1. Washington State DOH1 MOLDS WHY DO WE CARE?

2. Washington State DOH2 MOLDS F Health effects F Common molds F Testing for molds F Clean-up of moldy environments F Levels of concern

3. Washington State DOH3 HEALTH EFFECTS F Allergens F Toxic materials F Infections F Hypersensitivity Pneumonitis

4. Washington State DOH4 ALLERGENS F Asthma –Can be caused by spores, hyphal fragments and metabolites F Allergy –Sinusitis –Allergic Rhinitis –Conjuctivitis F Dermatitis

5. Washington State DOH5 TOXIC MATERIALS F Mycotoxins –Secondary metabolites not necessary for life functions –May be produced to gain ecological and reproductive advantage –Only well studied in animal ingestion situations

6. Washington State DOH6 TOXIC MATERIALS (con’t) F Volatile organic compounds –Primarily short chain alcohols and aldehydes –Associated with moldy, musty smell –Health effects of combinations not well studied in humans –May cause headache, dizziness, mucous membrane irritation

7. Washington State DOH7 INFECTIONS F Aspergillosis “ABPA” –Allergic bronchopulmonary aspergillosis F Candidiasis “thrush” common in babies F Histoplasmosis F Rare except in immune compromised individuals or in the case of aspergillosis in the asthmatic

8. Washington State DOH8 HYPERSENSITIVITY PNEUMONITIS F Susceptible individuals about two percent of the general population F Caused by exposure to many organic dusts F Can cause permanent lung damage and corresponding gas exchange impairment

9. Washington State DOH9 COMMON MOLDS F Most saprophytic decay organisms –Includes Penicillium, Aspergillis, Cladosporium, and Alternaria F Stachybotrys chartarum the poster child of toxic molds –Not associated with bleeding lung issues in infants –Very high water requirements

10. Washington State DOH10 TESTING FOR MOLDS F Bulk sampling –Visual identification may be difficult F Tape lifts –Visual identification difficult F Air sampling –Should include outdoor and indoor samples for relative comparison

11. Washington State DOH11 TESTING (con’t) –Should include viable and non-viable samples –May not capture full spectrum of particle sizes –May not capture robust viable sample –Need to know what to provide for growth media –May provide false negatives

12. Washington State DOH12 GUIDELINES F New York City guidelines for Stachybotrys clean-up Small isolated areas (10 sq.ft. or less) Mid sized isolated areas (10 to 30 sq.ft) Large isolated (30 to 100 sq.ft.) Extensive contamination (100 sq.ft. or more)

13. Washington State DOH13 CLEAN-UP OF MOLDS F Stop the water leaks F Determine the extent of growth F Isolate the affected area F Wear goggles, skin protection and breathing protection F Remove moldy materials F Bleach the molds at 1/4 cup of bleach per quart of water

14. Washington State DOH14 CLEAN-UP (con’t) F Bleach again and let dry F Rinse the affected area with a detergent rinse to remove allergens and toxins F Replace materials as needed F HEPA vacuum as needed

15. Washington State DOH15 LEVELS OF CONCERN F ACGIH outdoor levels routinely exceed 1,000 CFU/cubic meter –May exceed 10,000 CFU/cubic meter in the summer F Not uncommon to find 150 CFU/cubic meter in homes –500 CFU/cubic meter in the summer F Individual susceptibilities vary

16. Washington State DOH16 MOLDS MADE SIMPLE F Stop water leaks F Testing is ambiguous at best F If you see or smell molds it’s time to clean-up F Isolate the affected area F Remove moldy materials F Bleach at 1/4 cup per quart of water

17. Washington State DOH17 MOLDS MADE SIMPLE (con’t) F Rinse with detergent solution to remove allergens and toxins F Replace molded materials with new

18. Washington State DOH18 RESOURCES F www.doh.wa.gov/ehp/ts/iaq.htm www.doh.wa.gov/ehp/ts/iaq.htm F www.cmhc-schl.gc.ca/cmhc.html www.cmhc-schl.gc.ca/cmhc.html F www.epa.gov/iaq/molds/resources.html www.epa.gov/iaq/molds/resources.html F www.ci.nyc.ny.us/health www.ci.nyc.ny.us/health F DOH (360) 236-3363 F EPA (206) 553-2589

19. Washington State DOH19 MOLDS F Questions