Mold What are the health effects of mold

Mold What are the health effects of mold exposure? • 1

Who is affected? v Virtually anyone exposed to airborne mold can react to the toxigenic properties of mold spores. v Asthmatics and others with allergy to mold will react at lower exposure levels. • 2

Who is affected? v Heavily exposed individuals run the risk of serious illnesses, beyond the toxic and allergic reactions. v Infants and susceptible individuals (e. g. , persons with compromised immune systems, living with HIV, cystic fibrosis, and the aged) will likely react at lower concentrations and require special attention. • 3

Where are we? A lot of time indoors • 4

1. Infections Pathways Respiratory v Oral v Contact v Penetration v • 5

Opportunistic Infections People with weakened immune systems (immune compromised or immune suppressed) may be more vulnerable to infections caused by molds. Aspergillus fumigatus has been known to infect the lungs of immune compromised individuals. When the spores are inhaled the mold begins to grow in the lungs. • 6

Opportunistic Infections Athlete’s Foot Molds can cause skin diseases such as athlete’s foot, fingernail/ toenail fungus and other infections such as yeast infection. Case reports and epidemiologic studies show clear association between dampness and disease. • 7

Infectious Diseases Athlete’s Foot under a microscope • 8

2. Allergic Diseases Asthma, Hay Fever, and more aspergillus under a microscope Allergic rhinitis (hay fever) v Allergic asthma v Allergic bronchopulmonary aspergillosis -- ABPA v Extrinsic allergic alveolitis -- HP (hypersensitivity pneumonitis) v • 9

Allergic Diseases Allergic Bronchopulmonary Aspergillosis – ABPA Aspergillus in the attic Patient with aspergillus-related pneumonia Patient with aspergillusrelated tumor in mouth Aspergillus fumigatus Aspergillus favus Lung fibrosis and tumor from ABPA • 10

U. S. Allergy Disease Prevalence 1 of 5 Americans suffer from allergic disease v Indoor allergens responsible for significant share v Environmental control reduces disease severity v Source: NHLBI, 1991 • 11

Allergen Exposure Dust Mites Molds Animal Dander Pollen Allergenic Chemicals Genetic Predisposition or Susceptibility Allergic Disease Immunologic Sensitization Mild Moderate Severe (Death) Other Exposures Viruses Air Pollution Tobacco Smoke Source: Pope AM, et al. , eds. , 1993 • 12

3. Fungal Toxins Important Mycotoxins Aspergillus favus ………. . Aflatoxin B, Cyclopiazonic acid Aspergillus parasiticus …. Aflatoxin B Aspergillus terreus ……. . Citreoviridin Aspergillus versicolor …. . Sterigmatocysin, 5 Ethoxysterigmatocstin Fusarium …………………. . Trichothecene, Zearalenone Fusarium moniliforme …. . . Fumonisins Penicillium ………………. . . Citrinin, Patulin Penicillium veridicatum …. Penicillic Acid Stachybotrys chartarum …Trichothecene, Trichodermol, (black mold) Trichodermol • 13

Fungal Toxins Stachybotrys chartarum Black Mold • 14

Suite 1000, 8484 Georgia Ave. Silver Spring, MD 20910 Main Phone: 301 -578 -8500 Main Fax: 301 -578 -8572 www. cpwr. com Don Ellenberger DOE & EPA Training Director DEllenberger@cpwr. com Phone: 301 -495 -8504 Fax: 301 -578 -4190 • 15