Hurrass, Julia, Heinzow, Birger, Aurbach, Ute, Bergmann, Karl-Christian, Bufe, Albrecht, Buzina, Walter, Cornely, Oliver A., Engelhart, Steffen, Fischer, Guido, Gabrio, Thomas, Heinz, Werner ORCID: 0000-0002-7833-9202, Herr, Caroline E. W., Kleine-Tebbe, Joerg, Klimek, Ludger, Koeberle, Martin, Lichtnecker, Herbert, Lob-Corzilius, Thomas, Merget, Rolf, Muelleneisen, Norbert, Nowak, Dennis, Rabe, Uta, Raulf, Monika, Seidl, Hans Peter, Steiss, Jens-Oliver, Szewszyk, Regine, Thomas, Peter, Valtanen, Kerttu and Wiesmueller, Gerhard A. (2017). Medical diagnostics for indoor mold exposure. Int. J. Hyg. Environ. Health., 220 (2). S. 305 - 329. MUNICH: ELSEVIER GMBH. ISSN 1618-131X

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Abstract

In April 2016, the German Society of Hygiene, Environmental Medicine and Preventative Medicine (Gesellschaft fur Hygiene, Umweltmedizin und Praventivmedizin (GHUP)) together with other scientific medical societies, German and Austrian medical societies, physician unions and experts has provided an AWMF (Association of the Scientific Medical Societies) guideline 'Medical diagnostics for indoor mold exposure'. This guideline shall help physicians to advise and treat patients exposed indoors to mold. Indoor mold growth is a potential health risk, even without a quantitative and/or causal association between the occurrence of individual mold species and health effects. Apart from the allergic bronchopulmonary aspergillosis (ABPA) and the mycoses caused by mold, there is only sufficient evidence for the following associations between moisture/mold damages and different health effects: Allergic respiratory diseases, asthma (manifestation, progression, exacerbation), allergic rhinitis, exogenous allergic alveolitis and respiratory tract infections/bronchitis. In comparison to other environmental allergens, the sensitizing potential of molds is estimated to be low. Recent studies show a prevalence of sensitization of 3-10% in the total population of Europe. The evidence for associations to mucous membrane irritation and atopic eczema (manifestation, progression, exacerbation) is classified as limited or suspected. Inadequate or insufficient evidence for an association is given for COPD, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis, and cancer. The risk of infections from indoor molds is low for healthy individuals. Only molds that are capable to form toxins can cause intoxications. The environmental and growth conditions and especially the substrate determine whether toxin formation occurs, but indoor air concentrations are always very low. In the case of indoor moisture/mold damages, everyone can be affected by odor effects and/or impairment of well-being. Predisposing factors for odor effects can be given by genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for impairment of well-being are environmental concerns, anxieties, conditioning and attributions as well as a variety of diseases. Risk groups that must be protected are patients with immunosuppression and with mucoviscidosis (cystic fibrosis) with regard to infections and individuals with mucoviscidosis and asthma with regard to allergies. If an association between mold exposure and health effects is suspected, the medical diagnosis includes medical history, physical examination, conventional allergy diagnosis, and if indicated, provocation tests. For the treatment of mold infections, it is referred to the AWMF guidelines for diagnosis and treatment of invasive Aspergillus infections. Regarding mycotoxins, there are currently no validated test methods that could be used in clinical diagnostics. From the perspective of, preventive medicine, it is important that mold damages cannot be tolerated in indoor environments. (C) 2016 Elsevier GmbH. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hurrass, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heinzow, BirgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aurbach, UteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bergmann, Karl-ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bufe, AlbrechtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buzina, WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornely, Oliver A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Engelhart, SteffenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischer, GuidoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gabrio, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heinz, WernerUNSPECIFIEDorcid.org/0000-0002-7833-9202UNSPECIFIED
Herr, Caroline E. W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kleine-Tebbe, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klimek, LudgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koeberle, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lichtnecker, HerbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lob-Corzilius, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Merget, RolfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muelleneisen, NorbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nowak, DennisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rabe, UtaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Raulf, MonikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seidl, Hans PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steiss, Jens-OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Szewszyk, RegineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thomas, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Valtanen, KerttuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wiesmueller, Gerhard A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-234613
DOI: 10.1016/j.ijheh.2016.11.012
Journal or Publication Title: Int. J. Hyg. Environ. Health.
Volume: 220
Number: 2
Page Range: S. 305 - 329
Date: 2017
Publisher: ELSEVIER GMBH
Place of Publication: MUNICH
ISSN: 1618-131X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INVASIVE FUNGAL-INFECTIONS; DISEASES WORKING PARTY; SKIN-PRICK TEST; ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS; IN-HOUSE DUST; MOISTURE DAMAGE; STACHYBOTRYS-CHARTARUM; CHRONIC RHINOSINUSITIS; RESPIRATORY-TRACT; GERMAN SOCIETYMultiple languages
Public, Environmental & Occupational Health; Infectious DiseasesMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/23461

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