World Health Organization says mold is a health hazard. That ends the argument IMHO.

[James H. Bushart]

Originally Posted by mlarson

Do you understand the words potential and may?

As has been said, the evidence is not conclusive at this point in time.

Mike....I gotta tell you.....you are beginning to sound a lot like a CEO from R.J. Reynolds in a congressional hearing. Offer contradicting evidence if you have any.

[Michael Larson]

Originally Posted by jbushart

Mike....I gotta tell you.....you are beginning to sound a lot like a CEO from R.J. Reynolds in a congressional hearing. Offer contradicting evidence if you have any.

I did Jim. Did you read it?

[Nick Gromicko]

Let me ask you a question... if the World Health Organization, in it's summary where they painfully associate mold and health over and over and over, mentions causation ONLY ONCE in their ENTIRE SUMMARY... why should we emphasize it to any greater degree?

[Michael Larson]

Originally Posted by gromicko

Let me ask you a question... if the World Health Organization, in it's summary where they painfully associate mold and health over and over and over, mentions causation ONLY ONCE in their ENTIRE SUMMARY... why should we emphasize it to any greater degree?

I have read the executive summary for a third time.

The main point that I see over and over concerns itself with the level of dampness not mould/mold.

Organic growth is secondary.

BTW-Neither Nick or myself is qualified to fully understand the meaning of the WHO document.

Nick only response to asking for a debate of the issue is in so many words:

I Nick am right and Mr. Connell is wrong.

Each home inspector has to decide if if will offer mold testing and receive adequate training to do so.

We do ourselves and our customers a disservice to simply ridicule someone who does not agree with Nick and what he perceives the WHO position to be.

[rbibler]

So we just keep testing and advising buyers with bad information on mould in there homes.

Every house wife that cleans the bathroom shower wall tiles, should have this areas tested for mould infection as it may be TOXIC.

Over kill. This only plays into the hands of law firms. For get the WHO. Paper and just put some common scenes on the issue.

What info do you get out of testing with these mould kits? Every bit of the information that comes back is providing useless information to buyers.

They don't understand these reports. and not a one of them can provide an exact count.

Its junk Science. And its being sold to unsuspecting home buyers.

Look Mr home buyer you have a plumbing leak under the sink and the sheet rock is wet and has some black stuff on it. you should fix that leak and replace that dead wet sheet rock. Have a nice day...

NO relationship between mold and adverse health effects.

One can make this WHO paper say what ever one wants it to say but thats not a good thing.

Best

Ron

[Joe Farsetta]

Nick,

As soon as IAC2 distances itself from a testing lab, it will gain credibility. Again, I speak with some knowledge of mold. The fact that the person sitting 100 feet from me is a true CIH, who wrote standards on testing and remediation used nearly everywhere ads a bit of credibility to what I say.

It matters not the size of the org, but the credibility and power it yeilds; and not to the standard of members or revenue, but in scientific fact.

Not being unfair, I just returned from my friend's office and asked his opinion on taking multiple outdoor samples. He laughed.

By the way, I'd say that infestion control and how it related to mold is pretty inter-related. I am working on multiple projects involving a migration to recirculated air in certain clean environments. Its no joke. But, as long as "standards" are developed based on a premise that is, indeed, at odds with those with the pedigree to have meaningful input, you can say what you want...

It is meaningless.

[Nick Gromicko]

That "laugh" is not a well-formed argument to support the conclusion that IAC2's SOP requirement of 2 outdoor standards is at odds with any standard that requires 1 outdoor standard.... anymore than a "laugh" could be considered a well-formed argument that supports the conclusion that a square is not a rectangle.

My position is supported by the world's largest indoor air association, the world's largest laboratory, the nation's leading mycologist, numerous mold professionals who have recently switched from taking 1 outdoor sample to 2, and a repeatable experiment that anyone can try at home and verify for themselves. Your position is supported by someone nameless who has the giggles.

[Nick Gromicko]

Joe, why have you gone for days now without revealing what your giggly, nameless expert says is the correct number of outdoor samples to take?

If he says "3 is the correct number" will you also consider him to be "at odds" with the rest of the world who thinks either 1 or 2 is fine?

[Nick Gromicko]

From www.EPA.gov

Note that the root word of "causation" is "cause."

Can mold cause health problems?

Molds are usually not a problem indoors, unless mold spores land on a wet or damp spot and begin growing. Molds have the potential to cause health problems. Molds produce allergens (substances that can cause allergic reactions), irritants, and in some cases, potentially toxic substances (mycotoxins). Inhaling or touching mold or mold spores may cause allergic reactions in sensitive individuals. Allergic responses include hay fever-type symptoms, such as sneezing, runny nose, red eyes, and skin rash (dermatitis). Allergic reactions to mold are common. They can be immediate or delayed. Molds can also cause asthma attacks in people with asthma who are allergic to mold. In addition, mold exposure can irritate the eyes, skin, nose, throat, and lungs of both mold-allergic and non-allergic people. Symptoms other than the allergic and irritant types are not commonly reported as a result of inhaling mold. Research on mold and health effects is ongoing. This brochure provides a brief overview; it does not describe all potential health effects related to mold exposure. For more detailed information consult a health professional. You may also wish to consult your state or local health department.

[Joe Farsetta]

1 sample. And he is not the only one. I submit the following published article, where the bibliography is attached. One CIH/ICP is quoted as stating that 10 samples are taken per week, with 2 of them being control samples, and only one of the two is taken outdoors.

It also lists chemicals used for killing one particular species of mold, and its PROVEN adverse effect on humans.

So, as I stated, the WDO is primarily a political body, disguising itself as something else.

Here's the article. It links aspergillius in dust to air handlers, construction, and death in several hospitals in the US. It involved CIH, infection control professionals, and the CDC. It established protocols for controlling the problem. I submit that there is vital information contained therein which spreads valuable light on some myths. It's light reading...

Like I have said, I ain't no mold-is-gold kinda guy. But to say there is no link between some species of mold and adverse health effects is reckless.

A deadly dust may be in the wind during renovations
Work with construction crews to reduce risks to patients
Infection control practitioners at hospitals undergoing construction or renovation should ensure adequate air quality precautions are in place and strictly enforced to prevent deadly outbreaks of aspergillosis, advise ICP's who have investigated recent outbreaks.
Hospital construction and renovation projects pose particular risk to immunocompromised patients who may inhale airborne dust particles that can carry fungal spores that cause aspergillosis. The federal Centers for Disease Control and Prevention in Atlanta warns that construction increases the risk of aspergillosis, and the agency recommends using special airflow and air filtration systems to keep fungal spores down in bonemarrow transplant patient rooms. (CDC Guidelines included later in article)
But ICP's who have dealt with outbreaks have gone even further by working directly with construction crews to set up barriers, to redirect or block air intake systems from construction sites, and to restrict the movements of workers between construction and patient care areas. (Construction specifications included later in article)
Lorie Lerner-DurJava, RN, MSN, CIC, director of infection control, employee health, and safety at Children's Hospital Medical Centre of Akron (Ohio), says her facility limits access of workers to patient areas and had workers install ceiling-to-floor partitions to contain dust and debris.
Deaths - despite aggressive control measures
Despite implementation of the control measures, a patient was diagnosed with aspergillosis in January 1994, she says. A retrospective review uncovered other cases of nosocomial aspergillosis that had occurred since June 1993. The patients were from different areas of the hospital including the burn unit, the dialysis unit, and oncology. There were no common factors between them such as age, diagnosis or type of surgery. Three of the patients died. The demolition activity occurred and within 3 days they were diagnosed and that air handler directly connects the patient area to the construction area. Investigating the air-handling system at the hospital, she found that air intake vents in each of the nursing units the patients were housed in had not been covered during demolition.
Air-sampling testing done during construction indicated that any projects involving the removal of ceiling tiles were particularly likely to spread Aspergillus, she adds. "The aspergillus lives up there on top of those ceiling tiles," she explains. "It doesn't cause problems until you disrupt them, but when you start moving them around in that air space between the false ceiling and the cement ceiling, that's where the contaminated air will get picked up and recirculated.
Air testing indicated that negative air flow had to be used in construction areas at all times; otherwise, when any door was opened from the construction site into the hospital, Aspergillus would enter the hospital.
In addition, she tests air in areas that she anticipates could be problematic. Turner obtains 10 samples a week, 2 of which are control samples from outside and inside air.
"That makes a dent with my administrators," she explains. "When they say Aspergillus samples are nothing to worry about because they're from outside air, I can tell them there was no Aspergillus outside and that the contamination did happen indoors from construction."
Outbreak among surgery patients
At University Hospital in Hershey, PA, Mary Ann Bordner, MS, CIC, infection control specialist, says there were 3 patients who developed invasive Aspergillus fumigatus infections in March of 1992. All had undergone cardiothoracic surgery, and all died. When investigating the outbreak, Bordner found that the surgeries had taken place in 2 adjoining OR rooms that shared the same air-handling system. Two construction projects were going on near the operating rooms. Bordner says she cultured the air and environment in the OR, the construction area, and the air ducts supplying the rooms in question, and then had those air ducts cleaned. The same weekend the ducts were cleaned, another case of aspergillosis was identified that had been done in another OR with a different air-handling system.
" In addition, soon afterward, nonsterile latex gloves that had been used in the OR were found to have black moldy-looking growth on them. The cultures of the mold on the gloves grew A. fumigatus, the same type of Aspergillus infecting the patients.
Restriction endonuclease analysis (REA) testing on the Aspergillus strains from the gloves and the air and environment in the OR and the construction areas indicated there were heavy loads of Aspergillus in the construction areas, but very light loads in the OR air. But none of the strains from the gloves or from the construction site or the OR matched the strains from the infected patients. In addition, Bordner found out that the contaminated lots of gloves had not entered the hospital until after the patients had acquired their infections.
Aspergillus may have entered the OR via health care workers who carried it on their shoes after going through the construction areas, she suggests. Or, when the back entrance to the OR was open, the other door that led to the construction area may have been open as well, and a gust of wind could have blown the spores into the OR. Heavy demolition had been taking place prior to the patient's infections, which exacerbated the problem, Bordner adds.
Air is apparent, but water also can be a source
Keep in mind that not all aspergillus contamination is in the air. Water can act as a reservoir for the fungus, as well. During a construction project last year at the University of Minnesota Hospital in Minneapolis, a building contractor accidentally punched a hole in the roof and flooded a patient ward, says Andrew Streifel, MPH, hospital environmentalist.
"It stayed wet for about a week," he says. "It takes from 5 - 7 days for a good Aspergillus colony to set up. We found a lot of wet spots throughout the building afterward. Behind those wet spots there was mold growth, and in some places, there was pure Aspergillus fumigatus."
Cleanup included decontaminating the area with copper-8-quinolinolate, a chemical agent that kills Aspergillus on environmental surfaces.
When obvious wet places or molds are found, don't jump on it like a bull in a china shop, because then you disrupt this incredible reservoir of fungal spores that then move around the building," he warns.
Instead he advises decontaminating the area first with either bleach or copper-8-quinolinolate. Streifel says he prefers the latter.
"The reason I like it is it protects from future leaks and act as a preservative," he notes. "We've actually incorporated it into our structural steel insulation for our building."
If ICP's notice any wet spots in the hospital environment - especially wet ceiling tiles - the source of the leak should be investigated promptly and spills should be wiped up right away, he says.
It's very naive to think that buildings don't leak." Streifel says. "And once you put water together with anything made of cellulose - bingo - mold is everywhere."
Reference

1. Centers for Disease Control and Prevention's Hospital
   
   Infection Control Practices Advisory Committee. Guideline for Prevention of Nosocomial Pneumonia. Infect Control Hosp Epidemiol 1994; 15:587-627

One aspergillosis case should prompt inquiry Clinicians caring for high-risk patients beware
A single case of aspergillus pneumonia often is difficult to link to a specific environmental exposure, but without an active search, additional cases may go undetected, warns the federal Centers for Disease Control and Prevention in Atlanta.
The major extrinsic risk factor for opportunistic, invasive aspergillus infection is the presence of aspergilli in the hospital environment, especially from environmental disturbances during construction or renovation. Other less common causes of outbreaks in high-risk, immunosuppressed patients include bird droppings in air ducts and contaminated fireproofing material.
According to the CDC, an investigation for aspergillosis should include the following:

• an intensive retrospective review of microbiologic, histopathologic, and postmortem records for other cases;
• alerting clinicians caring for high-risk patients to the possibility of infection;
• establishing a system for prospective surveillance for additional cases.

If additional cases are detected, it is likely that an environmental source for aspergillus can be identified, especially from contamination of air-handling systems during construction projects.
According to the CDC, the protected environment for BMT patients usually includes the following:

• high efficiency particulate air (HEPA) filtration that is 99.97% efficient in filtering 0.3 micron-sized particles from incoming air, either centrally or at point of use;
• positive air pressure in the room relative to the corridor;
• well-sealed rooms;
• high rates of room-air exchanges (a minimum of 15 exchanges per hour).

The number of room-air changes necessary to prevent aspergillosis is unclear, but one study found that lower air-change rates of only 10 to 15 per hour kept cases of nosocomial aspergillosis at a low rate of 3.4%.
The most effective way to keep air clean in patients' rooms is to use laminar airflow, which consists of a bank of HEPA filters along an entire wall of the room that pump air into the room at a uniform velocity. Such systems make the air virtually sterile. Laminar airflow systems, however, are expensive to install and maintain, and further studies are needed comparing their efficacy at preventing aspergillosis with more traditional air-filtration measures.
Using the chemical agent copper-8-quinolinolate on environmental surfaces contaminated with Aspergillus also has been used as a control measure, but whether it should be used routinely has not yet been established.
References:

1. Centers for Disease Control and Prevention's Hospital Infection Control Practices Advisory Committee. Guideline for Prevention of Nosocomial Pneumonia. Infect Control Hosp Epidemiol 1994; 15;587-627
2. Streifel AJ, Vesley D, Rhame FS, et al. Control of air-borne fungal spores in a university hospital. Environment International 1989; 12:441-444.
3. Rhame FS. Nosocomial aspergillosis: how much protection for which patients? Infect Control Hosp Epidemiol 1989; 10:296-298

One last thing... please note the CDC guidelines for an aspergillius investigation. Keep in mind that this is a hospital environment, and we are dealing with houses, condos, and such... there is no mention of sampling in the guideline.

[Joe Farsetta]

According to my CIH friend, the breakdown comes in true causal effect. That is, the mere presence of any form of mold, in any quantity, does not guarantee anything to one exposed to it. Therein lies the breakdown the WDO mentions. Therein lies the breakdown, period.

This is why the EPA does not recommend testing.

Even in the article I presented above, it is more of a CYA thing. The fact is that immunocomprimised patients are exposed to a variety of molds inside and outside the hospital, and they arent killed from it. So, the causal effect, and levels of exposure, are fairly meaningless from a scientific standpoint.

As to sample quantities outdoors, and more specifically the concept of upwind and downwind... the question is upwind or downwind of WHAT. It's not like samples are being taken at a superfund site, by a spill of tolulyne.

For upwind and downwind samples to be meaningful, there needs to be a reason to take them, and something to refer to. In the case of a single-family house, these samples are meaningless.

[Michael Larson]

Originally Posted by gromicko

From www.EPA.gov

Note that the root word of "causation" is "cause."

Live by the sword, die by the sword.

EPA and Mold Sampling

Is sampling for mold needed? Usually, if the mold can be seen, sampling is unnecessary. After finding mold, the goal is to clean it up and fix the underlying water problem. Unless the results would or could make a change in your plans, you don't need to sample. Under certain circumstances, such as when litigation is involved, the source of the mold is unclear, or health concerns are a problem, you may consider sampling as part of your site evaluation. However, routine sampling for mold is not recommended. Keep in mind that the goal of mold remediation is to find the source of the water problem, fix it, and clean up the mold.



Let's bring in the experts to debate the WHO findings.

[Nick Gromicko]

How is that dying by the sword? I agree with the EPA. The EPA and WHO have it dead on right.

[Michael Larson]

Originally Posted by gromicko

How is that dying by the sword? I agree with the EPA. The EPA and WHO have it dead on right.

You're telling us that you do not promote mold sampling?

[Joe Farsetta]

If the mold can be seen, sampling is unnecessary.

Unless the results would or could make a change in your plans, you don't need to sample.

Under certain circumstances, such as when the source of the mold is unclear, you may consider sampling as part of your site evaluation.

This is what the EPA states...