Table 4. Qualitative reviews published after 2009 of associations of dampness and mold in homes with health

Issues Reviewed

Key Findings

Reference

Associations of health with qualitative assessments of dampness or mold (such as report of visible mold) and with quantitative measurements of microbial agents

Indoor dampness or mold determined visually or from mold odor was statistically significantly associated with increases in the following outcomes, generally with high consistency: asthma exacerbation, cough, wheeze, upper respiratory symptoms, asthma development, shortness of breath, ever diagnosed asthma, respiratory infections, bronchitis, allergic rhinitis, eczema. There was limited suggestive evidence of associations of dampness and mold with increased common cold and allergy/atopy.  There was insufficient evidence to determine if dampness or mold were associated with lung function or hypersensitivity pneumonitis. There was limited suggestive evidence of an association of increased wheeze with higher ergosterol (a fungal marker) in dust. There was limited suggestive evidence of an association of increased wheeze with higher endotoxin (primarily a marker of bacteria) in dust.

Mendell et al. 2011 [40]

Associations of allergic and asthma health outcomes in children with visible mold, mold concentrations in air or dust, concentrations of markers of mold in homes

Visible mold and mold spore levels were associated with increases in allergic respiratory health outcomes in children. There was less evidence of associations of other markers of molds or mold components with health.

Tischer et al. 2011a  [42]

Associations of respiratory health outcomes with indoor dampness and mold at home and away from the home

This review found evidence of associations of indoor dampness and mold or higher mold levels with development of asthma, asthma exacerbation, lower respiratory symptoms (such as cough, wheeze, shortness of breath), nasal and throat symptoms, and respiratory infections. There was also evidence that two relatively rare lung diseases - hypersensitivity pneumonitis and sarcoidosis – increase in buildings with dampness and mold problems. These findings were based on a review of studies of dampness and mold in both homes and workplaces.

 

Park and Cox-Ganser 2011 [41]

Associations of indoor environmental exposures, including indoor dampness and mold, with exacerbation of asthma

This review considered journal articles published between 2000 and 2013 and concluded: 1) there is a causal relationship between asthma exacerbation in children and indoor dampness or dampness-related agents; 2) asthma exacerbation in adults is associated with dampness or dampness-related agents; 3) there is limited or suggestive evidence of asthma exacerbation with indoor culturable Penicillium (a genus of fungi) and with indoor culturable total fungi.

Kanchongkittiphon et al 2015  [43]

Health effects of mold exposure

These two reviews focus on the health consequences of mold without an exclusive focus on indoor dampness and mold. Both articles find that there are relatively few health outcomes for which causal relationships between mold exposure and health has been proven. These few outcomes include mold infections and relatively rare lung diseases. The article by Borgers et al. finds that reports of “toxic mold syndrome or toxic black mold have been shown to be no more than media hype and mass hysteria.” The article by Pettigrew et al. finds that there is basically no evidence that mold causes autoimmune diseases and suggests that mold is not likely a cause of sick building syndrome symptoms.

Pettigrew et al. 2010 and Borchers et al. 2017 [44, 45]