Seminar 57 Dampness and Mold in Homes: Update on Health Effects and Environmental Assessments that Are Useful for Physicians

Wednesday, June 28, 2017: 11:00 AM-12:30 PM
Residential Buildings: Standards Guidelines and Codes
Chair: Elliott Horner, Ph.D., UL Environment
Sponsor: Environ Health // SSPC 62.1 // SSPC 62.2
CoSponsor: 1.12 Moisture Management in Buildings
Six recent peer-reviewed papers summarized the current state of knowledge regarding exposure to indoor mold colonization. New information on innate immunity interaction with microbial products offers a plausible mechanism in place of the “all mycotoxin” vs “only allergen” choice. Included in these papers is guidance for clinicians working with an Indoor Environmental Professional (IEP) and guidance for IEPs on what makes a clinically useful and relevant assessment report. The collaboration of IEP and clinician may become routine if the clinician requests assessments when appropriate and if the IEP reports are helpful. Some insurers are already considering the benefit/cost.

1  Finally Getting to the Cause: What Is Damp and Mold Doing to Residents?

Elliott Horner, Ph.D., UL Environment

Kevin Kennedy, MPH, CIEC, MS, Children's Mercy Hospitals and Clinics

The effects and clinical management of patients with respiratory disease that are exposed to indoor mold colonization are still not fully understood. A recent effort by a Working Group of the American Academy of Allergy compiled six peer-reviewed papers covering responses to fungal products and health effects related to exposure and clinical management. Recent information on the innate immune system and the interaction with various microbial components sheds light on the prevailing controversy of whether health effects associated with damp buildings are due to mycotoxins or allergens. Other microbial products are now seen as likely factors to these respiratory effects.

2  Key Elements of Relevant and Useful Home Assessments

Kevin Kennedy, MPH, CIEC, Children's Mercy Hospitals and Clinics
Significantly, information on the home environmental is now recognized as often important to the clinical management of respiratory disease. Guidance is presented for clinicians regarding questions they should be asking patients regarding residential conditions associated with dampness and mold, and how clinicians should work with Indoor Environmental Professionals (IEP). Key components are identified that should be included by an IEP in an environmental report if the report is to be useful to a clinician. The importance is stressed of an IEP avoiding making medical inferences and of a clinician not making conclusions about the building.

3  Residential Dampness Assessment: Elements of a Useful Report

Elliott Horner, Ph.D., UL Environment

If a home assessment is justified and requested, the report from the Indoor Environmental Professional (IEP) must provide accurate, useful and actionable information. An outline is provided including the necessary criteria for a report. These criteria include, ¨a rationale for each specific activity/measurement/sample, ¨ observations supported by objective evidence, ¨ conclusions prepared by the on-site investigator and incorporating data collected with ¨ priority assignments to any recommendations provided.

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