.; Evangelo Frigas, M.D.; Henry Homburger,
M.D.; and Mark Swanson. The University of Utah collaborator
was Gerald Gleich, M.D. Their work was supported by a grant
from The National Institute for Allergy and Infectious Diseases
and by the Mayo Foundation.
release date: 8-Oct-2004
Contact: Anne A. Oplinger
NIH/National Institute of Allergy and Infectious Diseases
sinusitis sufferers have enhanced immune responses to fungi
Scientists supported by the National Institute of Allergy and
Infectious Diseases (NIAID), part of the National Institutes
of Health, have discovered that people with chronic sinus inflammation
have an exaggerated immune response to common airborne fungi.
The results of their study appear online today in The Journal
of Allergy and Clinical Immunology.
|Additional Research of Note
remediation of mold damaged school--a three-year follow-up study
on teachers' health.
Patovirta RL, Husman T, Haverinen U, Vahteristo M, Uitti
JA, Tukiainen H, Nevalainen A.
National Public Health Institute, Kuopio, Finland. firstname.lastname@example.org
The health effects in teachers of a mold-damaged school before
and during an extensive remediation process were assessed. Health
data were collected with self-administered questionnaires from
teachers (n=31) working in a moisture and mold damaged school
and from the reference group of teachers (n=13) working in a
non-damaged school. The questionnaire study was repeated three
times. Spirometry was measured in 33 individuals in the spring
1997 and repeated in the spring 1999 and 2000. In the damaged
school, a cluster of eight asthma cases was identified, the
prevalence of asthma being 26%. Before the remediation, the
number of sinusitis episodes was higher (p=0.040) and the mean
duration of sick leaves longer (p=0.015) among the study group
than in the reference group. A higher prevalence of hoarseness
and perceived poor quality of indoor air were reported. During
the follow-up, no new asthma cases appeared. After the remediation,
bronchitis, conjunctivitis, symptoms of allergic rhinitis and
the sum of respiratory infection episodes decreased significantly.
Some of the asthmatics had low values in the spirometry but
no changes in the lung function were observed at the group level.
The remediation of the mold damage had beneficial effects on
PMID: 15068207 [PubMed - indexed for MEDLINE]
Fungal contamination of elementary schools: a new environmental
Santilli J, Rockwell W.
BACKGROUND: Sensitivity to fungi is a significant cause of allergic
diseases, and prolonged indoor exposure to fungi is a growing
health concern. OBJECTIVE: This study evaluates the health effects
of mold-contaminated schools on students and teachers. A discussion
of the effectiveness of current methods for evaluating these
schools, with a focus on the importance of using total mold
spore counts, is also provided. METHODS: Two Connecticut public
schools were tested using multiple air quality testing methods,
with the standard for a healthy indoor environment being total
mold spore counts lower than 1,000 spores/m3. The health impact
of the mold exposure at each school was evaluated using the
validated Rhinitis Outcomes Questionnaire. RESULTS: The testing
of the first school found indoor mold counts ranging from 6,000
to 50,000 spores/m3. Eighty-five of the students and teachers
reported significant allergic symptoms to the school nurse.
This school is currently being demolished. More than 2 years
after the exposure ended, a number of occupants of the school
continue to have elevated symptoms compared with before their
exposure to the school. The testing of the second school revealed
total mold spore counts ranging between 2,000 and 9,000 spores/m3,
qualifying it an unhealthy environment in need of immediate
remediation. Students reported significant allergic symptoms
from exposure to certain rooms that are currently being remediated.
CONCLUSIONS: Because of the negative impact on health that indoor
mold exposure has, particularly in atopic patients, schools
should be routinely tested for fungal contamination. Total mold
spore counts should be performed using volumetric air sampling
such as the Allergenco MK-3 (Allergenco, San Antonio, TX) because
testing air quality via semiquantitative culture sampling alone
does not give a true reflection of the extent of fungal contamination.
Finally, the standard for a healthy indoor environment should
be defined as having <1,000 spores/m3.
PMID: 12602667 [PubMed - indexed for MEDLINE]
ScientificWorldJournal. 2003 Nov 13;3:1128-37.
neurological significance of abnormal natural killer cellactivity
in chronic toxigenic mold exposures.
Anyanwu E, Campbell AW, Jones J, Ehiri JE, Akpan AI.
Neurosciences Research, Cahers Inc., Conroe, TX, USA.
Toxigenic mold activities produce metabolites that are either
broad-spectrum antibiotics or mycotoxins that are cytotoxic.
Indoor environmental exposure to these toxigenic molds leads
to adverse health conditions with the main outcome measure
of frequent neuroimmunologic and behavioral consequences.
One of the immune system disorders found in patients presenting
with toxigenic mold exposure is an abnormal natural killer
cell activity. This paper presents an overview of the neurological
significance of abnormal natural killer cell (NKC) activity
in chronic toxigenic mold exposure. A comprehensive review
of the literature was carried out to evaluate and assess the
conditions under which the immune system could be dysfunctionally
interfered with leading to abnormal NKC activity and the involvement
of mycotoxins in these processes. The functions, mechanism,
the factors that influence NKC activities, and the roles of
mycotoxins in NKCs were cited wherever necessary. 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. Although sleep is commonly considered
a restorative process that is important for the proper functioning
of the immune system, it could be disturbed by mycotoxins.
Most likely, mycotoxins exert some rigorous effects on the
circadian rhythmic processes resulting in sleep deprivation
to which an acute and transient increase in NKC activity is
observed. Depression, psychological stress, tissue injuries,
malignancies, carcinogenesis, chronic fatigue syndrome, and
experimental allergic encephalomyelitis could be induced at
very low physiological concentrations by mycotoxin-induced
NKC activity. In the light of this review, it is concluded
that chronic exposures to toxigenic mold could lead to abnormal
NKC activity with a wide range of neurological consequences,
some of which were headache, general debilitating pains, fever,
cough, memory loss, depression, mood swings, sleep disturbances,
anxiety, chronic fatigue, and seizures.
1: Arch Environ Health. 2003 Jul;58(7):410-20.
mold mycotoxicosis: immunological changes in humans followingexposure
in water-damaged buildings.
Gray MR, Thrasher JD, Crago R, Madison RA, Arnold L, Campbell
Progressive Healthcare Group, Benson, Arizona, USA.
The study described was part of a larger multicenter investigation
of patients with multiple health complaints attributable to
confirmed exposure to mixed-molds infestation in water-damaged
buildings. The authors present data on symptoms; clinical
chemistries; abnormalities in pulmonary function; alterations
in T, B, and natural killer (NK) cells; the presence of autoantibodies(i.e.,
antinuclear autoantibodies [ANA], autoantibodies against smooth
muscle [ASM], and autoantibodies against central nervous system
[CNS] and peripheral nervous system [PNS] myelins). A total
of 209 adults, 42.7 +/- 16 yr of age (mean +/- standard deviation),
were examined and tested with (a) self-administered weighted
health history and symptom questionnaires; (b) standardized
physical examinations; (c) complete blood counts and blood
and urine chemistries; (d) urine and fecal cultures; (e) thyroid
function tests (T4, free T3); (f) pulmonary function tests
(forced vital capacity [FVC], forced expiratory volume in
1 sec [FEV1.0], and forced expiratory flow at 25%, 50%, 75%,
and 25-75% of FVC [FEF25, FEF50, FEF75, and FEF2(25-75)]);
(g) peripheral lymphocyte phenotypes (T, B, and NK cells)
and mitogenesis determinations; and (h) a 13-item autoimmune
panel. The molds-exposed patients reported a greater frequency
and intensity of symptoms, particularly neurological and inflammatory
symptoms, when compared with controls. The percentages of
exposed individuals with increased lymphocyte phenotypes were:
B cells (CD20+), 75.6%; CD5+CD25+, 68.9%; CD3+CD26+, 91.2%;
CD8+HLR-DR+, 62%; and CD8+CD38+, 56.6%; whereas other phenotypes
were decreased: CD8+CD11b+, 15.6% and CD3- CD16+CD56+, 38.5%.
Mitogenesis to phytohemagglutinin was decreased in 26.2% of
the exposed patients, but only 5.9% had decreased response
to concanavalin A. Abnormally high levels of ANA, ASM, and
CNS myelin (immunoglobulins [Ig]G, IgM, IgA) and PNS myelin
(IgG,IgM, IgA) were found; odds ratios for each were significant
at 95% confidence intervals, showing an increased risk for
autoimmunity.The authors conclude that exposure to mixed molds
and their associated mycotoxins in water-damaged buildings
leads to multiple health problems involving the CNS and the
immune system, in addition to pulmonary effects and allergies.
Mold exposure also initiates inflammatory processes. The authors
propose the term \"mixed mold mycotoxicosis\" for the multisystem
illness observed in these patients.
1: Appl Neuropsychol. 2002;9(4):193-202. Related Articles,
performance of patients following mold exposure.
Baldo JV, Ahmad L, Ruff R.
Veterans Affairs Northern California Health Care System, Martinez,
California 91711-3948, USA.
This study investigated the effects of mold exposure (ME)
on human cognition by analyzing neuropsychological data from
patients who were exposed to mold in their homes or workplaces.
Compared tonormative data, ME patients were impaired (<10th
percentile) on anumber of cognitive measures, with the most
consistent deficits in visuospatial learning, visuospatial
memory, verbal learning, and psychomotor speed. We also examined
emotional functioning and found that a number of ME patients
showed evidence of both Axis I and Axis II pathology. Interestingly,
there was a significant correlation among patients\' scores
on the Beck Depression Inventory-Second Edition and the number
of neuropsychological tests falling within the impaired range.
Given the limited understanding of ME and its effect on the
human central nervous system, we provide a working model that
attempts to capture the complex interactions of impaired cognition,
psychosocial stressors, poor physical health, and emotional
functioning in patients following ME. Keywords: mold exposure,
mild traumatic brain injury, toxic exposure
PMID: 12584073 [PubMed - indexed for MEDLINE]
1: ScientificWorldJournal. 2003 Apr 28;3:281-90.
effects of chronic indoor environmental toxicmold exposure
Anyanwu EC, Campbell AW, Vojdani A.
Cahers Neurosciences Research, 8787 Shenandoah Park Drive,
122, Conroe, TX 77385, USA. email@example.com
The phenomenon of building-related diseases is attracting
much research interest in recent years because of the extent
to which it affects people with compromised immune systems,
especially children. In this study, we reported the neurological
findings in children who attended our Center because of chronic
exposure to toxic molds. Clinical neurological and neurobehavioral
questionnaires were administered with the cooperation of the
children\'s parents. The children then underwent a series
of neurophysiological tests including electroencephalogram
(EEG), brainstem evoked potential (BAEP), visual evoked potential
(VEP), and somatosensory evoked
potential (SSEP). The results showed high levels of abnormalities
in the analysis of the subjective responses derived from the
questionnaires. The EEG examination was abnormal in seven
out of ten of the patients compared to the controls with only
one in ten with episodes of bihemispheric sharp activity.
In all the patients, there
was frontotemporal theta wave activity that seemed to indicate
diffuse changes characteristic of metabolic encephalopathies.
Also,there was highly marked 1 to 3 Hz delta activity that
was asymmetrical in the right hemisphere of the brain in three
out of ten patients. The waveforms of BAEP showed abnormalities
in 90% of the patients with both 15\' and 31\' check sizes
compared to none in the controls. There were significant delays
in waveform V in a majority of the patients representing dysfunctional
cognitive process and conductive hearing loss in both ears.
VEP showed clear abnormalities in four in ten of the patients
with P100 amplitudes and latencies decreased bilaterally.
In all the patients, there was slowing of conduction in the
right tibial at an average of 36.9 ms and there was significant
decrease in amplitude of response at the proximal stimulation
site. Sensory latencies obtained in the median, ulnar, and
sural nerves bilaterally showed abnormalities in five out
of ten compared to none in the controls. The median, ulnar,
and sural sensory potentials were abnormal in six out of ten
patients. There was prolongation of the median distal sensory
latencies bilaterally at an average of 4.55 ms on the right
and an average of 6.10 ms on the left as compared to the ulnars
of 2.55 ms
Immunotoxicol. 2003 Nov;25(4):595-614.
Saliva secretory IgA antibodies against molds and mycotoxins
in patients exposed to toxigenic fungi.
Vojdani A, Kashanian A, Vojdani
E, Campbell AW.
Immunosciences Lab., Inc., Section of Neuroimmunology, Beverly
Hills, California 90211, USA. firstname.lastname@example.org
Upper respiratory exposure to different environmental antigens
results first in the activation of mucosal immunity and production
of IgA antibodies in different secretions including saliva.
Despite this there is no study, which addresses secretory
antibodies against molds and mycotoxins. The purpose of this
study was to evaluate mold-specific salivary IgA in individuals
exposed to molds and mycotoxins in a water-damaged building
environment. Saliva IgA antibody levels against seven different
molds and two mycotoxins were studied in 40 patients exposed
to molds and in 40 control subjects. Mold-exposed patients
showed significantly higher levels of salivary IgA antibodies
against one or more mold species. A majority of patients with
high IgA antibodies against molds exhibited elevation in salivary
IgA against mycotoxins, as well. These IgA antibodies against
molds and mycotoxins are specific, since using molds and mycotoxins
in immune absorption could reduce antibody levels, significantly.
Detection of high counts of molds in water-damaged buildings,
strongly suggests the existence of a reservoir of mold spores
in the environment. This viable microbial activity with specific
mold and mycotoxin IgA in saliva may assist in the diagnosis
of mold exposure. Whether mold and mycotoxin specific IgA
antibodies detected in saliva are indicative of the role of
IgA antibodies in the late phase of type-1 hypersensitivity
reaction or in type-2 and type-3 delayed sensitivities is
a matter that warrants further investigation.
PMID: 14686801 [PubMed - indexed for MEDLINE]
Effects of toxic exposure to molds and mycotoxins in building-related
Rea WJ, Didriksen N, Simon TR, Pan Y, Fenyves
EJ, Griffiths B.
Environmental Health Center-Dallas, Dallas, Texas 75231-4262,
The authors studied 100 patients who had been exposed to toxic
molds in their homes. The predominant molds identified were
Alternaria, Cladosporium, Aspergillus, Penicillium, Stachybotrys,
Curvularia, Basidiomycetes, Myxomycetes, smuts, Epicoccus, Fusarium,
Bipolaris, and Rhizopus. A variety of tests were performed on
all, or on subgroups of, these patients. Sensitivities and exposures
were confirmed in all patients by intradermal skin testing for
individual molds (44-98% positive), and by measurement of serum
antibodies. Abnormalities in T and B cells, and subsets, were
found in more than 80% of the patients. The findings of trichothecene
toxin and breakdown products in the urine, serum antibodies
to molds, and positive intradermal skin tests confirmed mycotoxin
exposure. Respiratory signs (e.g., rhinorrhea, sinus tenderness,
wheezing) were found in 64% of all patients, and physical signs
and symptoms of neurological dysfunction (e.g., inability to
stand on the toes or to walk a straight line with eyes closed,
as well as short-term memory loss) were identified in 70% of
all patients. Objective abnormal autonomic nervous system tests
were positive in all 100 patients tested. Brain scans, conducted
using triple-head single photon emission computed tomography,
were abnormal in 26 (86%) of 30 (subgroup of the 100) patients
tested. Objective neuropsychological evaluations of 46 of the
patients who exhibited symptoms of neurological impairment showed
typical abnormalities in short-term memory, executive function/judgment,
concentration, and hand/eye coordination.
PMID: 15143852 [PubMed - indexed for MEDLINE]
Health symptoms caused by molds in a courthouse.
Faculty of Environmental Design, The University of Calgary,
Calgary, Alberta, Canada. email@example.com
A majority of occupants of a newly renovated historic courthouse
in Calgary, Alberta, Canada, reported multiple (3 or more) health-related
symptoms, and several reported more than 10 persistent symptoms.
Most required at least 1 day outside of the building to recover
from their symptoms. Molds that produce mycotoxins, such as
Stachybotrys chartarum and Emericella nidulans, were identified
in the building, along with fungal organisms of the genera Aspergillus,
Penicillium, Streptomyces, Cladosporium, Chaetomium, Rhizopus/Mucor,
Alternaria, Ulocladium, and Basidiomycetes. Renovations to this
historic had building failed to provide adequate thermal and
vapor barriers, thus allowing moist indoor air to migrate into
the building enclosure, causing condensation to develop. Mold
grew on the condensation and was dispersed throughout the courthouse,
including on furniture and files. The courthouse was closed
and a new facility was modified with low-offgassing materials,
better ventilation and air filtration, and strict building maintenance
to accommodate those occupants of the older building who had
developed multiple chemical sensitivities.
PMID: 15143857 [PubMed - indexed for MEDLINE]
Additionally: A list of Texas
Tech University Health Sciences Center, Dept. of Microbiology
and Immunology, Center for Indoor Air Research publications
Texas Tech University's Reference
Guide for Fungi: A glossary of fungi which features
research abstracts from peer-reviewed journals for each
species – find out what the type of mold in your school or
building can do to humans, according to scientific research,
useful for medical and legal
The intro is as follows:
"In this reference guide for fungi we have listed
all the fungal species we are aware of that are associated
with indoor air quality investigations and more. Please note
however, that this reference guide does not cover every known
This reference guide for fungi is slightly different
than some of the other very good fungal glossaries on the
web. We have included detailed references and corresponding
abstracts that relate to allergenicity, toxicity and fungal
infection for all fungi listed.
We have a number of photographs of fungi in this
reference guide. However, we have many more. We are in the
process of producing a separate, comprehensive fungal guide
from these photographs and the information from this web page.
The guide will be available in book format and on CD at a
later date. The photos will show the front and (at times
important) reverse shots for several of the reference guide
organisms, on 3 different media (Malt Extract Agar, Sabourauds
Dextrose Agar and Potato Dextrose Agar). The photos are predominantly
taken at 7 days of incubation at 25oC. Accompanying
these photos are photomicrographs of these organisms.
One important note: after reading about the properties
of these organisms, one can become very concerned. However,
susceptibility to them can be dependant on how compromised
your immune system is, the amount of fungal spores you are
exposed to and how long you have been exposed to them,
among other factors. Most of us breathe numerous fungal spores
everyday and come to no harm."
Dr. Stephen Wilson, Director, Texas Tech University,
Department of Microbiology, Microbiology and Immunology
Dr David Straus, Professor, Texas Tech University,
Center for Indoor Air Research