Thursday, August 30, 2007
Are you suffering from brain mold?
Whether you're one of those hot, exhausted people cleaning up after a flood or just fighting the good fight to keep that dark, dank film off the grout in the shower -- mold could affect your mood.

In what's being hailed as a first, a public health study led by Brown University finds a link between regular old household mold and depression.

The study included data from the World Health Organization of nearly 6,000 people in Europe.
Some of the science is intuitive - sure, if you have a moldy home, you're likely to feel out of control - and perceptions of control are linked to depression.

And yes, if you're depressed, you might not be the best housekeeper.

Exposure to mold can produce physical symptoms that are well-documented: For those with allergies, asthma or suppressed immune systems, mold can make you sick- and if you're sick from mold, that could certainly affect your mental state.

But researchers hypothesize there may be another possible pathway: mold on the brain. Molds are toxins - and researchers suspect (but haven't proven) these toxins may impede the function of the frontal cortex, that touchy-feely part of our brain that rules emotion.

As someone slightly household-chore-challenged, I wondered - just how much mold might it take to affect my mood?

It's hard to quantify, says lead researcher and Brown University epidemiologist Ed Shenassa, adding that while a little mold in the bath won't do it, the more mold your have, the more likely it is to impact emotion.

Let's be clear: What we have here is an association between mold and mood-- more research is needed to see whether mold does indeed directly cause depression.

But Shenassa says there is a clear takeaway from this study: "Healthy homes promote healthy lives." That means not letting carpets, wallpaper or ceiling tiles to get wet, and stay wet for more than 48 hours, and giving leaks in the roof, walls and plumbing the immediate attention they deserve, because they're all sources of mold.

The study appears in the October edition of the American Journal of Public Health.

Do you have mold - and has it affected your mind, and body? Tell us your story.
Perhaps if they conducted a study where some participants were exposed to something that appeared to be mold (in sight, texture, smell), while others were exposed to real mold, you could help determine if its more psychological. Also, they could add mold to a room, but not inform the person. Of course you would probably want to test this with people who aren't allergic to mold or have asthma.
I lived in two different apt buildings where mold was a problem. I started to get sick at the first building and also had a problem leaving my apt due to severe panic attacks. At the second apt it got worse and the buildings owner was cited for the mold problem and then fined. My health got worse and the panic attacks also got worse.
I am now in a mold free building though my health is still a problem I do not suffer the same kind of panic attacks though it is still hard for me to go out in public unless I am with a friend.
In recent years especially, Americans have become increasingly marketed and sold on the idea of "germ-free" homes. As more consumer products are available to destroy these mold toxins, are we lowering our natural resistance to them over time?

The potential effect of this is to allow molds and other toxins to have a potentially greater effect when they are introduced. Are we seeing people truly effected neurologically by mold, or are we simply seeing people "create" allergies for themselves, which has a similar impact as referenced in the story?
There are many people from across the states that are very ill from molds in their homes, workplaces, and/or schools. I talk to many mold victim's on a daily basis, and many have depression from the molds along with many other illnesses caused from these silent killers. I am also a mold victim and have been for 18 months. I do suffer from depression do to the molds and my illnesses caused from the molds,and am on medication for it. I dedicate my website to mold victim's in trying to help them out with moral support, knowledge, and resources that they can turn to.


Mold is present in school buildings with leaks and poor maintenance practices, as well as defectively built new ones. Building molds can impact the brain, respiratory system and immune systems. A high percentage of schools have moisture and mold problems, and that means the school staff and students can get sick from these buildings. Visit for more information.

We hope Dr. Gupta will do a show on this topic, it is impacting the learning, mental state and health of all Americans who cycle through our damp schools.

Susan Brinchman
Director, Center for School Mold Help
I was exposed to mold at school. I was very sick from September through October(my last day in the building was 10/24/06). I developed asthma as a result of the moldy classroom. I have been on Paxil, but still find myself depressed because of a never ending "battle" with the school district. Even though I have had 2 Workman Comp hearings in my favor (and the mold reports from the district say in black and white the medium levels of pennicillium can make a person sick)the district continues to appeal the case. I have always been careful with my health and becoming sick from a moldy classroom was a nightmare.
I have suffered with depression and anxiety for many years now and since I moved from Chicago to Houston into a "so-called" luxury apartment complex, I have had to live with mold that the apartment management refuses to fix now going on 2 plus years now. Since, I have moved into this apartment, I have had 4 bouts of severe major depression and had to be hospitalized once as well. In my opinion and experience, mold does affect depression and mood as well as physical health.
This is a very interesting news piece which prompts me to inquire if the researchers at Brown University are aware that scientists at the US EPA have recently developed a DNA-based mold detection assay for monitoring the indoor environment. It was part of the US Department of Housing and Urban Development (HUD) American Healthy Homes Survey, so there is now a national index against which any homes mold level can be compared. The assay is called the Environmental Relative Moldiness Index (ERMI). The test is now commercially available, and represents a monumental improvement over traditional mold testing in sensitivity, specificity, reproducibility, etc. More information can be obtained from the EPA website or from any of the licensed labs offering the test.

I think that the mechanism by which mold exposure causes depression may be the same mechanism by which it inhibits hippocampal neurogenesis.

This may be caused by a number of mycotoxins, I've seen research on both ochratoxin A and several trichothecenes impacting neurogenesis. Here are the references for ochratoxin A

Neurotoxicology. 2006 Jan;27(1):82-92. Epub 2005 Sep 2
Acute neurotoxic effects of the fungal metabolite ochratoxin-A.
Sava V, Reunova O, Velasquez A, Harbison R, Sánchez-Ramos J.

Toxicol Sci. 2007 Jul;98(1):187-97. Epub 2007 Apr 21.
Adult hippocampal neural stem/progenitor cells in vitro are vulnerable to the mycotoxin ochratoxin-A.
Sava V, Velasquez A, Song S, Sanchez-Ramos J.

J Neurol Sci. 2006 Nov 1;249(1):68-75. Epub 2006 Jul 14.
Can low level exposure to ochratoxin-A cause parkinsonism?
Sava V, Reunova O, Velasquez A, Sanchez-Ramos J.

Islam Z, Harkema JR, Pestka JJ.
Related Articles, Links
Free in PMC Satratoxin G from the black mold Stachybotrys chartarum evokes olfactory sensory neuron loss and inflammation in the murine nose and brain.
Environ Health Perspect. 2006 Jul;114(7):1099-107.
PMID: 16835065 [PubMed - indexed for MEDLINE]

Also see
The mechanisms of neurotoxicity induced by a Stachybotrys chartarum Trichothecene Mycotoxin in an in vitro model
Karunasena, Enusha
doctoral dissertation
Toxigenic molds producing high toxins were found in my home. I
had become ill with bloody sinus,
rash, anxiety (I now know because
my adrenal gland was overtaxed as
half of it is used for hypersensitivity and my immune system
was overactive fighting what it
perceived as an overwhelming infection), chronic bronchitis,
bloating, acid reflux, etc. Later
the anxity gave way to chronic
fatigue ( my adrenalin gland was
fatigued), brain fog, and a
depressive state which I had never
experienced before in my 59 years.
My employees noticed a change in
my memory and mood as well as my
family and friends.
My allergist sent a blood test to
IBT Labs in Lenexa, Ks. and the
results showed I was positive for
HP a lung illness caused from
indoor molds from damp buildings.
He then sent me to a lung specialist. We had our home tested
after that and found several toxigenic molds which were producing high toxins. One of which
was Stachybotrys. We left our home
with only the clothes on our backs
which we disgarded upon checking into a motel. I saw Dr. Eckardt Johanning, Albany, N.Y. and he told
me I was hypersensitive now and
chemicals and weeds would bother
me now. Dr. Ritchie Shoemaker, has found
genetic testing of the HLA-typing
that shows 25% of the population
is effected and I was I was in the
lower 2% - one of the most dreaded
Dr. Johnathan Kerr, UK, has discovered all patients with Chronic Fatigue have different genes than the rest of the population. Dr. David Straus, Texas Tech has found not only the
spores carry toxins, but the micro
organisims that come off them carry toxins and come through cracks in walls and cause exposure
even if the spores aren't found in
air samples. Mold can be hidden
in walls.
I thank Brown University for their
study and I know they will find out
on their future studies what my
doctors already know by treating
patients exposed to toxins from
"indoor" molds- they cause multisystem-multisymptom problems.
I am a board member of Schoolmold
help, a non-profit org. which website has been established to
educate those who are concerned
with health issues in schools
that have indoor mold problems.

My name is Mandy, and while living in Oakland, Ca, I was staying in a room that had mold under the carpet for about six months. I had frequent sinus problems, headaches and fatigue. Over time it affected my ability to concentrate as well as lead to depression.
Finally! The deceit over the mold issue is being brought to greater light. People have been complaining that mold is causing cognitive difficulty in ever increasing numbers. The CDC knows this, but has intentionally failed to research in this area. Why? Because to acknowledge that moldy buildings can cause severe health effects, increases the liability for stakeholders of moldy buildings. (insurers, builders, real estate). Deny the illness - deny financial liability for the illness. What has been occurring within the CDC in partnership with private medical associations with close affiliations to industry - primarily occupational physician orgs with unholy relationships to workers comp insurers/disability, has caused a true American tragedy for the lives of many.

For more on the subject, read the following link the to Jan 2007, Wall Street Journal article titled "Court of Opinion, Amid Suits Over Mold Experts Wear Two Hats". Maybe mold has not made you sick, but this article surely will.

The CDC is outsourcing environmental medicine to the medical gatekeepers of industry.

Thank God, the truth is finally coming to light in spite of the conflicts of interest within the CDC and their private partners.
Hi Amy,

PLEASE help us. I live in a property identified as Public Housing in a rural community of Illinois. I reported the mold growing in my home July 8, 2006 to the landlord, and as of this date, the only thing they've accomplished is arrest me, harrass me, and come into my apartment when I'm gone. Their attorney literally made fun of me in court last Friday, August 24, saying he "didnt believe that mold could have such an affect on her like that". I moved there in March 2006 and I have gained 50 pounds, my mood is that of extreme euphoria and then immdediately drops to pessimism and despair. I'm extremely lathargic. There are moments in the past year that I have slept 24 36 hours at a time. Before I moved there, I would wake up every morning like clockwork at 5:09, one minute before my alarm, now I can hardly drag my self out of bed. I have a mold growth of some kinf on my skin, to which I've now been referred to a dermatologist. There are massive structural issues in this coomplex that they refuse to fix because of money, yet they recieve $15 millon of our federal tax money per year. There is evidence that they have been painting over the mold since 1999, as I recently met the gentleman who was their maintenace man for 6 years. He is dying of a calcified mold growth in his lungs the size of a lemon. They refused to provide him with PPE and instructed him to use bleach. Many of my neighbors are on respiratory equipment at night, because they can't breathe while sleeping. One lady to her baby to the clinic for his monthly well baby checkup and the nurse told her, "your baby smells like mold". Again, they think that i am causing a hysteria over this issue. On July 12, 2007 Keith Daniels if the Illinois Housing and Development Authority came from Chicago to do a thourough inspection at our request and was appalled at what he found. He told them they had 30 days to initiate some sort of plan, including hiring a professional abatement company. They have done nothing. In addition, I went to Chicago this week, only to dscover that the Illinois supervisor for this company, blatantly ignored the State's request, and did NOT respond to the State's request on what they plan to do. Last Friday in court, their attorney argued that "it's their property, they can paint over the mold if they want to". I was pissed!!!! I'll bet you $10 they don't live like this. I am even more appalled that they are building multi million dollar condos in Phoenix. Good way to hide money, huh. Come to Charleston, Illinois, I can provide you with 15 people in one apartment complex suffering from the ill effects of mold exposure. We don't want to be anonymous, WE WANT TO BE HEARD!! These are our tax dollars too. My cell phone number is 217-273-4128. My name is Diana Yamamoto. PLEASE, somebody help us.
Dear Amy,

THank you for the mold update. My room-mate who is in the building management business told me that. I had black spots mold growing on the bathroom walls and it may have influenced my mood, I don't know.

He told me the following:
1. Keep bathroom ventilated after taking a shower by opening a window and the bathroom door.

2. Wipe mold off with bleach

3. paint the walls with mold-resistant primer before you paint any other color.

I got ot the part of wiping mold off with bleach, using gloves offcourse.
Lets get over the denial that mold causes health problems AND JUST FIX THE DEFECTS! My God, the amount of time & money wasted on denial over the mold contamination- WE COULD HAVE THE PROBLEM CLEANED UP! Sweet Jesus- Why is there such dragging of our feet? IT MAKES PEOPLE SICK- CLEAN IT UP! It really is that simple.
For many years builders of homes and commercial properties have gotten by with using cheap materials and inadequate installation of materials with impunity. When brand new homes lead to leaky roofs, siding, windows, and foundations it will inevitably lead to water intrusion and toxic mold. It is past time that laws protecting these builders be changed so that they can be held accountable and responsible. Check out for more on homebuilding problems.
The frontal cortex does not rule emotion. The frontal cortex rules logic. Emotion happens in the mid-brain.
All of these stories are so eerily similar to mine in different ways. Isnt it obvious that there is "truth" to mold being toxic to people. Why is it that the people responsible for the buildings construction, or property management think this is some kind of joke? This is ridiculous. I see a specialist at National Jewish in Colorado and I now have asthma as a result of the mold exposure where I never had it before. These are highly certified specialist, that can account for the environmental toxins these molds produce. So here is my story. We are now homeless, jobless, carless, and in total despair. We need help desperately.

In August of 2005 we moved into an apartment complex in Longmont, Colorado having never seen the apartment before the actual move in date we had no idea what we were in for. When we entered the apartment and did the initial walkthrough we noted a large area of green, brown, and black mold growing in the pantry area. We immediately documented it in writing as well as contacted the management. When they sent out their maintenance crew to bleach the area we believed that this was the proper method of remediating the problem.
I was pregnant at the time we moved into the apartment and when our 3rd child was born in December of that year he immediately became very ill. Once a month and sometimes more freqently he would have upper respiratory infections, ear infections, skin rashes and colds. We attributed this to him being a winter baby and didn't know any better at the time. As we continued our lives into 2006 I became increasingly ill. I began having chronic sinus infections, fatigue, night sweats, dizzy spells, memory loss,hair loss, skin rashes,panic attacks, heart palpitations and gastrointestinal problems that ultimately resulted in gallbladder surgery in May of 2006. All of my illness and my infants sons illnesses led to excessive time missed from my job, the sole income for our family at the time. When my oldest boy then 6 began having complications with his eczema that led to skin infections and we again attributed it to a drier summer, or colder winter. All of these illnesses increased throughout the year. My husband began having chronic headaches and at times would cough up blood. Every morning I would wake up and gag because my throat was so dry or I had sinus drainage. My oldest, our daughter began experiencing weird rashes that looked like giant O's around the inner creases of both of her arms, she also began experiencing bladder infections and frequent incontinence. We also noticed that when we had company come in from out of town they would stay in my daughters room and often complain of headaches and scratchy, dry throats. In October of 2006, my then 6 yr old son had come down with yet another upper respiratory infection. This time however, it didnt go away. After a week of antibiotics we took him to urgent care where they diagnosed him with what they thought was strep throat. His neck was stiff and he could barely move it. The very next day he woke up and could not move his neck at all so we rushed him to the ER where he was diagnosed with a rare illness called a Retropharyngeal Abscess. The upper respiratory infection he had, led to tonsilitis which in turn seeped strep B into the deep neck area. He was hospitalized for 4 days and on day 5 (also his 7th birthday) he was whisked off to Childrens hospital to have surgery to remove the infection, and now requires a tonsilectomy, and adenoidectomy. All the while the family was still battling ongoing problems. I missed work constantly and was on the verge of losing my job.
It wasnt until Jan of 2007 that I noticed the area in the pantry where we had first documented mold had begun to resurface. I immediately contacted the apartment management by phone and told her we had a HUGE problem. Her response was " Are you trying to get out of your lease" and I was astounded. I explained to her, that my family had been sick since we had lived there and I wanted nothing more for the issue to be fixed or for us to be relocated. She sent out her maintenance crew again to "inspect" the area. The maintenace man barely browsed over the areas and told me they were nothing more than discoloration. I also notified him of the water damaged baseboards throughout the apartment. He said it was due to cheap plywood used. I wasn't satisfied with his response so I went and purchased an at home mold test kit. I waited the incubation period and low and behold the petri dish was growing. I took pictures of the test kit, as well as written request of transfer to another location, I went back to management in person and requested again that the issue be resolved or for us to be relocated to another unit. She insisted that maintenance had found no problem but she wanted to send him in to cut open the drywall to further inspect. I told her that this was unacceptable as long as my family still resided in the home. Management insisted and in two days maintenance came in to cut open the walls. He himself stated that it was dangerous to cut open the walls if there was in fact mold, and again stated that these areas were just discolored that he found no mold in the drywall that he did cut, which mind you were small pieces to which he couldnt even see into the wall far enough to inspect. After he left that evening on 02/14/2007 I decided that I had had enough and I knew that there was mold in that apartment. That it was in the air and in the ducts of the home too, which maintenance informed me had never been cleaned since the building had opened 7 yrs prior. After writing several letters to management, and the property management and getting no resolve I hired a professional mold inspector to come out and take some samplings. When an inspector from the inspection company came into our home he stated that he could smell the mold when he walked into the apartment. He conducted an indoor air sampling and an outdoor air sampling. His results were nothing short of disgusting. The outdoor spore count was 167 vs the indoor count of over 14,000/m3. We would have been safer living outside in a tent. Oh and the types of mold found were Alternaria,Ascospores, Aspergillus which were in the thousands (and they had to use a data quantifier to estimate the totals), Chaetomuim (again they had to use an approximation because the numbers were so high), Cladosporium, Stachybotrys, and some unclassified, Conidia. The results from the lab that I sent in also confirmed Chaetomium, Penicillum, and Stachybotrys. I again brought this to the attention of the management and her immediate response was to place a lease termination paper in front of me. I begged for her to relocate us as I didn't have the means to move, and lived close to my job which was already in jeopardy. She again refused. So I contacted the code enforcement for the city , and with the evidence from the inspector she deemed the apartment legally uninhabitable. I again in good faith attempted to get the apartments to relocate our family into another apartment or townhome but she refused. With no other options and medical bills mounting, we were forced to move. Our credit had been totally distroyed by medical expenses and we were denied a place to live left and right. With time running out before we needed to vacate I had no choice but to relocate to the only family who could house my 5 person family to my mothers over 200+ miles away. Where eventually I lost my job as a result as I could not reasonably commute, and my attendance from illnesses had finally taken its toll. We are still experiencing health issues, my panic attacks continue, my sinuses are absolutely destroyed. As stated by my ENT, and I am chronically fatigued. Please HELP!!!
Jamie S, Colorado
My home was flooded over 8 months ago and mold was found in many areas by a hygienist sent by the insurance company. The built mold containment units in severe areas, but they refused to re-home us. We have had to live in the house while the insurance companies delayed the progress of cleaning up the mess. I am 61 years old and am raising my grandchildren. I have never had any remarkable depression. I have become so depressed that I have difficulty with severe depression. My youngest son was married last week and I could not enjoy the wedding at all. When someone told me that they had seen Sanjay Gupta speak about the causal connection between mold and depression I was so relieved to hear that researchers had acknowledged this syndrome. I immediaely looked up this article and would be interested in follow up studies.
I have not personally had mold but had to be on the alert for it during my construction defect case because it did involve leaks. Because I sought information on my legal problem I also ran across people who had mold. It was clear that they were only suffering, not profiting, and yet society and the "defendants' side" repeatedly accused them of being crazy, greedy, etc. Their symptoms were real, and their symptoms often started before they realized that square yards of mold were growing inside walls and ceilings. When they got out of the situation their symptoms abated but for many did not entirely go away.

I have since met doctors who tell me how aspergillus can infect the lungs and is very real. I've read military documents about how some molds emit mycotoxins that can harm anyone even if they're not allergic.

In hindsight I now realize that two apartments I rented as a younger single person, that had chronic leaking problems, may have had mold. I was always sick there, and never knew why. When I left, my illness went away.

I believe mold can affect people's health. I also believe that there is a lot of money, power, and connections, on the "defendants' side" that can and probably has suppressed evidence of this. These industries are some of the top donors to politicians: home building, insurance, real estate.

Recently, a former US Surgeon General said health information has been suppressed by the government for politica reasons. Though this wasn't specifically about mold, (that he mentioned), I wouldn't be surprised if mold was among the things suppressed.
Please copy this down and save it.
Print it out and give it to your doctor. Clean it up, print it out, and send it by registered mail to your landlords (keeping a copy) Then they won't be able to play dumb anymore.

Current WDB References 06/22/07


1. Mudarri D, Fisk WJ. Public health and economic impact of dampness and
mold. Indoor Air 2007; 17: 226-236.


1. Hill AB. The environment and disease: association or causation?
Proceedings of Royal Society of Medicine Section of Occupational Medicine
01/14/65; 295-230.
2. Kundi M. Causality and the interpretation of epidemiologic evidence
Environmental Health Perspectives 2006; 114(7): 969-974.
3. Phillips CV, Goodman KJ. The missed lessons of Sir Austin Bradford Hill.
Epidemiologic Perspectives and Innovations 2004; 1(3): 1-5.
4. Carbone M, Klein G, Gruber J, Wong M. Modern criteria to establish human
cancer etiology. Cancer Research 2004; 64: 5518-5524.
5. Altman DG, Bland JM. Absence of evidence is not evidence of absence. BMJ
1995; 311: 485.
6. Maldonado G, Greenland S. Estimating causal effects. International
Journal of Epidemiology 2002; 31: 422-429.
7. Broderick G, Craddock RC, Whistler T, Taylor R, Klimas N, Unger ER.
Identifying illness parameters in fatiguing syndromes using classical
projection methods. Pharmacogenomics 2006; 7(3): 407-419.

1. Frederick R, Furtaw Jr EJ, Haugland RA, Hudnell K, Kolb L, Menetrez MY,
Macler B, Selgrade MK, Shoemaker JA, Van Emon JM, Vesper SJ, Ward MW, Wymer
LJ. Exposure of children to indoor molds. EPA Science Forum 2004;

CDC/New Orleans

1. Redd SC. State of the science on molds and human health. 2002; 1-10.
2. Rao CY, Riggs MA, Chew GL, Muilenburg ML, Thorne PS, Van Sickle D, Dunn
KH, Brown C. Characterization of airborne molds, endotoxins, and glucans in
homes in New Orleans after Hurricanes Katrina and Rita. Applied and
Environmental Microbiology 2007; 73(5): 1630-1634.
3. Verhoeff AP, Burge HA. Health risk assessment of fungi in home
environments. Ann Allergy Asthma Immunol 1997; 78: 544-556.
4. Gent JF, Ren P, Belanger K, Triche E, Bracken MB, Holford TR, Leaderer
BP. Levels of household mold associated with respiratory symptoms in the
first year of life in a cohort at risk for asthma. Environmental Health
Perspectives 2002; 110(12): A781-A786.
5. Solomon GM, Hjelmroos-Koski M, Rotkin-Ellman M, Hammond SK. Airborne mold
and endotoxin concentrations in New Orleans, Louisiana, after flooding,
October through November 2005. Environmental Health Perspectives 2006;
114(9): 1381-1386.
6. Chew GL, Wilson J, Rabito FA, Grimsley F, Iqbal S, Reponen T, Muilenberg
ML, Thorne PS, Dearborn DG, Morley RL. Mold and endotoxin levels in the
aftermath of Hurricane Katrina: a pilot project of homes in New Orleans
undergoing renovation. Environmental Health Perspectives 2006; 114(2): 1883-
7. Brandt M, Burkhart J, Burton NC, Cox-Ganser J, Damon S, Falk H, Fridkin
S, Garbe P, Kreiss K, McGeehin M, Morgan J, Page E, Rao C, Redd S, Sinks T,
Trout D, Wallingford KM, Warnock D, Weissman DN. Mold Prevention strategies
and possible health effects in the aftermath of Hurricanes Katrina and Rita.
CDC October 2005; 1-45.

Canada Ministry of Health

1. Minister of Health. Residential indoor air quality guideline for moulds.
2007-03-31 Canada Gazette Part I, 141(13).


1. Vesper SJ, McKinstry C, Haugland RA, Iossofova Y, Lemasters G, Levin L,
Hersgey GKK, Villareal M, Bernstein DI, Lockey J, Reponen T. Relative
moldiness index as predictor of childhood respiratory illness. Journal of
Exposure Science and Environmental Epidemiology 2006; 1-7.
2. Vesper S. Developing the EPA relative moldiness index based on
mold-specific quantitative PCR. The Synergist 2006; 39-43.
3. Vesper SJ, McKinstry C, Yang C, Haugland RA, Kercsmar CM, Yike I,
Schluchter MD, Kirchner HL, Sobolewski J, Allan TM, Dearborn DG. Specific
molds associated with asthma in water-damaged homes. JOEM 2006; 48(8): 852-

Association Studies

1. Hodgson MJ, Morey P, Leung WY, Morrow L, Miller D, Jarvis BB, Robins H,
Halsey JF, Storey. Building-associated pulmonary disease from exposure to
Stachybotrys chartarum and Aspergillus versicolor. J Occup Environ Med 1998;
40(3): 241-249.
2. Reijula K, Tuomi T. Mycotoxins of aspergilli: exposure and health
effects. Front Biosci 2003; 8: s232-235.
3. Skaug MA, Eduard W, Stormer FC. Ochratoxin A in airborne dust and fungal
conidia. Mycopathologia 2001; 151(2): 93-98.
4. Sebastian A, Larsson L. Characterization of the microbial community in
indoor environments: a chemical-analytical approach. Appl Envir Microbiol
2003; 69: 3103-3109.
5. Horner WE, Worthan AG, Morey PR. Air- and dust mycoflora in houses free
of water damage and fungal growth. Appl Environ Microbiol 2004; 70:
6. Murtoniemi T, Nevalainen A, Suutari M, Toivola M, Komulainen H, Hirvonen
MR. Induction of cytotoxicity and production of inflammatory mediators in
raw 264.7 macrophages by spores grown on six different plasterboards. Inhal
Toxicol 2001; 13(3): 233-247.
7. Bloom E, Bal K, Nyman E, Must A, Larsson L. Mass spectrometry-based
strategy for direct detection and quantification of some mycotoxins produced
by Stachybotrys and Aspergillus spp. in indoor environments. Applied and
Environmental Microbiology 2007; 73(13): 4211-4217.
8. Boutin-Forzano S, Charpin-Kadouch C, Chabbi S, Bennedjai N, Dumon H,
Charpin D. Wall relative humidity: a simple and reliable index for
predicting Stachybotrys chartarum infestation in dwellings. Indoor Air 2004;
14(3): 196-199.
9. Menzies D, Comtois P, Pasztor J, Nunes F, Hanley JA. Aeroallergens and
work- related respiratory symptoms among office workers. J Allergy Clin
Immunol 1998; 101(1): 38-44.
10. Meyer HW, Wurtz H, Suadicani P, Valbjern O, Sigsgaard T, Gyntelberg F.
Molds in floor dust and building-related symptoms among adolescent school
children: a problem for boys only? Indoor Air 2005; 15(Suppl 10): 17-24.
11. Bornehag G, Sundell J, Sigsgaard T. Dampness in buildings and health
(DBH): report from an ongoing epidemiological investigation on the
association between indoor environmental factors and health effects among
children in Sweden. Indoor Air 2004; 14(Suppl 7): 59-66.
12. Park JH, Cox-Ganser J, Rao C, Kreiss K. Fungal and endotoxin
measurements in dust associated with respiratory symptoms in a water-damaged
office building. Indoor Air 2006; 16: 192-203.
13. Andersson MA, Nikulin M, Koljajg U, Andersson MC, Rainey F, Reijula K,
Hintikka EL, Salkinojia-Salonen M. Bacteria, molds, and toxins in
waterdamaged building materials. Applied and Environmental Microbiology
1997; 63(2): 387-393.
14. Dales RE, Burnett R, Zwanenburg H. Adverse health effects among adults
exposed to home dampness and molds. Am Rev Respir Dis 1991; 143: 505-509.
15. Petola J, Andersson MA, Haahtela T, Mussalo-Rauhamaa H, Rainey FA,
Kroppenstedt RM, Samsom RA, Salkinoja-Salonen MS. Toxic-metabolite producing
bacteria and fungus in an indoor environment. Applied and Environmental
Microbiology 2001; 67(7): 3269-3274.
16. Page EH, Trout DB. The role of Stachybotrys mycotoxins in
building-related illness. AIHAJ 2001; 62: 644-648.
17. Wan GH, Li CS. Dampness and airway inflammation and systemic symptoms in
office building workers. Archives of Environmental Health 1999; 54(1):
18. Mahooti-Brooks N, Storey E, Yang C, Simcox NJ, Turner W, Hodgson M.
Characterization of mold and moisture indicators in the home. Journal of
Occupational and Environmental Hygiene 2004; 1: 826-839.
19. Cox-Ganser JM, White SK, Jones R, Hilsbos K, Storey E, Enright PL, Rao
CY, Kreiss K. Respiratory morbidity in office workers in a water-damaged
building. Environmental Health Perspectives 2005; 113(4): 485-490.
20. Gunnbjornsdottir MI, Franklin KA, Norback D, Bjornsson E, Gisason D,
Lindberg E, Svanes C, Omenaas E, Norrman E, Jogi R, Jensen EJ, Dahlman-
Hoglund A, Janson C. Prevalence and incidence of respiratory symptoms in
relation to indoor dampness: the RHINE study. Thorax 2006; 61: 221-225.
21. Jacob B, Ritz B, Gehring U, Koch A, Bischof W, Wichmann HE, Heinrich J.
Indoor exposure to molds and allergic sensitization. Environmental Health
Perspectives 2002; 110(7): 647-653.
22. Gunnbjornsdottir MI, Norback D, Plaschke P, Norrman E, Bjornsson E,
Janson C. The relationship between indicators of building dampness and
respiratory health in young Swedish adults. Respir Med 2003; 94(4): 302-307.
23. Kyle AD, Woodruff TJ, Axelrad DA. Integrated assessment of environment
and health: America’s children and the environment. Environmental Health
Perspectives 2006; 114(4): 447-452.
24. Weschler CJ, Wells JR, Poppendieck D, Hubbard H, Pearce TA. Workgroup
report: indoor chemistry and health. Environmental Health Perspectives 2006;
114(3): 442-504.
25. Miller JD, Rand TG, Jarvis BB. Stachybotrys chartarum: cause of human
disease or media darling? Medical Mycology 2003; 41: 271-291.
26. Jaakkola MS, Nordman H, Piipari R, Uitti J, Laitinen J, Karjalainen A,
Hahtola P, Jaakkola JJK. Indoor dampness and molds and development of
adult-onset asthma: a population-based incident case-control study.
Environmental Health Perspectives 2002; 110(5): 543-547.
27. Gent JF, Ren P, Belanger K, Triche E, Bracken MB, Holford TR, Leaderer
BP. Levels of household mold associated with respiratory symptoms in the
first year of life in a cohort at risk for asthma. Environmental Health
Perspectives 2002; 110(12); A781-A792.
28. Apostolakos MJ, Rossmoore H, Beckett WS. Hypersensitivity pneumonitis
from ordinary residential exposures. Environmental Health Perspectives 2001;
109(9): 979-981.
29. Trout D, Bernstein J, Martinez K, Biagini R, Wallingford K. Bioaerosol
lung damage in a worker with repeated exposure to fungi in a water-damaged
building. Environmental Health Perspectives 2001; 109(6): 641-644.
30. Menetrez MY. Emission exposure model for the transport of toxic mold.
Indoor and Built Environment 2004; 13(1); 75-82.
31. Craner J. Building-related illness in occupants of mold-contaminated
houses: a case series. Eastern New York Occupational & Environmental Health
Center 1999; 146-157.
32. Engelhart S, Loock A, Skutlarek D, Sagunski H, Lommel A, Farber H, Exner
M. Occurrence of toxigenic Aspergillus versicolor isolates and
sterigmatocystin in carpet dust from damp indoor environments. Applied and
Environmental Microbiology 2002; 68(8): 3886-3890.
33. Murtoniemi T, Nevalainen A, Hirvonen MR. Effect of plasterboard
composition on Stachybotrys chartarum growth and biological activity of
spores. Applied and Environmental Microbiology 2003; 69(7): 3751-3757.
34. Shelton BG, Kirkland KH, Flanders WD, Morris GK. Profiles of airborne
fungi in buildings and outdoor environments in the United States. Applied
and Environmental Microbiology 2002; 68(4): 1743-1753.
35. Sebastian A, Larson L. Characterization of the microbial community in
indoor environments: a chemical-analytical approach. Applied and
Environmental Microbiology 2003; 69(6): 3103-3109.
36. Hormer WE, Worthan AG, Morey PR. Air and dustborne mycoflora in houses
of water damage and fungal growth. Applied and Environmental Microbiology
2004; 70(11): 6394-6400.
37. Burge HA. Health effects of biological contaminants. Indoor Air and
Human Health Chapter 10 CRC Press 1996; 171-178.
38. Martinez KF, Rao CY, Burton NC. Exposure assessment and analysis for
biological agents. Grana 2004; 43: 193-208.
39. Pessi AM, Suonketo J, Pentti M, Kurkilahti M, Peltola K,
Rantio-Lehtimaki A. Microbial growth inside insulated external walls as an
indoor air biocontamination source. Applied and Environmental Microbiology
2002; 68(2): 963-967.
40. Krauter P, Biermann A. Reaerosolization of fluidized spores in
ventilation systems. Applied and Environmental Microbiology 2007; 73(7):
41. Thrasher JD, Kilburn K, Immes N. Indoor environment resulting from water
intrusion. Perspectives 2006; 4-53.
42. Flannigan B, McCabe EM, McGarry F. Allergenic and toxigenic
micro-organisms in houses. Journal of Applied Bacteriology Symposium
Supplement 1991; 70: 61S-73S.
43. Verhoeff AP, van Strien RT, van Wijnen JH, Brunekreef B. Damp housing
and childhood respiratory symptoms: the role of sensitization to dust mites
and molds. American Journal of Epidemiology 1995; 141(2): 103-109.
44. Malloy CD, Marr JS. Mycotoxins and public health: a review. J Public
Health Management Practice 1997; 3(3): 61-69.
45. Smoragiewucz W, Cossette B, Boutard A, Krzystyniak K. Trichothecene
mycotoxins in the dust of ventilation systems in office buildings. Int Arch
Occup Environ Health 1993; 65: 113-117.
46. Johanning E, Biagini R, Hull D, Morey P, Jarvis B, Landsbergis P. Health
and immunology study following exposure to toxigenic fungi (Stachybotrys
chartarum) in a water-damaged office environment. Int Arch Occup Environ
Health 1996; 68: 207-218.
47. Croft WA, Jarvis BB, Yatawara CS. Airborne outbreak of trichothecene
toxicosis. Atmospheric Environment 1986; 20(3): 549-552.
48. Hodgson MJ, Morey P, Leung WY, Morrow L, Miller D, Jarvis BB, Robbins H,
Halsey JF, Storey E. Building-associated pulmonary disease from exposure to
Stachybotrys chartarum and Aspergillus versicolor. JOEM 1998; 40(3):
49. Johanning E, Landsbergis P, Gareis M, Yang CS, Olmsted E. Clinical
experience and results of a sentinel health investigation related to indoor
fungal exposure. Environmental Health Perspectives 1999; 107(3): 489-494.
50. Sorenson WG. Fungal spores: hazardous to health? Environmental Health
Perspectives 1999; 107(3): 469-472.
51. Rautiala S, Reponen T, Hyvarinen A, Nevalainen A, Vehvilainen A,
Kalliokoski P. Exposure to airborne microbes during the repair of moldy
buildings. American Industrial Hygience Asso Journal 1996; 57: 279-284.
52. Tuomi T, Reijula K, Johnsson T, Hemminki K, Hintikka EL, Lindroos O,
Kalso S, Koukila-Kahkola P, Mussalo-Rauhamaa H, Haajtela T. Mycotoxins in
crude building materials from water-damaged buildings. Applied and
Environmental Microbiology 2000; 66(5): 1899-1904.
53. Redlich CA, Sparer J, Cullen MR. Sick-building syndrome. Lancet 1997;
349: 1013-1015.

Mycotoxin Effects

1. Meloche JL, Smith TK. Altered tissue amino acid metabolism in acute T-2
toxicosis. Proc Soc Exp Biol Med 1995; 210(3): 260-265.
2. Smoragiewicz W, Cossette B, Boutard A, Krzystyniak K. Trichothecene
mycotoxins in the dust of ventilation systems in office buildings. Int Arch
Occup Environ Health 1993; 65(2): 113-117.
3. Charpin-Kadouch C, Maurel G, Felipo R, Queralt J, Ramadour M, Henri D,
Garans M, Botta A, Charpin D. Mycotoxin identification in moldy dwellings.
Journal of Applied Toxicology 2006; 26: 475-479.
4. Yike I, Distler Am, Ziady AG, Dearborn DG. Mycotoxin adducts on human
serum albumin: biomarkers of exposure to Stachybotrys chartarum.
Environmental Health Perspectives 2006; 114(8): 1221-1226.
5. Nieminen SM, Karki R, Auriola S, Toivola M, Laatsch H, Laatikainen R,
Hyvarinen A, von Wright A. Isolation and identification of Aspergillus
fumigatus mycotoxins on growth medium and some building materials. Applied
and Environmental Microbiology 2002; 68(10): 4871-4875.
6. Brasel TL, Campbell AW, Demers RE, Ferguson BS, Fink J, Vojdani A, Wilson
SC, Straus DC. Detection of trichothecene mycotoxins in sera from
individuals exposed to Stachybotrys chartarum in indoor environments.
Archives of Environmental Health 2004; 59(6): 317-323.
7. Brasel TL, Martin JM, Carriker CG, Wilson SC, Straus DC. Detection of
airborne Stachybotrys chartarum macrocyclic trichothecene mycotoxins in the
indoor environment. Applied and Environmental Microbiology 2005; 71(11):
7376- 7388.
8. Panaccione DG, Coyle CM. Abundant respirable ergot alkaloids from the
common airborne fungus Aspergillus fumigatus. Applied and Environmental
Microbiology 2005; 71(6): 3106-3111.
9. Bennett JW, Klich M. Mycotoxins. Clin Microbiol Rev 2003; 16(3): 497-516.
10. Rao CY, Brain JD Burge HA. Reduction of pulmonary toxicity of
Stachybotrys chartarum spores by methanol extraction of mycotoxins. Applied
and Environmental Microbiology 2000; 66(7): 2817-2821.
11. Wannemacher RW, Wiener SL. Trichothecene Mycotoxins. Textbook of
Military Medicine: Medical Aspects of Chemical and Biological Warfare:
Chapter 34.
12. Creasia DA, Thurman JD, Jones J, Nealley ML, York CG, Wannemacher RW,
Bunner DL. Acute inhalation toxicity of T-2 mycotoxin in mice. Fundamental
and Applied Toxicology 1987: 8: 230-235.
13. Karunasena E, Cooley JD, Douglas DR, Straus DC. Protein translation
inhibition by Stachybotrys chartarum conidia with and without the mycotoxins
containing polysaccharide matrix. Mycopathologia 2004; 158: 87-97.
14. Peltola J, Ritieni A, Mikkola R, Grigoriev PA, Pocafalvi G, Andersson
MA, Salkinoja-Salonen MS. Biological effects of Trichoderma harzianum
peptaibols on mammalian cells. Applied and Environmental Microbiology 2004;
70(8): 4996-5004.
15. Neville J, Hodgson M. Background and toxicity on some mycotoxins commonly
found in water damaged buildings and outside ambient environment. PK-Jarvis
Microbiological, LLC.
16. Sorenson WG, Frazer DG, Jarvis BB, Simpson J, Robinson VA. Trichothecene
mycotoxins in aerosolized conidia of Stachybotrys atra. Applied and
Environmental Microbiology 1987; 53(6): 1370-1375.
17. Etzel RA. Mycotoxins. JAMA 2002; 287(4): 425-428.
18. Jarvis BB, Salemme J, Morais A. Stachybotrys toxins. 1 Natural Toxins 1995; 3:
19. Yike I, Rand TG, Dearborn DG. Acute inflammatory responses to Stachybotrys
chartarum in the lungs of infant rats: time course and possible mechanisms.
Toxicol Sci 2005; 84(2): 407-417.
20. Rand TG, Flemming J, David Miller J, Womiloju TO. Comparison of
inflammatory responses in mouse lungs exposed to atranones A and C from
Stachybotrys chartarum. J Toxicol Environ Health A 2006; 69(13): 1239-1251.
21. Rosenblum Lichtenstein JH, Molina RM, Donaghey TC, Brain JD. Strain
differences influence murine pulmonary responses to Stachybotrys chartarum.
Am J Respir Cell Mol Biol 2006; 35(4): 415-423.
22. Sorenson WG, Frazer DG, Jarvis BB, Simpson J, Robinson VA. Trichothecene
mycotoxins in aerosolized conidia of Stachybotrys atra. Appl Environ Microbiol
1987; 53(6): 1370-1375.
23. Tuomi T, Reijula K, Johnsson T, Hemminki K, Hintilla EL, Lindroos O, Kalso S,
Koukila-Kahkola P, Mussalo-Rauhamaa H, Haahtela T. Mycotoxins in crude
building materials from water-damaged buildings. Appl Environ Microbiol 2000;
66(5): 1899-1904.
24. Nielsen KF, Gravesen S, Nielsen PA, Andersen B, Thrane U, Frisvad JC.
Production of mycotoxins on artificially and naturally infested building materials.
Mycopathologia 1999; 145(1): 43-56.
25. Hodgson MJ, Morey P, Leung WY, Morrow L, Miller D, Jarvis BB, Robbins H,
Halsey JF, Storey E. Building-associated pulmonary disease from exposure to
Stachybotrys chartarum and Aspergillus versicolor. J Occup Environ Med 1998;
40(3): 241-249.
26. Jarvis BB, Miller JD. Mycotoxins as harmful indoor air contaminants. Appl
Microbiol Biotechnol 2005; 66(4): 367-372.
27. Fog Nielsen K. Mycotoxin production by indoor molds. Fungal Genet Biol 2003;
39(2): 103-117.
28. Fiedler K, Schutz E, Geh S. Detection of microbial volatile organic compounds
(MVOCs) produced by moulds on various materials. Int J Hyg Environ Health
2001; 204(2-3): 111-121.
29. Gao P, Martin J. Volatile metabolites produced by three strains of Stachybotrys
chartarum cultivated on rice and gypsum board. Appl Occup Environ Hyg 2002;
17(6): 430-436.
Nay Sayers
1. Lees-Haley PR. Toxic mold and mycotoxins in neurotoxicity cases: Stachybotrys,
Fusarium, Trichoderma, Aspergillus, Penicillium, Cladosporium, Alternaria,
Trichothecenes. Psychol Rep 2003; 93(2): 561-584.
2. Zacharisen MC, Fink JN. Is indoor “mold madness” upon us? Annals of Allergy,
Asthma & Immunology 2005; 94: 12-13.
3. Marmot AF, Eley J, Stafford M, Stansfeld SA, Warwick E, Marmot MG. Building
health: an epidemiological study of “Sick building syndrome” in the Whitehall II
study. Occup Environ Med 2006; 63: 283-289.
4. Khalili B, Montanaro MT, Bardana EJ. Indoor mold and your patient’s health:
from suspicion to confirmation. The Journal of Respiratory Diseases 2005;
26(12): 520-526.
5. Bobbitt RC, Crandall MS, Venkataraman A, Bernstein JA. Characterization of a
population presenting with suspected mold-related health effects. Ann Allergy
Asthma Immunol 2005; 94: 39-44.
6. Robbins CA, Swenson LJ, Nealley ML, Gots RF, Kelman BJ. Health effects of
mycotoxins in indoor air: a critical review. Applied Occupational and
Environmental Hygiene 2000; 15(10): 773-784.
7. Kelman BJ, Robbins CA, Swenson LJ, Hardin BD. Risk from inhaled mycotoxins
in indoor office and residential environments. International Journal of Toxicology
2004; 23: 3-10.
8. Council on Scientific Affairs. Adverse human health effects associated with
molds in the indoor environment. JOEM 2003; 45(5): 470-478.
9. Sudakin DL. Toxigenic fungi in a water-damaged building: an intervention study.
American Journal of Industrial Medicine 1998; 34: 183-190.
10. Sudakin DL. Stachybotrys chartarum: current knowledge of its role in disease.
Medscape General Medicine 2000; 1-8.
11. Hossain MA, Ahmed MS, Ghannoum MA. Attributes of Stachybotrys chartarum
and its association with human disease. J Allergy Clin Immunol 2004; 113(2):
12. Kuhn DM, Ghannoum MA. Indoor mold, toxigenic fungi, and Stachybotrys
chartarum: infectious disease perspective. Clinical Microbiology Reviews 2003;
16(1): 144-172.
13. Terr AI. Stachybotrys: relevance to human disease. Ann Allergy Asthma
Immunol 2001; 87(Suppl): 57-63.
14. Kolstad HA, Brauer C, Iversen M, Sigsgaard T, Mikkelsen S. Do indoor molds in
nonindustrial environments threaten workers’ health? A review of the
epidemiologic evidence. Epidemiol Rev 2002; 24: 203-217.
15. Fung F, Hughson WG. Health effects of indoor fungal Bioaerosol exposure.
Applied Occupational and Environmental Hygiene 2003; 18: 535-544.
16. Mahmoudi M, Gershwin ME. Sick building syndrome. III. Stachybotrys
chartarum. Journal of Asthma 2000; 37(2): 191-198.
1. Casadevall A, Pirofski LA. The weapon potential of human pathogenic fungi.
Medical Mycology 2006; 44: 689-696.
2. Sidell FR, Takafuji ET, Franz DR. Medical aspects of chemical and biological
warfare. 1997; NLM Unique ID: 9709389.
Hormonal Effects
1. Taylor MJ, Smart RA, Sharma RP. Relationship of the hypothalamic-pituitaryadrenal
axis with chemically induced immunomodulation. I. Stress-like response
after exposure to T-2 toxin. Toxicology 1989; 56(2): 179-195.
2. Desruisseaux MS, Nagajyothi, Trujillo ME, Tanowitz HB, Scherer PE.
Adipocyte, adipose tissue, and infectious disease. Infection and Immunity 2007;
75(3): 1066-1078.
3. Gonzalez-Rey E, Chorny A, Delgado M. Regulation of immune tolerance by antiinflammatory
neuropeptides. Nature Reviews Immunology 2007; 7: 52-63.
1. Cho SH, Seo SC, Schmechel D, Grinshpun SA, Reponen T. Aerodynamic
characteristics and respiratory deposition of fungal fragments. Atmospheric
Environment 2005; 39: 5454-5465.
2. Brasel TL, Douglas DR, Wilson SC, Straus DC. Detection of airborne
Stachybotrys chartarum macrocyclic trichothecene mycotoxins on particulates
smaller than conidia. Applied and Environmental Microbiology 2005; 71(1): 114-
3. Gorny RL, Reponen T, Willeke K, Schmechel D, Robine E, Boissier M,
Grinshpun SA. Fungal fragments as indoor air biocontaminants. Applied and
Environmental Microbiology 2002; 3522-3531.
4. Gorny RL. Filamentous microorganisms and their fragments in indoor air- a
review. Ann Agric Environ Med 2004; 11: 185-197.
5. Panaccione DG, Coyle CM. Abundant respirable ergot alkaloids from the
common airborne fungus Aspergillus fumigatus. Applied and Environmental
Microbiology 2005; 71(6): 3106-3111.
6. Schulz T, Senkpiel K, Ohgke H. Comparison of the toxicity of reference
mycotoxins and spore extracts of common indoor moulds. International Journal of
Hygiene and Environmental Health 2004; 207(3): 267-277.
1. Penttinen P, Pelkonen J, Huttunen K, Hirvonen MR. Co-cultivation of
Streptomyces of Streptomyces californicus and Stachybotrys chartarum stimulates
the production of cytostatic compound(s) with immunotoxic properties.
Toxicology and Applied Pharmacology 2006; 217: 342-351.
2. Gorny RL, Mainelis G, Grinshpun SA, Willeke K, Dutkiewicz J, Reponen T.
Release of Streptomyces albus propagules from contaminated surfaces.
Environmental Research 2003; 91: 45-53.
3. Huttunen K, Pelkonen J, Nielsen KF, Nuutinen U, Jussila J, Hirvonen MR.
Synergistic interaction in simultaneous exposure to Streptomyces californicus and
Stachybotrys chartarum. Environmental Health Perspectives 2004; 112(4): 659-
4. Martinez A, Kolvek SJ, Hopke J, Yip CLT, Osburne MS. Environmental DNA
fragments conferring early and increased sporulation and antibiotic production in
Streptomyces species. Applied and Environmental Microbiology 2005; 71(3):
5. Murtoniemi T, Penttinen P, Nevalainen A, Hirvonen MR. Effects of microbial
cocultivation on inflammatory and cytotoxic potential of spores. Inhal Toxicol
2005; 17(12): 681-693.
6. Penttinen P, Huttunen K, Pelkonen J, Hirvonen MR. The proportions of
Streptomyces californicus and Stachybotrys chartarum in simultaneous exposure
affect inflammatory responses in mouse RAW264.7 macrophages. Inhal Toxicol
2005; 17(2): 79-85.
1. Buttner MP, Cruz-Perez P, Stetzenbach LD. Enhanced detection of surfaceassociated
bacteria in indoor environments by quantitative PCR. Applied and
Environmental Microbiology 2001; 67(6): 2564-2570.
2. Inoue KI, Takno H, Yanagisawa R, Hirano S, Sakurai M, Shimada A, Yoshikawa
T. Effects of airway exposure to nanoparticles on lung inflammation induced by
bacterial endotoxin in mice. Environmental Health Perspectives 2006; 114(9):
3. Peltola J, Andersson MA, Haahtela T, Mussalo-Rauhamaa H, Rainey FA,
Kroppenstedt RM, Samson RA, Salkinoja-Salonen MS. Toxic-metaboliteproducing
bacteria and fungus in an indoor environment. Applied and
Environmental Microbiology 2001; 67(7): 3269-3274.
4. Gandara A, Mota LC, Flores C, Perez HR, Green CF, Gibbs SG. Isolation of
Staphylococcus aureus and antibiotic-resistant Staphylococcus aureus from
residential indoor bioaerosols. Environmental Health Perspectives 2006; 114(12):
5. Zughaier SM, Zimmer SM, Datta A, Carlson RW, Stephens DS. Differential
induction of Toll-like receptor 4-MyD88-dependent and –independent signaling
pathways by endotoxins. Infect Immun 2005; 73(5): 2940-2950.
6. Medvedev AE, Lentschat A, Wahl LM, Golenbock DT, Vogel SN. Dysregulation
of LPS-induced Toll-like receptor 4-MyD88 complex formation and IL-1
receptor-associated kinase 1 activation in endotoxin-tolerant cells. J Immunol
2002; 169(9): 5209-5216.
7. Dobrovolskaia MA, Medvedev AE, Thomas KE, Cuesta N, Toshchakov V, Ren
T, Cody MJ, Michalek SM, Rice NR, Vogel SN. Induction of in vitro
reprogramming by Toll-like receptor (TLR) 2 and TLR4 agonists in murine
macrophages: effects of TLR “homotolerance” versus “heterotolerance” on NFkappa
B signaling pathway components. J Immunol 2003; 170(1): 508-519.
8. Zhou HR, Harkema JR, Hotchkiss JA, Yan D, Roth RA, Pestka JJ.
Lipopolysaccharide and the trichothecene vomitoxin (deoxynivalenol)
synergistically induce apoptosis in murine lymphoid organs. Toxicol Sci 2000;
53(2): 253-263.
9. Islam Z, Moon YS, Zhou HR, King LE, Franker PJ, Pestka JJ. Endotoxin
potentiation of trichothecene-induced lymphocyte apoptosis is mediated by upregulation
of glucocorticoids. Toxicol Appl Pharmacol 2002; 180(1): 43-55.
10. Islam Z, King LE, Fraker PJ, Pestka JJ. Differential induction of glucocorticoiddependent
apoptosis in murine lymphoid subpopulations in vivo following
coexposure to lipopolysaccharide and vomitoxin (deoxynivalenol). Toxicol Appl
Pharmacol 2003; 182(2): 69-99.
11. Islam Z, Pestka JJ. Role of IL-1beta in endotoxin potentiation of deoxynivalenolinduced
corticosterone response and leukocyte apoptosis in mice. Toxicol Sci
2003; 74(1): 93-102.
12. Hirvonen MR, Huttunen K, Roponen M. Bacterial strains from moldy buildings
are highly potent inducers of inflammatory and cytotoxic effects. Indoor Air 2005; 15
Suppl 9: 65-70.
Environmental RX Health Problems
1. Menzies D, Popa J, Hanley JA, Rand T, Milton DK. Effect of ultraviolet
germicidal lights installed in office ventilation systems on worker’s health and
wellbeing: double-blind multiple crossover trial. The Lancet 2003; 362: 1785-
2. Wilson SC, Wu C, Andriychuk LA, Martin JM, Brasel TL, Jumper CA, Straus
DC. Effect of chlorine dioxide gas on fungi and mycotoxins associated with sick
building syndrome. Applied and Environmental Microbiology 2005; 71(9): 5399-
3. Kercsmar CM, Dearborne DG, Schluchter M, Xue L, Kirchner L, Sobolewski J,
Greenberg SJ, Vesper SJ, Allan T. Reduction in asthma morbidity in children as a
result of home remediation aimed at moisture sources. Environmental Health
Perspectives 2006; 114(8): 1574-1580.
4. Levetin E, Shaughnessy R, Rogers CA, Scheir R. Effectiveness of germicidal UV
radiation for reducing fungal contamination within air-handling units. Applied
and Environmental Microbiology 2001; 67(8): 3712-3715.
5. Bourbeau J, Brisson C, Allaire S. Prevalence of the sick building syndrome
symptoms in office workers before and after being exposed to a building with an
improved ventilation system. Occupational and Environmental Medicine 1996;
53: 204-210.
Brain and Neuro Injury
1. Martin LJ, Doebler JA, Anthony A. Scanning cytophotometric analysis of brain
neuronal nuclear chromatin changes in acute T-2 toxin-treated rats. Toxicol Appl
Pharmacol 1986; 85(2): 207-214.
2. Martin LJ, Morse JD, Anthony A. Quantitative cytophotometric analysis of brain
neuronal RNA and protein changes in acute T-2 mycotoxin poisoned rats.
Toxicon 1986; 24(9): 933-941.
3. Schoental R. Fusarial mycotoxins and behaviour: possible implications for
psychiatric disorder. Br J Psychiatry 1985; 146: 115-119.
4. Wang J, Fitzpatrick DW, Wilson JR. Effect of T-2 toxin on blood-brain barrier
permeability monoamine oxidase activity and protein synthesis in rats. Food
Chem Toxicol 1998; 36(11): 955-961.
5. Patton DE, Duff K, Schoenberg MR, Mold J, Scott JG, Adams RL. Base rates of
longitudinal RBANS discrepancies at one- and two-year intervals in communitydwellings
older adults. Clin Neuropsychol 2005; 19(1): 27-44.
6. Baldo JV, Ahmad L, Ruff R. Neuropsychological performance of patients
following mold exposure. Appl Neuropsychol 2002; 9(4): 193-202.
7. Kilburn KH. Indoor mold exposure associated with neurobehavioral and
pulmonary impairment: a preliminary report. Arch Environ Health 2003; 58(7):
8. Rea WJ, Didriksen N, Simon TR, Pan Y, Fenyves EJ, Griffiths B. Effects of toxic
exposure to molds and mycotoxins in building-related illnesses. Arch Environ
Health 2003; 58(7): 399-405.
9. Gordon WA, Cantor JB, Johanning E, Charatz H, Ashman TA, Breeze JL,
Haddad L, Abramowitz S. Cognitive impairment associated with toxigenic fungal
exposure: a replication and extension of previous findings. Applied
Neuropsychology 2004; 11(2): 65-74.
10. Sava V, Velasquez A, Reunova O, Sanchez-Ramos J. Acute ochratoxin-A
neurotoxicity: kinetics of distribution of the toxin, indices of oxidative stress and
DNA repair activities in mouse brain. Accepted Abstract for Platform
Presentation Society for Neuroscience, Annual Meeting Washington DC,
November 2005.
11. Sanchez-Ramos J, Sava V. Mycotoxins: can low level, non-lethal exposure result
in Parkinsonism? Abstract of invited lecture presented at Worlds Federation of
Neurology, Symposium on Neurotoxicology, Sydney, Australia 11/2005.
12. Bergmann F, Yagen B, Jarvis BB. The toxicity of macrocyclic trichothecenes
administered directly into the rat brain. Toxicons 1992; 30(10): 1291-1294.
13. Crago BR, Gray MR, Nelson LA, Davis M, Arnold L, Thrasher JD.
Psychological, neuropsychological, and electrocortical effects of mixed mold
exposure. Archives of Environmental Health 2004; 452-462.
14. Kilburn KH. Indoor mold exposure associated with neurobehavioral and
pulmonary impairment: a preliminary report. PubMed 2004.
15. Gordon KE, Masotti RE, Waddell WR. Tremorgenic encephalopathy: a role of
mycotoxins in the production of CNS disease in humans? Can J Neurol Sci 1993;
20: 237-239.
16. Fung F, Clark R, Williams S. Stachybotrys, a mycotoxin-producing fungus of
increasing toxicologic importance. Clinical Toxicology 1998; 36(1&2): 76-86.
17. Cooley JD, Wong WC, Jumper CA, Straus DC. Correlation between the
prevalence of certain fungi and sick building syndrome. Occup Environ Med
1998; 55: 579-584.
Gene Expression
1. Nielsen KF, Huttunen K, Hyvarinen A, Andersen B, Jarvis BB, Hirvonen MR.
Metabolite profiles of Stachybotrys isolates from water-damaged buildings and
their induction of inflammatory mediators and cytotoxicity in macrophages.
Mycopathologia 2002; 154(4): 201-205.
2. Trinchieri G, Sher A. Cooperation of Toll-like receptor signals in innate immune
defence. Nature Reviews Immunology 2007; 7: 179-190.
3. Romani L. Immunity to fungal infections. Nature Reviews Immunology 2004; 4:
4. Hudson B, Flemming J, Sun G, Rand TG. Comparison of immunomodulator
mRNA and protein expression in the lungs of Stachybotrys chartarum sporeexposed
mice. J Toxicol Environ Health A 2005; 68(15): 1321-1335.
5. Yike I, Rand T, Dearborn DG. The role of fungal proteinases in pathophysiology
of Stachybotrys chartarum. Mycopathologia 2007; July 3 PMID 17610048
6. Rao KMK, Ma JYC, Meighan T, Barger MW, Pack D, Vallyathan V. Time
course of gene expression of inflammatory mediators in rat lung after diesel
exhaust particle exposure. Environmental Health Perspectives 2005; 113(5): 612-
7. Flach CF, Qudri F, Bhuiyan TR, Alam NH, Jennische E, Lonnroth I, Holmgren J.
Broad up-regulation of innate defense factors during acute cholera. Infection and
Immunity 2007; 75(5): 2343-2350.
8. Ryan JC, Dechraoui MYB, Morey JS, Rezvani A, Levin ED, Gordon CJ,
Ramsdell JS, van Dolah FM. Genomic and proteomic analysis of whole blood in
mice exposed to the marine neurotoxin Pacific ciguatoxin-1.
9. Kim JM, Kim JS, Lee JY, Kim YJ, Youn NJ, Lim IY, Chee YJ, Oh YK, Kim N,
Jung HC, Song IS. Vacuolating cytotoxin Helicobacter pylori water-soluble
protein upregulates chemokine expression in human eosinophils via Ca2+ influx,
mitochondrial reactive oxygen intermediates, and NF-kB activation. Infection and
Immunity 2007; 75(7): 3373-3381.
10. Pestka JJ, Yan D, King LE. Flow cytometric analysis of the effects of in vitro
exposure to vomitoxin (deoxynivalenol) on apoptosis in murine T, B and IgA+
cells. Food Chem Toxicol 1994; 32(12): 1125-1136.
11. Poapolathep A, Ohtsuka R, Kiaptipattanasakul W, Ishigami N, Nakayana H, Doi
K. Nivalenol-induced apoptosis in thymus, spleen and Peyer’s patches of mice.
Exp Toxicol Pathol 2002; 53(6): 441-446.
12. Islam Z, Gray JS, Pestka JJ. P38 Mitogen-activated protein kinase mediates IL-8
induction by the ribotoxin deoxynivalenol in human monocytes. Toxicol Appl
Pharmacol 2006; 213(3): 235-244.
13. Leino M, Makela M, Reijula K, Haahtela T, Mussalo-Rauhamaa H, Tuomi T,
Hintikka EL, Alenius H. Intranasal exposure to a damp building mould,
Stachybotrys chartarum, induces lung inflammation in mice by satratoxinindependent
mechanisms. Clin Exp Allergy 2003; 33(11): 1603-1610.
14. Huttunen K, Hyvarinen A, Nevalainen A, Komulainen H, Hirvonen MR.
Production of proinflammatory mediators by indoor air bacteria and fungal spores
in mouse and human cell lines. Environ Health Perspect 2003; 111(1): 85-92.
15. Dong W, Azcona-Olivera JI, Brooks KH, Linz JE, Pestka JJ. Elevated gene
expression and production of interleukins 2, 4, 5, and 6 during exposure to
vomitoxin (deoxynivalenol) and cycloheximide in the EL-4 thymoma. Toxicol
Appl Pharmacol 1994; 127(2): 282-290.
16. Ouyang YL, Azcona-Olivera JI, Murtha J, Pestka JJ. Vomitoxin-mediated IL-2,
IL-4, and IL-5 superinduction in murine CD4+ T cells stimulated with phorbol
ester calcium ionophore: relation to kinetics of proliferation. Toxicol Appl
Pharmacol 1996; 138(2): 324-334.
17. Zhou HR, Harkema JR, Yan D, Pestka JJ. Amplified proinflammatory cytokine
expression and toxicity in mice co-exposed to lipopolysaccharide and the
trichothecene vomitoxin (deoxynivalenol). J Toxicol Environ Health A 1999;
57(2): 115-136.
18. Wong SS, Zhou HR, Marin-Martinez ML, Brooks K, Pestka JJ. Modulation of
IL1-beta, IL-6 and TNF-alpha secretion and mRNA expression by the
trichothecene vomitoxin in the RAW 264.7 murine macrophage cell line. Food
Chem Toxicol 1998; 36(5): 409-419.
19. Chung YJ, Jarvis B, Pestka J. Modulation of lipopolysaccharide-induced
proinflammatory cytokine production by satratoxins and other macrocyclic
trichothecenes in the murine macrophage. J Toxicol Environ Health A 2003;
66(4): 379-391.
20. Sugita-Konishi Y, Pestka JJ. Differential upregulation of TNF-alpha. IL-6, and
IL-8 production by deoxynivalenol (vomitoxin) and other 8-ketotrichothecenes in
a human macrophage model. J Toxicol Environ Health A 2001; 64(8): 619-636.
21. Chung YJ, Jarvis B, Pestka J. Modulation of lipopolysaccharide-induced
proinflammatory cytokine production by satratoxins and other macrocyclic
trichothecenes in the murine macrophage. J Toxicol Environ Health A 2003;
66(4): 379-391.
22. Islam Z, Pestka JJ. LPS priming potentiates and prolongs proinflammatory
cytokine response to the trichothecene deoxynivalenol in the mouse. Toxicology
and Applied Pharmacology 2006; 211: 53-63.
23. Chung YJ, Yang GH, Islam Z, Pestka JJ. Up-regulation of macrophage
inflammatory protein-2 and complement 3A receptor by the trichothecenes
deoxynivalenol and satratoxin G. Toxicology 2003; 186: 51-65.
24. Wang H, Yadav JS. Global gene expression changes underlying Stachybotrys
chartarum toxin-induced apoptosis in murine alveolar macrophages: evidence of
multiple signal transduction pathways. Apoptosis 2007; 12(3): 535-548.
25. Pestka J, Zhou HR. Toll-like receptor priming sensitizes macrophages to
proinflammatory cytokine gene induction by deoxynivalenol and other toxicants.
Toxicol Sci 2006; 92(2): 445-455.
26. Zhou HR, Islam Z, Pestka JJ. Induction of competing apoptotic and survival
signaling pathways in the macrophage by the ribotoxic trichothecene
deoxynivalenol. Toxicol Sci 2005; 87(1): 113-122
27. Zhou HR, Jia Q, Pestka JJ. Ribotoxic stress response to the trichothecene
deoxynivalenol in the macrophage involves the SRC family kinase Hck. Toxicol
Sci 2005; 85(2): 916-926.
28. Kinser S, Li M, Jia Q, Pestka JJ. Truncated deoxynivalenol-induced splenic
immediate early gene response in mice consuming (n-3) polyunsaturated fatty
acids. J Nutr Biochem 2005; 16(2): 88-95.
29. Pestka JJ, Uzarski RL, Islam Z. Induction of apoptosis and cytokine production in
the Jurkat human T cells by deoxynivalenol: role of mitogen-activated protein
kinases and comparison to other 8-ketotrichothecenes. Toxicology 2005; 206(2):
30. Nusuetrong P, Yoshida M, Tanitsu MA, Kikuchi H, Mizugaki M, Shimazu K,
Pengsuparp T, Meksuriyen D, Oshima Y, Nakahata N. Involvement of reactive
oxygen species and stress-activated MAPKs in satratoxin H-induced apoptosis.
Eur J Pharmacol 2005; 507(1-3): 239-246.
31. Jia Q, Zhuo HR, Bennink M, Pestka JJ. Docosahexaenoic acid attenuates
mycotoxin-induced immunoglobulin A nephropathy, interleukin-6 transcription,
and mitogen-activated protein kinase phosphorylation in mice. J Nutr 2004;
134(12): 3343-3349.
32. Moon Y, Pestka JJ. Deoxynivalenol-induced mitogen-activated protein kinase
phosphorylation and IL-6 expression in mice suppressed by fish oil. J Nutr
Biochem 2003; 14(12): 717-726.
33. Chung YZ, Zhou HR, Pestka JJ. Transcriptional and posttranscriptional roles for
p38 mitogen-activated protein kinase in upregulation of TNF-alpha expression by
deoxynivalenol (vomitoxin). Toxicol Appl Pharmacol 2003; 193(2): 188-201
34. Deva R, Shankaranarayanan P, Ciccoli R, Nigam S. Candida albicans induces
selectively transcriptional activation of cyclooxygenase-2 in HeLa cells: pivotal
roles of Toll-like receptors, p38 mitogen-activated protein kinase, and NF-kappa
B. J Immunol 2003; 171(16): 3047-3055.
35. Zhou HR, Lau AS, Pestka JJ. Role of double-stranded RNA-activated protein
kinase R (PKR) in deoxynivalenol-induced ribotoxic stress response. Toxicol Sci
2003; 74(2): 335-344.
36. Moon Y, Pestka JJ. Vomitoxin-induced cyclooxygenases 2 gene expression in
macrophages mediated by activation of ERK and p38 but not JNK mitogenactivated
protein kinases. Toxicol Sci 2002; 69(2): 373-382.
37. Moon Y, Uzarski R, Pestka JJ. Relationship of trichothecene structure to COX-2
induction in the macrophage: selective action of type B (8-keto) trichothecenes. J
Toxicol Environ Health A2003; 66(20): 1967-1983.
38. Yang GH, Jarvis BB, Chung YJ, Pestka JJ. Apoptosis induction by the satratoxins
and other trichothecene mycotoxins: relationship to ERK, p38 MAPK, and
SAPK/JNK activation. Toxicol Appl Pharmacol 2000; 164(2): 149-160.
39. Shifrin VI, Anderson P. Trichothecene mycotoxins trigger a ribotoxic stress
response that activates c-Jun N-terminal kinase and p38 mitogen-activated protein
kinase and induces apoptosis. J Biol Chem 1999; 274(20): 13985-13992.
Beta Glucans
1. Young SH, Roberts JR, Antonini JM. Pulmonary exposure to 1, 3-beta-glucan
alters adaptive immune responses in rats. Inhal Toxicol 2006; 18(11): 865-874.
2. Thorn J, Rylander R. Airways inflammation and glucan in a rowhouse area. Am J
Respir Crit Care Med 1998; 157: 1798-1803.
3. Young SH, Roberts JR, Antonini JM. Pulmonary exposure to 1, 3-B-glucan alters
adaptive immune responses in rats. Inhalation Toxicology 2006; 18: 865-874.
4. Brown GD. Dectin-1: a signaling non-TLR pattern-recognition receptor. Nature
Reviews Immunology 2006; 6: 33-43.
5. Robinson MJ, Sancho D, Slack EC, LeibundGut-Landmann S, Sousa CR.
Myeloid C-type lectins in innate immunity. Nature Immunology 2006; 7(12):
6. McCann F, Carmona E, Puri V, Pagano RE, Limper AH. Macrophage
internalization of fungal-B-glucans is not necessary for initiation of related
inflammatory responses. Infection and Immunity 2005; 73(10): 6340-6349.
7. Kataoka K, Muta T, Yamazaki S, Takeshige K. Activation of macrophages by
linear (1,3)-beta-D-glucans. Implications for the recognition of fungi by innate
immunity. J Biol Chem 2002; 277(39): 36825-36831.
8. Palma AS, Feizi T, Zhang Y, Stoll MS, Lawson AM, Diaz-Rodriguez E,
Campanero-Rhodes MA, Costa J, Gordon S, Brown GD, Chai W. Ligands for the
beta-glucan receptor, dectin-1, assigned using “designer” microarrays of
oligosaccharide probes (neoglycolipids) generated from glucan polysaccharides. J
Biol Chem 2006; 281(9): 5771-5779.
9. Herre J, Willment JA, Gordon S, Brown GD. The role of dectin-1 in antifungal
immunity. Crit Rev Immunol 2004; 24(3): 193-203.
10. Taylor PR, Tsoni SV, Willment JA, Dennehy KM, Rosas M, Findon H, Haynes
K, Steele C, Botto M, Gordon S, Brown GD. Dectin-1 is required for beta-glucan
recognition and control of fungal infection. Nat Immunol 2007; 8(1): 31-38.
11. Willment JA, Marshall AS, Reid DM, Williams DL, Wong SY, Gordon S, Brown
GD. The human beta-glucan receptor is widely expressed and functionally
equivalent to murine dectin-1 on primary cells. Eur J Immunol 2005; 35(5): 1539-
12. Taylor PR, Brown GD, Reid DM, Willment JA, Martinez-Pomares L, Gordon S,
Wong SY. The beta-glucan receptor, dectin-1, is predominantly expressed on the
surface of cells of the monocyte/macrophage and neutrophil lineages. J Immunol
2002; 169(7): 3879-3882.
13. Brown GD, Taylor PR, Reid DM, Willment JA, Williams DL, Martinez-Pomares
L, Wong SY, Gordon S. Dectin-1 is a major beta-glucan receptor on
macrophages. J Exp Med 2002; 196(3): 407-412.
14. Thornton BP, Vetvicka V, Pitman M, Goldman RC, Ross GD. Analysis of the
sugar specificity and molecular location of the beta-glucan-binding lectin site of
complement receptor type 3 (CD11b/CD18). J Immunol 1996; 156(3): 1235-
15. Ozment-Skelton TR, Goldman MP, Gordon S, Brown GD, Williams DL.
Prolonged reduction of leukocyte membrane-associated dectin-1 levels following
beta-glucan administration. J Pharmacol Exp Ther 2006; 318(2): 540-546.
16. Herre J, Gordon S, Brown GD. Dectin-1 and its role in the recognition of betaglucans
by macrophages. Mol Immunol 2004; 40(12): 869-876.
17. Adachi Y, Ishii T, Ikeda Y, Hoshino A, Tamura H, Aketagawa J, Tanaka S, Ohno
N. Characterization of beta-glucan recognition site on C-type lectin, dectin 1.
Infect Immun 2004; 72(7): 4159-4171.
18. McGreal EP, Rosas M, Brown GD, Zamze S, Wong SY, Gordon S, Martinez-
Pomares L, Taylor PR. The carbohydrate-recognition domain of dectin-2 is a Ctype
lectin with specificity for high mannose. Glycobiology 2006; 16(5): 422-430.
1. Netea MG, Van der Meer JWM, Sutmuller RP, Adema GJ, Kullberg BJ. From the
Th1/Th2 paradigm towards a Toll-like receptor/T-helper bias. Antimicrobial
Agents and Chemotherapy 2005; 49(10): 3991-3996.
2. Islam Z, Harkems JR, Pestka JJ. Satratoxin G from the black mold Stachybotrys
chartarum evokes olfactory sensory neuron loss and inflammation in the murine
nose and brain. Envir Health Perpe 2006; 114(7): 1099-1107.
3. Islam Z, Amuzie CJ, Harkema JR, Pestka JJ. Neurotoxicity and inflammation in
the nasal airways of mice exposed to the macrocyclic trichothecene mycotoxins
roridin A: kinetics and potentiation by bacterial lipopolysaccharide co-exposure.
ToxSci Advance Access May 2004.
4. Creasia DA, Thurman JD, Jones LJ, Nealley ML, York CG, Wannemacher RW,
Bunner DL. Acute inhalation toxicity of T-2 mycotoxin in mice. Fundamental and
Applied Toxicology 1987; 8: 230-235.
5. Rand TG, Flemming J, Miller JD, Womiloju TO. Comparison of inflammatory
responses in mouse lungs exposed to atranones A and C from Stachybotrys
chartarum. Journal of Toxicology and Environmental Health 2006; 69: 1-13.
6. van der Graff CAA, Netea MG, Verschueren I, van der Meer JWM, Kullberg BJ.
Differential cytokine production and Toll-like receptor signaling pathways by
Candida albicans blastoconidia and hyphae. Infection and Immunity 2005; 73(11):
7. Rivera A, Van Epps HL, Hohl TM, Rizzuto G, Pamer EG. Distinct CD4+-T-cell
responses to live and heat-inactivated Aspergillus fumigatus conidia. Infection
and Immunity 2005; 73(11): 7170-7179.
8. Huttunen K, Hyvarinen A, Nevalainen A, Komulainen H, Hirvonen MR.
Production of proinflammatory mediators by indoor air bacteria and fungal spores
in mouse and human cell lines. Environmental Health Perspectives 2003; 111(1):
9. Jiang H, Chess L. Regulation of immune responses by T cells. N Engl J Med
2006; 354: 1166-1176.
10. Kay AB. Natural Killer T cells and asthma. N Engl J Med 354(11): 1186-1188.
11. Akbari O, Faul JL, Hoyte EG, Berry GJ, Wahlstrom J, Kronenberg M, DeKruyff
RH, Umestsu DT. CD4+ invariant T-cell-receptor+ natural killer T cells in
bronchial asthma. N Engl J Med 2006; 354(11): 1117-1129.
12. Flemming J, Hudson B, Rand TG. Comparison of inflammatory and cytotoxic
lung responses in mice after intratracheal exposure to spores of two different
Stachybotrys chartarum strains. Toxicological Sciences 2004; 78: 267-275.
13. Stoeger T, Reinhard C, Takenaka S, Schroeppel A, Karg E, Ritter B, Heyder J,
Schulz H. Instillation of six different ultrafine carbon particles indicates a surface
area threshold dose for acute lung inflammation in mice. Environmental Health
Perspectives 2006; 114(3): 328-333.
14. Veranth JM, Moss TA, Chow JC, Labban R, Nichols WK, Walton JC, Watson
JG, Yost GS. Correlation of in vitro cytokine responses with the chemical
composition of soil-derived particulate matter. Environmental Health Perspectives
2006; 114(3): 341-349.
15. Nurkiewicz TR, Porter DW, Barger M, Millecchia L, Rao MK, Marvar PJ, Hubbs
AF, Castranova V, Boegehold MA. Systemic microvascular dysfunction and
inflammation after pulmonary particulate matter exposure. Environmental Health
Perspectives 2006; 114(3): 412-419.
16. Rand TG, Giles S, Flemming J, Miller JD, Puniani E. Inflammatory and cytotoxic
responses in mouse lungs exposed to purified toxins from building isolated
Penicillium brevicompactum dierckx and p. chrysogenum thom. Toxicological
Sciences 2005; 87(1): 213-222.
17. Donohue M, Wei W, Wu J, Zawia NH, Hud N, De Jesus V, Schmechel D, Hettick
JM, Beezhold DH, Vesper S. Characterization of nigerlysin c, hemolysin
produced by Aspergillus niger, and effect on mouse neuronal cells in vitro.
Toxicology 2006; 219: 150-155.
18. Rao CY, Burge HA, Brain JD. The time course of responses to intratracheally
instilled toxic Stachybotrys chartarum spores in rats. Mycopathologia 2000; 149:
19. Marc MM, Korosec P, Kosnick M, Kern I, Flezar M, Suskovic S, Sorli J.
Complement factors C3a, C4a, and C5a in chronic obstructive pulmonary disease
and asthma. American J of Respir Cell and Molecular Biology 2004; 31: 31-33.
20. Arason GJ, Kolka R, Hreidarsson AB, Gudjonsson H, Schneider PM, Fry L,
Arnason A. Defective prevention of immune precipitation in autoimmune diseases
is independent of C4a*Q0. British Society for Immunology, Clinical and
Experimental Immunology 2005; 140: 572-579.
21. Kelk P, Claesson R, Hanstrom L, Lerner UH, Kalfas S, Johansson A. Abundant
secretion of bioactive interleukin-1b by human macrophages induced by
Actinobacillus actinomycetemcomitans leukotoxins. Infection and Immunity
2005; 73(1): 453-458.
22. Romani L. Immunity to fungal infections. Nature Reviews Immunology 2004; 4:
23. Kohl J, Baelder R, Lewkowich IP, Pandey MK, Hawlisch H, Wang L, Best J,
Herman NS, Sproles AA, Zwirner J, Whirsett JA, Gerard C, Sfyroera G, Lambris
JD, Wills-Karp M. A regulatory role for the C5a anaphylatoxins in type 2
immunity in asthma. Journal of Clinical Investigation 2006; 116(3): 783-796.
24. Desjardins AE. Trichothecenes: from yellow rain to green wheat. ASM News
2003; 69(4): 182-185.
25. McCrae KC, Rand T, Shaw RA, Mason C, Oulton MR, Hastigns C, Cherlet T,
Thliveris JA, Mantsch HH, MacDonald J, Scott JE. Analysis of pulmonary
surfactant by Fourier-transform infrared spectroscopy following exposure to
Stachybotrys chartarum (atra) spores. Chemistry and Physics of Lipids 2001; 110:
26. Donohue M, Wei W, Wu J, Zawia NH, Hud N, De Jesus V, Schmechel D, Hettick
JM, Beezhold DH, Vesper S. Nigerlysin, hemolysin produced by Aspergillus
niger, causes lethality of primary rat cortical neuronal cells in vitro. 09/02/05; 1-
27. Vesper SJ, Vesper MJ. Possible role of fungal hemolysins in sick building
syndrome. Advances in Applied Microbiology 2004; 55: 191-213.
28. Jussila JJ. Inflammatory responses in mice after intratracheal instillation of
microbes isolated from moldy buildings. PhD dissertation 01/24/03 National
Public Health Institute, Finland.
29. Vesper SJ, Vesper MJ. Stachylysin may be a cause of hemorrhaging in humans
exposed to Stachybotrys chartarum. Infection and Immunity 2002; 70(4): 2065-
30. Mason CD, Rand TG, Oulton M, MacDonald JM, Scott JE. Effects of
Stachybotrys chartarum (atra) conidia and isolated toxin on lung surfactant
production and homeostasis. Natural Toxins 1998; 6: 27-33.
31. Nikulin M, Reijula K, Jarvis BB, Veijalainen P, Hintikka EL. Effects of intranasal
exposure to spores of Stachybotrys atra in mice. Fundamental and Applied
Toxicology 1997; 35: 182-188.
32. Wilkins CK, Larsen ST, Hammer M, Poulsen OM, Wolkoff P, Nielsen GD.
Respiratory effects in mice exposed to airborne emissions from Stachybotrys
chartarum and implications for risk assessment. Pharmacology & Toxicology
1998; 83: 112-119.
I just wanted to add a few things. To those people saying 'just clean it up with a little bleach' you are wrong. The people who are getting sick HAVE bathroom fans, they have kitchen fans. They do the best to keep humidity down INSIDE of their apartments/homes. The BIG problem with mold is with HIDDEN MOLD and its almost always inside of their walls on the back of sheetrock. There are no laws protecting people and people who complain are often attacked, evicted like my wofe and myself, EVERYTHING.. When the truth is finally acknowledged about mold the next day millions of eviction notices will go out to poor people everywhere. Landlords have known they were poisoning people for years but they thought they could get away with it. When they can't, they will condoize.. The market is broken. Canada has made all detectable toxic mold situations illegal, as of last March. We can't leave these big loopholes. And housing needs to be preserved which means that the repairs need to be done first, then remediation. You can't just stop the leaks, you also need to clean out the old mold on the insides of the wall cavities AFTERWARD. Using containment to prevent cross-contamination.


The fifth and sixth papers linked at the bottom of the first page show graphically why mold in cavities in wood buildings needs to be cleaned out.

Airaksinen M., Kurnitski J., Pasanen P. and Seppänen O., Fungal spore transport through a building structure.
If you live in Las Vegas, Nevada and have visible mold, a local homeowner advocacy group will come to your house and do FREE air sampling.

Las Vegas Lemonade was founded when I bought a new home that was damaged during construction and came with mold. The builder refused to clean the mold and raw sewage for weeks, stating that "by law, we don't even have to wipe that up." --Unfortunately, the builder was right; there are NO laws governing mold. Finally, a local reporter stepped in to help at no charge.

2 years later, Aspergillus/Penicillium (the second most toxic mold) was found in this same home. The Nevada State Contractors Board ruled in my favor and gave my home builder 20 days to remediate the mold or lose their license for the entire state. The Contractors Board is a FREE service for homeowners in Nevada.

As a result of these hardships, I went to mold school and learned how to perform air sampling. I bought professional level equipment to use when mold is visible in local homes.

Las Vegas Lemonade is a homeowner advocacy group that promoted a Nevada New Home Lemon Law during the 2007 Legislative Session. We will try again in 2009. Our website focuses on no-cost resolutions to housing problems.

Robin Vircsik
Founder, Las Vegas Lemonade
We Protect Dreams
Toxic mold poisoning due to a flood underneath our home has changed me from the person I once was, in everything from my physical health to my mental health, and I know it is not just for today, but for the rest of my life. All of this is in addition to the property loss and turmoil that was also a result of it. No-one should ever underestimate what harm mold can do.
I was told about this report by a friend who I confided in today about my frequent bouts of depression.

Over the last three years and have developed multiple health problems such as chronic headaches, sinusitis, ear aches, dizziness, blackouts, muscle/joint pains including limited range of motion, asthma, muscle twitching/seizure like activities, hair loss, abdominal pain, chest pain/palpitations, hives, chronic rhinitis and sleep apnea.
I began to notice that my symptoms would occur while I was at home. After seeing several physicians, I finally got tested for allergies and was found to be highly sensitive to molds. I then got my home tested for molds and it was positive for mold toxins. I have lived in my home for 3 years and have been chronically ill during this period. I was completely healthy prior to living in this home. My 13 year old has developed a lupus like rash and is now being tested for lupus.

Yes, mold does cause illnesses and more research needs to be done with regards to long term effects.
I was a productive, energetic teacher in my school district, but moved into a new school that leaked from day one. I spent 13 years emptying buckets. I had a long term exposure due to a lack of proper remediation responces and building mistakes. Improper remediation exacerbated the problems and my health damage. By the time I was ordered to put 14000 books back on library shelves (same wet books and shelves) I was unable to breathe without hiccup-like gasps for air and intense pains in my chest. My health plumeted from there. I was unable to process any synthetic chemicals (cleaners, fragrances in everything) or petroleum byproducts. I lived indoors pretty exclusivbely with filters for these past three years. My pres coverage continues at :
Currently my school has me on charges and a state education adjudicator is deciding if its legal that they fire me for the very disability they caused, or wil they need to follow the ADA. I was on the cover of the last NYTeacher. The decision will be precedent setting. I am ill from mold gasses, mycotoxins, not allergic, not an allergy, but a poisoning. This was established very early on in workers compenstation court, but hindsight is worth little now. That is, unless people like you are willing to speak truthfully against interests of multi million dollar chemical companies and insurance companies in whose interest any truth hurts profits. But this is CNN Im writing to, and they adverize... "keeping em honest"
I have had severe alergies since I was a young child.The alergy tests also indicated alergies to just about every type of mold. I have tried all my life to avoid mold. In the dry heat of California it was easy. I moved to oklahoma about 5 years ago since then I have had severe problems with both depression and ilneess. I have had 6 bouts with Phnemonia, aproximatly 12 with bronchitis. Not to mention the cronic sinus infections. Due to post nasal drip I have to use a asthma inhaler as well.
Now the reasons why the fisrt apartemtn we lived in I was fine no problems at all 3 months later we moved into our new apartment at first nothing looked wrong but my body knew better, within a few weeks I was very sick about 2 weeks after that we started to see black mold show up in closets and in the water heater chamber. Not just a little, a lot from the baseboards to about 4 feet up the wall. First call I made was to the apartment that just had a person come in and clean it with bleach as if that would fix it and knowing better. Second call was made to the Oklahoma housing athority who cited and fined them then went to inspect other unocupied units in the complex and fined them more. The management company then sold the units to another management company and I had to repeat the procedure still no action was taken to rectify the problem. I went on to spend 8 days in the hospital and then siting the mold situation and threatening to call the housing authority again i was let out of my lease.

The apartment was never fixed or repaired it was cleaned with bleach then repainted.I was so happy to move. Lukaily my new apartment did not have these same problems and ive been a bit healthier, but still chronicaly sick though not a servere as before.I also noticed i felt better when i would have time off work to stay at home.

The move from the moldy apartments also coinsided with a move from one tower to another at my work.A few months later an enginer left an electrical closet open and peered inside as I passed and there it was Black Mold all over one wall of the closet.This time I had to be more careful about filing my complaint I had to find the proper authority and be sure I could submit my complaint anonymously, I reported to OSHA and they in turn notified local agancies. They have indicated that in the public areas of the workplace the spore count is not high enough to cause health problems in the general population. This kind of angerd me.

My workplace is a call center and full of overweight people that in majority are either younger then 24 or older then 55 and most of us are sick at least 3 times a year with a non commumacble illness.I dont know who they use as their general population model of how out of date it is but I can tell you positivly that that mold is affecting all of us here.
To learn more about how to rid yourself to mold toxins go to
Well I have always had allergies on damp days (rain) and it's obviously mold.

And while I'm sure mold can have a depressive effect on people I think that the more likely cause for depression is the caged lives we live among hundreds of square miles of concrete and aspalt, surrounded by extremely rude people. It is inhuman to live like that.

At least we should try to model our cities where one can walk to the store and other places to do errands. I've actually often seen people driving to their mailbox from their apartment to check their mail! And we should create numerous green islands in every neighborhood in cities and suburbs.

Now doesn't that sound more reasonable? After all our ancestors have always been surrounded by molds and spores and such things.
The question I would ask is this, "which came first the devastating illness from the mold or the depression?". From my experience as a professional teacher, the devastation from losing your career, your health, the sense of community that a school provides is reason enough to be depressed. Even greater is the betrayal that most experience when they enter the worker's comp system to find that the school district they once were devoted too, has not only abandonded them but has allowed their insurer to treat them with such disrespect and in many cases joined forces with to try to discredit and humiliate the teachers. This certainly can be a cause of depression. Even when seeking professional help, a person can be turned away as I was because therapists don't want to take patients who are in the middle of a worker's comp case in my state because of the viciousness of the insurer. They don't want records to be obtained, they don't want to be called to testify, etc. Again, doesn't this add to depression? I believe that many of the people I have encountered who have had severe mold exposures are suffering from what I am, which is an adjustment disorder which in turn can cause depression especially when as mentioned above, professional help remains unavailable to the patient. Teachers in particular make good victims of this system because we inherently believe that all people are good. We believe that everyone wants to and will eventually "do the right thing". It's just part of our nature. Unfortunately, it makes us prime targets for insurance companies. Schools are like families. The betrayal of a school district is like a betrayal of a family. The lose of that family is huge. The loss of a career that is more than a job is tremendous. Teaching is not a job, it's a part of a teacher. It can't be seperated. When a teacher can no longer teach due to environmental sensitivies, cognitive damage, chronic fatigue, inflammation, etc. caused by their moldy classroom environment, it's devastating. We aren't malingers or people with psychosomatic illness. We are professionals who did our job and want to get back to our jobs. Simply put, we are and forever will be teachers.
Your article is one of many that are shedding light on the neurocognitve effects of mold and the toxins they produce on human health. Let's just hope that that "light" can shine through the insurance company paid experts. The time is right. But then again, isn't it always the right time to do the right thing?
Thank you Dr. Gupta!!!! Finally this insidious health issue is getting some serious attention. My 10 year old son, my husband and I have been suffering from the dire health effects brought on by toxic mold exposure in 2000.

We have been struggling with our health for over 7-years due to this mold exposure.

Let's add in here for good measure systemic candida for all three of us due to over-prescription of anti-biotics by doctors who were ignorant and un-educated about the seriousness of mold infection (and candidiasis!), also my own chronic mercury poisoning from the several silver amalgams (now all removed) in my teeth.

We have suffered severely, and in my opinion unnecessarily, due to first of all, high-handed doctors or doctors too scared to do further investigation.

My son, who was 2 1/2 years old at the time of the infection (confirmed by one of the only two labs who accurately test for mold in this country!!) now suffers from a learning disability. He was perfectly normal and even above the average mile-stones for his age. This to me is the most depressing aspect of this disease.

The anger we have felt towards the lackadaisical and closed-minded medical establishment has empowered us to search and finally find the answers and some relief and cure from this terrible affliction (not to mention the over $250,0000 to date on medical expenses and lab-tests out-of-pocket because Insurance is just as neanderthal in their attitudes as the AMA when it comes to the real medical problems people face.

And while the medical establishment is FINALLY accepting the link between mold and psychological disorders (and physical disease) let us also mention here that Arizona's "Valley Fever or Coccidiomycosis" is just as dangerous and overlooked, and it is not just confined to Arizonians or certain Californians or New Mexico. People who travel through Arizona or other endemic regions are exposed also. It can have fatal effects on immune-challenged individuals, and are mostly misdiagnosed, especially if the person is not a native to an endemic area.

Let us mention as well chronic candidiasis in people who have been overprescribed anti-biotics and never taught how to re-establish the healthy flora in their bodies after anti-biotic treatment. It is a wide-spread problem and doctors need to start looking at this seriously.

Thank you again for bringing this matter to light.
I live in a house that was built in 1907 and of course there is going to be "things" living the walls etc. Ever since we have moved into the house, I have been diagnosed with depression and been in the hospital several times, the last time, was informed I have no immune system left. And to add to it, I also have asthma. So I will most def follow up iwth the blogs and research on this. We are in the military and will be moving in the summer/fall of next year.
Good article on Mold our Development called Rancho Obispo in San Luis Obispo, CA was an upscale project by RW Hertel & Sons when MOLD was discovered and massive leaks and defects the Builder sued the owners who complained about the Mold to silence them, one home was so mold ridden the builder bought it back when the State Investigators found 51 of the 53 homes built to be defective and not to code the builder changed his name. Many people and children have gotten ill and AP did a story exposing the builder but Medical issues still plague people the story was helpful.
Mold is a big problem for me! I really can't drink wine anymore, or beer from a brew pub. Some wines contain mold, and some beer contains mold. My throat closes if I sip one with mold in it. I suspect is is in the lines, or maybe in the barrel. Cheap wines that are mass produced never affect me. I can microwave any wine and not have a reaction, so that kills the mold. I can't wash mushrooms with my hands, and I can NEVER eat raw mushrooms. They too make my throat close which is very painful.
As I sit here once again and write of how toxic mold has destroyed my quality of life after being affected in February 2006, it sadens me to say that my health has deteriorated that much more. We must as a community of victim’s of these toxin’s, spread awareness, knowledge and support one another in any possible way that we can. There are thousand’s of mold victim’s across the states that need everyone’s help,not just the help of other mold victim’s. We need the medical, political and public to open their eyes, listen with their ears to what we are telling them. Feel free to go on our website’s, or visit our blogs.

I would not ever want to see my loved one’s go through the horror that us mold victim’s experience. Our loved ones experience the turmoil with us, though sometimes not understand to the full extent by them.

When my little grand-daughter of three years old looks up at me and says Gramma, I will take care of you, or Gramma can I sleep over your house. You see, I can not let my grandchildren stay over at Gramma’s house, because Gramma’s house has mold, toxic mold throughout the building by know fault of my own. Will the problem be taken care of, not likely.

As I continue to breath with oxygen, take my nebulizer treatments, take all the medications to help me breath at this stage in my life is like a terrifying nightmare and at sometime I wish I will wake up and it will be gone.

Please feel free to visit my website and join my free forum for awareness, knowledge and support. Pray that this never happens to you or your loved one’s because it takes the once normal life that you had, and turns it completely upside down into horror.

Help support the mold victim’s of the world…spread the word…write to our political arena’s to pass bills that are stalled in congress for air quality regulation’s. For our schools, for our homes, for our workplace.

Visit our new website:
The Nation's Indoor Environment - Toxic Mold
Get a behind-the-scenes look at the latest stories from CNN's chief medical correspondent, Dr. Sanjay Gupta, and the CNN Medical Unit producers. They'll share news and views on health and medical trends -- info that will help you take better care of yourself and the people you love.
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