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CDC, IOM Damp Indoor Spaces, Mold Associated Illnesses

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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)

____________________________________

_Air Pollution and Respiratory Health_

(http://www.cdc.gov/nceh/airpollution/default.htm) _Environmental Public

Health Tracking_

(http://www.cdc.gov/nceh/tracking) _Asthma_

(http://www.cdc.gov/asthma/default.htm) _Health

Studies_ (http://www.cdc.gov/nceh/hsb/) _Division of Laboratory Sciences_

(http://www.cdc.gov/nceh/dls) _Mold_

(http://www.cdc.gov/nceh/airpollution/mold/default.htm) _Emergency and

Environmental Health Services_

(http://www.cdc.gov/nceh/divisions/eehs.htm) _Radiation Studies_

(http://www.cdc.gov/nceh/radiation/default.htm)

_U.S.-Mexico Border Environmental

Health_ (http://www.cdc.gov/nceh/hsb/borders.htm) _Environmental

Hazards and Health Effects_ (http://www.cdc.gov/nceh/ehhe/default.htm)

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(http://www.cdc.gov/health/diseases.htm)

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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