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New controversial report questions motives of AAAAI   PDF  Print  E-mail 
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Sunday, 20 March 2005

AAAAI claims mold allergy a bigger health concern than toxic mold?  What were they thinking?

March 20, 2005

Milwaukee, WI -  Mold is normally present in all homes, but is usually harmful only in large concentrations to allergic or sensitive individuals claims a controversial report published in this month's Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI). There has been a lot of controversy recently regarding some biased, incomplete, and false reports (ACOEM and IOM) that downplay the true health hazards of exposure to toxigenic molds.  This is mostly due to officials in the building, insurance, and pharmaceutical industry who have financial motives to squelch evidence regarding the the neurological and immunological effects of toxigenic mold.  Because of this, many lay people have ambiguous opinions of mold.  The general confusion seems to be that some molds are allergen-producing, not toxin-producing.  This grave confusion is common due to these questionable and incomplete reports, which many believe were meant to be used in courtrooms around the US for defense attorneys.

?Although toxic mold has received much media attention lately, toxic reactions caused by fungal exposure have not been found to be a significant health problem,? claimed lead author Jay M. Portnoy, The Children's Mercy Hospital in Kansas City, Mo. ?The more common household molds, when in the presence of moisture, can proliferate and cause problems and health effects that are generally due to allergy or irritation to fungal substances.? This appears to be another case of an ill-informed researcher, or one who profits as a well-paid expert witness in defense cases.

Fungi, including molds, are spore-producing organisms that comprise some 25 percent of the earth's biomass and function as decomposers of organic material. The most common fungi found in homes include Cladosporium, Aspergillus, Penicillium, Alternaria, and the most dangerous as they can destroy the myelin sheath; Chaetomium, and Stachybotrys. These molds are all toxin producing fungi that can be very dangerous if exposed to large counts.  If one is exposed too long to such molds and becomes poisoned, they can easily become hyper-sensitized, or allergic due to immune dysfunction.

This  new report claims, fungal allergy is best identified by testing for the presence of mold-specific IgE antibodies, combined with a history of symptoms following exposure. Once the specific IgE has formed, subsequent exposure to the fungus can result in an allergic reaction. Exposure to fungi has been linked to a wide range of illnesses, including asthma and rhinitis. More than 80 types of mold have been associated with respiratory tract disorders, not to mention autoimmune disease, such as Multiple Sclerosis.

?A number of studies have suggested that exposure to indoor fungi can trigger allergy symptoms. Fungal exposure is also associated with exacerbations of asthma, although it remains unclear that this exposure causes the disease,? Dr. Portnoy claimed.

He did acknowledge the dangers of toxigenic molds  as he  went on to state, "Adverse health symptoms associated with fungal contact also include fungal infection, irritant reaction to spores or fungal metabolites, and toxic reaction to mycotoxins, described in the report as follows:

-- Infection: Most common indoor fungi grow near room temperature and do not easily grow inside the human body. Aspergillus is the most likely to cause respiratory infections, where most other fungi tend to infect the skin, nails and other areas of the body that function a lower temperatures.

-- Irritant: An irritant reaction to fungi exposure causes inflammation and can happen without previous hypersensitivity. Substances produced by fungi that are suspected to cause irritant reactions include microbially derived volatile organic compounds (MVOCs), ergosterols and glucans. MVOCs are produced by fungi as a byproduct of their metabolism, and their health effects are undetermined. They may cause nontoxic adverse effects as irritants or trigger psychological effects because of their odor. Toxic reactions do not likely occur as a result of MVOC exposure due to the low concentrations present in even the most contaminated environments.

-- Toxic reaction: Most toxic reactions to fungi occur as a result of eating mold-contaminated foods. A toxic reaction is unlikely to occur from inhalation of fungi since the amount of exposure generally is too low to cause health effects. This statement is clearly incorrect and unfair to patients who are trying to find the cause of their symptoms.  Toxic reactions are more common than once thought and can cause a multiplicity of maladies from acid reflux to Rheumatoid Arthritis, and even Cancer.

Indoor levels of airborne fungi should be below outdoor levels of similar species in a well-constructed home without water damage. There can be some contribution from indoor sources, such as plants, pets and mold contaminates brought in on footwear and clothing.  The report did state some common sense that is  worthwhile advice; ?The best known management of indoor fungal contamination is prevention,? Dr. Portnoy said. ?Regular inspection for sources of moisture and their elimination is the most important strategy to control indoor fungal growth. Since fungal growth depends on moisture and a carbon source, the most important strategy for reducing or eliminating its growth is controlling the amount of moisture present.?

Although the presence of damp conditions and carpets increases spore counts - forced air-heating systems, dehumidifiers, air filters, and air conditioners reduces them. The authors suggest the following additional steps to prevent mold growth: maintain indoor relative humidity at no greater than 50 percent; seal all leaks to prevent water accumulation and use a sump pump in basements prone to flooding; and increase the use of bathroom and kitchen ventilation by using exhaust fans. Obtaining an inspection by a licensed testing professional is a must when contemplating any new living quarters.

It is important not to panic if you see mold growing in your living space.  Testing is generally inexpensive to moderately priced, but well worth the preventive cause.  the use of bleach was also mentioned by Dr. Portnoy, but this test was funded by Clorox.  Bleach is the worst possible substance to apply to mold  as it doesn't kill this type of fungi, but rather sets off dangerous mycotoxins into the air.

We hope that the ACAAI un-publishes this misleading report and conducts a more thorough and equitable report that tells the truth about the dangers of exposure to toxigenic molds.  It is a trade organization comprising nearly 5,000 allergists-immunologists and related health care professionals. The College is dedicated to the clinical practice of allergy, asthma and immunology through education and research. If you have any remarks regarding your opinions about this report, please click on the button below.

Citation: Portnoy, JM, et al. Health effects of indoor fungi. Ann Allergy Asthma Immunol 2005;94:313-320.

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Last Updated (Sunday, 20 March 2005)

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