Man (homo sapiens) has been on earth for about 100,000 years and by weight makes up about one ten-thousandth of living things. Moulds and fungi have been around for at least half-a-billion years and may comprise up to 25% of the earth's biomass1.
Practice PointSymptom of mould diseases that are scientific established either
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Allergy to, infection by and ingestion of moulds can cause clinical conditions with well-defined pathologies2.
In genetically-susceptible individuals, mould can trigger atopic bronchial asthma, can rarely cause allergic sensitivity of lung tissue (hypersensitivity pneumonitis AKA extrinsic allergic alveolitis), and is probably an uncommon cause of nasal allergy .
Commoner triggers are pollens, house-dust and animal dander. If the medical history is also suggestive for moulds, the diagnosis is confirmed by demonstration of IgE antibodies by skin- and blood-tests.
Allergic BronchoPulmonary Aspergillosis (ABPA) can progressively destroy the lungs of both atopic asthmatics and sufferers from cystic fibrosis.
Farmer's lung is an occupational disease that causes progressive scarring of the lungs3.
Allergic Fungal Rhinosinusitis is not yet fully characterised, is commonly caused by fungi that are prevalent in the southwestern United States, and appears to have features of both allergy and infection.
Fungal infection can be localised to particular organs or tissues, or widespread. It usually occurs in those who have a compromised immune system.
Mushroom poisoning is the most readily recognised form of mycotoxicosis.
Internal bleeding is the characteristic symptom of an important world-wide disease of large farm animals that feed on mould-contaminated hay or straw4. Human cases from contaminated grains were reported in Japan and Russia in the 1940s.
Almost all Toxic Mould litigation is based on research that is scientifically flawed.
Practice PointThe majority of Toxic Mould litigation is scientifically unsupportable |
Toxic mould litigation is now a multi-billion dollar industry, for which there is little if any scientific justification. State Farm, the largest US home insurer, is getting out of the business of covering mould-related risk as a survival tactic.
Stachybotrys atra (chartaram) is the mould most frequently implicated - for historical reasons. A case-report in 1986 first implicated this mould, and the unconfirmed suspicion was carried into epidemiological studies5 on workers in water-damaged buildings.
A cluster of cases of pulmonary hemorrhage in infants6 had in common water-damaged residences and growth of Stachybotrys atra. Subsequent research found that a causal link could not be established7.
Common features of such controversial conditions are 1) nonspecific symptoms such as fatigue and cognitive difficulties, 2) no physical findings, pathological features or laboratory evidence of disease, and 3) no plausible pathological mechanism of disease.
"The study8 most often cited in forensic cases as evidence of neuropsychological impairment due to mold neurotoxicity is not a scientific study...the methodology was fatally flawed9." Even the authors of the study concluded, "Validation on a larger sample of individuals is indicated."
Copyright © 2008 Electronic Handbook of Legal Medicine