Re: NEW NIOSH / CDC MOLD ADVICE FOR WORKERS IN DAMP BLDGS

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thanks Susan Brinchman.

On 6/13/10, Susan wrote:
> 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&37; 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