Reviewed By Brunilda Nazario, MD

May 25, 2004 -- Damp indoor spaces and the molds that breed are likely linked to lung problems including asthma and coughing, a new report issued by the Institute of Medicine shows.

A group of IOM experts reviewing existing research says that "sufficient evidence that certain respiratory problems, including symptoms in people with asthma who are sensitive to mold, are associated with exposure to mold and damp conditions." These symptoms may include coughing and wheezing as well as nasal and throat symptoms.
"Suggestive" evidence also exists connecting chronic indoor dampness with development of asthma and as well as shortness of breath and respiratory illnesses in otherwise healthy children, although the evidence is less certain in these circumstances.

"The committee concludes that excessive indoor dampness is a public health problem," the report states.
"In short, excessive building dampness is not your friend," says Noreen M. Clark, PhD, dean of the University of Michigan School of Public Health and the chair of the IOM panel.

Some of the hundreds of studies listed in the report show that dampness in the home can more than double the risk of asthma symptoms.

More Research Needed
Experts stress that not enough research has been done to determine whether leaky buildings may play a role in causing or aggravating a variety of other health problems, including chronic obstructive pulmonary disease, fatigue, stomach problems, or immune disorders.

But they do indicate that homeowners, builders, and others move to prevent water accumulation in buildings and move to clean up mold whenever it is spotted.

"We recommend that visible mold be removed," says William J. Fisk, head of the indoor environment department at the Lawrence Berkeley National Laboratory and a member panel.

Asthma has long been associated with molds, fungi and other allergens from dust mites, cockroach dander, and waste from rodents. All of those organisms tend to grow and thrive in indoor areas with excessive water accumulation.
The report says that not enough is being done to ensure that schools, offices, homes, and other structures don't leak, or to guarantee cleanup of water and mold when they are spotted. It calls for better regulation of indoor environments and improved building guidelines geared toward minimizing mold contamination.

"We're not consistently applying what we know to the design, construction, and maintenance of buildings," Clark says. The report goes on to stress that cheap construction in poor areas often fails to avoid leaking, possibly exposing residents there to health risks.

A spate of lawsuits blames so-called "toxic molds" for a variety of health problems including stomach disorders and chronic fatigue. Clark says that the report reflects "a dearth" of reliable scientific studies on whether common molds actually produce toxins and, if so, whether humans ingest enough toxins to get sick. That prevented experts from drawing a link between the non-respiratory health problems and mold, though they also could not rule out such a connection, she says.

"I think in many cases their concerns are ahead of the science that we have right now," adds Peyton A. Eggleston, MD, a professor of pediatrics and medicine at Johns Hopkins University's Bloomberg School of Public Health.
SOURCES: "Damp Indoor Spaces and Health," Institute of Medicine, May 25, 2004. Noreen M. Clark, PhD, dean, University of Michigan School of Public Health and IOM panels chair. William J. Fisk, director, indoor environment department, Lawrence Berkeley National Laboratory, Berkeley, Calif. Peyton A. Eggleston, MD, professor of pediatrics and medicine, Johns Hopkins University, Bloomberg School of Public Health.

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