PEDIATRICS Vol. 118 No. 6 December 2006, pp. e1909-e1926 (doi:10.1542/peds.2006-2829)

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TECHNICAL REPORT

Spectrum of Noninfectious Health Effects From Molds

ABSTRACT

Molds are multicellular fungi that are ubiquitous in outdoor and indoor environments. For humans, they are both beneficial (for the production of antimicrobial agents, chemotherapeutic agents, and vitamins) and detrimental. Exposure to mold can occur through inhalation, ingestion, and touching moldy surfaces. Adverse health effects may occur through allergic, infectious, irritant, or toxic processes. The cause-and-effect relationship between mold exposure and allergic and infectious illnesses is well known. Exposures to toxins via the gastrointestinal tract also are well described. However, the cause-and-effect relationship between inhalational exposure to mold toxins and other untoward health effects (eg, acute idiopathic pulmonary hemorrhage in infants and other illnesses and health complaints) is controversial and requires additional investigation. In this report we examine evidence of fungal-related illnesses and the unique aspects of mold exposure to children. Mold-remediation procedures are also discussed.

Key Words: mold exposure • health effects • allergies • hypersensitivity pneumonitis • mycotoxins • hemosiderosis • water damage • remediation • prevention

Abbreviations: Ig—immunoglobulin • ABPA—allergic bronchopulmonary aspergillosis • AFS—allergic fungal sinusitis • RAST—radioallergosorbent test • OR—odds ratio • CT—computed tomography • CF—cystic fibrosis • VOC—volatile organic compound • MVOC—microbial volatile organic compound • FAO—Food and Agriculture Organization of the United Nations • WHO—World Health Organization • DON—4-deoxynivalenol • CFU—colony-forming unit(s) • CI—confidence interval • CDC—Centers for Disease Control and Prevention • AIPH—acute idiopathic pulmonary hemorrhage • IOM—Institute of Medicine • SBS—sick building syndrome • EPA—Environmental Protection Agency