Survey Results of HHS and HHS-Sponsored Research on the Health Effects of Exposure to Indoor Mold
Centers for Disease Control and Prevention (CDC) Survey Results
Recently Completed Research

Project
Title		 Project
Description		 Agency
Contact		 Telephone
Number
Identification and Cloning of a Stachybotrys Antigen The presence of fungi in water-damaged homes and businesses has been implicated in a number of adverse health effects including subjective symptoms, such as fatigue, cognitive difficulties, and problems with memory to more definable diseases such as allergy, asthma, and hypersensitivity pneumonitis. One fungus in particular, Stachybotrys, has received a great deal of public attention because it is commonly found in water-damaged indoor environments and produces several potent mycotoxins. The association between Stachybotrys and building related disease is somewhat controversial in the medical literature, and direct evidence as to its involvement is lacking. To gain a better understanding of the role of this and various other fungi in building-related complaints, it is necessary to develop methods to measure the extent of exposure. To that end, it is essential to have sensitive tests but also tests that are specific for the various fungal species. Monoclonal antibody based tests are particularly suited for such a task, but crossreactivity between fungal species can be a problem. Recent work has lead to the development of a species-specific monoclonal antibody for Stachybotrys chartarum spores. This antibody can be used to specifically detect Stachybotrys in the environment, but development of quantitative methods will require purification of the antigen. The overall objective of the proposed project is to characterize the antigen to which this monoclonal antibody is directed with the goal of developing more accurate tests for Stachbotrys. Specifically, we will: (1) identify and characterize the antigen, (2) clone its cDNA and express the recombinant protein, and (3) develop an ELISA assay for detection and quantification of Stachybotrys. Production of the antigen as a recombinant protein allows for a continuous supply of the antigen for use in ELISA methods development and standardization. Furthermore, it is hypothesized that characterization of this Stachybotrys antigen will identify a class of proteins that could serve as the target for developing similar species-specific reagents for other fungi. Donald Beezhold 304-285-5963
Species-Specific Reagents for Measuring Airborne Fungi. Occupational exposure to fungi and especially fungal spores is of growing concern in a number of home and work environments. Currently, the actual effects of different fungi to cause or aggravate such adverse effects are not clear, and exposure guidelines for fungi have not been proposed. The purpose of this project was to produce diagnostic reagents for airborne fungi. The reagents will help to develop accurate monitoring techniques for fungal aerosols that are critical for the characterization and definition of exposure and disease relationships of fungal contamination in indoor environments. The principles and methods developed in this project should help provide healthier work environments in a variety of industries. Donald Beezhold 304-285-5963
Dampness and Mold in the Home and Depression: An Examination of Mold Related Illness and Perceived Control Over One's Home as Possible Depression Pathways Cross-sectional study of mold and depression in eight European cities. Mary Jean Brown 770-488-3727
Characterization of Airborne Molds, Endotoxins and Glucans in New Orleans after Hurricanes Katrina and Rita In August and September 2005, Hurricanes Katrina and Rita caused breaches in the New Orleans levee system, resulting in catastrophic flooding. The city remained flooded for several weeks, leading to
extraordinary mold growth in homes. To characterize the potential risks of mold exposures, we measured airborne molds and markers of molds and bacteria in New Orleans area homes. In October 2005, we
collected air samples from 5 mildly waterdamaged houses, 15 moderately to heavily water-damaged houses, and 11 outdoor locations. The air filters were analyzed for culturable fungi, spores,
(1?3,1?6)-ß-D-glucans, and endotoxins. Culturable fungi were significantly higher in the moderately/heavily water-damaged houses (geometric mean = 67,000 CFU/m3) than in the mildly water-damaged houses
(geometric mean = 3,700 CFU/m3) (P = 0.02). The predominant molds found were Aspergillus niger, Penicillium spp., Trichoderma, and Paecilomyces. The indoor and outdoor geometric means for endotoxins were
22.3 endotoxin units (EU)/m3 and 10.5 EU/m3, respectively, and for (1?3,1?6)-ß-D-glucans were 1.7 µg/m3 and 0.9 µg/m3, respectively. In the moderately/heavily water-damaged houses, the geometric means
were 31.3 EU/m3 for endotoxins and 1.8 µg/m3 for (1?3,1?6)-ß-D-glucans. Molds, endotoxins, and fungal glucans were detected in the environment after Hurricanes Katrina and Rita in New Orleans at
concentrations that have been associated with health effects. The species and concentrations were different
from those previously reported for non-water-damaged buildings in the southeastern United States.
heeze asthma or other allergic diseases. Our assembled team includes an aeroallergen scientist, asthma and social epidemiologists, a pediatric pulmonologist, and a statistician, all
of which are experienced in conducting large-scale, populationbased studies. If we show that travel to Puerto Rico is associated with sensitization to HDM, will this deter parents from
taking their children with them to the island? We hope not, because familial and cultural relations are important. This is where the blend of social and environmental science is crucial.
We must understand how the two lead to allergic sensitization and be cognizant that they both will be required for the most effective primary prevention of allergic asthma.		 Paul Garbe 770-488-3727
Knowledge, Attitudes, and Practices Related to Mold Exposure Among Residents and Remediation Workers in Posthurricane New Orleans To assess knowledge, attitudes, and practices related to mold exposure in postflood New Orleans, the authors surveyed 159 residents and 76 remediation workers, using logistic regression to explore associations. Nearly all answered "yes" to the questionnaire item, "Do you think mold can make people sick?" Most knew respirators were recommended for cleaning mold. Residents (87 percent) and workers (47 percent) said they believed that television or radio were the best ways to communicate information about mold. Workers (24 percent) also suggested employers provided the best means for communication of this information. Few participants reliably used all recommended protective equipment. Residents cited respirator discomfort and unavailability as reasons for noncompliance; workers cited discomfort and inadequate training, with 50 percent reporting respirator fit testing. Spanish-speaking workers relied on employers for information. Self-employed workers used protective equipment infrequently. The authors recommend that information on postflood mold exposure be disseminated through media and employers, that protective equipment be made readily available for residents, and that workers receive better training and fit testing. In addition, they suggest that targeted approaches may benefit Spanish-speaking workers and the self-employed. Paul Garbe 770-488-3727
Moisture and Mold in New Orleans Homes after Hurricanes Katrina and Rita This project assessed resident cleanup activities, characteristics of flood-damaged homes and airborne microbial concentrations in New Orleans, Louisiana, following Hurricanes. Paul Garbe 770-488-3727
Hazard Evaluation and Technical Assistance 2003-0300-2993: West Virginia Department of Health and Human Resources—Webster Springs District Office To investigate health complaints of employees and conduct environmental testing at an office building with indoor air quality problems, including the evaluation of methacholine challenge testing in support of building-related asthma investigation. Kathleen Kreiss 304-285-5800
Hazard Evaluation and Technical Assistance 2004-0138-2967: Samuel Staples Elementary School To investigate health complaints of employees at a school with indoor air quality problems, including linking of environmental observations with health complaints. Kathleen Kreiss 304-285-5800
Monitoring Bioaerosols on Commercial Passenger Aircraft The aim of this research was to comprehensively characterize bioaerosol contaminants (bacteria, fungi, and allergens) on widebody commercial passenger aircraft. On 12 randomly selected flights, samples were collected to monitor airborne and surface bacteria, airborne and surface fungi, and nonviable total spore counts at six distinct time periods within each flight. Comparison samples were collected both inside and outside the airport terminal at the origin and destination cities. While the results only relate to fungal and bacterial sized particles, they illustrate the time periods when the risk of potential airborne exposure will be highest. The results suggest disease prevention efforts focus on the time period before air is entrained into the filtration system. Three manuscripts have been published that pertain to this research. Lauralynn Taylor McKernan 513-847-4751
Health Hazard Evaluation Report: HETA-2004-0005-3024, Grove Park Inn Resort and Spa, Asheville, North Carolina To determine if stachylysin, a hemolysin produced by the fungus Stachybotrys chartarum, is a good biomarker of exposure to Stachybotrys chartarum. We also field tested a prototype minicentrifugal bioaerosol sampler that allows for fungal air sampling for extended time periods (8 hours) and separation of fungal fragments and spores. Allison Tepper 513-841-4386
Health Hazard Evaluation Report: HETA-2005-0126 and HETA-2005-0138-3004 International Marine Terminal, Portland, Maine To determine if stachylysin, a hemolysin produced by the fungus Stachybotrys chartarum, is a good biomarker of exposure to Stachybotrys chartarum Allison Tepper 513-841-4386