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Black Mold: How Bad Is It?

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Public health presentation for EHOH 6614 at the Colorado School of Public Health

Public health presentation for EHOH 6614 at the Colorado School of Public Health

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  • 1. BLACK MOLD HOW BAD IS IT? Group 5: Katelyn Hall, Danielle Rope, Katie Lupo, Blythe Dollar, & Kirk Shamley
  • 2. Background: What is black mold? Stachybotrys chartarum (Stachybotrys atra) greenish-black mold grows on material with high cellulose and low nitrogen content (fiberboard, gypsum board, paper, dust, lint) Occurs where there is water damage, excessive humidity, condensation Produces multiple mycotoxins that have potential to become airborne
  • 3. Risk Characterization Public health risk for Stachybotrys chartarum is broken down into three categories 1. Ingestion 2. Topical 3. Inhalation Stachybotrys chartarum spores dyed blue.
  • 4. Primarily due to the mycotoxin produced by the mold Reported and identified in farm animals having consumed affected feed, but rarely reported in humans Ongoing risk is unlikely in view of moderate agricultural methods and scrutiny of agricultural products. Risk Characterization: 1. Ingestion
  • 5. Direct infection, especially in immunocompromised populations Plausible but rarely reported and unlikely with modern medical care Risk Characterization: 2. Topical
  • 6. Allergic reaction and direct toxic effects to the lungs No confirmed cases but remains theoretically possible Risk Characterization: 3. Inhalation
  • 7. Etiology yet to be elucidated Role of Black mold remains theoretical but unproven “Sick Building Syndrome”
  • 8. Association of mold, including Stachybotrys, with is biologically plausible but still theoretical Hypothetically, black mold could be a surrogate marker for poor and substandard housing, a known link to poor health Dampness-related illnesses
  • 9. Risk is theoretical only Potential for a large number of people to be affected would appear to justify continued scrutiny
  • 10. Exposure Assessment Lack of standardized method for describing mold burden Stachybotrys rarely exists in isolation Questionnaires, visual or engineering inspections Sample air, dust or contaminated materials Heavy mold burdens can usually be seen or smelled
  • 11. Exposure Assessment Cont. Air sampling is most common Typically done for several hours Determination of total spore counts (generic, species usually not identified) Unknown how well air samples represent a breathing zone Currently, reliable sampling of mold is costly and no standard for interpretation of results EPA recommends removing any mold that is found regardless of species
  • 12. Exposure Assessment Cont. EPA recently developed metric called the Environmental Relative Moldiness Index (ERMI) DNA analysis called Mold Specific Quantitative PCR (MSQPCR) Dust samples are collected and DNA from mold is analyzed Sample is compared to the ERMI Used only for research at this time, not yet validated for routine public use
  • 13. Unintended Consequences “There is no way to test for Stachybotrys in the body, nor for poisoning after it has left the body.” black mold blood tests - IgA (Immunoglobulins) urine sample - mycotoxins “According to respected scientific bodies like the Environmental Protection Agency and Centers for Disease Control, among others, there is very little scientific evidence linking mold with serious human illness, particularly considering the low levels of exposure in most homes.”
  • 14. Unintended Consequences: Symptoms of Black Mold Exposure Exposure to the mycotoxins present in specific types of mold makes some people sick Skin problems, flu-like symptoms, chronic fatigue, headaches, respiratory and heart problems, nose bleeding, bronchitis, pulmonary hemorrhage Learning disabilities, mental deficiencies, cancer, multiple sclerosis, lupus,fibromyalgia, rheumatoid arthritis
  • 15. Linkedin Discussion 1994 - case of bleeding lung disease in children 10,000 pending cases in the United States Just to be safe - get your house checked out and remove mold!
  • 16. Hazard Assessment Best prevention from adverse health effects from exposure to Stachybotrys chartarum is to REMOVE THE MOLD!!! Can call a mold removal company to assess and remove the mold Can remove the mold yourself
  • 17. Hazard Assessment: Mold Removal If you decide to remove the mold yourself: Open windows and doors in the area Wear non-porous gloves and protective eyewear Wear a mask to prevent inhalation of mycotoxins Wear protective clothing and do not have exposed skin
  • 18. Hazard Assessment: Mold Removal Cont. To remove mold from hard surfaces mix 1 cup of bleach to 1 gallon of water and clean the surface Absorbent porous materials like drywall, ceiling tiles, or carpet should be thrown away if contaminated with mold 1 Cup Bleach 1 Gallon Water
  • 19. Hazard Assessment: Mold Removal Cont. If the area to be cleaned is larger than 10 square feet consult the U.S. Environmental Protection Agency (EPA) guide titled Mold Remediation in Schools and Commercial Buildings Or hire a professional mold removal company
  • 20. Hierarchy of Controls
  • 21. Personal Protective Equipment Remediation in Schools & Commercial Buildings (EPA Guidelines) Skin and Eye Protection Properly fitted goggles or a full-face respirator with HEPA filter. Respiratory Protection Small area affected by mold: N-95 respirator; covers the nose and mouth, will filter out 95% of the particulates in the air, and is available in most hardware stores. Limited PPE: half-face or full-face air purifying respirator equipped with a HEPA filter cartridge; contain both inhalation and exhalation valves that filter the air and ensure that it is free of mold particles. High levels of airborne dust or mold spores are likely or when intense or long-term exposures are expected: a full-face, powered air purifying respirator (PAPR) is recommended; HEPA- filtered air is supplied to a mask that covers the entire face or a hood that covers the entire head.
  • 22. Administrative Controls (i.e., Gaps in Solutions) EPA: Standards or Threshold Limit Values for airborne concentrations of mold have not been set. No regulations or standards for airborne mold contaminants. OSHA: No standard for mold exposure. No enforcement directive for mold exposure. Federal Legislation: Congress has failed several times to pass federal legislation requiring inspections and remediation of rental properties and new homes sales, establishing EPA and HUD guidelines, establishing a FEMA catastrophic loss program, and requiring Medicaid coverage for “mold victims”. State Legislation: Most states have enacted legislation regarding mold, including California’s Toxic Mold Protection Act, which establishes permissible exposure limits. Lawsuits: A surge in lawsuits in the early to mid 2000s awarded billions of dollars to plaintiffs claiming property damage and health problems due to black mold.
  • 23. Engineering Controls/Substitution Mold Resistant Building Materials Insulation Lumber Paint Drywall
  • 24. Engineering Controls: The Breathe Easy Home
  • 25. Elimination Control potential water sources. To prevent mold growth, control the places where water can get in and cause damage, including: Temporary holes in roofing, walls, or siding during construction/renovation. Leaking roofs, windows, siding, crawl spaces, etc. Plumbing or washing machine leaks, dishwasher backups or pump failure, leaking icemaker water line to refrigerators, toilet overflows, slow water pipe leaks inside walls, etc. Bathing/showering areas, cooking areas, indoor plants, or pet urine. Condensation from poorly insulated windows or cold surfaces. Repair leaks quickly. Because mold and bacteria grow very rapidly, it is important to fix the source of water intrusion immediately. If not fixed, the mold will simply grow back. Without moisture, microbes cannot grow and will not be a health concern indoors. Dry wet areas within 48 hours. Mold and bacteria grow quickly, so dry water-damaged areas within 48 hours. Discard any building materials that have not been dried and can support mold and bacterial growth. Materials that are not dried within 48 hours will grow mold, and the mold spores will remain in the material. Dead and dried mold causes more health problems than moist.
  • 26. Colorado Floods Boulder County mold information and resources: https://www-static.bouldercolorado.gov/docs/post-flood-mold- information-resources-1-201310091553.pdf Colorado Department of Public Health and Environment Protect Yourself From Mold: http://www.colorado.gov/cs/Satellite?blobcol=urldata&blobheadernam e1=Content-Disposition&blobheadername2=Content- Type&blobheadervalue1=inline%3B+filename%3D%22Protect+yours elf+from+mold.pdf%22&blobheadervalue2=application%2Fpdf&blobk ey=id&blobtable=MungoBlobs&blobwhere=1251885530334&ssbinary =true
  • 27. QUESTIONS?
  • 28. References Anonymous. 2014. [online] Available at: http://www.socialissues.us 17701.html [Accessed: 31 Mar 2014]. Bashir, S. (2002). Home is where the harm is: Inadequate housing as a public health crisis. American Journal of Public Health, 92(5), 733-738. Bay., T. 2014. Mold Removal Tampa | Mold Remediation Tampa Clearwater Florida. [online] Available at: http://www.idestroymold.com/ [Accessed: 31 Mar 2014]. Cabral, J. (2010). Can we use indoor fungi as bioindicators of indoor air quality? Historical perspectives and open questions. Scientific Total Environment, 408(20), 4285-95. Centers for Disease Control and Prevention. Mold: Facts about Stachybotrys chartarum and Other Molds. Accessed Mar 29, 2014 at http://www.cdc.gov/mold/stachy.htm#Q11 Chapman, J. (2003). Stachybotrys chartarum and other problems caused by allergenic fungi. Allergy Asthma Procedures, 24(1), 1-7. Damp Indoor Spaces and Health, Committee on Damp Indoor Spaces and Health, Board on Health Promotion and Disease Prevention, Institute of Medicine, 2004. Facilitiesnet. 2014. Mold: Behind the Hype - Facilities Management IAQ Feature. [online] Available at: http://www.facilitiesnet.com/iaq/article/Mold-Behind-the-Hype--1523# [Accessed: 31 Mar 2014]. Hardin, B., Kelman, B., and Saxon A. (2003). Adverse human health effects associated with molds in the indoor environment, Journal of Occupational Environmental Medicine, 45(5), 470-8. Hope, J. (2013). A Review of the mechanism of injury and treatment approaches for illness resulting from exposure to water-damaged buildings, mold, and mycotoxins. The Scientific World Journal. Hossain, A., Ahmed, M., & Ghannoum, M. (2004). Attributes of Stachybotrys chartarum and its association with human disease. Journal Allergy Clinical Immunology, 113(2), 200-207. Occupational Safety and Health Administration. ( 2011) . Indoor Air Quality in Commercial and Institutional Buildings. Khalili B., Montanaro, M., & Bardana, E. (2005). Inhalational mold toxicity: fact or fiction? A clinical review of 50 cases. Annals Allergy Asthma Immunology, 95(3), 239-246.
  • 29. References Laumbach, R. & Kipen, H. (2005) Bioaerosols and sick building syndrome: particles, inflammation, and allergy. Current Opinions Allergy Clinical Immunology, 5(2),135-139. Lagasse, T.S, & Reyna, K.N. (2004). 30 states and counting: Mold legislation continues to sweep the nation. Mold. Macher, J., McNeel, S., & Waldman, J. (2005). Implementation of the Toxic Mold Protection Act. Richmond, CA: California Department of Health Services. Menetrez, M.Y., Foarde, K.K., Webber, T.D., Dean, T.R., & Betancourt, D.A. (2007). Testing antimicrobial paint efficiency on gypsum wallboard contaminated with Stachybotrys chartarum. Journal of Occupational and Environmental Hygiene, 5, 63-66. National Institute of Environmental Health Sciences. (2005). Guidelines for the protection and training of workers engaged in maintenance and remediation work associated with mold. Washington, DC. National Research Council. (2004). Damp Indoor Spaces and Health. Washington, DC: The National Academies Press. Nelson, B.D. (2001). Stachybotrys chartarum: The Toxic Indoor Mold. APSnet Features. Online. doi: 10.1094/APSnet Feature-2001-1101. Nytimes.com. 2014. Infants' Lung Bleeding Traced to Toxic Mold. [online] Available at: http://www.nytimes.com/1997/01/24/us/infants-lung-bleeding-traced-to-toxic-mold.html [Accessed: 31 Mar 2014]. PUBH 5103: Exposures to Environmental Hazards: Indoor Mold. Accessed Mar 29, 2014 at http://enhs.umn.edu/current/5103/molds/absorption.html Takaro, T.K., Krieger, J., Song, L., Sharify, D., & Beaudet, N. (2011). The Breathe-Easy Home: The impact of asthma-friendly home construction on clinical outcomes and trigger exposure. American Journal of Public Health, 101(1), 55-62. Toxic-black-mold-syndrome.com. 2014. Toxic Black Mold Syndrome, Symptoms, Testing and Treatment. [online] Available at: http://www.toxic-black-mold-syndrome.com/ [Accessed: 31 Mar 2014]. United States Environmental Protection Agency. (2008). Mold remediation in schools and commercial buildings. (EPA 402-K-01-001). Washington, DC. World Health Organization. (2009). WHO guidelines for indoor air quality: dampness and mould.