October 14, 2005

Existence of toxic mold syndrome questioned

By Will Boggs, MD

NEW YORK (Reuters Health) - Mold and dampness can cause
coughing and wheezing, but there is little evidence to support
the existence of the so-called toxic mold syndrome, according
to a report by researchers at the Oregon Health Sciences
University in Portland.

Toxic mold syndrome -- illnesses caused specifically by
exposure to mold -- continues to cause public concern despite a
lack of evidence that supports its existence, researchers
explain in the September issue of the Annals of Allergy, Asthma
& Immunology. Several critical reviews have failed to find
scientific support for toxic effects from breathing in mold
spores as a viable mechanism of human disease, they add.

Dr. Barzin Khalili and Dr. Emil J. Bardana, Jr. describe
the clinical characteristics of 50 patients with complaints of
illness they attributed to mold exposure in their home or
workplace. The patients had been referred by a defense attorney
in a civil litigation or by insurance adjusters representing
worker's compensation agencies.

There was no consistent set of symptoms, the authors
report, with patients having an average of more than eight
symptoms. Most patients reported a family or personal history
of allergy or asthma.

Three quarters of the patients had abnormal physical
examination results, the researchers note, with inflammation of
the eye or skin and congestion occurring most commonly.

Thirty patients had other non-mold-related illnesses that
could explain most, if not all, of their mold-related
complaints, the report indicates, and nearly two thirds of the
individuals had evidence of a previously diagnosed mood

"In fact," the investigators write, "when the entire
history and objective evidence were scrutinized, a number of
well-established and plausible diagnoses emerged that explained
many, if not all, the complaints."

In a commentary in the journal, Dr. Abba I. Terr from UCSF
Medical Center, San Francisco contends that toxic mold disease
is "the latest in a series of environmentally related
pseudo-illnesses" that include multiple chemical sensitivity,
also known as idiopathic environmental intolerance, and chronic
fatigue syndrome, which was attributed at one time to infection
with Epstein-Barr virus.

"Since these authors have determined that the patients they
describe do not have a mold-related disease but are
nevertheless seeking compensation for presumed illness through
a legal process that has defined it in those terms, toxic mold
disease is truly a diagnosis of litigation," Terr concludes.

SOURCE: Annals of Allergy Asthma and Immunology, September