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----- Original Message -----
From: snk1955@...
Sent: Monday, May 16, 2005 2:21 PM
Subject: [sickbuildings] CDC, IOM Damp Indoor Spaces, Mold Associated Illnesses
Summary of Institute of Medicine's Damp Indoor Spaces and Health Review
(2004)
Evidence of Association
Table 1: Association between Damp Indoor Environments and Mold Health
Outcomes
Health outcome or symptom Exposure to damp indoor environments Presence of
mold/other agents in damp indoor environments Upper respiratory tract
symptoms_1_ (http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#1) Sufficient
evidence of an association_7_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#7) Cough_2_ (http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#2)
Sufficient evidence of an association Wheeze_2_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#2) Sufficient evidence of an association Asthma
symptoms in sensitized persons with asthma Sufficient evidence of an
association Hypersensitivity pneumonitis_3_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#3) in susceptible persons Studied in relation to specific
agents Sufficient evidence of an association Shortness of breath (dyspnea)_2_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#2) Limited or
suggestive evidence_8_ (http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#8)
Inadequate or insufficient evidence_9_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#9) Respiratory illness in otherwise healthy children Limited or
suggestive evidence Respiratory illness in otherwise healthy adults Inadequate
or insufficient evidence _Acute idiopathic pulmonary hemorrhage in infants_
(http://www.cdc.gov/nceh/airpollution/mold/AIPHIcasedef.htm) Inadequate or
insufficient evidence Fungal sinusitis_4_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#4) No specific studies associated the condition with damp
or moldy indoor spaces Severe respiratory infections in people whose
immune system is severely immunocompromised_5_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#5) Not applicable_10_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#10) Sufficient evidence of an association
Fungus-related illnesses in people whose immune system is severely immunocompromised_5_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#5) and who have
_chronic obstructive pulmonary disease (COPD)_
(http://www.cdc.gov/nceh/airpollution/copd/default.htm) Not applicable_10_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#10) Sufficient evidence of an association Colonization and
potential lung infection in people with some chronic pulmonary disorders_6_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#6) Not applicable_10_
(http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#10) Sufficient evidence
of an association
Notes:
1. Upper respiratory tract symptoms include nasal congestion, rhinitis,
allergic rhinitis “hay fever", sneezing, runny or itchy nose, sinusitis and
sore throat.
2. Lower respiratory tract symptoms include cough with or without
production of phlegm, wheeze, chest tightness, and shortness of breath.
3. Hypersensitivity pneumonitis is a lung disease that is the result of
exposure and sensitization to antigens inhaled with a variety of organic
dusts. Symptoms include dry cough, dyspnea, and fever and sometimes acute
bronchospasm.
4. Fungal sinusitis is associated with molds but molds may come from
the indoor or the outdoor environment.
5. Immunocompromised persons are at increased risk for fungal
colonization or opportunistic infections.
* It is well established that fungal exposures causes opportunistic
cutaneous and subcutaneous fungal infections of the skin of severely
immunocompromised persons.
* Respiratory infections can result from exposure to fungi, including
Aspergillus spp. and Fusarium spp.
* Severely immunocompromised persons include persons who undergo
high-dose cancer chemotherapy, are recent recipients of a solid-organ transplant,
or are otherwise immunocompromised.
6. Chronic pulmonary disorders include cystic fibrosis, asthma, and
COPD. Colonization and infections result from exposure to fungi such as
Aspergillus.
7. "Sufficient evidence of an association" means that studies show an
association between the agent and disease and chance, bias, and confounding
were ruled out with reasonable confidence.
8. "Limited or suggestive evidence of an association" means that
evidence is suggestive of an association between the agent and the disease but is
limited because chance, bias, and confounding cannot be ruled out with
confidence.
9. "Inadequate or insufficient evidence to determine whether an
association exists" means that the available studies are of insufficient quality,
consistency, or statistical power to permit a conclusion regarding the presence
of an association. Alternatively, no studies exist that examine the
relationship.
10. Respiratory infections, fungus-related illnesses, and colonization
with lung infection relating to specific organisms.
Source:
Institute of Medicine’s "_Damp Indoor Spaces and Health_
(http://www.nap.edu/books/0309091934/html/) " (_http://www.nap.edu/books/0309091934/html/_
(http://www.nap.edu/books/0309091934/html/) ).
_top_ (http://www.cdc.gov/nceh/airpollution/mold/iom_sum.htm#top)
____________________________________
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This page last reviewed March 03, 2005
Air Pollution and Respiratory Health Branch
National Center for Environmental Health
Centers for Disease Control and Prevention
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