1. Sandler Occupational Medicine Associates © 2008 Current Mold Issues & Evaluation Anne M. Stumpf CSP, CIH, MS Sandler Occupational Medicine Associates, Inc. January 07, 2008

2. Sandler Occupational Medicine Associates © 2008 Confusing issues No documentation of universal adverse health effects related to exposure to mold No established standards to measure individuals’ exposure No true definition of “toxic” mold No universally accepted standard procedures for sampling of or testing for mold in the indoor environment No clear “standards of care” for mold assessment and remediation work No established qualifications for mold “experts” (e.g., training, education, experience) Media hype and legal issues

3. Sandler Occupational Medicine Associates © 2008 Questions To Be Addressed What is mold? Why are we concerned with mold? What is the Toxicity of mold? How does mold get inside buildings? How can I prevent mold growth? How do I remediate mold? How and when to test for mold?

4. Sandler Occupational Medicine Associates © 2008 What is Mold? Forms of fungi found year around both inside & outside Thousands of species of mold each with unique growth patterns Produce spores that act like seeds to promote more colonies Encouraged by warm, humid and moist conditions Common term of mildew Naturally occurring and plentiful

5. Sandler Occupational Medicine Associates © 2008 Common species of mold Cladosporium Penicillium Alternaria Aspergillis

6. Sandler Occupational Medicine Associates © 2008 Why are we concerned with mold? Small amounts are not a major concern as most places have some mold In some inside environments mold is amplified Large amounts can cause health effects in certain individuals Produces nuisance odors Can damage building materials

7. Sandler Occupational Medicine Associates © 2008 What is the Toxicity of Mold? Most people have no reaction to mold Some people have allergic reactions Irritation to eyes and respiratory system Most symptoms are temporary and are eliminated by correcting the mold problem

8. Sandler Occupational Medicine Associates © 2008 Mold Health Effects Allergies are most common reaction to contact with molds.Symptoms include: rhinitis, asthma and dermatitis Infection may occur in susceptible persons (compromised immune systems). Molds implicated include: Aspergillus fumigatus, Coccidioides, Histoplasma, and Blastomyces Reaction to mold odors: headache, nasal stuffiness, nausea or even vomiting.

9. Sandler Occupational Medicine Associates © 2008 Other reported symptoms Respiratory problems---wheezing, difficulty in breathing Nasal and sinus congestion Eyes-burning, watery, reddened, blurry vision, light sensitivity Dry, hacking cough Sore throat Nose and throat irritation Shortness of breath and lung disease Chronic fatigue and immune system suppression Skin irritation Central nervous system problems (constant headaches, loss of memory, and mood changes) Aches,pains, fever, headaches and diarrhea

10. Sandler Occupational Medicine Associates © 2008 Who May Be Affected Wide variability in how mold affects individuals Some people who may be more susceptible to health effects Infants & children Elderly Pregnant woman Individuals with respiratory illnesses like asthma, allergies People with weakened immune systems

11. Sandler Occupational Medicine Associates © 2008 Can Mold Be toxic Some molds produce toxic substances called mycotoxins Airborne mycotoxins have not been shown to cause health problems in occupants of commercial buildings & residences Some association with agricultural work with high chronic exposures “Toxic Black Mold” refers to Stachybotrys chartum typically associated with heavy water damage

12. Sandler Occupational Medicine Associates © 2008 How Does Mold Get inside Buildings Construction materials Materials, Furnishings, plants Tracked in – dirt Air infiltration

13. Sandler Occupational Medicine Associates © 2008 Common sources of water that supports mold growth Condensation Water intrusion, diffusion High Humidity Water damage to materials Leaks (i.e. plumbing, roof, slab, gutters, windows) Excessive use of water for cleaning

14. Sandler Occupational Medicine Associates © 2008 How Can I prevent Mold Growth Control Moisture Keep humidity levels between 40%-60% Use an air conditioner or dehumidifier Use adequate ventilation such as exhaust fans Repair water leaks or intrusions promptly Dry out wet materials & carpeting immediately. (48 hours rule) Maintain positive pressure in buildings Don’t keep buildings too cool

15. Sandler Occupational Medicine Associates © 2008 Information to assess Mold Complaints Location of the water intrusion Materials affected –carpet, wallboard Length of time of water intrusion or problem What has already been done to address water intrusion or odor (i.e. cleaners, removal of materials, etc.) Description of mold visible growth or odors (hidden behind or within)

16. Sandler Occupational Medicine Associates © 2008 How To Remediate Mold First – Repair water intrusion problem Remove wet building materials HEPA Vacuum dry surfaces Use de humidifiers Can use bleach solution to clean non- porous surfaces Do not try to dry carpet with A/C

17. Sandler Occupational Medicine Associates © 2008 When & How to Test for Mold Surface/ bulk samples Spore traps (non-viable) Cultured samples (Viable) Clearance samples –if previous sampling has already been conducted. No set standards for testing and no “”safe” limits established Moisture readings < 10% Sampling is not recommended if mold is visibly present

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19. Sample Results No established limits Compare inside to outside Identify similar species Varies with seasons & time of day

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33. Conclusion Prevent excessive moisture Stop water intrusion/source Gather as much history as possible regarding intrusion & complaints Remove damaged materials Conduct follow-up investigations or remediation to confirm that water intrusion has been eliminated

34. Sandler Occupational Medicine Associates © 2008 Additional Resources www.aiha.org www.cdc.gov www.epa.gov www.osha.gov www.niosh.gov www.acgih.org

35. Sandler Occupational Medicine Associates © 2008 Thank You For Your Interest “We invite you to visit our newly designed website at www.somaonline.com!”