Tales About Rampant Toxic Mold Get Plenty of Attention, but Science Tells a Less Dramatic Story

[Guest guest]

http://www.washingtonpost.com/wp-dyn/articles/A26083-2002Sep16.html

It's Everywhere

Tales About Rampant Toxic Mold Get Plenty of Attention, but Science Tells a

Less Dramatic Story

By Wanjek

Special to The Washington Post

Tuesday, September 17, 2002; Page HE01

In the fictitious horror movie " Attack of the Killer Mold, " a creeping

pathogen that starts out as a little dot in the corner of the utility room

turns into a seething green-black slime that soon consumes the entire house.

Hapless householders who breathe in the killer's spores collapse into

paroxysms of wheezing and spend the rest of their shortened lives in

intensive care.

Brave men in protective moon suits cart away mold-laden rugs and floorboards

before crews begin rebuilding the house, brick by brick, plank by plank. And

before the credits roll, the evil corporation responsible for the mold is

brought to justice and made to pay not only punitive damages but the

plaintiffs' legal costs, too.

Like most Hollywood creations, this is a story based more on hype and

fantasy than fact. Nevertheless, it's playing in a courtroom near you.

Several things about molds and health are well-known. Some molds growing in

homes and buildings trigger allergic reactions and asthma symptoms in some

people. A smaller group of people, including those with compromised immune

systems, are susceptible to lung infections caused by inhaling mold spores.

And a small group of molds does produce toxins.

But the impression that toxin-producing molds are rampant and more virulent

than ordinary molds -- an impression created by some news reports and on the

Internet, often on sites operated by companies that sell mold tests, cleanup

systems or legal services -- is not supported by evidence. In fact,

according to those who have studied the issue, there is little conclusive

evidence that mold toxins in the home or office (as opposed to an

overabundance of ordinary mold) can cause serious harm to humans.

" Mold is everywhere, " said Gailen Marshall, director of the Division of

Allergy and Clinical Immunology at the University of Texas Medical School at

Houston. " For most, mold is a mostly ignored part of their lives. For some

with mold allergies, the smell can cause nasal allergy or even asthma

symptoms. Yet what is increasingly clear is that their mold-related illness

has nothing to do with toxic substances produced by molds. "

That is, airborne mold spores, much like pollen, dust or animal dander,

trigger allergic reactions. But mold toxins, however potentially harmful,

never get into the body in high enough levels to cause harm.

These mycotoxins, secreted by a dozen or so mold species, are known to be

deadly to animals that ingest them in large amounts (typically while feeding

on stored hay or grain). Very few cases of toxic mold inside homes have been

shown to cause serious human health problems, and they usually involve

someone who ate very old food laced with toxic mold, according to the

Centers for Disease Control and Prevention (CDC) and the Environmental

Protection Agency (EPA).

Several widely publicized cases of " killer mold " have drawn headlines in

part because real toxins are involved; in reality, they involve vast growths

of ordinary mold, too:

.. Entertainer Ed McMahon filed a $20 million lawsuit against his insurance

company and contractors after a broken pipe in his Beverly Hills mansion

left widespread mold growth that allegedly sickened him and his wife and

killed his dog, Muffin.

.. A jury awarded $32 million in damages after mold took over a Texas

family's mansion.

.. After mold caused $600,000 worth of damage in her new home,

activist-cum-celebrity Brockovich lobbied for California's Toxic Mold

Protection Act last year.

Although rampant mold growth in these cases may have caused illnesses,

scientists have been unable to show a clear link between some of the more

frightening reported symptoms, such as memory loss and internal bleeding,

and breathing in mold toxins. Three recent large reviews of the medical

literature found no support for the claim that toxic mold levels in the home

or office can lead to chronic or life-threatening health problems. These

independently funded reviews were conducted largely to educate health care

professionals and industrial hygienists about mold exposure. A fourth study

is now underway by the Institute of Medicine for the CDC.

Mold is by no means always benign. The most recent of the completed reviews,

conducted in part by Norman King, an epidemiologist for a Montreal regional

public health board, found a strong association between mold and respiratory

problems, such as exacerbation of asthma. Scientists cannot rule out the

possibility that mold levels cause more serious problems, King said, but no

link has yet been demonstrated. Doctors at the Mayo Clinic in Rochester,

Minn., independently concluded that molds may be responsible for a majority

of sinus infections in the United States.

Yet the validity of the 1994 case that largely started the toxic mold

scare -- eight babies in Cleveland hospitalized with bleeding lungs, thought

to be from toxic mold exposure -- is questionable, according to the CDC.

Further investigation found discrepancies in mold sampling from house to

house, as well as no evidence that the internal bleeding wasn't caused by

other factors, such as a viral infection.

For now, the mantra of the health community is to clean up mold, regardless

of its type, and to fix leaks and quickly dry or remove water-damaged

materials so that mold won't spread.

It's Everywhere

Mold is the stuff that can turn a lemon into something that looks like a

Chia Pet, even in the safety of your closed refrigerator. Some cheeses and

beers rely on mold for their earthy tastes. We live with so many molds,

according to the EPA, that it has not been possible to identify which ones

might make us ill.

Toxins from mold -- such as those from an infamous black mold called

Stachybotrys, which is often cited in lawsuits as causing grave harm to

human health -- are not readily airborne, and are therefore not likely to be

breathed in. Even if the toxins piggyback on spores, it's nearly impossible

for them to enter the human body in large enough quantity to cause illness,

according to Coreen Robbins, an industrial hygienist with Global Tox Inc., a

firm based in Redmond, Wash.

Robbins, who participated in a review of the Cleveland case for the CDC,

said that Stachybotrys often grows below floors and behind walls, and we are

unlikely to breathe in its toxins because they cling to mold and dust

particles. The mere presence of toxic mold, according to Robbins, is no

indication that the air contains mycotoxins.

" This is a fairly complex topic, so it is ripe for a bit of bamboozlery, "

Robbins said. Cottage industries have sprung up overnight to test for and

clean up toxic mold. She said newly minted " mold consultants " are

participating in what " is like a huge hoax. " While common sense tells us we

should clean up moldy stuff indoors, Robbins said, removing floorboards,

walls and ducts upon detection of a few Stachybotrys spores is often

unnecessary. There are no exposure standards for mold and mold toxins, she

added, and the point at which mold exposure becomes a health threat is

unknown.

The Mold Rush

Nevertheless, insurers are being inundated with mold claims, which cost them

more than $1.2 billion for repairs and litigation last year, according to

the Insurance Information Institute (III). Farmer's Insurance Group, which

is appealing that $32 million judgment in Texas, paid $85 million for mold

claims in 2001. The III says about 10,000 mold-related lawsuits are pending

nationwide, a 300 percent increase since 1999.

" This is the classic progression of first the hype, then the fear and then

the big awards, " said Sweeney, a Baltimore lawyer with the firm Miles &

Stockbridge who defends class actions and mass consolidations of toxic

torts. He said that people often look for someone or something to blame for

health problems with no known cause and that insurance companies don't alway

s act swiftly and cooperatively when dealing with their clients' fears, even

if they are unfounded. Also, jurors are naturally sympathetic to the notion

that the home should be a place of safety and refuge.

" ly, insurance companies too often act like insurance companies, "

Sweeney said. " If builders and insurance companies aren't sensitive [to mold

concerns], then they are provoking people to bring claims to justify their

own fears. "

Sweeney said that plaintiffs often win their cases with the argument that

mold growth was exacerbated by the insurance company's or builder's actions,

but not on proof that mold made the plaintiff sick.

A Mold Too Far

Mold only becomes a health issue when there is too much of it, said Harriet

Burge, a mold expert at Harvard School of Public Health and the chair of the

committee conducting the new review for the CDC. And that " too much "

threshold varies from person to person.

Mold is a member of the fungi kingdom, which includes mushrooms, mildew and

yeast. Mold spreads to new areas by releasing spores, analogous to a plant's

seeds. Breathing in certain mold spores, particularly in high numbers, can

trigger allergies and asthma, Burge said. Common allergenic mold species are

likely present in your home now, maybe clinging to the back of that mushy

wallboard under your sink. Mold also increases the risk of infection in

people with compromised immune systems, according to the CDC.

Yet there are simple ways to keep mold growth in check. " If one does have

mold in the home, " Burge said, " panic should not be the first response. "

Molds thrive on moisture. Removing the moisture kills the mold and ensures

that new mold doesn't take hold. Exhaust fans in the bathroom and the

kitchen, or an open window, can help dry surfaces before mold can spread. A

solution of bleach and water will kill mold. Mold will not consume a house

unless there is a constant supply of water allowing it to spread.

Mold may grow in places you cannot see, but " there are a lot of clues if you

pay attention, " said Burge. For example, if you encounter a musty smell when

you enter your house or basement, then there's likely to be an excessive

amount of mold. Mold grows easily on fabrics and cellulose material, such as

newspapers, cardboard, wood and the paper covering of drywall.

Somewhere there is excess moisture keeping this material wet, perhaps from

flooding, a leaky pipe, poor ventilation or seepage through the walls of a

basement.

Thus, there is certainly a place in this world for mold consultants and mold

removal, according to Robbins. It's just that some consultants may take

advantage of the current fear and loathing, and some businesses and schools

might attempt to remove all mold (which is technically impossible) for fear

of a lawsuit.

The worry over " toxic " mold is " way out of hand, " said Marshall, an

allergist who routinely meets with patients frightened and sometimes angry

that they have " toxic mold disease, " a term that has no medical meaning.

The Houston-based Marshall is at ground zero of the toxic mold scare. That

$32 million lawsuit -- brought by a family in Dripping Springs, Tex. -- has

made toxic mold a household word across the state. (Mold in Dripping

Springs? Who would have guessed?)

Last year's floods in Houston and recent floods in other parts of Texas have

heightened the fear. And mold, folks are thinking, is the cause of all their

ills, Marshall said.

" I don't doubt for one second that most of these people are ill, " said

Marshall. " But there is no evidence that those individuals are getting toxic

amounts of spores. "

Toxic poisoning from mold won't sneak up on you, according to Robbins. Very

moldy conditions are needed, and extremely large amounts of mold particles

have to get into the air before you even begin to breathe in enough mold to

get a toxic dose. The mold will trigger symptoms such as allergies or eye

irritation long before you reach a toxic dose.

There is no conclusive evidence that mold is more prevalent today than in

previous periods, according to the CDC. Many health experts have their

suspicions, though, particularly in schools and office buildings. One

thought is that cost-cutting in construction and maintenance have led to

situations where moisture builds up or damage goes unrepaired, according to

the EPA.

There are few studies of mold prevalence, so reports are anecdotal. However,

a nationwide EPA study found that 45 percent of the office buildings

inspected had active water leaks.

In New York's East Harlem section, old homes and leaky apartment buildings

are rife with mold, and this may be an underlying cause of the sharp rise in

asthma rates there, said Suzanne Gaynor, an assistant professor in the

Department of Community and Preventive Medicine at Mount Sinai School of

Medicine.

" These buildings were never built to last, " Gaynor said. Also, people stay

indoors more often now. Thus, the combination of old, leaky buildings and

folks exposed to the mold for longer periods might be contributing to the

perception that mold is more common and more noxious today.

California's Toxic Mold Protection Act, with its key directives of setting

indoor mold exposure limits and devising standards for mold assessment and

removal, became law this year. However, many health experts contend that

such limits will be difficult to determine, considering the sheer abundance

and variety of molds and of people's reaction to them.

Mold is certainly not a new problem. The Book of Leviticus instructs that

for perpetual mold and mildew, the house " must be torn down, and its stones,

its wood and all its plaster must be carried out of the city to an unclean

place. "

More proof, if you need it, that some lawyers read the Bible. .

Wanjek is a frequent contributor to the Health section.

© 2002 The Washington Post Company