1. Mansel A Nelson Institute for Tribal Environmental Professionals An Introduction to Mold and Moisture 1

2. 2 Topics I. Overview II. Indicators III. Health Effects IV. Prevention V. Investigation VI. Clean-up 2

3. I. Overview Key information Types of molds Factors contributing to mold growth 3

4. 4 Types of Molds What are molds? Part of class of “biological” contaminants that includes bacteria, mildew, viruses, animal dander, dust mites, cockroaches, pollens Part of “Fungi” kingdom that includes molds, yeasts, mushrooms, rusts Microscopic organisms that form and colonize through airborne spores Under a microscope 4

5. 5 Types of Molds (continued) Over 100,000 different types; about 10 different species common indoors 5

6. 6 Factors Contributing to Mold Growth What do molds need to grow? Food supply Moisture Warm temperatures, and Oxygen 6

7. 7 Food Sources  Organic sources  Soils, food, plant matter  Human and animal hair and dander  Clothing and fabric fibers  Fibers from floor coverings, insulation, building materials  Building materials  Certain materials –particleboard, LP siding, OSB, expanded styrene, cellulose insulation – all better food sources, absorb and hold moisture 7

8. 8  Building envelope leaks  Plumbing leaks  Damp soil & basements  Occupant activities  Condensation Moisture Sources 8

9. 9 Optimum Relative Humidity 9

10. Source Health and Energy Testing Services, NE http//www.healthandenergy.com/ 10

11. II. Indicators Key information Recognizing indicators of potential mold infestation Finding sources of information 11

12. 12 Recognizing Indicators 1. Known or suspected water damage Occupants may know of leak, flood, water intrusion (helpful to know extent, length, actions taken) Visible signs of water damage – may be clearly evident Less visible signs require further visual investigation behind wallpaper, baseboards, cabinets; in crawlspaces, on building exteriors, rust, drywall staining 12

13. 13 Recognizing Indicators 2. Reports from maintenance or custodial staff Know building history, repairs, structural issues May be first to report occupant complaints 3. Musty/mildew odors Indicator of mold growth; may not be visible 13

14. 14 Recognizing Indicators 4. Visible mold Appearance of spores not only indicator Range of colors (all “black” molds are not toxic, though proceed with caution) Growth patterns vary, depending on point of moisture contact 14

15. 15

16. 16

17. 17

18. 18 Is it Mold? 18

19. 19 Is it mold? 19

20. 20 II. Indicators 5. Reported health problems Clear links allergy/respiratory Possible flu-like symptoms, repeated viral infections, fatigue, frequent ER visits/hospitalizations NOTE: Symptoms overlap with other illnesses and issues 20

21. III. Health Impacts Key information Types of impacts Who is at most at risk 21

22. 22 Health Impacts “Exposure to damp and moldy environments may cause a variety of health effects, or none at all.” www.CDC.gov/mold Health impacts vary widely and are individual in impact. Health issues can result from a variety of environmental issues and it can be difficult to identify specific causes. 22

23. 23 Types of Effects 1. Irritant Exposure can irritate eyes, skin, nose, throat, and lungs, in allergic and non-allergic individuals Effect is dose-related, usually transient 2. Allergen Common symptoms runny nose, itchy eyes, sneezing, sore throat, nasal congestion, eczema, dermatitis In high concentrations, molds can trigger symptoms in individuals with no known allergies Long-term exposure can sensitize an individual, inducing allergies and airway-reactivity 23

24. 24 Types of Effects (cont.) 3. Infectious Direct infection occurs when pathogens attack immune- compromised individuals E.g., Aspergillus fumigatus known to cause aspergillosis (ABPA) 4. Toxic (rare) Toxic molds produce chemicals called mycotoxins Certain species (e.g, stachybotrus, fusarium, trichoderma) are known carcinogens Mycotoxins readily absorbed by intestinal lining, airways, skin Presence of toxic molds usually associated with long-standing water problem 24

25. 25 Who is most at risk? Individuals with lower-airway diseases Asthma, chronic bronchitis Molds directly tied to presence, persistence and increased severity of asthma episodes Young children (birth to age 2 – critical window) Allergic sensitization/genetic predisposition Incidence of RSV Elders Individuals with compromised immune systems Individuals with allergies (upper respiratory) 25

26. IV. Prevention 26

27. 27 Principles for Existing Buildings Work with occupants, maintenance and custodial staff to focus on prevention practices 1. Keep it clean 2. Keep it dry 3. Keep it well ventilated 4. Keep it well maintained 27

28. 28 1. Clean  Control dust sources  Regular cleaning  Carpet removal where possible  Use of walk-off mats  HEPA-filter vacuuming  Reduced clutter  Shoes-off policy Principles for Existing Homes (cont.) 28

29. 29 Principles for Existing Homes (cont.) 2. Dry & Ventilated  Ventilation  Install & use exhaust fans vented to outdoors in kitchens and bathrooms, clothes dryers–eliminate moisture that builds up from everyday activities  Attic and crawl spaces – Keep humidity below 50% to prevent condensation on building materials  Water damage  Thoroughly clean & dry water-damaged carpets and building materials (within 24 hours, if possible) or  Consider removal or replacement 29

30. 30 Ventilation Necessary to remove humidity, dilute and remove contaminants Bathroom  moisture condenses on cold ceiling Whole house ventilation  Fans, HRV/ERVs Kitchens 30

31. Source Health and Energy Testing Services, NE http//www.healthandenergy.com/ 31

32. 32 Tips for Residents Furniture 6” away from exterior walls Do not hang blankets on exterior walls Use proper window treatments and open during the day – No blankets Run bath fan after each bathing event for 30 minutes! Diligence – keep an eye for problem prone areas 32

33. V. Investigation Key information Objectives of investigation Types of sampling 33

34. 34 Objectives of Investigation 1. Identify all moldy areas If occupant reports mold, search throughly (under sinks, in cabinets, behind toilets, behind furniture; sub-floor, drywall, crawl space) 2. Identify all possible causes Plumbing or appliance leaks? High humidity? Condensation? 3. Reduce exposure to occupants in home/building 4. Develop plan for clean-up/remediation 5. Ensure that maintenance staff and occupant are informed 34

35. 35 Types of Samples When is sampling necessary?  If legal action is being considered or there are serious health impacts that require specialized medical treatment. Is species identification necessary?  Identifying species of mold or airborne sampling is not recommended for investigation or remediation Microscope can help confirm presence of mold No standards for exposure levels of mold / spores 35

36. 36 Mold Complaints A mold complaint may include some other IAQ issues Consider other possibilities for IAQ concerns Follow air-flows Look for additional air pollutant sources, including items the occupants use 36

37. VI. Remediation / Clean-up 37

38. 38 First Things First Mold clean-up is not effective until the source of moisture is addressed. Mold is a moisture problem 38

39. To consider before remediating: Existing moisture problems Hidden sources of moisture or is the humidity too high? Building occupants reporting musty or moldy odors? Building occupants reporting health problems? Building materials or furnishings visibly damaged? Maintenance been delayed? Building been recently remodeled or its use changed? Consultation with medical or health professionals indicated? 39

40. Remediation Planning Protect the health & safety of the occupants and remediation team. Fix the moisture problem. Assess the size of the mold problem (next slide). Select a remediation manager as needed Consider use of PPE. Consider use of containment. Plans can vary greatly in size and complexity. Communicate with occupants. Do they need to be relocated? 40

41. 41 Mold Remediation Less than 10 sq ft PPE (minimum) N-95 respirator, gloves, goggles Containment: None required Between 10 sq ft and 100 sq ft PPE limited or full (use “professional judgment”) Respirator (N-95, half-face, full-face) Gloves, goggles, foot covering Disposable overalls/disposable full body clothing 41

42. 42 Mold Remediation Continued  Containment: Limited  Polyethylene sheeting ceiling to floor around affected area, slit entry, covering flap  Maintain area under negative pressure with HEPA filtered fan unit.  Block supply and return air vents within containment area More than 100 sq ft Call in professionals / get training 42

43. Communication People will probably demand that you test the air whether it is warranted or not. Be prepared to explain why you will or why you won’t. You may need an expert. However, outside experts are often viewed by a suspicious community as a “hired gun.” Consider involving the affected community in selecting a consultant. Release information quickly. Reports not released quickly become “secret” reports which “can’t be good news.” We want sampling! 43

44. 44 Mold Clean-up Hard, non-porous materials can be cleaned  Use a sponge or cloth to wipe the area clean.  Never mix bleach with other cleaning products  Clean thoroughly… If you leave some mold behind, the spores will be easily released back into the air when the material dries out. Remove porous materials  Ceiling tiles, carpeting or sheetrock (drywall) and dispose 44

45. 45 Mold Clean-up If mold is the result of flooding:  Remove all sheetrock to at least 12 inches above the high water mark.  Inspect the interior of the walls to ensure all contaminated sheetrock removed. Allow the area to dry for 2-3 days after cleaning.  Use fans and dehumidifiers 45

46. Personal Protective Equipment Remediation/investigation may disturb mold and mold spores. Avoid inhaling spores and skin and eye contact. Minimum: N95 respirator mask, goggles with no vent holes, rubber gloves, long sleeves and long pants. 46

47. Personal Protective Equipment More respiratory protection Limited: half or full face purifying respirator with HEPA filter cartridge. HEPA filters do not provide protection against vapors or gases. Should always be approved by NIOSH. NOTE: All individuals using half or full face respirators must be trained, have medical clearance and must be fit-tested by a trained professional. The use of respirators must follow a complete OSHA program. 47

48. Personal Protective Equipment More respiratory protection Full: Use in situations when high levels of dust or spores are likely or when intense long- term exposures are expected. Full-face powered air purifying respirator (PAPR) is recommended. 48

49. Personal Protective Equipment Clothing Disposable clothing is recommended during medium or large jobs. Limited: disposable paper overalls Full: mold-impervious head, body and feet clothing made of breathable material such as TYVEK. 49

50. 50 Safety Guidelines & Resources To prevent exposure and assure containment, critical that maintenance staff employ safety guidelines… 50

51. 51 Safety Guidelines - Occupants  Prevention and clean-up for small areas (cleaning non-porous surfaces and wood with detergent; repair moisture source; dry material, etc)  Many people use bleach, which kills mold, but is not a good cleaning agent  Bleach is a strong respiratory irritant  Surfactant (soap) is better 51

52. 52 More Information General mold information http://www.epa.gov/mold/ Mold Remediation in Schools and Commercial Buildings http://www.epa.gov/mold/mold_remediation.html Mold and Moisture: Guidance for Clinicians http://oehc.uchc.edu/CIEH.asp 52

53. 53 Institute for Tribal Environmental Professionals Mansel A. Nelson Senior Program Coordinator Indoor Air Quality in Tribal Communities Northern Arizona University (NAU) http://www.nau.edu/iaqtc/ mansel.nelson@nau.edu Voice 928 523 1275 FAX 928 523 1280 PO Box 5768, Flagstaff, AZ 86011 53