NASHVILLE, Tenn. - You can't fix what you don't measure. Likewise, you can't hold a meeting to solve a major problem without keeping the discussions within strict boundaries. This is doubly true when the subject is politically, economically, and emotionally charged - like mold.

The Healthy Indoor Partnership Workshop on Mold took place in Montreal late last year, bringing together more than 85 North American experts - manufacturers, consultants, and builders, as well as occupational hygiene, health, and property management specialists.

Their goal was to reach a consensus on state-of-art and R&D priorities on two aspects of mold in buildings. They agreed that the top priorities regarding mold are:

1. Potential health impacts.

2. Remedial technologies.

The report they gave at this year's Annual Meeting of the American Society of Heating, Refrigerating,

and Air-Conditioning Engineers (ASHRAE) described what they learned in Canada and how they came to these conclusions.

In his presentation titled "Overview of the Healthy Indoor Partnership Mold Workshop," Morad R. Atif, Ph.D., of the National Research Council of Canada (Ottawa), pointed out that "Mold is part of the contaminants we deal with.

"We have defined major gaps that will allow us to move forward, strategies for the future, and the current state of knowledge."

He noted this session provided much more useful information than the typical fare of insurance and liability costs, and reported case studies with no practical solutions that many meetings provide.

Mold Priorities

Marie-Alix D'Halewyn, Ph.D., of the Institut National de Sante Publique du Quebec, Ste.-Anne-de-Bellevue (Quebec), presented "Identified R&D Themes and Priorities for Mold in Buildings." Health solutions, she said, need to include prevention, control, and remediation, as well as symptom treatment. The goal was to find out what the experts know, what don't they know, and where they want more targeted research.

There were 80 participants, D'Halewyn said. "We wanted to create a dialogue, but that was not a given." The most important information they hoped to get, she said, was an assessment of the level of R&D needed. They started off in small groups that included health researchers, public health officials, physicians, advocates, patients, building owners, occupants, and contractors.

The current state of knowledge was set down in documents from the American Conference of Governmental Industrial Hygienists (ACGIH) and other expert sources - documents that were circulated during the conference. Based on that, they determined what kinds of information they lacked.

On day two they looked at potential solutions, including building products and envelopes, ventilation and air conditioning systems, public health research priorities, the effects of climate change, assessment, and remedial techniques.

In addition to health concerns, there is concern over the reliability of information available given the huge amount available on the Internet. (A recent search for "mold" using Google resulted in 1.58 million hits in 33 seconds.)


The participants agreed that most useful guidelines are difficult to locate; when you do find them, they tend to compete with each other, and there are discrepancies in the information they provide. They noted documents are not universally accepted - and there are no "action" documents.

It may be still more difficult to assess the health effects of mold, she said. This can lead to a loss of credibility among professionals, who may come across as if they don't know what they are doing.

Moreover, the "mold is gold" attitude creates a lot of self-proclaimed experts who are out to make a buck, she said. This impedes valid research and collaboration.

In addition, the health care community lacks clinical and fundamental definitions; in short, there are no clinical tests to determine that a patient's symptoms were caused by mold exposure. Other illnesses and conditions must be ruled out first.

"There is no easy way to measure exposure criteria," D'Halewyn said. "Basic knowledge is trickling down to practitioners," but they need more.

The participants came up with a wish list of their most critical needs to address these concerns:

  • Establish research priorities.

  • Promote research.

  • Create a clearinghouse for in-formation.

  • Create seminars and curricula for pre-med and med students.

  • Set up an accreditation agency for best practices.

    There is plenty of information about mold, but a lack of consensus on how and when to remediate. (Photo courtesy of Emerson Climate Technologies.)


    Atif said that on the building side, "People assume there is a lot of consensus in remediation technology." The major issues pinpointed at the conference, he said, were:

  • A lack of basic knowledge.

  • Health impacts for remediation employees that are not well known or recognized.

  • Mold management decisions that are difficult.

  • Risk assessment that is difficult, with no established exposure threshholds.

    Even the information that is available is problematic, he said. It is wide ranging and sometimes of questionable validity and quality, and may lead to misconceptions. Documents may look similar but they are different. And, there is "a flagrant lack of coordination" among building professionals, he said.

    He said the meeting also pointed to a lack of standards, guidelines, and best practices in the following areas:

  • Building and operations - Design guides lack details. Building performance standards are incomplete. Quality control/inspection during construction is lacking.

  • Mold detection.

  • Remediation/deconstruction.

    In renovation situations, the aging building stock needs attention. Changes in building usage often are not taken into account.

    Opportunities exist in R&D, as well as codes, legislation, and guidelines. The need for practical solutions is very urgent, Atif said.

    R&D has opportunities to create:

  • Modeling techniques for building design.

  • Methods to prevent moisture ingress.

  • Durable materials.

  • Detection methodology.

    Code-making bodies can affect change in:

  • Building codes.

  • Management policies (which should not wait for research results, considering the urgency of the issue).

  • Building consensus.

    Practical solutions/tools should include:

  • Mold detection and risk assessment.

  • Remediation protocols.

  • A homeowners' guide.

  • Training and certification.

    "Consensus will close the gaps," Atif said. "The key is credibility. Quality assurance is what we need."

    The workshop was completed successfully, he said. The participants identified the previously mentioned issues, and formulated strategies in health and prevention.


    According to D'Halewyn, the following considerations must be made in mold inspections and remediation:

  • First perform a visual inspection. Once you have identified something as mold, "decontaminate, don't study it." There is no standard inspection protocol, she pointed out.

  • Document and quantify moldy surfaces. Take pictures and measurements (areas and density).

    For most types of mold, "Any level of visible fungal contamination could potentially represent a health risk for certain populations," she said. So, when are air samples and spore counts needed? Only when necessary for documentation's sake, she noted.

    Anyway, what do you do with such reports?

    "No number equates to contamination," D'Halewyn said. Results are interpreted by comparison methods, but how much is there naturally in the environment? Most indoor molds are different species than those found outdoors, she said. It is difficult to assess.

    During inspection and especially during remediation, "Containment and personal protection are needed," she said. You also need to know the total area contaminated (square footage, percent of room, percent of building).

    "When it's very moldy, you have to treat it like asbestos abatement," she said. Steps include:

  • Correct the cause of contamination (i.e., prevent water ingress).

  • Remove fungal growth.

  • Remove porous building materials.

    On the big board of life in the building community, if you have mold, go directly to assessment and remediation, D'Halewyn said. Do not pass Go. Do not collect $200.

    Sidebar: Analyzing The Effects Of Mold

    NASHVILLE, Tenn. - Marie-Alix D'Halewyn, Ph.D., of the Institut National de Sante Publique du Quebec, Ste.-Anne-de-Bellevue (Quebec), also discussed the impact of mold, mycology, harmful substances, and health effects at the ASHRAE Annual Meeting.

    In northern climates, she said, 30 percent of all city and suburb homes have mold. Public buildings, schools, and hospitals also have high rates of mold. "It is accepted that the health effects are on the rise," she said.

    Mold needs food and water to survive and multiply, D'Halewyn said. "It grows anywhere except where there is snow and ice." Spores and organic materials can get in readily. "All we need is water to grow mold from spores," she said. Around 250 different species of mold have been documented.

    Harmful substances can include noxious organic substances that act as irritants, allergens, immunogenic agents, and toxic agents. (This is a concern whether spores are viable or not. "Poisons are poisons," she said.)

    Health effects from allergens include rhinitis, asthma, sinusitis, and hypersensitivity pneumonitis. Organic dust toxic sundrome (ODTS) is well known in occupational settings, such as grain silos. Long-term exposure can result in mycotoxicosis (respiratory and cytotoxic - literally cell death). Neurologic and fatigue-related symptoms have not been proven; however, they have not been disproven.

    There are many examples of food-related allergies, she said, but a lack of epidemiological studies for inhalation allergies.

    - B. Checket-Hanks

    Publication date: 08/16/2004