Mold Doctors: Do You Need to See an Expert in Environmental Medicine - a Mold Doctor?
InspectAPedia® -
Is mold making someone sick?
Do you need to hire a professional to find, test, or remove mold?
Acceptable or unacceptable mold levels
How to prevent mold in buildings
Directory of physicians specializing in environmental medicine & mold related illness - free online listing for mold doctors
This document discusses the decision to consult a physician who has expertise in mold and mold related illness. We suggest a few questions to ask your doctor about the possibility of building-related illness, we include a list of physicians with expertise in mold and environmental medicine, and we provide a article series that can help you assess the risk of mold related illness in a building. Physicians who are expert in environmental medicine can be listed here at no fee - just CONTACT us.
InspectAPedia tolerates no conflicts of interest. We have no relationship with advertisers nor with topics or services discussed at this website.
Mold "mildew," moisture, in
your house or office, building-related illness, involves your physician,
medical treatment, sick building investigators, possibly professional cleaning companies, steps to reduce the future
creation of mold or other indoor irritants, and possibly the special
products to help clean buildings and air.
DO I NEED TO SEE A MOLD DOCTOR?
Quoting from the Center for Environmental Medicine (Portland OR) - The decision you and your doctor make about your treatment will grow out of the careful assessment of your particular needs, adequate laboratory testing, frank discussions, and your expectations. You will need to consider your responsibilities and commitment as well as the benefits you will achieve. The content found on this site is for informational purposes only. It is not medical advice and is not intended to diagnose, treat or cure. It does not provide or constitute professional advice or consultation.
When should you consult with physicians and knowledgeable indoor environment experts? If you suspect that your building is making you sick, particularly if you are someone at extra risk, such as asthmatic, allergic to mold, undergoing cancer treatment, immuno-suppressed, immunocompromised, immune impaired, elderly, or infant, it is certainly smart to consult with a physician who is experienced in mold related illness or an expert in environmental medicine.
We have encountered clients living in very moldy, high-risk environments who suffer respiratory or other illnesses, and who, on consult with their physician, were given palliative care but for whom the question of an environmental contributor to their complaint was never raised. Remember to ask your doctor, allergist, pulmonologist, or G.P. if s/he thinks that your living or work environment could be a cause or contributor to your complaints.
A simple clue that suggests that one may be suffering from building related illness is the abatement of symptoms
when the person with the complaint spends time out of the building. However the converse - when symptoms do not abate - does not rule
out a building as a contributor to the complaints.
Some mold-related illness symptoms are slow to diminish, and more than one building can contribute to complaints. Proving with scientific accuracy that a substance in a building has actually caused or aggravated a specific illness is a difficult and
costly procedure.
A common approach taken by building diagnosticians who are considering whether or not mold in a building is (or could be) making someone sick is simply to look for substances which are believed likely to cause or
aggravate illnesses and complaints. If such materials are present at significant levels they should be removed.
Some People Should Stay Away From Even Small Mold Cleanup Operations
If you are sick, asthmatic, immune-impaired, suffer from COPD or other respiratory illness, before attempting any mold cleanup yourself you should see your family doctor, allergist, pulmonologist, medical toxicologist, or other appropriate specialist to discuss the chances that the environment might cause or contribute to or aggravate your illness. If you suspect that your illness is caused by or aggravated by conditions in your building
you should discuss that with your physician.
Our field investigation photo (left) shows multiple genera/species of more than "cosmetic" mold that was found throughout a large basement ceiling. Unlike the mold case depicted in our page top photo, this area and possibly this entire home are likely to be a health hazard to almost anyone.
And if you are yourself or if people with these characteristics are present: elderly, immune impaired, infant, asthmatic, suffer from COPD or other respiratory or immune
disorders or any illness that could be aggravated by exposure to respiratory irritants, VOC's, allergens, mycotoxins, etc., you should be
wary of allowing any handling moldy or dusty materials without first checking with your doctor. Medical relocation of certain high-risk building
occupants may be needed before moldy materials are disturbed.
MOLD EXPERT, WHEN TO HIRE contains more discussion of evaluating mold risk in buildings for sensitive individuals or people at extra risk of mold related illness.
WHERE CAN I FIND A MOLD DOCTOR? - Directory of Physicians with Expertise in Environmental Medicine & Mold Related Illness
Physicians who are expert in environmental medicine can be listed here at no fee - just Contact Us or use the simple information form found at InspectAPedia's LINK EXCHANGE INSTRUCTIONS.
American Academy of Environmental Medicine, 6505 E. Central Ave., #296, Wichita KS 67206 316-684-5500 - http://www.aaemonline.org/
American College of Occupational and Environmental Medicine, ACOEM,
25 Northwest Point Blvd.,
Suite 700,
Elk Grove Village, Illinois, 60007-1030
Telephone: 847/818-1800, Fax: 847/818-9266 - http://www.acoem.org/
ACOEM provides a "doctor finder" service via their website.
Australian College of Nutritional & Environmental Medicine, ACNEM, 10/23-25 Melrose Street,
Sandringham, Victoria 3191, Australia. - ACNEM, lists ACNEM-trained physicians; +61 03 9597 0363, mail@acnem.org - www.acnem.org - provides training in environmental and nutritional medicine.
Center for Environmental Medicine (Portland OR), 10748 NE Halsey Street Portland, OR 97220-3961 USA,
Tel.: (503) 261-0966 Fax: (503 252-2691 Tel.: (360) 690-0017
E-mail: info@cemmed.com - Dr. Chris Hatlestad,MD, ABFM
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We are dedicated to making our information as accurate, complete, useful, and unbiased as possible.
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Physicians who are expert in environmental medicine can be listed here at no fee - just Contact Us or use the simple information form found at InspectAPedia's LINK EXCHANGE INSTRUCTIONS.
Can You Refer me to a Specific Mold Doctor or Specialist
Question:
I am emailing you to ask for a referral to a mold doctor. I live in an apartment infested with black mold. I have allergies, and suppressed immune system and as I have health insurance I cannot afford the co-pay to go see a doctor or be able to pay for the balance that my insurance does not meet. Can you refer me to a doctor in my area that can assist me. I believe with all of my symptoms I have extensive exposure to black mold to a high level. I have researched the symptoms and realize I have mild skin breakouts in this past two weeks and respiratory problems that are indicative of black mold toxins. Please refer and advise if possible. I can travel to Portland if necessary. Can you also refer me to an agency that can help relocate me from this apartment? S.S.
Reply
You can find a physician specializing in environmental medicine and mold related illness by taking the following steps:
Ask your own personal physician or general practitioner for a referral to a doctor specializing in environmental medicine or mold related illness
Do the same search on the web using zip codes near your home
Watch out: If you already know that your home has large areas of toxic or allergenic mold (more than 30 sq.ft.) then you should probably be taking steps asap to remove yourself from that environment asap
- if you move, and if your home is proven to be badly mold contaminated, your possessions including soft goods, clothing, curtains, etc. will probably need to be cleaned. Do not let an amateur try performing a "mold cleanup job" in a very moldy home: the risk is that they make the problem worse by spreading moldy dust all over everything, making the workers or building occupants sick in the process.
Watch out: in the above message the writer refers to "black mold" - but not all black mold is harmful, and there are a great many molds of other colors that are at least as harmful or more harmful. Don't guess at the level of severity of a mold contamination by the color of the mold. See MOLD APPEARANCE - WHAT MOLD LOOKS LIKE and also Recognize Harmless Black Mold.
More Questions About Mold Causes and Finding a "Mold Doctor"
Why do I Have Mold and Mildew in My Closets and Bathrooms - due to my Air Conditioner? I Need a Mold Doctor
I have had a problem for almost 4 years in trying to get the installers of
my new air conditioning unit to find out why I have mold and mildew in my
closets and bathroom--never had any problems before installing the new
unit. It was installed in April--mold was covering the metal vents in
August after a hot summer--followed by their excuses as to why this would
happen--then in November I started felling dizzy--having muscle aches and
pains--went to the doctor and spent the next year and a half getting a
diagnosis.
I was then diagnosed with fibromyalgia--I did not put the two
together for awhile. I have contacted an attorney and have had the vent
filters checked at a lab-tested positive for Aspergillus--Cladosporium--Hyphae--Penicillium/Aspergillus. The attorney
says that I will need a Doctor that will be able to connect the symptoms to
the diagnosis. I live 2 hours from Atlanta GA--Knoxville TN--Birmingham
Al. Any information will be helpful. L.G., GA TN
Reply
A competent onsite inspection by an expert usually finds additional clues that help accurately diagnose a problem. That said, here are some things to consider:
An air conditioning system that is not properly sized (for example one that is too big) may cool a building without dehumidifying it, leading to increased indoor moisture and potentially contributing to a mold problem. We explain this problem in detail at A/C Not Dehumidifying.
There could be other building sources of leaks or high moisture that contribute to or actually cause an indoor mold problem.
In looking for a "mold doctor" start by asking your own, or in this case your mom's own primary care physician for advice and a referral. But because the doctor knows the patient but not the patient's home environment, you might want to ask for an onsite visual inspection and case history-review performed by an experienced building diagnostician or even an experienced home inspector. Those experts (EXPERT DIRECTORY) should be good at finding likely sources of leaks or moisture - gating factors in indoor mold problems, and they also can keep an eye open for other hazards that you haven't noticed.
Proving that an illness is caused by a specific mold exposure is very difficult because of variations in individual health history and because most people are exposed to a wide variety of environments during their daily life. As a (retired) onsite investigator and forensic lab operator often asked to study these concerns, my approach (DF) has been to avoid making claims of "proof" of mold related illness causation, and to focus on detecting whether or not there is an indoor mold problem present. If there is a large reservoir of problematic indoor mold it needs to be removed and its cause corrected.
It is also interesting to note that while there are more than a million mold species, the US FDA has approved just a few mold genera/species, less than ten, that may be used to prepare serums or chemicals used in testing for mold allergies. Now it's surely true that there are going to be some chemical similarities between the "approved for testing" fungal species and others that may be in your environment, so the actual functional breadth of "mold exposure or mold allergy" testing may be more broad than you'd think. But surely there are other mold species found in our environment. So our OPINION is that while a positive reaction to a mold allergy or mold exposure test may be indicative, a negative reaction probably should not be taken as an assurance that there is no mold exposure.
My mom has been living in a house with toxic black mold ...
My mom has been living in a house with toxic black mold in it for about 4 or 5 months. I want to get her seen by a doctor because she has seemed to be getting very sick. Are there any good doctors that specialize in mold that you can recommend for me? - A.R.
Reply
Because it can be difficult to find a physician who has the special expertise you are looking for, our first advice is always to start by asking your own, or in this case your mom's own primary care physician for advice and a referral. The primary care physician who knows your mom's health and health history can help be sure that you are pursuing the right avenue of medical investigation and care.
Mold Atlas of Common Indoor Clinical Mold, Pathogens, Allergens, & Other Particles - Medical Health Effects of Mold: Allergenicity, Toxicity, Pathogenicity, Other
MOLD EXPERT, WHEN TO HIRE - how to decide when the mold risk in a building justifies bringing in an expert to inspect, test for mold, write a mold remediation plan, or perform a post-cleanup mold clearance inspection and test.
MOLD EXPOSURE, FOOD HAZARDS - a history of foodborne mold related illness, definitions of mycotoxins, aflatoxins, etc., moldy food advice
MOLD EXPOSURE STANDARDS - world standards for mold exposure levels - and discussion of the difficulty of quantitative mold standards
MOLD RELATED ILLNESS GUIDE - Mold-Related Illness: sickness and health risks or complaints caused, or suspected to be caused or aggravated by indoor airborne mold, by physical contact, or other means of mold exposure
MOLD RELATED ILLNESS SYMPTOMS - a long list of all of the known, suspected, or simply documented health complaints voiced by people who have been or are suspected to have been exposed to problematic mold
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) - this is an absolutely excellent and wide-ranging mold reference available online in PDF format.
More Reading: If you are looking for evidence of a mold problem in a building you should review these articles.
Mold Detection - What Does Mold Look Like? Mold spores in the Home - a Photo ID Library for detection and identification of mold allergens
Mold Detection - How to Find and Test for Mold in Buildings - Looking for Mold - A 'how to' photo and text primer on finding and testing for mold in Buildings
Mold Detection - Stuff that is Not Mold but is often mistaken for it - things you may not want to test. Not all "black mold" is toxic or harmful.
Stuff that is not mold but is often mistaken for it - things you may not want to test. Also, not all "black mold" is toxic - here are examples of harmless black mold.
For more in-depth information on mold investigation in buildings see these articles
Mold Investigation Tips for Home Inspectors how to find mold, where to look, what is likely to be important. Advice to building inspectors intending to inspect or test for toxic or problematic mold indoors, mold inspection methods, and mold test methods which are valid or invalid
Mold Testing Methods - Brief Tutorial: Toxic Mold and Toxic Gas Testing Methods Compared -
valid vs. invalid tests, recommendations. Lists mold testing methods and protocols, links to longer articles describing air tests for mold, surface tape or bulk mold tests, and gas testing such as MVOC's or toxic gases. Longer articles explain the shortcomings and discuss mold testing protocols.
Critique, contributions wanted: Contact Us to suggest corrections or additions to articles at this website, and if you wish, to receive online listing and credit as a contributor. Particular thanks are due to the many experts and also consumers who read and critique technical articles at InspectAPedia.com.
Additional technical contributors & reference sources for this article are listed below.
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American Academy of Environmental Medicine, 6505 E. Central Ave., #296, Wichita KS 67206 316-684-5500 - http://www.aaemonline.org/ The American Academy of Environmental Medicine was founded in 1965, and is an international association of physicians and other professionals interested in the clinical aspects of humans and their environment. The Academy is interested in expanding the knowledge of interactions between human individuals and their environment, as these may be demonstrated to be reflected in their total health. The AAEM provides research and education in the recognition, treatment and prevention of illnesses induced by exposures to biological and chemical agents encountered in air, food and water.
American College of Occupational and Environmental Medicine, ACOEM,
25 Northwest Point Blvd.,
Suite 700,
Elk Grove Village, Illinois, 60007-1030
Telephone: 847/818-1800, Fax: 847/818-9266 - http://www.acoem.org/ The American College of Occupational and Environmental Medicine (ACOEM) is a medical association of physicians, dedicated to protecting the health and safety of the American workforce and their communities. Members must adhere to the ACOEM’s Code of Ethical Conduct. The ACOEM Doctor Finder Service provides basic professional information about each occupational medicine physician member who has elected to participate in this public listing service. The American College of Occupational and Environmental Medicine (ACOEM) represents more than 5,000 physicians and other health care professionals specializing in the field of occupational and environmental medicine (OEM). Founded in 1916, ACOEM is the nation's largest medical society dedicated to promoting the health of workers through preventive medicine, clinical care, research, and education. A dynamic group of physicians encompassing specialists in a variety of medical practices is united via the College to develop positions and policies on vital issues relevant to the practice of preventive medicine both within and outside of the workplace.
Australian College of Nutritional & Environmental Medicine, ACNEM, 10/23-25 Melrose Street,
Sandringham, Victoria 3191, Australia. - ACNEM, lists ACNEM-trained physicians; +61 03 9597 0363, mail@acnem.org - www.acnem.org - provides training in environmental and nutritional medicine.
Center for Environmental Medicine (Portland OR), 10748 NE Halsey Street Portland, OR 97220-3961 USA,
Tel.: (503) 261-0966 Fax: (503 252-2691 Tel.: (360) 690-0017
E-mail: info@cemmed.com - Dr. Chris Hatlestad,MD, ABFM
Journal of Occupational & Environmental Medicine, JOEM, Paul W. Brandt-Rauf, MD, ScD, DrPH, Editor;
ISSN: 1076-2752
Online ISSN: 1536-5948, 12 issues / year,
Ranking: Public, Environmental, and Occupational Health 44/105 - http://journals.lww.com/joem/pages/default.aspx
Mold Atlas of Common Indoor Clinical Mold, Pathogens, Allergens, & Other Particles - Medical Health Effects of Mold: Allergenicity, Toxicity, Pathogenicity, Other
MOLD EXPERT, WHEN TO HIRE - how to decide when the mold risk in a building justifies bringing in an expert to inspect, test for mold, write a mold remediation plan, or perform a post-cleanup mold clearance inspection and test.
MOLD EXPOSURE, FOOD HAZARDS - a history of foodborne mold related illness, definitions of mycotoxins, aflatoxins, etc., moldy food advice
MOLD EXPOSURE STANDARDS - world standards for mold exposure levels - and discussion of the difficulty of quantitative mold standards
MOLD RELATED ILLNESS GUIDE - Mold-Related Illness: sickness and health risks or complaints caused, or suspected to be caused or aggravated by indoor airborne mold, by physical contact, or other means of mold exposure
MOLD RELATED ILLNESS SYMPTOMS - a long list of all of the known, suspected, or simply documented health complaints voiced by people who have been or are suspected to have been exposed to problematic mold
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) - this is an absolutely excellent and wide-ranging mold reference available online in PDF format.
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.
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
Associations: Sick House, Sick Building, SBS - Air Quality, Government, Private Associations and Information Resources
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
Atlas of Indoor Mold, Online Clinical Mold Atlas, Toxins, Pathogens, Allergens and Other Indoor Particles - Medical Health Effects of Mold (separate online document)
Black Mold that is Harmless Photos of recognizable, usually harmless black mold on wood, bluestain, ceratocystis, ophistoma
Building Floods: quick steps after a building flood or plumbing leak can prevent costly mold contamination
Classes of Mold: what types of cosmetic, allergenic, or toxic mold are a problem? Can mold be cleaned-up successfully?
"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
"Disease Prevention Program for Certain Vegetable Crops," David B. Langston, Jr., Extension Plant Pathologist - Vegetables, University of Georgia (PDF document) original source: www.reeis.usda.gov/web/crisprojectpages/209797.html
"Disease Prevention in Home Vegetable Gardens,"
Patricia Donald,
Department of Plant Microbiology and Pathology,
Lewis Jett
Department of Horticulture, University of Missouri Extension - extension.missouri.edu/publications/DisplayPub.aspx?P=G6202
Fifth Kingdom, Bryce Kendrick, ISBN13: 9781585100224, is available from the InspectAPedia online bookstore - we recommend the CD-ROM version of this book. This 3rd/edition is a compact but comprehensive encyclopedia of all things mycological. Every aspect of the fungi, from aflatoxin to zppspores, with an accessible blend of verve and wit. The 24 chapters are filled with up-to-date information of classification, yeast, lichens, spore dispersal, allergies, ecology, genetics, plant pathology, predatory fungi, biological control, mutualistic symbioses with animals and plants, fungi as food, food spoilage and mycotoxins.
Ozone Warnings - Use of Ozone as a "mold" remedy is ineffective and may be dangerous.
Rot concerns in buildings-some building mold such as Meruliporia incrassata "Poria" risks serious rot and hidden structural damage
US EPA: Una Breva Guia a Moho - Hongo [Copy on file as /sickhouse/EPA_Moho_Guia_sp.pdf - en Espanol
OTHER IAQ ISSUES: How To Find and Address Other Indoor Air or Indoor Environment Contaminants Besides Mold
Mold or allergens may not be the only or even the main indoor environmental contaminant. Don't let media attention to mold
cause so much enviro-scare fear that other, possibly more urgent hazards go un-addressed.
Ozone Warnings - Use of Ozone as a "mold"
remedy is ineffective and may be dangerous.
Pet control - if you can't say goodbye to your bird, cat, dog, guinea pig, hamster, tropical fish, then limit the
areas they occupy and limit the airflow from that area to sleeping or other areas of the building, use allergenic
bedding, eliminate wall-to-wall carpeting, improve housecleaning including use of a HEPA-rated vacuum cleaner. For more details
see our article Dog, Cat, and Other Animal Dander - Information for Asthmatics and Indoor Air Quality
Rodents, Mice, Squirrel Control - I find high levels of mouse and rodent dander, fecal dust, and urine-contaminated dust in some buildings,
and high levels of these materials in building insulation in those locations. If you have a mouse problem, particularly if mice and their waste (fecals or urine) are contaminating
the building HVAC or building insulation, may need both steps to clean up or remove infected materials and steps to stop an ongoing
rodent problem. If squirrels are a problem, the cleanup needs to include closing off entry openings into the building. Get some
help from a licensed pest control expert.