TOXIC MOULD

SUMMARY:  Well-substantiated conditions caused by mould allergy, infection and ingestion are relatively rare.  Almost all Toxic Mould litigation is based on research that is scientifically flawed.

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

Non-controversial Mould Diseases

Practice Point

Symptom of mould diseases that are scientific established either

  1. occur in those with an allergic tendency or compromised immune system, or

  2. are those of acute (mushroom) poisoning or internal bleeding

Allergy to, infection by and ingestion of moulds can cause clinical conditions with well-defined pathologies2

Allergy

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 . 

Asthma

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. 

Pneumonitis

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.   

Nasal Allergy

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. 

Infection

Fungal infection can be localised to particular organs or tissues, or widespread.  It usually occurs in those who have a compromised immune system

Ingestion

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. 

Controversial Diseases and Conditions

Almost all Toxic Mould litigation is based on research that is scientifically flawed. 

Practice Point

The 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.   

Neuropsychological Impairment

"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