Mold is a naturally occurring organism in our world and we are all exposed on some level in our indoor and outdoor environments. However, whether it is harmful to us or not depends on the sensitivity of the individual, the level of exposure, and the type of mold involved.
Let’s consider this case and explore each of those elements.
A 20-something year old man has a cough that began about 4 months ago. In addition to the cough, he has noticed shortness of breath, wheezing, and chest tightness that occurs primarily when he is at work. He does not experience the cough on weekends when he does not work. He began working in his current office about 5 months ago; he describes it as being in an old building. Shortly after the cough began, he was initially treated for suspected bronchitis with antibiotics, which did not improve his symptoms. Due to his ongoing symptoms and his concern that there may be an exposure in his workspace that caused his symptoms, he requested that his office be tested for mold. He learned that prior to his working in his current office, there was significant flooding in the space.
Let’s take a break here and talk about some of the specific ways that mold exposure can cause human disease. Let’s review these in brief.
1) Mold Allergy: Occurs when someone develops specific antibodies to specific molds. Symptoms usually involve those typically seen with other airborne environmental allergies, such as itchy eyes, runny or stuffy nose, cough, wheeze, or shortness of breath. Treatment is focused on avoidance in addition to other similar to treatments for other environmental allergens.
2) Mold Toxicity: Occurs when certain molds produce toxins that can be dangerous when someone is exposed in large enough quantities. These toxins are only produced under certain conditions, so the presence of a certain mold does not mean that a person was exposed to the toxins. The level required to cause health effects from inhalation is difficult to reach in most settings. It may occur through ingestion in large amounts. In the case that an individual had symptoms associated with a mold toxin, the symptoms would usually last for a limited time, from a few hours to a few days.
3) Mold Irritant Reactions: Occur when certain elements of mold that can be irritating – such as the spores or other chemical components – cause irritation when they are, for example, breathed into the nose or lungs or are in contact with the eyes. The extent to which a person is affected depends on the individual and the amount of irritants they are exposed to. Typically, the effects are in close proximity to the exposure and resolve after the person leaves the environment. Irritant reactions do not usually last for weeks or more after one is no longer exposed.
4) Specific Diseases Caused by Mold: These include infections (of the skin, blood, sinuses, or lungs), hypersensitivity pneumonitis, allergic bronchopulmonary aspergillosis, or allergic fungal sinusitis. These each have specific symptoms associated with them and specialized treatment that will not be detailed here.
Now back to our patient. He was found to be allergic to a common indoor mold through allergy skin testing. His office space was evaluated for mold and there was found to be a significant amount of mold in the wall behind his desk, where an ongoing leak was discovered. He was moved to a new office space while the mold was treated in his original workspace. His symptoms resolved shortly after he moved to the new space.
In this case, mold allergy was the cause of his symptoms, but there are other ways in which mold can make you sick. Keep in mind that in most cases, the symptoms are usually limited and they resolve once the exposure ends, except in the case of some mold-specific diseases, for which mold-specialized treatment may be needed.