DOHMH guidelines on fungi assessment and remediation, Apr 2000

NYC 9/11 Public Portal Document

infectious disease that can occur in immunosuppressed persons. Health effects in this population can be severe. Several species ofAspergillus are known to cause aspergillosis. The most common is Aspergillus/umigatus. Exposure to this common mold, even to high concentrations, is unlikely to cause infection in a healthy person.’

Exposure to fungi associated with bird and bat droppings (e.g., Histoplasma capsulatum and Cryptococcus neoformans) can lead to health effects, usually transient flu-like illnesses, in healthy individuals. Severe health effects are primarily encountered in HUllQtlTi immimocomprranisedpersons.^’^^’

13 Medical Evaluation

Individuals with persistent health problems that appear to be related to fungi or other bioaerosol exposure should see their physicians for a referral to practitioners who are trained in occupational/envirc tai medicine or related specialties and are knowledgeable about these types of exposures. Infants (less than 12 months old) who are experiencing non-traumatic nosebleeds or are residing in dwellings with damp or moldy conditions and are experiencing breathing difficulties should receive a medical evaluation to screen for alveolar hemonbage. Following this evaluation, infants who are suspected of having alveolar hemorrhaging should be referred to a pediatric pulmonologist Infants diagnosed with pulmonary hemosiderosis and/or pulmonary hemorrhaging should not be returned to dwellings until remediation and air testing are completed.

Clinical tests that can determine the source, place, or time of exposure to fungi or their products are not currently available. Antibodies developed by exposed persons to fungal agents can only document that exposure has occurred. Since exposure to fungi routinely occurs in both outdoor and indoor environments this information is of limited value.

13 Medical Relocation

Infants (less than 12 months old), persons recovering from recent surgery, or people with immune suppression, asthma, hypersensitivity pneumonitis, severe allergies, sinusitis, or other chronic inflammatory lung diseases may be at greater risk for developing health problems associated with certain fungi. Such persons should be removed from the affected area during remediation (see Section 3, Remediation). Persons diagnosed with fungal related diseases should not be returned to the affected areas until remediation and air testing are completed.

Except in cases of widespread fungal contamination that are linked to illnesses throughout a building, a building-wide evacuation is not indicated. A trained occupational/envirc mtal health practitioner should base decisions about medical removals in the occupational setting on the results of a clinical assessment

2. Environmental Assessment The presence of mold, water damage, or musty odors should be addressed immediately. In all instances, any source(s) of water must be stopped and the extent of water damaged determined.

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