In late 2017 the American Journal of Respiratory and Critical Care Medicine released a Public Health Brochure about mould. In this blog post I want to talk about this document because it is very relevant to Australians as well as our American counterparts. The point of this PDF which I’ll link to at the bottom of this post is to inform people about what to do after natural disasters such as hurricanes, tornadoes, and floods and what to do when there is excess moisture or standing water after a flood.
It is important to recognise that any persons returning to a home or building that has been flooded should be aware that mould is likely to be present and is a very real health risk for first responders, occupants, tenants, workers and in fact any person, child or pet.
The American Thoracic Society who authored this public-health document highlight the salient questions: How do I know if my house has mould?
There are two questions you need to ask yourself to determine the answer regarding if your building or property may have excess levels of mould.
The authors point out that although mould may not always be seen or smelled it definitely needs to be tested in order to confirm or refute the overall hygiene of the building after water damage and flooding. The best person to carry out an assessment includes trained mycologists/microbiologists, industrial hygienists and occupational health personnel. It is very important when engaging any person purporting to be able to quantify mould and test air quality that they are qualified and that the methods they use will be capable of measuring the presence or absence of mould and to what degree. Always insist on an explanation of what lab work is being used and what it will enable the assessor to comment on?
The American Thoracic Society stated that people with asthma, allergies and other respiratory conditions may be more sensitive to mould as well as persons who are pregnant, immunocompromised or unwell due to other illness. Such persons should always try to avoid entering buildings that have become contaminated with mould.
Many people ask me what are some of the typical symptoms of mould sensitivity. Again, this has been summarised very well by the American Thoracic Society and typical symptoms of mould sensitivity include: irritated eyes, skin irritation/rash, stuffy nose, shortness of breath, wheezing and cough.
So, what can you do to prevent mould growth? The best way is to control the underlying water problem. The most critical factor in minimising further mould growth is to dry out the house by opening doors and windows, installing dehumidifiers and physically removing and discarding water damaged building elements and soft furnishings such as carpet and mattresses pillows and any paper-based products. It is very likely that plasterboard walls will need to be stripped out or at least back to the frame, and water damaged insulation removed and discarded.
Be very careful of disaster management restorers/remediators/Insurance contractors and assessors who claim that they need to structurally dry out the house. In many cases, the use of fans and forced hot air only spreads the mould spores throughout the home, thereby making a contained problem a new, whole-of-house problem. Water damaged buildings need to be contained using physical barriers before structural drying is even considered and then only with high efficiency particulate matter (HEPA) air scrubbers in use to extract the particulate matter.
Obviously, it is very important to protect yourself whilst cleaning up any mould and therefore efficient respiratory protection using quality face masks must be used along with protective eyewear to minimise exposure of mucous membranes with cell wall fragments and spores that easily become airborne.
It is imperative that any persons who may suffer from chronic lung conditions or weakened immune systems are cautioned that they should not enter water damaged, mould containing buildings due to the fact that they could develop fungal lung infections. Similarly, it is important to assess a home following water damage to establish baseline mould levels and assess the impact of the remediation/cleaning efforts.
The take home messages are therefore:
Reference: Mold-Specific Concerns Associated with Water Damage for Those with Allergies, Asthma, and Other Lung Diseases. W. Graham Carlos, MD, Charles Dela Cruz, MD, PhD, Shazia Jamil, MD, Howard Kipen, MD, MPH, Cecile Rose, MD. Am J Respir Crit Care Med. 2017 Oct 1;196(7):P13-P14. doi: 10.1164/rccm.1967P13.
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