Post Hurricane Environmental Health Issues MOLD

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Post Hurricane Environmental Health Issues MOLD
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Post-Hurricane Environmental Health Issues

• Pittsburgh has always
• experienced floods,
• many of great
• intensity.

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Hurricane Ivan

• The remnants of Hurricane Ivan passed through the
  Commonwealth on September 17th and 18th, 2004,
  dropping up to nine and one-half inches of rain.
  The banks of many streams overflowed, flooding
  low-lying areas.

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What is Mold?

• Molds are types of fungi.
• Mold grows indoors when mold spores come in
  contact with wet areas.
• You can find molds in places with water damage,
  high humidity and dampness.

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Are all molds hazardous?

• Of the thousands of types of molds, only a
  relatively few have been associated with harm to
  humans. These include

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Alteraria

• Most commonly associated with Sinusitis, asthma

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Aspergillus sp.

• Allergic bronchopulmonary aspergillosis symptoms
  similar to asthma, but more chronic and severe

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Cladosporium sp.

• Very common, especially air, decaying vegetation,
  food contaminant opportunist
• Uncommon human pathogen

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Penicillium spp.

• Rare human infections symptoms would be
  bronchopulmonary (pneumonia) keratitis
  peritonitis
• May cause problems for those allergic to
  Penicillium.

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Stachybotrys

• Most infections are associated with hay
  fever-like symptoms some strains produce
  mycotoxins

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Health and Mold
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U.S. Disease Prevalence

• 1 of 5 Americans suffer from allergic disease
• Indoor allergens responsible for significant
  share.

Source NHLBI, 1991
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Health and Mold

• Molds can produce allergens, irritants and in
  some cases toxins.
• Breathing or touching mold spores may cause an
  allergic response in some people and worsen
  breathing problems such as asthma.
• Common reactions to mold are cough, congestion,
  runny nose, burning eyes, headaches, sneezing and
  sore throat.
• Children, pregnant women, the elderly and people
  with weak immune systems may be more sensitive to
  mold.

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Toxic Molds or Black Toxic Molds

• Toxic molds are those molds that produce
  compounds called mycotoxins.
• Mycotoxins are produced as a defense against
  other microorganisms.
• Black toxic mold can refer to a certain type of
  moldStachybotrys chartarum (also known as
  Stachybotrys atra).

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Toxic Molds or Black Toxic Molds

• Toxic Mold - Stachybotrys
• 1994 10 cases of acute pulmonary hemosiderosis
  in infants in Cleveland Stachybotrys found in
  houses.
• Local Health Dept conclude an association between
  indoor mold and children's condition
• 2000 CDC study - not enough evidence to
  conclude an association between indoor mold and
  childrens condition
• CDC position on health effects no consensus

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Toxic Molds or Black Toxic Molds

• Texas Medical Association Council of Scientific
  Affairs
• No evidence that Stachybotrys causes serious
  health problems or aggravates existing health
  conditions.
• Houston Chronicle 22 Sept. 2002

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Toxic Molds or Black Toxic Molds

• Stachybotrys Relevance to Human Disease
• Conclusions The current public concern for
• adverse health effects from inhalation of
• stachybotrys spores in water-damaged buildings
• is not supported by published reports in the
• medical literature.
• Annals of Allergy Asthma Immunology Vol. 87 Dec.
  2001 p. 57- 63

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Toxic Molds or Black Toxic Molds

• Fungi Toxic Killers or Unavoidable Nuisances
• Conclusions The review led to the conclusion
  that
• the primary effect from fungal exposure is
  allergic
• disease, and that the evidence for inhalation
  disease resulting from mycotoxin exposure in
  residential and office settings is extremely
  weak.
• Annals of Allergy Asthma Immunology Vol. 87 Dec.
  2001 p. 57-63

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Toxic Molds or Black Toxic Molds

• Levels of exposure in the indoor environment,
  dose-response data in animals, and dose-rate
  considerations suggest that delivery by the
  inhalation route of a toxic dose of mycotoxins in
  the indoor environment is highly unlikely at
  best.
• American College of Occupational and
  Environmental Medicine October 2002

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Toxic Molds or Black Toxic Molds

• Sufficient evidence for opportunistic
  infections in immunocompromised persons.
• Sufficient evidence for an association between
  both damp indoor environments and mold and
  respiratory symptoms.
• Institute of Medicine. Damp indoor spaces and
  health. Washington DC National Academies press
  20004

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Health Concerns Associated with Mold

• October 2005 CDC Study Health Concerns
  Associated with Mold in Water-Damaged Homes After
  Hurricanes Katrina and Rita --- New Orleans Area,
  Louisiana.
• The report found that 46 of inspected homes had
  visible mold growth .
• Predominant fungi indoors and outdoors were
  Aspergillus spp. and Penicillium spp.

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Health Concerns Associated with Mold

• The report concluded that, in the New Orleans
  area post-hurricane, indoor environmental
  conditions and personal practices provided
  exposures that potentially put residents and
  remediation workers at risk for negative health
  effects.
• No significant increases in cases of wheezing,
  pneumonia or asthma attacks observed.

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Prevention and Remediation

• When microbial contamination is found, it should
  be eliminated by means that not only limit the
  possibility of recurrence but also limit exposure
  of occupants and persons conducting the
  remediation.
• Institute of Medicine. Damp indoor spaces and
  health. Washington DC National Academies press
  20004

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Prevention and Remediation

• STAY ALERT FOR PROBLEMS AND BE PATIENT ABOUT
  REBUILDING

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Public Health Interventions

• Emphasize the importance of safe remediation
  practices and ensure the availability of
  recommended personal protective equipment.

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Public Health Interventions
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• Questions