# Presentation: 229270

## When Mold Infestation Turns Deadly

**When Mold Infestation Turns Deadly**
**For Patients and Staff  **

**Wednesday, September 10, 2003**

**National Safety Congress Chicago, Ill**

***A Joseph S. McFadden Presentation            ******JSM1950@aol.com***

## Mold Characteristics

**Molds are the most typical forms of fungus**
**Molds are ubiquitous and essential decomposers of organic substances**
**The **_***mycelium***_*** ******is made from strings of ***_***hyphae,***_*** which makes the ***_***body***_*** that we see***
**Molds reproduce via spores**

## Mold Characteristics

**Molds can spread by transplantation of broken hyphae into an area of moisture and organic “food” material**
**“****Food” material consists of wood, paper, paint, fabric, plant soil, dust, cooked or raw foods, and damp inorganic matter such as glass and bare concrete that is covered by a layer of **_***biofilm***_

## Mold Characteristics

**Some molds germinate in four-to-twelve hours**
**Left undisturbed, mold can grow and spread in 24-72 hours**
**Floods, leaking pipes, leaking windows, leaking roofs, humidity, spoiled food, and poor housekeeping can lead to mold growth and infestation**
**Molds can “hide away” until the right conditions cause germination and growth**
**Some molds produce **_***toxic mycotoxins***_
_***All ***_**molds, under the proper conditions, are capable of eliciting a negative health response in humans**

## How Mold Enters the Facility

**The molds can enter:**
**Through doorways and windows**
**Through ventilation and air conditioning systems**
**On people, clothing, shoes, and bags**
**On construction material**
**On wheelchair and gurney wheels**
**On supplies and linen**

## Where Molds Live in Health Care Facilities

**On and in insulation**
**In water damaged areas and on water damaged goods and materials**
**In moist and high humidity areas**
**In air conditioning and ventilation ducts**
**Behind and in drywalls and other construction material**
**In dust and accumulated water**

## Mold Properties: Potential Threats to Human Health

**Can inflict a variety of health responses in humans**
**Severity of health reaction = type and amount of mold and susceptibility and sensitivity of individual**
**Exposure occurs via ingestion, inhalation, or skin/eye contact with mold or infested material**

## Mold Properties: Potential Threats to Human Health

**Mold components known to elicit a response in humans:**
_***VOC ***_**(odor in cheeses): headaches, attention deficit, dizziness, and mucous membrane irritation**
_***Allergens***_** (present on spores; all molds can cause allergic reactions in humans): mild, transitory responses like runny nose and eyes to severe, chronic illnesses like sinusitis and asthma**

## Mold Properties: Potential Threats to Human Health

**Mold components known to elicit a response in humans:**
_***Mycotoxins***_** (natural organic compounds capable of producing a toxic response in vertebrates). Molds need a specific genetic potential and specific environmental conditions to create mycotoxins.**

**Aspergillus Niger (can produce mycotoxin)**

## Potential Health Effects of Mold

**Four species of mold found to be consistently responsible for many of the adverse health effects in humans and vertebrates:**
***Aspergillus***
***Cladosporium***
***Penicillium***
***Stachybotrys***

***Penicillium Mold***

## Potential Health Effects of Mold

**The extent to which an individual may be affected depends on:**
**His/her state of health**
**Susceptibility to disease**
**The organism of exposure**
**The duration and severity of the exposure**

## Potential Health Effects of Mold

**Those at risk for **_***systemic***_** fungal infections are:**
**Severely immumocompromised individuals:**
**Undergoing chemotherapy**
**Have had organ or bone marrow transplants**
**Have HIV/AIDS**

## Those at Risk in Health Care

**Infants**
**The elderly**
**The chronically ill**
**Severely immunocompromised individuals**
**Patients**
**Volunteers**
**Sitters**
**Employees**
**Doctors**

## Aspergillus

**Includes *****A. fumigatus, A. niger, and A. flavus***
**Three clinical types of pulmonary **_***aspergillosis***_**: allergic; aggressive tissue invasion; and fungus ball**
**Culture requires 1-3 weeks to grow**
**Is a serological test for aspergillosis**
**Commonly found in food, soil, air vents, and paint**

## Cladosporium

**Frequently found in water damaged environments, on fiberglass duct insulation, paint and textiles**
***Cladosporium***** species are causative agents for skin lesions, keratitis, onychomycosis, sinusitis, edema, and pulmonary infections**
**Common allergen and some strains can produce mycotoxins**

## Penicillium

***P.Chrysogenum *****is the mold that creates the drug**
***Penicillium*****, in general, is rapid growing, with a musty odor.**
**Found in soil, carpet, cellulose, water-damaged material, paint, wall paper, and in fiberglass**
**Associated with allergic reactions, hypersensitivity pneumonitis, a variety of severe lung conditions, and organ and bone marrow infections**
**Inhalation, skin contact, and ingestion are the main routes of entry**

## Stachybotrys Chartarum

**Found in cellulose-containing products (such as wood, wicker, ceiling tile, dry wall, vapor barriers, and fiberboard) and water damaged materials**
**Can produce mycotoxins and spores and mycotoxins are very bad if inhaled or ingested **
**Can cause lung disorders, and permanent neurological, pathological, psychological, and immunological effects on the human body**

## Some Signs and Symptoms of Diseases Caused by Mold

**Allergic reaction/sensitivity (hives, runny nose runny eyes, headache) when in the facility**
**Acute or chronic cough**
**Fatigue and confusion**
**Shortness of breath**
**Body aches and pains – fairly intense and chronic**
**Lethargy**
**Coma**

## Diagnostic Process

**Serological testing for patients and staff**
**Rule-out of other conditions for the inpatient**
**Identification of mold invasion in the facility**
**Physical health condition of patient or staff member**
**Staff needs to be seen by employee health and/or own physician**
**Construction projects in or around facility**
**Community outbreak**

## Prevention of Mold Infestation and Disease

**Clean up and fix all leaks**
**Replace all water-damaged materials and goods**
**Keep HVAC clean and standing water free**
**Ensure that there are good housekeeping practices that include deep carpet, cloth, furniture and drapery cleaning**
**Target critical areas, patients and staff for closer observation**
**If it smells like mold, it probably **_***IS ***_**mold**