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http://www.tucsoncitizen.com/local/8_6_02kino_mold.html

Kino mold to cost county at least $4M

Extensive renovations will eliminate fungi at hospital

Wearing a respirator and a disposable anti-contamination suit,

Maldonado, an abatement specialist with Environmental Strategies Inc., loads

material from the fifth floor of Kino Community Hospital.

GARY GAYNOR/Tucson Citizen

ANNE T. DENOGEAN

Tucson Citizen

Aug. 6, 2002

The county is spending $4 million to rip out mold-contaminated drywall and

make related renovations at Kino Community Hospital following the discovery

of the fungi in patient rooms this year.

County and hospital officials say the mold never posed a health threat,

because it was found mostly on the insides of bathroom walls and in barely

visible amounts in enclosed bathroom vanities.

However, the mold problem is fairly extensive and work crews are tearing out

everything with mold on it, said Pima County Administrator Chuck

Huckelberry.

" In many cases, they're going in having to gut the entire bathroom and, in

some cases, the entire room, " Huckelberry said.

" In a hospital setting, you don't want a trace. That's why we've gone beyond

the steps of just remediating the bathrooms. We are being extraordinarily

cautious. "

Tuinstra, director of county facilities management, said renovations

are complete on 40 patient rooms and bathrooms, with an additional 120

patient rooms to be remodeled in the future. Some of the work is preventive

because not all the rooms have mold.

The county has budgeted $2.2 million for the work this fiscal year and $1.8

million for next year, Huckelberry said.

Mold is everywhere in the environment, and most healthy people won't

experience anything more severe than an allergic reaction with hay-fever

like symptoms if exposed to it, according to Mark Sneller, a microbiologist

and indoor air consultant.

But mold in a hospital is potentially dangerous because it can lead to an

opportunistic fungal infection - especially of the lungs - in vulnerable

patients, including infants, the elderly, people with AIDS and those on

corticosteroids or chemotherapy.

And one of the two types of mold found at Kino - Aspergillus - has been

indicated as " the bad boy " for more than 50 years in these rare but

potentially life-threatening infections, Sneller said.

" It will set up an infection in the body and begin to grow in the lungs

under extreme circumstances, " he said.

Kino Administrator Floden said the mold was first discovered by a

nurse who noticed a musty smell in the bathroom of a vacant patient room on

the fourth floor.

The county soon discovered that the mold contamination extended to other

rooms on the fourth and fifth floors, the dental clinic lab and the

behavioral science unit. The south half of the fourth floor was closed and

patients were moved to a vacant wing as remediation began in March.

The source of the problem, it turned out, dated to the hospital's

construction in the mid-1970s.

" As they investigated, they found we had a problem with the materials used

in the bathrooms. The problem was that they laid the tile flat on the floor

(of the shower) instead of normally you put down a metal pan (to drain away

moisture). And they used just plain old drywall instead of water-resistant

or ceramic, " Floden said.

" If you use just plain drywall on tile, any time there's humidity and the

water soaks under. It can get absorbed and that's what happened, " he said.

All the bathrooms are getting new vanities and water-resistant drywall.

It's the first renovation of the bathrooms since the hospital opened in

1977, Tuinstra said.

The county also plans to examine the galleys in the affected wings and other

high-humidity areas in the hospital.

Mold cultures taken earlier this year from the patient rooms revealed

Aspergillus and Penicillium, common molds found indoors and outdoors and not

associated with severe health effects in healthy people. Tests of the air in

the rooms revealed spore counts of zero to 180 per cubic meter of air,

compared to 10 to 20 spores per cubic meter of air outdoors, Tuinstra said.

Those numbers are definitely in the low range and not a threat to a healthy

person, Sneller said, though he noted it wouldn't take a lot of Aspergillus

to pose an infection threat to a severely immunocompromised patient.

The mold problem has led to complaints from Kino employees.

In March, a group of them complained to the Arizona Department of

Occupational Safety and Health that they were " experiencing headaches,

nausea, vomiting, etc., because of mold growth on the ceiling of the

surgical unit on the fourth floor. "

Tuinstra said the department was unable to trace the health complaints to

mold.

Above: Aspergillus, a type of mold found in Kino Community Hospital

Health and mold

In generally healthy people, inhaling mold spores or touching mold can cause

an allergic reaction. Allergic responses can include such hay-fever type

symptoms as sneezing, runny nose, red eyes and skin rash (among those who

actually touch mold).

Mold can trigger asthma episodes in people who have both asthma and an

allergy to mold. The irritants produced by molds also may worsen asthma in

nonallergic people.

People with weakened immune systems - which can include infants, the elderly

and patients on corticosteroids or chemotherapeutic agents that suppress the

immune system - may be more vulnerable to opportunistic lung infections by

mold. The mold spores can lodge in their lungs and start growing.

Source: U.S. Environmental Protection Agency

MOLD IN TUCSON:

Tucson is a low-mold city, but there have been some noteworthy moldy

buildings in recent years:

son Elementary, built in early 1900s, is one of the oldest schools in

Tucson's oldest district. Three classrooms, two bathrooms and a closet were

closed at the school this spring because of mold. Since then, Tucson Unified

School District has decided to raze the school because of its age and

excessive maintenance needs.

City, the University of Arizona's family housing complex, was

torn down in 2000 because it was in poor condition and infested with mold.

An environmental consulting firm found the potentially toxic fungus

Strachybotrys chartarum in 20 units in the complex, at North Columbus

Boulevard and East Fort Lowell Road. The sometimes visible fungus was in

carpeting and cooler pads.

Rather than pay an estimated $2.5 million to remove the mold, UA officials

closed the complex.

UA officials said a handful of residents complained of symptoms potentially

related to the fungus.

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