House mold threatens healthMar 24, 2003 | Knight Ridder Newspapers Dr. Sam Scheinfield hadn't missed a day at work in 28 years.
But after the medical building that housed his family practice was renovated, Scheinfield started sneezing and suffering with itchy eyes, he says. The symptoms began in July 1999 and escalated to frequent nosebleeds, shortness of breath, skin rashes and fatigue.
His health continued to deteriorate even after he complained to the clinic's manager and the carpeting was replaced, he says.
Two separate investigations by environmental health firms found a foul-smelling black moldy substance blanketing his office the result of several flooding incidents attributed to a construction flaw.
Scheinfield hasn't worked since Nov. 25, 2000, and his health still hasn't returned.
"It's taken my career and changed my life," says the 58-year-old Farmington Hills resident.
Increasingly within medical and scientific circles, mold is identified as a cause of soaring rates of allergy and asthma. What's unclear is how big a contributor mold is, compared to other indoor asthma triggers, and which health problems it causes.
Asthma, for example, has reached epidemic proportions in urban regions. Many people who have mold allergies develop asthma, but not all. Doctors are trying to find out why.
They also are trying to tease out whether indoor mold is as significant a contributor to asthma as exposure to dust mites, which, like mold, thrive in damp environments. Recent Scandinavian studies suggest indoor mold aggravates asthma more than dust mites, but more research is needed, the studies' authors say.
A bigger dispute in medical and legal circles involves whether exposure to indoor mold causes serious, chronic health problems like Scheinfield's.
But while doctors await more research, many are putting household inventories in their patients' histories and recommending bleach-and-water solutions for mold cleanup, or even abandoning a suspect environment.
"When I trained, there wasn't much talk about toxic mold," says Dr. Rick Vinuya, a busy allergy specialist who has practices in Ann Arbor and Novi, Mich. He's been practicing for eight years. "Now I see heightened sensitivity to it. We're looking for it now. We're asking about it."
Responsibility for cleaning it up and preventing it begins at home. Checking for mold regularly and cleaning up trouble spots quickly often helps. And families need to appreciate how vulnerable some people might be to mold, particularly cancer and transplant patients, elderly people and children, especially if they are exposed to cigarette smoke, experts say.
"Coming from an allergy and asthma viewpoint, I truly believe mold is a problem," Vinuya says. "It's something we need to look for and eradicate. In terms of toxic black mold, the data aren't there yet to substantiate serious health effects. But there is an association. It's just very difficult to find the cause and effect. The bottom line is, when black mold is found we have to take it out."
While research continues, Dr. Michael Harbut, director of the Center for Occupational and Environment Health in Royal Oak, Mich., hopes doctors take a middle road and use the diagnostic tools and medicines available to people who suspect they have health problems related to mold.
Harbut orders skin and blood tests for his patients, and takes an extensive personal health history and a household inventory. He suggests trial absences from a home or workplace, to see whether symptoms improve.
For patients like Scheinfield, one of several hundred people Harbut sees with mold-linked problems, he orders CT-scans and performs regular lung function tests to determine the extent of the problems. Over months, even years, some patients get better, he says.
Scheinfield, however, is waiting for his health to improve.
That's basically the position the American College of Occupational and Environmental Medicine took in October when it released a report titled "Adverse Human Health Effects Associated with Molds in the Indoor Environment." Called an "evidence-based statement," the report said outdoor molds contribute more to allergies than indoor sources.
But members of the college attacked it and questioned what they see as the authors' conflicts of interest and omission of key research that found that indoor mold exposure is a bigger health problem than the authors conclude.