Markku Seuri, FIOH, MOULDY HOUSE PROBLEM Tartu

Markku Seuri, FIOH, DEFINITIONS  mould = microbes and their (toxic) products in moisture and water damaged building materials  mouldy house = a building partly damaged by moisture and microbial growth  damages can be visible or within building structures

Markku Seuri, FIOH, THE MAIN DIFFICULTY  the exposure is not known  several candidates: – spores – toxins – microbial volatile organic compounds – microbes themselves – structures of microbes – allergens

Markku Seuri, FIOH, LIVING EXPOSURE  the exposure changes over time  the microbes change: –material –type of damage –degree of moisture – temperature – nutrition –selection of species in time  the health effects change

Markku Seuri, FIOH, SPORES  commonly measured and expressed as colony forming units (cfu) per cubic meter of air, gram of material  poor relation to the health effects  one has to consider to microbial species, no only the amount  measure of the damage, not of the health effects or the risk

Markku Seuri, FIOH, MICROBIAL ALLERGENS  mould allergens exist, but most of the health effects are not IgE related allergies  fungal allergens are commonly essential enzymes in the fungus  similarities between the allergens of different species

Markku Seuri, FIOH, STRUCTURES OF MICROBIAL WALL  beeta-glucans of fungi  endotoxin of gram negative bacteria  rarely seen in the air of mouldy houses  can be a problem in renovation  can cause irritation of respiratory tract  not a probable cause of health effects

Markku Seuri, FIOH, MICROBIAL VOLATILE ORGANIC COMPOUNDS  do MVOCs exist? –MVOCs are released also from moistened materials without microbial growth –a measure of moisture damage on materials  not capable of producing irritation in the concentrations seen in mouldy houses

Markku Seuri, FIOH, MICROBIAL TOXINS  their role in causing health effects in mouldy houses controversial  good potential cause: –various health effects - many toxins –potential (ng/g -level) –most difficult health effects are seen in old damages - selection of species in time  no way to measure small quantities (at the moment)

Markku Seuri, FIOH, MICROBES THEMSELVES  not fungi commonly found in mould damages  only less than 10% of the microbial growth of any environmental sample can be named  interest in two groups: –slowly growing mycobacteria –microbes living with in amoeba

Markku Seuri, FIOH, AMOEBA AND LEGIONELLOSIS  Legionella is intracellular bacteria  found in natural and man-made water systems  multiplies in degrees of C (32-40 ideal)  survives in the environment within amoeba  can be an occupational diseases, for instance in work place showers  an epidemic in a Finnish hospital has been found

Markku Seuri, FIOH, AMOEBA SHELTER OTHER BACTERIA  over 40 bacteria have been found within amoebae  including Chlamydia pneumoniae  we have found amoebae in damaged building material samples (in about one fifth of samples sent to our laboratories in Kuopio)

Markku Seuri, FIOH, MOULD DAMAGES AND IMMUNOCOMPROMISED PATIENTS  Aspergillus spp have caused infections in hospitals, even fatal case  at the moment there is no evidence that the fungi in the mouldy buildings could cause diseases to health inhabitants

Markku Seuri, FIOH, SYMPTOMS AND DISEASES FOUND IN MOULDY BUILDINGS  irritation  “toxic” or “general” symptoms  increased number of respiratory infections  diseases

Markku Seuri, FIOH, IRRITATION SYMPTOMS  respiratory tract: –commonly the higher, rarely the lower  irritation of the eyes  irritation of the skin  the most common symptoms  transient  usually relieves in a few days

Markku Seuri, FIOH, “TOXIC” OR “GENERAL” SYMPTOMS  symptoms like: –headache –tiredness –aching muscles and joints –fever and chills  transient  may need a week or two to be relieved

Markku Seuri, FIOH, RESPIRATORY INFECTIONS  normal flues  sinusitis  the incidence is higher in mouldy houses  some toxins restrain the cilial movement in the respiratory tract in vitro

Markku Seuri, FIOH, DISEASES 1  asthma is the most common  mechanism is not known  most asthma cases seen in mouldy houses are not allergic  the risk of asthma is about two in the mouldy houses, but the risk is not divided evenly among them

Markku Seuri, FIOH, DISEASES 2  allergic rhinitis have been shown  some clusters of inflammatory rheumatic diseases have been published –the causal link not established –the risk of these diseases seen rarely