Mold Exposure update

My building has the distinction of being an on-going laboratory for the study of how certain fungi behave in indoor environments with individual unit ventilators. I have tried to get speciation data from three main sources of fungal contamination in the building: visible mold in books, visible mold on ceiling panels and spores in floor dust in water-damaged rooms. I have concentrated the microscopy studies and ERMIs on the rooms that impact me the most. On the first floor, that would include the custodial room, the Dark Room, an art room, a science room and my own classroom. On the second floor, there is the Library, the 2nd floor hallway and a foreign language room.

The mold species present in this building must be very happy. They have a continuing supply of water, dust and dirt to nourish them. The humidity is above 60% several days a week in the spring and fall, and most of the time during the summer. The filters on the unit ventilators are no threat because they cannot catch and remove spores from the indoor air environment. Fungicides are not used in the building, so fungal-eating bacteria are the only natural predators facing the spores (unless you include me).

The following is a summary of the major fungal players at the middle school where I teach. I will specify whether the species of mold appears on the EPA Group One or Group Two lists, Dr. Jack D. Thrasher’s list of signal molds (“species of concern”) [Research Committee Report on Diagnosis and Treatment of Chronic Inflammatory Response Syndrome Caused by the Exposure to the Interior Environment of Water-Damaged Buildings, Ritchie C. Shoemaker MD, Laura Mark MD, Scott McMahon MD, Jack D. Thrasher PhD, Carl Grimes HHS, CIEC, July 27, 2010, page 19], and the list of nine target organisms that Dr. Ritchie C. Shoemaker relies on in assessment of WDB links to human illnesses.

• Aspergillus niger [EPA Group One, Thrasher, Shoemaker] – Niger has shown up in significant amounts in several water-damaged library books, in floor dust in the 2nd floor library and the adjoining workroom. Niger has also shown up in floor dust in the custodial room ten feet from my classroom in two different ERMIs. The library book The Arabian Nights had 22,882 spores/mg.
• Aspergillus fumigatus [EPA Group One, Thrasher, Shoemaker] – Fumigatus was the major toxigenic mold found in the custodial room ten feet from my classroom. Art teacher Christine Goldman’s hall duty in the year that she got sick was in front of this room. Even though the school system’s industrial hygienists were BCPS consultants on my 504 (and accommodation # 11 required the industrial hygienists to remediate the mold in the custodial room), they refused to come out to the school to inspect the room in 2009 or the first five months of 2010. By May of 2010, the visible mold bloom was eight feet tall and four feet wide. The undercover remediation of this room by two facilities personnel resulted in the injury of a student in May of 2010 [see chapter 20 of Surviving Mold]. In November of 2010, six months after the room had been scrubbed and repainted, the two industrial hygienists visited the room (apparently for the first time) and wrote that they could not remediate the mold in the custodial room because none was there!
• Aspergillus penicillioides [EPA Group One, Thrasher, Shoemaker] – Penicillioides has been found in my classroom, the custodial room, an art room and one water-damaged library book. The amount in my classroom was small and probably gained access to my room on the flat mops used by the custodial staff or through normal air circulation. Until I complained in my application for 504 accommodations, the normal custodial procedure was to mop up all of the dust with a long flat dry dust mop and then shake out all of the collected dust in the classroom doorway before going into the next room to “clean.” This cleaning procedure was in fact putting tiny bacterial and fungal particulates back into the indoor air environment on a daily basis. After I filed for accommodations, the custodial staff was equipped with smaller mops with washable microfiber cloths (although they didn’t always use them). In the fall of 2011, the custodial department stopped using the microfiber cloths altogether and returned to the old flat dust mops.
• Aspergillus sydowii [EPA Group One] – Sydowii has shown up in water-damaged library books and in floor dust in several rooms on both floors of the school. It has not established itself on any of the water-damaged ceiling panels.
• Eurotium amstelodami [EPA Group One, Thrasher] – Eurotium has not shown up in any of the tested books, but it has shown up in floor dust in each room tested on both floors of the school. More ominously, it was one of several molds that managed to travel beyond the radius of the water-damage in the library and establish itself in a visible mold colony on a water damaged ceiling panel in a foreign language classroom during the summer of 2010.
• Aureobasidium pullulans [EPA Group One] – Pullulans has been found in floor dust in every room tested. It does not appear to have much appetite for water-damaged books in the school. It was the leading Group One mold in my classroom. A visible colony of Aureobasidium developed on a ceiling panel in a science classroom around the corner from my classroom over the summer of 2011.
• Cladosporium sphaerospermum [EPA Group One] – This species of fungus was present in floor dust in my classroom, Christine Goldman’s art room, the custodial room and in the library. There was a minor colony found in The Arabian Nights (550 spores/mg). In September of 2011, a visible colony was found on a ceiling panel in a science classroom. The number of spores/swb present was 84,755. In October of 2011, small amounts were found on a ceiling panel in a storeroom in the school’s cafeteria kitchen.
• Penicillium purpurogenum [EPA Group One] – For several years, purpurogenum only showed up in miniscule amounts in floor dust. Then unexpectedly in 2010, it established itself in a water-damaged textbook originating in a foreign language classroom and the next year in a water-damaged ceiling panel in the same room. In fact, it made-up one third of the Group One molds found in that textbook. This is a good illustration of how an opportunistic fungus can take advantage of the humid indoor air environment in a water-damaged building and proliferate when provided with a suitable food source.
• Penicillium crustosum [EPA Group One] – Crustosum had 1,139,745 spores/mg in The Arabian Night making it the largest Group One colony in this library book. Its influence has not spread beyond the library.
• Penicillium brevicompactum [EPA Group One, Thrasher] – Brevicompactum established a significant colony in the book The Arabian Nights (4,878 spores/mg), but it too has failed to spread beyond the confines of the library.
• Penicillium glabrum [EPA Group One] - There were 390 spores/mg of dust in the first floor custodial room. It’s influence has not spread beyond that room.
• Paecilomyces variotti [EPA Group One] – Paecilomyces loves paper. It established huge colonies in several water-damaged library books. There were 475,651 spores/mg in The Arabian Nights. This is another one of those molds whose influence has not been felt outside of the contaminated library. Small amounts have been found in floor dust.
• Chaetomium globosum [EPA Group One, Thrasher, Shoemaker] – Chaetomium is probably the most dangerous mold currently infesting the indoor air environment of the school. There were 10,331 spores/mg in The Arabian Nights. It was also present in significant amounts in two other library books. Since then, Chaetomium has found some fertile areas on the second floor and seems to be thriving. It made its expanding presence known by establishing itself on a water-damaged ceiling panel outside of the library. I went into the 2010-2011 school year thinking that I needed to keep off the second floor as much as possible to avoid inhaling spores from this dangerous mold. Then to my surprise, in December of 2010, it turned up in a visible mold colony in a Spanish textbook used by a 7th grade boy in my classroom!!! I taught five periods of 8th grade American history in my classroom in the fall of 2010 and a Spanish teacher “floated” into my room one period each day. All of my efforts to avoid exposure to Chaetomium were undone by a 12-year old who managed to get his textbook wet in early November of 2010. [When I saw Dr. Shoemaker in June of 2011, I showed him the blood lab for C4a that Dr. Colleen Pietrowski had ordered the previous winter. It was over 23,900 (ten-times above normal). When Dr. Shoemaker expressed his concern, I replied that despite all of my precautions, I had managed to expose myself to some serious fungi during the school year including Chaetomium.]
• Alternaria alternata [EPA Group Two] – Alternaria does not seem to like paper in the school, but it does like the cellulose in ceiling panels. It is found in floor dust on both floors of the school. Alternaria was one of the molds that managed to establish a visible colony on the ceiling panel in the hallway outside the library, on the ceiling panel in the Spanish classroom and in the main lobby of the school. In October of 2011, speciation of a sample found on a ceiling panel in a storeroom next to the cafeteria kitchen revealed 5,019 spores/mg.
• Cladosporium cladosporioides (types one and two) [EPA Group Two, Thrasher] – It does not seem to like books in the school, but it is in floor dust in multiple rooms. Both types showed up in a visible colony on a ceiling panel in a science classroom in September 2011. Cladosporioides Type One is the second most-prevalent Group Two species found in floor dust in my classroom. The presence of this mold demonstrates the failure of the filters used in the unit ventilation system to trap outdoor molds that are being sucked into the building by the air intake system.
• Cladosporium herbarum [EPA Group Two, Thrasher] - It has not established itself in books or ceiling panels, but it is in floor dust in multiple classrooms including my own. It was the most prevalent Group Two mold in the contaminated custodial room.
• Epicoccum nigrum [EPA Group Two, Thrasher] – Epicoccum was the most-prevalent species of Group Two mold in dust in my classroom, the library and an art room. It has not yet established any visible colonies in books or ceiling panels in the school.
• Mucor amphibiorum [EPA Group Two] – This species of mold was found in library books with minor amounts in floor dust from the library. Its influence has not spread beyond the library.
• Penicillium chrysogenum [EPA Group Two, Thrasher] – Chrysogenum likes books (1,712,919 spores/mg in The Arabian Nights) and the cellulose in multiple ceiling panels.
• Aspergillus ustus [EPA Group Two] - This mold is a major player in the school. It has been found in multiple books (including 12,850,920 spores/mg in The Arabian Nights) and on multiple ceiling panels. In October 2010, it was the predominant mold in the visible mold colony in room 212 (an astounding 64,087,560 spores/ml liquid). In September of 2011, it was found on a visible colony on a ceiling panel in a first floor science room (85,764 spores/swb). In October of 2011, it was found on a visible colony on a ceiling panel in a storage room next to the cafeteria kitchen (860,439 spores/mg). Like Alternaria alternata, it appears to be an extremely opportunistic outdoor fungus that has latched onto water-damaged books and ceiling panels in the school and then reproduced at an astounding rate. As a moisture-loving, paper and cellulose-munching fungi, Aspergillus ustus has found an ideal home in the hot humid indoor air environment of my building.

I drew several important conclusions from the Group One data that affected my 2010 application for accommodations under Section 504 of the Rehabilitation Act. The most important one was that that my room was probably one of the least impacted rooms in the T-wing of the building (where the majority of the classrooms are located). Dr. Shoemaker noted that I had to keep my room as safe as possible and that would involve obtaining a HEPA 0.3 air purification system. Of course, teachers cannot hide out in their classrooms forever. You have to walk through the lobby with the water-damaged ceiling panels to get to the office. You have to walk down the contaminated second floor hallway to get to the grade-level team meetings. I also realized that vacations would only be short-term reprieves to the chaos going on in my innate immune system. Re-exposure was going to be my constant companion – after Christmas vacation, after Easter vacation, after summer vacation – year-after-year-after-year.

The ERMI mechanism invented and patented by the EPA has given ordinary teachers and workers a major tool in assessing the overall indoor health of the building where they work. One of the industrial hygienists in our school system once said that the ERMI numbers were normed by the EPA for a house and not a school; therefore, the data that I was collecting in the school building was basically useless. He was referring to both the ERMI scores and the speciation data identified through the PCR process. I would agree that an ERMI score in a building with over 100 rooms, closets and storage areas is not a universal value on the mold burden of the entire school; however, it is pseudo-science to ignore the speciation data (and accumulating medical data from the building’s occupants). Art teacher Christine Goldman had an abnormal haplotype and worked in a classroom with Aspergillus penicillioides, Eurotium amstelodami and Aspergillus niger present in dust samples, and she did hall duty each day in front of a custodial room with Aspergillus fumigatus – no wonder she got sick! Corporate pseudo-science attacks on two levels: have the insurance doctor deny the validity of the medical data while the industrial hygienists and building engineers deny the validity of the environmental evidence – all to the detriment of the employees (and children) exposed to the poor indoor air quality conditions.

The interpretation of the Group 2 mold data in my building has been an enigma for me. When developing the ERMI Index, the EPA was trying to objectively describe the mold burden in a home. 26 species associated with homes with water damage were chosen for the Group One list. Ten species that were found in homes independent of water damage were chosen for the Group Two list. I do not think that the EPA considered the possible toxicity of the Group 2 molds when it made its list. Scientific data on possible toxin-formers on the Group 2 list is still in its infancy. Further, how safe is a school with extraordinarily high Group 2 spore counts for an eleven or twelve-year old student with an underdeveloped immune system and severe allergies/asthma. How many times must a student be transported to the hospital by ambulance before someone links the high Group 2 counts with repeated incidents of asthma? Aspergillus ustus is not regarded as particularly toxigenic in the current literature, but at 64,087,560 spores/ml liquid, even minor toxins and metabolites from this mold could cause havoc on the respiratory system of an asthmatic or allergic student. As for Cladosporium cladosporioides (types 1 and 2), Cladosporium herbarum, Epicocum nigrum and Penicillium chysogenum, all of which are present in my school, what impact are they having on the students? Are they toxin-formers? Are they a serious factor in causing respiratory ailments in the building? Students – keep those inhalers handy!

A few other molds of note have appeared in small quantities including Aspergillus flavus, Aspergillus versicolor and Stachybotrys chartarum [EPA Group One, Thrasher, Shoemaker]. At some point, they may become a serious health risk given the current state of the humid indoor air environment of the building, so they are also molds of concern to watch out for in future ERMI’s. My nightmare scenario would be a return of toxigenic species of mold to the custodial room near my classroom. Aspergillus fumigatus may be gone from that room, but other opportunistic molds lie in wait. This dark humid room has wet floors, damp unpainted wood at floor level and no mechanical or natural air ventilation (not even a window). It is an invitation for an opportunistic mold to settle and proliferate.

Stachybotrys, with its sticky spores, may have helpers in schools like mine – helpers with the potential to walk through colonies in floor dirt and then transfer spores to other areas of the school at night. This will allow me to transition into my next segment in Mold Wars – the double R’s – roaches and rodents.