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Brief Summary

GUIDELINE TITLE

Spectrum of noninfectious health effects from molds.

BIBLIOGRAPHIC SOURCE(S)

GUIDELINE STATUS

This is the current release of the guideline.

All clinical reports and policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

BRIEF SUMMARY CONTENT

 
RECOMMENDATIONS
 EVIDENCE SUPPORTING THE RECOMMENDATIONS
 IDENTIFYING INFORMATION AND AVAILABILITY
 DISCLAIMER

 Go to the Complete Summary

RECOMMENDATIONS

MAJOR RECOMMENDATIONS

  1. Because there are established health hazards, inquire about the presence of mold as part of a "healthy home" inventory. Questions about a child's environment are basic to a comprehensive pediatric health history (American Academy of Pediatrics, 2003). Questions can be incorporated during visits for health supervision or sick visits. Asking about a child's environment should be routine for children with common illnesses, such as allergic rhinitis/conjunctivitis and asthma, as well as for those with less common illnesses, such as hypersensitivity pneumonitis.
  2. Provide guidance to parents of all children about:
    • The adverse health effects of mold exposure, especially the causal relationship between mold and allergic illness and respiratory symptoms; and
    • Preventing and reducing mold exposure in the immediate indoor and outdoor environments.
  3. Educate families on mold remediation. Visible signs of mold growth (e.g., discolored patches or cottony or speckled growth on walls or furniture, evidence of dampness or water damage or an earthy musty odor in a particular area) suggest a damp environment and mold growth. In areas where flooding has occurred, prompt cleaning (within 24 hours) of walls and other flood-damaged items is necessary to prevent mold growth. Testing the environment for specific molds is usually not necessary. In general, individuals can perform mold cleanup for areas less than 10 ft (Centers for Disease Control and Prevention, 1997).
  4. When treating an infant with acute idiopathic pulmonary hemorrhage (AIPH), inquire about mold and water damage in the home. Report cases of AIPH to state health departments. Although a causal relationship between AIPH and damp, moldy indoor environments has not been firmly established, the knowledge is incomplete at this time. Therefore, it is prudent to recommend that parents of infants with AIPH try to find and eliminate sources of chronic moisture and mold growth before the child returns to the home. Avoidance of exposure to secondhand cigarette smoke is always recommended, but especially in cases of AIPH.
  5. Be aware that there are no uniformly accepted, valid, quantitative environmental sampling methods or serologic tests to assess exposures to mold and other agents associated with damp indoor environments. There are also no accepted valid airborne levels of mold that predict adverse health effects.
  6. Be aware that there is currently no method to test humans for toxigenic mold exposure (California Department of Health Services, 2005).
  7. Be aware that mold-contaminated foods (especially grains) can contain harmful amounts of mycotoxins. The US Department of Agriculture has set allowable limits in certain food items and has some routine monitoring in place to prevent harmful ingestion of mycotoxin-contaminated foods. Inquire about dietary history if a mycotoxin-induced illness is suspected.

See the original guideline document for recommendations to government.

CLINICAL ALGORITHM(S)

None provided

EVIDENCE SUPPORTING THE RECOMMENDATIONS

REFERENCES SUPPORTING THE RECOMMENDATIONS

TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The type of evidence supporting the recommendations is not specifically stated.

IDENTIFYING INFORMATION AND AVAILABILITY

BIBLIOGRAPHIC SOURCE(S)

ADAPTATION

Not applicable: The guideline was not adapted from another source.

DATE RELEASED

2006 Dec

GUIDELINE DEVELOPER(S)

American Academy of Pediatrics - Medical Specialty Society

SOURCE(S) OF FUNDING

American Academy of Pediatrics

GUIDELINE COMMITTEE

Committee on Environmental Health

COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

Committee on Environmental Health, 2005-2006: Michael W. Shannon, MD, MPH, Chairperson; Dana Best, MD, MPH; Helen J. Binns, MD, MPH; Joel A. Forman, MD; Christine L. Johnson, MD; Catherine J. Karr, MD, PhD; *Janice J. Kim, MD, PhD, MPH; *Lynnette J. Mazur, MD, MPH; James R. Roberts, MD, MPH

Liaisons: Elizabeth Blackburn, RN, US Environmental Protection Agency; Mark Anderson, MD, Centers for Disease Control and Prevention/National Center for Environmental Health; Martha Linet, MD, National Cancer Institute; Walter Rogan, MD, National Institute of Environmental Health Sciences

Staff: Paul Spire

*Lead authors

FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Not stated

GUIDELINE STATUS

This is the current release of the guideline.

All clinical reports and policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

GUIDELINE AVAILABILITY

Electronic copies: Available from the American Academy of Pediatrics (AAP) Policy Web site.

Print copies: Available from American Academy of Pediatrics, 141 Northwest Point Blvd., P.O. Box 927, Elk Grove Village, IL 60009-0927.

AVAILABILITY OF COMPANION DOCUMENTS

PATIENT RESOURCES

None available

NGC STATUS

This NGC summary was completed by ECRI on April 2, 2007. The information was verified by the guideline developer on April 9, 2007.

COPYRIGHT STATEMENT

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please contact the Permissions Editor, American Academy of Pediatrics (AAP), 141 Northwest Point Blvd, Elk Grove Village, IL 60007.

DISCLAIMER

NGC DISCLAIMER

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Readers with questions regarding guideline content are directed to contact the guideline developer.


 

 

   
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