Molds are ubiquitous in nature, and mold spores are a common component of household and workplace dust. However, when mold spores are present in large quantities, they can present a health hazard to humans, potentially causing allergic reactions and respiratory problems. Mycotoxins include aflatoxins, ochratoxins, fumonisins, trichothecenes, citrinin, and patulin, among others.
Some molds also produce mycotoxins that can pose serious health risks to humans and animals. Some studies claim that exposure to high levels of mycotoxins can lead to neurological problems and in some cases death. Prolonged exposure, e.g. daily home exposure, may be particularly harmful. Research on the health effects of mold has not been conclusive. The term “toxic mold” refers to molds that produce mycotoxins, such as Stachybotrys chartarum, and not to all molds in general. These toxic properties may also be used to the benefit of humans e.g. penicillin from Penicillium and so on. In low doses these toxins that could otherwise be deadly can be controlled to our benefit to fight off infection.
Mold in the home can usually be found in damp, dark or steamy areas e.g. bathroom or kitchen, cluttered storage areas, recently flooded areas, basement areas, plumbing spaces, areas with poor ventilation and outdoors in humid environments. Symptoms caused by mold allergy are watery, itchy eyes, a chronic cough, headaches or migraines, difficulty breathing, rashes, tiredness, sinus problems, nasal blockage and frequent sneezing.
Growth in buildings and homes
Mold growth in buildings can lead to a variety of health problems. Various practices can be followed to mitigate mold issues in buildings, the most important of which is to reduce moisture levels that can facilitate mold growth. Removal of affected materials after the source of moisture has been reduced and/or eliminated may be necessary for remediation.
Mold-associated conditions
Health problems associated with high levels of airborne mold spores include allergic reactions, asthma episodes, irritations of the eye, nose and throat, sinus congestion, and other respiratory problems, although it should be noted that mold spores won’t actually cause asthma, just irritate existing conditions. For example, residents of homes with mold are at an elevated risk for both respiratory infections and bronchitis. When mold spores are inhaled by an immunocompromised individual, some mold spores may begin to grow on living tissue, attaching to cells along the respiratory tract and causing further problems. Generally, when this occurs, the illness is an epiphenomenon and not the primary pathology. Also, mold may produce mycotoxins, either before or after exposure to humans, potentially causing toxicity.
Fungal infection
A serious health threat from mold exposure for immunocompromised individuals is systemic fungal infection (systemic mycosis). Immunocompromised individuals exposed to high levels of mold, or individuals with chronic exposure may become infected. Sinuses and digestive tract infections are most common; lung and skin infections are also possible. Mycotoxins may or may not be produced by the invading mold.
Dermatophytes are the parasitic fungi that cause skin infections such as athlete’s foot and tinea cruris. Most dermatophyte fungi take the form of a mold, as opposed to a yeast, with appearance (when cultured) that is similar to other molds.
Opportunistic infection by molds such as Penicillium marneffei and Aspergillus fumigatus is a common cause of illness and death among immunocompromised people, including people with HIV, AIDS, COPD, and Asthma to name a few.
Mold-induced hypersensitivity
The most common form of hypersensitivity is caused by the direct exposure to inhaled mold spores that can be dead or alive or hyphal fragments which can lead to allergic asthma or allergic rhinitis. The most common effects are rhinorrhea (runny nose), watery eyes, coughing and asthma attacks. Another form of hypersensitivity is hypersensitivity pneumonitis. Exposure can occur at home, at work or in other settings. It is predicted that about 5% of people have some airway symptoms due to allergic reactions to molds in their lifetimes. Hypersensitivity may also be a reaction toward an established fungal infection in allergic bronchopulmonary aspergillosis.
Mycotoxin toxicity
Molds excrete toxic compounds called mycotoxins, secondary metabolites produced by fungi under certain environmental conditions. These environmental conditions affect the production of mycotoxins at the transcriptional level. Temperature, water activity and pH, strongly influence mycotoxin biosynthesis by increasing the level of transcription within the fungal spore. It has also been found that low levels of fungicides can boost mycotoxin synthesis. Certain mycotoxins can be harmful or lethal to humans and animals when exposure is high enough.
Extreme exposure to very high levels of mycotoxins can lead to neurological problems and in some cases death; fortunately, such exposures rarely to never occur in normal exposure scenarios, even in residences with serious mold problems. Prolonged exposure, e.g. daily workplace exposure, can be particularly harmful.
However, not all mycotoxins are harmful, and some are even beneficial to humans, e.g. penicillin.
The health hazards produced by mold have been associated with sick building syndrome, but no validated studies have been able to demonstrate that normal indoor exposures to these common organisms pose a significant threat.
It is thought that all molds may produce mycotoxins and thus all molds may be potentially toxic if large enough quantities are ingested, or the human becomes exposed to extreme quantities of mold. Mycotoxins are not produced all the time, but only under specific growing conditions. Mycotoxins are harmful or lethal to humans and animals only when exposure is high enough.
Mycotoxins can be found on the mold spore and mold fragments, and therefore they can also be found on the substrate upon which the mold grows. Routes of entry for these insults can include ingestion, dermal exposure and inhalation.
Some mycotoxins cause immune system responses that vary considerably, depending on the individual. The duration of exposure, the frequency of exposure and the concentration of the insult (exposure) are elements in triggering immune system response.
Aflatoxin is an example of a mycotoxin. It is a cancer-causing poison produced by certain fungi in or on foods and feeds, especially in field corn and peanuts.
Originally, toxic effects from mold were thought to be the result of exposure to the mycotoxins of some mold species, such as Stachybotrys chartarum. However, studies are suggesting that the so-called toxic effects are actually the result of chronic activation of the immune system, leading to chronic inflammation. Studies indicate that up to 25% of the population have the genetic capability of experiencing chronic inflammation to mold exposure, but it’s unknown how many actually experience such symptoms due to common misdiagnosis.
A 1993â94 case study based on cases of pulmonary hemorrhage in infants in Cleveland, Ohio originally concluded there was causal relationship between the exposure and the disease. The investigators revisited the cases and established that there was no link to the exposure to S. chartarum and the infants in their homes.