A comprehensive review of mold research literature from 2011 - 2018

Ming Dooley, Scott W. McMahon



Increasing evidence is reported supporting associations between exposure to indoor microbial growth/dampness in water-damaged buildings (WDB) and increased respiratory and allergic symptoms. Less attention is paid to associations between indoor microbial growth/dampness with multi-system and non-respiratory 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.


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.


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.


Of 114 epidemiological articles, 112 (98.2%) were supportive of single/multi-system symptoms. The current literature supports multi-system adverse human health effects in those chronically exposed to indoor microbial growth/dampness.


Mold, microbial growth, dampness, water-damaged buildings, adverse health effects, Chronic Inflammatory Response Syndrome, innate immune system, Sick Building Syndrome, comprehensive review, systematic review

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DOI: http://dx.doi.org/10.18103/imr.v6i1.836


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