The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #57770

Joseph Q. Jarvis, MD, MSPH, Department of Family and Community Medicine, University of Nevada School of Medicine, 51 North Wolcott Ave., Salt Lake City, UT 84103, 801-533-0503, jqjarvis@ix.netcom.com

Unusual indoor mold exposures have been associated with both irritant symptoms and allergic respiratory disease. Moisture damage to a building interior may cause unusual mold proliferation on or within structural materials, leading to atypical airborne mold exposure for building occupants. Investigators encountering an alleged cluster of symptoms or illness among occupants of a water damaged building should follow standard observational epidemiologic methods, including: 1) verify that a cluster exists; 2) establish a case definition; 3) estimate risk of exposure; 4) support findings with clinical data. A county owned office building located in a coastal California town opened in 1995. Over five years water damage was observed in many areas of the building. An environmental investigation in 2000 documented unusual mold proliferation in the building. Interviews with 44 of 286 building occupants indicated that both irritant symptoms and allergic disease may have occurred. A cross sectional questionnaire study was used to investigate self-reported symptom and disease prevalence in the problem building and a nearby county owned building selected as a comparison. Selection biases were identified during questionnaire analysis. After accounting for selection bias, however, a cluster of respiratory symptoms was identified in the problem building. After establishing a case definition for respiratory illness, risk for respiratory problems due to exposure to mold and water damage was estimated to be 3 to 4 times background. Clinical evaluations supported the diagnosis of new onset allergic respiratory disease among building occupants.

Learning Objectives:

After attending this session, the learner will be able to:
• Describe the most common health problems associated with indoor mold exposure;
• Identify unusual indoor mold exposure using tape, bulk, and air sampling methods; and
• Apply observational epidemiologic methods to the investigation of alleged symptom or disease outbreaks among occupants of water and mold damaged buildings.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.