[Frontiers in Bioscience E3, 757-771, January 1, 2011]

Mold exposure and respiratory health in damp indoor environments

Ju-Hyeong Park, Jean M. Cox-Ganser

Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Respiratory Disease Studies, Morgantown, West Virginia


1. Abstract
2. Introduction
3. Scope of the article
4. Respiratory illnesses in damp/moldy indoor environments
4.1. Asthma
4.2. Lower respiratory symptoms
4.3. Rhinitis/Rhinosinusitis
4.4. Hypersensitivity pneumonitis
4.5. Sarcoidosis
4.6. Other respiratory illnesses
4.6.1. Infections
4.6.2. Pulmonary hemorrhage in infants
5. Conclusions
6. Acknowledgements
7. References


Almost all modern buildings experience at least minor, and sometimes serious, water damage during their life span. Excess moisture in buildings becomes a critical factor for mold (fungal) proliferation in nutrient-rich environments. As a result, building occupants may be exposed to increased levels of microbial agents such as fungal spores, cell fragments, cell wall components, or toxins. Such exposures may result in various diseases and symptoms, both respiratory and non-respiratory. Respiratory health complaints are common in damp buildings and have been more thoroughly studied than non-respiratory complaints. Respiratory diseases and symptoms which may be produced by exposure to indoor fungi include asthma development, exacerbation of asthma, hypersensitivity pneumonitis, cough, wheeze, dyspnea (shortness of breath), nasal and throat symptoms, and respiratory infections. In addition to these illnesses, rhinosinusitis and sarcoidosis in water-damaged building occupants are also drawing more scientific attention. In this article, we explore the evidence for adverse effects of fungal exposure on respiratory health in damp indoor environments and potential disease mechanisms related to the exposure.