http://inspectapedia.com/index.htm The above website is an invaluable resource for most anything about living spaces.

Citing this document: Readers wishing to provide citations of the contents of this atlas may do so by citing this web page InspectAPedia.com/mold/moldatlas.htm or where the original texts are available those should be cited. In some cases where I have been unable to locate an authoritative source of medical information for certain particles I may express an opinion about the possible effects based on field observation and client complaints but such opinions are labeled as such and should not be considered authoritative. Suggestions and criticism are welcomed..

Mold Atlas of Indoor Clinical Mold, Pathogens, Allergens & Other Indoor Particles
InspectAPedia

Atlas of Common Indoor Clinical Mold Species, Pathogens, Allergens, Particles Medical Health Effects of Mold, House Dust Health Effects of Fiberglass, Animal Dander, Insect Fragments, Etc. Photographs of building mold are in this document, elsewhere at this website, and/or are further available from our library on request Questions & answers about the health effects of individual mold genera/species: which building molds cause or contribute to which illnesses?

What are the health effects of specific kinds of mold? Here is a photo-Atlas of common building mold contamination & other indoor particles that describes the medical health effects of mold and indoor particles such as animal dander, cat, dog, mouse dander and dust, asbestos, fiberglass from insulation or other sources, dust mite fecals, house dust, insect fragments, insect hairs, insect fecals, talc, and ultra fine sub micron particles. Dust from the world trade center collapse, and other particles have entries in this list.

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Alphabetic List of Molds and Airborne Particles With a Summary of Particle Toxicity and Clinical References
This guide to harmful indoor mold contaminants contains microphotographs of building mold observed in air, surface, or vacuum samples collected during our building investigations. Citations are collected from a variety of authoritative sources, primarily the authoritative "Clinical Mold and Toxic Particle References" cited in the extensive bibliography at the end of this document. References to online resources are included.
Also see MOLD CLINICAL REFERENCE TEXTS for a guide to clinical references to mold-related illnesses. See MOLD GROWTH on SURFACES for an index of what mold genera/species are frequently found on various building surfaces and materials, and see Mold Related Illness: Index of Symptoms.

Index to Building Mold Genera/Species in This Document Directories of 6 atlases or indices of building mold

1. MOLD ATLAS & PARTICLES INDEX - A-to-Z Mold Atlas of Indoor Clinical Mold, Pathogens, Allergens & Other Indoor Particles 2. MOLD APPEARANCE - WHAT MOLD LOOKS LIKE - What Does Black or Dark Indoor Mold Look Like? Black Mold spores in the Home - a Photo ID Library. What toxic black mold or other indoor mold looks like in buildings. 3. MOLD GROWTH ON SURFACES, PHOTOS - What Does Mold Look Like on Various Materials & Surfaces? An extensive photographic guide to mold as it is found growing on various building materials & surfaces. Also see MOLD GROWTH on SURFACES, TABLE OF - a Table of Kinds of Mold Growth Found on Building Surfaces, lists mold genera/species most often found on specific building surfaces, materials, or contents 4. MOLD in the PETRI DISH, PHOTOS. - Photographs of Mold Growing on Petri Dishes or Mold Culture Plates or Settlement Plates 5. MOLD BY MICROSCOPE - Mold spores under the Microscope - a Photo ID Library for detection and identification of toxic or other mold 6. MOLD RELATED ILLNESS SYMPTOMS - Mold Related Illness: Index of Symptoms. Readers should not rely on this document for medical diagnosis and instead should consult with their physician or with a specialist such as a medical toxicologist
NOTICE: This Mold and Airborne Particle Toxicity Atlas ( 2012 - 1985 DJF All Rights Reserved) is organized alphabetically by mold genera/species or other particle name. For each mold genera/species or for other particles, known medical, allergenic, pathogenic, or toxicological effects are listed. Research on the toxicology of mold and other indoor particles is incomplete and people may express a wide range of symptoms and health complaints which may appear to be related to mold and other indoor contaminants notwithstanding the lack of confirming research.

Information About Individual Mold Genera/Species found in Buildings

A Absidia sp. "A zygomycete fungus. Reported to be allergenic. May cause mucorosis in immune compromised individuals. The sites of infection are lung, nasal sinus, brain, eye and skin. Infections may have multiple sites." U. Minn. [NOTE: Citations labeled U. Minn. refer to the University of Minnesota Department of Environmental Health and Safety - see www.dehs.umn.edu/ --DJF] Acrodictys sp. - -- no medical information was located, i.e. this fungus is not cited in common clinical fungi references which concern fungal species which are pathogens. Where this mold has been found observers should be alert for other fungal species as mold-conducive conditions are present. This fungus may be a woodrotter.-- DJF [NOTE: Citations or comments with the "--DJF" suffix represent the author's opinion and without further research may not be authoritative.]

Acremonium sp. (Cephalosporium sp.) - "Reported to be allergenic. Can produce a trichothecene toxin which is toxic if ingested. It was the primary fungus identified in at least two houses where the occupant complaints were nausea, vomiting, and diarrhea. Asexual state of Emericellopsis sp., Chaetomium sp., and Nectripsis sp. It can produce mycetomas, infections of the cornea and nails." - U. Minn. [See Gliomastix sp. discussion.] Acremonium species are found in soil, sewage, and on vegetation and food and are an airborne spore. Human infections with Acremonium used to be rare but are reported more frequently, associated with hyalohyphomycosis (fungal tumors or masses, or eye infections). Acremonium mold has been associated with systemic infections: endocarditis, osteomyelitis, arthritis, and pumonary infections as well as infections of skin, nails and hard palate. This fungus has also been reported to colonize on contact lenses - Fundamentals of Diagnostic Mycology, Fisher & Cook 1998, excerpted by DF.

Alternaria sp - [Very common mold, widespread outdoors.-DF] A very common allergen with an IgE mediated response. Outdoors it is common in soil, seeds, and on plants. Indoors it is often found in carpets, textiles, and on horizontal surfaces in building interiors. Often found on window frames. The large spore size of Alternaria mold conidiophores suggests that the spores from this fungi will deposited in

the nose, mouth and upper respiratory tract. It may be related to baker's asthma. It has been associated with hypersensitivity pneumonitis. The species Alternaria alternata is capable of producing tenuazonic acid and other toxic metabolites which may be associated with disease in humans or animals. Alternaria sp. can be a common cause of extrinsic asthma (immediate-type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms; chronic cases may develop pulmonary emphysema. -- U. Minn. Dept. of Environmental Health & Safety. A. alternata is an outdoor mold, considered an important allergenic mold. -- labspec.co.za 8/01 -df -- The genus contains 44 species of which most are plant parasites, but a few species are ubiquitous and are also frequently soil-borne. A. alternata is the commonest of these. Although usually seen as saprophytic contaminants, Alternaria species are recognized causative agents of mycotic keratitis and phaeohyphomycosis. Clinical manifestations include cutaneous infections, paranasal sinusitis, osteomyelitis and peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD). Clinical group: Opportunistic mycoses Mycosis: Phaeohyphomycosis -- U. Adelaide Amerospores - one-celled fungal spores generally round to oval with a length/width ratio < 15:1 and without significant curvature or ornamentation. Spores are placed in this "amerospore" general class when the sample in which they are found lacks additional identifying characteristics and when the spores do not by size and ornamentation appear to be commonlyrecognizable instances of Penicillium, Aspergillus, or Basidiomycetes. If large amounts of any un-speciated fungi are present indoors it would be prudent to clean or remove the mold using methods that protect the worker as well as protecting the environment from spread of moldy dust and debris. If only incidental occurrences of amerospores are found in a sample they are not considered significant.

Animal Dander: According to the US EPA and other expert sources, [paraphrasing document cited below] animal skin flakes, urine, feces, saliva, and hair can trigger asthma or other allergic reactions. Dogs, cats, chinchillas, mice, rabbits, rats, other rodents, squirrells, and other mammals can trigger asthma/allergic reaction in people who have an allergy to animal dander. Proteins in these materials have been reported to sensitize people and can cause allergic reactions or can trigger asthma episodes in people who are already sensitive to animal allergens. Our laboratory photographs (below) show domestic rabbit hair (below left) and rabbit dander (below right).

The most effective method to control animal allergens is to remove the animal from the building, followed by thorough [professional] cleaning. The EPA indicates that allergens are found months after a pet (or mouse problem) has been removed. I often find significant levels of allergens in buildings where the source animal(s) have been gone for years if professional cleaning has not been performed. Even when cleaning is thorough I can find allergen materials remaining. While adequate cleaning after animal removal is usually successful, for people who are extremely sensitive even low remaining allergen levels may be a problem, particularly if stirred or distributed by HVAC equipment or other sources of air movement. After removing the pet or pest animal(s), the following measures are recommended: thorough professional duct cleaning, commercial steam cleaning of some materials, dry-cleaning or very hot water laundering of clothing, freezing of small items (to kill dust mites), washing and HEPA vacuuming of interior surfaces. Note that ordinary vacuum cleaning is not effective and may make matters worse for sensitive occupants as it causes allergenic particles to become airborne. Animal dander particles can be less than 1 micron in size and thus may remain airborne for more than 8 hours after vacuuming. Many sources offer advice aimed at keeping a pet in the home: keeping pets out of bedrooms and other sleeping areas and keeping these areas isolated from pet-occupied areas, keeping pets away from fabric-covered furniture, frequent washing of pets, frequent house cleaning using the extensive means described above are all listed. (No expert sources other than drug suppliers cite using medication as the first choice in addressing pet allergies.) However most expert sources agree that " - the most effective method to control exposure to animal allergens is to keep your [building] pet [and animal-pest] free." -- Reference and source for both paraphrasing and quotations above:
http://www.epa.gov/iaq/asthma/triggers/pets.html (keep pets out of building and other advice) also see: www.allergynursing.com/questions/pets.html (keep pets outside), www.cheshire-med.com/programs/pulrehab/asthma/alltrigg.html , (remove pets from building) http://allergy.mcg.edu/advice/pets.html , (avoid pets that have fur), www.nwasthma.com/resources/mitesInfo.htm ,(avoid warm-blooded animals), www.webmd.lycos.com/conent/article/1728.75135 (keep dogs out of the house) Biological Pollutants in Your Home, original source U.S. EPA http://web.archive.org/web/20050923142014/http%3A//www.epa.gov/iaq/pubs/bio_1.html www.epa.gov/iaq/biolobic.html , (vacuuming can increase airborne allergens), http://www.iaq.iuoe.org/iaq_htmlcode/iaq_news_clips (air purifiers don't work) and www.cuhumane.org/topics/allergh.html (if refuse to say goodbye to pets, keep out of bedroom)

Arthrinium: common on dead plants and grasses. Uncertain identification. Arthrographis: "This fungus causes a pink stain in heartwood and sapwood of pine, birch, hemlock, spruce, fir, oak, and Douglas Fir - ; Wang &al (1982) judged A. cuboidea to be a "non-soft rotter," [it does not rot softwoods] Wang & Zabel, "Identification Manual for Fungi from Utility Poles" 1990. Possible association with Onychomycosis (associated to A. kalrae) according to fungusweb.utmb.edu 5/10/2000 [A. kalrae=Oidiodendrum.] fungusweb.utmb.edu/mycology/arthrographis.html . A. cuboidea is one I have found in buildings. - DJF. Onychomycosis is a fungal infection of the fingernails and toenails. The actual infection is of the bed of toenail and of the plate under the surface of the nail. [Thanks to A. Puentes for this note.] Asbestos: see Asbestos Identification in buildings: How to find recognize, and identify asbestos or asbestoscontaining materials in buildings by visual inspection methods - list and photos of asbestos containing building products.

Ascospores: or Ascomycetes are ubiquitous spore with more than 3000 genera. Allergic reaction varies depending on genus and species; they have been poorly studied. Common indoor ascomycetes include Chaetomium and Ascotricha. -- EMLAB www.emlab.com We (DF) find these spores individually in air samples indoors and outside, and we find them in dense profusion on occasion on decaying building surfaces. Our remarkable photograph of an ascomycete shown here is Pleospora in the process of being born, collected from a wood post in a building basement by our associate Craig Balchunas and identified in our lab by the author D. Friedman.

Aspergillus/Penicillium: [Common in indoor environments where moisture or flooding have occurred, where it is commonly found in carpet, wallpaper, and in interior fiberglass building or HVAC duct insulation--DF] Also referred to as "Pen/Asp," this category is used to report spores when found without sufficient accompanying details or associated fungal material to distinguish reliably between the two genera, and where additional steps to further identify to genera and species (for example by culture) is not requested or not warranted. Often the identification of these two species is combined as their spores are nearly impossible to differentiate by microscopy unless the underlying mold structure can also be found. The Aspergillus genus contains over a hundred species of which 15 are commonly found in residential buildings. Penicillium genus is similar. A wide number of organisms have placed in this genera. Identification to species is difficult and can require multiple

cultures. Often found in aerosol samples. This pair of genera is commonly found in soil, food, cellulose and grains. It is also found in paint and compost piles. It may cause hypersensitivity pneumonitis, allergic alveolitis in susceptible individuals. It is reported to be allergenic (skin). Some species can produce mycotoxins. Common cause of extrinsic asthma (Immediate type, hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema. Some are more toxic than industrial cancer-causing substances and are acutely toxic to the liver, brain, kidneys, and heart. Symptoms of acute aflatoxicosis are fever, vomiting, coma, and convulsions. Symptoms that occur in most moderately contaminated buildings are not fully known but are expected to be less severe. Toxicity, even within a particular strain, may vary depending on the particular growth conditions. My lab work often does not identify the sub-species of this genus so we do not know if very dangerous species are present in the building. Most of these spores when found growing indoors are toxigenic or allergenic. Given the risks of serious illness cleanup should be handled carefully and with expert advice. People with other illnesses or compromised immune systems (chemotherapy, bronchiectasis, carcinoma, or other mycoses) are at particular risk. Any environment where this mold/fungus is found is a potential health hazard. -- U. Minn. and others. A. fumigatus may be low-count in air but high in localized areas. Diseases including Farmers Lung, invasive aspergillosis, and aspergiloma are linked to this mold. A. fumigatus and A. niger (which is shown in the photograph just above), appear to be allergenically distinct from A. versicolor, nodulus, and glaucus groups. -labspec.co.za 8-01. See www.aspergillus.man.ac.uk The Aspergillus Website. Aspergillus sp.: " - especially A. fumigatus, is one of the few genera of opportunistic pathogens consistently associated with disease. Aspergillosis is the general term for the infection caused by any species of Aspergillus. Four leading types of Aspergillosis are colonization, allergy, disseminated infection, and toxicity. Pulmonary colonization and allergic reactions are induced by inhalation of large numbers of conidia."-Fundamentals of Diagnostic Mycology, Fisher & Cook. Reported to be allergenic. Members of this genus are reported to cause ear infections [Mould Allergy, Yousef Al-Doory and Joanne F. Domson, Lea and Febiger, Philadelphia, 1984]. Many species produce mycotoxins which may be associated with disease in humans and other animals [ibid.]. Toxin production is dependent on the species or a strain within a species and on the food source for the fungus. Some of these toxins have been found to be carcinogenic in animal species. Several toxins are considered potential human carcinogens [Dangerous Properties of Industrial Materials, 7th Edition, N.Irving Sax and Richard J. Lewis, Sr., Van Nostrand Reinhold, New York, New York, 1989.] Common cause of extrinsic asthma (immediate-type hypersensitivity: type I) [Manual of Medical Mycologyby John thorne Crissy, Heidi Lang, Lawrence Charles Parish, Blackwell Sciences, Cambridge, Massachusettes, 1995]. Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema [Ibid.]. The Aspergillus genus contains over 170 species of which 15 are commonly found in residential buildings. A wide number of organisms have placed in this genera. While some species can be identified from field samples, identification to species is generally difficult even using culture methods. PCR methods can speciate if data is already in the PCR database. Often found in aerosol samples. Commonly found in soil, food, cellulose and grains. It is also found in paint and compost piles. Of the 170, 16 species and one variety have been found to cause Aspergillosis, a respiratory illness in humans. It may cause hypersensitivity pneumonitis, allergic alveolitis in susceptible individuals. It is reported to be allergenic (skin). It is commonly found in carpet, wallpaper, and in interior fiberglass duct insulation. Some species can produce mycotoxins. Common cause of extrinsic asthma (type-type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema.

Most of these spores are toxigenic or allergenic. Some are more toxic than industrial cancer-causing substances and are acutely toxic to the liver, brain, kidneys, and heart. Symptoms of acute aflatoxicosis are fever, vomiting, coma, and convulsions. Symptoms that occur in most moderately contaminated buildings are not fully known but are expected to be less severe. Given the risks of serious illness cleanup should be handled carefully and with expert advice. People with other illnesses or compromised immune systems (chemotherapy, bronchiectasis, carcinoma, or other mycoses) are at particular risk. Any environment where this [Aspergillus] mold/fungus is found [at contamination levels] is a potential health hazard. -- U. Minn., Fundamentals of Diagnostic Mycology, Fisher & Cook, Identifying Filamentous Fungi, St.Germain and Summerbell, and others. A. fumigatus may be low-count in air but high in localized areas. Diseases including Farmers Lung, invasive aspergillosis, and aspergiloma are linked to this mold. A. fumigatus and A. niger appear to be allergenically distinct from A. versicolor, nodulus, and glaucus groups. -labspec.co.za 8-01. See www.Aspergillus.man.ac.uk The Aspergillus Website. Aspergillus, a general opinion: texts and expert resources are not fully consistent in level of concern regarding the health risk of exposure to Aspergillus spores. Depending the individual Aspergillus member species, on the size of the mold reservoir, the ease of spore movement from mold reservoir to occupied areas, the health and level of exposure of individuals being exposed, particular colony characteristics which may be influenced by the material and conditions on and under which the mold is growing, and variations in building conditions which can cause drastic changes in the amount of airborne spores in the environment, the level of risk to human health ranges from significant to insignificant. It is prudent to be cautious and thorough in cleaning or removing this mold from building interiors and it would be particularly advised for people who are at-risk to avoid any exposure. -DF Aspergillosis: "Although metabolites of species of Aspergillus (Hyphomycetes) cause other health problems, such as acute and chronic aflatoxin poisoning, we are concerned here only with diseases caused by the growth of the fungus itself somewhere in the body. Bronchopulmonary aspergillosis is usually caused by Aspergillus fumigatus, which colonizes mucus within the bronchi, evoking a severe allergic reaction. In Aspergilloma, the fungus forms a mycelial ball in a lung cavity produced by an earlier attack of tuberculosis. The wall of the cavity may erode, causing the patient to spit blood, and necessitating surgical intervention. Invasive aspergillosis is found only in patients who are severely debilitated, or are immunosuppressed, as in AIDS. The fungus grows outward from the lung, invading blood vessels and spreading to other organs through the bloodstream. This insidious disease is usually fatal, and is often diagnosed only when an autopsy is performed." - The Fifth Kingdom, Chapter 23, Bryce Kendrick. Aspergillus: specific species Aspergillus candidus: "Associated with respiratory complaints in a recent house investigation. Can produce the toxin petulin which may be associated with disease in humans and other animals." - U. Minn. Aspergillus carneus: occasionally pathogenic - U Minn. Aspergillus clavatus: "Can produce the toxin petulin which may be associated with disease in humans and other animals. This species is only occasionally pathogenic." - U. Minn. DJF note: check for more severe opinions at other sources. Aspergillus deflectus: occasionally pathogenic - U. Minn. Aspergillus flavus: "Some strains are capable of producing a group of mycotoxins - in the aflatoxin group. Aflatoxins are known animal carcinogen. There is limited evidence to suggest that this toxin is a human carcinogen. The toxin is poisonous to humans by ingestion. It may also resulting occupational disease via

inhalation. Experiments have reported to be allergenic. Its presence is associated with reports of asthma. It can be found in water damaged carpets. The production of the fungal toxin is dependent on the growth conditions and on the substrate used as a food source. This fungus is associated with Aspergillus of the lungs and or disseminated aspergillosis. This fungus is occasionally identified as the cause of corneal, otomycotic and nasoorbital infections." - U. Minn. Aspergillus fumigatus: "Major cause of aspergillosis. Both invasive and allergic aspergillosis are caused by this organism. Aspergillosis affects individuals who are immune compromised. It is considered a human pathogen." - U. Minn. "This is the species of Aspergillus most frequently isolated from human patients." -- Fundamentals of Diagnostic Mycology, Fisher & Cook, p.47. These authors continue with "A. fumigatus and other species are exogenous (literally, "generated outside" - not part of the normal flora), and are not infectious. Typically people are at risk only when they are seriously debilitated or weakened as a result of another disease process ( - or treatment for some life-threatening illness). Injuries or infections that cause scarring of the lung tissue may predispose a person to an aspergillosis, especially an aspergiloma." - ibid. -- DF Aspergillus glaucus: "Common outdoor fungus in winter. It is reported to be allergenic. This species is only occasionally pathogenic. It can grow on leather. This fungus can grow at low moisture levels on grain, sugary food products, meat and wool." - U. Minn. "Pathogenicity: Only a few cases of pulmonary or disseminated infection have been reported from immunocompromised patients." -- Identifying Filamentous Fungi, St.Germain and Sumemrbell. Aspergillus nidulans:"Can produce the mycotoxin sterigmatocystn. This toxin has been shown to produce liver and kidney damage in lab animals. This fungus is associated with aspergillosis of the lungs and or disseminated aspergillosis. This species is only occasionally pathogenic." According to U. Minn. However de Hoog et als (Atlas of Clinical Fungi) report that "this species has been reported as an etiologic agent of diverse infections in humans and animals, either alone or in association with other opportunistic fungi, among them pulmonary infections, sinusitis, osteomyelitis, and superficial as well as disseminated infections." - 2010 DJ Friedman Aspergillus niger: "Less common cause of aspergillosis. It has a musty odor. It is commonly found on textiles, in soils, grains, fruits, and vegetables. It has been reported to cause skin and pulmonary infections. It is a common cause of fungal related ear infections-otomycosis." - U. Minn. Aspergillus ochraceus: "Found in grains, soil, and salted food products. It is not usually associated with decaying vegetation. Can produce a kidney toxin ochratoxin A which may produce ochratoxicosis in humans. This is also known as Balkan nephropathy. The ochratoxin may also be produced by other Aspergillus sp. and Penicillium sp. Other toxins which can be produced by this fungus include penicillin acid, xanthomegnin and viomellein. These are all reported to be kidney and liver toxins." - U. Minn. Aspergillus oryzae: occasionally pathogenic. - U. Minn. Aspergillus parasiticus: "Some strains are capable of producing a group of mycotoxins - in the aflatoxin group. Aflatoxins are known animal carcinogen. There is limited evidence to suggest that this toxin is a human carcinogen. The toxin is poisonous to humans by ingestion. Experiments have indicated that it is teratogenic and mutagenic. It is toxic to the liver. The production of this fungal toxin is dependent on the growth conditions and on the substrate used as a food source." - U. Minn. Aspergillus penicilloides: Conidia dimensions 3-3.5 x 4-5 microns [abbreviated further as "u" in this document]. C"Mould Allergy," Yousef Al-Doory and Joanne F. Domson, Lea and Febiger, Philadelphia, 1984.] Aspergillus restrictus: This species is only occasionally pathogenic. - U. Minn.

Aspergillus sydowi: This species is only occasionally pathogenic. ["Manual of Medical Mycologyby," John thorne Crissy, Heidi Lang, Lawrence Charles Parish, Blackwell Sciences, Cambridge, Massachusettes, 1995.] Aspergillus terreus: Conidia dimensions 1.8-2.4u / 2 - 2.5u. Aleurospores 6 - 7u in diameter are also produced. Found in warmer soil and in grains, straw. cotton and decomposing vegetation Can produce the toxin patulin and citrinin which may be associated with disease in humans and other animals. This fungus is associated with aspergillosis of the lungs and or disseminated aspergillosis. Found as an isolate from otomycosis - ear infection and onychomycosis - infection of finger or toe nails.[Op.cit.Mould Allergy & Manual of Medical Mycology]. -U. Minn. Aspergillus ustus: This species is only occasionally pathogenic [Op. Cit. Manual of Medical Mycology]. - U. Minn. Aspergillus versicolor: Conidia dimensions 2-3.5u It is commonly found in soil, hay. cotton and dairy products, It can produce a mycotoxin sterigmatocystin and cyclopiaxonic acid. These toxins can cause diarrhea and upset stomach. It is reported to be a kidney and liver carcinogen. This species is only occasionally pathogenic. [Op.cit.Mould Allergy][Op. Cit. Manual of Medical Mycology] - U. Minn. OBS - Aspergillus sp.: Reported to be allergenic [Burge, H.A. 1985. "Fungus allergens," Clin. Rev. Allergy , 3:19-329]. Members of this genus are reported to cause ear infections. Many species produce mycotoxins which may be associated with disease in humans and other animals. Toxin production is dependent on the species or a strain within a species and on the food source for the fungus. Some of these toxins have been found to be carcinogenic in animal species. Several toxins are considered potential human carcinogens [Dangerous Properties of Industrial Materials, 7th Edition, N.Irving Sax and Richard J. Lewis, Sr., Van Nostrand Reinhold, New York, New York, 1989] Common cause of extrinsic asthma (immediate-type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema [Op.cit.Mould Allergy] [Op. Cit. Manual of Medical Mycology] - U. Minn. Aspergillus sydowi: This species is only occasionally pathogenic [Op. Cit. Manual of Medical Mycology]. Aspergillus terreus: Conidia dimensions 1.8-2.4u to 2 - 2.5u. Aleurospores 6 - 7u in diameter are also produced. Found in warmer soil and in grains, straw. cotton and decomposing vegetation. Can produce the toxin patulin and citrinin which may be associated with disease in humans and other animals. This fungus is associated with aspergillosis of the lungs and or disseminated aspergillosis. Found as an isolate from otomycosis - ear infection and onychomycosis - infection of finger or toe nails [Op.cit.Mould Allergy][Op. Cit. Manual of Medical Mycology] - U. Minn.

Aureobasidium: typically Aureobasidium pullulans, this is a common species found in leaves, soil, wood materials, paper, leather, cotton, and on paint, plastic, concrete, and some optical lenses. It is common on bathroom walls and shower curtains, often perceived as "mildew," and it also is found outdoors on siding. "This yeast-like fungus is commonly found on caulk or damp window frames in bathrooms. Aureobasidium may be pink or black in color. Although Aureobasidium mold exposure seldom causes infections, it can be allergenic. This is one type of mold that is a type of mildew [That comment is almost certainly incorrect: Aureobasidium is not a mildew, since per Haines mildew is an obligate parasite growing only on living plants - DF]. It will grow in cooler climates and along with Cladosporium is commonly found growing on siding." -- Cit: restcon.com/links/articles/mold_and_mildew.html -- Aureobasidium sp. is typically fast-growing black, brown, cream, or pink colonies, one of several genera of "black yeasts." Common world-wide, usually found as a saprophyte (causing wood decay), and occasionally from skin and nails. Clinical group: opportunistic mycosis; Mycosis: Phaeohyphomycosis; -- Ref: Mycology online, Malloch Lab (U. Toronto), and fungus web at U.Texas. - in buildings unlikely to be a human pathogen, may be allergenic "Black mold" in attics when found as discoloration on the under-side of roof sheathing, particularly plywood roof sheathing, is frequently Aureobasidium pullulans as shown in the photograph here. In this photgraph of Aureobasidium pullulans in a tape sample lifted from an area of black-stained plywood roof sheathing where no obviously moldy material was visible to the naked eye (just discolored black plywood roof decking), this fungus was growing on and in wood fibers pulled from the plywood roof decking by our tape sample. This is typical of the black discoloration seen on roof sheathing in attics where there has been excessive moisture on those surfaces such as from roof leaks or due to condensation in an inadequately-vented attic. While we find this fungus on wood building surfaces we do not usually find it at any significant level in indoor air--Opinion: DF.

B Bacteria-like material: Bacteria-like material or Bacteria-covered skin scales, fibers, or mite fecals should be taken as a tip to look for and reduce sources of water entry or moisture. If the sample appears to contain significant levels of bacteria you should also be looking for a possible source such as a sewage backup or burst

drain piping which could have left pathogens in the building. Airborne skin scales may carry pathogens such as bacteria which, on occasion, can be visible as sub-micron structures on individual scale particles. High levels of bacteria (not fully determined by microscopic examination) could indicate other biological contamination and health risks including pathogenic hazards such as harmful bacteria or viruses. Where this evidence is present, where there is a history of sewage leaks or backup in a building, or where building-related illness is suspected and we have not found obvious mold or allergens, additional testing for bacteriological or viral hazards should be considered. Other possible sources of bacterial or viral pathogens include aerosolized droplets from a humidifier or air conditioner, and soil dust, for example from a basement or crawl space where there has been a sewage spill or where animal fecal waste has been deposited. [Although bacteria may be visible in environmental particle samples, (and will be reported here) bacteria and viruses are beyond the scope of my inspection and are not my expertise.]-DF Also see: Indoor Air Quality Investigations: Sewage or Septic contamination in buildings - -DF

Basidiomycetes- Fungal spores which are from mushrooms. The specific mushroom species cannot be identified on the culture plate. Many mushroom spores are reported to be allergenic. -- U. Minn." Frequently associated with dry rot, Basidiomycetes are primarily mushrooms, toadstools, puffballs, rusts and smuts. High levels of these spores can contribute to allergies in indoor environments. Poria incrassata (Meruliporia incrassata) is a particularly destructive fungal organism that falls into this classification. "Poria"has resulted in the collapse of severely infested buildings." -- Cit: .restcon.com/links/articles/mold_and_mildew.html When basidiomycete mold spores are found indoors in quantity I recommend additional inspection to identify the source of this mold and extent of its presence as it's likely to be found in areas of wet conditions where there is risk of rot or other structural damage. (Search our website for Meruliporia for more information about house eating fungi. Our mold photograph shown here is of Ganoderma applanatum collected by the author during a building inspection. When this spore is being released it is ubiquitous in air samples and we almost always find at least a few of these spores in indoor and outdoor air and often in settled dust indoors or outside. Another important interpretation of high levels of indoor Basidiomycetes might be the indication of wet conditions and wood-rot as an indicator of a higher risk of presence of other health-complaint problematic molds such as Aspergillus/Penicillium spores or Stachybotrys chartarum spores - three groups of molds which are common in wet buildings and which are often associated with IAQ and health complaints.- DJF

Beauvaria sp.: often,B. bassiana. This is a cosmopolitan soil fungus, also isolated from parasitised insects (muscardine disease of the silkworm). Beauvaria is rarely responsible for infection in humans or animals, causing rare cases of keratitis, and one case of Pneumonia has been reported in an immunocompromised patient. -Identifying Filamentous Fungi, StGermain and Summerbell. Elsewhere this fungus is described as a "virulent insect pathogen," with confirmation that infections in humans are rare. The pulmonary infection reported by Freour (1966) was probably Acrodontium sp. A pulmonary infection has also been reported in a captive American alligator and in a tortoise. - Atlas of Clinical Fungi, deHoog et als. Sources paraphrased by DJ Friedman. Biological Pollutants in the Home - general guidance from the US EPA - BIOLOGICAL POLLUTANTS in the
HOME - EPA

Bipolaris sp. -(photo at left) A fungus with large spores which would be expected to be deposited in the upper respiratory tract. Bipolaris fungus can produce the mycotoxin - sterigmatocystin which has been shown to produce liver and kidney damage when ingested by laboratory animals. U. Minn.

Bispora sp. - No medical information at hand. In absence of data it is reasonable to expect fungal spores to be allergenic if present indoors at high levels. Bispora is a widespread fungus found in temperate climates. Bispora betulina is found in buildings on wood in wet areas. It can cause soft-rot wood decay. - Identification Manual for Fungi from Utility Poles in the Eastern United States, CJK Wang and RA Zabel, 1990; The Atlas of Clinical Fungi, 2nd Ed., deHoog et als, 2000, does not cite this genus as associated with known illnesses (p. 1016). Blastomyces sp. - Human pathogen. The fungus is commonly found in soil. It is a dimorphic fungus which has filamentous fungus when grown at 25 degrees C and a yeast form at 37 degrees C. -- U. Minn. Botrytis sp.- Reported to be allergenic. It is parasitic on plants and soft fruits. Found in soil and vegetables. Possibly associated with allergic symptoms (skin tests). U. Minn. Cf labspec.co.za also. Associated with plants, can cause allergic asthma. www.restcon.com/links/articles/mold_and_mildew.html

C Candida sp.: "=Part of the normal flora of mouth and other mucous membranes in the body. Thrush and other diseases caused by Candida albicans usually occur after prolonged treatment with antibiotics or steroids. The environment is not a likely source of exposure for this fungus. Cells from the organism are usually not airborne [Atlas of Moulds in Europe causing respiratory Allergy, Foundation for Allergy Research in Europe, Knud Wilken-Jensen and Suzanne Gravesen, Eds. ASK Publishing, Denmark, 1984.]. Reported to be allergenic [Op. Cit. Burge, H.A. 1985. "Fungus allergens,"]." - U. Minn. Capronia sp.(Ascomycete) - teleomorph (sexual stage) of Cladophialophora - Atlas of Clinical Fungi DeHoog et als. See Cladophialophora. Cellulose and plant fragments: most likely due to open windows and outside leaf blowing and mulching, likely to be a temporary spike in occurrence. Other plant fragments and plant trichomes found in some of my samples are very common indoors and do not indicate a problem in most cases.

Ceratocystis/Ophistoma sp. - C. piliferumand C. virescens are common dark molds found on the surface of framing lumber in construction. Gonatobotryum is a mycoparasitic mold (a fungus parasitizing another fungus) that is often found growing on C/O group. The C/O group is not reported to infect humans or animals. Details about this fungus are at BLACK MOLD, HARMLESS
COSMETIC

A connection between Ophiostoma and the human pathogen Sporothrix schenckii has been proposed but not confirmed. The C/O group is probably present in a very large number, arguably a majority, of wood framed buildings. It could therefore be inferred that the health risks are very low and the issue for this group of fungi is largely cosmetic-paraphrased by DF from EMLab's Pyam Fallah 6/04. The presence of this species inside a building on framing lumber is called "blue stain" or "sap stain" and is cosmetic - Haines & Gallup 10/01 to DF; Ceratocystis fimbriata is a plant pathogen causing blue rot, Dutch elm disease, oak wilt and cacao wilt. - Iowa State University. Also, see Ophistoma sp. Ceratocystis fimbriata fungal contamination in sweet potato leads to the production of ipomeamarone, a hepatoxin, while other metabolites like 4-ipomeanol are pulmonary toxins. Baking destroys only 40 percent of these toxins. Catalano et al. (1977) reported that peeling blemished or diseased sweet potatoes from 3 to 10 mm beyond the infested area is sufficient to remove most of the toxin. See Ceratocystis and Ophistoma, Taxonomy, Ecology, and Pathogenicity, Wingfield, Siefert, and Webber, Ed., APS press, 1993. Cerebella sp. - -- no medical information was located, i.e. this fungus is not cited in common clinical fungi references which concern fungal species which are pathogens. Where this mold has been found observers should be alert for other fungal species as mold-conducive conditions are present. This fungus may be a woodrotter.-- DJF

Chaetomiumsp. Large ascomycetous fungus producing perithecia. It is found on a variety of substrates containing cellulose including paper and plant compost. It has been found on paper in sheetrock. Chaetomium is reported to be allergenic. -- U. Minn. Commonly found indoors are C. globosum and C. funicola.-DJF. Associated with a "musty odor" indoors, and while not well studied, some rare compounds may be reported as mutagenic. Where this mold is found indoors, you should consider it a water/wet condition indicator, which means that other problematic molds may be present - further investigation may be appropriate. Chaetomium is a common cause of soft-rot in buildings - look for structural damage -- DJF Chains of mold Spores such as Pen/Asp, in chains:The presence of mold spores in chains suggests that there is some active mold growth in this building. These chains are so fragile that if mold were only entering from outdoors it is more likely that I would only see single spores or very small fragments. Chlamydospores: are thick-walled resistant spores which develop to permit a fungal species to survive in a dormant state, typically waiting for more favorable conditions for growth. They are an indication of conditions previously favorable to fungal growth, and can produce future fungal activity. -- Illustrated Dictionary of Mycology, Ulloa & Hanlin, American Phytopathological Society, 2002. Chrysosporium: This is a common fungus found on dead organic material (saprobe). occasional reports of skin and nail infections are questioned by Germain/Summerbell. One species has been (rarely) substantiated as an agent of onchomycosis -- Identifying Filamentous Fungi, Germain and Summerbell; " - isolated as a rare cause of hyalohyphomycosis, endocarditis, osteomyelitis, and adiaspiromycosis - (enlargement of conidia in tissue without replication, at high temperature)" - Fundamentals of Diagnostic Mycology, Fisher, Cook; both sources paraphrased/quoted by Daniel Friedman. Cladophialophora sp. -velvety to powdery to woolly gray-green to olive green to black (front) and black (reverse) colonies (in culture), absent or inconspicuous conidiophores. Hyphae are septate, brown. Conidia: one-celled dry spores arising in long, poorly-branched, often coherent chains, conidial scars nearly unpigmented, or per Dr. Fungus, no attachment scares are visible. Conidia are smooth, (or occasionally echinulate or mixed C. bantiana), lemon-shaped (C. bantiana, C. carrionii) or round (C. boppi). Pathogenic to humans.

Each Cladophialophora species provokes a mycosis characteristic for that species. C. bantiana causes cerebral phaeohyphomycosis in humans and is usually fatal. The fungus is probably introduced by inhalation; it is opportunistic in immune-compromised patients. Tolerant to cycloheximide, intolerant to benomyl. C. boppi & C. carrionii are a relatively common cause of chromoblastomycosis, localized skin and subcutaneous lesions leading to superficial, warty, cauliflower-like tumors when introduced by cutaneous injury - trauma and exposure to soil are main predisposing factor for this species. C. boppi may also cause skin lesions. C. devriesii has been reported to cause disseminated phaeohyphomycosis. - doctorfungus.org & Atlas of Clinical Fungi DeHoog et als. Any building where this mold family is present or even might be present should be treated with extreme caution and professional inspection, remediation, and if appropriate, medical advice obtained promptly-opinion of DJF.

Cladosporium sp. (Hormodendrum sp.). [Most commonly identified outdoor fungus, and existing in a great many varieties (possibly 50).-DF] The outdoor numbers are reduced in the winter. The numbers are often high in the summer. Often found indoors in numbers less than outdoor numbers. It is a common allergen. Indoor Cladosporium sp. may be different (C. sphaerospermum) than the species most often identified outdoors (C. herbarum, C.sporoioides C. acaciicola) but the outdoor species often accompany indoor brethren in samples. Cladosporium sphaerospermum (photo at left) and some other C. sp. species is commonly found on the surface of fiberglass duct liner in the interior of supply ducts. We also find this mold growing on painted block walls in basements and crawl spaces. Cladosporium sphaerospermum (and some other species of Cladosporium) can cause mycosis. Produces greater than 10 antigens. Common cause of extrinsic asthma (Immediate type, Hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema . -U. Minn. -- labspec.co.za - allergenic; additional editing of U. Minn text by DJF. Cladosporium fulvum (Fulvia fulva): "Conidia dimensions 12-47 x 4-10u. It is found on the leaves of tomatoes" [Op.Cit. Mould Allergy , Yousef Al-Doory et als.]. - U. Minn.

Cladosporium herbarum: Conidia dimensions 5-23 x 3-8u. It is found on dead plants, woody plants, food, straw, soil, paint and textiles [Op.Cit. Mould Allergy , Yousef Al-Doory et als.] - U. Minn. Cladosporium macrocarpum: Conidia dimensions 9-29 x 5-13u. It is found on dead plants, woody plants, food, straw, soil, paint and textiles [Op.Cit. Mould Allergy , Yousef Al-Doory et als.] - U. Minn. Cladosporium sphaerospermum: Conidia dimensions 3-4.5u. It is found as a secondary invader of plants, food, soil, paint and textiles [Op.Cit. Mould Allergy , Yousef Al-Doory et als.] - U. Minn. This spore is often found indoors in buildings and by my field experience much less often in outdoor air samples. - DJF. Clay: used in ceramics, many ingredients such as additives and glazes may pose particular respiratory health hazards. Some articles addressing a few of these concerns are at http://www.claytimes.com/index_S.htm In addition to asbestosis, cobalt or cadmium poisoning, kaolinosis, lead poisoning, silicosis, "Hypersensitivity pneumonia, asthma, or other respiratory problems may occur with exposure to molds growing in wet clay that is being soured or aged in a damp place, in slips that stand for months, or with inhalation of dry aged clay. Molds can cause or exacerbate skin problems and change the workability of clay." -- Princeton University's Art Safety Guide. This resource provides a good summary of hazards from clay and its common constituents. Guide: http://web.princeton.edu/sites/ehs/artsafety/sec12.htm. Also see http://www.goshen.edu/art/DeptPgs/Hazards.html "Hazards in Ceramics". Kilns in basements present particular hazards (of hazardous condensates) if they are not expertly and reliably vented. Also see Clay, Talk, Nephaline syenite, Cornwall Stone. Cornwall stone: repeated exposure risks silicosis. http://www.lagunaclay.com/msds/2glaze/GR19.pdf Also see Clay, Talk, Nephaline syenite, Cornwall Stone. Cryptococcus sp. Cryptococcus neoformans, a blastomycete, is widespread and is particularly likely to be found where pigeons (or other birds) have roosted. It has been found in dairy products, fruits, and vegetables. With a typical size of 2u, these spores can be inhaled deeply into the lung alveoli where they establish colonies and can cause disease. It is an opportunistic pathogen which can cause meningitis (life-threatening meningoencephalitis) in immunocompromised patients. "Exposure to soil contaminated with pigeon excrement (and possibly Cryptococcus) is particularly hazardous to those who are immunosuppressed." Quoted and paraprased from Fundamentals of Diagnostic Mycology, Fisher & Cook -- DJF. The fungus, Cryptococcus neoformans, "has two sexes, alpha and a, but the vast majority of C. neoformans isolates seen clinically and in the environment are alpha, leaving them with apparently few chances to mate. It turns out, though, that the alpha C. neoformans go through a process known as "fruiting," which researchers thought was asexual" but apparently isn't after all. - paraphrased from Science magazine quoting Nature magazine, 2005. [LAB NOTE: Prepare suspect samples in India ink and look for the characteristic white circles against the black background -see Fisher Cook 7.16 p. 213. ]

Cockroach allergens: the principal sources of cockroach allergen are roach body parts, egg casings, and digestive secretions. These cockroach allergens, typically larger than the most problematic mold spores, tend to settle quickly from the air but will remain on building surfaces for a long while, even tough the cockroach population may have been exterminated. Our photo (left) illustrates fragments of cockroach insects that are also found in house dust along with the other parts listed above - in this case cockroach mouth and jaw parts. Such allergens are easily disturbed and made airborne by activities in the living area, and therefore can be inhaled, creating a particular risk for asthmatics, children, the elderly, and others who may be at special risk. Reference: There are numerous studies and citations supporting this subject. A starting point in MEDLINE which will provide links into this data is this article: The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma," N Engle J Med. 1997 May 8;336(19):1356-63. PMID: 9134876 [Plumbed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=9134876&dopt=medline --DF 11/03 Some cockroach control and asthma-related resources include: New York State Integrated Pest Management Program: http://www.nysipm.cornell.edu/psa/ University of Nebraska, Cockroach Control: http://pested.unl.edu/cocktoc.htm Environmental Health Watch Cockroach Control Guide: http://www.ehw.org/Asthma/ASTH_Cockroach_Control.htm Univ. of Calif. Statewide Integrated Pest management Program: http://www.ipm.ucdavis.edu/PMG/PESTNOTES/pn7467.html Control of Factors Contributing to Asthma Severity: http://www.vh.org/adult/provider/internalmedicine/AsthmaIM/comp2/Control.html Alliance for Healthy Homes, guidance on cockroaches: http://www.afhh.org/dah/dah_cockroaches.htm Conidiobolus: "fungi of the order Entomophthorales which can cause a type of chronic zygomycosis presenting initially as an infection of the nasal mucus membranes. Recently, some cases of disseminated infection in the immunocompromised host have been reported." - Identifying Filamentous Fungi, St-Germain & Summerbell 1996, p100. An agent of nasal granuloma in man, can lead to nasal obstruction. Found particularly in outdoor workers in tropical rainforests of West Africa where the fungus is normal in soil, and also in patients with underlying disease. Has been reported in a dog and a horse. Paraphrasing from Atlas of Clinical Fungi, 2nd Ed. DeHoog et als.

Conidiophore: the component of a fungus which produces fungal spores. A conidiogenous cell, or a fertile fungal cell which is specialized for the production of conidia (fungal spores). [paraphrased] - Illustrated Dictionary of Mycology, Ulloa and Hanlin. Conidobolus sp.: Can cause a chronic inflammatory disease of the nasal mucosa (entomophthoromycosis) [Medically Important Fungi - A Guide to Identification, 2nd edition, Davise H. Larone, American Society for Microbiology, Washington, D.C. 1995.] - U. Minn. Cryptostroma corticale: Conidia dimensions 4-6.5 x 3.5-4u. Found on the bark of maple and sycamore trees and on stored logs [Op.Cit. Mould Allergy , Yousef Al-Doory et als.] - U. Minn. Cunninghamella sp.: Can cause disseminated and pulmonary infections in immune compromised hosts [Op.Cit. Medically Important Fungi - A Guide to Identification] . - U. Minn. Curvularia sp. - Curvularia sp. - Allergen, Irritant, Hypersensitivity pneumonitis, Dermatitis--OSHA; Phaeohyphomycosis including sinusitis, endocarditis, peritonitis and disseminated infection--Univ. Adelaide, Australia; Allergenic; may cause corneal infections, mycetoma, and infections in immune compromised hosts. U. Minn.; Phaeohyphomycosis - a group of mycotic infections which take the form of local abscesses - Univ. of Texas; Curvularia is mainly an opportunistic leaf spot fungus and a weak pathogen that survives mostly as a saprophyte. It is easily isolated from dead turf (thatch) and other weakened and dead plant tissue. It causes leaf spots on grasses as well as storage molds of grains. Georgia College of Agriculture & Environmental Science, Cooperative Extension, Dept. of Plant Pathology. http://fungusweb.utmb.edu/mycology/phaeohyphomycosis.html http://www.ces.uga.edu/Agriculture/plantpath/epphomep.html http://www.osha-slc.gov/dts/chemicalsampling/data/CH_230250.html "In the last half century, this species has emerged as a human pathogen, although such diseases are extremely rare outside of the tropics. Due to its relatively large size, the spore remains in the nose or sinus after inhalation. Rarely, a chronic, allergic sinusitis may be provoked in patients with existing allergic rhinitis (hay fever). A Serine protease has been identified as a major allergen of C. lunata. A potent mycotoxin curvularin has been isolated from C. lunata, a rice contaminating species. Experimental mycotoxicosis were produced in albino rats. Another toxin, curvularol, from Curvularia sp., RK 97-F166 (Nagasaki, Japan) inhibited cell cycle progression of normal rat kidney cells in G1 phase at 150ng/ml. These effects have not been observed in people, and exposure to sufficient toxin to cause illness is extremely unlikely." - "Fungus of the month: Curvularia species," Srivandana Kilambi, Environmental Reporter, April 2005.

D Dactylosporium sp. - no information Daldrinia sp. - Very common basidiospores, no medical data. Debris at excessive levels: this comment means that the sample contained excessive levels of particle debris. When a sample collects to much debris important particles may be obscured in the debris. If it was an air or vacuum sample, high levels of debris can also cause important particles, particularly small spores such as Penicillium sp. or Aspergillus sp. to fail to adhere to the collection media. Both of these factors tend to make any estimate of the levels of spores or problem particles lower than actual in samples containing excessive levels of debris.

Dicyma sp. - No information found about health effects or toxicity. Allergenicity and toxicity have apparently not been studied. Dicyma olivacea is found on building surfaces by tape lifts [J. Haines, NY State Museum and DJF personal experience], but it will not generally appear in cultured samples using typically-selected culture media. In the absence of medical research it may be prudent to consider large areas of fungal contamination as potentially allergenic and as a respiratory irritant. Ref: Farr, D.F., Rossman, A.Y., Palm, M.E., & McCray, E.B. (n.d.) Fungal Databases, Systematic Botany & Mycology Laboratory, ARS, USDA also Ellis, M.B. (D.H.) and EMLAB. Retrieved April 25, 2003-DJF. Drechslera, Bipolaris, and Exserohilium (group commonly identified together and not speciated) - some species produce mycotoxins which affect the liver. Also associated with eye infections, sinus infections, asthma, and hay fever.-- Aerobiology Research Labs Dicyma sp. - No information found about health effects or toxicity. Allergenicity and toxicity have apparently not been studied. Dicyma olivacea is found on building surfaces by tape lifts [J. Haines, NY State Museum and DJF personal experience], but it will not generally appear in cultured samples using typically-selected culture media. In the absence of medical research it may be prudent to consider large areas of fungal contamination as potentially allergenic and as a respiratory irritant. Ref: Farr, D.F., Rossman, A.Y., Palm, M.E., & McCray, E.B. (n.d.) Fungal Databases, Systematic Botany & Mycology Laboratory, ARS, USDA also Ellis, M.B. (D.H.) and EMLAB. Retrieved April 25, 2003-DJF. Diplococcium sp. - this fungus is an anamorph of Helminthosphaeria - Dictionary of the Fungi, 9th ed.; we have not found reference to it in clinical or medical references such as Fundamentals of Diagnostic Mycology, Fisher/Cook, or Atlas of Clinical Fungi, 2nd ed., deHoog et als. Found on dead, often rotting wood and bark of various tree [species]. - Dematiaceous Hyphomycetes, M.B. Ellis. If found in a building sample it should be considered a water/moisture indicator which in turn should be considered an alert for possible presence of other, problematic fungi - DJ Friedman. Diplosporium flavum - This is a saprophytic fungus which I have found occasionally in indoor samples on drywall. No information was found about health effects or toxicity. Allergenicity and toxicity have apparently not been studied. In the absence of medical research it may be prudent to consider large areas of fungal contamination as potentially allergenic and as a respiratory irritant.-DJF Doratomyces sp. - common in soil, dung, and decaying plant materials. Medical information - not at hand. Dust and House Dust in buildings - see "Sub-micron particulates" and "World Trade Center Dust" below

E Efflorescence is a mineral salt, usually whitish and crystalline in appearance, left behind when water evaporates; it is commonly found on masonry surfaces where there has been water leakage. While this material is not a fungal spore, its presence indicates a history of high moisture in the area where it could be collected. In turn, high moisture is a key component in the presence of unwanted fungal spore growth as well as other possible building problems. - DJ Friedman. Some of us misspell efflorescence as "efflorescence" - this misspelling is here to help search engines find the right word: efflorescence or efflorescence salts on buildings. Please see Efflorescence & white or brown deposits for detailed information. Emmonsia parva (=Chrysosporium parvum): " - is the etiolotic agent of adiaspiromycosis, a usually asymptomatic pulmonary infection encountered in animals and more rarely in humans. The disseminated form of the infection is rarely seen in the immunocompromised host. E. parva var. crescens is the only type isolated from humans, while E. parva var. parva is often isolated from animals." [paraphrasing and quoting:]

Chrysosporium has produced occasional, questionable, reports of skin and nail infections, and one species has been substantiated on rare occasions as an agent of onchomycosis. - Identifying Filamentous Fungi, A Clinical Laboratory Handbook, Guy St. Germain, Richard Summerbell 1996. Also see Atlas of Clinical Fungi, deHoog et als. P. 635 which adds that this fungus occurs in rodent burrows (soils), and adds that [on inhalation] "The adiaspore remains localized and does not reproduce, causing no or only a mild disease." Among rodents the percentage of animals is "remarkably high" according to my op.cit. --DJF Emericella sp. - this is a teleomorph (sexual state) of Aspergillus. Emericella is found frequently in air and dust samples. Because Emericella is widespread and often found at low levels in indoor and outdoor air, I do not consider incidental occurrences of it in IAQ samples as indicative of a problematic level of mold indoors. Teleomorph: the sexual (perfect) state of a fungus (ascomycete or basidiomycete) whose spores are produced by meiosis. - Illus. Dictionary of Mycology, Ulloa and Hanlin. Epicoccum sp. - a secondary decomposer of plants, soil, paper, etc., common on dying substrates, cereals, plants, compost, human skin, sputum; more likely to be in air in calm dry weather; appears to be allergenic. -labspec.co.za and can grow at higher temperatures than some other molds. Exophiala sp. - "E. jeanselmei is the principal species of medical importance. [= Phialophora heteromorpha per deHoog et als.] occasionally a cause of mycetomas and of other subcutaneous phaeohyphomycoses. Exophiala werneckii is the etiologic agent of a superficial inspection known as tinea nigra. Exophiala infections have also been reported from animals, especially fish." Identifying Filamentous Fungi, a Clinical Laboratory Handbook, Guy St-Germain, Richard Summerbell.

F Feather barbules: if present in quantity may be allergenic; depending on the source (down quilts versus pigeons or pet birds) presence of this material could indicate other biological contamination and health risks including bacteriological hazards. (DF)

Fiberglass insulation fragments are inorganic material typically from fiberglass building insulation or duct work. Depending on their size and quantity these may be a respiratory irritant or may contribute to more serious health concerns. The presence of incidental fibers in buildings is common. The Association of Man-made Mineral Fiber Producers asserted to the US EPA in 1992 that a study at that time " - does not provide evidence of significant

adverse health effects following inhalation of glass fiber." ("Respirable Fibrous Glass Chronic Multidose Inhalation Study-Preliminary Final Results," TIMA, 4 May 1992 delivered to U.S. EPA by hand.) The Seventh Annual Report on Carcinogens (June 1994) lists glass fibers of respirable size as a substance "reasonably anticipated to cause cancer in humans." DJF-note: in my opinion a there is a growing level of concern regarding these fibers; I suspect that they constitute a serious health risk. Here are some additional references which address this concern: http://www.osha.gov/media/oshnews/may99/trade-19990518.html OSHA release on worker protection; http://www.aiha.org/abs01/01iaq1.html papers on fiberglass duct research http://www.hhinst.com/Artfiberglass.html John Bower's article on fiberglass (Healthy House Institute) http://www.epa.gov/appcdwww/iemb/biocontam.htm U.S. EPA project on evaluation of fungal growth on fiberglass duct http://www.sustainableenterprises.com/fin/basic.htm fiberglass information network http://www.sustainableenterprises.com/fin/Victims/brown.htm litigation involving fiberglass duct http://consumerlawpage.com/article/fiber.shtml published by a personal injury law firm; http://eces.org/articles/static/80198280073119.shtml fiberglass as a more potent carcinogen than asbestos; http://www.lungusa.org/diseases/fiberglass01.html safety of fiberglass insulation;

Fiberglass fragments in air: frequent presence of fiberglass fragments in air and some dust samples, suggesting that the duct system may be contributing unwanted and potentially unsafe levels of these fibers. While the fiberglass industry does not agree that this is a hazard, independent studies and warnings at US government health-related websites suggest that there may be carcinogenic or respiratory health hazards from exposure to high levels of fiberglass particles. If we find frequent presence of fiberglass fibers in air or interior dust samples further investigation, cleaning, and particularly investigation of air handling equipment and duct systems in the building would be appropriate. If fiberglass HVAC duct work has been installed I very often find significant fiberglass levels in interior air and dust samples. Because these materials cannot be mechanically cleaned and because I do not recommend encapsulant sprays, replacement could be in order. I would not expect movement of significant levels of fiberglass fragments from insulated attics, walls, ceilings into living areas under normal conditions. Additional in-depth information on fiberglass hazards in buildings can be found at my website at InspectAPedia.com/sickhouse/fiberglass.htm - opinion DJF.

Fuglio septica mold growth: The Fuligo septica mold spores in our photo provide very different information than what we can get by eye looking at a mold culture plate or petri dish. Fungicide: A non-sealing clear fungicide was sprayed in areas of the --- according to the --- [mold remediation report excerpt] . This may temporarily retard mold re-growth but does not protect longer term against mold nor against moisture uptake in these materials It also does not serve to immobilize particles which may have been left behind after surface cleaning.

Fusariella sp. - No information is available regarding health effects or toxicity, having checked our library of clinical references on mold toxicity and allergenicity. Allergenicity is also unknown. The photograph of [probably] Fusariella bizzozeriana shown here was found in an indoor dust sample by DJF. Other photos of Fusariella are provided by Grant Smith and sketches are in our M.B. Ellis reference below. Fusariella sp. fungus may be found on tape samples of indoor and in air. Grows on organic material such as leaves, dead stems, and litter (many plants), possibly on wood. [We [DJF] have identified this fungus in some attic samples where we found indications of active fungal growth, possibly on grass and leaves brought into the

building by birds or rodents, and contaminating nearby fiberglass building insulation]. Fusariella sp. can travel long distances in air, as reported found in smoke from Yucatan [Fungal spores are transported long distances in smoke from biomass fires, Mims & Mims, 2003] Identification references for Fusariella sp. fungal spores and Fusariella sp. conidiophores (long phialidic with collarettes, spores often in chains) include Fusareilla atrovirens, F. indica, F. hughesii, F. bizzozeriana, F. concinna, F. obstipa, F. intermedia, F. kansensis, F. aegyptiaca, and F. sarniensis. Ellis indicates that all of these are usually 3-septate: Dematiaceous Hyphomycetes and More Dematiaceous Hyphomycetes, M.B. Ellis.] Fusarium sp. - A common soil fungus found on a wide range of plants and often found in humidifiers and water-damaged carpets. Hard to find in air samples because the spores may be slimy. Several species in this genus can produce potent trichothecene toxins. The trichothecene (scirpene) toxin targets, the following systems: circulatory, alimentary, skin and nervous. Produces vomitoxin on grains during unusually damp growing conditions. Symptoms may occur either through ingestion of contaminated grains or possibly inhalation of spores. The genera can produce hemorrhagic syndrome in humans (alimentary toxic aleukia). This is characterized by nausea, vomiting, diarrhea, dermatitis, and extensive internal bleeding. Reported to be allergenic. Frequently involved in eye, skin and nail infections. -- U. Minn. And others. Produces toxins at lower temperatures than many other fungi; invades corn, barley; Reported by others as associated with allergies, asthma, mycotoxin production, and in immune-impaired people, can cause infection. Fusarium solani: Macroconidia dimensions 27-52 x 4.4-6.8; Microcondia dimensions 8-16 x 2-4u. Found in plants and soils. Can produce trichothecene toxins which may be associated with disease in humans and animals [Op.Cit. Mould Allergy , Yousef Al-Doory et als.] - U. Minn. Eye Infections, caused by Fusarium keratitis were linked to lens cleaners: the U.S. CDC indicates that 191 cases were reported related to contaminated contact lens cleaner solutions from Baushch & Lomb, Advanced Medical Optics, and Alcon. Potentially blinding eye infections can result (according to an attorney representing the first reported victim to lose an eye) (C.C. Warriner III, West Palm Beach, FL.). The companies and federal agencies involved disputed the lawyer's chartges. -- "191 Reports of Eye Infections Linked to Lens Cleaners," New York Times, 3 May 2006, Barnaby J. Feder, P. C4. Bausch & Lomb are now (5/6/2006) studying their packaging and ingredients because although there is evidence of Fusarium keratitis blinding fungal eye infections associated with use of their contact lens cleaner ReNu with MoisureLoc lens solution, the company has observed that Fusarium contamination was not observed at the U.S. Greenville factory, and some countries that received the solution from Greenville (Indonesia, Phillipines) have not reported an unusual increase in the infection rate. The product has been withdrawn by the company during the investigation. -- from an article by Barnaby J. Feder, New York Times, 6 May 2006, p. C3.-DF

G Ganoderma sp.: A common spore found in outdoor air, released from a shelf fungus which grows on trees; While this genera has seasons of high spore release, I find this spore in outdoor air samples nearly all year. The common species I find are G. applantum and G. tsuge.We have no information indicating toxicity or allergenicity of these basidiomycetes. Geotrichum sp- A common contaminant of grains, fruits, dairy products, paper, textiles, soil and water, and often present as part of the normal human flora. The species Geotrichum candidum can cause a secondary

infection (geotrichosis) in association with tuberculosis. This rare disease can cause lesions of the skin, bronchi, mouth, lung and intestine. -- U. Minn. Genera (genus-singular): one of the principal ranks in the naming structure of organisms, this is the first part of the standard two-part species name genera species, for example Aspergillus niger. A given genera e.g. Aspergillus, may be made up of many species members, and individual species may vary considerably in their importance to human health. Species - (abbreviated sp.) - the lowest principal rank in the nomenclatural hierarchy [for living organisms], consisting of two elements (a binominal): a generic name ["family"] and a species epithet [specific individual member in the family. A genera such as Aspergillus may have more than 100 species, each with different potential medical and other effects. Finally, the potential medical effects of an individual species may themselves vary depending on growth conditions such as choice of nutrient substrate, stage in sexual development of the organism, and other factors.] - taken in part from Dictionary of the Fungi, 9th ed., Kirk, et als. [annotations by DJF]. In some instances the contents of an indoor sample (air, dust, surface, etc) may contain particles which permit determination of the mold genera, but not the species. In this case we report the finding name as "genera sp." such as Aspergillus sp. rather than the more-detailed example "Aspergillus niger." Where appropriate additional work can often be ordered for such samples in order to determine the individual species as well. Gliocladium sp.: A fungus which is structurally similar to Penicillium sp. Reported to be allergenic [Op. Cit. Burge, H.A. 1985. "Fungus allergens,"]. - U. Minn. "Gliocladium sp. are not known to be a human pathogen." Fundamentals of Diagnostic Mycology, Fisher & Cook, p. 71. It is not cited at all in the Atlas of Clinical Fungi, de Hoog et als. --DJF Gliomastix sp.: Gliomastix murorum is the type species for this genera, also referred-to as Acremonium murorum - see www.sciences.adelaide.edu.au/research/resources/mycology.html for a sketch. Some sources (such as Doctorfungs website below) distinguish between some Gliomastix species and Acremonium species, asserting that G. murorum produces "olive-green to greenish-black colonies and chains or balls of dark conidia." M.B. Ellis, our senior expert in the field, equates them in his texts. "Acremonium is a filamentous fungus known to cause opportunistic infections in immunocompromised patients, such as the bone marrow transplant recipients - .Acremonium is one of the causative agents of eumycotic white grain mycetoma. [Plant pathogen] Rare cases of onychomycosis, keratitis, endophthalmitis, endocarditis, meningitis, peritonitis, and osteomyelitis due to Acremonium have also been reported [see reference links at the following website]. This fungus is known to cause opportunistic infections in immunocompromised patients, such as bone marrow transplant recipients [see web ref]. Infections of artificial implants due to Acremonium sp. are occasionally observed [see web ref]." - www.doctorfungus.org Acremonium sp. (Cephalosporium sp.) - "Reported to be allergenic. Can produce a trichothecene toxin which is toxic if ingested. It was the primary fungus identified in at least two houses where the occupant complaints were nausea, vomiting, and diarrhea. Asexual state of Emericellopsis sp., Chaetomium sp., and Nectripsis sp. It can produce mycetomas, infections of the cornea and nails." - U. Minn. [See Gliomastix sp. discussion.] Non-fungal granular debris: commonly found in house dust samples, often dominated by gypsum or plaster particles. At elevated levels these materials may be a respiratory irritant, often alkaline, and have been associated with chronic respiratory illness and hypersensitive disorders.

Helmintosporium sp. common in air, seasonal and more likely to be in air on hot dry days; parasites of cereals and grasses, also in soil and on textiles; allergenic bronchopulmonary mycosis has been reported per labspec.co.az Histoplasma sp.: A fungus which has filamentous growth at 25 degrees C and yeast growth at 37 degrees C. It is reported to be a human pathogen. It may be associated with birds. - U. Minn. Humicuola sp.: Grow on products with a high cellulose content. These fungi are also found in soil and on plant debris. [Smith's Introduction to Industrial Mycology, 7th edition, A.H.S. Onions, D. Allsopp, H.O.W. Eggins. Edward Arnold (Publishers) Ltd. London, UK, 1981.] - U. Minn. Hyaline Mycelia: Sterile mycelia which is white or transparent. No fruiting structures are produced by the mycelia. Visual identification of these organism is not possible. Often associated with allergic symptoms. - U. Minn. Hyphal fragments or mycelia are components of fungal growth (similar to the roots and branches of a tree); it is common to find small hyphal fragments in outdoor air and possibly in indoor dust. But their presence in indoor air samples, if in quantity or in large segments, suggests an active fungal colony in the building. Their presence in a surface sample in quantity or in large segments indicates that active fungal growth is present or nearby, or that fungal material has been disturbed in the building. May be allergenic. -DF See MOLD HYPHAL FRAGMENTS for additional discussion.

I Insect parts: if present in large quantity, carpet beetle hair, fly hairs, and insect scale are all indications of moisture at levels to support insect and mold growth even though it's below the level visible to naked eye. Insect parts may be highly allergenic, as may their fecal pellets and dust particles of the same. Interior trench-and-drain systems: IF basement or crawl space water entry in the building continues after attending my exterior recommendations cited above you may consider installation one or more interior trenchand drain systems to drain to a sump pit which in turn, ideally, drains to daylight (or is pumped with a battery backup). This is a costly procedure, particularly for crawl spaces, and it is less preferable than preventing water entry in the first place. Furthermore some such systems only prevent wet floors, not high interior moisture. For these reasons I recommend deferring this measure until the less costly and more obvious outdoor maintenance and corrective items have been addressed and the result of that effort evaluated. J K

L Leptosphaeria sp. "Can cause allergic diseases and asthma attacks. Cause of rhinitis and skin infections." Aerobiology Research Labs.

Limited invasive inspection always must leave some risk of un-discovered mold or other allergens in a building. The building leak history, observation of leak stains and other visual clues, and examination of strategically-collected samples of building dust and debris can combine to provide an acceptably-confident evaluation of building conditions, balanced with the need to limit the amount of demolition at a property.

M Memnoniella - Memnoniella/Stachybotrys. These two spores are very similar and are close relatives; the spore structure on a few hyphae (stem fragments) and conidiophores (spore producing structure) are consistent with Stachybotrys and key as that spore. However, most spores in the sample are spherical (Stachybotrys spores are commonly oblate but can be spherical) and in chains, indicating Memnoniella spores. These mold spores are treated by most references as identical. They are considered potentially allergenic, toxigenic, and opportunistic. See http://www.bsu.edu/web/IEN/archives/060200.htm for recent comments on Memnoniella/Stachybotrys. http://www.thefairways.com/literature.htm and http://www.epa.gov/nerlcwww/2001.htm support treat Memnoniella and Stachybotrys as pathogenically the same. Meruliporia incrassata: There is risk of severe structural damage from this wood destroying fungus investigate further and remove all infected wood plus 12-24" past last sign of infection. Poria incrassata and Merulius lacrymans are two Basidiomycetes that cause brown rot, sometimes called "dry rot" since these fungi can transport their own water over great distances into a building structure and can continue to cause damage even when the building appears "dry". Meruliporia links: http://www.human.cornell.edu/dea/extension/docs/fal96/fungi.htm http://www.psms.org/sporepr/sp351.html http://www.ucfpl.ucop.edu/HOTopics.htm Microsporum sp.: Causes ringworm in humans [Op.Cit. Medically Important Fungi - A Guide to Identification] - U. Minn. Mite fecals: commonly found, these indicate the presence of dust mites and related allergens. Mite fecals and other insect fecals and parts are allergenic and can be a severe risk to asthmatics. Dust mites are microscopic relatives of spiders. They live in bedding, upholstered furniture, carpeting, curtains, and they feed on skin flakes from humans and animals. They are found in every property. See http://www.niehs.nih.gov/airborne/prevent/mites.html for more suggestions on mite control. Mildew: an obligate parasite form of mold that grows on living plants. See Mildew Photographs for details. Mildew: Among the major groups of molds is a very large mold family, Basidiomycota (or basidiomycetes); this family in turn includes, among the many Basidiomycota members, we find a relatively small sub-group, the Ustilaginales, also familiarly called Smuts and Mildews. Both smuts and mildews are parasites of living plants and cause serious crop damage as well as damage to ornamental shrubs. See Kiss et als. for an example of mildew damage to tomatoes. Common mildews are divided into two sub-groups, 1. Oidium-Erysiphe, familiarly named Powdery Mildew 2. Peronosporaceae, familiarly named Downy Mildew Mitospores - this is an artificial collection of a large group of fungi which is used by aerobiologists to refer to members of the deuteromycete class of asexual fungi which could not be identified to genera/species in the particular sample. Many of these have been related to the ascomycetes or basidiomycetes groups. If a spore is

recognizable as a specific genera or genera/species, particularly one which is already known to be problematic in indoor air it will be so-named and will not be reported in this group. Monilia sp.: Reported to be allergenic [Op. Cit. Burge, H.A. 1985. "Fungus allergens,"]. This fungus produces soft rot of tree fruits. Other members produce a red bread mold. It is infrequently involved in corneal eye infections [Op.Cit. Smith's Introduction to Industrial Mycology,] [Op.Cit. Medically Important Fungi - A Guide to Identification] . - U. Minn. Moniliella sp.: M. acetoabutens (reported as Moniliella suaveolens, cf deHoog), anamorphic Ascomycete, a basidiomycetous yeast-like genus pylogeneticlaly close to Trichosporon. Pathogen: skin leisons on the palms. Paraphrased from Atlas of Clinical Fungi, deHoog et als. This yeast-like fungus may be airborne - see " Biodiversity and concentration of airborne fungi in a hospital environment," Johannes Rainer, Ursula Peintner and Reinhold P der, Mycopathologia, Springer Science+Business Media B.V., Formerly Kluwer Academic Publishers B.V. ISSN: 0301-486X (Paper) 1573-0832 (Online), and may be associated with certain yeast infections (http://wlapwww.gov.bc.ca/wat/wq/reference/fungi.html) -DF Monodictys sp.: no information on allergenicity was located in my clinical medical references, suggesting that this fungus has not been identified as a pathogen or serious allergen for humans. Some species of this fungus grow on wood and have been found on water-damaged wood indoors. It is occasionally confused with Stemphylium (which grows more often on herbaceous plants and less often on wood). Occasionally also confused with Ulocladium sp. Uncommon in air. Soil and Seed Fungi, Pictorial Atlas, 2d ed., Tsuneo Watanabe, CRC Press 2002 equates the appearance of this fungus with the aleuriosporous form of Neta quadriguttata. M. asperospora has been found on sheep dung. Microfungi on Miscellaneous Substrates, Martin B. Ellis, J. Pamela Ellis, Timber Press 1988. Ellis (Dematiaceous Hyphomycetes and More Dematiaceous Hyphomycetes) reports this fungus on twigs, apple trees, oak, and other plants and soil composites.-DJF Monodictys sp. was not cited in common clinical fungi references which concern fungal species which are pathogens. Where this mold has been found observers should be alert for other fungal species as mold-conducive conditions are present. This fungus may be a woodrotter, as Ellis has reported its growth on organic substrates (bones, paper, cloth,etc.) - DJF, Ref: Microfungi on Miscellaneous Substrates, an Identification Handbook, Martin B. Ellis & J. Pamela Ellis, Croom Helm, London, 1988, ISBN 0-7099-5316-X. , Ref: Microfungi on Miscellaneous Substrates, an Identification Handbook, Martin B. Ellis & J. Pamela Ellis, Croom Helm, London, 1988, ISBN 0-7099-5316-X. Mortierella sp.: Diseases associated with members of Mortierella sp. See www.emedicine.com/ent/topic639.htm - regarding fungal sinusitis and www.doctorfungus.org/mycoses/human/zygo/zygomycosis.htm - regarding zygomycosis Mucor - a rapidly growing fungus, usually dark gray or light olive gray when grown on typical laboratory media. Mucor, together with Rhizopus, is one of the most quickly invading organisms able to contaminate many kinds of stored food products. Mucor has worldwide distribution and is often found in hay, stored seeds, horse manure and house dust, regardless of geographical location. It is also frequently found in air samples from indoor environments. Accumulated dust in HVAC systems and poorly maintained carpeting may contain high concentrations of Mucor spores. One study of the most frequent molds found in house dust in samples of homes found Mucor in 98% of the samples from homes in Denmark and 31% of the samples in homes in Canada. Heavy exposure to the spores of Mucor can cause extrinsic allergic alveolitis, a type 3 (IgG) allergic response. It is generally associated with occupational exposure to wood chips and sawdust. The symptoms, which occur 6-8 hours after exposure include: elevated temperature, flu-like symptoms, general malaise, difficulty breathing and later asthma.

Eliminating Mucor mold exposure before the onset of pulmonary fibrosis usually leads to a return to a normal, healthy state. Mucor is also a rare opportunistic pathogen, attacking individuals with significantly compromised immune systems, metabolic acidosis, uncontrolled diabetes, starvation, severe trauma or other forms of debilitation. -- Aerolabs; labspec.co.za Also: "A Zygomycetes fungus which may be allergenic ( skin and bronchial tests) Reported to be allergenic [Op. Cit. Burge, H.A. 1985. "Fungus allergens,"]. 17). This organism and other Zygomycetes will grow rapidly on most fungal media. May cause mucorosis in immune compromised individuals [Op.Cit. Medically Important Fungi - A Guide to Identification]. The sites of infection are the lung, nasal sinus, brain, eye and skin [Op.Cit. Medically Important Fungi - A Guide to Identification] . Infection may have multiple sites [Op.Cit. Medically Important Fungi - A Guide to Identification] ." - U. Minn. Mycelium - the entire mass of hyphae that constitutes the vegetative [non-sporulating] body or thallus of a fungus. - Illus. Dictionary of Mycology, Ulloa & Hanlin. A mycelium is a mass of fungal hyphae; hyphae are long chains of fungal cells which form the growing/feeding component of a fungus. Spores may not be present with some hyphae, and may be produced only when environmental conditions encountered by the hyphae stimulate it to produce, and perhaps release fungal spores. When hyphae are present without any evidence of fungal spores or spore-producing bodies I refer to such growths as "sterile hyphae." Mycelia: a mass of hyphae; the thallus of a fungus, this is the vegetative body portion of the organism, akin to the "root" structure of a plant, used to absorb nutrients. Mycelia would not easily be visually identifiable as belonging to a specific species unless other components of the fungus are present. Particles of this material are probably allergenic. - DF; derived from "Dictionary of the Fungi," 9th Ed., Kirk, Cannon, David, and Stalpers. Mycetoma: [paraphrasing the reference source] a chronic granulomatous infection, typically on one of the extremities. About half are caused by fungi, the others by bacteria. All are subcutaneous infections characterized by swollen, tumor-like areas with sinuses that drain through multiple sinus tracts. For more information see my source: Fundamentals of Diagnostic Mycology, Fisher & Cook, p. 158. Mycotoxin - Reference list: http://www.ttuhsc.edu/SOM/Microbiology/mainweb/aiaq/FungalReferenceGuide/withoutframes/Main%20page/ MycoRefAb.htm

N Nephaline syenite: a material used in glazes and paints, may pose respiratory hazards and appears in a variety of MSDS available online. Also see Clay, Talk, Nephaline syenite, Cornwall Stone. Nigrospora sp. - Nigrospora sphaerica - Reported to be allergenic (Burge, H.A. 1985. "Fungus allergens," Clin. Rev. Allergy , 3:19-329.); Nigrospora oryzae found in corn and peanuts may be toxic or carcinogenic (Pilt JL, Hocking AD, Bhudhasa et als); "Nigrospora has been isolated from cutaneous lesions of a leukemic patient and from a case with keratitis. However, its pathogenic role as a causative agent is not well-known." (doctorfungus.org) Aerobiology Research Labs. has similar opinion regarding allergenicity.

O Oidium sp.: widespread anamorphic fungi such as Erysiphe; a mildew, also called oidiospores or arthrospores such as Geotrichum candidum, a (teleomorph) form of an ascomycetous yeast, may be associated with Candida infections. "The main human disorders caused by G. candidum are colonization of the intestinal tract and bronchial or pulmonary infections in humans as well as in other mammals. - Blood-stream infection with

sepsis is occasionally noted." - Atlas of Clinical Fungi, deHoog et als - DJF. See Mildew Photographs for details. Ophistoma - see Ceratocystis/Ophistoma group

P Paecilomyces sp. - Commonly found in soil and dust, less frequently in air. P. variotii can cause paecilomycosis. Linked to wood-trimmers disease and humidifier associated illnesses. They are reported to allergenic. Some members of this genus are reported to cause pneumonia. It may produce arsine gas if growing on arsenic substrate. This can occur on wallpapers covered with Paris green. -- U. Minn. This fungus is a contaminant/opportunistic pathogen found worldwide in soil and decaying vegetation. Important from a health-concern view, the spores are airborne [and small]. Occasionally it has been reported as a pathogen in pulmonary infections, endocarditis, and sinusitis. Infections of cutaneous lesions have occasionally occurred after traumatic inoculation of the host. Paecilomyces sp. have been associated with infections in patients who have had organ transplants. May be found in respiratory secretions, tissue biopsy specimens, blood, and aspirates from abscesses. - Fundamentals of Diagnostic Mycology, Fisher/Cook, paraphrased by D. Friedman. P. crustaceous has been isolated from a bronchial lavage of a patient with pulmonary infarction; it was grown repeatedly from monocyte cultures of patients suffering with AIDS and has been reported as causing peritonitis. - Atlas of Clinical Fungi, 2nd ed., deHoog et als, paraphrased by D. Friedman. Particulates - see "Sub-Micron Particulates" below. Penicillium/Aspergillus spores in air: There is no official standard for acceptable mold spore levels. To create such a guide would require standards for each of possibly thousands of genera/species and conditions. However "clean" residential buildings are typically 230/m3 +630/-230. buildings with evidence of flooding are typically much higher: 2200/m3 and mold-damaged buildings are typically extremely high in comparison: 36,000/m3. I usually find only trace levels of Pen/Asp indoors, so higher counts make further investigation a reasonable course of action, particularly where occupants may be at extra risk due to fragile health.

Penicillium is a common fungus often found growing in buildings where moisture problems are present. Colonies on building surfaces can be difficult to see without careful inspection.

They may appear light in color, ranging from white to blue to green. I often find this genera growing on previously wet-drywall, but more distant from the source of moisture than some other genera often found in these locations like the easier-to-spot Stachybotrys chartarum. Penicillium mold is commonly considered an allergen and a producer of a number of mycotoxins, each of which may have different effects which may also vary in different individuals. Because this genera is more difficult to see in-situ in buildings and since its spores are more difficult to spot under a microscope (colorless and small, about 2 to 3 u) I suspect that this genera is under-reported in both field and laboratory work. Yet because it is more easily airborne than the media-popularized Stachybotrys chartarum, and because its smaller spores (2u rather than 10-12u) may be breathed deeply into the lungs, I suspect it is more likely to be an airborne problem in buildings.-DJF Penicillium sp. "A wide number of organisms have placed in this genera. Identification to species is difficult. Often found in aerosol samples. Commonly found in soil, food, cellulose and grains. It is also found in paint and compost piles. It may cause hypersensitivity pneumonitis, allergic alveolitis in susceptible individuals. It is reported to be allergenic (skin). It is commonly found in carpet, wallpaper, and in interior fiberglass duct insulation. Some species can produce mycotoxins. Common cause of extrinsic asthma (type-type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema." -- U. Minn. "The common occurrence of Penicillium in food is a particular problem. Some species produce toxins and may render food inedible or even dangerous. It is a good practice to discard foods showing the development of any mould. On the other hand, some species of Penicillium are beneficial to humans. Cheeses such as Roquefort, Brie, Camembert, Stilton, etc. are ripened with species of Penicillium and are quite safe to eat. The drug penicillin is produced by Penicillium chrysogenum, a commonly occurring mold in most homes." -- U. Toronto. Most Penicillium spores are toxigenic or allergenic. Some are more toxic than industrial cancer-causing substances and are acutely toxic to the liver, brain, kidneys, and heart. Symptoms of acute aflatoxicosis are fever, vomiting, coma, and convulsions. Symptoms that occur in most moderately contaminated buildings are not fully known but are expected to be less severe. Keep in mind that my lab work does not identify the subspecies of this genus so we do not know if very dangerous species are present in the building. However given the risks of serious illness cleanup should be handled carefully and with expert advice. People with other illnesses or compromised immune systems (chemotherapy, bronchiectasis, carcinoma, or other mycoses) are at particular risk. Any environment where this mold/fungus is found is a potential health hazard. "Penicillium species have been shown to be fairly common indoors, even in clean environments, but certainly begin to show up in problem buildings in numbers greater than outdoors ( Burge, 1986; Miller et al., 1988; Flannigan and Miller, 1994). Spores have the highest concentrations of mycotoxins, although the vegetative portion of the mold, the mycelium, can also contain the poison. Viability of spores is not essential to toxicity, so that the spore as a dead particle can still be a source of toxin." -- "Is Indoor Mold Contamination a Threat to Health?" - Harriet M. Ammann, Ph.D., D.A.B.T.Senior Toxicologist Washington State Department of Health Penicillium Diseases: "Rare agent of infection, cases of keratitis, peritonitis, and systemic disease reported for species other than P. marneffei. P marneffei is the major pathogen in the genus. It is the etiologic agent of penicilliosis marneffei a systemic disease in immunocompromised hosts." -- U. Texas Periconia: no information available; watch Univ. of Minnesota for future data. Perithecia, Cleistothecia, or similar fungal bodies are fungal fruiting bodies formed to store and protect fungal spores, for example when moisture conditions or lack of food create hostile growing conditions. They may not be identifiable to genera/species without additional culture steps. In absence of other medical information I would consider this material possibly allergenic.

The most common perithecia we find in buildings is for Chaetomium sp., a fungus associated with moisture and wood soft-rot. Chaetomium is reported to be allergenic. Peronospora: Peronosporaceae, familiarly named Downy Mildew See Mildew Photographs for details. Phoma sp. - A common indoor air allergen. It is similar to the early stages of growth of Chaetomium sp. The species are isolated from soil and associated plants (particularly potatoes). Produces pink an purple spots on painted walls. It may have antigens which cross-react with those of Alternaria sp.. It will grow on butter, paint cement and rubber. It may cause phaeohyphomycosis a systematic or subcutaneous disease. -- U. Minn. "In exceptional cases, a cause of infections in humans or animals. To date only a few cases of subcutaneous phaeohyphomycosis have been reported." - Identifying Filamentous Fungi, a Clinical Laboratory Handbook, StGermain & Summerbell & Atlas of Clinical Fungi, deHoog et als. contains key identification features to distinguish from ascomycetes. - DJF Phialophora sp. found in soil, water, dung, wood and plant debris; According to U. Toronto (botany department, www.botany.utoronto.ca, (MallochLab), this genera is similar to Exophiala with only subtle differences. Wang/Zabel combine these genera. according to fungusweb.utmb.edu this genera has been associated with chromoblastomycosis, phaeohyphmycosis, and keratitis as a human pathogen. Other refs: "Identification Manual for Fungi from Utility Poles in the Eastern United States," Wang & Zabel. "Fungusweb" at the U. Texas Medical Branch, department of Pathology, does not call for special handling precautions other than ordinary care. P. heteromorpha = Exophiala jeanselmei [deHoog et als],was documented as attacking wood products. This source (WZ) also provides a key to human pathogenic species of Phialophora, citing: P. richardside, P. verrucosa, and P. repens. doctorfungus.org cites this genera as follows: "Phialophora species are among the causes of chromoblastomycosis and phaeohyphomycosis. Phialophora verrucosa is the principal causative agent of chromoblastomycosis in tropical and subtropical areas, particularly at Japan and South America. The clinical forms of phaeohyphomycosis may be diverse, including cutaneous infections, subcutaneous cysts, keratitis, endocarditis, arthritis, osteomyelitis, cerebral infection, fatal hemorrhage, and disseminated infection [1879, 549, 1266]. Phialophora europaea has been isolated from cutaneous and nail infections in North-western Europe [485]." See notes for Exophiala. Phialophora parasitica - "The original isolate of P. parasitica was from a subcutaneous lesion in man (Ajello et al. 1974). It also caused diseases in woody plants in Iraq, Tunisia, Costa Rica, and USA (Hawksworth et. al. 1976). - Identification manual for Fungi from Utility Poles in the Eastern United States, CJK Wang and RA Zabel 1990. Pithomyces. (P. chartarum is most commonly isolated species.) Common outdoors, grows on decaying plants and organic matter. P. Chartarum produces a mycotoxin called sporidesmin which causes liver necrosis in sheep, a sometimes-fatal disease. -- The Fifth Kingdom, Kendrick, p. 326. Also: http://nt.ars-grin.gov/index.htm Systematic Botany & Mycology Laboratory, USDA, Beltsville MD. Plaster and mold risk: Where we cannot find other evidence of mold contamination within a wood-framed plaster wall, and where there are not significant mold odors, leaving plaster in place can be an acceptable procedure. I do not often find significant mold growth on plaster except on painted or dirty plaster surfaces. We speculate based on field and lab investigation experience that the alkaline nature of the material is a retardant to many fungal species. If plaster develops a moldy odor it may be possible to "cure" the problem by surface cleaning and use of a sealant. If these clues are indicators of a wet wall cavity there is still risk of fungal spores on wood surfaces within the wall.

Pleospora sp. - no medical data; however see my notes regarding Stemphylium sp. (Pleosporum); Pollen: it is typical to find at least a few pollen grains in an indoor air sample; pollen is often allergenic and may contribute to or trigger other respiratory illness and some forms of asthma. Pollen levels vary widely with season, wind, weather, temperature, rainfall, and other conditions. Pollen found indoors in seasons where it is not expected in outdoor air may indicate an indoor dust and pollen reservoir such as a dirty HVAC system. Pollen grains are plant particles, not fungal spores. ALso see http://InspectAPedia.com/sickhouse/pollen.htm Plant Flower Tree Pollen - a Photo ID Library for asthma and allergy sufferers. Pycnidia: a flask-shaped conidioma of fungal tissue with a circular or longitudinal ostiole, the inner surface of which is lined entirely or partially with conidiogenous cells. See Phoma for example.

QR Riessia sp. is a basidiomycete which has been reported as a wood saprophyte - growing on rotting wood. My clinical texts do not cite medical data for this fungus. Where found in buildings you should consider this a water-indicator fungus which means that you should be alert for other, problematic molds or water-related damage. - DJF Rhizomucor sp.: The Zygomycetous fungus - reported to be allergenic [Op. Cit. Burge, H.A. 1985. "Fungus allergens,"]. It may cause mucorosis in immune compromised individuals. It occupies a biological niche similar to Mucor sp. It is often linked to occupational allergy [Op.Cit.Atlas of Moulds in Europe causing respiratory Allergy]. May cause mucorosis in immune compromised individuals [Op.Cit. Medically Important Fungi - A Guide to Identification] . The sites of infection are the lung, nasal sinus, brain, eye and skin [Op.Cit. Medically Important Fungi - A Guide to Identification] . Infection may have multiple sites [Op.Cit. Medically Important Fungi - A Guide to Identification] . - U. Minn. Rhizopus sp.: The Zygomycetous fungus - reported to be allergenic [Op. Cit. Burge, H.A. 1985. "Fungus allergens,"]. It may cause mucorosis in immune compromised individuals. It occupies a biological niche similar to Mucor sp. It is often linked to occupational allergy [Op.Cit.Atlas of Moulds in Europe causing respiratory Allergy] May cause mucorosis in immune compromised individuals. The sites of infection are the lung, nasal sinus, brain, eye and skin. Infection may have multiple sites [Op.Cit. Medically Important Fungi - A Guide to Identification]. - U. Minn. Frequently found in house dust, soil, fruits, nuts, and seeds, fruit and vegetable garbage, leftover food. Exposure to large numbers of Rhizopus spores has reportedly caused respiratory complications. Rhizopus can be an allergen and opportunistic pathogen for immunocompromised individuals, especially those with diabetic ketoacidosis, malnutrition, or severe burns. -- www.restcon.com/links/articles/mold_and_mildew.html [NOTE: the cited article has some mycological inaccuracies. For example, "mildew" named as a concern in the article does not normally appear in buildings - it grows on living plants as an obligate parasite.-- DJF] Rhodotorula sp.: A reddish yeast typically found in moist environments such as carpeting, cooling coils and drain pans. In some countries it is the most common yeast genus identified in indoor air This yeast has been reported to be allergenic [Op. Cit. Burge, H.A. 1985. "Fungus allergens,"]. Positive skin tests have been reported. It has colonized terminally ill patients. [Op.Cit.Atlas of Moulds in Europe causing respiratory Allergy]. [Op.Cit. Medically Important Fungi - A Guide to Identification]. - U. Minn. May also include yellow yeasts - DF

S Saccharomyces sp.: Reported to be allergenic [Burge, H.A. 1985. "Fungus allergens," Clin. Rev. Allergy , 3:19329.] Scopulariopsis sp. - It may produce arsine gas if growing on arsenic substrate. This can occur on wallpapers covered with paris green. It has been found growing on a wide variety of materials including house dust. It is associated with type III allergy. "Scopulariopsis species are usually a contaminant, but they have been recovered on numerous occasions from patients with onychomycosis. It is a rare cause of pneumonia, keratomycosis, otitis, and septicemia."-Fisher & Cook, Fundamentals of Diagnostic Mycology. Also see StGermain & Summerbell, Identifying Filamentous Fungi, a clinical laboratory handbook: Onchomycosis is occasionally reported; subcutaneous and pulmonary infection are rare and primarily affect people who are immunocompromised. --DF Serpula lacrymans - Common cause of extrinsic asthma (immediate-type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema. Smut: "Members of the order Ustilaginales, known as smut fungi, create black, dusty spore masses on the plants they infect. There are approximately 1,200 species of smuts within 50 genera (Vanky, 1987)." - Estelle Levetin, U. Oklahoma, "Mycology of the Air," Haines et als, October 2000. Two large genera are Tilletia and Ustilago. These are plant pathogens on cereals. They also grow on grasses. Smut teliospores are allergenic, with Tilletia peaking in late summer (August-September) and Ustilago early summer (June-July). I have not found reports of human infection from this fungus. - DJF 2002 Sporotrichum - commonly considered nonpathogenic. A few cases of repeated isolation of Sporotrichum pruinosum from respiratory secretions are suggestive of a bronchopulmonary colonization. This is a common fungus isolated from decaying wood and from soil, anamorphs of basidiomyceteous fungi which are important agents of wood decay. Look for wood rot damage in structures where this fungus is found - DJF & "Identifying Filamentous Fungi, A Clinical Lab Handbook", St-Germain & Summerbell. Species - (abbreviated sp.) - the lowest principal rank in the nomenclatural hierarchy [for living organisms], consisting of two elements (a binominal): a generic name ["family"] and a species epithet [specific individual member in the family. A genera such as Aspergillus may have more than 100 species, each with different potential medical and other effects. Finally, the potential medical effects of an individual species may themselves vary depending on growth conditions such as choice of nutrient substrate, stage in sexual development of the organism, and other factors.] - Dictionary of the Fungi, 9th ed., Kirk, et als. [bracketed annotations by DJF]. In some instances the contents of an indoor sample (air, dust, surface, etc) may contain particles which permit determination of a mold genera, but not the species. In this case we report the finding name as "genera sp." such as Aspergillus sp. rather than the more-detailed example "Aspergillus niger." Where appropriate additional work can often be ordered for such samples in order to determine the individual species as well. Spore, conidia, or "fungal spore," "a small unit of propagation, - capable of giving rise to a new individual. A spore functions like a seed. - Spores can be spread by air, water, insects, or other animals. Illustrated Dictionary of Mycology, Ulloa and Hanlin [paraphrased by DF]. In buildings airborne spores are the ones likely to be of greatest risk to humans, although certain other spores which are not intended to be spread in air can be infectious if placed directly in an eye, an open cut, or on other sensitive tissues. -DF Sporidesmium (over 60 species). Found on dead twigs, leaves, cedar planks, dead wood of oak, and other wood material. No medical information is cited in my clinical references; this mold may be allergenic. When found

indoors I associate it with wet conditions and rotting wood. You should consider it an indicator organism, showing wet conditions, and you should be alert for other problematic molds in the area. -DF Sporobolomyces sp.: Reported to be allergenic [Op.Cit. Burge, H.A. 1985. "Fungus allergens,"]. - U. Minn. Sporothrix sp.: Can cause sporotrichosis. Usually only in populations which are immune compromised. - U. Minn. (S. schenckii): " - found worldwide in soil, vegetable debris, moist wood, wood pulp, sphagnum moss, and some fertilizers - infection is associated with gardening - nicknamed rose gardener's disease'" may also be associated with aquaria. A cause skin mycoses characterized by development of ulcers and abscesses along the lymphatic channels; most infections area caused by traumatic inoculation of the fungus into the host tissues but infection can be contracted by inhalation." Fundamentals of Diagnostic Mycology, Fisher & Cook. According to Identifying Filamentous Fungi, A Clinical Laboratory Handbook, St-Germain & Summerbell, it " - also [besides skin ailments] may rarely manifest in an opportunistic respiratory or disseminated form which affects humans and animals." Sporotrichum sp.: Reported to be allergenic [Op.Cit. Burge, H.A. 1985. "Fungus allergens,"]. See also Sporothrix sp.. there is some taxonomic confusion between these two genera. This genera does not cause sporotrichosis. - U. Minn. St-Germain/Summerbell report Sporotrichum as commonly considered nonpathogenic, with a few cases of repeated isolation of Sporotrichum pruinosum from respiratory secretions as suggestive of a bronchopulmonary colonization. -Identifying Filamentous Fungi, St-Germain and Summerbell. Stachybotrys chartarum (previously referred-to as Stachybotrys atra) colonizes high-cellulose material (cellulose, paper on gypsum board) in areas where temperature is right (2-40 C) and where there is cyclic water/wet activity (such as basement water entry). This fungus can produce several toxins which affect the human immune system. The US EPA and the Cleveland Dept. of Health speculate that this fungus may be responsible for a cluster of acute pulmonary hemolysis/hemosiderosis cases from 1993 to present and in which nine of 36 infants from these homes died. Adult symptoms include immune suppression, bleeding, and adverse reproduction effects. These are serious threats to health but this is a new topic and much research remains to be done. Any environment where this mold/fungus is found is a potential health hazard. -- U. Minn. Dept. of Environmental Health & Safety and others. Mold Inspection & Testing Warning: where this mold is found you should consider it an "indicator organism" showing that wet building conditions have been present. Wet building conditions usually produce more than a single mold genera/species in the environment. Different genera/species may be found growing on different building materials (e.g. drywall vs. wood vs. insulation). Different genera/species may be found growing on the same building material in different areas depending on variations in material moisture (wetter drywall near a wet floor producing S. chartarum vs. less wet material higher on the same wall producing genera/species more difficult tot see, such as lighter-colored Aspergillus sp., or different genera/species on the drywall exterior from that found inside the wall cavity). Therefore where this mold you should be alert for the possible presence of other, possibly more harmful (more airborne) molds in the building. Further investigation may be appropriate. Stachybotrys chartarum spores in air are a strong indication of a significant fungal contamination in the building as this species is not easily airborne. Here is additional detail quoted from the University of Minnesota Environmental information web: Several strains of this fungus (S. atra, S. chartarum and S. alternans are synonymous) may produce a trichothecene mycotoxin- Satratoxin H - which is a poisonous by inhalation. The toxins are present on the fungal spores. This is a slow growing fungus on media. It does not compete well with other rapidly growing fungi. The dark colored fungi grows on building material with a high cellulose content and a low nitrogen content. Areas with

relative humidities above 55% and are subject to temperature fluctuations are ideal for toxin production [Op. Cit. Mycotoxicology - Introduction to the Mycology...] [Op. Cit. Croft. W.A., Jarvis, B.B., and Yatawara, C.S.]. Individuals with chronic exposure to the toxin produced by this fungus reported cold and flu symptoms, sore throats, diarrhea, headaches, fatigue, dermatitis, intermittent local hair loss [Manville, C. 1996. Poor drainage leads to fungal infestation, Adverse health effects. Indoor Air Quality Update. 3:11-12] and generalized malaise. The toxins produced by this fungus will suppress the immune system affecting the lymphoid tissue and the bone marrow Animals injected with the toxin from this fungus exhibited the following symptoms, necrosis and hemorrhage within the brain, thymus, spleen, intestine, lung, heart, lymph node, liver, and kidney. [Croft. W.A., Jarvis, B.B., and Yatawara, C.S. 1986. Airborne outbreak of trichothocene toxicosis. Atmos. Environ. 20:549552] Affects by absorption of the toxin in the human lung are known as pneumomycosis [Op. Cit. Mycotoxicology - Introduction to the Mycology...]. This organism is rarely found in outdoor samples. It is usually difficult to find in indoor air samples unless it is physically disturbed or if there is (speculation- a drop in the relative humidity). The spores are in a gelatinous mass. Appropriate media for the growth of this organism will have a high cellulose content and a low nitrogen content. The spores will die readily after release. The dead spores are still allergenic and toxigenic. Percutaneous absorption has caused mild symptoms [Op.Cit. Medically Important Fungi - A Guide to Identification] . Stachybotrys chartarum (previously referred-to as Stachybotrys atra) colonizes high-cellulose material (cellulose, paper on gypsum board) in areas where temperature is right (2-40 C) and where there is cyclic water/wet activity (such as basement water entry). This fungus can produce several toxins which affect the human immune system. The US EPA and the Cleveland Dept. of Health speculate that this fungus may be responsible for a cluster of acute pulmonary hemolysis/hemosiderosis cases from 1993 to present and in which nine of 36 infants from these homes died. Adult symptoms include immune suppression, bleeding, and adverse reproduction effects. These are serious threats to health but this is a new topic and much research remains to be done. Any environment where this mold/fungus is found is a potential health hazard. -- U. Minn. Dept. of Environmental Health & Safety and others. Stachybotrys Found: ld Inspection & Testing Warning: where this mold is found you should consider it an "indicator organism" showing that wet building conditions have been present. Wet building conditions usually produce more than a single mold genera/species in the environment. Different genera/species may be found growing on different building materials (e.g. drywall vs. wood vs. insulation). Different genera/species may be found growing on the same building material in different areas depending on variations in material moisture (wetter drywall near a wet floor producing S. chartarum vs. less wet material higher on the same wall producing genera/species more difficult tot see, such as lighter-colored Aspergillus sp., or different genera/species on the drywall exterior from that found inside the wall cavity). Therefore where this mold you should be alert for the possible presence of other, possibly more harmful (more airborne) molds in the building. Further investigation may be appropriate. Here is additional detail quoted from the University of Minnesota Environmental information web: Several strains of this fungus (S. atra, S. chartarum and S. alternans are synonymous) may produce a trichothecene mycotoxin- Satratoxin H - which is a poisonous by inhalation. The toxins are present on the fungal spores. This is a slow growing fungus on media. It does not compete well with other rapidly growing fungi. The dark colored fungi grows on building material with a high cellulose content and a low nitrogen content. Areas with relative humidities above 55% and are subject to temperature fluctuations are ideal for toxin production [Op. Cit. Croft. W.A., Jarvis, B.B., and Yatawara, C.S.] Individuals with chronic exposure to the toxin produced by this fungus reported cold and flu symptoms, sore throats, diarrhea, headaches, fatigue, dermatitis, intermittent local hair loss [Op. Cit. Manville, C. 1996. Poor drainage leads to fungal infestation] and generalized malaise. The toxins produced by this fungus will

suppress the immune system affecting the lymphoid tissue and the bone marrow [Op. Cit. Mycotoxicology Introduction to the Mycology...] . Animals injected with the toxin from this fungus exhibited the following symptoms, necrosis and hemorrhage within the brain, thymus, spleen, intestine, lung, heart, lymph node, liver, and kidney. [Op. Cit. Croft. W.A., Jarvis, B.B., and Yatawara, C.S.] Affects by absorption of the toxin in the human lung are known as pneumomycosis [Op. Cit. Mycotoxicology - Introduction to the Mycology ...] This organism is rarely found in outdoor samples. It is usually difficult to find in indoor air samples unless it is physically disturbed (or, speculatively, if there is a drop in the relative humidity). The spores are in a gelatinous mass. Appropriate media for the growth of this organism will have a high cellulose content and a low nitrogen content. The spores will die readily after release. The dead spores are still allergenic and toxigenic. Percutaneous absorption has caused mild symptoms [Op.Cit. Medically Important Fungi - A Guide to Identification]. Starch granules: this material is often found where food or snacks have been consumed, or where some talcum or similar body powders are in use. Corn starch is widely use in many consumer products besides food, including body powders and on rubber gloves. Rice and potato starch are also often found in indoor samples. It is common for us to find starch granules in indoor dust and occasionally air samples. We identify potato starch, corn starch, and rice starch using polarized light microscopy. At high levels the presence of these particles may tell us something about building history - a product containing starch granules may have been in heavy use in the building, including not only toiletries but certain cleaning products. When we find high levels of starch granules in building areas other than baths or dressing areas, a concern is raised for possible related mold growth or high levels of insect activity which in turn can produce problematic problem mold or high levels of dust mite fecals or insect fragments. Those secondary particles may be a respiratory irritant especially to people with respiratory disorders or asthma. In such cases a review of possible starch sources, halting the use of such products in excess, and additional professional building cleaning may be in order. Stemphylium sp. Most species are plant pathogens with occasional isolates from soil. Stemphylium can be confused with and are difficult to distinguish from Ulocladium unless their growth structures (conidia) can be isolated or cultured. They are rarely seen in the clinical laboratory according to the mycology reference at the University of Adelaide. --AU. S. botryosum (Pleosporum) common cosmopolitan temperate and subtropical on vegetation and in polluted water, bark, leaves of citrus; on tomatoes, wheat, barley; with Alternaria, considered a most important mold allergen in the US. -- labspec.co.az "Known allergen. It is considered an opportunist. Shares the same allergens as Alternaria species." - Aerobiology Research Labs. Stemphylium mold may share the same Pathogenicity as Alternaria as well - cases of subcutaneous phaeohyphomycosis - Atlas of Clinical Fungi, 2nd ed. De Hoog et als. You should consider this mold at least a water-indicator organism which means that conditions that produced it risk production of other problematic genera; in particular, I have found this mold present with Penicillum/Aspergillus. -- DF From EMLAB Environmental Reporter 12/04: Stemphylium, a dematiaceous (pigmented or colored) filamentous fungus, was first described in 1833 by Wallroth. To the naked eye colonies appear to be grey, brown, olivaceous brown or black in color and velvety or cottony in texture. Under the microscope the conidia (spores of the fungus) are single celled, pale to mid brown in color, both rough and smooth walled, oblong or sub spherical rounded at the tips with transverse and vertical septations and thickened scars at the base. Conidiophores (the spore producing structures) are identified by the presence of many vesicular swellings. The spores are dry and wind disseminated.

Pleospora is the sexual state of this genus (producing ascospores). Other synonyms include Epochniella, Fusicladiopsis, Soreymatosporium, Thyrodochium and Thyrospora. Approximately 20 species of Stemphylium are known. Stemphylium is a ubiquitous fungus found mostly growing in outdoor environments. Indoors it is mostly found in dust as a part of the normal flux of outdoor particles. It is frequently isolated from soil, wood, paper, decaying vegetation, and air. Stemphylium is generally considered to be both saprophytic (lives on dead organic matter) and pathogenic on plants. Studies related to the incidence of fungal spores at homes of allergic patients in an agricultural community, in association with local crops in California, showed a prevalence of Stemphylium spores along with Alternaria and Macrosporium during asparagus and strawberry harvesting time. From an agricultural point of view, Stemphylium acts as a leaf pathogen. Some species of Stemphylium are found to cause purple leaf blotch of leeks, leaf blight of garlic and a new disease in barley. In Oran Ankara, Turkey, the fungus was isolated from the plasters (inner surfaces) of prefabricated houses. Stemphylium spores are distinctive and readily identifiable on both spore traps and tape lifts (direct examination), although young spores or spore fragments may be confused with other pigmented spores such as Ulocladium, Alternaria or Pithomyces. Sporidesmium (over 60 species). Found on dead twigs, leaves, cedar planks, dead wood of oak, and other wood material. Sub-micron non-biological particulates: Particles less than 10u are considered respirable. Ultra fine particles (smaller than 2-3u) are common in building dust and non-fungal granular debris. However if large amounts of sub-micron particulates are present they are likely to be a respiratory irritant and may be a health hazard, depending on level and duration of exposure, and the general health risk of the exposed person. Common sources of fine particulates are cigarette smoke, spray air fresheners, scented candles, and other combustion products. Common sources of larger particulates indoors are carpets and other fabrics, soil and mineral fragments from outdoors. (Most outdoor biological particles such as mold and pollen are in the largersized group, though some mold spores and of course bacteria are in the small-sized group.) Since individual particles vary widely in toxicity, raw particle counts can be misleading as a toxicity hazard. "The National Ambient Air Quality Standard for particles is 150 ug/m3 (24-hour) or 50ug/m3 (annual average). Control of fine-particle aerosols - indoors - is best achieved by banning smoking - " - Ref. 1 below. Asbestos and fiberglass may be particular indoor hazards as well, though vested interests have supported contradictory "research" on this topic. In addition to respiratory hazards, skin rashes may result from very low levels of fiberglass exposure (Ref 1 p. 406). See " Health Impacts of Ultrafine Particles, Desktop Literature Review & Analysis," Morawska, Moore, and Ristovski, Austrailian DEP and " Particle Deposition Indoors ," Lai, A.C.K., relating indoor deposition of biological particles and sick building syndrome. and " Fine Particles Are More Strongly Associated than Coarse Particles with Acute Respiratory Health Effects in Schoolchildren," Schwartz & Neas, Epidemiology, Non-regulated non-biological particulates, such as soot from fires, can include ultra-fine particles which can be breathed deeply into the gas-exchange area of the lung. In my field investigations I use both settled surface dust collection (adhesive tape) and surface or crevice-dust collection (vacuum using Zefon or MCE-filter cassettes) to obtain material for microscopic examination. Quantitative testing using other methods that permit calculating of particle exposure by weight are available but I do not employ them [it is outside my area of expertise]. If such particles were collected and examined they are shown in the Lab Report.

If the sampled environment contains even subjectively-determined (no quantitative analysis) high-levels of submicron particulates (e.g. reported as among the dominant particles present in a sample) then further investigation and testing may be appropriate, depending on the complaints of building occupants, and special cleaning measures may be appropriate, as well as measures to identify and remedy the particle source. - DJF References for quotations and some paraphrasing above: The Occupational Environment, Its Evaluation and Control, DiNardi, S.R. (Ed.), AIHA press; the Detector Tube Handbook, Drager Safety, and personal communication, DF with Drager consultants, 2004. Syncephalastrum sp.: Can cause a respiratory infection characterized by a solid intracaitary fungal ball (26). U. Minn.

Taeniolella sp. - allergenic and medical data not known. This is a stunning, huge septate spore that we often find on plywood subflooring where there have been water leaks and rot such as below a bathroom or at a leaky sliding glass door. Our Taeniolella photo at left is probably T. phialosperma. Talc: Talc may be a respiratory dust hazard, depending on its source and contents. See New York State Tremolitic Talc and Asbestos. Other sources, including the talc industry, disagree. See Does talc inhalation pose a risk of lung cancer to humans [which is a Talc industry document]. Also see Clay, Talk, Nephaline syenite, Cornwall Stone. Teleomorph: the sexual (perfect) state of a fungus (ascomycete or basidiomycete) whose spores are produced by meiosis. - Illus. Dictionary of Mycology, Ulloa and Hanlin.

Tetraploa sp.: e.g. Tetraploa aristata. The species has been reported as an agent of keratitis and subcutaneous infection. - Atlas of Clinical Fungi, deHoog et als. We find instances of this spore in outdoor and occasionally indoor air samples. - DJ Friedman (Photo at left shows a Tetrapoloa sp. spore at center along with some Alternaria, one of which picked up lactophenol cotton blue stain.) Note that we don't always see four (tetra) legs on the spore, depending on several variables including spore position and microscope focus. Phaeohyphomycotic cyst caused by Tetraploa aristata. Markham WD, Key RD, Padhye AA, Ajello L. Department of Pathology, Flowers Hospital, Dothan, Alabama 36302. "A case of phaeohyphomycotic cyst on the left knee of a 54-year-old man caused by Tetraploa aristata is described. Identification was based on the coloration and morphology of the fungus in tissue and the macro- and micro-morphologic characteristics of the mould isolated from the cyst fluid. T. aristata is a dematiaceous hyphomycete found on the leaves and stems of a variety of plants. Previously, it has been known as an etiologic agent of two human cases of keratomycosis. This article describes the first known subcutaneous phaeohyphomycotic infection caused by T. aristata." -www.ncbi.nlm.nih.gov

Torula sp. -(photo, left) reported to be allergenic and a possible cause of hay fever and asthma.

Trichocladium uniseptatum: no medical information available. Check websites at U. Minnesota and U. Adelaide for updates which may add data on this genera and species. I have found this fungus in a number of building inspections where there was leak damage and wood rot present. Trichocladium asperium is a wood rotter, and occasional cases of keratitis were reported - Atlas of Clinical Fungi, 2nd Ed. p.941.

Trichoderma sp. - It is commonly found in soil, dead trees, pine needles, and paper, unglazed ceramics. It often will grow on other fungi. It produces antibiotics which are toxic to humans. Trichoderma sp. has been reported to be allergenic. It readily degrades cellulose. U. Minn. These spores are spread by air transport. "[Cases of human] infections with Trichoderma are rare but increasing numbers have been reported.

Trichodema species we often encounter in buildings are T. harzianum (green globose spores) and T. koningii (green ellipsoidal spores); also T. polysporium (generally white) which looks like greenish clumps of grapes and also shows up clearly in mite or some other insect fecal pellets when mites or other insects are feeding on the mold - shown in our photo at above left (at 100x). No stain was used in slide preparation. Our Trichoderma photo at above right illustrates this mold fungus growing on wood surfaces in a basement. Some microscopists refer to the green species of Trichodemra as T. viride. Trichoderma fungus has been associated with hyalohyphomycosis and has been reported from nosocomial [hospital-acquired] infections traced to contaminated solutions. Grows at 25-30degC. " - Fundamentals of Diagnostic Mycology, Fisher/Cook.1998. Often found in buildings, esp. T. harzanium (per W. Zabel's key); other species include T. koningii and T. polysporium; I find T. viride in many indoor samples on pine T&G subfloor over wet crawl spaces or basements-DF Trichophyton sp.: Can cause ring worm, athlete's foot, skin, nail, beard and scalp, found in soil and on skin. [Op.Cit. Mould Allergy , Yousef Al-Doory et als.] 6). Reported to be allergenic [Op.Cit. Burge, H.A. 1985. "Fungus allergens,"]. Found on soil and skin - U. Minn. Trichothecium sp.: 0.90 Conidia dimensions 12-23 x 8-10u. Found in decomposing vegetation, soil, corn seeds and in flour. The species Trichothecium roseum can produce a trichothecene toxin which may be associated with disease in humans and other animals [Op.Cit. Mould Allergy , Yousef Al-Doory et als.]. Reported to be allergenic [Op.Cit. Burge, H.A. 1985. "Fungus allergens,"]. - U. Minn. Tritarachium sp: this is a common, cosmopolitan saprobe (wood rotter) commonly found on decaying plant or wood material and on water-damaged materials. It has not been reported as a source of infection or human illness according to A Clinical Laboratory Handbook, St. Germain & Summerbell. However T. oryzae as an airborne spore which has been associated with corneal ulcers. It was also isolated from a case of otomycosis,

Atlas of Clinical Fungi, de Hoog et als. Reported to be allergenic [Op.Cit. Burge, H.A. 1985. "Fungus allergens,"] according to U. Minn. In sum, it might be a source of fungal eye infection or eye ulceration paraphrased by DJF. Truffles, see Tuber melanosporum - Black Truffle Tuber melanosporum - Black Truffle, or Black Prigord Truffle: truffles, a food delicacy sought by humans, and as well by animals who are attracted by sex hormone mimicing odors produced by black truffles and white truffles, are the fruiting body of a symbiotic fungus that is itself found in soils near the roots of trees, particularly oak (black truffles), but also beech, poplar, birch, hornbeam, hazel, and pine trees. The fruiting season of this fungus group varies by time of year, tree genera/species, and other conditions, and the fruiting bodies, or truffles, are found between leaf and organic litter and soil. In the New York Times (March 2010) reporter Nicholas Wade provides an accessible, well-written summary of current knowledge and gene decoding research involving Black Prigord Truffle or Tuber malanosporum. Tuber magnatum is the genus and species name for white truffles. Most truffle species are members of the genus Tuber, and their symbiotic relationship with trees is an extra level of nutrients provided to their host trees by these fungi. Also see "Basidiomycota truffles: Cup fungi go underground", Karen Hansen.

Ulocladium sp. - U. Chartarum is common in house dust and bedding and in HVAC equipment. Related to Alternaria, and along with Stemphylium, it is among the most common mold allergens. -- Hoffman in 3 p. 109 per labspec.co.za 8/01; also can cause hay fever and asthma and rarely, subcutaneous tissue infection. -Most Ulocladium species are soil fungi and they are rarely seen in the clinical laboratory. But they are found in house dust and mold growth. Clinical group: Saprophytes Mycosis: Dematiaceous hyphomycetes - U. Adelaide. Common on water-damaged materials, drywall, paper, vinyl wallpaper, paint, plaster walls. "Ulocladium is known to be a common airway allergen, causing Type I allergies such as hay fever and asthma one of the most common mold allergens in the United States. - also known to be a rare cause of subcutaneous

infections and phaeohyphomyces (a mycotic infection caused by a dematiaceous conidial mold where the tissue morphology of the causative organism is mycelial) in immuno-compromised patients. Ulocladium's ability to produce mycotoxins is not clearly known."- EM Lab Dr. Srivandana Kilambi 8/04. Common in kitchens and bathrooms; U. botrytis common on window sashes/jambs.U. atrum proffered no medical data on my search; this species is commonly found growing on wood; in absence of other data it is reasonable to presume that it may be allergenic as is U. chartarum. -DJ Friedman

Verticillium sp.: Conidia dimensions 2.3-10 x 1-2.6u. Found in decaying vegetation, on straw, soil and arthropods [Op.Cit. Mould Allergy , Yousef Al-Doory et als.]. A rare cause of corneal infections [Op.Cit. Medically Important Fungi - A Guide to Identification] . - U. Minn. Verticillium fungus is a common parasite on other fungal colonies. We have found Verticillium sp. with Aspergillus sp. and Stachybotrys chartarum. If Verticillium is found at substantial levels on indoor surfaces the investigator should be alert for the presence of other fungal colonization as well. - DJF Our photo (above left) shows a Verticillium-like fungal colony collected in a building.

WXYZ Wallemia sp. (W. serbi) - Found worldwide in house dust, air samples, dry foodstuffs and soil. Wallemia attacks materials with low water activity, is an allergen and may produce mycotoxins. It is known to grow on materials with high salt content. www.restcon.com/links/articles/mold_and_mildew.html 0.75 Conidia dimensions 2.5-3.5u Found in sugary foods, salted meats, dairy products, textiles, soil, hay and fruits [Op.Cit. Smith's Introduction to Industrial Mycology] [Op.Cit. Mould Allergy , Yousef Al-Doory et als.] - U. Minn.

World Trade Center Collapse Dust from the WTC twin towers collapse on 9/11/2001 See InspectAPedia.com/WTC/WTCdust.htm - World Trade Center Dust Particle Photographs - microscopic photos of dust created by the World Trade Center Collapse following the 9/11/2001 terrorist attack on the United States

Yeast - Yeasts are simple unicellular forms of fungi. Various yeasts are commonly identified on air samples. Some yeasts are reported to be allergenic [Op. Cit. Burge, H.A. 1985. "Fungus allergens,"]. They may cause problems if a person has had previous exposure and developed hypersensitivity's. Yeasts may be allergenic to susceptible individuals when present in sufficient concentrations (E) -- U. Minn.

What Does Indoor Mold Look Like? Black Mold spores in the Home photo guide to toxic black mold & other indoor mold in buildings
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Photos of black mold & other dark colored mold on & in buildings - how to find & recognize mold on building surfaces Photographs of black and other dark colored mold on drywall, on plywood subfloor, behind wallpaper, and in wall cavities and on building insulation kraft facing paper Questions & Answers about what black mold, "toxic black mold" or plain cosmetic (harmless black mold) looks like in buildings, including homes, offices, and even in boats, cars, trucks, and mobile homes.

What does building mold look like? Here is an online reference photo library of various kinds and colors of mold as it is found growing in buildings. These photos of mold on indoor building surfaces may help you recognize mold in buildings, recognize probably-cosmetic mold, and recognize stuff that is not mold and does not need to be tested. If you don't see information you want, ask us for it using the comments box at the end of this article. Also see MOLD GROWTH ON SURFACES, PHOTOS.

Identification Photographs of Black Mold in Buildings - what does black mold look like?

Black mold in the laundry room may look like this extensive case. In cases of large areas of visible mold, unless the mold proves to be only cosmetic mold, professional cleaning is probably needed. Look closely when inspecting or collecting test samples of "toxic black mold" because often there are other molds, sometimes more harmful and more easily airborne mold species on the same surface, on the hidden side of the same surface of drywall, or nearby. These include lighter colored genera/species of Aspergillus sp., Penicillium sp. etc. which are too often missed when investigators or building owners focus only on "black mold" testing.

Tiny Stachybotrys toxic black mold colony on drywall behind a laundry room baseboard. If this is all that's present this is a trivial cleanup and does not need testing and remediation. But if this is a "tip of iceberg" clue of a larger hidden problem in the wall, or if it might be, further investigation, at least exploring the wall cavity, would be appropriate.

Black mold on rotting subfloor below a leaky sliding glass door - this "black mold" was Taeoniella rudus for which no medical issues have been reported - a wood rotting organism though. An investigation of the source of outside leaks and extent of damage to the structure were needed at this building.

Black Stachybotrys chartarum black mold on wallpaper below a leaky window. The window had been left open more than once during rainy weather. We found that water was leaking into the wall cavity, not just behind the wallpaper. Replacement of a small section of drywall, wall cavity insulation, and wallpaper were appropriate at this location where the first symptom was loose peeling wallpaper which exposed black mold.

Toxic black mold, Memnoniella echinata visible at a small test cut into the wall cavity and contaminating fiberglass insulation in a NY City high rise apartment after water leaked from an A/C condensate line into the metal track of the metal-stud wall. Larger wall cuts to look for hidden mold and final demolition exposed a very extensive toxic mold colony in this building. Lab processing of a tape sample of this mold was necessary to identify it. Notice the funny black mold growth pattern on the cavity side of the opposing drywall. This pattern maps the points of contact of the wall insulation kraft paper with the drywall surface, and the movement of moisture and spreading mold growth on the wall surface. It is characteristic of wall cavity mold and is different from the growth pattern of mold growing on a freely exposed-to-air drywall surface.

Black and hidden mold in fiberglass wall insulation in a basement exposed to prolonged wet conditions from a wall leak at a water pipe entry point. This mold was almost hidden except for a small mold-suspect patch and larger water stains on the exposed side of the drywall. The wall cut exposed a surprise point of water entry. Black mold was visible on the insulation kraft paper. The problematic mold in this case was not visible but was found by a special sampling technique we used to examine the building insulation for Aspergillus sp. and Penicillium sp. (problem molds) in the fiberglass - it was found to be highly contaminated and was determined to be an active reservoir releasing high levels of airborne mold into the basement.

More Photos & Close ups of Black Mold on Building Surfaces

Our mold photo at above left shows black mold colonies growing among green mold colonies on a laundry room ceiling, covering both plastic ceiling tile material (around the plumbing pipes) and drywall. It is often the case that multiple mold genera/species may be growing in the same area, often on the same surface, and at times, on top of one another. As we advised earlier, look closely when inspecting or collecting test samples of "toxic black mold" because often there are other molds, sometimes more harmful and more easily airborne mold species on the same surface, on the hidden side of the same surface of drywall, or nearby. In this building that was still wet at the time we took this photograph, the airborne level of Aspergillus sp. and Penicillium sp. (the green, gray, and light colored molds in the photo) was very high while the level of airborne Stachybotrys chartarum, Cladosporium sphaerospermum, and Nigrospora sp. (black molds found on these surfaces) was very low. Our photo at above right shows black mold colonies as smaller "spots" growing on the painted surface of cloth covering asbestos pipe insulation.

Our black mold photos above show dense black fungal growth on drywall (black mold on Sheetrock type wall surfaces) in areas that have been very wet. The distinct top edge of mold growth may mark a flood water level or a discontinuity in the wall material, such as a tape joint in drywall that affected the moisture gradient in the wall and thus the mold growth pattern.

Close up Photographs of Black Mold on Building Surfaces

Here we begin to "zoom in for a closer look at dense black mold growth on indoor building surfaces in a wet basement. Notice that the mold growth on drywall and often on other surfaces includes a family of circular growth patterns (upper area of photo at above right) until the mold growth has expanded to form a solid black covering (left wall of photo at left and lower wall of black mold in photo at right).

Our photo at above left shows black mold colonies as individual rounded "rings" on the cavity side of drywall on a building crawl area wall. The black mold photo at right shows how dense black mold may be hidden from view behind wall baseboard trim (removed for this picture) in a building that has suffered wet floors.

Black mold growth on furniture is obvious in these two photographs, of a mold on a leatherette surface (left) and on an upholstered chair (right).

In our photo at above left we see black mold and other mold growths on the kraft paper facing of fiberglass building insulation. Our black mold photo at above right shows that mold colonies do not always grow in the neat round ring-like colonies shown in some our earlier photographs.

Here we start to zoom in our photographs of black mold on building surfaces to show what mold colonies look like on close inspection in-situ. At left is mold on water stained drywall in a basement utility area. At right are small mold colonies that have appeared on a kitchen ceiling in just a few days after a heating system leak led to high indoor moisture and humidity levels.

Much more closely we can examine an individual black mold colony on a painted drywall ceiling (above left). In the microscope at 1000x we can see individual spores of Stachybotrys chartarum - a well known black mold that is often found on indoor building surfaces.

Questions & Answers about what mold looks like in buildings

Question: Is this stuff on my ceiling mold?

I just moved into a rental trailer and it had a strong musty smell. I thought, maybe it hasn't been aired out. well, after two days of doors and windows open, it still smells. I found the brown discoloration on the ceiling in the kitchen cabinets. Is it mold? Thank you, - L.B.

Reply: maybe not, but those water stains mean there may be a significant risk of hidden mold indoors
Your photo shows some heavy staining on what looks like suspended ceiling tiles. The brown stains themselves may not be mold but rather brown materials carried by roof leaks into the ceiling structure. Older trailers and mobile homes often have leaky roofs. It looks as if water has also run down the wall surface and quite likely the wall cavity of the home below those same stains.

In this case the stains you see might not be mold but they do indicate that there is a high risk of mold in this home. Here are spots where I'd suspect a more hidden but possibly larger problem reservoir of mold when we see leak stains like yours: The ceiling tiles may themselves be moldy on their upper or hidden surface, depending on what they are made-of. Even plastic-faced fiberglass suspended ceiling tiles that might not look moldy may in fact be contaminated if they have been wet. See INSULATION MOLD. The back side of wallpaper that has been soaked is often moldy. At Other Places to Look for Hidden Mold we include a photo of mold found behind wallpaper that looked just fine from the room side. If the walls are covered with drywall behind that wallpaper, its cavity side may be moldy, though more likely your walls are paneled. Un-painted cavity side of wood paneling often supports mold growth and of course insulation within the wall cavity may be wet and moldy too. Finally, where we see significant stains at a wall/ceiling juncture indicating a history of roof leaks that sent water into and down the wall, we take a close look at carpeting, carpet padding, and insulation that may be under the floor below. I suggest having someone take a look at the insulation and floor condition in the area of leakage from below the mobile home. If that area is wet and damaged you can pretty much expect that there is hidden damage and mold in the ceiling and wall above. If the damage is not so extensive that immediate major repairs to the structure are needed, but if there appears to be anything greater than 30 sq.ft. of moldy material, professional cleaning and repairs are needed. And the cleaning and repair work cannot be concluded before the leaks are fixed. Also see ACTION GUIDE - WHAT TO DO ABOUT INDOOR MOLD. Watch out: in some mobile homes where there has been chronic leakage we have seen floors that were badly deteriorated and even collapse. Finally, because you are renting, you will want to see our mold advice for renters: RENTERS & TENANTS: MOLD ADVICE

What are the Most Common Indoor Molds Found in buildings ?

Frequency of mold genera/species in buildings Table of most common building molds Which molds are most commonly found indoors? Why are some molds reported more often than others? Questions & answers about the most common mold contamination types found in buildings and on building surfaces

Here is a mold frequency table guide to the most common building molds found in mold test samples collected in buildings, based on surface tape samples submitted to an expert mycologist in New York State, with additional explanation and interpretation by Daniel Friedman, an expert mold/IAQ/building diagnostic field investigator also versed in aerobiology and mold lab microscopy and mold identification procedures.

Table of Most Common Indoor Molds Reported by Mold Test Kits

Simple "mold screening methods" which omit the inspection, and "test only" sampling methods, such as air and culture methods can produce very unreliable results when used quantitatively - as we discuss at IAQ Methods and at other articles at this website. See MOLD GROWTH on SURFACES for an index of what mold genera/species are frequently found on various building surfaces and materials during expert building mold inspections. Readers should be sure to see the notes following the table since the data in this table is skewed by variations in the ability of the original sample collectors to find and recognize important mold contamination in buildings. Careful visual inspection combined with physical sampling of visible mold or other key building surfaces remain the key ingredients in a reliable indoor mold investigation. Easy-to-see molds are over-reported and hard-to-see molds are under-reported in consumergenerated mold tests and samples. This reporting error also confounds attempts to correlate mold related illness and sick building complaints with specific genera or species of indoor mold. Therefore our mold frequency table shown just below reflects what people, including largely amateurs, see and sample in buildings, and it under-reports hard-to-see light colored molds such as many of the Penicillium or Aspergillus species.

Table of Frequency of Occurrence of Indoor Building Molds2 Mold

Cladosporium sp. Cladosporium sphaerospermum. Stachybotrys chartarum Aspergillus sp. Penicillium sp. Unidentified mold Ulocladium sp. Cladosporium cladosporioides Non-sporulating fungi Chaetomium globosum Alternaria sp. Chaetomium sp. Ulocladium sp. Alternaria alternata Penicillium/Aspergillus sp. Acremonium sp. Chrysosporium sp. Dicyma olivacea Gliomastix murorum Meruliporia incrassata Gliomastix sp. Phoma sp. Ascotricha chartarum MILDEW in buildings ?

Percent of Samples
16.67 16.57 16.37 06.02 03.85 03.85 03.06 02.47 02.47 02.37 02.17 01.97 01.97 01.97 01.28 0.99 0.89 0.79 0.69 0.69 0.59 0.49 0.20 0.00

Mold
Ceratocystis sp. Aureobasidium pullulans Peziza cerea Aspergillus versicolor Unid. wood rot fungus Mucor sp. Cladosporium herbarum Chaetomium murorum Acrodictys sp. Aspergillus niger Papalomyces Cunninghamella blakesleana Paecilomyces varioti Oidiodendron sp. Memnoniella echinata Microascus triganosporus Dendriphiella sp. Cladosporium oxysporium Ulocladium botrytis Verticllium sp. Trichoderma harzianum Chaetomium piluliferum Bispora betulina

Percent of Samples
0.49 0.49 0.49 0.39 0.39 0.39 0.39 0.30 0.30 0.30 0.30 0.20 0.20 0.20 0.20 0.20 0.20 0.20 0.20 0.20 0.20 0.20 0.20

Notes to Table 1. J. Haines, New York State Museum, multi-year survey of surface samples collected on adhesive tape and submitted to NY DOS by home owners or by health department officials. Personal communication to DJ Friedman. Arranged by percent of total samples analyzed. The contents of this web page are the opinion of the author and are subject to update pending further technical and professional review.

2. Warning: because most of the samples submitted to Dr. Haines were collected by people who were not expert at recognizing or even finding the most-problematic molds in buildings, there may be an over-reporting of the dark, easy-to-see molds such as the top three in this list, and an under-reporting of the often light, hard-to-see problematic molds such as Aspergillus. sp. and Penicillium sp.. In my own field work responding to client-detected mold concerns, in most cases where the occupant or owner has seen a "scary black mold" or a "toxic black mold" a more careful study of the building discloses that it is the previously un-detected Aspergillus. sp. and Penicillium sp. which were the mobile, airborne, and dominant problematic molds to which the occupants were actually exposed. In addition, we have been using special methods to test fiberglass building insulation for Penicillium/Aspergillus sp. in areas where the insulation has been wet or where insulation has been exposed to active mold growth such as over a wet crawl space or a moldy basement. I have often found large reservoirs of these problem molds in building insulation, observing that the reservoir is releasing high levels of airborne mold spores. This mold contamination is discoverable by contextual inspection and special test methods, but it is not at all visible to the naked eye. An exception to the speculation that these small, hard-to-see molds are the more serious problem in buildings is during amateur cleanup and demolition work without adequate containment measures. Demolition can cause molds which are not normally airborne, such as Stachybotrys chartarum to become widely dispersed in a building. 3. Some of the molds listed in this table, even though found indoors, are unlikely to be indicative of a growing mold reservoir of that genera/species. For example, I often find Cladosporium herbarum and certain Basidiomycetes such as Ganoderma sp./G. applanatum/G. tsuge in indoor air samples but I have not found these genera/species growing on building materials. Rather they enter in outdoor air. 4. For identification photographs of mold in buildings see MOLD ATLAS & PARTICLES INDEX; for photographs of mold under the microscope see MOLD by MICROSCOPE. In conclusion, this interesting table needs additional research with data provided by expert building investigators rather than self-collected data by individuals who spot first and sample first dark molds on building surfaces. Readers should see How to Look For Mold.

Mold Related Illness Guide

This Mold Related Illness Guide provides a broad index of reports of health complaints or symptoms, of Illnesses that are either caused, or aggravated by indoor mold exposure or alternatively, that were believed or suspected by individuals to Broad classes of reactions to allergenic, pathogenic, or toxic mold, allergens, and other indoor gases or particles Readers should see MOLD DOCTORS - ENVIRONMENTAL MEDICINE. Also see MOLD RELATED ILLNESS and Mold spores in the Home - a Photo ID Library for detection and identification of mold allergens on indoor building surfaces and for an atlas of building molds and for more microphotographs of building mold samples observed in our laboratory, see Mold Atlas of Indoor Clinical Mold, Pathogens, Allergens & Other Indoor Particles. Readers may also see MOLD EXPOSURE STANDARDS.

In understanding how exposure to mold might cause or contribute to illnesses it is useful to distinguish among the meanings of the words allergenic, pathogenic, and toxic effects that exposure to something might explain.

Allergenic - causing allergic Reactions - rhinitis, sinusitis, asthma, skin problems, other Pathogenic - Produces Infections, caused by pathogens such as bacteria or viruses Mold Smell Illnesses - headaches, vomiting, nausea, blocked noses, and asthmatic [MVOC's--DF] Toxic Illnesses - where mold is involved, may be produced by mycotoxins that are produced by some, not all, mold species. Note that even for a "toxic" mold species, the actual level of toxicity can vary significantlty depending on growing conditions such as the growth substrate (what the mold is feeding-on), humidity, moisture, and other factors. Respiratory Illnesses Digestive Tract Illnesses - liver diseases: fibrosis and necrosis; vomiting, diarrhea, intestinal bleeding Reproductive Illnesses - infertility, variations in reproductive and hormonal cycle Highly Serious Illnesses - Cancer, Tuberculosi, Lupus, Sudden Infant Death Syndrome (SIDS), Chronic Fatigue Disorder (CFS), Fibromyalgi, Epstein-Barr, aspergillosis This list of mold related illness symptoms and complaints is arranged alphabetically and begins just below. This list is a combination specific, diagnosed medical illnesses and other anecdotally reported complaints associated with mold in buildings. Research to establish a firm chain of causation between mold and other indoor particles (or other substances) and these complaints in many cases has not been completed.

We capitalize names of known medical conditions. While the following list may be of assistance to some readers researching this topic, it should by no means be considered as scientifically authoritative nor complete.

Some complaints are listed here without any solid medical evidence regarding causation, if the complaints have been expressed to us by people investigating mold-related illness or building mold contamination. Such data should be considered for research purposes and not medically authoritative. Contact Us for content suggestions or link exchange requests. Alphabetic List of Mold Related Illnesses and Health Complaints, both Medical and Anecdotal - alphabetical Warning: this MOLD RELATED ILLNESS SYMPTOMS list is a complaint list, not a medical document. It has not been peerreviewed by the medical profession, and this list is not in any medical sense authoritative, nor can it be complete. It does, however, collect both substantiated mold-related-illness complaints and a wide sampling of the nature and range of other complaints from people who believe or fear that mold or similar exposure has been a factor in their physical or mental health, a general reference for individuals or physicians interested in reading the nature and range of these complaints that may or may not actually be building or environment-related.

MOLD RELATED ILLNESS SYMPTOMS - Mold Related Illness: Index of Symptoms. Readers should not rely on
this document for medical diagnosis and instead should consult with their physician or with a specialist such as a medical toxicologist Can Mold Make You Sick? We live in a sea of mold, and other stuff in the air we breathe, on cushions we sit on, clothes we wear, pools we swim-in, and so on. Most mold is not hurting anyone, and some of it makes us well when we're sick(Penicillium notatum, for example). Fear of mold (mycophobia) is unjustified and in our opinion, more a result of media hype, enviro-scare, and gouging consumers.

A healthy person walking through a room of moldy air is not likely to die. On the other hand, there is a wealth of less rigorous empirical data matching occupant complaints with indoor mold and allergens. Finally, for certain people, mold can be a serious problem if it's at high levels indoors. It's probably an overstatement by those authorities who assert that "... there are no proven links between mold and illness." we refer readers to some of our lab's references for descriptions of illness-related molds, some of which are found in buildings:

Alphabetic Index to Common Mold-related Illness Symptoms & Complaints A Abdominal pain abnormal pap smears acid reflux acne Allergy symptoms (wide variety of), mild to severe and from transitory to chronic - Ref: Middleton and assoc. Allergic bronchiopulmonary Aspergillosis - worsening of underlying asthma or cystic fibrosis, coughing up blood, weight loss - uncommon Allergic Rhinitis and asthma are associated with responses mediated by immunoglobulin E (IgE) "Damp house linked to kids' risk of nasal allergies", New York Times, 1 Aug 2010 Altered immunity Anaphylaxis Apnea, sleep Aspergilloma (fungal growth in lung), cough, coughing up blood, weight loss. Uncommon. Asthma and asthmatic signs asthma, adult onset asthma, sudden onset, any age

asthma, increased symptoms or renewal of previously diminished symptoms Asthma due to fungal allergens: chest tightness, wheezing, cough, dyspnea. Worsens w/ exposure. Cx typically occur within 1 hr of exposure

B balance, loss of bladder and kidney pain bleeding lungs blood pressure irregularities body aches and muscle pains boils on skin, especially neck, especially following disturbance of moldy materials (S. chartarum) (photos on file) breathing difficulties Bronchopulmonary aspergillosis / allergic bronchopulmonary aspergillosis: inflammatory disease caused by immunologic response Aspergillus sp., usually A. fumigatus, growing in bronchi of asthmatics reported in immunocompromised patients and patients with chronic obstructive pulmonary disease (COPD) and has been linked to building-related illness (BRI) bruising easily burning mouth burning eyes burning throat burning lungs

C Cancer Candida, systemic Chronic Candidiasis FAQ - see Dr. Fungus: doctorfungus.org/mycoses/human/candida/Chronic_Candidiasis.htm central nervous system disorders (CNS) chest pain associated with excessive coughing chills choking

cholesterol or triglycerides unusual variations Chronic fatigue syndrome (CFS) chronic sinus infections coated tongue coccidioidomycosis colds, recurrent constipation Cough, dry hacking coughing up blood Cryptococcosis D dandruff resistant to usual treatments dark urine death in extreme cases (humans, other animals) Depression Dermatitis: red, itchy skin, rashes diarrhea difficulty concentrating difficulty in swallowing dirt-like taste in mouth Disorientation Dizziness

E endometriosis Eye infections, (beware of undiagnosed fungal eye infections), loss of vision

eye irritation

F face flushing intermittent facial movements, unexplained twitching farmers' lung disease fevers fibrous discharge from the nose, nasal fibers, mucosa - (See Morgellon's syndrome or Morgellon's disease below) Fibromyalgia - numerous websites and articles discuss possible connections between mold exposure and Fibromyalgia - including these: http://www.mold-survivor.com/fibromyalgia.html http://www.swarthmore.edu/NatSci/SigmaXi/docs/PosterSummaries2003/zagoryjessica.pdf#search=%22Fibromyalgia%20mold%20%22 - Swarthmore study http://www.personalconsult.com/cgi-bin/htsearch - free clinical search we have also corresponded with people who report suffering from Fibromyalgia and significant mold exposures, though the identification of genera/species and level of exposure were lacking. Flu-like symptoms: WARNING: flu-like symptoms can be a sign of potentially fatal carbon monoxide poisoning! Immediate help may be required. Food allergies frequent bloody noses frequent infections Fungal infections, systemic such as histoplasmosis, coccidioidomycosis, and cryptococcosis, responding to contaminated bird droppings or construction dusts

G Glucan sensitivity: Glucans are glucose polymers that are components of most fungal cell walls, and exposure to airborne 13-beta-D-glucan has been known to cause irritation symptoms due to airway inflammation (7). However, these irritant effects are transient and self-limiting

H hair loss headaches heart attack Hypersensitivity Pneumonitis - (Extrinsic Allergic Alveolitis) - tightness of chest, difficulty breathing, cough, fever, muscle aches, reactions occur 6-8 hrs after exposure. - Uncommon. hemorrhagic pneumonitis Extrinsic Allergic Alveolitis - (Hypersensitivity Pneumonitis) heartburn Histoplasmosis Hives hypersensitivity to airborne allergens or house dust hypersensitivity to mold hypersensitivity pneumonitis, associated with T-cell responses and responses mediated by immunoglobulin G (IgG). hypersensitivity pneumonitis is characterized by recurrent symptoms of fever, cough, and chest tightness and the presence of pulmonary infiltrates on a chest radiograph. Chronic hypersensitivity pneumonitis features progressive dyspnea, fatigue, interstitial pneumonitis, and pulmonary fibrosis (Farmer's lung)

I Immune system deterioration, decreased resistance indigestion infertility Invasive pulmonary aspergillosis - pneumonia, fever, bone pain, chills - occurs in immunocompromised patients uncommon irritation: aggravated existing allergic rhinitis or asthma irritability irritable bowel syndrome

itching skin, eye, nose, mouth J judgment, loss of ability to think clearly and make decisions K kidney pain and failure L learning difficulties leaky gut syndrome liver pain long lasting flu-like symptoms M Memory loss Menopause, unanticipated onset Metallic taste in mouth Migraine headaches Mood swings, sudden Morgellon's syndrome or Morgellon's disease: symptoms including fibers in nasal secretions fibers in skin and scalp particles or scrapings - skin lesions. According to the Mayo Clinic Staff, Morgellons disease is a mysterious skin disorder characterized by disfiguring sores and crawling sensations on and under the skin. Although Morgellons disease isn't widely recognized as a medical diagnosis, experts from the Centers for Disease Control and Prevention (CDC) are investigating reports of the condition, which they refer to as unexplained dermopathy. ... Morgellons disease shares characteristics with various recognized conditions, including Lyme disease, liver or kidney disease, schizophrenia, drug or alcohol abuse, and a mental illness involving false beliefs about infestation by parasites (delusional parasitosis - Mayo Clinic

Note: OPINION-DF: various indoor environmental contaminants may in some cases be associated with skin irritation complaints, including exposure of insulation workers to high levels of contact with fiberglass insulation. In our experience skin irritation from fiberglass insulation generally diminishes rapidly and stops within 24-48 hours of bathing and thorough washing of dusty clothing - Ed.

Question on Morgellons and fiber identification: I am a Morgellons Sufferer, how would you feel about analyzing my fibers? [I am attaching a ] slide show of 3 different samples, .... At least you can see the "hair" inside the bag. I have a video on youtube; I took the images with a hand held QX5 Microscope. All images are the "things" that came out of my skin. I had the bugs in my skin, but I didn't have a microscope then. I've heard of some 20 pathogens involved in Morgellons. Fungus is believed to be one of them. - G.P.

Reply: I took a look at your photos, but I cannot identify anything that is diagnostic or useful from those images other than to comment that I saw what appear to be hairs (and possibly other fibers) stored in plastic bags. Your QX5 microscope, while useful for general fiber examination at up to 200x, is unlikely to be adequate to the task of both fiber and small particle identification both because of limitations of the equipment and because training and experience in particle identification are important. To examine and identify fibers or small particles, including fungal spores, insect fragments, or non-fungal debris, requires both proper forensic traning in the type of particles being examined and training in microscopy, including the use of high powered light and polarized light microscopy, typically from 400x to 1200x.

Unfortunately examining hairs or fibers at low power is probably not reliable nor diagnostic. You should of course discuss your symptoms and concerns with a physician who is expert in environmental medicine. And if the physician obtains medical samples from skin surface or sub-surface areas and that need identification, in addition to medical lab examination, a particle or forensic lab might then be of service. - DF

Mucous accumulation on back of the throat Multiple chemical sensitivity (MCS) Mycosis - various mycoses ascribed to mold exposure including Aspergillosis Blastomycosis Candidiasis Coccidioidomycosis Cryptococcosis Histoplasmosis Paracoccidiomycosis

Sporotrichosis Zygomycosis also see Trichothecene poisoning (below) Mycotoxicosis - Mycotoxins, which typically are cytotoxic, disrupt cell membranes and interfere with the synthesis of protein, RNA, and DNA The only well-documented human mycotoxicoses have been the result of ingestion rather than inhalation also see Trichothecene poisoning (below)

N Nasal discharge, green slime, fungus, mucous, other (See Morgellon's syndrome or Morgellon's disease above) neck boils or round rash spots (see online photos) night sweats and hot flashes nose irritation nosebleeds numbness in face and limb O odors, increased sensitivity to (See ODOR DIAGNOSIS CHECKLIST) Pungent odors may initiate avoidance reactions, a generalized feeling of discomfort, breath holding, and a burning sensation on the skin Open skin sores and lacerations open sores on head organic dust toxic syndrome

P Peripheral nervous system effects personality changes pets, sudden odd behavior, aggressiveness, disorientation, running in circles,

stumbling, falling, respiratory disorder, sudden death, incl8uding death of pets due to pulmonary hemorraging [area of ongoing research by DJF - web author] See: circling disease in sheep. See "The Toxic Effects of Mycotoxins on Humans, Sheep, & Possibly on Pets" discussed at MOLD EXPOSURE STANDARDS Pets, Cryptococcosis of Cats; pet fatalities including pulmonary hemorrhaging, aberrant pet behavior similar to circling disease in sheep poor appetite puffy or droopy eyes Pulmonary hemorrhaging: Stachybotrys chartarum (S. atra) is a large sticky spore not easily made airborne. Stachybotrys mycotoxin was thought to cause acute pulmonary hemorrhage and death in infants, but the CDC has stated that the association has not been proved). About 10 ng of mycotoxins are produced for every 1 million mold spores [Probably widely variable from zero to high numbers based on environmental variables as well as species variation--DF]. Assuming the exposure is cumulative, inhalation of 109 spores per hour would be required for toxic effects. [This is a very low level and easily obtained in circumstances where occupants are exposed to moldy building materials during demolition or cleaning.-- DJF] Therefore, [in the opinion of some experts--DF] it is unlikely that inhalation of fungal parts presumed to contain mycotoxins could produce significant human illness--particularly in a nonagricultural setting.

QR Rashes redness of eyes respiratory distress Rhinitis Ringing in ears Runny nose

S Seizures [Observed also in animals/pets - DF] smells, increased sensitivity to spleen pain shortness of breath (see Asthma, COPD, respiratory disorders)

sinus congestion Sinusitis, chronic skin rashes or irritation skin redness sleep disorders slurred speech or verbal dysfunction (trouble in speaking) sneezing fits spitting up or vomiting mucous swollen glands swollen lymph nodes Syndromes, mold-related Chromoblastomycosis Eye Infections Lobomycosis Mycetoma Nail, Hair, and Skin disease Onychomycosis (Tinea unguium) Piedra Pityriasis versicolor Tinea barbae Tinea capitis Tinea corporis Tinea cruris Tinea favosa Tinea nigra Tinea pedi Otomycosis Phaeohyphomycosis

Rhinosporidiosis Systemic candida infection

T Throat irritation Tightness in the chest (this can be a common symptom of many complaints including mold-triggered asthma attacks) Tinea: most common fungal disease is this superficial mycosis, not linked to IAQ/building-related illness Tremors (shaking) Trichothecene poisoning (Alternate names: Mycotoxins, T2, Yellow rain) - possibly related to mycotoxin exposure from some molds. The US CDC offers lab criteria for diagnosis of Trichothecend poisoning including: Biologic: Selected commercial laboratories are offering immunoassays to identify trichothecenes or trichothecenespecific antibodies in human blood or urine (2, 3). However, these procedures have not been analytically validated and are not recommended. Environmental: Detection of trichothecene mycotoxins in environmental samples, as determined by FDA. References for poisoning by mycotoxins, T2, Yellow Rain, or Trichothecenes: Clinical Guide to Bioweapons and Chemical Agents, Vincent E. Friedewald, Springer, London, ISBN 978-1-84628-787-9 (online), Trichothecene poisoning is discussed in depth at the US CDC website where the following references are also provided: Wannemacher RW Jr, Wiener SL. Trichothecene mycotoxins. In: Zajtchuk R, Bellamy RF, eds. Textbook of military medicine: medical aspects of chemical and biologic warfare. Washington, DC: Office of the Surgeon General at TMM Publications, Borden Institute, Walter Reed Army Medical Center; 1997:655-77. Croft WA, Jastromski BM, Croft AL, Peters HA. Clinical confirmation of trichothecene mycotoxicosis in patient urine. J Environ Biol 2002;23:301-20. Vojdani A, Thrasher HD, Madison RA, Gray MR, Heuser G, Campbell AW. Antibodies to molds and satratoxin in individuals exposed in water-damaged buildings. Arch Environ Health. 2003;58:421-32. Tuomi T, Reijula K, Johnsson T, et al. Mycotoxins in crude building materials from water-damaged buildings. Appl Environ Microbiol 2000;66:1899-904. US CDC: "Case Definition: Trichothecene Mycotoxin", http://www.bt.cdc.gov/agent/trichothecene/casedef.asp 3/30/09 discusses the possibility of making weapons from Trichothecene mycotoxins. U unexplained fevers

Upper respiratory symptoms (eg, nasal congestion, sinus headache, episodic dyspnea) urinary tract infection (UTI)

V Vaginal yeast infections - wee Women' health problems (below) vertigo or dizziness VOC sensitivity: volatile organic chemicals may reach levels sufficient to produce central nervous system symptoms such as headache, inability to concentrate, or dizziness vomiting (nausea)

WXYZ Weakness, loss of strength wheezing breath women's health problems, nonspecific yeast infections, vaginal, (other?) symptoms: Vaginal. Recurrent episodes of Candida vaginitis associated with the classic symptoms of pruritus, burning and abnormal discharge. Gastrointestinal. Heartburn, bloating, diarrhea or constipation. Respiratory allergy. Rhinitis, sneezing and/or wheezing. Central nervous system. Anxiety, depression, memory deficits and/or loss of ability to concentrate. Menstrual abnormalities. Severe premenstrual tension and/or menstrual irregularities. Other Systemic Symptoms. Fatigue, headache and/or irritability.