MOULDY HOUSE PROBLEM Tartu 10 3 -11 3

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MOULDY HOUSE PROBLEM Tartu 10. 3. -11. 3. 2004 Markku Seuri, FIOH, 2004 1

DEFINITIONS mould = microbes and their (toxic) products in moisture and water damaged building materials mouldy house = a building partly damaged by moisture and microbial growth damages can be visible or within building structures Markku Seuri, FIOH, 2004 2

THE MAIN DIFFICULTY the exposure is not known several candidates: – – – spores toxins microbial volatile organic compounds microbes themselves structures of microbes allergens Markku Seuri, FIOH, 2004 3

LIVING EXPOSURE the exposure changes over time the microbes change: – – – material type of damage degree of moisture temperature nutrition selection of species in time the health effects change Markku Seuri, FIOH, 2004 4

SPORES commonly measured and expressed as colony forming units (cfu) per cubic meter of air, gram of material poor relation to the health effects one has to consider to microbial species, no only the amount measure of the damage, not of the health effects or the risk Markku Seuri, FIOH, 2004 5

MICROBIAL ALLERGENS mould allergens exist, but most of the health effects are not Ig. E related allergies fungal allergens are commonly essential enzymes in the fungus similarities between the allergens of different species Markku Seuri, FIOH, 2004 6

STRUCTURES OF MICROBIAL WALL beeta-glucans of fungi endotoxin of gram negative bacteria rarely seen in the air of mouldy houses can be a problem in renovation cause irritation of respiratory tract not a probable cause of health effects Markku Seuri, FIOH, 2004 7

MICROBIAL VOLATILE ORGANIC COMPOUNDS do MVOCs exist? – MVOCs are released also from moistened materials without microbial growth – a measure of moisture damage on materials not capable of producing irritation in the concentrations seen in mouldy houses Markku Seuri, FIOH, 2004 8

MICROBIAL TOXINS their role in causing health effects in mouldy houses controversial good potential cause: – various health effects - many toxins – potential (ng/g -level) – most difficult health effects are seen in old damages - selection of species in time no way to measure small quantities (at the moment) Markku Seuri, FIOH, 2004 9

MICROBES THEMSELVES not fungi commonly found in mould damages only less than 10% of the microbial growth of any environmental sample can be named interest in two groups: – slowly growing mycobacteria – microbes living with in amoeba Markku Seuri, FIOH, 2004 10

AMOEBA AND LEGIONELLOSIS Legionella is intracellular bacteria found in natural and man-made water systems multiplies in 20 -50 degrees of C (32 -40 ideal) survives in the environment within amoeba can be an occupational diseases, for instance in work place showers an epidemic in a Finnish hospital has been found Markku Seuri, FIOH, 2004 11

AMOEBA SHELTER OTHER BACTERIA over 40 bacteria have been found within amoebae including Chlamydia pneumoniae we have found amoebae in damaged building material samples (in about one fifth of samples sent to our laboratories in Kuopio) Markku Seuri, FIOH, 2004 12

MOULD DAMAGES AND IMMUNOCOMPROMISED PATIENTS Aspergillus spp have caused infections in hospitals, even fatal case at the moment there is no evidence that the fungi in the mouldy buildings could cause diseases to health inhabitants Markku Seuri, FIOH, 2004 13

SYMPTOMS AND DISEASES FOUND IN MOULDY BUILDINGS irritation “toxic” or “general” symptoms increased number of respiratory infections diseases Markku Seuri, FIOH, 2004 14

IRRITATION SYMPTOMS respiratory tract: – commonly the higher, rarely the lower irritation of the eyes irritation of the skin the most common symptoms transient usually relieves in a few days Markku Seuri, FIOH, 2004 15

“TOXIC” OR “GENERAL” SYMPTOMS symptoms like: – – headache tiredness aching muscles and joints fever and chills transient may need a week or two to be relieved Markku Seuri, FIOH, 2004 16

RESPIRATORY INFECTIONS normal flues sinusitis the incidence is higher in mouldy houses some toxins restrain the cilial movement in the respiratory tract in vitro Markku Seuri, FIOH, 2004 17

DISEASES 1 asthma is the most common mechanism is not known most asthma cases seen in mouldy houses are not allergic the risk of asthma is about two in the mouldy houses, but the risk is not divided evenly among them Markku Seuri, FIOH, 2004 18

DISEASES 2 allergic rhinitis have been shown some clusters of inflammatory rheumatic diseases have been published – the causal link not established – the risk of these diseases seen rarely Markku Seuri, FIOH, 2004 19

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