MEDICAL EVIDENCE
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REPORT
COMPLETE: October 12, 2009
DATE OF ANALYSIS:
Peter Helfrich
35 Clinton St., Apt #10
Plattsburgh, NY 12901
REPORT ID:1118
SAMPLES RECEIVED: 1
Dear Peter,
This is a final report from MouldWorks for the single bulk sample we received October 5th, 2009, taken from your home at 35 Clinton St., Apt. #10, Plattsburgh, NY. Here are your results.
1118-1 tape (Bathroom - Behind Shower)
Microscope:
Penicillium sp./Aspergillus sp.
Stachybotrys sp.
Cultured
Aspergillus sydowii
Aspergillus versicolor
Oedocephalum glomerulosum
Stachybotrys sp.
Trichoderma harzianum
Actinomycetes
Dry-spored Acremonium sp.
General Comments
Our analysis of the above set of samples found abundant evidence of a mold infestation in the bathroom sampled in this home. The sample contained viable spores, vegetative cells and/or reproductive structures from a variety of fungal species, including many molds which require moderately high to extremely high levels of available moisture before they can colonize an indoor site. The presence of these microorganisms can be directly attributed to elevated levels of available moisture locally. Specifically, Stachybotrys requires a water activity of at least 0.94 before it can germinate and colonize indoor sites. Water activity is a measure of the proportion of moisture available to organisms growing on a semi-solid substrate. Finding molds indoors that require such high levels of moisture is a strong indication that this site has experienced flooding, leaks or other water intrusion events. I gather from the chain of custody form that the shower stall had been leaking for some time and this is almost certainly the source of the moisture that supports these colonies. Without first addressing the moisture problems behind the mold growth, molds will undoubtedly continue to plague this site.
Due to the presence of several toxigenic mold species, I'd strongly recommend having a professional come in and clean up the infestation properly to avoid stirring up spores and risking further personal exposure. A professional mold remediator will have the equipment and expertise needed to remove the colony safely, under containment, ensuring that any spores released during the work are removed from the building. It is important that any remediation job is guaranteed with third-party air sampling for mold spores following completion. Without this step, you have no way of knowing whether the project succeeds in improving the indoor air quality
Health Effects
Some of the molds found in this sample have the potential to adversely affect your health. In the paragraphs below, I'll detail some of the risks thought to be associated with exposure to each of the concerning molds that were identified. Let's start by looking at the most concerning mold found in this sample, Stachybotrys.
The whole issue of stachybotryosis and trichothecene mycotoxins is reviewed in a recent book by Nicholas Money (Carpet Monsters and Killer Spores, Oxford University Press). He concludes that Stachybotrys should be taken very seriously indeed. Here is what the findings of the last 5 years suggest:
Stachybotrys toxins include a very potent trichothecene, Satratoxin G, which may seriously damage lungs and internal organs. It is probably the agent responsible for the burning sensation when active strains are inhaled (not advised). In a study published just a little over a year ago, researchers at Michigan State University established a link between Satratoxin G and the death of nerve cells in the part of the brain responsible for the sense of smell in mice. Researchers allowed mice to sniff a single dose of Satratoxin G equivalent to that which a person without respiratory protection would be exposed to in a room contaminated with Stachybotrys chartarum. They then tracked the damage to the neurons lining the nasal passages of the mice at time intervals after exposure. Every mouse exposed to Satratoxin G developed a significant loss of these nerve cells through a process known as apoptosis within a day of exposure. In apoptosis, a type of programmed cell death, cells essentially commit suicide, in this case in response to exposure to Satratoxin G. Additionally, each exposed mouse developed inflammation of the nasal lining and the olfactory bulb, the part of the brain that relays sensory information from the nose to other parts of the brain. Significantly, this inflammation and loss of nerve cells were also triggered by exposing the mice to smaller doses over five consecutive days indicating a cumulative effect.
Although it isn't yet known how Satratoxin G affects human noses, it is known that the nerve cells damaged in the mouse study are similar in both species. Studies in the past have focused on the role very small mold spores or pieces of spores might play in irritating the lungs. However, this study conclusively shows that the nasal passages may be damaged as well. The nose acts as a "scrubber" removing significant amounts of both very large (>5 microns) and very small (nanoparticle-sized) constituents of aerosols. More work needs to be carried out on the effect these particles have once deposited.
In addition there are several other categories of nasty substances made by the fungus, including several which are immune system depressants and may account for vulnerability of people who are chronically exposed to the toxin to respiratory illness - colds, etc. The fungus also makes stachylysin, which causes leakage of blood from the small capillaries and breakdown of the red blood cells.
There are two species of Stachybotrys commonly recovered from interior habitats, S. chartarum and S. chlorohalonata (formally described just a few years ago). These two species can be distinguished on a special culture medium, and I did this routinely in the past. However, after discovering several instances in which both species were present in the same sample, I thought it prudent to consider any Stachybotrys infestation as potentially hazardous. Only about half of S. chartarum strains make trichothecenes, but they may make the other kinds of toxins mentioned above. S. chlorohalonata does not make trichothecenes, but it does make other mycotoxins known to be mutagenic.
It has been claimed that the spores of Stachybotrys are too large to get far into the respiratory passages. However, it is now known that the trichothecenes in Stachybotrys chartarum are localized in the spores and that tiny fragments of the spores (sub-micron sized) can become airborne. These observations suggest in turn that aerosols containing mycotoxins can be generated in environments where Stachybotrys infestations occur even if no spores are seen in air samples. Indeed, pure mycotoxins have been filtered from the air in buildings where Stachybotrys infestations are severe. Given this information, it would be prudent to regard any Stachybotrys infestation as a potential danger and treat the site with respect.
The two Aspergillus species observed in the cultures prepared from your sample are also of some concern. These molds can produce huge numbers of dry spores which are easily lofted into the air and are slow to settle. Spores from any species of Aspergillus should therefore be presumed allergenic. In addition, each of the species identified in this sample may present additional health risks worth discussing:
Aspergillus versicolor produces the mycotoxin sterigmatocystin. This compound is a chemical cousin to aflatoxin, one of the most mutagenic substances known. Fortunately, sterigmatocystin is much less mutagenic than aflatoxin, but sources I consult advise caution when dealing with this mold. Beyond this, it is now known that A. versicolor also produces aerosols of sub-micron particulates that could easily penetrate deep into the respiratory tract; these tiny particles can be mycotoxin-laden, creating a dangerous situation. Very recent work has shown that mycotoxin production in these fungi occurs only at relative humidities in excess of 90% when growing on wallboard and other building materials. The author (Kristian Nielson) concludes that sites which have experienced alternate cycles of wetting and drying are at most risk for mycotoxin contamination. Sites such as this, in which Aspergillus versicolor is mixed in with Trichoderma, Actinomycetes or other wet wall microorganisms, are at maximum risk for contamination by sterigmatocystin. Having said all of that, I must mention that sterigmatocystin does not become really mutagenic until it has been acted on by enzymes in the liver, and it is an open question whether inhaled mycotoxins ever get to the liver.
Aspergillus sydowii is a frequent agent of invasive aspergillosis. The fungus is able to enter the body through the epithelial cells of the lung and disseminate through the blood resulting in acute pneumonia. Although this sounds quite frightening, this condition requires the patient to have a previously existing severe loss of immunocompetence for the fungus to gain hold. Cases in otherwise healthy patients haven't been reported.
Lastly, the Actinomycetes found in this sample are not molds at all, but filamentous bacteria. They produce huge numbers of really minute dry spores which are probably allergenic, since their small size would allow them to penetrate respiratory passages efficiently. Actinomycetes typically grow in wet sites and are part of the wet wall syndrome. These bacteria are typically ignored in mold reports - but they should not be. Workers in Finland have reported that some Actinomycete spores, unlike most toxic mold spores, may actually trigger inflammatory responses in the lungs.
All samples have been processed and analyzed using MouldWorks SOP 1, SOP 2 and SOP 7.
All samples were inspected prior to processing to ascertain their condition. Unless expressly stated in the report, all samples were in adequate condition for analysis.
Sincerely,
Matt Visser
Mycologist and Lab Manager
MouldWorks, LLC
3190 Lakeview Drive
Beulah, MI 49617
541-844-6236
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