Re: World Health Organization Guide of Dampness and Mould, pdf

[Guest guest]

I sent the following response to the WHO. If you would like to have a copy of

the list of articles I attached to my letter, please go to:

http://truthaboutmold.info/world_health_organization

October 7, 2009

The 2009 WHO " Guidelines for Indoor Air Quality--Dampness and Mould " is an

excellent report. The report is making a significant difference in the

international understanding of the health effects of moulds and mycotoxins. It

is specifically noted that the WHO did an outstanding job of highlighting the

immunological effects.

As I mentioned in my previous communication, there are several additional

publications that were not included in the literature review for the WHO report.

There are also several items that were excluded from the IOM review when they

prepared their 2004 report on " Damp Indoor Spaces and Health. " I appreciate

your invitation to provide a list of additional literature items for your

consideration. As you are aware, there are thousands of publications on this

topic. The attached lists are not intended to consist of all possible

documents, but I hope you find it helpful and hope it leads you to additional

sources of information.

I would like to provide a few brief comments:

1. There are two files attached. The first file includes literature items that

were published prior to the WHO cutoff date of June 2007 and prior to the IOM

cutoff date of 2003. The second file has a few select items that have been

published since July 2007. I included only a few of the newer items because I

am sure you will do an extensive search when you are ready to update your

report.

2. I included the report by Etzel et al titled " Acute Pulmonary Hemorrhage in

Infants Associated with Exposure to Stachybotrys atra and Other Fungi. " On page

81 of the WHO 2009 Guidelines for Indoor Air Quality, it states that this 1998

report by Etzel et al had been retracted. That statement is incorrect. Per Dr.

Etzel, this report has not been retracted.

3. There are certain stakeholders who try to confuse this issue by claiming that

molds and mycotoxins are only harmful if ingested (not inhaled or touched). This

is simply a marketing ploy and is not valid. Molds and mycotoxins are harmful

to humans whether exposure is by " ingestion, inhalation, skin and mucosal

exposure, or by a combination of two or more of these routes. " The following

items represent a few examples where this issue is addressed.

a. From page 96 of the " U.S. Army Medical Management of Biological Casualties. "

" Exposure causes skin pain, pruritis, redness, vesiculation, necrosis, and

sloughing of the epidermis. Effects on the airway include nose and throat pain,

nasal discharge, itching and sneezing, cough, dyspnea, wheezing, chest pain, and

hemoptysis. Toxin also produces similar effects after ingestion or eye contact.

Severe intoxication results in prostration, weakness, ataxia, collapse, shock,

and death. "

b. The following quote is from page 284 of the 2006 paper titled, " What the

Primary Care Pediatrician Should Know about Syndromes Associated with Exposures

to Mycotoxins " (by Etzel RA).

" Mycotoxins can have protean manifestations; the symptoms depend on the specific

toxin or mixture of toxins, the age, sex, and diet of the child, the dose, and

whether exposure is by ingestion, inhalation, skin and mucosal exposure, or a

combination of two or more of these routes. The most well-characterized

presentations among infants and children are summarized in Table 2 under four

headings: vomiting illness, bone marrow failure, acute pulmonary hemorrhage, and

recurrent episodes of apnea and/or pneumonia. "

c. Another good source is the ACGIH book (published in 1999) titled

" Bioaerosols: Assessment and Control. " This book has a lot of information about

the health effects of mycotoxins including the chart of health effects from

" ingestion, dermal, or inhalation exposure " on page 24-3.

d. The following statements are from Dr. Harriet Amman's 2002 report titled " Is

Indoor Mold Contamination a Threat to Health? "

" Because molds grow in moist or wet indoor environments, it is possible for

people to become exposed to molds and their products, either by direct contact

on surfaces, or through the air, if mold spores, fragments, or mold products are

aerosolized. "

" Health effects from exposures to molds in indoor environments can result from

allergy, infection, mucous membrane and sensory irritation and toxicity alone,

or in combination. "

e. On page 6 of the 2008 report by the U.S. Government Accountability Office,

they state:

" Mold may affect human health through a number of routes and mechanisms. While

inhalation is generally the most common route of exposure for mold in indoor

environments, exposure can also occur through ingestion (for example,

hand-to-mouth contact) and contact with the skin. The roles of these routes of

exposure in causing illness are unclear. Once exposure occurs, health effects

may arise through several potential mechanisms, including allergic (or

immune-mediated), infectious, and toxic. It is not always possible to determine

which of these mechanisms is associated with a specific health outcome. "

Thank you again for your invitation to submit additional literature items. I

look forward to hearing from you after you have had an opportunity to review

this information.

" This submission is dedicated to the millions of families, teachers, employees,

and school children throughout the world who have been harmed by exposure to

molds and mycotoxins...and to the countless advocates, doctors, scientists and

others who have been working tirelessly for years to bring this very important

issue to the forefront. "