A Detailed Guide to Mold Related Illness and Other Indoor Air Quality Sicknesses

Index to detailed articles aid in identifying illnesses that may be related to toxic or allergenic mold exposure
An atlas of mold related illness symptoms and complaints
A clinical atlas of mold toxicity
Finding and curing odors and gases in buildings
How to identify pollen and other allergens in buildings
Catalog of products to reduce mold and allergy problems
Bacterial hazards in buildings, sewer backups
Dog, cat, and other animal allergens, sources, testing, cleanup, prevention
MOLD RELATED ILLNESS SYMPTOMS - separate article
Questions & Answers about Actual or Suspected Mold Related Illness
What does a home inspector need to know? Home inspection training and education curriculum recommendations
References

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InspectAPedia tolerates no conflicts of interest. We have no relationship with advertisers, products, or services discussed at this website.

Mold related illness research & references: here we provide key articles on mold-related illness, including lists of mold related symptoms and complaints, a clinical atlas of mold toxicity, fiberglass hazards, odors and gases, pollen and other allergens, how to recognize allergens in buildings, and suggestions about possible bacterial hazards such as due to sewage backups.

List of Articles Providing a DETAILED GUIDE TO MOLD RELATED ILLNESSES - Asthma, Allergies, Lung, Neurological, Other Complaints

Readers who need to find a physician experienced in mold related illn esses should see MOLD DOCTORS - ENVIRONMENTAL MEDICINE. Also see MOLD RELATED ILLNESS SYMPTOMS and MOLD EXPOSURE STANDARDS and ACCEPTABLE MOLD LEVEL. See MVOCs & MOLDY MUSTY ODORS also MYCOPHOBIA, STAINS MISTAKEN for MOLD.

For background on how and why molds can be toxic, see this World Health Organization Mold Bulletin. Our page top photo shows severe mold contamination on the ceiling of a building basement exposed to flooding.

This website provides information and procedures for finding, testing, cleaning and preventing indoor mold, toxic black mold, green mold, testing building indoor air quality, and other sick house / sick building investigations. We also offer detailed advice on mold prevention and mold-resistant construction resistant to indoor problem molds such as the Aspergillus sp., Penicillium sp. and Stachybotrys chartarum groups.

Allergen Tests in Buildings advice about how to test, what to look for, in evaluating the level of dog, cat, or other animal allergens in a building
Animal Allergens: Dog, Cat, and Other Animal Dander - Cleanup & Prevention Information for Asthmatics and regarding Indoor Air Quality.
Atlas of Mold Related Illness Symptoms & Complaints - list of documented health complaints associated with indoor exposure to mold, dampness, allergens, cockroaches, insects, VOCs, MVOCs, etc. We include illustrations of a number of skin rashes and other more serious complaints reported by clients exposed to indoor mold contamination.
Cat Dander: how to inspect and test a building for past or current presence of cats, cat hair, cat dander, and cat allergens
Clinical Atlas of Mold Toxicity - An Online Description of Toxic, Pathogenic, Allergenic Fungi, Fungal Diseases
Fiberglass Insulation Contains Mold© 2005 comments about a field study in process, & more about health hazards from fiberglass insulation - DJF
MOLD ACTION GUIDE - WHAT TO DO ABOUT MOLD - the basics of how to find, remove, and prevent mold problems in buildings
MOLD DOCTORS - ENVIRONMENTAL MEDICINE - do you need to consult with a physician who is expert in mold related illness? It's not a bad idea.
MOLD EXPOSURE, FOOD HAZARDS - what are the mold and bacterial hazards from eating moldy food or food products?
MOLD EXPOSURE RISK LEVELS - how do we characterize the level of risk of mold exposure in a building?
MOLD EXPOSURE STANDARDS - what are the standards for allowable exposure to allergenic or toxic mold - what are the problems with trying to make any general quantitative mold exposure standard?
MOLD ODORS, MUSTY SMELLS - if you smell mold, is there a problem? What about "mildew" odors?
Odors, Odor Detection, Smells, & Gases how to find and identify sources of noxious or toxic odors and gases
Other environmental risks, Our much longer list: Asbestos, carbon monoxide, electromagnetic fields, etc.
Pollen Allergens: identification,
Products to Reduce Mold & Allergy Problems to reduce indoor mold or allergen levels: air cleaners, air purifiers, dust mite covers, vacuum cleaners, crawl space vents
Recognizing Allergens: What various indoor allergens look like - identification photos to help identify pollen, dust mites, animal dander, toxic or allergenic mold - Common Mold and other Allergens, Irritants, Remedies & Advice
Rodent control issues, including dander, fecal, and urine contamination of Buildings and Building insulation are discussed at our Mold Action Plan page.
Sewage and Septic backup contamination in Buildings: inspection, testing, remediation, & references to expert sources

Keywords for topics addressed in these articles include: Sick House Investigations, Indoor Air Quality, Mold, Mildew, Dampness, Leaky Basements, Indoor Air Quality, Stachybotrys, Fleas, Dust Mites, Pets, Animal Hair, Dander, Allergens, Bioaerosols, Asthma, ASHI Home Inspections, ASHI Home Inspection, ASHI Home Inspector, ASHI Home Inspectors ASHI Soot Stains Fungus Fungi American Society of Home Inspectors mold testing services by an expert mold testing lab, mold sample testing, including bulk samples, air samples, vacuum samples for mold spores, spore identification, and mold health concerns, mold report of mold test results by the mold lab include written advice, photographs, mold species identification to help spot dangerous mold species and to guide mold remediation advice. Sick House Investigations, allergy, allergies, allergens, asthma, asthmatics, dust mites, mold, mildew, fungi, indoor air quality, heating system ventilation, soot, stains, combustion air, chimney defects, moisture, water entry, wet basements, surface and roof drainage, flooding, water damage, air quality measurements

Frequently Asked Questions (FAQs) about Mold Exposure, Suspected Mold Related Illness, How to Proceed, How to find a Mold Doctor

Question: Chronic Cough and Post Nasal Drip - PND - What's a Reliable Mold Test Kit?

I have been bothered by chronic cough and post nasal drip for several years, and I am suspicious that the building in which I work is the cause. I know that I am allergic mainly to molds – eight different kinds. So, I tried a test kit that I ordered online. It was not conclusive. Not sure if it was any good either. Can you recommend reliable test kits? - K.H., Wilmington DE

Reply: Mold test kits have a useful role to play, but you may need a competent building inspection first

A competent onsite inspection by an expert usually finds additional clues that help accurately diagnose a problem, such as a source of irritating dust that you didn't recognize, a leak or moisture problem, or a hidden mold reservoir. That said, here are some things to consider:

While there is a use for testing as part of an expert building inspection, using any test kit to screen a building for mold is not reliable. See MOLD TESTING METHOD VALIDITY if you want a detailed exposition.

In particular, a "negative" result (a test that does not detect significant indoor mold contamination) used without an expert inspection is unreliable in that there is a significant risk of missing an existing mold problem.

Even a "positive" mold test kit result (the test says problem mold is present at a significant level) does not necessarily identify the actual mold problem in the building as opposed to the mold the kit happened to catch. For example, most molds won't grow in culture, so using a culture to screen for mold is a unreliable.

The use, accuracy, and reliability of mold culture test kits for screening buildings for mold contamination are discussed at MOLD CULTURE TEST KIT VALIDITY and MOLD CULTURE SAMPLING METHOD and see Mold Culture Plate Test Errors.

We recommend starting with a detailed case history of the home and your complaints, combined with a thorough visual inspection for conditions likely to cause an indoor mold problem - if mold's the focus. Don't forget there can be other irritants. I'd also ask the doctor for advice on the sorts of things that s/he thinks would be a particular problem in your environment.

Take a look also at MOLD EXPERT, WHEN TO HIRE for help in deciding if it's worth hiring an expert -

Question: where can I find similar advice about a water-damaged automobile?

Are there any good articles on DIY mold remediation for a water damaged automobile? Both my boyfriend and I have cars with long-term leaks in the trunks AND many symptoms of mold sickness. Once we fix the leaks, I would like to know how we can clean the carpets/ flooring/ surfaces and ventillation/ heating and A/C system. - Kate (8/17/2011)

Reply:

Sure Kate, we've written quite a bit about mold and mold smells in cars. Just search InspectAPedia for
"CAR MOLD" to see details. Use the search box found within the top or bottom of any of our web pages. Or take a look at CAR SMELL - Mold DEODORIZING where we discuss tracking down and curing mold in cars, boats, RVs, etc.

Question: We moved out of a moldy home but may have brought along mold or moved into a new one also moldy; my children appear to have serious mold-related illnesses. How can we find a suitable doctor? What else can we do?

We are a family of 8 who previously lived in a modular home built against code without vapor barriers or flashing around wooden windows frames. It was many years before we realized there was mold in between the walls and after many medical diagnosis of my family.

My eldest developed a severe allergy to her own estrogen that her allergist said is a cross sensitivity to an estrogen-mimicking mold, as she would have the same reaction to mold as she did premenstrually. It was a horrible reaction with flu-like symptoms and multiple blistering in her mouth. She'd need steroids, and even narcotics some times, to get through an episode. She now lives in Arizona and is totally symptom free except for visits out to the NE, and one episode during "monsoon season" in Az.
My second eldest developed bleeding in his kidneys. We monitor it through a urologist.
My fifth child, who was an infant when an extension was going on in our home, has tested (+) for severe memory problems and is a "special needs" child. We also have allergies, asthma, eczema and thyroid problems among members of my family.

We have since moved from that house, but my eldest will still react when she visits, and had vomiting and diarrhea along w/ her other usual allergy symptoms. So I'm guessing we have dragged some of our microtoxins with us and she is now more sensitive to them. Her allergist in Az had her tested for molds we found present in our home, and she did test (+) for some of them.

These were basic tests w/ basic molds identified. I do not believe they tested for microtoxins.

My quandry is that the new home we live in not only has the mold we apparently dragged with us, but with such high ground saturation in the NE area in the past 3 years, much of our possessions in the downstairs part of our split level ranch is now newly contaminated with mold.

We are considering moving to Az where we know through my eldest's experience, there's a resolution. However, I've yet to find a doctor beyond who my eldest has seen, to link (toxic?) mold to what the rest of us suffer from.

Could you please advise me of any doctors in the mid-Hudson NY State region that specialize in toxicology of mold? I am an RN and have done much research and realize from credible sources such as the US EPA or the Mayo Clinic that my children seem to suffer from toxic reactions of mold and not just allergy reactions, but I've yet to find a doctor to confirm this. Could you please help me?

Thank you so much - N.N. (2/29/12)

Reply:

Thank you for mold/health question - it helps us realize where we need to work on making our text more clear or more complete. A competent onsite inspection by an expert usually finds additional clues that help accurately diagnose a problem with building leaks, high moisture, and both visible mold and potentially problematic hidden mold reservoirs. That said, here are some things to consider:

Did mold make someone in your home sick?

It is very difficult to prove absolutely that a potentially harmful building mold has actually caused or aggravated a medical complaint. Burge[6] lists criteria that are burdensome enough in cost and trouble that all of the steps she outlines are rarely followed. Instead most professionals agree on the position that if there is a large reservoir of problem mold in a building, professional cleaning, correction of the cause, and in cases such as you describe, consulting with a medical professional are all appropriate.

See our clinical mold references [7] below for authoritative citations of specific molds that are associated with specific illnesses.

Watch out: individual sensitivty to mold and other indoor contaminants varies widely and, as your own description suggests, individual sensitivty to mold, allergens, other indoor contaminants can be increased by exposure. Also, don't rule out other possible indoor contaminants (such as mis-applied chemicals, pesticides, paints, cleaners).

Do you need to look for harmful mold or other contaminants more carefully at your present environment?

From your description of your case, it is certainly plausible to suspect that

You imported dusty moldy contents from your old home into the new one. Even if mold was not actively growing on items that you brought to the new home you may have brought items that are thus contaminated.

The good news is that most such items can be successfully cleaned: laundering or dry-cleaning clothes, curtains, bedding, even area rugs is often cheaper and smarter than doing a lot of mold-testing on those items.

Hard goods (dishes, etc.) are surface cleaned using normal cleaning methods. If you had active mold growth on an upholstered couch, most likely it is not cost feasible to remove and reupholster the covering and padding.
If you believe or if your expert advises that you have a high level of moldy (or otherwise problematic) dust in your present home, additional cleaning (HEPA vacuuming, wiping) may be in order. But first it would make sense to be sure that any mold reservoirs in the present home are found, removed, and their cause cured - if there are any.

At MOLD EXPERT, WHEN TO HIRE we list some criteria that can help decide if such an investigation is appropriate and justified in your present home.

From your description it sounds as if indeed an expert, one who actually conducts an interview, inspects the entire building, and perhaps collects some screening samples, would be appropriate.

Watch out: Beware of a "mold consultant" who simply stops by to conduct a few "tests" - that alone is an unreliable approach and even if such a superficial test suggests that action is needed, it was not suffiiciently diagnostic - you would not know how to proceed without still another costly inspection.

How to find a mold doctor:

The right place to start in looking for a physican who has the expertise in mold and enviornmental hazards that you seek is with your own primary care doctor, one whom you trust. Ask his/her help in recommending a physician who specializes in environmental medicine and who has expertise in the mold, complaints, and conditions that you can describe.

Aso see MOLD DOCTORS - ENVIRONMENTAL MEDICINE and when you find a local physican who you find helpful, encourage him/her to submit a listing to us for that directory - there is no cost or fee to anyone for such listings.

Question: brain infection, meningitis; suspected moldy home, is mold on a nasal spray bottle diagnostic?

My husband, a Baptist evangelist, has been debilitated since last June with an illness that we believe is mold-related (our travel trailer, which was our only home, was severely infested, and we had to abandon it). He was hospitalized then for a brain infection, although the pathogen causing the infection was never uncovered.

Traditional doctors in our area refused to consider mold exposure, and he was released, being told he would recover from the meningitis within weeks. He has yet to recover to a point where he can preach (a few attempts have gone poorly), so we have been without income and home for quite a while. We have since been seeing a naturopath,who also cannot pinpoint the illness or the reason Ron is not healing.

Recently Ron believed that he felt the illness migrating to his sinuses. A day later, his nasal spray bottle grew spores. We believe that these came from his body, and we would like testing to determine what exactly they are, and if they could be the root of his ongoing problem. Perhaps if we have a clear-cut cause for his illness it will aid us in its treatment. I would like to request that you consider either pro-bono or reduced fees, but if not, then please advise me on what costs would be and on how to send you the sample on the nasal spray bottle. - A.A.

Reply:

If someone in your home is seriously ill, in my opinion you and that person should consult a medical doctor, starting with your general practitioner who can refer you to a physician who specializes in envrionmental medicine if that is what's needed. If you are not comfortable with your local MD, ask him/her for a referral to another doctor - as one point in starting your own search for a physician in whom you have confidence.

While I respect your wish to consult with a naturopathic physician, there may be important differences between a naturopath (unregulated in some jurisdictions) and a naturopathic physician - an M.D. who also uses principles of naturopathy in his/her practice. In any event, you may be consulting someone who lacks the specific expertise and experience that you and your husband need.

Regarding conditions in your home, a competent onsite inspection by an expert usually finds additional clues that help accurately diagnose a problem well beyond what a homeowner may observe.

That said, here are some things to consider:

there is no reliable correlation between mold that grows on a nasal spray bottle and environmental contamination
a more thorough building inspection, site interview, etc. would be required to form an accurate evaluation of mold risks in your home

Therefore, although you could collect a tape sample of what's on the nasal spray bottle, it's not, in my opinion, a reliable direction of investigation.

Take a look at MOLD APPEARANCE - WHAT MOLD LOOKS LIKE and if you find significant mold contamination in your home, you'll want to see MOLD ACTION GUIDE - WHAT TO DO ABOUT MOLD

If you want to collect one to four samples of suspect mold and perhaps some settled dust from a room where your husband spends a lot of time, we'll examine them in our lab - pro bono (no fee) and report to you. But keep in mind that your collected samples, as you're not an expert, are not by any means a thorough investigation. Follow the sampling procedure at MOLD TEST KITS for DIY MOLD TESTS and Include a copy of this email with your samples so I won't be looking for a check.

Take a look also at MOLD EXPERT, WHEN TO HIRE for help in deciding if your home conditions justify bringing in a professional.

...

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Technical Reviewers & References

Related Topics, found near the top of this page suggest articles closely related to this one.

[1] "Spectrum of Noninfectious Health Effects from Mold", Lynnette J. Mazur, MD, MPH, Janice Kim, MD, PhD, MPH, the Committee on Environmental Health, American Academy of Pediatrics, technical report appearing in PEDIATRICS Volume 118, Number 6, December 2006, see aappolicy.aappublications.org/cgi/reprint/pediatrics;118/6/e1909.pdf OR
aappolicy.aappublications.org/cgi/content/full/pediatrics;118/6/e1909
for this excellent article, or contact the American Academy of Pediatrics, 141 Northwest Point Blvd., Elk Grove Village, IL, 847-434-4000
[2] World Health Organization bulletin: Human eases Caused by Mold - http://www.inspectapedia.com/sickhouse/WHO_Mold_Bulletin.htm
[3] tp://www.inspectapedia.com/sickhouse/Mold_Standards.htm
[4] Guidance for Clinicians on the Recognition and Management of Health Effects Related to Mold Exposure and Moisture Indoors, [on file as /mold/Mold_Guide_UConn.pdf] - Eileen Storey, MD MPH, Kenneth H. Dangman, MD PhD MPH, Paula Schenck MPH, Robert L DeBernardo MD MPH, Chin S Yang PhD, Anne Bracker CIH MPH, Michael J Hodgson MD MPH, University of Connecticut Health Center, Division of Occupational and Environmental Medicine, Center for Indoor Environments and Health, 266 Farmington Ave., Farmington CT 06030-6210, 30 September 2004. [We have edited this file to remove blank pages in order to speed its load-time and to add a link back to this website.] This document was designed to help the healthcare provider address patients with illnesses related to mold in the indoor environment by providing background understanding of how mold may be affecting patients. The guidance was published in 2004, with support from a grant by the U.S. EPA, by the Center for Indoor Environments and Health, or CIEH at the University of Connecticut Health Center. " -- original source: oehc.uchc.edu/images/PDFs/MOLD%20GUIDE.pdf (1.13MB PDF file, slow loading)
[5] History of major mold outbreaks: see the WHO bulletin above, also see a nice summary of the history of major mold related illness outbreaks is at moldbacteria.com/newsletters/2005/sep2005.html provided by Dr. Jackson Kung'U, a microbiologist, mycologist, writing for that website.
[6] Dr. Harret Burge, Harvard School of Public Health (ret). The four tests (proposed by Burge, Harvard School of Public Health) are stringent beyond your means as an inspector. Mold at high levels may cause and almost certainly aggravates or contributes to a wide variety of complaints.
[7] Clinical mold references: here are some of our lab's references for descriptions of illness-related molds, some of which are found in buildings:
- Identifying Filamentous Fungi, A Clinical Laboratory Handbook, Guy St-Germain, Richard
- Fundamentals of Diagnostic Mycology, Fran Fisher, Norma B. Cook, W.B. Saunders Co. 1998, ISBN 0-7216-5006-6
- Atlas of Clinical Fungi, 2nd Ed., GS deHoog, J Guarro, J Gene, & MJ Figueras, Centraalbureau voor Schimmelcultures, Universitat Rovira I Virgili, 2000, ISBN 90-70351-43-9 (you can buy this book at Amazon) - The Atlas of Clinical Fungi is also available on CD ROM
- Clinical Microbiology and Infectious Diseases: An Illustrated Colour Text, W. John Spicer MBBS(Melbourne) FRACP FRCPA FACSHP FASM DTM&H(Sydney) DipBact(London), Churchill Livingstone; 2d Ed, 2007, ISBN-10: 0443103038, ISBN-13: 978-0443103032
- MOLD CLINICAL REFERENCE TEXTS contains a more extensive reference list for clinical mold related illness resources
- MOLD RELATED ILLNESS List lists complaints that people have suggested or believed may have been related to indoor mold contamination in buildings (note that not all of these complaints are substantiated by experts)
- BIBLIOGAPHY for ENVIRONMENTAL HEALTH, MOLD, IAQ is our master index of Aerobiology, Building Science, Microscopy, Environmental Illness, Mold Testing, Field Practice & Laboratory References

Books & Articles on Building & Environmental Inspection, Testing, Diagnosis, & Repair

Our recommended books about building & mechanical systems design, inspection, problem diagnosis, and repair, and about indoor environment and IAQ testing, diagnosis, and cleanup are at the InspectAPedia Bookstore. Also see our Book Reviews - InspectAPedia.

The Home Reference Book - the Encyclopedia of Homes, Carson Dunlop & Associates, Toronto, Ontario, 25th Ed., 2012, is a bound volume of more than 450 illustrated pages that assist home inspectors and home owners in the inspection and detection of problems on buildings. The text is intended as a reference guide to help building owners operate and maintain their home effectively. Field inspection worksheets are included at the back of the volume. Special Offer: For a 10% discount on any number of copies of the Home Reference Book purchased as a single order. Enter INSPECTAHRB in the order payment page "Promo/Redemption" space. InspectAPedia.com editor Daniel Friedman is a contributing author.

Or choose the The Home Reference eBook for PCs, Macs, Kindle, iPad, iPhone, or Android Smart Phones. Special Offer: For a 5% discount on any number of copies of the Home Reference eBook purchased as a single order. Enter INSPECTAEHRB in the order payment page "Promo/Redemption" space.

Building inspection education & report writing systems from Carson, Dunlop & Associates Ltd

Carson Dunlop, Associates, Toronto, have provided us with (and we recommend) Carson Dunlop Weldon & Associates' Technical Reference Guide to manufacturer's model and serial number information for heating and cooling equipment
Special Offer: Carson Dunlop Associates offers InspectAPedia readers in the U.S.A. a 5% discount on any number of copies of the Technical Reference Guide purchased as a single order. Just enter INSPECTATRG in the order payment page "Promo/Redemption" space.
Environmental Health & Investigation Bibliography - our technical library on indoor air quality inspection, testing, laboratory procedures, forensic microscopy, etc.
Adkins and Adkins Dictionary of Roman Religion discusses Robigus, the Roman god of crop protection and the legendary progenitor of wheat rust fungus.
Kansas State University, department of plant pathology, extension plant pathology web page on wheat rust fungus: see http://www.oznet.ksu.edu/path-ext/factSheets/Wheat/Wheat%20Leaf%20Rust.asp
"A Brief Guide to Mold, Moisture, and Your Home", U.S. Environmental Protection Agency US EPA - includes basic advice for building owners, occupants, and mold cleanup operations. See http://www.epa.gov/mold/moldguide.htm
US EPA - Mold Remediation in Schools and Commercial Building [Copy on file at /sickhouse/EPA_Mold_Remediation_in_Schools.pdf ] - US EPA
US EPA - Una Breva Guia a Moho - Hongo [Copy on file as /sickhouse/EPA_Moho_Guia_sp.pdf - en Espanol


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List of Articles Providing a DETAILED GUIDE TO MOLD RELATED ILLNESSES - Asthma, Allergies, Lung, Neurological, Other Complaints

Frequently Asked Questions (FAQs) about Mold Exposure, Suspected Mold Related Illness, How to Proceed, How to find a Mold Doctor

Question: Chronic Cough and Post Nasal Drip - PND - What's a Reliable Mold Test Kit?

Reply: Mold test kits have a useful role to play, but you may need a competent building inspection first

Question: where can I find similar advice about a water-damaged automobile?

Reply:

Question: We moved out of a moldy home but may have brought along mold or moved into a new one also moldy; my children appear to have serious mold-related illnesses. How can we find a suitable doctor? What else can we do?

Reply:

Did mold make someone in your home sick?

Do you need to look for harmful mold or other contaminants more carefully at your present environment?

How to find a mold doctor:

Question: brain infection, meningitis; suspected moldy home, is mold on a nasal spray bottle diagnostic?

Reply:

Ask a Question or Search InspectApedia

Technical Reviewers & References

Books & Articles on Building & Environmental Inspection, Testing, Diagnosis, & Repair