Posted by Susan on 6/13/10

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URGENT ATTN: JUNE 1, 2010: NEW NIOSH / CDC MOLD ADVICE FOR
WORKERS IN DAMP BLDGS

THE FOLLOWING WAS UPDATED 6/1/2010 ON THE NIOSH / CDC
WEBSITE

THIS IS IN ALIGNMENT WITH THE REQUESTS MADE OF CDC BY
CENTER FOR SCHOOL MOLD HELP AND WHO INFORMATION, WHICH IS
NOT CITED ON THIS PAGE

THIS INFORMATION WILL IMPACT EVERY WORKER IN AMERICA WHOSE
WORKPLACE IS DAMP, WATER-DAMAGED, AND/OR MOLDY. PRINT THIS
REPORT DIRECTLY FROM THE URL BELOW AND SHOW YOUR PHYSICIAN,
ATTORNEYS, AND EMPLOYERS IF YOU THINK YOU ARE ILL FROM A
DAMP BUILDING.(Susan Brinchman, Director, Center for School
Mold Help, www.schoolmoldhelp.org)

----------------------------------------

http://www.cdc.gov/niosh/topics/indoorenv/mold.html

NIOSH
Workplace Safety and Health Topics
Industries & Occupations
Indoor Environmental Quality
INDOOR ENVIRONMENTAL QUALITY
Dampness and Mold in Buildings

On this Page:
What is Mold?
"Toxic Mold" & Stachybotyrs chartarum
Remediation of dampness and mold contamination
I suspect mold in my workplace. How do I test for mold?
Symptoms related to dampness and mold
What workers can do?
What management and building owners can do
Resources
References

Dampness results from water incursion either from internal
sources (e.g. leaking pipes) or external sources (e.g.
rainwater). Dampness becomes a problem when various
materials in buildings (e.g., rugs, walls, ceiling tiles)
become wet for extended periods of time. Excessive moisture
in the air (i.e., high relative humidity) that is not
properly controlled with air conditioning can also lead to
excessive dampness. Flooding causes dampness. Dampness is a
problem in buildings because it provides the moisture that
supports the growth of bacteria, fungi (i.e., mold), and
insects.

In the presence of damp building materials the source of
water incursion is often readily apparent (e.g., leaks in
the roof or windows or a burst pipe). However, dampness
problems can be less obvious when the affected materials
and water source are hidden from view (e.g., wet insulation
within a ceiling or wall; excessive moisture in the
building foundation due to the slope of the surrounding
land).

What is mold?
Mold is a fungal growth that forms and spreads on various
kinds of damp or decaying organic matter. There are many
different mold species that come in many different colors.
Molds are sometimes referred to as mildew. They are found
both indoors and outdoors in all climates, during all
seasons of the year. Outdoors, molds survive by using
plants and decaying organic matter such as fallen leaves as
a source of nutrition. Indoors, molds need moisture to grow
as well as a carbon source from building materials or
building contents.

Excess moisture is generally the cause of indoor mold
growth. Molds reproduce by releasing tiny spores that float
through the air until landing in other locations. When they
settle on wet or moist surfaces, the spores can form new
mold colonies. Moderate temperatures and available nutrient
sources make most office buildings ideal for mold growth.

Recent media attention has increased public awareness and
concern over exposure to molds in the workplace. While this
may seem to be a new problem, exposure to molds has
actually occurred throughout history. In fact, the types of
molds found in office buildings are not rare or even
unusual. It is important to understand that no indoor space
is completely free from mold spores – not even a surgical
operating room. Molds are everywhere, making our exposure
to molds unavoidable, whether indoors or outdoors, at home
or at work.

"Toxic Mold" & Stachybotyrs chartarum
Certain molds are toxigenic, meaning they can produce
toxins (mycotoxins), but the molds themselves are not
toxic, or poisonous. Hazards presented by molds that may
produce mycotoxins should be considered the same as other
common molds which can grow in your house or workplace.
Contradicting research results exist regarding whether
toxigenic mold found indoors causes unique or rare health
conditions such as bleeding in the lungs. Research is
ongoing in this area.

Mold growing in buildings, whether it is Stachybotrys
chartarum (Stachybotrys atra) or another mold, indicates
that there is a problem with water or moisture. This is the
first problem that needs to be addressed.

Remediation of dampness and mold contamination
First and foremost, determine the source of moisture and
take appropriate measures to make repairs. Damp or wet
building materials and furnishings as a result of leaks or
flooding should be dried within 24 to 48 hours to prevent
the growth of mold. Mold can be cleaned and removed from
hard surfaces with commercial products, soap and water, or
a bleach solution of no more than 1 cup of bleach in 1
gallon of water. Never mix bleach with ammonia or other
household cleaners. Mold in or under carpets typically
requires that the carpets be removed. Once mold starts to
grow in insulation or wallboard, the only way to deal with
the problem is removal and replacement. (CDC- Facts about
Stachybotrys chartarum and Other Molds) For complete
remediation guidelines go to the New York City Department
of Health and Hygiene’s Guidelines on Assessment and
Remediation of Fungi in Indoor Environments at
www.nyc.gov/html/doh/html/epi/moldrpt.... For "green"
environmentally friendly cleaning solutions, go to
Greenguard Environmental Institute at www.greenguard.org.

I suspect mold in my workplace. How do I test for mold?
CDC does not recommend routine sampling for molds.
Generally, it is not necessary to identify the species of
mold growing in a building. Measurements of mold in air are
not reliable or representative. If mold is seen or smelled,
there is a potential health risk; therefore, no matter what
type of mold is present, you should arrange for its
removal. Furthermore, sampling for mold can be expensive,
and standards for judging what is and what is not an
acceptable or tolerable quantity of mold have not been
established.

Symptoms related to dampness and mold
Health problems associated with excessive damp conditions
and mold include:
ALLERGIES

Allergic responses like those to pollen or animal dander
are the most common types of health problems related to
mold. Typical symptoms include sneezing; irritation of the
nose, mouth, or throat; nasal stuffiness and runny nose;
and red, itchy or watery eyes. Inhaling or touching mold or
mold spores can cause a person who was not previously
allergic to mold to become allergic to mold. For people
with known allergies, molds can trigger asthma symptoms
such as shortness of breath, wheezing, or cough. Irritation
can also occur in non-allergenic (non-sensitized) people.
Additionally, scientific studies indicate that exposure to
molds in the workplace can make pre-existing asthma worse.
Recent NIOSH investigations document that some damp
buildings are associated with developing new asthma.
HYPERSENSITIVITY PNEUMONITIS

Hypersensitivity pneumonitis (HP) is a kind of lung
inflammation that occurs in persons who develop immune
system sensitization (similar to an allergy) to inhaled
organic dust. It can be mistaken for pneumonia, but it does
not get better with antibiotics for infection.

Symptoms of HP can vary. Some persons have shortness of
breath, cough, muscle aches, chills, fever, night sweats,
and profound fatigue. These symptoms usually first appear 2
to 9 hours after exposure and last for 1 to 3 days. Other
affected persons have progressive shortness of breath and
cough, as well as weight loss. Work-relatedness may only
become apparent over long holidays if symptoms resolve and
then recur on return to work. With continued exposure, the
persistent lung inflammation of both kinds of symptoms can
lead to scarring and permanent damage. The slow progression
of symptoms and the persistence of symptoms away from work
may result in delayed recognition of work-related lung
disease by both workers and physicians.

HP has been referred to as Bird breeder’s lung and Mushroom
picker’s disease in specific occupations with a risk of HP
from biological dusts. HP has been documented in workers in
buildings with mold and bacteria contaminated air-
conditioners (including spray-water cooling systems), and
contaminated ductwork and filters. This lung disease has
also occurred in workers who worked in water-damaged
buildings with roof leaks, plumbing leaks, poorly draining
condensation pans, and high indoor relative humidity.

HP is not contagious and is due to a person’s immune system
reaction to inhaled microorganisms, whether dead or alive.
It is possible for workers to have both dampness-related HP
and asthma at the same time. Additionally, workplaces that
have workers with HP may also have workers with building-
related asthma.
ASTHMA

Asthma is a form of lung disease in which the airways
develop inflammation and bronchospasm (reversible
narrowing) in response to sensitizing or irritating
exposure. Affected individuals can experience episodes of
shortness of breath, cough, chest tightness, and wheezing.
These symptoms occur after exposure to nonspecific
irritating substances in the air or after exposure to
substances to which an individual is allergic. Medical
testing typically reveals evidence of bronchial
hyperresponsiveness such as an abnormal methacholine
challenge test or reversible airways obstruction on
spirometry (a test of lung function). It is important for
affected individuals to have a comprehensive asthma
treatment plan and regular follow-up with their physician.
Early diagnosis and removal from the impacted damp office
environment can cure asthma caused by workplace exposures.

In approximately 15% of asthmatics, the illness may have
been caused, or made worse, by workplace exposures. Some
occupational exposures are well known risks for asthma
development (e.g., western red cedar; isocyanates). Indoor
environment research has identified evidence of an
association between damp buildings and asthma symptoms in
individuals with pre-existing asthma. There is also new
evidence of an association between damp buildings and new-
onset asthma. In an individual with new-onset asthma or
worsening of stable pre-existing asthma, measurements of
lung function made several times a day at work and at home
over several weeks may reveal a pattern of changing lung
function that suggests a workplace cause.

For individuals with new-onset asthma or worsening of
stable pre-existing asthma that is suspected to be related
to the indoor environment, controlling or eliminating the
sources of indoor contaminants, along with optimal medical
treatment, may lead to symptoms of improvement or
resolution.
What workers can do
When workers suspect their health problems are caused by
exposure to building-related mold and dampness, workers
should:

Report concerns immediately to supervisors or those persons
responsible for building maintenance
See your doctor for proper diagnosis and treatment
Ask your doctor whether you should be medically restricted
from the affected environment
What management and building owners can do
When health problems are believed to be caused by exposure
to mold in the workplace, owners and managers should:

Advise workers to see their doctor for proper diagnosis and
treatment
Evaluate the work area for evidence of mold and dampness
Repair leaks and remediate water damaged materials
Communicate with workers about areas of the building with
evidence of mold or moisture damage and provide the status
of remediation plans
Arrange for relocation of workers whose doctors restrict
them from the implicated work environments
Resources
Facts About Mold - American Industrial Hygiene Association
(AIHA)

Recognition, Evaluation, and Control of Indoor Mold
Fairfax, VA: American Industrial Hygiene Association 2008.
ISBN 978-1-931504-91-1

Facts About Mold and Dampness - Centers for Disease Control
and Prevention (CDC)

Mold Resources - Environmental Protection Agency (EPA)

Damp Indoor Spaces and Health - Institute of Medicine (IOM)

Preventing Mold-Related Problems in the Indoor Workplace -
Occupational Safety and Health Administration (OSHA)

Guidelines on Assessment and Remediation of Fungi in Indoor
Environments - New York City Department of Health (NYCDOH)

References
Brandt M, Brown C, Burkhart J, Burton N, Cox Ganser J,
Damon S, Falk H, Fridkin S, Garbe P, McGeehin M, Morgan J,
Page E, Rao C, Redd S, Sinks T, Trout D, Wallingford K,
Warnock D, Weissman D. Mold prevention strategies and
possible health effects in the aftermath of hurricanes and
major floods. MMWR. 2006 June; 55(RR-8):1-27.

Cox-Ganser JM, White SK, Jones R, Hilsbos K, Storey E,
Enright PL, Rao CY, Kreiss K. Respiratory Morbidity in
Office Workers in a Water-Damaged Building. Environ Health
Perspect. 2005 April; 113(4): 485-490.

Fink JN, Ortega HG, Reynolds HY, Cormier YF, et al. Needs
and Opportunities for Research in Hypersensitivity
Pneumonitis. American Journal of Respiratory and Critical
Care Medicine, 2005 April 1.

Hoffman RE, Wood RC, Kreiss K. [1993]. Building-related
asthma in Denver office workers. Am J Public Health 83:89-
93. Environ Health Perspect. 2005 April; 113(4): 485-490.

Park J, Cox-Ganser J, Rao C, Kreiss K. Fungal and endotoxin
measurements in dust associated with respiratory symptoms
in a water-damaged office building. Indoor Air 2006 Jun;
16:192-203.

Park JH, Cox-Ganser JM, Kreiss K, White SK, Rao CY.
Hydrophilic fungi and ergosterol associated with
respiratory illness in a water-damaged building. Environ
Health Perspect. 2008 Jan; 116(1):45-50.

Sahakian NM, White SK, Park JH, Cox-Ganser JM, Kreiss K.
Identification of mold and dampness-associated respiratory
morbidity in 2 schools: comparison of questionaire survey
responses to national data. J Sch Health. 2008 Jan; 78
(1):32-37.

Page updated June 1, 2010

NIOSH: Dampness and Mold in Buildings

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