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November 15, 2004

Health Center Manual Focuses on Effects
of Mold, Moisture, Indoor Air Quality

Well known in Connecticut for its focus on the relationship between disease and indoor air quality, the Center for Indoor Environments and Health at the UConn Health Center is now set to make an impact nationally through the publication of one of the first comprehensive guides on the health effects of mold and moisture indoors.

“Chronic water incursion that results in microbial growth is a problem that people are becoming more aware of and worried about, and they are going to their physicians with their concerns,” says Dr. Eileen Storey, chief of the Division of Occupational and Environmental Medicine. Storey wrote the book with other faculty members from the Center for Indoor Environments and Health with a grant of nearly $208,000 from the Environmental Protection Agency. The book, Guidance for Clinicians on the Recognition and Management of Health Effects Related to Mold Exposure and Moisture Indoors, was released by the EPA last week.

“Something is going on in our indoor environment that is making us sick,” says Storey. “We see it in office workers. We see it in school teachers. Their illnesses range from chronic runny nose to sinusitis or more serious conditions like asthma and hypersensitivity pneumonitis. Their symptoms often diminish when they leave the workplace for the weekend or the summer, but we don’t know what is actually causing their illness.”

She says that in recent years, a lot of attention has focused on architecture, construction materials, and ventilation systems. “We use wallboard instead of plaster,” she says. “We don’t build with wood and bricks as much; instead we use steel and concrete. Modern materials don’t shed water as well. When water comes into contact with wallboard and wall-to-wall carpeting, it can create a beautiful environment for growing mold.”

Storey says the guide is designed as a manual for primary care physicians.

“We give them an approach to use with their patients,” she says. “We help them identify patients and the illnesses or complaints that may be related to mold or other indoor contaminants. We give them assessment tools for those patients. We tell them how to counsel their patients and guide them to resources their patients can use to reduce moisture and mold in their homes.”

For example, the book contains a questionnaire physicians can use to evaluate a patient when an environmental problem is suspected. It can be filled out by the patient in a few minutes and contains questions that help explore moisture and mold in the patient’s home, school, or work environment. Any positive response may indicate uncontrolled moisture with a potential for biological growth and can be a starting point for a dialog between patient and health care provider. The book provides a list of references to specific books or pamphlets that patients can use to eliminate problem moisture.

“We know that exposure to mold and other contaminants in indoor environments may adversely affect a person’s health,” says Paula Schenck, another author of the book. “We spend nearly 90 percent of our time indoors. Asthma has increased substantially in recent years, so we suspect the indoor environment plays a role. But not everyone is sensitized to indoor contaminants, and different people become sensitized in different ways.”

The book provides approaches for assessing indoor environments and gives physicians strategies to recognize environmentally related clinical problems, Schenck adds.

She says the book provides primary care physicians with the tools they need to address environmental illnesses.

“If a patient presents with persistent respiratory symptoms, physicians should inquire about the presence of chronic moisture in the home, workplace, or school,” she says. “It’s like tobacco. Thirty years ago, doctors didn’t think of tobacco as an issue for them in their practice. Now it’s standard health care practice for physicians to ask their patients about tobacco use and provide counseling for it. We hope this book will do the same thing for indoor air quality. We want them to ask their patients about environmental issues that might be related to their illnesses and be able to provide counseling about them.”

Besides Storey and Schenck, authors are Dr. Kenneth H. Dangman; Dr. Robert L. De Bernardo; Chin S. Yang; Anne Bracker; and Dr. Michael J. Hodgson.

The book presents illustrative case reports, briefly discusses fungal ecology, reviews current literature on health effects from mold and moisture, and outlines principles that underlie a professional environmental assessment. It is available at the Center for Indoor Environments and Health website: