Summary of Institute of Medicine's Damp Indoor Spaces and Health Review (2004)

Table 1. Evidence of Association between Damp Indoor Environments and Mold Health Outcomes
Health outcome or symptom Exposure to damp indoor environments Presence of mold/other agents in damp indoor environments
Upper respiratory tract symptoms1 Sufficient evidence of an association7
Cough2 Sufficient evidence of an association
Wheeze2 Sufficient evidence of an association
Asthma symptoms in sensitized persons with asthma Sufficient evidence of an association
Hypersensitivity pneumonitis3 in susceptible persons Studied in relation to specific agents Sufficient evidence of an association
Shortness of breath (dyspnea)2 Limited or suggestive evidence8 Inadequate or insufficient evidence9
Respiratory illness in otherwise healthy children Limited or suggestive evidence
Respiratory illness in otherwise healthy adults
 		 Inadequate or insufficient evidence
Acute idiopathic pulmonary hemorrhage in infants Inadequate or insufficient evidence
Fungal sinusitis4 No specific studies associated the condition with damp or moldy indoor spaces
Severe respiratory infections in people whose immune system is severely immunocompromised5 Not applicable10 Sufficient evidence of an association
Fungus-related illnesses in people whose immune system is severely immunocompromised5 and who have chronic obstructive pulmonary disease (COPD) Not applicable10 Sufficient evidence of an association
Colonization and potential lung infection in people with some chronic pulmonary disorders6 Not applicable10 Sufficient evidence of an association
Notes:
  1. Upper respiratory tract symptoms include nasal congestion, rhinitis, allergic rhinitis “hay fever", sneezing, runny or itchy nose, sinusitis and sore throat.
  2. Lower respiratory tract symptoms include cough with or without production of phlegm, wheeze, chest tightness, and shortness of breath.
  3. Hypersensitivity pneumonitis is a lung disease that is the result of exposure and sensitization to antigens inhaled with a variety of organic dusts. Symptoms include dry cough, dyspnea, and fever and sometimes acute bronchospasm.
  4. Fungal sinusitis is associated with molds but molds may come from the indoor or the outdoor environment.
  5. Immunocompromised persons are at increased risk for fungal colonization or opportunistic infections.
    • It is well established that fungal exposures causes opportunistic cutaneous and subcutaneous fungal infections of the skin of severely immunocompromised persons.
    • Respiratory infections can result from exposure to fungi, including Aspergillus spp. and Fusarium spp.
    • Severely immunocompromised persons include persons who undergo high-dose cancer chemotherapy, are recent recipients of a solid-organ transplant, or are otherwise immunocompromised.
  6. Chronic pulmonary disorders include cystic fibrosis, asthma, and COPD. Colonization and infections result from exposure to fungi such as Aspergillus.
  7. "Sufficient evidence of an association" means that studies show an association between the agent and disease and chance, bias, and confounding were ruled out with reasonable confidence.
  8. "Limited or suggestive evidence of an association" means that evidence is suggestive of an association between the agent and the disease but is limited because chance, bias, and confounding cannot be ruled out with confidence.
  9. "Inadequate or insufficient evidence to determine whether an association exists" means that the available studies are of insufficient quality, consistency, or statistical power to permit a conclusion regarding the presence of an association. Alternatively, no studies exist that examine the relationship.
  10. Respiratory infections, fungus-related illnesses, and colonization with lung infection relating to specific organisms.
Source:

Institute of Medicine’s "Damp Indoor Spaces and Health" (http://www.nap.edu/books/0309091934/html/). [external link]

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