Indoor Mold, Toxigenic Fungi, andStachybotrys chartarum: Infectious Disease Perspective

Abstract

Damp buildings often have a moldy smell or obvious mold growth; some molds are human pathogens. This has caused concern regarding health effects of moldy indoor environments and has resulted in many studies of moisture- and mold-damaged buildings. Recently, there have been reports of severe illness as a result of indoor mold exposure, particularly due to Stachybotrys chartarum. While many authors describe a direct relationship between fungal contamination and illness, close examination of the literature reveals a confusing picture. Here, we review the evidence regarding indoor mold exposure and mycotoxicosis, with an emphasis on S. chartarum. We also examine possible end-organ effects, including pulmonary, immunologic, neurologic, and oncologic disorders. We discuss the Cleveland infant idiopathic pulmonary hemorrhage reports in detail, since they provided important impetus for concerns about Stachybotrys. Some valid concerns exist regarding the relationship between indoor mold exposure and human disease. Review of the literature reveals certain fungus-disease associations in humans, including ergotism (Claviceps species), alimentary toxic aleukia (Fusarium), and liver disease (Aspergillys). While many papers suggest a similar relationship between Stachybotrys and human disease, the studies nearly uniformly suffer from significant methodological flaws, making their findings inconclusive. As a result, we have not found well-substantiated supportive evidence of serious illness due to Stachybotrys exposure in the contemporary environment. To address issues of indoor mold-related illness, there is an urgent need for studies using objective markers of illness, relevant animal models, proper epidemiologic techniques, and examination of confounding factors

Trichothecene Mycotoxins Activate Inflammatory Response in Human Macrophages

“…This toxic mold has often been associated to the DBRI (1). Mycotoxins, especially the trichothecene mycotoxins it produces, are probably a reason behind the symptoms (1,47,48). Trichothecenes have immunoregulatory and cytotoxic effects on immune cells (28, 36, 49 -52).…”

Biomechanics of conidial dispersal in the toxic mold Stachybotrys chartarum

“…For example, species of Aspergillus and Penicillium produce heads of thousands of tiny, spherical, dry conidia. The morphology of S. chartarum conidia is an important consideration for researchers investigating putative mold-related illnesses because (i) the sticky clusters of spores appear poorly adapted for dispersal in air, and (ii) the individual conidia are too big for inhalation deep into the lung (Kuhn and Ghannoum 2003). The second issue is complicated by the recent discovery of tiny, highly-respirable particulates from colonies of S. chartarum (Brasel et al, 2005).…”

Moldy buildings, health of their occupantsand fungal prevention

“…Some epidemiological studies of damp buildings have focused on health risks from indoor exposure to toxic fungi and mycotoxins (6)(7)(8). Most of these studies have not considered assessment of such hazards in the outdoor environments (8).…”