Carers and Damp Homes

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Steve Webster of the Manchester Carers Centre, UK talks about the support and services offered by the centre in Manchester and the other centres throughout the UK. Graham Atherton talks about our progress in the understanding of the health effects caused by damp homes, and how to avoid them!

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Carers and Damp Homes

  1. 1. LED BY GRAHAM ATHERTON SUPPORTED BY NAC CENTRE MANAGER CHRIS HARRIS GEORGINA POWELL, DEBBIE KENNEDY & DEB HAWKER CARER SUPPORT NATIONAL ASPERGILLOSIS CENTRE UHSM MANCHESTER Support Meeting for Aspergillosis Patients & Carers Fungal Research Trust
  2. 2. Programme  1.30 Steve Webster– Carer support  1.50 Graham Atherton – the trouble with damp homes  2.30 Patients Discussion (Break)  2.45 Group discussion/Requests for information  Low – allergy gardening (Book now available)  Artificial organs – kidney  Food for patients meeting?  Patients survey  3.15 Q & A from the floor or online
  3. 3. Patients group Saline nebulisers and their effectiveness Media portraying aspergillosis as easy to cure What is important to you isn’t always obvious to your carer When you are ill patience is inevitably shortened!
  4. 4. Damp homes Damp is known to cause health problems – asthma, Hypersensitivity Pneumonitis, allergy Many with aspergillosis & asthma are particularly effected What else?
  5. 5. What is damp? Damp is unwanted water, moisture that has become persistent and is causing a problem (or going to cause a problem) to the structure or decoration of the building. There are sources of water that are present in a home that don’t cause problems eg water running down a window isn’t a problem unless it wets constantly and causes rot out the growth of mould.
  6. 6. What is a damp problem? Once moisture becomes persistent it can: Stain wall/paint/wallpaper Cause surface coatings to lift Damage wooden flooring Cause mould growth!
  7. 7. Damp causes mould growth Moulds are present in the air at all times. To grow they need to settle on a food source (paper/paste/plasterboard/dirt) and be provided with some moisture. If the moisture dries quickly ( a few hours) little growth will occur, otherwise growth will begin, invisibly at first Dark, black/brown/green patched develop
  8. 8. When does mould become a problem? If the mould is in a normal ‘wet’ room (bathroom/kitchen) on surfaces designed to be wet and wipe with cleaner & disinfectant as you always have done
  9. 9. When is mould a problem? If mould is in room which are not designed to be wet or/and on surfaces not designed to be wet there is a problem
  10. 10. When is mould a problem? Difficult to give a general answer to this but a recent study showed that the appearance of mould patches larger than a postcard was evidence of a damp problem than could cause health problems.
  11. 11. What do we do about it? Identify the source of the moisture & stop it.  Mainly – condensation  Also check for broken guttering or downpipes leaking and pouring water down the outside wall when its raining  Leaking internal pipes  Many more of these – if unsure contact ISSE (www.isse.org.uk) for advice & good surveyor. Generally not a good idea to call in a company you find in the yellow pages as many are unqualified salesmen!
  12. 12. What do we do about it? Small amounts: Superficial  Don’t just paint over! Remove the mouldy material as it will regrow quickly if it becomes damp again.  Remember much of the mould is invisible so use a disinfectant – 10% bleach is effective as are other fungicides and it helps to add in some detergent to aid cleaning.  If you are sensitive or have aspergillosis/asthma don’t do this yourself and ensure the room is well ventilated to dry it out! Large amounts: growing through material  Use a professional company to clean & replace material– get a recommendation from your surveyor
  13. 13. Full guidelines http://www.epa.gov/mold/moldguide.html
  14. 14. How do we stop it reoccurring? If there was a leak then hopefully after cleaning no further action will be needed. If the problem is condensation then you need to assess how well ventilated your home is  Ventilate more to remove moisture – open windows, install vents, check existing vents are clear, take advice from ISSE.  Remove / reduce sources of moisture in the air – open windows when showering/boiling water in kitchen, dry clothes outside or in a vented dryer.  New homes can have very little airflow. Older homes with fireplaces may need to have their natural vents restored.
  15. 15. What health problems can occur? Those with aspergillosis & sinusitis & allergies may find some symptoms worsening – it is worth keeping moulds out of your home! Damp homes are known to caused asthma to worsen in children and adults Hypersensitivity – can be brought about by flooding in a home. Severe breathing difficulties. Can be triggered again if you re-enter the home even after a cleanup! Neurophysiological symptoms (?)
  16. 16. Toxic moulds – controversial? There seems to be a group of patients living in damp or flooded homes that suffer from quite vague symptoms that are difficult to measure like headache, lethargy, aches, tingling, tinnitis and more Over last 10 years lots of claims & counterclaims driven by insurance/compensation claims in the main
  17. 17. History of Sick Buildings From 1970’s onwards claims of illness in particular buildings. One cause found to be damp 2000 onwards: a few research groups starting to publish papers correlating damp & moulds with respiratory symptoms and lots more less measurable symptoms. A fair bit of this effort seemed to centre around mycotoxins but this was not the only culprit suggested
  18. 18. History of Sick buildings 2006 onwards some doctors start to offer treatments to attempt to remove low level mycotoxins detected in bodies of people living in damp/mouldy homes, also treatments to attempt to protect patients bodies from ‘oxidative damage’ Current thinking suggests an illness with many symptoms caused by many factors – fine particles generated by fungi when they dry out, spores, mycotoxin, other types of toxin, odours etc.
  19. 19. Sick buildings? As symptoms are difficult to measure, research is difficult. Results controversial. A lot of information is talked about in books, on websites and in the media but much less seems to be proven as yet. What is published has weak points that prevent general acceptance of these theories – we are not even told how successful treatments are other than one or two small papers. Caution!!
  20. 20. How does it effect NAC? We are here to diagnose & treat aspergillosis – newly described illnesses that might be related to damp & moulds are not our main area of interest. Damp homes DO effect our patients and those of our ‘clinical neighbours’ at UHSM – CF & asthma. This is our main area of interest. We do however occasionally get asked for our opinions on other aspects of health in damp homes and our collaboration with ISSE gives us a source of good advice on surveying side. Common interests – assessment & remediation
  21. 21. Damp & Human Health Damp – eliminate it and nearly all of these health problems will be alleviated or never appear. Until we know more about the health issues: Treat the damp!
  22. 22. Low Allergen Gardening Allergy-free Gardening: A Revolutionary Approach to Landscape Planning by Thomas L. Ogren (1 Mar 2000) £82.43 new, £30.00 used
  23. 23. Q & A Questions? Areas of interest online Itraconazole toxicity – risk of heart problems Low – allergy gardening (books purchased) Artificial organs – kidney Food for patients meeting? Damp homes – do you see damp/moulds?
  24. 24. Itraconazole and Heart Failure Patients NEW to itraconazole should be aware of the possibility of heart problems Patietns who have been taking itraconazole for over 6 – 12 months with no problems should not develop problems in future ALL should be watchful for signs such as:
  25. 25. Itraconazole and Heart Failure The symptoms of heart failure can vary from person to person. The main symptoms are breathlessness, extreme tiredness, and ankle swelling, which may extend up the legs. These symptoms may be caused by conditions other than heart failure, and sometimes there may be more than one cause for them. http://www.nhs.uk/Conditions/Heart- failure/Pages/Symptoms.aspx If in any doubt see your doctor
  26. 26. Regrown organs
  27. 27. Regrown organs - progress Kidney – complex organ Has been stripped down & rebuilt using stem cells (rat) and then re-implanted into host Works with 5-10% efficiency compared with original – thought to be sufficient to avoid transplant!
  28. 28. Food for Meeting Can’t transfer funds to research Funds come out of NAC/NHS ‘hospitality’ funds Could do less – tea & biscuits?
  29. 29. Patients Survey Taken in February each year Assessment of satisfaction of all aspects of our service 140 answered questionnaires  Questions about Patient information  Questions about this meeting
  30. 30. Patients Survey
  31. 31. Patients Survey
  32. 32. Patients Survey
  33. 33. Patients Survey Of those that answered no, 32% of them do not have a computer or use the internet. Anything we can do to improve this?
  34. 34. Patients Survey
  35. 35. Patients Survey Can we fix this in any way?
  36. 36. Patients Survey Can we improve this?
  37. 37. Patients Survey Can we improve this?
  38. 38. Thank You “The best chance we have of beating this illness is to work together” Living with it, Working with it, Treating it Fungal Research Trust

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