Fungal contamination of elementary schools: a new environmental hazard

Abstract

BACKGROUND: Sensitivity to fungi is a significant cause of allergic diseases, and prolonged indoor exposure to fungi is a growing health concern. OBJECTIVE: This study evaluates the health effects of mold-contaminated schools on students and teachers. A discussion of the effectiveness of current methods for evaluating these schools, with a focus on the importance of using total mold spore counts, is also provided. METHODS: Two Connecticut public schools were tested using multiple air quality testing methods, with the standard for a healthy indoor environment being total mold spore counts lower than 1,000 spores/m3. The health impact of the mold exposure at each school was evaluated using the validated Rhinitis Outcomes Questionnaire. RESULTS: The testing of the first school found indoor mold counts ranging from 6,000 to 50,000 spores/m3. Eighty-five of the students and teachers reported significant allergic symptoms to the school nurse. This school is currently being demolished. More than 2 years after the exposure ended, a number of occupants of the school continue to have elevated symptoms compared with before their exposure to the school. The testing of the second school revealed total mold spore counts ranging between 2,000 and 9,000 spores/m3, qualifying it an unhealthy environment in need of immediate remediation. Students reported significant allergic symptoms from exposure to certain rooms that are currently being remediated. CONCLUSIONS: Because of the negative impact on health that indoor mold exposure has, particularly in atopic patients, schools should be routinely tested for fungal contamination. Total mold spore counts should be performed using volumetric air sampling such as the Allergenco MK-3 (Allergenco, San Antonio, TX) because testing air quality via semiquantitative culture sampling alone does not give a true reflection of the extent of fungal contamination. Finally, the standard for a healthy indoor environment should be defined as having <1,000 spores/m3.