By Dr. Larry Chiaramonte
A recent study, published in the Annals of Allergy, Asthma & Immunology, followed 176 children from birth through age 7. One of the variables measured was the presence of mold in the home. What they found should surprise no one who reads this website regularly: By age 7, 18% of the children had asthma, and those who lived in a home rated as having a high level of mold during the first year of life were 2.6 times more likely to have asthma as those whose homes had low level of mold. This study focuses on a problem that allergists have recognized for ages. Dr. John Weiner, the Australian allergist who did a recent post for us, sent us a link from 2002 that included this:
“Skin prick test results from 1132 people with asthma in Australia, Europe and the US showed that those sensitized to molds were up to 3 times more likely to have severe asthma (BMJ 2002;325:411).”
We harp on the subject of mold because it is a potent allergen and because it is frequently overlooked in taking medical history. Just recently we were asked to review a questionnaire for a consumer pediatric website that when complete could be presented to doctors to help jumpstart the diagnostic process. It was very competent concerning seasonal allergens and behavior, but it was missing, among other things, any mention of water damage either at home or at school. Big omission.
The six most obnoxious words in the English language are: “As we say in our book.” But we can’t help it; it’s all there. As we say in our book:
“Molds are widespread in the environment and are common causes of severe allergies and asthma. Molds are a primitive type of plant. Their spores are similar in size to pollen grains. Some common molds are visible, such as the blue mold that grows on stale bread and cheese or the black mildew between your bathroom tiles. Molds grow inside homes wherever it is moist, such as in damp basements and around leaky plumbing. Like pollen grains, the mold spores themselves are microscopic so most molds cannot be seen.”
As we also point out, mold can afflict brand new homes as well as old ones because of poor construction. What makes this problem more vexing is that the sensory clues for mold are both visual and olfactory. You can see water damage and you can smell mold. Water damage should be repaired. Mold spores can be effectively removed by regular ventilation and washing affected areas with household bleach. Indoor humidity should be maintained at 50 percent or lower by using air conditioning and dehumidifiers. Sump pumps should be used in damp or flooded basements.
Unfortunately, as I have observed over the years, and as Dr. Ehrlich recently confirmed, immunotherapy for mold is effective only 50% of the time, compared to 80% or more for most common allergens. I believe this is because it encompasses the whole mold, not the spores that fly through the air and cause allergies. A colleague of mine developed an extract to the spores, which must be technically very challenging and expensive to make because it was not commercially viable under managed care reimbursement rates, and so it was discontinued.