The type and severity of health effects that result from molds exposure is widely variable among different locations, from person to person and over time. Risk assessment for mold is currently difficult due to limited information and research conducted on mold inhalation.Mold sources may be easy or difficult to identify. Some sources can be easily observed growing on building materials while other sources can be hidden within walls, ceilings, flooring, and HVAC systems. Finding the source of hidden mold may take special instruments and sampling methods. If a mold source is discovered, several steps should be taken to prevent exposure. Once a source has been discovered, it is critical to repair the problem that caused mold growth.

1. Dr. Mohamed Noweir
Indoor Airborne Mold Management
Sources
Health Impacts Remedia9on
Program

2. • Background
• What is Mold
• Types of
Mold
• Condi9ons
Favoring
Growth
• Sources
• Individuals
at Risk
• Health
Impacts
• Mold
Inspec9on
• Sampling
• Mold
Remedia9on

4. Background
2. Indoor concentra9ons of most pollutants are higher than
outside
3. Increasing number of indoor diseases/health effects
4. We keep sensi9ve equipment/precious ar9facts inside

5. • It is the physical, chemical, and biological
characteris9cs of indoor environment with no
internal industrial processes or opera9ons that
can affect the comfort or health of the occupant.
OR:
• “it is the nature of indoor environment that
affects the health and well-being of occupants”.

6. Agent Host
Environment
Classical Epidemiological Triad

7. •
Their Airborne fragments may cause eye irrita4on,
allergies, eye-ears-nose-throat infec4ons, asthma
a8acks, fa4gue and depression.

8. Mold - What Is It?
• The Kingdom fungi includes mushrooms,
mold and yeast
• Microscopic Fungi (living, naturally
occurring organism)
• “Mold” and “ fungi” terms can be used
interchangeably
What is Mold?

9. v There are over 30,000 known species of mold
v Common “toxigenic” species in buildings include:
> Pennicillium
> Aspergillus
> Cladosporium
> Chaetomium
> Alternaria

10. • Powerful chemical released by fungi to help in
compe99on for food
• Contained in the spores, viable or nonviable
• E.g. Penicillin, Aflatoxins
• Explain some, but not all of hazardous proper9es of mold
v Known allergens
v Molds → mycotoxins
v Disease - Mycotoxicosis
Mycotoxins

11. Condi9ons Favoring Growth
Leaks
Floods
Condensa9on Steam
High Humidity
> 60%

12. Sinks HVAC Systems
Dishwashers Outside Sprinklers Spraying
on the wall
Leaking roofs and Pipes Washing and dryer Machines
Steam (Showers/Cooking)
Indoor Plants
Sources of Moisture Indoor

14. Indoor
Ven9la9on
Natural
Infiltra9on
Window
Doors
Mechanical
Note: Infiltration is air leakage through cracks and interstices, around
windows and doors, and through floors and walls into a building
Inadequate ven9la9on causes Mold to grow

16. HVAC Systems
• It keeps the temperature and humidity indoor
within Thermal comfort levels.
• Can be responsible for distribu9ng Mold Spores
throughout the building
• Can have moldy installa9on inside
• Must be serviced by an HVAC specialist

17. Heat Ven9la9on Air Condi9oning Systems
Ducts

18. What Types Of Materials Will Mold Grow On?
v Just about anything
v Primarily cellulose containing products
v Ceiling 9les
v Drywall
v Wood
v Glass
v Metal
v Concrete block
v Plas9c

19. There are no codes or standards regarding indoor fungal
bioaerosols or fungal loading levels.
• Growth in HVAC systems and ducts
• When asthma9cs, immune-compromised and other
sensi9ve occupants are present
• Serial episodes of mold contamina9on in the same
area / building ,may be reason for concern
• Recommenda9ons for addressing fungal
concentra9ons detected indoor have been developed
by a diverse range of organiza9ons

20. • Persistent presence of poten9ally pathogenic or
toxogenic fungi such as Stachybotrys or Fusarium
spp. is unacceptable at any concentra9on
• The measurement of any single species >50 c.f.u./
m3 of the same species other than Cladosporium or
Alternaria are detected, there may be reason for
concern
• Or overall mixed concentra9on >500 c.f.u./m3
warrants addi9onal inves9ga9on.
&
Na9onal Health and Walefare Canada guidelines

22. Comparison between the different species of isolated fungal spores in
indoor samples based on the percentage of each species in Primary
schools
YeastAlternaCladosporiumPenecilliumAspergillus
93.8%100%53.1%98.4%81.2%less than 50 cfu/m3
6.2%0%46.9%1.6%18.8%more than 50 cfu/m3
• Rabau A ,Noweir M. Indoor fungal spores levels in Dammam
primary Schools. Final Gradua9on project 2010.

23. Total fungal Counts cfu/m3
Less than 500 cfu/m3 92.2%
More than 500 cfu/m3 7.8%
comparison between sampled classrooms according to the total
counts of Mixed isolated fungal spores in indoor samples

25. Any one exposed to airborne mold can react to various
proper9es of viable and nonviable mold spores.
• IMMUNOCOMPROMISED
• INFANTS
• ELDERLY
• PREGNANCY
• SMOKERS
• ASTHMATICS
• CHRONIC DISEASE STATES
• ATOPIC INDIVIDUALS
Popula9on at Risk

26. • Allergy due to exposure to Fungal VOCs
OR
• Toxicity due to Mycotoxins exposure.
• General belief that removal of person
from mold-infested environment
alleviated condi9on

27. NOSOCOMIAL ASPERGILLOSIS
A RETROSPECTIVE REVIEW OF AIRBORNE DISEASE SECONDARY TO ROAD
CONSTRUCTION AND CONTAMINATED AIR CONDITIONERS
JOSEPH R. LENTINO1,, MARI ANN ROSENKRANZ1
American Journal of Epidemiology .2000, Vol. 116, No. 3: 430-437
Infec9on

28. Signs and symptoms
v Respiratory system – asthma and pnuemoni9s
v Impaired immune system func9on – toxicosis
v Severe headaches, chronic fa9gue, muscle pain
v Skin irrita9on and derma99s
v Cold and flu-like symptoms

30. Control of Indoor Env. Pollu9on
General Prac9ces
Source
Management
Contaminant
Control
Improved
Ventilation
1) Source exclusion
2) Removal
3) Treatment
1)Natural
2)Mechanical

31. Elements of Effec9ve Mold Remedia9on
Program
Mold
Assessment
Protocol
Mold &
Moisture
Survey
Mold
Tes9ng &
Inves9ga9on
Remedia9on
Program
Post
Remedia9on
Verifica9on

32. Phase A: Mold and Moisture Survey
• Mold & Moisture Survey should be a non-invasive
physical survey of all accessible areas in order to
iden9fy poten9al mold and moisture problems. It
should be done by highly trained specialists that
are trained to gather data using tools including:
• Fact Gathering
• Visual Inspec9on of Accessible Areas
• Non invasive procedures

33. Mold Inspec9on
• An inves9ga9on for mold growth begins with an
inspec9on for visible mold growth
• If there is no visible mold immediately no9ceable,
an inspec9on for signs of water damage is
completed and areas with possible moisture
sources are inspected

34. • Molds can be found almost
anywhere; they can grow on
virtually any substance,
providing moisture is present.
Mold Inspec9on

35. Signs of Mold Growth or Water Damage

40. Non-Invasive measurment
• FLIR - Thermal
Imaging and Infra-
red Cameras
scanning
• Non invasive wall
Moisture meter
Moisture Measurement

41. Invasive measurement
• 50% of mold problems may
be hidden from view
• Concealed problems within
wall cavi9es, ducts, beneath
carpets and 9les etc.
• Holes can be cut for visual
inspec9on, air samples,
moisture meter probes
Moisture Problems Difficult to Find

42. Phase B: Mold Tes9ng and Inves9ga9on
• To inves9gate poten9al areas of concern revealed
during the Phase A Survey,
• Evaluate the extent of the mold problem if one is
found
• Iden9fy the underlying moisture problem

43. • Primarily to determine fungi iden99es and
concentra9on in biological aerosols
• Requires an understanding of what is being
measured and a full descrip9on of the
circumstances during sampling

44. Air samples
• Viable or “Culture-based”
– Employs the use of an Andersen (or similar)
sampler
– Results usually reported as “colony forming units
per cubic meter of air” (CFU/m3)
• Non-viable or “Non-culture-based”
– Employs the use of a spore trap sampler
– Results usually reported as “par9cles per cubic
meter of air” (par9cles/m3
) e.g. A-O- cell
cassejes
Types of Biological Samples

45. A.
B.
C.
A. Impactor sampler
B. Sieve impactor sampler (Anderson 6
stage)
C. Glass impinger sampler
D. A-O- cell sampler e.g. zofen
Types of Air Samplers
D.

48. Remedia9on and Abatement
• The key to mold control is moisture control
– Remember to address the source of the
moisture problem .
– Remember to check for high humidity and
condensa9on problems as well as actual water
leaks, maintenance issues, and HVAC system
problems
Phase C: Remedia9on Program

49. • Protect the health and safety of building
occupants and abatement workers
• Contractors should be using personal
protec9ve equipment and containment
as appropriate
Mold Cleanup safe prac9ces

51. • The purpose of a abatement should
be to mi9gate mold while preven9ng
human exposure and minimizing
damage to building materials and
furnishings
• All mold contamina9on must be
cleaned up
• Dead mold is s9ll allergenic and some
dead molds can be toxic
Mold Cleanup

52. • Due to the health risks of biocides it should be used
only as a last op9on for controlling fungal growth
indoors
• materials visibly colonized by mold should be
removed
• Nega9ve pressuriza9on is recommended for removal
of moldy materials with a surface area greater than
about 3m so that the flow of air is always from clean
areas into the loca9on where cleaning is occurring.
• Evacua9on of building occupants should also be
considered in large-scale fungal remedia9on.

53. • Porous materials such as paper fiber gypsum
board, ceiling 9les visually moldy should be
discarded
• non-porous materials as sheet metal, ceramic
9les, glass, etc., shows Mold growth is physically
removed by cleaning.
• Tap water with detergents or surfactants should
be effec9ve for most cleanings.

54. Phase D: Post Remedia9on Verifica9on
• At minimum, these quality assurance indicators
should be followed and documented:
• No visual and / or sensory evidence of mold contamina9on during
walkthrough of the building
• No visual and / or sensory evidence of mold contamina9on during
inspec9on of HVAC system
• Measurements of temp., humidity, CO2, and CO within
recognized guidelines / standards
• Acceptable results following sampling and analyses for mold