Mold and indoor contaminants can cause a wide variety
of health effects. Contamination in water-damaged
buildings is a very complex situation that can result in
multi-symptom, 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 the 2010 World Health Organization report:
WHO Guidelines for Indoor Air Quality: Selected Pollutants. Click here to read the report.
Clean air is a basic requirement of life. The quality of air inside homes, offices, schools, day care centres,
public buildings, health care facilities or other private and public buildings where people spend a large part
of their life is an essential determinant of healthy life and people’s well-being. Hazardous substances emitted
from buildings, construction materials and indoor equipment or due to human activities indoors, such as
combustion of fuels for cooking or heating, lead to a broad range of health problems and may even be fatal.
Indoor exposure to air pollutants causes very significant damage to health globally – especially in
developing countries. The chemicals reviewed in this volume are common indoor air pollutants in all regions
of the world.
_____________________________________________________________________________________
From Dr. Harriet Ammann:
Is Indoor Mold Contamination a Threat to Health? Click here to read the report.
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.
From Ritchie, Shoemaker, M.D., Laura Mark, M.D., Scott McMahon M.D., Jack D. Thrasher, Ph.D.,
Carl Grimes, HHS, CIEC:
Research Committee Report on Diagnosis and Treatment of Chronic Inflammatory Response
Syndrome (CIRS) Caused by Exposure to the Interior Environment of Water-Damaged Buildings
Click here to read the report.
Exposure to these (water-damaged buildings) WDB environments can cause a readily identifiable illness
syndrome characterized by specific metabolic disturbances stemming from lack of neuropeptide control of
host inflammatory responses, genetic susceptibility and abnormal downstream inflammatory parameters that
not only define the illness but also provide the academic basis for sequential therapeutic interventions.
CIRS-WDB is a multisystem, multisymptom illness acquired following exposure to the interior environment of
WDB and it exists as a recognizable syndrome.
Re-exposure of previously affected patients will bring about immunological host responses that are
enhanced in their rapidity of onset and magnitude, such that these patients are "sicker, quicker."
_____________________________________________________________________________________
From Dr. Ruth Etzel:
What the Primary Care Pediatrician Should Know about Syndromes Associated with Exposures to
Mycotoxins Click here to read the report.
"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 Jack Thrasher, Ph.D.:
Dr. Thrasher's paper on Biocontaminants Click here to read the report.
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.
_____________________________________________________________________________________
Neurotoxic Effects of Toxigenic Molds and Mycotoxins
Report on Neurotoxic Effects Click here to read the report.
"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 the 2008 Report of the U.S. Government Accountability Office (GAO):
GAO Report Click here to read the report.
"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 Dr. Ritchie Shoemaker:
How Do I Know If I Have Biotoxin Illness? Click here to go to the website.
Have you been feeling sick but your doctors can't seem to find anything wrong? Have you been diagnosed
with Chronic Fatigue Syndrome, Fibromyalgia, Lyme Disease, or Gulf War Illness? Have you been in a water
damaged or environmentally sick building (often you can't tell until you are sick)? Are you more tired than
normal? Do you have problems thinking, remembering things or with word recall? Are you unmotivated,
depressed or have unusually high levels of anxiety? Do you have problems sleeping? Do you have tingling
or twitching or other central nervous system symptoms that can't be explained? If you have one or more of
these unexplainable symptoms, you may have been exposed to a biotoxin.
_____________________________________________________________________________________
Cognitive Impairment Associated with Toxigenic Fungal Exposure
Report on Cognitive Impairment Click here to read the report.
"Most participants were found to have reduced cognitive functioning in multiple domains, with memory and
executive functions the most commonly affected areas. This study adds to a growing body of literature
relating exposure to mycotoxins to cognitive dysfunction."
_____________________________________________________________________________________
From a study by Brown University:
Brown University Study Click here to read the press release.
"A groundbreaking public health study, led by Brown University epidemiologist Edmond Shenassa, has
found a connection between damp, moldy homes and depression."
_____________________________________________________________________________________
From a study by the Mayo Clinic:
Mayo Clinic study Click here to read the news article.
"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 study by Berkeley Labs and the EPA:
Berkeley Lab and EPA study Click here to read the press release.
"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 the Bulletin of the World Health Organization:
Toxic Effects of Mycotoxins in Humans Click here to read the report.
"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."
of health effects. Contamination in water-damaged
buildings is a very complex situation that can result in
multi-symptom, 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 the 2010 World Health Organization report:
WHO Guidelines for Indoor Air Quality: Selected Pollutants. Click here to read the report.
Clean air is a basic requirement of life. The quality of air inside homes, offices, schools, day care centres,
public buildings, health care facilities or other private and public buildings where people spend a large part
of their life is an essential determinant of healthy life and people’s well-being. Hazardous substances emitted
from buildings, construction materials and indoor equipment or due to human activities indoors, such as
combustion of fuels for cooking or heating, lead to a broad range of health problems and may even be fatal.
Indoor exposure to air pollutants causes very significant damage to health globally – especially in
developing countries. The chemicals reviewed in this volume are common indoor air pollutants in all regions
of the world.
_____________________________________________________________________________________
From Dr. Harriet Ammann:
Is Indoor Mold Contamination a Threat to Health? Click here to read the report.
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 Ritchie, Shoemaker, M.D., Laura Mark, M.D., Scott McMahon M.D., Jack D. Thrasher, Ph.D.,
Carl Grimes, HHS, CIEC:
Research Committee Report on Diagnosis and Treatment of Chronic Inflammatory Response
Syndrome (CIRS) Caused by Exposure to the Interior Environment of Water-Damaged Buildings
Click here to read the report.
Exposure to these (water-damaged buildings) WDB environments can cause a readily identifiable illness
syndrome characterized by specific metabolic disturbances stemming from lack of neuropeptide control of
host inflammatory responses, genetic susceptibility and abnormal downstream inflammatory parameters that
not only define the illness but also provide the academic basis for sequential therapeutic interventions.
CIRS-WDB is a multisystem, multisymptom illness acquired following exposure to the interior environment of
WDB and it exists as a recognizable syndrome.
Re-exposure of previously affected patients will bring about immunological host responses that are
enhanced in their rapidity of onset and magnitude, such that these patients are "sicker, quicker."
_____________________________________________________________________________________
From Dr. Ruth Etzel:
What the Primary Care Pediatrician Should Know about Syndromes Associated with Exposures to
Mycotoxins Click here to read the report.
"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 Jack Thrasher, Ph.D.:
Dr. Thrasher's paper on Biocontaminants Click here to read the report.
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.
_____________________________________________________________________________________
Neurotoxic Effects of Toxigenic Molds and Mycotoxins
Report on Neurotoxic Effects Click here to read the report.
"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 the 2008 Report of the U.S. Government Accountability Office (GAO):
GAO Report Click here to read the report.
"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 Dr. Ritchie Shoemaker:
How Do I Know If I Have Biotoxin Illness? Click here to go to the website.
Have you been feeling sick but your doctors can't seem to find anything wrong? Have you been diagnosed
with Chronic Fatigue Syndrome, Fibromyalgia, Lyme Disease, or Gulf War Illness? Have you been in a water
damaged or environmentally sick building (often you can't tell until you are sick)? Are you more tired than
normal? Do you have problems thinking, remembering things or with word recall? Are you unmotivated,
depressed or have unusually high levels of anxiety? Do you have problems sleeping? Do you have tingling
or twitching or other central nervous system symptoms that can't be explained? If you have one or more of
these unexplainable symptoms, you may have been exposed to a biotoxin.
_____________________________________________________________________________________
Cognitive Impairment Associated with Toxigenic Fungal Exposure
Report on Cognitive Impairment Click here to read the report.
"Most participants were found to have reduced cognitive functioning in multiple domains, with memory and
executive functions the most commonly affected areas. This study adds to a growing body of literature
relating exposure to mycotoxins to cognitive dysfunction."
_____________________________________________________________________________________
From a study by Brown University:
Brown University Study Click here to read the press release.
"A groundbreaking public health study, led by Brown University epidemiologist Edmond Shenassa, has
found a connection between damp, moldy homes and depression."
_____________________________________________________________________________________
From a study by the Mayo Clinic:
Mayo Clinic study Click here to read the news article.
"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 study by Berkeley Labs and the EPA:
Berkeley Lab and EPA study Click here to read the press release.
"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 the Bulletin of the World Health Organization:
Toxic Effects of Mycotoxins in Humans Click here to read the report.
"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."
Health Effects
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