When Mold Infestation Turns Deadly

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When Mold Infestation Turns Deadly For Patients
and Staff
National Safety Congress Chicago, Ill
Wednesday, September 10, 2003
A Joseph S. McFadden Presentation
JSM1950_at_aol.com
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Mold Characteristics

• Molds are the most typical forms of fungus
• Molds are ubiquitous and essential decomposers of
  organic substances
• The mycelium is made from strings of hyphae,
  which makes the body that we see
• Molds reproduce via spores

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Mold Characteristics

• Molds can spread by transplantation of broken
  hyphae into an area of moisture and organic
  food material
• Food material consists of wood, paper, paint,
  fabric, plant soil, dust, cooked or raw foods,
  and damp inorganic matter such as glass and bare
  concrete that is covered by a layer of biofilm

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Mold Characteristics

• Some molds germinate in four-to-twelve hours
• Left undisturbed, mold can grow and spread in
  24-72 hours
• Floods, leaking pipes, leaking windows, leaking
  roofs, humidity, spoiled food, and poor
  housekeeping can lead to mold growth and
  infestation
• Molds can hide away until the right conditions
  cause germination and growth
• Some molds produce toxic mycotoxins
• All molds, under the proper conditions, are
  capable of eliciting a negative health response
  in humans

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How Mold Enters the Facility

• The molds can enter
• Through doorways and windows
• Through ventilation and air conditioning systems
• On people, clothing, shoes, and bags
• On construction material
• On wheelchair and gurney wheels
• On supplies and linen

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Where Molds Live in Health Care Facilities

• On and in insulation
• In water damaged areas and on water damaged goods
  and materials
• In moist and high humidity areas
• In air conditioning and ventilation ducts
• Behind and in drywalls and other construction
  material
• In dust and accumulated water

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Mold Properties Potential Threats to Human Health

• Can inflict a variety of health responses in
  humans
• Severity of health reaction type and amount of
  mold and susceptibility and sensitivity of
  individual
• Exposure occurs via ingestion, inhalation, or
  skin/eye contact with mold or infested material

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Mold Properties Potential Threats to Human Health

• Mold components known to elicit a response in
  humans
• VOC (odor in cheeses) headaches, attention
  deficit, dizziness, and mucous membrane
  irritation
• Allergens (present on spores all molds can cause
  allergic reactions in humans) mild, transitory
  responses like runny nose and eyes to severe,
  chronic illnesses like sinusitis and asthma

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Mold Properties Potential Threats to Human Health

• Mold components known to elicit a response in
  humans
• Mycotoxins (natural organic compounds capable of
  producing a toxic response in vertebrates). Molds
  need a specific genetic potential and specific
  environmental conditions to create mycotoxins.

Aspergillus Niger (can produce mycotoxin)
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Potential Health Effects of Mold

• Four species of mold found to be consistently
  responsible for many of the adverse health
  effects in humans and vertebrates
• Aspergillus
• Cladosporium
• Penicillium
• Stachybotrys

Penicillium Mold
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Potential Health Effects of Mold

• The extent to which an individual may be affected
  depends on
• His/her state of health
• Susceptibility to disease
• The organism of exposure
• The duration and severity of the exposure

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Potential Health Effects of Mold

• Those at risk for systemic fungal infections are
• Severely immumocompromised individuals
• Undergoing chemotherapy
• Have had organ or bone marrow transplants
• Have HIV/AIDS

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Those at Risk in Health Care

• Infants
• The elderly
• The chronically ill
• Severely immunocompromised individuals
• Patients
• Volunteers
• Sitters
• Employees
• Doctors

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Aspergillus

• Includes A. fumigatus, A. niger, and A. flavus
• Three clinical types of pulmonary aspergillosis
  allergic aggressive tissue invasion and fungus
  ball
• Culture requires 1-3 weeks to grow
• Is a serological test for aspergillosis
• Commonly found in food, soil, air vents, and paint

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Cladosporium

• Frequently found in water damaged environments,
  on fiberglass duct insulation, paint and textiles
• Cladosporium species are causative agents for
  skin lesions, keratitis, onychomycosis,
  sinusitis, edema, and pulmonary infections
• Common allergen and some strains can produce
  mycotoxins

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Penicillium

• P.Chrysogenum is the mold that creates the drug
• Penicillium, in general, is rapid growing, with a
  musty odor.
• Found in soil, carpet, cellulose, water-damaged
  material, paint, wall paper, and in fiberglass
• Associated with allergic reactions,
  hypersensitivity pneumonitis, a variety of severe
  lung conditions, and organ and bone marrow
  infections
• Inhalation, skin contact, and ingestion are the
  main routes of entry

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Stachybotrys Chartarum

• Found in cellulose-containing products (such as
  wood, wicker, ceiling tile, dry wall, vapor
  barriers, and fiberboard) and water damaged
  materials
• Can produce mycotoxins and spores and mycotoxins
  are very bad if inhaled or ingested
• Can cause lung disorders, and permanent
  neurological, pathological, psychological, and
  immunological effects on the human body

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Some Signs and Symptoms of Diseases Caused by Mold

• Allergic reaction/sensitivity (hives, runny nose
  runny eyes, headache) when in the facility
• Acute or chronic cough
• Fatigue and confusion
• Shortness of breath
• Body aches and pains fairly intense and chronic
• Lethargy
• Coma

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Diagnostic Process

• Serological testing for patients and staff
• Rule-out of other conditions for the inpatient
• Identification of mold invasion in the facility
• Physical health condition of patient or staff
  member
• Staff needs to be seen by employee health and/or
  own physician
• Construction projects in or around facility
• Community outbreak

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Prevention of Mold Infestation and Disease

• Clean up and fix all leaks
• Replace all water-damaged materials and goods
• Keep HVAC clean and standing water free
• Ensure that there are good housekeeping practices
  that include deep carpet, cloth, furniture and
  drapery cleaning
• Target critical areas, patients and staff for
  closer observation
• If it smells like mold, it probably IS mold