Evaluation of the relationship between fungal burden in residential settings and health outcomes: A cross-sectional study

The purpose of this study was to determine whether an index of increased mold levels inside a residence can be used to predict an increased risk for adverse health effects. While researchers advocating the fungal allergen perspective have shown associations between exposures to some fungal allergens and allergic responses in humans and animals, relatively little is known about health impacts of these allergens in residential settings. These researchers argue that the lack of adequate data exploring the fungal allergen perspective has resulted in the inability to evaluate the risk of adverse health effects for indoor air quality investigations. Therefore this study analyzed the relationships between specific residential fungal exposures and adverse health outcomes. Participants of this cross sectional study included residents of a southern U.S. state ages 18 and above and who have resided at least 1 year in a single-family residence. Self-reported health symptoms were collected, and settled dust collected from the residence was analyzed using the environmental relative moldiness index (ERMI) protocol developed and validated by the U.S. Environmental Protection Agency (EPA). Binary logistic regression was used to demonstrate that as the ERMI value increased there was a statistically significant increase in reports of fatigue in participants; whereas, in contrast, ERMI values in the lower quartile were significantly associated with decreased reports of headaches. Increased levels of several individual fungal species were significantly associated with increased reports of respiratory irritation, headaches, and wheezing. This study provides progress toward a validated and standardized method for indoor air quality investigations that can lead to improved health outcomes for people in residential settings.