ABSTRACT
Background Increasing evidence is reported supporting associations between exposure to indoor microbial growth/dampness in waterdamaged buildings (WDB) and increased respiratory and allergic symptoms. Less attention is paid to associations between indoor microbial growth/dampness with multi-system and nonrespiratory adverse health effects. Contrary to the medical literature, testimony is given in court that it is very unlikely for sufficient mycotoxin to amass in WDB to cause multi-system illness. We reviewed epidemiological evidence of multi-system associations between exposure and adverse health effects published from 2011-2018.
Methods
We performed a comprehensive PubMed literature search targeting epidemiological articles referencing indoor microbial growth/dampness and adverse human health effects. We reviewed articles using a pre-determined format. Articles were sorted into 2 classes, non-supportive and supportive. Supportive articles were sorted into reports demonstrating statistically significant associations between indoor microbial growth/dampness and adverse human health at levels of: i) at least one association with OR (odds ratio) or RR (relative risk) ≥2.0; ii) an OR or RR ≥1.5; iii) an OR or RR ≥1.25; or iv) the inability to calculate an OR or RR from the published data.
Results
One hundred fourteen epidemiological articles were identified referencing chronic indoor microbial growth/dampness exposure with adverse human health effects. One hundred twelve (98.2%) were supportive linking chronic exposure to the interior of WDB and altered human health. Results referenced numerous systems including respiratory, neurological, immunologic (allergic and non-IgE mediated), cognitive, ophthalmologic and dermatologic among others. Seventy-nine articles reported one or more statistically significant OR or RR ≥2.0. Ninety-eight studies reported one or more OR or RR ≥1.50. Thirteen studies were supportive without adequate data to calculate OR or RR.
