Understanding the exact nature of mold is well in order before proceeding to more detailed discussions regarding mold growth and mold control. Mold is, to put it in the simplest of terms, a type of fungus. Fungi are classified as eukaryotic microorganisms. As far as numbers are concerned, only insects rank ahead of fungi in organic variety. Fungi are often divided into two broad categories by mycologists:

Yeasts – Yeasts are mono-cellular fungi that typically grow and reproduce by simple budding.

Mold – Molds are multi-cellular fungi. They are microscopic and typically grow and reproduce by a process called apical reproduction. Unlike yeasts, molds exist in characteristic vast networks.

Just like every species of fungi, mold is much different in structure, development and decay to animals or plants. One mold unit (a set of cells) consists of a fibrous body (hyphae) and an apex. In this form, mold cannot sustain on its own and soon decays. In a network of millions, however, mold can not only sustain for years – sometimes decades – but also grow exponentially to form a thriving colony of sorts. A sizeable colony of molds can produce billions of reproductive agents, called spores, each day. These spores can be as small as 2 microns in diameter. They are easily airborne and can travel hundreds of miles before settling in a suitable place. They are also carried by water and other organisms (microbes and insects) from one place to another. Molds are microscopic and thus, cannot be observed by the naked eye, unless they exist in a substantial network. It must be noted that molds are, for all practical purposes, everywhere. In that sense, they are truly ubiquitous. All it takes for dormant molds to manifest out of nowhere is a right set of conditions. Another interesting thing to note about molds is that even though they appear in a number of colors (black, white, brown, green, blue, yellow etc.), most of the mold genii themselves are colorless organisms (with certain exceptions). The color exhibited by a colony of molds is primarily determined by the organic matter that they decompose – their food. A majority of molds found indoors, however, tend to have colored nuclei and hence, can be easily identified. While it’s possible to eradicate mold colonies from indoors, it’s next to impossible to get rid of mold spores. Mold spores can lie dormant for years on end before they are activated by growth-friendly environment. The number of mold spores that exists in a given indoor environment depends upon various factors like the season, weather and time of the day. In a larger scheme of things, molds play a major role in keeping the carbon cycle up and running. They are singularly responsible for the decay of organic matter all around the world – from wasted food to discarded paper and from rotten trees to dead bodies. That being said, molds can pose a number of problems when they decay materials that are not supposed to be decayed. Here are a few most common ways in which mold can cause problems:

The most prolific growth of mold occurs on food and other purely organic materials like fallen leaves or natural fibre clothing. Mold is one of the biggest contributors to food spoilage in the United States.
Unchecked mold growth on walls of a building is aesthetically and hygienically unpleasant. Moreover, in due course of time, it can cause serious structural deficiencies in the building. These range from cracks in walls to structural collapses. Quite predictably, mold growth in a house or any building for that matter significantly reduces the resell value of that property.
Presence of molds in a significant colonies indoors greatly deteriorates the quality of overall indoor environment by way of airborne spores and foul odor.
Although there’s very little scientific evidence that molds can themselves cause serious health issues, it’s widely held that molds have the potential to trigger a number of health hazards in humans.

What Makes Molds Grow?

Mold growth, both outdoors and indoors, is quite common. In suitable and conducive environment, molds have enormous reproduction and multiplication capabilities. Outdoors, where there’s no limiting factor or bottleneck to their growth, molds are known to sweep entire forest floors within a few rainy weeks. Indoors, however, it takes a certain set of encouraging conditions for molds to settle, grow and reproduce. As noted earlier, mold spores can remain airborne or lie dormant on indoor surfaces for prolonged periods. Just as they are exposed to correct set of conditions, they establish themselves and begin reproducing at a rapid pace, soon forming sizeable colonies. For molds to grow indoors, four basic criteria (necessary and sufficient, when accounted for in tandem) need to be met. Under these conditions, molds can commence the exponential growth phase in as few as 24 hours. These are outlined below:

Mold Spores

The very first requirement for molds to grow indoors is the abundance of airborne or surface-settled mold spores. In most places, extreme weather conditions (steep sub-zero temperatures, excess heat of the drylands etc.) excluded, mold spores are to be found indoors. These are often carried through air currents. A simple activity like opening the window can allow millions of mold spores indoors. This is not, in itself, a sufficient condition for molds to grow, neither is it a cause of concern – simply, because it just can’t be helped.

Availability of Organic Matter

Every organism, irrespective of its size or family, needs food to come into being and grow. Molds are no exceptions. They are, however, quite comfortable with consuming anything and everything, so long as it can be decayed. Organic matter – anything that contains carbon atoms – is the only source of food for molds. Since almost everything, barring few items, that is found most commonly indoors is organic, it’s virtually impossible to preclude the possibility of mold growth indoors by merely limiting organic content. Right from innocuous looking things like papers and clothes to easily digestible organic material like stale food or leather surfaces, molds can consume a range of materials. Even non-organic material like metals or plastic can attract mold, provided that there’s a layer of organic substance on its surface. The simple act of touching a phone receiver transfers enough topical skin oil onto the surface of the receiver – a perfect breeding ground for molds, given that other criteria are met.

Excessive Moisture

For the establishment and growth of mold colonies, excessive moisture is the foremost requirement. It is also the most easily controllable parameter indoors. In absence of sufficient moisture in and around the surface of the organic matter that they are trying to consume, molds simply cannot grow. Molds are only found in places or surfaces that offer continuous excess of moisture, either through water activity or through environmental humidity. Water activity of any substance is defined as the equilibrium water level that is required for environmental hydration of that substance. Higher the water activity of a substance, lower environmental humidity it will take for that substance to be in equilibrium, and vice versa. Molds find it easier to grow on organic substances that have higher water activity, because water is essential for mold networks to transfer nutrients from the site of exploitation to the site of non-exploitation. Higher activity organic matter includes cooked food, fruits, vegetables, wet clothes and such. Molds can grow on the surface of a low water activity organic substance if the indoor air humidity is high enough to establish the aqueous equilibrium. Wet surfaces indoors are prone to mold growth. Some of these common household situations are known to be great hosts for molds:

Undried clothes or soggy carpets
Water leakage in pipes
Inefficient drainage
Seepage of rainwater in building walls and ceilings
Damp basements
Faulty HVAC systems (poor ventilation and humidity control)

Indoor humidity levels upwards of 55% are generally known to assist molds by providing enough atmospheric moisture to establish and grow their colonies.

Indoor Temperature

Just like any other organism, molds have a set of optimum temperatures within which they show heightened growth activity. These temperature ranges vary from one mold genus to another; but when considered on a wholesome basis, they are not too greatly spaced. Most indoor molds have an optimum temperature range of 60 to 90 degrees Fahrenheit (roughly 15 to 30 degree Celsius). As one would notice, this also happens to be the optimum temperature range for human comfort. That’s why, it’s rather difficult to control mold activity purely by manipulating temperature. Another way that indoor temperature distribution can contribute to mold growth the presence of high temperature gradients. A temperature gradient is simply the difference in temperatures of two surfaces or two bodies. If a room has poor temperature distribution, warm air carrying enough moisture can come in contact with relatively cooler surfaces, condensing the moisture on that cooler surface. This provides an ideal starting point for molds to grow. When all of these conditions exist without mutual exclusion, mold growth can be all but guaranteed. At this point, it becomes necessary to reiterate that mold spores can survive the harshest of environments to stay dormant. Perhaps, that explains why molds can be found in dysfunctional freezers and even toasters.

Potential Signs of Mold

Growth of molds indoors should always be kept in check to make sure that further complications, in regard with health and otherwise, don’t arise. There’s no better way to achieve this than getting rid of mold before it grows into obdurate colonies that are sometimes resistant to even extreme measures like pest control or other chemical remedies. However, it’s not always easy to say with confidence whether a certain building or a house is infected by mold unless there is an irrefutable visual evidence. A certain set of prognostic observations, hence, needs to be resorted to, in order to confirm the presence of mold infestation. Here are some potential signs of mold infestation indoors. It should be noted that despite not exhibiting the following signs, mold colonies are known to exist and thrive. These symptoms are, hence, only indicative and not exhaustive.

Visual Confirmation (visible growth)

The most alarming sign of considerable mold growth on any surface, indoors and outdoors, is visual confirmation. Whenever there is visible growth of mold indoors, it must be regarded as substantial growth and a strong enough indicator of potential spreading of mold. All common indoor molds have a fuzzy texture. They can appear in a variety of colors (black, white, yellow, green, grey, blue) and sizes (from a small patch to a large enough to cover entire walls). Mold colonies are generally either smooth and velvety or rough and leathery. Visible mold growth, in all cases, warrants a thorough inspection of the building. Faulty infrastructure like leaking waterworks, stagnant water or seepage are often the precedents of visible mold growth. Mold growth is also preceded by discoloration of the surface. In case of walls and ceilings, the color starts fading while the surface itself becomes scaly and uneven. Spotting mold in well-lit indoor areas is relatively easier. Parts of a house or a building that are not frequented often, are rather poorly lit and damp provide the most helpful conditions for mold growth and are harder to inspect. These include attics, basements, cellars, fascias, garages and tree houses. Professional inspection is often required to ascertain mold growth in such cases.

Mold Odor

Another sign that often accompanies mold growth is their distinctive odor. Even though some indoor molds do not have any inherent odor, most mold colonies are characterized by a certain foul odor that can be best described as earthen. This odor is the result of decomposition of organic matter that molds carry out. It’s strong, musty and often repulsive. In houses or buildings where mold growth is substantial, overall indoor air quality is completely ruined by this odor. It renders such buildings unpleasant and unsafe for living. In places that are inaccessible (such as AC vents, sink cabinets or behind the wallpapers) for visual inspection, mold odor is the best way to check for the presence of mold.

Persistent Dampness

Another thing that can be a definitive sign of mold growth is persistent dampness – especially on walls, ceilings and floors. Mold colonies are known to extract atmospheric moisture to assist the decay of organic matter. This often results into excess dampness, known as mold sweat on that particular surface, which further assists mold growth. It is a run-away process that makes the affected surface persistently damp or wet. Mold infested walls are thus most vulnerable to further mold growth, even when there is no external water infusion.

Passive Signs (Health Symptoms)

Mold growth indoors may or may not manifest itself through one of the signs listed above. If it doesn’t, there are some passive signs that one inspect to arrive at a conclusion. These health symptoms, despite not being explicitly indicative of mold growth, warrant swift and immediate remediation. An indoor mold colony can release billions of mold spores every day. The commonest way in which these spores affect human health is through respiratory problems. People who are already suffering from lung diseases, have sensitive respiration, allergies or lower immunity are the ones to get affected first. Symptoms range from mild headaches and nausea to severe nasal and lung infections. If there is suspicion of mold growth and any member of the household exhibits above mentioned symptoms, mold growth is quite likely to be present. Upon having confirmed the presence of mold, irrespective of the state or scale of infestation, necessary corrective and preventive measures need to be taken so as to ensure the safety of inhabitants and the building itself.

Common Types of Mold

There are estimated to be millions of species of fungi – a large number of which is made up by molds. These various mold species differ from one another in aspects like life span and favorable growth conditions. However, there are a handful of mold species that particularly thrive in indoor environment. They are found in plenty all over the globe. Some of them are outlined below.

Cladosporium

Cladosporium are found in abundance all over the world. They are most commonly found in rotting plant matter and wooden materials. Bringing in fruits, vegetables that have already been infected by Cladosporium allows Cladosporium spores to enter the indoor environment. Unlike other mold species, Cladosporium can thrive in less humid environments. Surfaces that are cooler than the surroundings often attract Cladosporium growth.

Penicillium

Perhaps the most celebrated kind of molds, Penicillium genus family specializes in the decay of damp organic matter and high-nitrogen animal waste. Wallpapers, newspaper stashes, abandoned clothes, damp mattresses, carpets and furniture cushions are some of the most commonly affected areas. Penicillium molds are much quicker to establish and reproduce than other mold species. Select few members of this family are used in the synthesis of penicillin – an antibacterial drug.

Alternaria

Alternaria form the most tenacious genus of mold family. They can virtually grow anywhere, provided that there’s a shred of organic matter to feed on. They are also the prime motivators of allergy related health hazards that often derive themselves from indoor molds. Despite primarily being an outdoor species, they are often known to thrive indoors in extreme wet conditions – on wet bathroom floors, leaking pipes and perpetually damp rooflines.

Aspergillus

Aspergillus species of mold are usually found in indoor environments where high humidity periods and low humidity periods tend to alternate. They can establish a colony within 24 hours of germination and tend to grow at rapid rates. They are known to trigger a number of respiratory conditions and allergies among the inhabitants of a house that is affected. Molds are classified among four classes relating their potential to cause health hazards to humans.

Class A

Class A molds are often the ones that have a potential to elevate the mold spores count in a closed indoor environment in a short span of time. They are also known to produce toxins as by-products of decomposition processes. These are regarded as highly unwanted in the presence of humans and require express remedial actions.

Class B

Class B molds are known to cause health hazards only upon prolonged exposures. These hazards are often limited to allergic reactions and are temporary.

Class C

Class C molds are relatively risk-free in terms of health hazards. They are still, however, capable of creating unpleasant appearances indoors. The following table identifies common indoor molds and their potential to cause damage. Table 1: Common indoor molds, their identifying colors and potential health hazards

Color exhibited	Name	Hazard Class	Potential health hazards
Pink (in streaks, dots, sun-burst or random patterns)	Fusarium and/or Gibberella	A	Can produce toxins that, upon ingestion, can affect livers, kidneys and stomach lining; along with causing serious birth defects and unusually rapid weight loss.
Black (fibrous, smooth and slimy)	Aspergillus	A	Less toxic than Fusarium. Can cause mild nausea, vomiting or flu-like symptoms upon ingestion. Inhalation is mostly risk-free.
White (dotted with black)	Diplodia	C	Often found in dairy products, these molds are not known to create toxins.
Mineral blue/sea-blue/white	Penicillium	B	Not known to produce toxins. They are, in fact, used in many medicines and dairy products. Capable of causing temporary allergies.
Brown and/or black	Alternaria	B	Not known to create toxins. However, they are widely held responsible for respiratory allergies and conditions.

Mold Clean-up Guidelines

It has been fairly accepted globally that indoor mold infestation is hazardous to human health. However, it is quite difficult to quantify this potential. Research in this area is still ongoing in various universities and institutions around the world. A direct result of this inadequacy when it comes to quantification is that there are no explicit guidelines from health and safety governance bodies like Occupational Safety and Health Administration (OSHA) or National Institute of Occupational Safety and Health (NIOSH) about indoor air quality at residences or workplaces in regard with mold infestation levels or airborne mold spore concentration. Contrary to popular belief, however, mold clean-up involves a lot more than simple ‘scrubbing and scraping’. In fact, scrubbing and scraping only leads to extensive contamination of other surfaces (walls, ceilings, furniture etc.) by releasing unusually high number of mold spores in the air. Similarly, using biocide to kill mold does not suffice. Even dead masses of molds contain toxins and other chemicals that can, in the long run, be a cause of various allergies in humans. The first and foremost mold clean-up measure should ideally be correcting the cause of excessive moisture as detailed below:

If the mold infestation is around leaking pipes or stagnant water (including wet flooring and basement flooding), the first clean-up step should be to fix leakages. Professional plumbing assistance should be sought to avoid the recurrence of molds in the future.
If the mold infestation is on and around the walls or ceiling, the likeliest cause of excess moisture is water seepage from the roof. By seepage proofing the roof, mold outbreak can be significantly reduced.
Another cause of excess moisture indoors is poor ventilation or malfunctioning HVAC system. Letting fresh air in and stale air out can easily stabilise the indoor humidity. If humidifiers are used to maintain humidity indoors, it needs to be checked if they are properly functioning. However, if any of the occupants of the house/building suffer from dry skin problems or other dermic ailments associated with dry air, proper medical advice should be sought before lowering indoor humidity levels below 45%.
If the mold has infiltrated porous surfaces like rugs, carpets or furniture cushions, it is best advised to get rid of the materials altogether as mold spores tend to stay dormant inside the pores and future infestation is a strong possibility in such cases.

Mold Clean-up Procedures

There exist a number of mold clean-up procedures to exterminate and remove mold infestations, along with pre-empting potential future recurrences with preventive measures. The plan of action for mold removal typically depends upon:

Type of the building (residential/industrial/commercial/public)
Scale of infestation (small/medium/large)
Nature of molds (toxic/non-toxic)
Period of infestation (small/medium/large)
Affected materials

Some of the commonest methods of mold removal and remediation are described in brief below. Ø Detergent Wipes This is, by far, the simplest and quickest method of removing mold. It is particularly useful when mold infestation is still in its early stages, and the affected surfaces are washable. The implementation is quite easy. A cotton washcloth soaked in detergent grade soap (either home or industrial) or bleach is usually used to gently wipe away the mold from affected surface (walls, wooden furniture, sink, flooring etc.). Once the surface is rid of mold, it is again wiped gently with a fresh cotton washcloth soaked in a disinfectant. Lastly, another is used to wipe the surface clean with mineral/saline water. Even though this method is easy, it doesn’t always guarantee the best results. Furthermore, special care needs to be taken to ensure that the wiped surface is dried off thoroughly and further dampening is prevented by employing relevant measures. Ø Wet Vacuuming This method is employed when there is relatively larger accumulation of mold and the affected areas are considerably wet – sometimes fully waterlogged. Wet vacuum cleaners are specially designed vacuum cleaners that can be used to dry of indoor waterlogged areas. The functionality of wet vacuum cleaners is based on the simple vacuum suction principles and they are much stronger in action that regular vacuum cleaners. If the surface is not adequately wet, application of wet vacuum cleaners is not advised, as it is likely to deform the affected surface by way of pore exhaustion. In the process, the wet vacuum cleaner can also get damaged. The hose of a wet vacuum cleaner is immersed in the body of logged water to suction it all into the collection chamber. Once the majority of water is thus removed, corrective actions (such as fixing leakage or repair of wall cracks) is undertaken. Once the repair work is over, leftover moisture is allowed to dry off naturally. The detergent wipe method described earlier is also, at times, used to complement this process. Wet vacuum cleaners need to be thoroughly cleaned and disinfected after the application, as they are most likely to carry and mold spores all over. Ø Industrial Vacuum Industrial vacuum cleaners are used only when mold infestation is of a high degree and a regular vacuum cleaner cannot handle excess of micro-particles (dust and mold spores). Industrial vacuums are also known as High Efficiency Particulate Air Vacuums (HEPA). This process is seldom used in isolation. One or more other processes are always used to complement HEPA Vacuums. HEPA Vacuums are especially useful to clean up the affected area and its surroundings after the initial and major removal of mold is carried out. HEPA Vacuums are extremely powerful and are to be used only by trained experts, as physical injuries by improper handling of HEPA Vacuums can be quite serious. It is also to be made sure that proper filters (usually micron filters) are used to filter out suctioned air. This prevents mold spores from re-entering the indoor environment. Donning suitable gear (details to follow) is essential while handling HEPA Vacuums. Ø Using Chemicals Most people resort to chemical methods of mold removal without proper consultation with experts. It must always be remembered that extreme methods that involve chemicals are warranted in residential buildings only when there is a sudden outbreak of mold that threatens the lifestyle and health of the residents with immediate effect. Moreover, the use of chemical methods to remove mold from indoors should be employed as the last resort. Just like in other methods of mold clean-up, chemical methods must be preceded and succeeded by complementary corrective measures that address the root causes of mold infestation. It’s highly improbable to sterilize an area completely. It should also be taken into account that once the sterilization effect wears off, mold spores can quickly regain their footing if moisture or temperature issues have not already been taken care of. Biocides – the chemicals that are used to kill unwanted organisms – range from insecticides to pesticides. To exterminate mold colonies, agricultural grade fungicides are used. These chemicals are toxic for all organisms, including humans and domestic animals, in varying degrees. Hence, while using fungicides as mold removal chemicals, adequate care must be taken to keep the whole building properly ventilated. Direct inhalation or ingestion of fungicides should strictly be avoided. The application of fungicides should be kept limited to surface levels that are affected. Only trained pest control professionals should be entrusted with the use of fungicides and other chemicals. Cautionary Note: Fungicides should never be handled without prior experience and proper training. Mixing of two fungicides/biocides should never be carried out unless advised by a qualified expert. Immediate medical assistance should be sought in case of accidental inhalation, ingestion or contact with fungicides. Always heed the product labels before using. It is a cognizable offence and a breach of Federal Health and Safety Laws (Indoors and Outdoors) to use any kind of chemical product in a way that’s not consistent with its motive of synthesis. Ø Disposal of Mold Once the dead mass of mold is collected using any one (or a combination thereof) of the methods listed above, the next thing to ensure that it is properly disposed of. Dead mold mass is not ordinary solid waste. It is often classified as hazardous bio-waste and hence, it cannot just be dumped in a bin. Dead mold mass – and all the debris, dust and affected materials that are being discarded – should be separately collected in special non-permeable polyethylene bags. These bags are then to be labelled as hazardous to avoid accidental release of mold spores in the environment. If mold mass is larger in size and chunky in nature, it needs to be collected together and wrapped in several layers of polyethylene sheets. These sheets can then be safely placed inside non-permeable polyethylene bags and then disposed of.

Containment of Affected Areas by Mold

As noted earlier, there are no Federal guidelines dictating the treatment of mold affected buildings/areas. However, there are in place some standard norms that most professional mold removal companies operate with. These are discussed below. Small Sized Isolated Areas

Small sized isolated areas that have been affected by mold are relatively easier to deal with. These include small patches on walls, ceilings or flooring.
As long as the affected area is equal to or lesser than 10 sq. ft., regular maintenance team of the building is authorized and expected to carry out the task of mold removal – provided that at least 2 members of the team are duly trained in health and safety at residential places. They need to be well adept in the use of protective gears and proper management of relevant equipment under the concerned OSHA standards.
Regarding the use of protective gear, OSHA guidelines that dictate the same are to be strictly followed.
Everyone except the maintenance staff is expected to stay away from the affected area while the mold removal operation is ongoing. It’s not quite necessary to evacuate adjacent rooms, but susceptible individuals should be asked to stay away from the site of operation. This set includes infants, chronically ill patients, convalescents, and people with compromised immunity and other respiratory conditions.
Affected areas should be thoroughly cleaned with simple soap solution and washcloth, post operation. It should, if the need be, displayed with a sign to indicate its wet status.

Moderately Sized Isolated Areas

Areas ranging from 10 to 30 sq. ft. are often regarded as moderately sized isolated areas. These areas require somewhat more intense servicing than small sized isolated areas.
Duly trained members of the regular maintenance staff of the building can carry out mold removal operations for mid-sized areas.
Evacuation of the entire building is not necessary. However, all the inhabitants near the affected area should preferably be evacuated, with special emphasis on infants, chronically ill patients, convalescents, and people with compromised immunity and other respiratory conditions.
Prior to the commencement of mold removal operations in areas of this size, all the other surfaces nearby (walls, furniture, carpet etc.) should be covered with regular plastic sheets (to be disposed of later).
There are many commercially viable techniques available to suppress the rousing of dust and other finer particles. These methods (misting, gelling, to name a few) should be used to minimize the contamination of indoor air that is anticipated in the process of mold removal.
Heavily affected materials or objects (especially porous surfaces) that cannot be cleaned should be disposed of in a way described before the operation begins.
Once the active operation is over, entire area should be allowed to dry off. Using industrial vacuums to clean off all the surfaces is generally recommended by experts as a method of reducing the peaked count of airborne mold spores.

Large Sized Isolated Areas

Areas measuring over 30 sq. ft. are generally classified as large sized in terms of environmental maintenance. If a large sized area is infested by mold, it is strictly advised that only professionals who are trained and experienced in handling bio-hazardous materials/chemical and microbial treatments should be entrusted with the task.
All susceptible people (as defined earlier) should be asked to stay away from the site of operation for the duration of operation. Clearly visible signs warning non-members of the maintenance team to stay away from the site of operation should be displayed.
Large sized areas often cause a lot of infection to adjacent areas. In fact that’s how small sized areas turn into large sized affected areas. Hence, while treating large sized areas for mold infestations, every care should be taken not to get adjacent areas affected by way of contamination. Polyethylene sheets can be used to sheath the adjacent surfaces so that newly released mold spores or other contaminated debris doesn’t come into direct contact with these surfaces.
Another important thing to consider is to shut off all the ways in which contaminated debris or mold spores could get disbursed in the adjacent areas/rooms of the building. This includes temporarily sealing off vents, ducts, air conditioners and exhaust fans.
The use of professional and industrial methods to prevent the rousing of contaminated debris/dust/mold spores is a must in such operations. Misting and gelling are two examples of such methods.
It must be ensured that the whole area under operation is cordoned off prior and post operation for at least 3 hours. During this time, use of industrial vacuums is recommended to clean up the operation site and make it safe for human occupation again.
All the collected material including dead mold mass and other contaminated debris should be disposed of in a manner explained earlier in this section.

Areas of Acute Infestation

Acute infestation of mold typically occurs in areas that have been either abandoned or not frequented by people.
Acute infestation is generally spread over large areas. It is fundamentally different than regular mold infestation in that areas of acute infestation can potentially be dangerous for the very structure of a building.
Acute infestation manifests itself in thick continuous bedding of mold. Some professionals refer to as a mold farm.
Operations at such acutely infested sites should not be undertaken by non-professionals. Health and safety audit of the building needs to be carried out at least 24 hours before the commencement of the operation.
Duly qualified, trained and experienced bio-hazard technicians and microbial environment specialists must make for a part of the team that conducts the operation.
Other procedures for such operations are similar to the ones applicable for large sized isolated areas.
Operations in acutely infested sites usually tend to generate considerable volumes of contaminated debris. This is because abrasive plans of action (friction, scaling, de-plastering or polishing) are often warranted in such operations.
Hence, it is best advised to completely evacuate the adjacent areas to minimize the probability of accidental inhalation of mold spores or other infected fine particles by non-protected individuals.

The following table summarizes mold clean-up guidelines for various areas. Table 2: Mold Clean-up Guidelines for Contaminated Areas (OSHO Guidelines)

	Area (sq. ft.)	Who should undertake the clean-up operation?	Is evacuation of adjacent areas necessary?
Small Sized	Less than 30	Regular Maintenance Team	No
Moderately Sized	10-30	Regular Maintenance Team	No
Large Sized	Greater than 30	Trained Mold Removal Professionals	Not necessary, but advised
Acute Infestations	Variable	Trained Mold Removal Professionals along with experienced microbial environment and bio-hazard containment specialists	Yes

What to Wear when Cleaning Mold Affected Areas

Cleaning up mold colonies is not a task that comes without its own perils. To begin with, it must be conceded that the concentration of mold spores just around and over the surface of mold colonies is, quite predictably, extremely high. This means that using personal protective gear while cleaning up mold from indoors – irrespective of the size of the infestation – is highly recommended. Mold colonies tend to have a considerable aggregation of by-products and in some cases, even toxins. Hence, handling the clean-up procedure with utmost care in order not to come directly in contact with mold is important. This becomes an even more pressing issue when the procedure being opted for mold removal involves one or more destructive/invasive/intrusive techniques. These typically include de-plastering, creating and exploring wall cavities, friction, scrubbing and scraping. During these activities, a bulk of contaminated debris is generated and often, left airborne. Therefore, such procedures should be undertaken only by experienced professionals. The summary of what one should wear while cleaning up mold is presented below.

Skin Protection

Skin is most likely to come in a direct contact with mold itself, or other contaminated debris like affected materials and dust. That’s why, having adequate skin protection before commencing a mold clean up activity is the best course of action. Long chemical grade gloves that extend up to forearms are known to provide easy handling experience. These gloves and non-porous. If the operator has any kind of allergies relating to latex or chemical grade rubber, special lightweight polyethylene gloves can be used. However, these are more tenuous than rubber gloves, and hence, need to be used gently. To keep the rest of the body from coming in a direct contact with contaminated debris or mold, disposable overalls (chemical grade) can be used. These overalls are worn as an additional layer of clothing over the regular layers. These are to be disposed of along with the collected debris and mold, as described earlier. Regular shoes that leave no skin exposed to air will suffice in most cases.

Hair Protection

Most professionals have experienced that while performing mold cleaning operations, exposing one’s hair to mold spores and other contaminated debris can be very risky. Human hair has elevated adsorptive properties, especially when oil or other hair products are applied. This means that human hair is a great platform for dust and other finer particles to get settled on. This is also one of the primary causes of scalp related problems and dermatitis. That’s why, exposing one’s hair to mold spores is nothing short of inviting these pathogens to get hosted. Covering hair while performing mold clean-up operations, thus, should be deemed mandatory, and not just necessary. There are many ways to protect hair from contaminated debris and mold spores. The most common way is using latex headgear (if not already using the respiratory hood). Simple and easily available resources like swimming caps or construction hats (also called miner’s hats) can preclude the possibility of mold spores settling in hair. When dealing with acute mold infestations, it is recommended that two or three layers of protective headgear should be worn, while making sure that movability or functionality of the operator is not compromised.

Eye Protection

Eyes are widely considered to be the most fragile organs of human anatomy. They are not only delicate in nature physically, they are also quite susceptible to foreign body attacks – including dust, debris and bacteria. That’s why, to look after one’s eyes while undertaking potentially dangerous operations like mold cleaning is of paramount importance. Irrespective of the scale of operation and the size of mold colonies, it is highly recommended that all operators, supervisors and inspectors – including people in the workplace – wear protective eye gear. Safety goggles that are used in chemical laboratories or construction sites suffice in most cases. These goggles are without ventilation holes and typically encompass the whole eyesight, leaving no room for dust or other particles to enter eyes. People with acute eyesight problems or permanent visibility impairments should not be allowed to undertake operations, keeping in mind the safety of their own and other personnel on site.

Respiratory Protection

Another common way for personnel to get affected by airborne mold spores and other contaminated debris is by way of inhalation or accidental ingestion (on a micro level). The fact of the matter is, mold is known to be most harmful to human body when spores are inhaled or ingested. There are many diseases and allergens (to be discussed soon) that can be triggered by the intake of mold spores in a human body. According to the OSHA guidelines regarding general maintenance and clean-up, including bio-hazardous operations, use of respirators on site by every present individual is mandatory. Not using respirators is often considered to be grossly irresponsible and dangerous work practice during such operations. It should also be made sure that the respirators used are technically equipped to block the passage of micro-particles, as mold spores generally are classified in this category. All respirators used on site should be procured directly from the NIOSH website. If that’s not possible, efforts should be made to use other NIOSH certified respirators. There are many types of bio-immune respirators available. Most of these generally hold good for mold clean-up operations. Some of these are discussed in brief below.

Partial Respirators

Partial respirators are also known as half face respirators. These form the most common and most rudimentary class of workplace respirators. They don’t cover the full face of the wearer while ensuring that no fine particles are inhaled. Partial respirators can be used for small sized or moderately sized isolated mold infestation clean-up operations (less than 30 sq. ft.).

Full Sized Respirators

Full sized respirators are sometimes referred to as full face masks or full face respirators. As the name suggests, full sized respirators cover the full face of the wearer, thus eliminating the necessity for wearing protective goggles. These are to be used in mold clean-up operation on a larger scale (more than 30 sq. ft.).

N-95 Masks

N-95 masks are respirators designed to obstruct the inhalation of about 95% of airborne particles. These are typically used at construction sites and in mining operations. For mold clean-up activities of small or moderate scale, N-95 masks are a good fit.

N-99 Masks

These are just like N-95 masks, only more selective and more efficient. They are known to block about 99% of all airborne particles, including mold spores. These can be used in place of N-95 masks if additional respiratory protection is desired.

N-100 Masks

N-100 Masks are the most efficient respirators available in the market. They can block out the possibility of inhalation of almost all airborne particles and mold spores (up to 99.97%, in test conditions). They can be used in during almost every mold clean-up operation.

Summarizing Personal Protection Strategies during Mold Clean-up

The following table summarizes various personal protection strategies to be used during mold clean-up operations at various scales. Table 3: Personal Protection Equipment (PPE) Guidelines for Mold Clean-up Operations

PPE Standard	Skin	Hair	Eyes	Respiration
Minimum	Gloves and full sleeved clothing	Any sort of headgear that covers hair	Protective goggles	N-90/N-99/N-100 masks
Limited	Gloves and disposable overalls	Any sort of headgear that covers hair or swimming caps	Protective goggles	Full face respirators
Full	Gloves and disposable overalls	Protective headgear that accompanies hoods/masks	Protective goggles	Full face respirators with HEPA negative pressure

Just like during the operation, safety measures need to be taken after the completion of a mold clean-up operation. These include:

Every personnel on-site (regardless of their participation in the operation) should dispose of the disposable protective gear in a fashion described earlier.
All non-disposable protective gear should be disinfected duly, at least twice. Use of saline water along with a chemical disinfectant (alcohol based, or otherwise) is recommended.
All personnel should take a thorough wash (preferably a shower) and clean themselves with a mild disinfectant soap or an anti-bacterial body gel.
The site of operation should be left undisturbed for at least two hours, or until it is fully dry again.

Signs of a Successful Mold Clean-up

Although it’s often left to guesswork, ensuring that a mold clean-up operation has been successful is one of the most essential steps in making a place mold free. There are certain benchmarks with which one can assert with confidence that a particular mold clean-up operation has been completed successfully.

Upon immediate completion of the operation, there should be no signs of visible mold at the site of operation. Persistent mold colonies tend to re-attach the previous sites of infestation due to inefficient or non-thorough removal of mold colonies. Hence, all such colonies should be thoroughly exterminated by the end of a clean-up operation.
Within a few hours of the completion of the operation, there should be no leftover mold odor present at the site of operation. If there is a hint of mold odor present, it could well mean that the operation hasn’t managed to get rid of all of infestation.
At least 3 weekly and 3 monthly on-site inspections are recommended by qualified maintenance professionals after the completion of a mold clean-up operation. These inspections should assess the state of moisture at the site of operation and if there is any new mold growth present.
If the residents/occupants of the building are satisfied with the operation and there have been no unusual health concerns, it is a good enough sign to state the mold clean-up operation has been successful. This should be regarded as a rule of thumb as no guidelines or instructions regarding this have been issued by OSHA or NIOSH.

Mold Clean-up: Tips and Techniques for Households

In a majority of households, people come across mold in one form or another, at various scale and in various places. Granted that mold renders the looks of a building ungainly, it is often persistent and what’s even worse, it poses health concerns for the people who reside in the building; it’s not always necessary to panic and seek the help of professionals. Minor mold infestations (the ones that typically appear suddenly and in very small patches) can be treated if necessary caution in maintaining one’s own safety is taken.

Locating Mold

The most difficult and challenging part of getting a building rid of mold infestation is to actually be able to locate the affected sites. Mold doesn’t necessarily grow on the outer and visible surfaces. It is more common for mold to settle and reproduce in places of least human contact – the places that are not easily accessible. These include nooks, crannies and those dark place in the attic, garage or kitchen. Since moisture is the basic need for life of mold, mold is often found in and around wash-pipes, drainage pipes and places that tend to collect water. Since locating mold colonies visually is not an option in such cases, one must rely on their olfactory senses to confirm the presence of mold. Damp, unpleasant and musty odor accompanies most species of molds.

Keeping Mold Away

Keeping mold away from the indoor environment of a building is not only important, it is also indispensable, as some mold species have serious health hazards associated with them (as described earlier). Prevention, as the old adage goes, is much better than the cure. To keep mold from setting foot in a building, the foremost measures that need to be taken are:

Keeping the building well ventilated
Regular maintenance
Timely disposal of waste matter
Low humidity

All of these points will be discussed in more details in latter parts of this article.

Mold on Fabric

Natural or semi-natural fabrics including cotton, silk, wool and hemp form an easy target for mold. They are highly organic and often wet for a long time (from washing or other reasons). Once a piece of garment made from such natural fibres catches mold infestations, its life of utility is as good as over. That piece of garment can and should not be used again. Discarding is the best option for mold infested clothing and other garments. Curtains, carpets and mattresses also tend to catch mold because of occasional collection of moisture or seepage (from damp walls, accidental spillage of liquids or high indoor humidity). In such cases, mold colonies can be expected to be present on the surface as well as inside such objects. Mattresses are often ‘eaten’ by mold from the inside if it is left undetected. Again, in such cases, the only viable and feasible option is to discard these affected objects safely. Another frequent host for mold in every household is sponge. Sponges are used for a variety of purposes – from body scrubs to car wipes. The very ability – to soak water – that makes sponges useful also helps mold grow on it. Most sponges, if not properly wind dried or sun dried, will host mold colonies that not only make the sponge useless, they can also spread in the other areas of the building through the mold spores that they emit every hour. Hence, affected sponges should be discarded readily, and drying a sponge after using should be made a habit. Household Hacks for Mold Clean-up If the extent of mold infestation is relatively smaller and manageable, simple household remedies can help you to get it all cleaned up to a good degree to professionalism, without actually hiring professionals. Four such simple and DIY (Do it yourself) household remedies for small and occasional outbreaks of indoor mold are discussed below. Please note that mold clean-up activities – irrespective of their scale and the size of mold infestation – should never be undertaken by minors, people with sensitive respiratory allergies, asthma, bronchitis, weak or impaired immune system or any other condition that can be worsened by inhalation of mold spores.

Tea Tree Oil

Tea is one of the most consumed beverages in the world, especially in the orient. It also happens to be the oldest natural beverage recorded in the written history – older than beer, wine and coffee! But uses of tea are not just limited to getting your mornings together or shooing away common cold. Tea tree oil – extracted from the barks and stems of tea plants – is an exceptionally potent fungicide that has very little effect on organisms of larger size (including humans). So, in a way, it provides a targeted drug delivery system that only works against fungi (i.e. mold) without causing any major side effects (at that concentration). Tea tree oil has a distinct aroma that can be identified with blended tea leaves. This aroma itself should be a strong enough reason to use tea tree oil for skin treatment and other household cleaning purposes. If you spot a small colony of mold indoors, here’s how tea tree oil can help you get rid of it in as few as 24 hours. Considering that tea tree oil is not available easily and it’s rather expensive, it is often used in diluted doses. A 1:1 dilution is known to work to a satisfactory degree of potency. The best part is that this mixture doesn’t go bad even after one year of shelf life. So, it can be pretty cost effective in the long run of things.

Mix a cup of tap water and a cup of tea tree oil together.
Pour the resultant (immiscible) mixture in a spray bottle.
Shake it vigorously to temporarily emulsify the mixture.
Then spray it generously over the spotted infestation of mold.
If you don’t see results in 24 hours, repeat the procedure for two more days. If the mold colony is still persistent, you may need to seek professional help.

Clove and Pepper Oil

Another simple way to get rid of common indoor mold (on a small scale) is to use clove and pepper oil. The method is quite similar to the one explained above (for tea tree oil). However, unlike tea tree oil, clove and pepper oil isn’t easily procurable. That’s why, you might want to prepare it at home. The preparation involves blending a handful of cloves and about half a cup of black pepper thoroughly. You can either use regular cooking oil or coconut oil to gel the paste together. Once you have a runny paste ready, mix it with water in 1:1 proportion. Unlike tea tree oil, this mixture will be mostly miscible. Pour it into a spray bottle and spray it over the mold colony. It must be remember at this point that clove and pepper oil has a very powerful aroma that can last for hours after the application. People with sensitive noses – especially children – should not allowed near the site of infestation as they can develop temporary cases of sinus or nasal inflammation as a result of accidental inhalation of pepper and clove.

Grapefruit Seed Pulp

Grapefruit seed pulp/extract is more easily available than clove and pepper oil. You can either use the commercially available grapefruit seed pulp or you can easily prepare it yourself. Grapefruit seeds have been used for centuries as oral medicines for stomach and bowel infections. These very fungicidal properties, mild but effective in nature, can be used to get rid of indoor mold infestation. Grapefruit seed extract is mixed with small quantities of water to prepare a thin solution. This solution is the poured into a spray bottle and spread over the mold colonies repeatedly, for 2 to 3 days in a row. Most kinds of domestic mold that has not spread into large colonies can be exterminated and contained using this method.

Household Vinegar

Vinegar is a very potent biocide, if used properly and in high concentrations. Household vinegar is a diluted aqueous solution of acetic acid. Acetic acid itself is a weak acid in nature. To control minor outbreaks of indoor mold, household vinegar can be a very effective solution. It can either be sprayed directly over the mold colonies or it can be gently smeared over the surface using a cotton washcloth. The latter method is only to be used when mold colonies are very small in size and scattered.

Who Should Do Mold Clean-Up?

Minor infestations of mold colonies can be easily tackled by some strategic planning and methods as explained earlier. However, whenever the mold outbreak is persistent, larger in area and considerable in thickness, professionals needs to be consulted. Before moving on to discussing who should do the clean-up, it would be well in order to take a look at who cannot. Following factors should be taken into consideration while takin up mold clean-up at home:

Mold clean-up should never be undertaken by individuals with weak immune system/impaired immunity as a result of diseases like HIV AIDS or cancer.
People with sensitive health should not be allowed to clean-up the mold.
Individuals who have a recorded and known history of respiratory ailments and/or allergies should not be allowed to undertake mold clean-up operations.
Children and elderly should not be allowed to undertake mold clean-up operations as they are most susceptible to forming new allergies as a result of accidental inhalation of mold spores.
Individuals with any kind of skin condition including allergy spurts like dermatitis should refrain from cleaning up indoor mold.

If the mold outbreak indoors is considerable, professional assistance should be sought. Areas covering more than 10 sq. ft. infested with reasonably thick mold colonies often require professional treatment and cannot be contained with household remedies. There are many professional services extending household and business mold removal assistance available throughout the US. Before hiring any of these services, it should be made sure that the service provider has a good deal of experience in handling various kinds of indoor mold, without disrupting the lives of the occupants of the building. It should also be ascertained that all the procedures involved in the mold clean-up operation are in perfect compliance with the guidelines set up by the American Conference of Governmental Industrial Hygienists (ACGIH) or the EPA. To fix problems regarding ventilation, plumbing and sanitization pre and post operations, concerned professionals should be consulted with. Since moisture and stale air directly contribute to the growth of mold indoors, services from experienced and competent professionals in plumbing, HVAC repair and construction should be sought.

How Much Does Mold Testing or Removal Cost?

It’s difficult to put forth an exact cost of mold testing, inspection or removal in a particular household. The costs incurred in mold removal typically depend on the following factors:

Extent of mold outbreak – size of the colonies
Places of infestation – walls, ceilings, bathrooms, outer surfaces, kitchen etc.
Nature of the place – household or business
Severity of mold – species and toxicity
Time it takes to complete the procedure

There are many Do It Yourself (DIY) kits available for mold inspection. These kits are quite handy to deal with small scale mold outbreaks that occur in most of the households around the country. They are easily procurable from the open market and typically cost anywhere between $10 and $150. Contingent on the prices, these kits include a number of accessories to test and inspect the indoor mold. With some kits, sophisticated laboratory procedures such as petri dish culture assessments are available. Using these methods, you can scrape a small sample of mold from house and place it in the given petri dish loaded with organic matter. Depending upon whether mold grows or not, and the color of petri dish colony, mold species can be easily identified. Once identified, it’s much easier to deal with them as you will have an exact idea of its potential to cause harm to health and well-being of the occupants of the building. If the mold colonies are persistent and widespread (more than 10 sq. ft., every professional service hired will cost you. Taken collectively, for an average sized home, a thorough inspection for mold and remediation (assuming the highest degree of infestation), the costs can rise from $250 to $600. There are many factors to be considered while arriving at the final cost. These are typically the techniques being used (HEPA alone, on its own, can add up to $300 to the final cost) and personnel it requires to carry out the operation on a given day. Intrusive, abrasive or destructive techniques like cavity inspections for walls and flooring may further increase the final costs incurred to your as the homeowner. The same services will cost anywhere between $400 and $1200 for large sized houses (typically with carpet area upwards of 8,000 sq. ft.) and commercial/professional/business centers. Things to Remember while Hiring Professional Mold Remediation Services Here are a few things that must be checked before hiring a particular mold remediation service.

Service provider should have prior experience in handling, inspecting and exterminating most species of indoor mold.
Their services should include complete packages – from inspection to removal. If it’s difficult to find a contractor that offers both inspection and removal, it is recommended to split the operation between two different service providers.
They should be able to certify that your household or business center has been inspected and treated for mold inspection as per the norms set up by your local state offices.
They should be able to carry out destructive testing and remediation if need be.
They should be certified by due agencies (both federal and state) to carry out bio-hazardous operations in areas of human occupation. The Institute of Inspection, Cleaning and Restoration Certification (IICRC) is one of the premier certification program for such professionals. Certifications from the IICRC speak highly of the contractor’s competence.
They should perform all the operations in stringent compliance with guidelines set up by the Center for Disease Control (CDC).

How do Molds Affect You?

It is an undisputed fact that molds have a potential to affect the lives of people that they come in contact with. This impact can be varied. It ranges from the shabby looks that they render the building to weakening the structural integrity of the building itself and from causing mild allergies to extreme discomfort that follows through respiratory ailments and in rare cases, these impacts can be fatal in the long term. The effect that mold can have on different individuals is different. It all basically boils down to the state of the health of the individual in question. Those who have compromised immune systems are most likely to get affected by the presence of mold in house and mold spores in the indoor environment. There’s no way to tell if an individual will get affected in a certain way by a certain species of mold because molds, on their own, have very restricted damage potential. The real impact they have on humans is through conditions they help trigger – either through their physical being (allergens) or through their chemical emissions (by products, toxins and proteins). Misdiagnosis of mold related ailments and physical discomforts is quite common throughout the world. Most medical practitioners do not consider indoor air as the primary source of pathogens and prioritize the diagnosis based on more pressing fronts. This invariably results in delayed diagnosis and hence, delayed treatment. A simple mold allergy, thus, can result into something that would need to be treated like a major disease – wasting the patient’s time, energy, money and peace of mind; not to mention compromising their health.

How Mold Affects Individuals with Weak Immune System

Individuals with weak immunity, as stated earlier, are the easiest of targets for molds. Such individuals form a perfect host for the pathogenic traits of various domestic molds, thus allowing them to make temporary settlements in their own bodies. The commonest way for molds to manifest their impact in such individuals is through symptoms like wheezing, coughing and persistent cold. These symptoms, admittedly, do not readily lead their way towards a correct diagnosis and hence, mold can get enough time to extend the damage. It can range from simple cough that naturally wanes and disappears as the personal immune systems fights the actions of mold spores inhaled or ingested. When this fails, typically in people with chronic cases of asthma, other pulmonary ailments and weakened or impaired immunity arising from natural deficiencies or other diseases like cancer and AIDS. Usual treatments for such major diseases involve chemotherapy, phototherapy, radiotherapy, transplants, infusions and heavy drugs – all of which factors contribute to the debilitation of patients’ immunity. Young children and elderly are also at the highest risk of these infections as their immune systems are yet to develop or naturally weakened, respectively. Mold can not only create discomfort through such symptoms, it can also worsen the already present diseases. For example, chronic patients of asthma, when exposed to high concentrations of airborne mold spores, were found to suffer from heightened and more regular asthma attacks that, in some unfortunate cases, grew to be chronic. Similarly, in many cases, mold inhalation is the prime reason for the development of allergic bronchopulmonary aspergillosis. Even though ABA in itself isn’t potent enough to cause long term damage to the patient’s lungs, it can certainly cause extreme discomfort for the period of affectation. More importantly, ABA further damages the immune system, leaving the patient vulnerable to the attacks from other viruses and pathogens.

Symptoms and Allergies

It is through allergies that molds make known their presence and their impact on one’s health. These allergies are difficult to trace back to mold unless the mold colonies indoor are distinctly visible or easily detectable. They can range from irritation to inflammation. Commonly affected parts of a human body are eyes, skin, scalp and respiratory system. Eyes and skin can be affected by way of allergies that can either be temporary or persistent. Temporary allergic reactions like swelling of the eyelids, watery eyes, itchy eyes, red eyes, painful eyes, rashes on the skin , scratchy skin and substantial increase in scalp problems (dandruff, for example) are quite frequently observed throughout the world, wherever there is high concentration of airborne mold spores indoors. More serious reactions may include excessive bloating of skin, widespread rashes that don’t wane on their own within 24 hours of appearance. Other common health concerns associated with indoor molds are all related to the respiratory system. There is always some concentration of airborne mold spores in every environment, irrespective of whether it’s indoors or outdoors. This concentration, however, peaks substantially if there is a presence of indoor mold colonies. These colonies release millions of mold spores in the indoor environment every day. Inhalation of these spores doesn’t remain, in such cases, an accident – it becomes a foregone conclusion. Inhaling mold spores can trigger all sorts of allergic reactions in one’s respiratory system. Coughing is the most profound reaction caused. Depending upon the intake of mold spores by an individual, the seriousness of cough related symptoms does vary. In healthy individuals, such cough symptoms reduce and disappear all within 24 hours. In other cases, these symptoms tend to be more persistent and cannot be dealt without medical attention. Sneezing is the instant reaction of human body to inhalation of fine particles. Hence, inhaling a large dose of mold spores from an indoor environment can cause sudden and continuous bursts of sneezes among sensitive or allergy prone individuals. These outbreaks of sneezes tend to wane and disappear as the concerned individual moves to an environment with significantly lower concentration of airborne mold spores and other fine particles. Along with coughing and sneezing, inhalation of mold spores also sometimes results into dry and parched throat. These symptoms are similar to any common flu symptoms. As mold spores are adsorbed on the inner surfaces of the throat, reflex actions cause consistent bouts of dry throat. On similar lines, inhalation of mold spores, in almost every case, results in a runny nose and itchy nasal cavities. Again, these symptoms resemble the common flu and cold symptoms starkly. For healthy individuals, most of these symptoms do tend to disappear following simple actions such as moving to another room, letting the stale air out and fresh air in or turning on the HVAC system. Even though household indoor environment cannot create enough sustenance for most species of molds, it is an entirely different case altogether when one is to discuss occupational mold hazards. Individuals who are continuously exposed to high concentrations of airborne molds for prolonged periods (typically in occupational environments like greenhouses, stables, farms, gardens, furniture companies, paper companies and warehouses) pose a high risk of developing hypersensitivity pneumonitis (HP). Hypersensitivity pneumonitis is a form of respiratory disorder that often manifests itself through persistent bouts of vigorous coughs and a sudden shortness of breath. HP, for most people, tends to be acute and short lived. In this form, an individual can experience chest pain, deep cough and nausea. In some rare cases that result from decades of sustained exposure to mold spores, HP can be chronic and difficult to treat. It can even lead to permanent scarring of lungs and extreme reduction in the strength of lungs, as can be identified by shallow breathing cycles and difficulties in performing daily tasks like climbing up the stairs. In this form, HP resembles asthma quite keenly.

More Serious Symptoms of Mold Infection

If not diagnosed and treated correctly, prolonged exposure to more airborne mold spores can lead to more serious outcomes. Many individuals who have been diagnosed with mold infection have complained about constant headaches that they mistook for hypertension or eyesight related problems – even migraines in some cases. Similarly, prolonged and continued exposure to airborne mold spores is known to trigger sudden nose bleeds and panic attacks that follow such instances. Since airborne mold spores primarily enter the body of the host through inhalation, respiratory tracts are affected first. Symptoms like difficulty in breathing, chest pain and throat pain are some of the symptoms of respiratory tract and/or lung infection due to mold spores. If mold spores are allowed to be hosted anywhere in the respiratory systems, there are high chances that, upon successful establishment, they will spread in other parts of the host’s body triggering symptoms like diarrhoea, vomiting and excessive sweating – all of which invariably result in severe dehydration and cramps. Another condition that follows such mold triggered dehydration is the feeling of nausea. Many patients suffering from mold infections complain about the feeling of sickness, nausea and constant fatigue that just cannot go away despite lengthy resting periods and intake of energy drinks or supplements. Mold infestation thus spread to the GI tract and gastric system as a whole can further create serious complications. Growth of mold inside intestines is often known to cause ailments like chronic indigestion, constipation, inflammatory bowel disorder (IBS) and loss of appetite. In other symptoms, sudden weight loss and hair loss is known to be linked indirectly to acute mold infection. Weight loss often follows dehydration and loss of appetite and is not known to be an isolated symptom. Hair loss is linked to scalp infection or scalp dermatitis. In some cases, neurological disorders have also resulted indirectly from habitual mold spores inhalation or ingestion. These include temporary short term memory losses and false pain alarms in the central nervous system. Swollen glands – especially in the upper half of the body – are also characteristics of prolonged exposure to airborne mold spores. Other symptoms that have been linked to such exposures, but not exclusively accepted or confirmed, include temporary sexual deficiencies and bladder infection. Persistent pain in joint, muscles and ligaments are also known to accompany severe mold infections.

Rare and Complicated Cases of Mold Infection

Extremely complicated cases of mold infection arise from prolonged exposure to very (and uncommon) exposure to ultra-high concentrations of airborne mold spores. Such cases are quite uncommon and are a direct result of lack of hygiene and maintenance at the workplaces and households. If left untreated for a period of days, many species of household molds can easily penetrate beyond the immune system of a human body. What results is a breakdown of central immunity, leaving the body vulnerable to other diseases that further debilitate one’s health. Some particular species of indoor molds can produce high concentrations of toxins (mycotoxins) that are easily absorbed in the blood. High levels of these toxins in bloodstream can lead to long term (permanent) memory loss and/or paralysis. Cancer is also believed to be a direct result of such mycotoxins. Permanent injuries to lungs, called pulmonary hemosiderosis, are also believe to result. Other assorted conditions that can be directly tracked back to prolonged and acute exposure unusually high levels of mold spores include various gastrointestinal diseases, cardiac conditions development and deterioration, complications during pregnancy and even brain damage, in the rarest of rare cases.

Mold Infections at a Glance

Following table summarizes various impacts that molds generally have on people. Table 4: Various Health Hazards Caused Directly/Indirectly by Indoor Molds

Allergies	Serious Symptoms	Rare and Potentially permanent and/or fatal symptoms
Skin rashes Runny nose Watery/Itchy eyes Cough Wheezing Difficulties in breathing Shortness of breath Hair loss Dermatitis Sinusitis Bronchitis Sneezing Sore/Dry throat	Headaches Nosebleed Dizziness Fibrosis Muscle/Joint/Ligament pain Diarrhoea Vomiting Weight loss Cramps Limb pains Persistent fatigue Nausea Drop in productivity Difficulties in concentrating on objectives	Blindness Brain damage Paralysis Permanent memory loss GI diseases Cancer Complications during injury

Impact of Mold Exposure: Common Misdiagnoses

Many experts believe that mold exposure symptoms and diseases are quite routinely misdiagnosed in the United States. According to the National Treatment Centers for Environmental Diseases (NTCED) and Mayo Clinic, there are roughly 55 to 60 million Americans who regularly suffer from sinusitis caused directly or indirectly by indoor mold. What’s more interesting is that almost all of these patients (96%, to take help from the numbers published by the NTCED) are diagnosed wrongly by medical practitioners. The fact of the matter is that misdiagnosis can not only delay the prognosis, it invariably delays the right treatment – in a way stripping the patients of their fundamental right to being in a good health. Here are some of the commonest misdiagnoses for mold related sicknesses.

Asthma and Emphysema Family

When a patient complains of sudden shortness of breath and a general difficulty in breathing, many medical practitioners tend to probe him/her for asthma or some other emphysema family disease. It would serve the purpose well to know what asthma really is. Asthma is an exclusively respiratory syndrome in which affected individuals’ lung capacity is greatly compromised by way of sudden compression of spastic airways. The exact reason for this condition to get triggered is, even after decades of research, is still not discovered in precisions. Many scholars believe that asthma is triggered by a number of fine particles – mold spores being among them. However, even though mold infection can trigger asthma, the original microbial infection would still warrant extra treatment, which is, quite commonly not extended to the patients. This can result into prolonged stay of molds inside the respiratory system of the patients, further complicating the road to the restoration of health.

Chronic Sinusitis

Most mold species can trigger regular or irregular sinus problems among the residents of the building. Quite too many times, the underlying reasons behind frequent sinusitis outbreaks aren’t fathomed. Most medical practitioners, in such cases, diagnose that such individuals are suffering from chronic sinusitis. Chronic sinusitis is not an alarming diagnosis in its own right. In fact, close to 30 million American citizens are estimated to be suffering from chronic sinusitis – on an average one among ten adults in America. However, if misdiagnosed and mistreated for, chronic sinusitis can not only persist, it can get complicated, leading to other pulmonary and respiratory diseases like asthma.

Fibromyalgia

Fibromyalgia, also known as fibrositis, is a disease of central nervous and muscle network ailment. It has been quite difficult for medical science to define the exact symptom or effect boundaries of fibromyalgia, because more than 40 different symptoms are known to be linked eventually to it. Some of these symptoms include insomnia, persistent joint and muscle pain, inability to focus, incessant fatigue, nausea, a common feeling of being ill, headaches, unpronounced dizziness, backaches and sudden tingling sensation in fingertips. Many of these symptoms also point towards ailments that can be easily ruled out or verified (e.g. vertigo and diabetes). However, persistence of these symptoms in isolation or collection usually makes medical practitioners to diagnose and treat the patient for fibromyalgia. Internal infections caused by many species of mold uncannily mirror more than half of these symptoms in unison. This results in misdiagnoses and mistreatments.

Chronic Bronchitis

Bronchitis is another common pulmonary and respiratory disease that mold infection is often mistaken for. Bronchitis can be triggered by fine particles like dust, smog or pollens. It results into temporary but recurring disintegration and/or inflammation of airways and lung lining symptomized by wheezing, shortness of breath, sudden chills or fever, hacked coughing and sneezing. Most individuals exhibit these symptoms upon getting infected by excess airborne mold spores, as well.

Ways to Reduce Allergies Triggered by Mold

If you are sensitive to fine particles and already suffer from respiratory or pulmonary allergies, you will be at the highest risk of developing more lasting and persistent forms of these allergies because of exposure to high concentration of airborne mold. However, there are a few simple ways with which one can limit their exposure to mold and other allergens. A few lifestyle changes and a few precautionary steps are all it takes to virtually shield yourself from mold related allergies and a level of discomfort that follows.

Knowing when to be careful

Indoor concentration of airborne mold spores can increase only in two scenarios. The first involves growth of already established mold colonies indoors while the second involves natural increase in airborne mold spore outdoors. Regular and times inspections by professional can preclude the possibility of indoor mold growth. Therefore, if one is to know when the airborne mold spore count increases outdoors, preventive measures can be adopted to make sure that these increased levels of airborne mold spores don’t infiltrate the indoor environment. The American Academy of Allergy, Asthma and Immunology (AAAAI, under the National Allergy Bureau) provides regular and real time updates regarding variables in outdoor environment such as airborne mold count, pollen count, dust levels and smog levels. Keeping yourself updated with this information can be a very effective way of knowing when to be cautious.

Knowing where to be careful

Regardless of outdoor concentration of mold spores, there are places that always carry higher concentrations than the ordinary and predicted level. These are usually sites of business or occupation like greenhouses, farms, factories, food processing plants, leather processing units, animal husbandries and such. These places provide a very conducive breeding ground for most species of mold. They are usually damp from industrial processes, they carry huge amounts of decomposable organic matter and waste, and they are usually poorly ventilated and isolated from communities. If you are to visit such places, you need to ensure that you have adequate respiratory protection. You can use any of the respiratory masks or filters discussed in the earlier parts of this articles. Also, wearing clothes that keep you fully covered (overalls, full sleeved shirts, trousers, gummy boots and hats) can keep you well away from accidental inhalation of mold spores.

Knowing what to avoid

The best way to steer clear of mold infections and allergies is to know what to avoid. For those who are particularly sensitive to fine particles, avoiding outdoor activities that involve leaves, grass and trees may be an easy and effective way of avoiding a major source of airborne mold spores. Rotting remains of trees tend to have some of the highest concentrations of mold spores around them. Similarly, if you are chronically allergic to mold, it’s better to avoid food that’s not cooked indoors, especially during the fall season and the peak of the summer. This way, you can avoid accidentally ingesting mold spores or grown up molds and thus stay away from subsequent allergies or conditions. For people who have high sensitivity towards molds and allergies, some foods and drink should be consumed in moderation, keeping in mind the outside weather and overall stability of their health. These foods typically are:

Alcoholic Beverages: Alcohol is basically a fermented liquid. By this definition, its roots can be easily traced back to fungi and bacteria. That’s why, it’s important to stay away from alcoholic beverages or at least consume them with in strict moderation, if you happen to be a sensitive individual toward molds and allergies.

Dairy Products: Dairy products usually contain a high number of bacteria and fungi species. Even though almost all of these species (found in fresh products) are innocuous (in some cases, even helpful) for human bodies, people with weakened immune system or high sensitivity towards mold infections should try to find alternatives to dairy products for daily consumption. Fermented dairy products or dairy associated products like sauerkraut, cheeses and yoghurts should especially be avoided.

Subterranean Fruits and Vegetables: Most people who are sensitive to mold infection are known to be allergic to subterranean fruits, vegetables and pulses. These include cabbages, radishes, groundnuts, potatoes and sweet potatoes. Similarly, high carbohydrate grains like corn and barley can also contain various mold species lodged onto them. However, since it’s impossible to not include all these foods in regular diet, it’s recommended that processed forms of these foods (such as pickled radishes or microwaved potatoes) should be preferred to raw forms. This will help you stay away from mold species without having to sacrifice a major portion of what makes regular American meals.

Knowing how to manage your health

If you an allergy prone individual, it becomes very important you to keep track of any significant changes you make to your food, lifestyle, schedule or even clothes. Things that don’t seem quite important superficially do have the potential to trigger all sorts of mold related allergies. That’s why, even though it’s a difficult and limiting prospect, allergy prone individuals are best advised to note down their activities on a routine basis. The most difficult part in combating mold infections and other allergies is not the treatment itself but the diagnosis. In some cases, diagnosis can take far too long while in some cases it may never arrive. If that happens, treatment can be as good as guesswork. However, if the patient has a recorded history of their activities, it can be easier for medical professionals to narrow down the options they have, making the journey toward diagnosis much shorter and more accurate. You can simply note these down in your own diary or notes. There are many resources available online that can help you get started with this. Many smartphone apps have also been published for these purposes.

Mold Sickness Treatment

Treating mold sicknesses is a fairly straightforward practice that usually involves an antibiotic or a combination thereof to selective attack the resident mold species. However, the biggest roadblock is presented in the form of misdiagnoses, as discussed in details earlier. If not diagnosed correctly, mold infections can grow to be worse and further complicate the matters. Hence, a successful and quick diagnosis is the best way to move forward while dealing with mold infections and subsequent treatments. Mold infections have pretty vague symptoms that can overlap or mimic a number of other similar conditions. When faced with these symptoms, it becomes necessary to point out facts (like changed lifestyle, travels, new food, new house, new workplace etc.) to the medical practitioner you are seeking advice from. Some common methods undertaken by medical practitioners, allergists and general physicians all around the world to get an insight into the nature of infections and allergies are described below.

Physical and Superficial Examination

This is the most rudimentary way of reducing the number of possible causes that can be responsible for the allergy or infection. In logic, this is termed as the process of elimination. Using this logical procedure, it becomes simpler for the practitioners to arrive at correct a correct diagnosis. Physical and superficial examination of allergies frequently involves the appearances of symptoms. If the allergies are affecting the patient’s skin, the color of rashes, their patterns, severity, itchiness, dry/wet nature, spread, frequency, flakiness of the affected parts of the skin and depth of penetration of rash wounds are some of the signs that can lead to a correct diagnosis. If the allergies or infections are internal, they typically exhibit themselves through nasal secretions, mucus, sneezes, cough and wheezes. Understanding the nature of phlegm is an important part of such physical examinations. In other cases, when allergies affect eyes, the color of eyes, frequency of heightened redness, impact on eyelids, possibility of dermatitis and related conditions can be verified or ruled out using such superficial examinations. It should, however, be remembered that these physical examinations do not necessarily always point to the real reason behind allergies – they are just indicators of potential courses to be followed.

Skin Testing

Skin testing is a common diagnostic and conjectural procedure followed by medical practitioners to assess the nature of skin allergies where molds can possibly be the culprit. Skin testing is to be performed by qualified medical authorities (practitioners or allergists) only in laboratory environment. Highly purified and less potent batch of assorted mold species is injected in the outer skin of a patient suffering from allergies or skin conditions. Once this is done, the injected mold species reside on the patient’s skin and within 24 hours, reactions by the skin to these species develop. These reactions are studied in order to compare their resemblance with the already present symptoms. This can help proceed with the diagnosis. Even though immensely helpful, this technique cannot be extensively performed at every medical center. Furthermore, availability of laboratory grade purified batched of all species of indoor mold is not quite common.

Blood Testing

Blood testing is a more common route used by most medical practitioners and allergists to arrive at solid conclusions. Just like skin testing, blood testing involves an assessment of reactions caused by purified batches of various mold species. Collectively, these tests are also known as Memory Lymphocyte Immunostimulation Assay, or simply MELISA tests. These tests help one arrive at diagnoses regarding allergens, chemicals, fine particles and mold spores. Most domestic species of molds can be identified using MELISA tests. Unlike skin testing, blood testing can be conducted remoted. The patient doesn’t has to travel to the site of testing as blood can be extracted and sent to the nearest laboratories where MELISA testing facilities are available. However, skin test is more useful to measure the levels of infection, once the presence of mold is confirmed; whereas blood testing only tells if the patient has contracted mold infection or not. Somewhat similar to MELISA tests, Enzyme-Linked Immunosorbent Assay (ELISA) tests can provide a great insight into the presence of all sorts of foreign bodies in the patient’s bloodstream. For ELISA tests to work, there has to be some presence of pathogens or toxins that affect the natural enzyme activity. Since molds often seem to alter the course of lipid activity and enzyme activity in human body, ELISA tests can be useful to identify a majority of common household indoor mold species. In an event where neither primary superficial testing nor blood testing using MELISA or ELISA tests present a conclusive evidence for a particular mold species, a more complex approach can be employed with the help of radioallergosorbent (RAST) testing. RAST tests are not used in regular courses of action as they are complex, expensive and resource intensive. Mold sickness treatment depends on a number of factors and in many cases it can be extremely patient specific if there’s no recorded precedent or reference. Hence, most medical practitioners and allergists are particularly careful about prescribing drugs for the treatment of mold. In healthy individuals, a majority of mold infections is cured naturally as the immune system combats the pathogens over time. However, if this doesn’t happen – because the mold species are tenacious or immune system is weak – external drugs in various forms and doses are indispensable. There are various schools of thought when it comes to treating mold related sicknesses. Alternative therapists believe that antibiotics make the mold species even stronger in the long run while allopathic treatment heavily relies on the use of antibiotics for instant relief from the discomforting symptoms along with quickened healing process. A few of these mainstream mold sickness treatments are discussed below.

Cholestyramine

Cholestyramine is prescribed for all sorts of mold exposure, not only in the United States, but throughout the world. Abbreviated as CSM, cholestyramine is basically an amine and hence, has all the chemical properties that are generic to amines (weak acidity, polar nature and ability to form complexes). These properties are useful in the functionality of CSM while combating mold infections in human bodies. Although CSM can be found naturally, it often has to be synthesized in laboratories for the prescription purposes. CSM acts as a binding agent and sequestrate for the gastric acid present in human bodies. As it binds the gastric acid molecules together, it becomes impossible for pathogens to take advantage of already present gastric acid for their own metabolism. Furthermore, CSM has an ability to form ionized complexes with organ walls that are infected by molds and mycotoxins released by these molds. This keeps molds from reabsorbing nutrients from the host’s body, effectively neutralising them in a matter of hours, if not days. CSM is to be used only as directed by qualified medical professionals and physicians. It should never be used just before or just after eating any kind of food or food supplements as it tends to bind most types of proteins and lipids found in foods. CSM is often available in tablet forms and needs to be ground to powder before consumption. Here are a few scenarios when the use of CSM for mold infection treatment is not advised:

Serious GI conditions (chronic indigestion, constipation, IBS etc.)
Recorded history of being allergic to CSM and its constituent drugs
Ongoing courses of drugs like leflunomide (for arthritis, joint pains, paralysis, rheumatisms etc.)
During pregnancy

The effectivity of CSM in mold sickness treatments has often been debated. However, despite not having any proven chemistry to support its functionality, CSM continues to be the most commonly prescribed anti mold infection drug simply because it works. When taken in smaller doses, CSM has no cognizable side effects on human health, even in cases of people with suppressed, weakened or compromised immune system.

Antihistamines

Antihistamines are generic drugs used to combat mold and other fungal infections in human bodies. They are typically available over the counter in most states and are branded with various names by most of the leading pharmaceutical companies. Although antihistamines can act very rapidly (within a matter of hours), it may take about 2 to 3 days for the allergy or infection to get completely cured. All of the common species of indoor mold, especially black mold that grows on damp walls and in bathrooms, are treatable by the use antihistamines. Patients who have a known history of mold allergies can use mild doses of commercially available doses of antihistamines when mold infection symptoms surface. Antihistamines can bring immediate relief when symptoms like persistently runny nose, itchy skin, red eyes or scaled scalp are encountered.

Common Cold Medicines

As long as the mold infection is in its primary stages, it can be easily contained with regular cold medicines, provided that the patient is not suffering from auto-immune diseases or has a congenial immune system problems. Decongestants can be used to clear blocks nasal airways, making breathing a little easier for the patient. This reduces the unnecessary strain on throat muscles and sore throat symptoms that soon follow. Oral decongestants, nasal sprays and household therapies like sauna therapy or herbal teas can also be used to alleviate symptoms. These medicines, however, should not be used for longer periods. If condition doesn’t improve within 48 hours or discomfiture doesn’t diminish, appropriate medical attention should be sought immediately.

Corticosteroids

Almost every indoor species of mold causes upper respiratory allergies and difficulties in breathing. Considering this, corticosteroids, when administered nasally, can be very efficient, quick and effect in combating such upper respiratory mold symptoms. Nasal corticosteroids are branded and sold by a number of pharmaceutical companies and are generally available with ease over the counter. Inflammation of nasal cavities, throat, tonsils, lungs and difficulties in breathing are better and faster managed by corticosteroids than by other prescription drugs like cholestyramine. Even though they are relatively safer for long term usage, continued use of nasal corticosteroids is discouraged by most medical practitioners. Side effects of using nasal corticosteroids include sore throat, sore mouth, loss of appetite, occasional nosebleed and dry nose.

Montelukast

Montelukast is commonly prescribed to patients who have chronic cases of asthma and other allergy related conditions. Leukotrienes are secreted on an automatic basis by the central immune system when presence of pathogens (molds, in this case) is detected. These chemicals trigger a number of reactions and symptoms in the body – the most prominent being runny nose, itchy eyes and fatigue. As these symptoms develop, a physician may try out a dose of Montelukast to make sure that the symptoms are directly related to mold or other fungal infection. Montelukast binds to leukotrienes and reduces the discomfort caused by these symptoms. As the symptoms wane in severity, other treatment methods can be continued alongside to tackle mold infection.

Anti-Infection Vaccines

Vaccines are often looked at the least preferred curative treatment method and most preferred preventive treatment method. If various tests conducted suggest the infection is caused by a particular species of mold, anti-infection vaccines can be used to get rid of these species from the host’s body. Although not always successful, anti-infection vaccines can certainly help the patient’s immune system to get used to combating mold infections better.

Lavages

Nasal lavage is a popular household method of dealing with mold infection symptoms that cause discomfort. Runny nose or stuffed nose, the level of discomfort caused by either of these is considerable and can, in many cases, affect the productivity of the individual. That’s why, simple remedies like daily (or twice a day) washing of nasal airways with saline water can significantly palliate these symptoms. Salt acts as a natural antibiotic and relieves superficial blockages of nasal cavities caused by mucus. There are a number of ready to use nasal lavage kits available in pharmacies and online stores. With the help of these kits, easy and non-chemical way of dealing with nasal infections can be accessed. It should always be ensured that getting rid of indoor mold colonies is as important in priority and urgency as treating yourself or other affected individuals is. If indoor mold colonies are not cleaned up, there is high chance that mold related allergies and other symptoms that follow will recur. A number of mold clean-up guidelines and techniques have been described in the earlier parts of this articles. Any of these methods that suits given needs should be adopted to ascertain that indoor count of airborne mold spores is brought down significantly. Only in such cases will the external medical treatments will have a positive impact on the patient’s health and recurrences of mold infections and sicknesses can be avoided.

Mold Toxins (Mycotoxins)

There are many species of indoor molds and not all of them are deemed to be toxic. However, certain species of mold, especially the ones classified as class A or B in terms of potential to cause health hazards, are toxic in nature. This toxicity is imparted to these mold due to chemicals that they tend to form. These chemicals are called mycotoxins. The term mycotoxin is a portmanteau formed by two words myco (Greek) meaning fungus and toxins. Mycotoxins are generally typical to various species of molds and these species can be easily identified with the existence of these characteristic mycotoxins. However, a given species of mold does not necessarily produce a single mycotoxin. Mycotoxins are mostly found in complementary groups in which one prominent mycotoxin can characterize the mold species. When compared on a toxicity to weight ratio basis, mycotoxins are some of the most toxic substances on the planet. However, since mold species do not tend to form relatively lower quantities of these, their ability to cause health hazard to humans is limited. This is not, by any means, to say that mycotoxins are not lethal. In some cases, continued exposure to mycotoxins is known to be debilitating and even fatal. To put it in the simplest of terms, mycotoxins are products of life processes of mold species – especially the metabolism processes. There are two primary categories of mycotoxins. The first, and certainly more toxic, includes mycotoxins that are formed as a result of primary metabolism processes. Primary metabolism processes for any organisms are the ones through which they carry on their life cycle. This involves procuring food, processing it, distributing energy across their cell structure and discard the non-useful substances. Primary mycotoxins are always found in higher concentrations as compared to secondary mycotoxins. Secondary mycotoxins are formed as a result of secondary metabolism and survival processes. These processes, per se, are not essential for the life cycle of mold species. The fact that secondary mycotoxins are still existent can be attributed to the added survival and defence mechanism that they impart to the mold colonies. Primary mycotoxins are, as mentioned briefly earlier, characteristic of mold species, whereas secondary mycotoxins are more or less characteristic of environment that the mold grows in. Organic matter that they are decomposing, temperature, humidity are some of the factors that can determine which secondary mycotoxins are formed in mold colonies. Many people quite naively consider mycotoxins as secondary mold structures. Mycotoxins are not organisms in themselves. They are just chemicals that molds and other fungi, intentionally and unintentionally. Mycotoxins are not specifically designed to attack competing species or more evolved organisms. In this aspect, they are quite opposite to other natural venoms and toxins like snake venom or jelly fish poison. However, it has also been observed that in more ‘threatening’ environment, the production of mycotoxins by molds increases substantially. In a way, mycotoxins are the only entities that resemble the defence mechanism of molds and yeasts. Just as mold tries to get settled in a host’s body, it has to overcome the resistance from the host’s immune system. Perhaps, this is why mycotoxins are produces in a much higher concentration in hosts’ body than outside of it. Mycotoxins have a wide array of effects on humans. These effects depend primarily upon the health of the receptor (host), concentration of mycotoxins, duration of impact and secondary factors like the potency of complementary mycotoxins formed by the same species of mold. Complex effects with contradictory symptoms can be observed in hosts if more than one species of mold comes in contact with them. In such case, it is not only difficult to identify the source of damage, it is also challenging to treat such contradictory mycotoxins in isolation. There are estimated to be thousands of mycotoxins and their variants present in nature, only a handful can be encountered in indoor environments, some of which are discussed below.

Fumonisin

Fumonisin is a name given to the group of mycotoxins produced exclusively by mold species in the family Fusarium. As noted earlier, Fusarium molds are generally classified as class A, meaning that they have the highest potential to cause health hazards to humans who come in contact with them. This potential can solely be attributed to fumonisin. Fusarium itself is known to produce over 50 distinct types of mycotoxins that vary in chemical structures and adverse effects. All of these are generally referred to as fumonisin. Fumonisin has been known to people in almost every part of the world, on account of their widespread ability to destruct corn, wheat and barley fields. Their usual entry-point into indoor environment is through such untreated natural food products and grains. The effects of fumonisin can vary widely depending upon the conditions in which they are allowed to act. These effects, in humans, can range from mild headaches to permanent nervous problems. In pregnant women, high intake of fumonisin can result into complications in pregnancy and congenial nervous diseases, mainly neural tube defects, in the offspring. Long duration of fumonisin in human bodies is also often linked to a heightened possibility of esophageal cancer. Although these conditions are definitely alarming and serious in nature, it should be taken into account that these are not known to be common occurrences. What fumonisin can cause on a regular basis, however, is food poisoning (acute mycotoxicosis). This results from the ingestion of affected plants and vegetables. Inhalation of Fusarium mold spores is not known to cause acute mycotoxicosis. Symptoms of acute mycotoxicosis include diarrhoea, vomiting and flu-like symptoms. Dehydration follows typically during the convalescence stages.

Aflatoxin

Aflatoxin is produced by many species of Aspergillus molds. Aflatoxin is a highly potent and dangerous carcinogen. Even in as low concentrations as 0.06 ppm, aflatoxin has the potential to cause irreversible damage to human hosts. The Food and Drug Administration (FDA) of the United States has set the safe levels of aflatoxin in solid food products and animal feeds at 0.02 ppm while it is even lower for dairy products, at 0.0005 ppm.

T-2 Group of Toxins

T-2 group of toxins is typically produced by Fusarium family of molds. These are more potent than fumonisin group of mycotoxins. Although occurring in very low frequency, damage caused by T-2 group of toxins is often permanent. Continued exposure to these toxins can result into pulmonary hemosiderosis (bleeding of lungs). Digestive tract and liver are also at high risk from T-2 toxins. Acute internal bleeding, if not attended to in due time, can quickly result into death of the host.

Gliotoxin

Gliotoxin is considered to be a secondary mycotoxin and is produced by a number of indoor mold species, including Penicillium, aspergillum and Alternaria. Effects of gliotoxin on human bodies are temporary and receding. Weakening of immune system (auto-immune symptoms) are caused in elderly people and young children.

Sterigmatocystin

Sterigmatocystin is produced by Aspergillus. It is a potent carcinogen when present above threshold levels.

Vomitoxin

Vomitoxin is considered to be characteristic to most species of Fusarium that are found to thrive in indoor environment. As the name suggests, Vomitoxin can cause severe bouts of vomiting caused by dysfunctional GI operations. This invariably results into acute dehydration, leaving the host vulnerable to other conditions like depletion in the platelet number.

Citrinin

Citrinin is produced by Penicillium and Aspergillus mold species. This is a comparatively less toxic mycotoxin that causes temporary conditions like cough and runny nose. Prolonged exposure can trigger bronchitis like symptoms, and in rare cases bronchitis itself.

Trichothecene

Trichothecene is one of the most potent mycotoxins. It is generally produced by Stachybotrys, spotted worldwide (known colloquially as black mold). Stachybotrys species of mold are found exclusively indoors. Interestingly, these species are not known for a good concentration of airborne mold spores. They, thus, are known to enter human body via accidental ingestion or contact.

Why mycotoxins are difficult to act against

Human immune system tries to act against every unknown body and chemical that enters the body. However, the cases can be quite complicated against mycotoxins (as can be against all toxic substances). Central immune system finds it difficult to identify mycotoxins as foreign chemicals. Many mycotoxins resemble enzymes and proteins that are regularly produced in human body by glands and organs. Furthermore, these mycotoxins are mistaken by the central immune system for useful proteins and enzymes. This makes getting rid of these chemicals by natural means all the more difficult. Mycotoxins are often circulated in the blood stream and very little percentage of their concentration is actually thrown out of the system by way of excretion.

How Mycotoxins can be dealt with

However clichéd it may sound, the only and most effective way of acting against mycotoxins is to not allow them the opportunity to enter one’s body. Regular maintenance of the buildings and taking up precautionary measures can greatly reduce the risk of indoor mold infestations. This automatically rules out the possibility of mycotoxic interactions. Once infected, the only way to counter mycotoxins is to bind them together by means of external medication. Drugs like CSM have the ability to get attached to mycotoxins and thus allow the immune system to recognize them as foreign sets of substrates that need to be excreted.

Microbial Volatile Organic Compounds (mVOCs)

Microbial volatile organic compounds (mVOCs) are highly volatile compounds that are produced during the metabolism cycles of molds. These compounds, as they are generated, readily evaporate due to their volatile nature. Since these compounds typically carry strong odor with them, mold growth is associated with their odor that resembled musky, earthen smell. In most species of molds, mVOCs have typically common organic functional groups like benzene rings and aldehyde carbonyl bonds. mVOCs are only produced when the metabolism cycle of molds is active and functional. In another words, mVOCs are vital signs of existence and life of molds. Whenever there is that characteristic strong odor is present about mold colonies, it can be taken for granted that such colonies are functional, alive and growing. There is no reported study confirming that mVOCs, by themselves, are capable of any health damage to individuals living or residing in the close vicinity of mold colonies. However, their smell can be nauseating and dizzying, if indulged with for long hours. Nasal irritation and respiratory inflammation are also experienced by many people who come in contact with mVOCs. These tend to dissipate on their own when the contact becomes non-existent. Even after the mold colony is cleaned up, mVOCs ‘hang about’ indoors if proper and effective ventilation cycle is not carried out. Following table collates a few of the common mVOCs that accompany indoor mold growth. Table 5: Commonly Experienced Indoor mVOCs and Corresponding Functional Groups

*Functional Group*	*mVOCs*
Aldehydes	Formaldehyde Acetaldehyde Propanal Butanal Pentanal Hexanal
Ketones	Acetone 2-Heptanone 2-Pentanone 3-Hexanone
Terpenes	Limonene Pipene
Alcohols	Methanol 1-Propanol 1-Butanol 2-Butanol 2-Pentanol 1-Pentanol Geosmin
Sulphuric Compounds	Disulphides

Mold Prevention

Mold prevention is the only sure-fire way of staying away from mold infections and a hoard of diseases that follow. With enough care and regularity of maintenance, allowing no breeding ground indoors for mold species is not a herculean task. Here are a few easy tips that can help you keep your household or workplace fresh, clean and free of nasty mold colonies.

Marking Problem-prone Areas

It is a common sense that there are some areas that are most likely to attract mold growth. The perpetually wet parts of a building – bathrooms, kitchen sinks, pipes, garages, basements, attics, nooks and rooftops – are, thus, most likely to have mold colonies settle on them. Identifying these problem prone areas can certainly help the overall maintenance of a building. It becomes much easier to inspect for mold if you have already marked these areas in the building.

Keeping It Fresh

Keeping indoor environment fresh is a vital part of overall health of a building. Stale air tends to trap moisture and mold species thrive in moist air. So, properly ventilated buildings can get past this problem with relative ease as there is no room for air to grow stale in a ventilated building. If natural ventilation is absent or not feasible, artificial HVAC units can be used. However, these units themselves tend to attract mold colonies. So, if HVAC units are installed, they should be marked for regular inspection.

No Stagnant Water or Condensation

In any indoor environment, there should be no stagnant water present. Stagnant water tends to increase overall humidity of the indoor environment and it presents a perfect breeding ground for a number of mold species. Of course, there are number of other algae and bacteria that tend to grow in stagnant water. If there is accidental spillage of water/watery liquids, care should be taken to dry wet areas immediately. If clothes or carpets are wet, they should either be sun dried or artificially dried (either by using drying lamps or heaters). Similarly, surface condensation inside the building (on pipes or cooler objects) should be kept in check.

Maintaining Indoor Air Quality

Another key to keeping your house or workplace free and clear of any sort of mold infestation is to ensure that indoor air quality is high. This quality depends upon a number of factors such as temperature, humidity, ventilation, fine particles count and freshness of air. Maintaining a right balance between temperature and humidity can render indoor air quite useless for mold species, thereby blocking their growth and reproduction.

Maintenance

Regular maintenance of the outer surfaces of the building blocks easy access to rainwater into the building. This includes regular and times maintenance of the roofline, windows, fascias, gutters, drain pipes and balconies. If there is even a hint of moisture seepage through walls or ceiling, professional assistance should be sought to fix the relevant issues. Painting inner walls of the building with a paint with mold inhibitor additives is also a great way of preventing future mold growth.

Garden Care

It is very commonplace for mold spores to enter the indoor environment via garden plants. There are rotting fertilizers, leaves that haven’t been raked, damp tree trunks, wet grass and a part of the garden forever deprived of sunshine. These are very conducive places for mold to grow. Once there is mold growth in the garden, it wouldn’t take much more than a gust of wind in the right direction to bring all those airborne mold spores into the building. Hence, proper and regular maintenance of house garden is of utmost importance.

Testing and Sampling for Mold

The first step towards successful clean-up of indoor mold is mold detection. It’s not always the case that mold grows quite obviously on the front facing wall of the living room. Mold often tends to grow in places that are not easily accessible and hence experience quite less human contact and maintenance. In instances where mold is not obviously noticed (visually or by smell), need for more technical methods of mold detection arises. The best way of confirming or ruling out the presence of indoor mold is by laboratory testing and sampling. That being said, it should first be understood when sampling and testing is really necessary.

When is Testing or Sampling for Mold Necessary?

Testing or sampling for mold is called for in one or more of the following situations:

When moisture seepage in walls and/or ceiling is apparent
When there is untraceable musty smell that won’t go away
When one or more occupants of the building/workplace develop sudden allergies or sickness
When maintenance of the building has been long overdue

These situations require sampling or testing on an urgent basis. Sampling should not take place in usual weather. Regardless of these conditions, however, most experts advise that indoor air should be tested for mold at least twice every year.

From Where should the Indoor Air be Sampled?

Sampling of indoor air for mold spores cannot be done on a haphazard or random basis. Following are the areas that should be prioritized for sampling indoor air for mold:

Bathrooms and toilets
Attics, garages, basements
Kitchen
Waterworks
Garden (if the experts deem it fit)

How should Solid/Liquid Samples be collected?

There is a certain procedure to collect visibly molded solid or liquid samples.

Adequate protective gear (described earlier) should be donned.
Approximate 1 sq. inch of solid surface with undisturbed growth of mold should be cut/scalped/trimmed/plucked/torn from the object.
Such sample should be placed in double layered and non-permeable plastic bags (preferably with zip locks).
Time, date and place of collection should be noted on this bag (preferably with a photograph).
Same procedure should be adopted for liquid. About 5 to 10 mL of molded liquid surface should suffice for testing.
This liquid sample can be stored in a plastic bottle or sampler.

Whenever possible, sampling should be left to experts. Procedures performed by non-professionals regularly allow for contamination of sample, and this results into wrong or inconclusive results that do not help the cause. Despite this, if you decide to undertake the sampling by yourself, you can use the chain of custody (COC) form available here to properly document the process of sampling. This will help the laboratory personnel to duly test the samples you have collected. A list of all the laboratories in the United States that accept indoor air and other solid/liquid samples is available here.

Hidden Mold

Mold prevention can be hindered quite significantly if there’s no mold to be seen. However, if the mold is making its presence felt through smell or sudden allergies and sicknesses, there is a good chance that hidden mold is up and thriving somewhere inside the building. Spotting hidden mold is not as easy as it sounds. Mold can grow in the most unthinkable of places – even beneath wallpapers. Of course, nobody would go about their houses scraping wallpapers to check for mold. That’s why, knowing where to look for hidden mold becomes important. Here’s when active mold search campaign should be undertaken to confirm and locate the presence of hidden mold:

Damp, musty, mold-like smell that doesn’t seem to dissipate
Allergies among occupants of the building
Poor and stale indoor air quality
A feeling of nausea upon entering the indoors

It is difficult for non-professionals to successfully trace the signs to actual mold colonies that are hidden. Many times, abrasive or destructive techniques need to be employed to locate mold colonies. Hence, these tasks are best left to professionals. At workplaces, hidden mold location operations should be undertaken on weekends (or when there’s no occupation of the workplace). Following are the areas that typically harbour hidden mold in many households/workplaces:

Wall cavities
Under the floorboards
Behind wallpapers
Beneath ceiling plaster/tiles
Under the carpet
Inside the mattresses
Behind curtains
Inside HVAC units and ducts
Beneath bathroom tiles/flooring panels
On the walls of attics/caches/garages/basements
Under the kitchen sink and deep inside cabinets

Mold Resources

Mold is not an uncommon problem in the United States. There are a number of guidelines available from the authorities, both Federal and State, regarding mold prevention and clean-up at households, workplaces and community centers. Following table summarizes all relevant mold resources for easier access, understanding and references. Table 6: Mold Resources

Resource	Name and Link
Environmental Protection Agency	Indoor Mold Guide
Department of Housing and Urban Development	Household Mold Guide For Indian Countries
Environmental Protection Agency	Moisture Control Guide for Construction
Office of Native American Programs (A Study Report Presented to the Congress)	Mold Problems in Native American Houses
Environmental Protection Agency	Mold Guide For Schools and Workplaces
Centers for Disease Control and Prevention	Dealing with Environmental Molds
Centers for Disease Control and Prevention	FAQs Regarding Household Mold Species
New York City Department of Health	Understanding Mold
Institute of Inspection, Cleaning and Restoration Certification	Maintenance and Damage Reparation Techniques

Besides these few authoritative resources, every state’s own health department regularly updates household mold management guidelines and indoor air quality criteria for residential and commercial buildings. To get a list of mold inspection, sampling, testing and remediation service providers in your area, any yellow pages book or website can be used. If you think you are suffering from mold related sicknesses caused by mold infestation in your workplace, you can approach your state health department for assistance.

Flooding and Mold Infestation

When a building suffers from flooding, an acute mold infestation is a more or less certainty. Floods bring with them all of the conditions that mold spores find ideal to settle, grow and reproduce rapidly in. These are:

Flood affected households or commercial buildings remain damp not only for the duration of the floods, but long after the floods have receded, as well. Persistent dampness on such a high scale is nothing but an invitation for various species of molds.
Whenever there’s a flood, buildings with basements are the first and the most to suffer. Floodwater that enters basements is very difficult to get rid of. Moreover, being underwater for days – in some cases, weeks on end – surely provides an ideal breeding ground for molds.
Everything that is stored in houses/building gets wet because of floodwaters. This includes carpets, mattresses, linens, furniture, windows, walls, food stocks, clothing – everything that mold can potentially feed on with ease!

Flooding can be a disastrous outcome for mental, physical and financial health of the communities or neighborhoods that get affected. However, it becomes necessary to act fast in order to avoid further damage to your property, because a molded building boasts of nothing but a highly depreciated value on the property market. Here are a few steps to follow in case of flooding:

Fast Response

Whenever a flood hits your house/workplace, you should be quick to react. Once everyone’s safety is accounted for, you can think about mold prevention. It takes less than a full day for mold to get settled and start growing in helpful conditions. Hence, acting swiftly is the key here.

Removing the bulk of floodwater

Quite obviously, removing the floodwater should be the first step in such cases. Every technique possible – from buckets to powerful pumps – should be used to ensure that the bulk of floodwater is out of your house. Once that is done, dampness can be dealt with.

Dealing with the Dampness

Dampness can linger around in flooded building for weeks after the floods have receded. This is a direct result of water that has been absorbed by materials in the building (walls, furniture, fabrics etc.). To get rid of this dampness, all of the affected and ruined objects should be discarded as soon as possible. This will allow the indoor air to be dryer and less helpful for mold growth.

Deciding what to keep and what to discard

It’s rather a difficult decision to make. However, it’s a necessary decision, and an important one in the long run. Everything that has been affected by mold after a flood should be discarded straightaway. All kinds of fabrics (carpets, linens, mattresses, curtains etc.) will never be reusable again. So, it’s wiser to part with them. Similarly, furniture that has been molded (unless it’s really expensive) should be discarded or recycled, in the least.

Cleaning a flooded house

Floods tend to bring all sorts of unwanted things into a building. From stray shoes to sewage water and from wooden logs to even 10 ft long alligators. That’s why, it becomes necessary to thoroughly clean a flooded house with disinfectants. There are many professional service providers and cleaning companies that can take these tasks and complete theme to a high quality.

Mold: Where it can grow

It’s quite normal to have a certain concentration of airborne mold spores at all times – both outdoors and indoors. However, mold becomes a real headache when it starts to grow indoors. Mold can virtually feed on every organic matter. Even synthetic material with just some traces of organic matters (synthetic fibres, for example) are known to be used by molds as their ‘food’. Therefore, to understand what really drives mold spores to choose a certain place for their colonies, we have to take a look at where mold species can grow and reproduce. Ø Mold on Glass Among the conditions that are of foremost importance for mold to grow anywhere, the availability of decomposable organic matter is one. Glass, per se, is not an organic material. Chemically speaking, glass is just a compound of silica formed under extreme temperature and pressure condition. Despite this being the fact, mold can be observed to grow on glass in some cases. This primarily happens because of a fine layer of organic matter that tends to grow on the surface of glass (especially window glass) over time. As dirt and dust settles on glass, so do other organic matters like bacteria, food particles, smears of skin oil from human contact and so forth. Even this fine layer of organic matter is enough for mold spores to grow on. This is the reason why mold can be observed to grow on glass. Unlike fabric or wooden materials, mold growing on glass can be quite easily removed. Since there is not much to feed on for mold on glass, the colonies of molds growing on glass are inherently small in size. So, just a simple and strong wipe with a washcloth dipped in household detergent should suffice to get rid of mold growing on glass. However, if the mold has also spread on adjoining materials (window sills, curtains etc.), it is better advised to seek professional mold clean-up help. Following precautions should be taken while cleaning mold on glass:

Mold clean-up should not be carried out without gloves.
For minute mold infestations on glass, respirators won’t probably be needed. However, if available they should always be used. If respirators aren’t available, simple cotton kerchief or napkin should be used to cover your nose.
Bleach or other chemicals shouldn’t be used without prior professional experience or in the company of elderly, convalescent or infants.

Ø Mold on Tiles Bathrooms are the first places to get affected by mold indoors as provide a very easy road to existence for mold. Mold can grow on bathroom tiles (irrespective of whether they are ceramic, clay or marble). Humidity and moisture are available on a regular basis in bathrooms. To add to it, dirt, dust, washed up soap lather and stagnant water creates a very fertile space for mold to grow on. In almost all cases, mold growth in bathroom can be linked to irregular maintenance and clean-up schedules. As tiles are not organic in themselves, mold growth on tiles can be removed just like mold growth on glass. Use of chemicals like bleach or ammonia isn’t really necessary as long mold growth is substantial in size and spread. Simple scrubbing with detergent water and a bathroom brush or a discarded toothbrush should be enough to scrape mold off the tiles. Once mold is removed, the space should be washed with clean water and should be allowed to dry out completely – either by natural ventilation or with the help of exhaust fans and drying lamps. If proper water drainage is not present, mold growth will almost certainly recur. Hence, drainage should be improved by consulting with professional plumbers and contractors. Mold growth on and around shower heads and on tiles in kitchens/dining rooms should be cleaned in the same fashion. Ø Mold on Stainless Steel Stainless steel is among the most important materials mankind has managed to prepare. It is often used in testing conditions such has high pressure, high temperature and highly corrosive ambiances because it can withstand such adversities with ease. However, stainless steel is not quite immune to mold growth from time to time. Whenever there is a minute layer of dirt, dust or any other organic matter on the surface made of stainless steel, it will get molded in a matter of days, provided that there is enough moisture in the air. This problem is encountered in most households, especially in the kitchen. Sink and dishwasher are two typical stainless steel objects that have to handle water and food particles on a regular basis. This makes it very easy for mold to grow on the inner surfaces of dishwashers and sinks. If there is a strong and unpleasant odor present about the dishwasher, it can be the sign of mold growth on the inner surfaces. If putting the dishwasher through a wash cycle doesn’t get rid of the smell, visual inspection is warranted. If mold is found to be present inside the dishwasher, it is recommended that it is cleaned up using mild detergents and in rare cases chemicals like hydrogen peroxide. For minute mold colonies, putting the dishwasher through a wash cycle while feeding mildly acidic (ammonia) or basic (chlorine) water to it. Adequate personal protection equipment should be donned before taking up any mold cleaning operation. Ø Use of Mold in Art Mold is definitely not the first choice companion for any sort of art. Paintings, statues, sculptures, parchments, manuscripts – they are all susceptible to mold attacks. Artists, by the very definition of the word, know how to rise beyond such obstructions. In fact, some artists have taken to using mold itself as their primary medium of expression. It might sound quite strange, but some of these artists have managed to garner global critical and popular acclaim using mold as their muse. Daniel Del Noro is a prominent name in the Italian art circles. He has also implemented mold art in quite fascinating pieces. Using black and white paper dotted with nutrients, he has created some visually and thematically stunning works of art. His ‘After Effects’ series of such works depicting the endless possibilities in a post-apocalyptic world has been hailed as a masterpiece by many critics. On a more cerebral lever, Spanish artist and music producer Oscar Martin has even tried to make the mold ‘sing’. Slime mold is known to create a cumulative brain that is a great example of synergetic living. Using electrical impulses to transmit and receive ‘information’, slime mold colonies are known to exist even in the least favorable of places. Oscar Martin used these electrical impulses, amplified them and converted them into understandable (light and sound) entities. What results from this is nothing less than ground-breaking. An outer world tone (typical to space rock bands like ELO and Pink Floyd) coupled with a chilling undertone of baritone-esque noise, the output is truly a piece of art. Ø Mold on Food Food is the easiest and most convenient place for mold to grow on. It provides ready-to-exploit sources of nutrients and moisture. Molds can grow on and every food irrespective of its nature, texture, taste or even state. Solid and liquid foods are just as susceptible to mold infestation. The signs of mold growth on food often means that infected food is no fit for human consumption. Consumption of molded fit is nothing but attracting mold allergies and associated diseases, as discussed in the earlier parts of this article. A study carried out by the International Food Policy Research Institute (IFPRI) and endorsed by the United Nations states that in 2014, the global hunger index was as high as 18. In such times, allowing perfectly good food to go to waste because of mold infestation is not only irresponsible, it’s offensive in a larger scheme of things, as well. Here’s how food can be prevented from being wasted because of mold:

Dry Freezing
Sun Drying
Air-tight Packaging
Microwaving
De-moisturising
Pressure treatments
Use of preservatives

Even though mold is well-known for spoiling food, there are some constructive uses of mold in food processing. Some cheeses inherently contain higher concentrations of mold species that allow these cheese to age better and acquire a unique taste. Camembert and Roquefort are two examples of such cheeses. In Asian countries, a number of food products like rice and barley are half-fermented by molds to create mildly intoxicating drinks.

Mold: Signs, Types of Mold, Clean-up, Effects on Health, Toxins, Mold Prevention and Additional Resources