Patients have been reporting multiple ill health effects linked to exposures to mold. Studies of more than 1600 patients suffering ill effects associated with fungal exposure were presented at one meeting in Dallas in 2003 (21st Annual Symposium of Man and His Environment, Dallas, Texas, 19–22 June 2003) .To cite a few studies: Lieberman examined 48 heavily mold-exposed patients who had the following health problems: muscle and/or joint pain (71%), fatigue/weakness (70%), neurocognitive dysfunction (67%), sinusitis (65%), headache (65%), gastrointestinal problems (58%), shortness of breath (54%), anxiety/depression/irritability (54%), vision problems (42%), chest tightness (42%), insomnia (40%), dizziness (38%), numbness/tingling (35%), laryngitis (35%), nausea (33%), skin rashes (27%), tremors (25%) and heart palpitations (21%). Rea et al.’s study of 150 heavily indoor mold-exposed patients found the following health problems: fatigue (100%), rhinitis (65%), memory loss and other neuropsychiatric problems (46%), respiratory problems (40%), fibromyalgia (29%), irritablebowel syndrome (25%), vasculitis (4.7%) and angioedema (4.0%). These clinical reports suggest that there can be multisystem adverse effects of airborne mold. All reported cases had environmental mold exposure consistent with toxic mold exposure.
Fungi can exert ill health effects by three major mechanisms: allergy, toxicity, and infection.
Fungi produce a wide variety of toxic chemicals called mycotoxins. Some common mycotoxins include: aflatoxins—very potent carcinogens and hepatotoxins, produced by some Aspergillus species; ochratoxins—nephrotoxic and carcinogenic, produced by some Aspergillus and Penicillium; sterigmatocystin—immunosuppressive and a liver carcinogen, produced by Aspergillus species, especially A. versicolor; trichothecenes—produced primarily by Stachybotrys and Fusarium species and have been reported to inhibit protein synthesis and cause hemorrhage and vomiting. Fungi also produce beta glucans, which have immunological effects. The smell of molds comes primarily from volatile organic compounds.Adverse human and animal effects from mycotoxin-contaminated foodstuffs have been well recognized since the early twentieth century, but the pathway of mycotoxin injury through inhalation is questioned. Because it is unethical to conduct controlled studies on humans with inhaled mycotoxin exposure, only controlled animal exposures and human cohort and case–control studies can be carried out. The literature reveals that significant amounts of mycotoxins (including ochratoxin, sterigmatocystin and trichothe- cenes) are present in indoor dust and dust or fungal particles less than 10mm in diameter are respirable, thus allowing absorption of mycotoxins through the lungs.Patients exposed to indoor Stachybotrys have been found to have measurable blood levels of the Stachybotrys hemorrhagic toxin stachylysin. Levels of trichothecene mycotoxins in urine have also been found in significantly higher levels in patients exposed to high indoor fungal levels as opposed to an unexposed control group.Blood ochratoxin levels have been found to be significantly higher in food industry workers exposed to airborne ochratoxin vs. unexposed controls. These findings support an inhalation pathway for entry of mycotoxins into the body.