Checklist for Mold Remediation

As per the US EPA:

Investigate and evaluate moisture and mold problems

Please note that this checklist was designed to highlight key parts of a school or commercial building remediation and does not list all potential steps or problems.

• PDF Version of the Checklist for Mold Remediation (PDF, 1 page, 20KB, About PDF)
• Assess size of moldy area (square feet)
• Consider the possibility of hidden mold
• Clean up small mold problems and fix moisture problems before they become large problems
• Select remediation manager for medium or large size mold problem \
• Investigate areas associated with occupant complaints
• Identify source(s) or cause of water or moisture problem(s)
• Note type of water-damaged materials (wallboard, carpet, etc.)
• Check inside air ducts and air handling unit
• Throughout process, consult qualified professional if necessary or desired

Communicate with building occupants at all stages of process, as appropriate

• Designate contact person for questions and comments about medium or large scale
• remediation as needed

Plan Remediation

• Adapt or modify remediation guidelines to fit your situation; use professional judgment
• Plan to dry wet, non-moldy materials within 48 hours to prevent mold growth (see Table 1 and text)
• Select cleanup methods for moldy items (see Table 2 and text)
• Select Personal Protection Equipment - protect remediators (see Table 2 and text)
• Select containment equipment - protect building, occupants (see Table 2 and text)
• Select remediation personnel who have the experience and training needed to implement the remediation plan and use Personal Protective Equipment and containment as appropriate

Remediate moisture and mold problems

• Fix moisture problem, implement repair plan and/or maintenance plan
• Dry wet, non-moldy materials within 48 hours to prevent mold growth
• Clean and dry mold materials (see Table 2 and text)
• Discard moldy porous items that can't be cleaned (see Table 2 and text)

Questions to Consider Before Remediating

• Are there existing moisture problems in the building?
• Have building materials been wet more than 48 hours? (See Table 2 and text)
• Are there hidden sources of water or is the humidity too high (high enough to cause condensation)?
• Are building occupants reporting musty or moldy odors?
• Are building occupants reporting health problems?
• Are building materials or furnishings visibly damaged?
• Has maintenance been delayed or the maintenance plan been altered?
• Has the building been recently remodeled or has building use changed?
• Is consultation with medical or health professionals indicated?

Avoid Exposure to and Contact with Mold

• Use Personal Protective Equipment (PPE)

For more information go to Source: www.epa.gov/mold

Guidance Document For Management of Mold Related Health Effects

Read the Guidance for Health Professionals - Guidance for Clinicians on the Recognition and Management of Health Effects Related to Mold Exposure and Moisture Indoors (September 30, 2004), published by the Center for Indoor Environments and Health at University of Connecticut Health Center with support from a grant by the U.S. EPA.

For more information, see http://oehc.uchc.edu/clinser/indoor.htm This 120 page document is also available in PDF format from their site http://oehc.uchc.edu/clinser/MOLD GUIDE.pdf

Source: http://www.epa.gov/iaq/molds/index.html

A Brief Guide to Mold, Moisture, and Your Home

As per the USEPA http://www.epa.gov/iaq/molds/moldbasics.html

Why is mold growing in my home?

Molds are part of the natural environment. Outdoors, molds play a part in nature by breaking down dead organic matter such as fallen leaves and dead trees, but indoors, mold growth should be avoided. Molds reproduce by means of tiny spores; the spores are invisible to the naked eye and float through outdoor and indoor air. Mold may begin growing indoors when mold spores land on surfaces that are wet. There are many types of mold, and none of them will grow without water or moisture.

Can mold cause health problems?

Molds are usually not a problem indoors, unless mold spores land on a wet or damp spot and begin growing. Molds have the potential to cause health problems. Molds produce allergens (substances that can cause allergic reactions), irritants, and in some cases, potentially toxic substances (mycotoxins). Inhaling or touching mold or mold spores may cause allergic reactions in sensitive individuals. Allergic responses include hay fever-type symptoms, such as sneezing, runny nose, red eyes, and skin rash (dermatitis). Allergic reactions to mold are common. They can be immediate or delayed. Molds can also cause asthma attacks in people with asthma who are allergic to mold. In addition, mold exposure can irritate the eyes, skin, nose, throat, and lungs of both mold-allergic and non-allergic people. Symptoms other than the allergic and irritant types are not commonly reported as a result of inhaling mold. Research on mold and health effects is ongoing. This brochure provides a brief overview; it does not describe all potential health effects related to mold exposure. For more detailed information consult a health professional. You may also wish to consult your state or local health department.

How do I get rid of mold?

It is impossible to get rid of all mold and mold spores indoors; some mold spores will be found floating through the air and in house dust. The mold spores will not grow if moisture is not present. Indoor mold growth can and should be prevented or controlled by controlling moisture indoors. If there is mold growth in your home, you must clean up the mold and fix the water problem. If you clean up the mold, but don't fix the water problem, then, most likely, the mold problem will come back.

Mold Remediation in Schools and Commercial Buildings

The US EPA has a documented entitled "Mold Remediation in Schools and Commercial Buildings". As per the US EPA's website www.epa.gov/mold/mold_remediation.html -

Concern about indoor exposure to mold has been increasing as the public becomes aware that exposure to mold can cause a variety of health effects and symptoms, including allergic reactions. This document presents guidelines for the remediation/cleanup of mold and moisture problems in schools and commercial buildings; these guidelines include measures designed to protect the health of building occupants and remediators. It has been designed primarily for building managers, custodians, and others who are responsible for commercial building and school maintenance. It should serve as a reference for potential mold and moisture remediators. Using this document, individuals with little or no experience with mold remediation should be able to make a reasonable judgment as to whether the situation can be handled in-house. It will help those in charge of maintenance to evaluate an in-house remediation plan or a remediation plan submitted by an outside contractor. Contractors and other professionals who respond to mold and moisture situations in commercial buildings and schools may also want to refer to these guidelines.

Molds can be found almost anywhere; they can grow on virtually any organic substance, as long as moisture and oxygen are present. There are molds that can grow on wood, paper, carpet, foods, and insulation. When excessive moisture accumulates in buildings or on building materials, mold growth will often occur, particularly if the moisture problem remains undiscovered or unaddressed. It is impossible to eliminate all mold and mold spores in the indoor environment. However, mold growth can be controlled indoors by controlling moisture indoors.

Molds reproduce by making spores that usually cannot be seen without magnification. Mold spores waft through the indoor and outdoor air continually. When mold spores land on a damp spot indoors, they may begin growing and digesting whatever they are growing on in order to survive. Molds gradually destroy the things they grow on.

Many types of molds exist. All molds have the potential to cause health effects. Molds can produce allergens that can trigger allergic reactions or even asthma attacks in people allergic to mold. Others are known to produce potent toxins and/or irritants. Potential health concerns are an important reason to prevent mold growth and to remediate/clean up any existing indoor mold growth.

Since mold requires water to grow, it is important to prevent moisture problems in buildings. Moisture problems can have many causes, including uncontrolled humidity. Some moisture problems in buildings have been linked to changes in building construction practices during the 1970s, 80s, and 90s. Some of these changes have resulted in buildings that are tightly sealed, but may lack adequate ventilation, potentially leading to moisture buildup. Building materials, such as drywall, may not allow moisture to escape easily. Moisture problems may include roof leaks, landscaping or gutters that direct water into or under the building, and unvented combustion appliances. Delayed maintenance or insufficient maintenance are also associated with moisture problems in schools and large buildings. Moisture problems in portable classrooms (see IAQ Design Tools for Schools - Portable Classrooms for more information) and other temporary structures have frequently been associated with mold problems.

When mold growth occurs in buildings, adverse health problems may be reported by some building occupants, particularly those with allergies or respiratory problems. Remediators should avoid exposing themselves and others to mold-laden dusts as they conduct their cleanup activities. Caution should be used to prevent mold and mold spores from being dispersed throughout the air where they can be inhaled by building occupants.

This exerpt was taken from http://www.epa.gov/mold/intro.html

Health Concerns Associated With Mold After Hurricanes

Health Concerns Associated with Mold in Water-Damaged Homes After Hurricanes Katrina and Rita --- New Orleans Area, Louisiana, October 2005

After Hurricanes Katrina and Rita made landfall on August 29 and September 24, 2005, respectively, large sections of New Orleans (Orleans Parish) and the three surrounding parishes (Jefferson, Plaquemines, and St. Bernard) were flooded for weeks, leading to extensive mold growth in buildings. As residents reoccupied the city, local health-care providers and public health authorities were concerned about the potential for respiratory health effects from exposure to water-damaged homes. On October 6, CDC was invited by the Louisiana Department of Health and Hospitals (LDHH) to assist in documenting the extent of potential exposures. This report summarizes the results of that investigation, which determined that 46% of inspected homes had visible mold growth and that residents and remediation workers did not consistently use appropriate respiratory protection. Public health interventions should emphasize the importance of safe remediation practices and ensure the availability of recommended personal protective equipment.

Remaining report can be found at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5502a6.htm

Mold Prevention and Possible Health Effects Report

The duration and extent of flooding and the number of structures flooded as a result of Hurricanes Katrina and Rita make the likelihood of massive mold contamination in buildings a certainty. Many structures remained flooded weeks after the hurricane and became saturated with water. Some early observers suggested that as many as 60% to 80% of residential structures in New Orleans sustained severe flood damage. Outside New Orleans, extensive hurricane damage without prolonged flooding occurred. This more typical pattern of destruction as a result of wind and rain will result in problems with mold, but will not be as extensive as in New Orleans.

This publication provides comprehensive information on how to limit exposure to mold and how to identify and prevent mold-related health effects. It will be especially useful to public health practitioners, health care providers, building managers, custodians, and others who are responsible for building maintenance. Contractors and other professionals (e.g. environmental consultants and other health or safety professionals) who respond to mold or moisture situations in buildings will also find the information of use, as might the public.

The entire publication can be found at http://www.epa.gov/hurricane/pdf/2005_moldreport.pdf

How Can People Decrease Mold Exposure

How can people decrease mold exposure?

Sensitive individuals should avoid areas that are likely to have mold, such as compost piles, cut grass, and wooded areas. Inside homes, mold growth can be slowed by keeping humidity levels between 40% and 60%, and ventilating showers and cooking areas. If there is mold growth in your home, you should clean up the mold and fix the water problem. Mold growth can be removed from hard surfaces with commercial products, soap and water, or a bleach solution of no more than 1 cup of bleach in 1 gallon of water.

If you choose to use bleach to clean up mold:

Never mix bleach with ammonia or other household cleaners. Mixing bleach with ammonia or other cleaning products will produce dangerous, toxic fumes.
Open windows and doors to provide fresh air.
Wear non-porous gloves and protective eye wear.
If the area to be cleaned is more than 10 square feet, consult the U.S. Environmental Protection Agency (EPA) guide titled Mold Remediation in Schools and Commercial Buildings. Although focused on schools and commercial buildings, this document also applies to other building types. You can get it free by calling the EPA Indoor Air Quality Information Clearinghouse at (800) 438-4318, or by going to the EPA web site at http://www.epa.gov/mold/mold_remediation.html. [external link]
Always follow the manufacturer’s instructions when using bleach or any other cleaning product.

Source: http://www.cdc.gov/mold/faqs.htm

Mold Prevention Strategies and Possible Health Effects in the Aftermath of Hurricanes and Major Floods

Summary:

Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a person's health are presented. Evidence is included about assessing exposure, clean-up and prevention, personal protective equipment, health effects, and public health strategies and recommendations. The recommendations assume that, in the aftermath of major hurricanes or floods, buildings wet for >48 hours will generally support visible and extensive mold growth and should be remediated, and excessive exposure to mold-contaminated materials can cause adverse health effects in susceptible persons regardless of the type of mold or the extent of contamination.

For the majority of persons, undisturbed mold is not a substantial health hazard. Mold is a greater hazard for persons with conditions such as impaired host defenses or mold allergies. To prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust.

Clinical evaluation of suspected mold-related illness should follow conventional clinical guidelines. In addition, in the aftermath of extensive flooding, health-care providers should be watchful for unusual mold-related diseases. The development of a public health surveillance strategy among persons repopulating areas after extensive flooding is recommended to assess potential health effects and the effectiveness of prevention efforts. Such a surveillance program will help CDC and state and local public health officials refine the guidelines for exposure avoidance, personal protection, and clean-up and assist health departments to identify unrecognized hazards.

Source www.cdc.gov/mmwr/preview/mmwrhtml/rr5508a1.htm

Molds In The Environment

What are molds?
Molds are fungi that can be found both indoors and outdoors. No one knows how many species of fungi exist but estimates range from tens of thousands to perhaps three hundred thousand or more. Molds grow best in warm, damp, and humid conditions, and spread and reproduce by making spores. Mold spores can survive harsh environmental conditions, such as dry conditions, that do not support normal mold growth.


What are some of the common indoor molds?
Cladosporium
Penicillium
Alternaria
Aspergillus
top

How do molds affect people?
Some people are sensitive to molds. For these people, exposure to molds can cause symptoms such as nasal stuffiness, eye irritation, wheezing, or skin irritation. Some people, such as those with serious allergies to molds, may have more severe reactions. Severe reactions may occur among workers exposed to large amounts of molds in occupational settings, such as farmers working around moldy hay. Severe reactions may include fever and shortness of breath. Some people with chronic lung illnesses, such as obstructive lung disease, may develop mold infections in their lungs.


Where are molds found?
Molds are found in virtually every environment and can be detected, both indoors and outdoors, year round. Mold growth is encouraged by warm and humid conditions. Outdoors they can be found in shady, damp areas or places where leaves or other vegetation is decomposing. Indoors they can be found where humidity levels are high, such as basements or showers

Excerpt from www.cdc.gov/mold/faqs.htm

Frequent Questions About Mold

What are molds?

Molds are tiny microscopic organisms that digest organic matter and reproduce by releasing spores. Molds are a type of fungi and there are over 100,000 species. In nature, mold helps decompose or break-down leaves, wood and other plant debris. Molds become a problem when they go where they are not wanted and digest materials such as our homes.

What makes molds grow in my home?

Mold enters your home as tiny spores. The spores need moisture to begin growing, digesting and destroying. Molds can grow on almost any surface, including; wood, ceiling tiles, wallpaper, paints, carpet, sheet rock, and insulation. The mold grows best when there is lots of moisture from a leaky roof, high humidity, or flood. There is no way to get rid of all molds and mold spores from your home. But you can control mold growth by keeping your home dry.

Can I be exposed to mold?

When molds are disturbed, they release spores into the air. You can be exposed by breathing air containing these mold spores. You can also be exposed through touching moldy items, eating moldy food or accidental hand to mouth contact.

Do molds affect my health?

Most molds do not harm healthy people. But people who have allergies or asthma may be more sensitive to molds. Sensitive people may experience skin rash, running nose, eye irritation, cough, nasal congestion, aggravation of asthma or difficulty breathing. People with an immune suppression or underlying lung disease, may be at increased risk for infections from molds.

A small number of molds produce toxins called mycotoxins. When people are exposed to high levels of mold mycotoxins they may suffer toxic effects, including fatigue, nausea, headaches, and irritation to the lungs and eyes. If you or your family members have health problems that you suspect are caused by exposure to mold, you should consult with your physician.

When is mold a problem?

You know you have mold when you smell the "musty" odor or see small black or white specks along your damp bathroom or basement walls. Some mold is hidden growing behind wall coverings or ceiling tiles. Even dry, dead mold can cause health problems, so always take precautions when you suspect mold.

Mold is often found in areas where water has damaged building materials and furniture from flooding or plumbing leaks. Mold can also be found growing along walls where warm moist air condenses on cooler wall surfaces, such as inside cold exterior walls, behind dressers, headboards, and in closets where articles are stored against walls. Mold often grows in rooms with both high water usage and humidity, such as kitchens, bathrooms, laundry rooms, and basements. If you notice mold or know of water damaged areas in your home, it is time to take action to control its growth.

When should I sample for mold?

You don't need to sample for mold because in most cases you can see or smell mold. Even a clean, dry house will have some mold spores, but not enough to cause health problems. If you smell mold it may be hidden behind wallpaper, in the walls or ceiling or under the carpet. If you suspect you have hidden mold be very careful when you investigate, protect yourself from exposure in the same manner as you would for a clean-up.

http://www.doh.wa.gov/ehp/ts/IAQ/GOT_Mold.html

Aspergillus and Aspergillosis - Part II

How is Aspergillus spread?

Since Aspergillus is so common in the environment, most people breathe in Aspergillus spores every day. It is probably impossible to completely avoid breathing in some Aspergillus spores. For people with healthy immune systems, this does not cause harm, and the immune system is able to get rid of the spores. But for people with compromised immune systems, breathing in Aspergillus spores, especially breathing in a lot of spores (such as in a very dusty environment) can lead to infection. Studies have shown that invasive aspergillosis can occur during building renovation or construction. Outbreaks of Aspergillus skin infections have been traced to contaminated biomedical devices.
What are the symptoms of aspergillosis?
There are many different kinds of aspergillosis, causing different symptoms. As mentioned above, ABPA can cause respiratory symptoms like wheezing, coughing and even fever in people with asthma or cystic fibrosis, and occasionally in people who are otherwise healthy. Aspergillus can also cause allergic sinusitis, and it can cause aspergilloma, or a “fungus ball” in the lung or other organs. Lung aspergillomas usually occur in people with other forms of lung disease, like emphysema or a history of tuberculosis. People with an aspergilloma in the lung may have no symptoms at all. Sometimes they may cough up bloody mucus. People who have invasive aspergillosis in the lung may have symptoms such as fever, chest pain, cough, and shortness of breath. Other symptoms may develop if the infection spreads beyond the lungs. When invasive aspergillosis spreads outside of the lungs, it can affect almost any organ in the body, including the brain.
How is an Aspergillus infection diagnosed?
Your doctor might perform a variety of tests to make the diagnosis. In addition to considering your risk factors, symptoms, and findings on physical examination, your doctor might ask you to have an imaging test performed, such as a chest x-ray or CT scan of the lungs. Also, samples of respiratory secretions or samples from affected tissues may be sent to the laboratory for fungal culture. Biopsies of affected tissue might be taken to look for evidence of the fungus under a microscope. There are other, newer tests that can help monitor for invasive aspergillosis in high-risk persons who are severely immunocompromised.

How can Aspergillus infections be prevented?
It is almost impossible to avoid all exposure to this fungus. It is present in the environment. However, for persons who are very immunocompromised, some measures that may be helpful include: avoidance of dusty environments and activities where dust exposure is likely (such as construction zones), wearing N95 masks when traveling near dusty environments, and avoidance of activities such as gardening and lawn work. Other air quality improvement measures such as HEPA filtration may be used in healthcare settings, and prophylactic antifungal medication may in some circumstances be prescribed by your doctor.

http://www.cdc.gov/nczved/dfbmd/disease_listing/aspergillosis_gi.html

Aspergillus and Aspergillosis - Part I

What is Aspergillus?
Aspergillus is a fungus (or mold) that is very common in the environment. It is found in soil, on plants and in decaying plant matter. It is also found in household dust, building materials, and even in spices and some food items. There are lots of different types of Aspergillus, but the most common ones are Aspergillus fumigatus and Aspergillus flavus. Some others are Aspergillus terreus, Aspergillus nidulans, and Aspergillus niger.

What is aspergillosis?
Aspergillosis is disease cause by Aspergillus. There are many different kinds of aspergillosis. One kind is allergic bronchopulmonary aspergillosis (also called ABPA), a condition where the fungus causes allergic respiratory symptoms, such as wheezing and coughing, but does not actually invade and destroy tissue. Another kind of aspergillosis is invasive aspergillosis, a disease that usually affects people with immune system problems. In this condition, the fungus invades and damages tissues in the body. Invasive aspergillosis most commonly affects the lungs, but can also cause infection in many other organs and can spread throughout the body.

Who gets aspergillosis?
ABPA can affect people who are otherwise healthy, but it is most common in people with asthma or cystic fibrosis. Invasive aspergillosis generally affects people who have compromised immune systems, such as people who have had a bone marrow transplant or solid organ transplant, people who are taking high doses of corticosteroids, and people getting chemotherapy for cancers such as leukemia. Rarely, persons with advanced HIV infection can acquire the infection.

Heath Effects and Symptoms Associated with Mold Exposure

Health Effects and Symptoms Associated with Mold Exposure

When moisture problems occur and mold growth results, building occupants may begin to report odors and a variety of health problems, such as headaches, breathing difficulties, skin irritation, allergic reactions, and aggravation of asthma symptoms; all of these symptoms could potentially be associated with mold exposure.

All molds have the potential to cause health effects. Molds produce allergens, irritants, and in some cases, toxins that may cause reactions in humans. The types and severity of symptoms depend, in part, on the types of mold present, the extent of an individual's exposure, the ages of the individuals, and their existing sensitivities or allergies.

Potential Health Effects Associated with Inhalation Exposure to Molds and Mycotoxins
Allergic Reactions (e.g., rhinitis and dermatitis or skin rash); Asthma; Hypersensitivity Pneumonitis; Other Immunologic Effects

Research on mold and health effects is ongoing. This list is not intended to be all-inclusive.

The health effects listed above are well documented in humans. Evidence for other health effects in humans is less substantial and is primarily based on case reports or occupational studies.
Specific reactions to mold growth can include the following:


Allergic Reactions

Inhaling or touching mold or mold spores may cause allergic reactions in sensitive individuals. Allergic reactions to mold are common - these reactions can be immediate or delayed. Allergic responses include hay fever-type symptoms, such as sneezing, runny nose, red eyes, and skin rash (dermatitis). Mold spores and fragments can produce allergic reactions in sensitive individuals regardless of whether the mold is dead or alive. Repeated or single exposure to mold or mold spores may cause previously non-sensitive individuals to become sensitive. Repeated exposure has the potential to increase sensitivity.

Asthma

Molds can trigger asthma attacks in persons who are allergic (sensitized) to molds. The irritants produced by molds may also worsen asthma in non-allergic (non-sensitized) people.

Hypersensitivity Pneumonitis

Hypersensitivity pneumonitis may develop following either short-term (acute) or long-term (chronic) exposure to molds. The disease resembles bacterial pneumonia and is uncommon.

Irritant Effects

Mold exposure can cause irritation of the eyes, skin, nose, throat, and lungs, and sometimes can create a burning sensation in these areas.

Opportunistic Infections

People with weakened immune systems (i.e., immune-compromised or immune-suppressed individuals) may be more vulnerable to infections by molds (as well as more vulnerable than healthy persons to mold toxins). Aspergillus fumigatus, for example, has been known to infect the lungs of immune-compromised individuals. These individuals inhale the mold spores which then start growing in their lungs. Trichoderma has also been known to infect immune-compromised children.

Healthy individuals are usually not vulnerable to opportunistic infections from airborne mold exposure. However, molds can cause common skin diseases, such as athlete's foot, as well as other infections such as yeast infections.

http://www.epa.gov/mold/append_b.html