June 24, 2018 | Black & Kletz Allergy
Molds are fungi that grow in the form of multicellular filaments that are called hyphae. Fungi that grow in a single celled environment are called yeasts. Mildew is also a fungus that closely resembles mold; however, the color of mildew tends to be white whereas mold tends to be black, blue, green, or red. Regardless, mold, mildew, and yeast can all play havoc to individuals who are either sensitive or allergic to them. Mold and mildew produce unwanted odors that many individuals find offensive or downright problematic as they can cause ailments to those exposed.
The physical appearance of molds usually is recognized by a discoloration and fuzziness presentation. Molds can be found anywhere outdoors or indoors and are typically found on old or expired foods, rotten decaying debris (e.g. wet fallen leaves in the Fall, compost piles, grasses, rotting wood), and in places where increased moisture or water exists (e.g., basements, bathrooms, kitchens). Molds produce mold spores which are their tiny microscopic reproductive structures. The size of a mold spore generally ranges from 3 to 45 microns in diameter which is less than half the width of a human hair. These spores begin to germinate and multiply. The spores multiply by producing reproductive hyphae. They and are released into the air and given their microscopic size, they are able to float in the air sight unseen. Mold spores can grow in any environment with a constant source of moisture. There are even types of molds that can survive in very arid conditions such as deserts. During the growth process, mold spores begin to undergo chemical reactions that allow them to consume nutrients and further multiply. These chemical reactions cause fumes to be released into the atmosphere. These fumes are responsible for the unpleasant musty mold odor. Of note, there are over 400,000 types of molds.
In the Washington, DC, Northern Virginia, and Maryland metropolitan area, the numbers of mold spores in the environment are generally higher than in many other parts of the country. Washington, DC was built on a swamp. In addition, the Washington, DC metropolitan area tends to have a fairly high relative humidity when compared to many other areas of the U.S. This combination exposes the residents of our metro area to a higher concentration of molds. In turn, it places us at a greater risk to develop mold allergies and other non-allergic mold-related conditions that may occur in sensitive individuals. Non-allergic mold-related illnesses may result from either the growth of pathogenic molds within the body or from the effects of ingested or inhaled toxic compounds called mycotoxins which are produced by molds. The molds that produce mycotoxins can pose serious health risks to humans and animals. Some studies claim that exposure to high levels of mycotoxins can lead to neurological problems and prolonged exposure may be particularly harmful. The research on the health effects of these types of molds has not been conclusive. The term “toxic mold” refers to molds that produce mycotoxins, such as Stachybotrys chartarum and not to all molds in general.
Mold allergies are very common and the symptoms are the same as other causes of hay fever (i.e., allergic rhinitis) and/or asthma. The symptoms may include runny nose, sneezing, nasal congestion, post-nasal drip, itchy nose, itchy eyes, watery eyes, redness of the eyes, sinus headaches, wheezing, coughing, chest tightness, and/or shortness of breath. Symptoms often worsen when a sensitive individual is in a damp or moldy environment such as a basement or crawl space.
Approximately 1-2% of patients with asthma have an allergic or hypersensitive reaction to a type of mold known as Aspergillus fumigatus. Similarly, 2-15% of children with cystic fibrosis have the same reaction to this mold. Aspergillus fumigatus is generally found in the soil. Asthmatics and cystic fibrosis patients with that react to this mold have a condition called allergic bronchopulmonary aspergillosis (ABPA). ABPA is more common in adolescents and male individuals. The symptoms of ABPA are very much the same symptoms of asthma; however they may also cough up mucus with brownish flecks and may also have a mild fever. The diagnostic workup may include radiographic studies, bloodwork, sputum culture, pulmonary function tests, and allergy skin testing. The treatment may involve the use of oral corticosteroids and/or antifungal medication in addition to the typical asthma medications such as corticosteroid inhalers, long-acting beta agonists, leukotriene antagonists, short-acting beta agonists, and/or theophyllines.
The diagnosis of mold allergy is done by a board certified allergist who will do a comprehensive history and physical examination. Allergy testing to molds can be done via skin testing or blood testing.
Treatment of mold allergy should always begin by trying to prevent exposure to mold. There are many things that can be done in one’s home or workplace that may help reduce one’s exposure. Reducing the humidity, fixing any leaks, wearing a mask when doing yardwork, limiting outdoor activities when the mold counts are high, using air conditioning with a HEPA filter, installing a dehumidifier, and removing carpeting from places where it can get wet are some of the ways to reduce mold exposure. The allergist may prescribe allergy medications (e.g., antihistamines, decongestants, nasal corticosteroids, nasal antihistamines, eye drops, leukotriene antagonists, asthma inhalers) to help alleviate one’s symptoms. Allergy shots (i.e., allergy injections, allergy immunotherapy, allergy desensitization, allergy hyposensitization) are extremely effective in the treatment of mold allergy. They are effective in 80-85% of the patients who take them. They have been utilized in the U.S. for more than 100 years and get more to the root of the underlying problem by causing an individual to develop protective antibodies against mold as well as other allergens (e.g., pollens, dust mite, pets, cockroach).
The board certified allergists at Black & Kletz Allergy have 3 locations in the Washington, Northern Virginia, and Maryland metropolitan area. Our offices are located in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. All of our offices have on-site parking and the Washington, DC and McLean, VA offices are also Metro accessible. The McLean office has a complementary shuttle that runs between our office and the Spring Hill metro station on the silver line. The allergy doctors at Black & Kletz Allergy diagnose and treat both adult and pediatric patients. To make an appointment, please call our office or you may click Request an Appointment and we will respond within 24 hours by the next business day. The allergy specialists at Black & Kletz Allergy have been helping patients with mold allergies and other causes of hay fever, asthma, hives, sinus disease, eczema, food allergies, medication allergies, insect sting allergies, and immunological disorders for more than half a century. If you suffer from mold allergies or any other type of allergies it is our mission to improve your quality of life by reducing or preventing your undesirable and irritating allergy symptoms.
