From a 2020 paper confirming that health effects caused by exposure to mold in water-damaged buildings are sometimes irreversible

The Roles of Autoimmunity and Biotoxicosis in Sick Building Syndrome as a “Starting Point” for Irreversible Dampness and Mold Hypersensitivity Syndrome

"Persistent or cumulative exposure to DM (dampness microbiota) may make SBS (sick building syndrome) potentially life-threatening and lead to irreversible dampness and mold hypersensitivity syndrome (DMHS)."

"The impact of DM and mycotoxins on the initiation of SBS and further deterioration of many bodily functions has become already established even if water damage has been removed."

"Many indoor air mycotoxins are neurotoxic. They have multiple actions on the cell: they may increase the production of reactive oxygen species (ROS), may deplete ATP synthesis, may alter mitochondrial membrane potential and facilitate the release of mitochondrial proteins into the cytosol. Exposure to mycotoxins activates inflammasome machinery in the cell. This will promote the production of the pro-inflammatory IL-1β cytokine, the marker of the activation of innate immunity. When IL-1β cytokine binds to its cognate receptor, IL-1R1, intracellular signal transduction will follow. This mechanism will lead to a vicious cycle of inflammation."

This report includes a discussion about the importance of using the correct procedures for sampling and testing. For example, it explains why air sampling is inaccurate and ineffective. Here is an excerpt of that discussion:

"Air sampling completely ignore the fact that toxigenic indoor microbes, such as Stachybotrys, emit toxins as liquid vesicles (micro vesicles, exoms) in which the concentrations of toxins are more than 1000-fold higher than the emissions coming from the same microbial particle (spores, hyphae fragments)."

From the 2016 UNICEF report:

UNICEF: Clear the Air for Children

The UNICEF report highlights the significant impact of indoor and outdoor pollution on children and emphasizes the urgent need for countries to take action now. They say it very succinctly with the comment “the impact is commensurately shocking."

Children breathe twice as quickly as adults, and take in more air relative to their body weight. Their respiratory tracks are more permeable and thus more vulnerable. Their immune systems are weaker. Their brains are still developing.

Pollutants don't only harm children's developing lungs, they can actually cross the blood brain barrier and permanently damage their developing brains and, thus, their futures. No society can afford to ignore air pollution.

Ultrafine, airborne pollutants -- caused primarily by smoke and fumes -- can more easily enter and irritate children’s lungs, causing and exacerbating life-threatening disease. Studies show these tiny particles can also cross the blood-brain barrier, which is less resistant in children, causing inflammation, damaging brain tissue, and permanently impairing cognitive development. They even can cross the placental barrier, injuring the developing fetus when the mother is exposed to toxic pollutants.

From a 2016 World Health Organization report:

Ambient Air Pollution: A Global Assessment of Exposure and Burden of Disease

"Air pollution continues to take a toll on the health of the most vulnerable populations – women, children and the older adults," adds Dr. Bustreo. "For people to be healthy, they must breathe clean air from their first breath to their last."

From the 2009 World Health Organization report:

WHO Guidelines for Indoor Air Quality: Dampness and Mould

Indoor air pollution--such as from dampness and mould, chemicals and other biological agents--is a major cause of morbidity and mortality worldwide.

Many of the health effects may result from recurrent activation of immune defence, leading to exaggerated immune responses and prolonged production of inflammatory mediators. Overproduction of these compounds damages the surrounding tissues and may manifest itself as chronic inflammation and inflammation-related diseases, such as asthma.

From the Executive Summary :

Exposure to microbial contaminants is clinically associated with respiratory symptoms, allergies, asthma and immunological reactions. 

Toxicological evidence obtained in vivo and in vitro supports these findings, showing the occurrence of diverse inflammatory and toxic responses after exposure to microorganisms isolated from damp buildings, including their spores, metabolites and components.

From the Introduction, page 1 :

Exposure to microbial contaminants is clinically associated with respiratory symptoms, allergies, asthma and immunological reactions.

From the Introduction, page 5 :

Mechanisms of injury include exposure to Beta-glucans, toxins, spores, cell fragments and chemicals followed by immune stimulation, suppression and autoimmunity as well as neurotoxic effects.

From Chapter 2 :

Mycotoxins, or fungal toxins, are low-relative-molecular-mass biomolecules produced by fungi, some of which are toxic to animals and human beings. Mycotoxins are known to interfere with RNA synthesis and may cause DNA damage.

From a report by Dr. Ruth Etzel:

What the Primary Care Pediatrician Should Know about Syndromes Associated with Exposures to Mycotoxins

Mycotoxins can have protean manifestations; the symptoms depend on the specific toxin or mixture of toxins, the age, sex, and diet of the child, the dose, and whether exposure is by ingestion, inhalation, skin and mucosal exposure, or a combination of two or more of these routes.  The most well-characterized presentations among infants and children are summarized in Table 2 under four headings: vomiting illness, bone marrow failure, acute pulmonary hemorrhage, and recurrent episodes of apnea and/or pneumonia.

From a report by Jack Thrasher, Ph.D.:

The Biocontaminants and Complexity of Damp Indoor Spaces: More Than What Meets the Eyes

Exposure of occupants mainly results from inhalation and, to a lesser extent, skin absorption and ingestion.  Molds produce mycotoxins during rapid growth.  At low concentrations, they cause mycotoxicosis in humans and animals. The mycotoxins causing disease include aflatoxins, ochratoxin A, trichothecenes, citreviridins, fumonisins and gliotoxins.  Mycotoxins can regulate the immune system up or down as well as inhibit synthesis of protein, RNA and DNA.  Moreover, they can form DNA adducts, protein adducts and cause oxidative stress as well as mitochondrial directed apoptosis.

Toxic encephalopathy involves multiple symptoms, including loss of balance, recent memory decline, headaches, lightheadedness, spaciness/disorientation, insomnia, loss of coordination.

From the 1989 report by the Massachusetts Special Legislative Commission on Indoor Air Pollution:

The Commonwealth of Massachusetts, Special Legislative Commission on Indoor Air Pollution: Indoor Air Pollution in Massachusetts

The Commission's efforts confirm the seriousness of the indoor air pollution health threat, which worsened with the energy conservation efforts of the 1970s.  More insulation and tighter construction led to lower ventilation rates and build-up of contaminants.  Many 'sick' buildings have been identified where occupants suffer severe or recurring discomforts such as headaches, dizziness, fatigue, eye irritation, and respiratory problems.  Other conditions attributable to indoor air contaminants include: cancer; bronchitis; pneumonia; heart, circulatory and respiratory problems; impaired vision; skin rash; chemical sensitivity; birth defects; and mental, nervous and immunological disorders.

From a 2004 paper on the effects of toxic mold on the neurological and immune systems:

Molds and Mycotoxins: Effects on the Neurological and Immune Systems in Humans

Forgacs noted in 1962 that mold mycotoxicosis was called "the neglected disease." The manifestations and disorders in humans caused by molds and mycotoxins continues to be overlooked or unnoticed by many physicians. Each year studies continue to be published throughout the world medical and scientific literature elucidating and explaining the pathological processes and biomechanisms by which exposure to molds and mycotoxins cause sickness in humans.

Campbell et al. (2003) studied 119 patients with symptoms of neurotoxicity with documented measured exposure to molds. These patients complained of fatigue, memory loss, cognitive function loss, headaches, tremors, numbness and tingling, blurred vision, tinnitus, and muscle weakness. Ninety-nine of these patients had abnormal clinical neurological examinations, abnormal findings on neurophysiological testing, and elevated antibodies to neuronal antigens.

Campbell et al. (2003) concluded their observations on changes in  nerve conduction velocities and the presence of neural antigen autoantibodies  as follows: "The increased latency for motor and sensory nerves  observed in the 55 patients with mixed neuropathy is suggestive of a demyelinating process (Busby et al., 2003}." This was accompanied by  a decrease in velocities for the median, ulnar, and peronoal nerves while  the tibial nerve had a decrease in the amplitude. All three sensory nerves (median, ulnar, and superficial peroneal) exhibited increased latencies  and decreased amplitudes. Thus the polyneuropathy observed in these  patients appeared to be a demyelinating process with decreased number  and size of fibers (decreased amplitude) and chronic involvement of the  nerve (decreased velocities) (Busby et al., 2003; Steck et al., 1987).

The motor neuropathies (17 patients) had decreases in latencies (peroneal and tibial nerves), decreased amplitudes (median and peroneal nerves),  and decreased velocities (median, ulnar, peroneal, and tibial nerves). This  appeared to be a diffuse neuropathy and may involve some  demyelination  (Berger et al., 2003). Finally, the sensory neuropathies (27 patients) had  increased latencies for all three nerves, with that of the superficial peroneal  being not significant. The increased latencies and the decreased  amplitude of the superficial peroneal suggested  demyelination was occurring (Reindl et al, 1999; Willison and Yuki, 2002).

Report from Finland (2017)

Severe Sequelae to Mold-Related Illness as Demonstrated in Two Finnish Cohorts

The following statements in a 2017 research paper in Finland provide a good summary of this situation (i.e., the government agencies, medical organizations, insurance companies and other naysayers and deniers that refuse to admit the truth about the health effects of toxic mold) and how it is harming patients and keeping them from getting proper medical care:

"Mold-related illness should not be viewed as a so-called medically unexplained syndrome, as has been claimed. In our opinion, providing these patients with cognitive or behavioral therapy is medically unethical—it represents a denial that mold-exposed individuals are suffering from a somatic illness. Moreover, cognitive/behavioral therapy is not effective. 

We can assume that providing the mold-exposed patient with only psychotherapy in combination with high dosages of corticosteroids while he/she continues to live or work in a hazardous environment is inappropriate “medication;” in fact, it will aggravate their risks of suffering severe morbidity and even dying. 

On the basis of the present data, we think that it is irresponsible to claim that indoor molds cause only transient irritation symptoms and pose only a 1.5-fold risk for the development of asthma. Even though more and more knowledge is available on the mechanisms underpinning the health hazards associated with moldy environments, mold-related disease is still called a “non-disease,” or “somatoform disorder,” with some physicians trying to label it as a “fashionable” disorder, or stating that its sufferers are exhibiting hysteria. 

Mold-related illness is a somatic disorder; the symptoms are physical, not psychosocial problems, although this has been claimed for almost 20 years. In most cases, later it can become a psychosocial problem as patients suffer mental distress from their failure to convince physicians that they are ill. 

Our data show that occupying a contaminated building for even 2–3 years (either a home or a school) can seriously impair the well-being of potentially healthy individuals, even to the extent of loss of life. Therefore, any attempt by governmental/medical authorities to deny the serious effects of toxic molds on human health should be combatted."

From a 2016 report by United Kingdom's Royal College of Physicians:

Every Breath We Take: The Lifelong Impact of Air Pollution

In this report, they discuss the impact of indoor air pollution and also mention new indoor air pollutants that need to be considered such as advanced materials and three-dimensional printing.

The multiplicity of contaminants can make it more problematic to determine the precise source of an exposure-triggered illness and more difficult for epidemiologists to quantify cases. However, the report estimates indoor air pollutants “cause, at a minimum, several thousands of deaths per year in the U.K., and associated with healthcare costs in the order of tens of millions of pounds.”

In the report, they estimate that 40,000 deaths per year are attributable to outdoor air pollution, with an annual cost of 20 billion pounds. And, they also include information about indoor air pollutants (including radon, tobacco smoke, carbon monoxide, lead, nitrogen dioxide, particulate matter, PCBs, VOCs, formaldehyde, asbestos, kitchen products, faulty boilers, open fires, fly sprays, air fresheners, biological materials, mould, etc.).

"When our patients are exposed to such a clear and avoidable cause of death, illness and disability, it is our duty as doctors to speak out."

From a November 12, 2016, article about the effects of indoor and outdoor pollution in India:

Dirty Air Could be Killing 4 Kids Every Hour in Uttar Pradesh

Studies across the world and also in India prove that outdoor and indoor air pollution is a serious environmental risk factor that causes or aggravates acute and chronic diseases and has been identified as the fifth highest cause of morbidity in India.

Four kids could be dying every hour in UP (Uttar Pradesh ) of pneumonia caused by respirable suspended particulate matter (PM) 1, 2.5 and 10, which form a large part of the air we breathe. Alarmingly, the number adds up to 104 deaths per day and 38,000 a year.

From a report by Dr. Harriet Ammann:

Is Indoor Mold Contamination a Threat to Health? Part One  (2003) 

Health effects from exposures to molds in indoor environments can result from allergy, infection, mucous membrane and sensory irritation and toxicity alone, or in combination.

Mycotoxins are nearly all cytotoxic, disrupting various cellular structures such as membranes, and interfering with vital cellular processes such as protein, RNA and DNA synthesis.

• Vascular system (increased vascular fragility, hemorrhage into body tissues, or from lung, e.g., aflatoxin, satratoxin, roridins).
• Digestive system (diarrhea, vomiting, intestinal hemorrhage, liver effects, i.e., necrosis, fibrosis: aflatoxin; caustic effects on mucous membranes: T-2 toxin; anorexia: vomitoxin.
• Respiratory system: respiratory distress, bleeding from lungs e.g., trichothecenes.
• Nervous system, tremors, incoordination, depression, headache, e.g., tremorgens, trichothecenes.
• Cutaneous system: rash, burning sensation sloughing of skin, photosensitization, e.g., trichothecenes.
• Urinary system, nephrotoxicity, e.g. ochratoxin, citrinin.
• Reproductive system; infertility, changes in reproductive cycles, e.g., T-2 toxin, zearalenone
• Immune system: changes or suppression: many mycotoxins.

From a 1989 U.S. EPA Report for Congress on Indoor Air Pollution:

U.S. EPA Report for Congress on Indoor Air Quality. Volume II: Assessment and Control of Indoor Air Pollution

Health effects from indoor air pollution cover the range of acute and chronic effects, and include eye, nose, and throat irritation, respiratory effects, neurotoxicity, kidney and liver effects, heart functions, allergic and infectious diseases, developmental effects, mutagenicity, and carcinogenicity.

From a report on the neurotoxic effects of toxigenic mold and mycotoxins:

Neurotoxic Effects of Toxigenic Molds and Mycotoxins 

Exposure to mycotoxins may occur via enteric, inhalation, or direct contact to skin and mucosa.  Acute and chronic disorders, irritation, systemic reactions and even cancer may develop after the exposure to these toxins.  

Symptoms include respiratory complaints that involve the nose and lungs; eye symptoms, and mucous membrane irritation. The major presentations are headache, general debilitating pains, nose bleeding, fevers with body temperatures up to 40 degrees C (104 degrees F), cough, memory loss, depression, mood swings, sleep disturbances, anxiety, chronic fatigue, vertigo/dizziness, and in some cases, seizures.

Mycotic demyelinating optic neuritis is a neurological disorder of the visual system caused by mycotoxins released by indoor toxic molds. 

Other neurobehavioral manifestations in the mold-exposed individuals are abnormal decrease in steady balance, reaction time, blink-reflex latency, color discrimination, visual fields, and grip, compared to control. Hence, most exposed patients have reduced cognitive functioning in multiple domains, with memory and executive functions the most commonly affected areas. 

From a 2005 paper on neurotoxicity caused by Stachybotrys chartarum:

The Mechanisms of Neurotoxicity Induced by Stachybotrys chartarum Trichothecene Mycotoxin in an In vitro Model

Studies conducted on students who were exposed to poor IAQ due to fungal contamination, demonstrated acoustic mycotic neuroma. Initial symptoms associated with this condition included sensorineural hearing loss, tinnitus, and unsteadiness. This condition is associated with hearing loss and tumor development in nerve tissues associated with hearing and this tumorous tissue must be removed through surgical techniques. In addition, these individuals had other symptoms associated with neurological damage from SBS conditions, such as headaches, memory loss, and lack of concentration, fatigue, sleep disturbance, facial swelling, rashes, nosebleeds, diarrhea, abdominal pains and respiratory problems.

From a 2012 paper on the effects of toxic mold on 6-year-old children:

Cognitive Function of 6-year old Children Exposed to Mold-contaminated Homes in Early Postnatal Period. Prospective birth cohort study in Poland.

The results of this study draw attention to the harmful effect of early postnatal exposure to indoor molds on children's cognitive development and provide additional evidence on the role of environmental determinants in human cognitive development.

From a 1983 paper on protection against the health effects of trichothecene mycotoxins:

Protection Against Trichothecene Mycotoxins

In response to a request from the Department of the Army, a committee was formed to study the means by which human health can be protected against exposure to trichothecene mycotoxins.

Because trichothecenes are part of the natural environment and can cause widespread injury to plants, animals and humans, the committee considered their biological behavior in the biosphere as a whole. Accordingly, the recommendations in this report may also be applied to protection of human populations exposed to trichothecenes from natural sources.

A broad literature search was conducted, and the effort extended beyond a review of the vast scientific literature on trichothecene mycotoxins to include unpublished material from scientists involved in research, officials from federal agencies and the military, and scientific representatives from foreign governments. However, only information available to the public was considered.

So, in 1983, they admitted to hiding the truth about the dangers of mycotoxins when they refused to include all available sources of information.

The timing of this report is interesting because the U.S. Army was in the process of conducting a 3-year research study on the effects of T-2 mycotoxins. That study by the Army occurred from 1982-1985, and the 1985 report from that study is also posted on our website.