Contributions by Immo Tilgner, P Eng (professional Engineer, Health Canada - Senior Industrial Hygenist)

People who worry about their immune system or skin rash may want to look at this info. There was NO indication that there is bird contamination in building air, but that does not rule out previous (10 years ago) exposure because people can get it from soil or while cleaning rain gutters around the home. Note that this is a fungal disease so it will NOT be treated with antibiotic.- Immo

The skin lesions of histoplasmosis are varied and can be caused by an immune reaction to acute pulmonary (lung) involvement. In this case, lesions called erythema nodosum or erythema multiforme (target lesions) occur. Skin lesions can also be a manifestation of disseminated histoplasmosis, where the fungus has spread to distant organs throughout the body including the skin, the bone marrow and the brain amongst others. Disseminated histoplasmosis is more common amongst immunosuppressed people, (such as those who receive cancer treatment or who have AIDS).

From the National Institutes of Health (NIH), US department of Health and Human Services-MedlinePlus_

What's under your kitchen sink, in your garage, in your bathroom, and on the shelves in your laundry room? Learn more about what's in these products, about potential health effects, and about safety and handling.

Information in the Household Products Database is taken from a variety of publicly available sources, including brand-specific labels and Material Safety Data Sheets (MSDS) prepared by manufacturers. - from the Household Products Database

Fabrics are treated with dyes, with pesticide, fungicide and maybe fire retardants. There may be effects on skin.

In addition scented wash chemicals may affect some people, as well as the products used in the dryer. Just take one of those dryer towel fabric softeners, hold it in your hand and wet the towel. You end up with a messy paste on your hands. That past goes into the fabric as it rolls around inside the dryer with your favourite shirt. Some sensitive skin may object.

Some time back our coast guard had been issued new uniforms that were treated with fire retardent. The result was skin rash that affected the entire crew of one vessel heading north. They had to return to port and get a new issue of old uniforms. The crew was fine after that. The new uniforms were withdrawn from the service.

With respect to fire safety of fabrics I found this on www.consumerreports.org, after a little bit of research:

| Fiber content plays a role in performance. A different fleece | sweatshirt containing 80 percent cotton and 20 percent polyester | passed the federal threshold when new, when laundered by machine, and | when laundered according to the federal protocol. When you buy fleece, | note that the more polyester in the blend, the safer. | Many polyester fibers extinguish on their own and go a long way toward | limiting the potential for injury.

This is a fabric that does NOT require chemical treatment to be fire retardent, but all fabric will eventually burn. The effects on the skin depends on the individual and possibly the combination of toiletries and fabric chemicals in contact with sensitized skin.

This may also be helpful to review: - Immo

Environmental hypersensitivity (EH) is a very controversial subject within the medical community and among patients and other stakeholders. It is a very difficult condition to classify and diagnose given that it presents a large range of physical and central nervous system symptoms which vary from one person to another and may be triggered by a large number of stimuli. (posted 26 August 2004)

What can happen just cleaning out your aquarium (posted 26 August 2004)

01 October 2004

Hi Bob

I have looked at the effects of fragrance on building occupants over time, and my only advice is to inform people on the effects of fragrance on others. Lets face it, that's how and why fragrance is in the market place, to affect other people.

No one seems to sell fragrance by telling people to watch out for ill effects, so only the assumed positives are used in TV ads. People suffering from sensitivities can tell you a different story; sensitivities that may have been acquired decades ago.

Some people in the workplace worry about immune system response that may come from fragrance allergy.
If you need to have some information for discussing environmental sensitivities, the American College of Occupational and Environmental Medicine has an interesting position paper found at

http://www.acoem.org/guidelines/article.asp?ID=46

as does the Asthma and Allergy Foundation of America at

http://www.aafa.org/templ/display.cfm?id=376&sub=396

Both organizations are at a loss in trying to explain the phenomenon, so it looks like the people who suffer the allergies may be limited to treatment of their specific symptoms, with the remaining community trying to provide as much comfort as they are willing to provide. That would be in the form of limiting use of fragrance products.

It is important to try and make people as comfortable as possible in the workplace, within given circumstances, and this is certainly a contentious issue, however, it is important to have as much knowledge as possible about an issue before trying to deal with it.

Having dealt with a fair number of these cases, I find it is important to look at all sides of this issue before making a call. Invariably it is the personal physician who has to deal with the patient. All we can do is to make people aware of the needs of others and improve the work environment.
That environment may not be perfect, as pollutants are both inside and outside of buildings and workplaces.

Buildings really do not have the machinery to make the building environment perfect, but awareness can help reduce the load of Volatile Organic
Compounds - VOC's - in the workplace that may affect some people.

There was also a good article in OHS Canada, but I can't remember exactly when.

Immo
 

Hi Bob

Note in the top web site that the bugs may favour certain geographical settings such as moisture, or shielded from wind.

Two years ago it was reported that biting midges were responsible for a "significant number" of complaints at one of our home football games.

http://archive.columbiatribune.com/2002/sep/20020917news001.asp

According to the following web site, some of these critters can pass through standard window screens. It is also said that their bites are "vicious" and out of proportion to their size.

http://edis.ifas.ufl.edu/IG081

I'm not saying this is your fellow workers' problem, but thought you might find it of use.
 

Hi Bob

Further to the rash reports from employees I have come accross reports like the one below a number of times in warehouse, school or office settings.
Note that at times paper fibre floating in air may acquire an electric charge which tends to discharge on contact with the skin, producing the biting sensation.

Have you conducted a search on the internet?
Here are some links I found...

http://citybugs.tamu.edu/FastSheets/Ent-1012.html
http://delusion.ucdavis.edu/, look up Delusional Parasitosis http://www.pestweb.com/ipca/mystery.html



In recent months we've seen an increase in the number of our custormer service representatives reporting "bug bites." Usually the employees feel the "bites" but no one has been able to see the insect. Many times the skin will show a reaction such as a bit of redness, welt, or rash. This has been occurring in a large building complex, but only in the parts of the two floors occupied by the customer service center (these are people on the phone with customers all day).

The facilities department has been responsive to these and previous reports that have been made from time to time. A pest control contractor visits regularly but has not found any suspect insects. A chemical is applied to the ground outside the building each year to prevent clover mites from climbing the walls. Spraying has not been done except in very limited and targeted areas that are not in this part of the complex. Vacuuming of floors and furniture has been stepped up.

There was a similar episode of these "biting sensations" in the CSC about 6 years ago that lasted for about a year. A data analysis revealed no patterns in time of day, location within the CSC, employee activity, etc.
Microscopic analysis by the entomologist of vacuum samples and scotch tape placed immediately over the "bites" on the skin revealed no suspect insects. Eventually the reports tapered off to almost zero.

As we now embark on a new investigation, I'd welcome your suggestions or insights into this problem.
 

Anyway, we thought we determined it to be an employee with 5 cats that were fairly flea infested. She kept bringing the fleas into work on her clothing and then they would jump off and "hop" around occasionally biting someone.
Once she "de-flea'd" the animals, the problem stopped in 60 days. Or maybe it went away because of the winter... No flea can survive our winters, they all go to Florida!

Anyway, that is what we figured, it was never "proven beyond a reasonable
doubt". But if I was you, I might put out a subtle questionnaire asking
people if they have pets, or if they are around pets before they come to work. Make it the excuse you are thinking of allowing pets to be placed as dependents on your healthcare policy or something. Obviously if people believe you are going to blame them for the "pestilence", they will be less than forthcoming with the information.

Also note, your building caretaker can place flea traps around the office(open pan-ultraviolet light type), they work very well, and capture all kinds of other creepy crawlies you didn't know you had.

Good luck!!

Contributions from our anonymous friend

No immediate symptoms, but long-term risk of chest and abdominal cancers and lung diseases. Smokers are at higher risk of developing asbestos-induced lung cancer. The most dangerous asbestos fibers are too small to be visible. After they are inhaled, they can remain and accumulate in the lungs. Asbestos can cause lung cancer, mesothelioma (a cancer of the chest and abdominal linings), and asbestosis (irreversible lung scarring that can be fatal). Symptoms of these diseases do not show up until many years after exposure began. Most people with asbestos-related diseases were exposed to elevated concentrations on the job; some developed disease from exposure to clothing and equipment brought home from job sites

Indoor pollution sources that release gases or particles into the air are the primary cause of indoor air quality problems in homes. Inadequate ventilation can increase indoor pollutant levels by not bringing in enough outdoor air to dilute emissions from indoor sources and by not carrying indoor air pollutants out of the home. High temperature and humidity levels can also increase concentrations of some pollutants.

Yamada H, Kotaki H, Takahashi T.

Pharmacy Division, Institute of Medical Science, University of Tokyo, Tokyo 108-8639, Japan.

Incidences of fungal pneumonias have increased in immunocompromised patients with HIV infection or receiving bone marrow replacement or solid organ transplantation. Fungal pneumonias including aspergillosis, cryptococcosis, candidiasis, coccidioidomycosis, histoplasmosis and blastomycosis are one of the major causes of morbidity and mortality among the immunosuppressed hosts. Therefore

Johnson P, Sarosi G.

Division of General Internal Medicine, University of Texas Medical School, Houston.

The treatment of the major systemic fungi encountered in the United States--Histoplasma capsulatum, Blastomyces dermatitides, and Coccidioides immitis--depends on an understanding of the natural history of disease.

Bradsher RW.

Division of Infectious Diseases, University of Arkansas for Medical Sciences, Little Rock 72205, USA.

Histoplasmosis and blastomycosis are caused by dimorphic fungi, can be epidemic or endemic, and can produce a spectrum of illness, from subclinical infection to progressive disseminated disease. Diagnosis of both is best made by visualization of yeast in tissue or by culture. Itraconazole is the drug of choice for treatment of both histoplasmosis and blastomycosis, except in cases of life-threatening infection, for which amphotericin B is indicated.

Goldman M, Johnson PC, Sarosi GA.

Department of Medicine, Indiana University School of Medicine, Indianapolis, USA. mgoldman@iupui.edu

Each year, a vast number of individuals are infected with the endemic fungi. An expanding population, along with further land development in endemic areas, will likely continue to place individuals at risk for exposure to these organisms

Borish L, Joseph BZ.

National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado.

The atopic diseases--allergic rhinitis, asthma, and atopic dermatitis--are chronic inflammatory diseases characterized by an exacerbating and remitting course and can only rarely be associated causally with allergen exposure.

is a chronic inflammatory condition of the bladder that causes frequent, urgent, and painful urination and pelvic discomfort. The natural lining of the bladder (epithelium) is protected from toxins in the urine by a layer of protein called glycoaminoglycan (GAG). In IC this protective layer has broken down, allowing toxins to irritate the bladder wall. The bladder then becomes inflamed and tender and does not store urine well.

Our immune system allows us to resist infection and disease caused by organisms such as viruses, bacteria and fungi. There are two major functional divisions of the immune system: "innate" and "acquired" immunity. The first of these, innate immunity, is our bodies' normal response to recognizing and reject" anything foreign, including molds where there are common non-human structures.

This is a selection of recent court cases involving damages due to mold. As the sampling of cases demonstrates, mold-related lawsuits may target different types of defendants, including contractors, subcontractors, construction managers, property managers, architects, construction component suppliers, and building owners, as well as commercial and personal lines insurers. Damages may include the cost of mold remediation, loss of property, and health-related claims.

INTRODUCTION This chapter addresses the medical and causal links between common symptoms and the phenomenon of indoor air quality (IAQ) concerns. From a medical perspective, several of the health effects people often claim are related to indoor air are not legitimately causal; nor do these effects follow the patterns of clinical diagnosis used in medicine for many years. The author recognizes that well intentioned and sincere advocates for other views do exist, but this chapter reflects on the findings of medical research papers and the author's own clinical experiences.

Stained ceiling tiles (you may be very surprised as to what may be growing underneath) or walls.

Musty, earthy, or urine type odor.

Black, brown, orange, pink, or green speckled walls or around any plumbing grout or tile.

Deficient siding, siding that is not covering a building adequately, or certain types appear to be more prone to mold (i.e., Hardie Plank® which is ;not installed properly; meaning without a "tray," L.P.®, and untreated wood, particleboard or wood and materials not weather protected in ;lumberyards and prior or during construction; "lumberyard mold").

Wood siding where the paint has cracked and water has intruded (poor maintenance).

Health care facilities are undergoing construction and renovations to address restructuring in the health care system. If dust particles contaminated with bacteria and fungi are dispersed during construction, there may be health risks for patients, staff, and visitors(1).

Clinical Microbiologist, Capital Health Region, Victoria B.C.   CASE HISTORY In May 1999, following months of complaints from nursing staff on a rehab unit in a chronic care hospital, an investigation was undertaken. The nursing staff complained of a “terrible odor” from one patient’s room, and most of them had experienced numerous allergic and fatigue related symptoms. When the room was vacated

Michael D. Clark / Cincinnati Enquirer 15apr01

UNION TOWNSHIP -- One evening last summer after watering the lawn around his Clermont County home, John Maxwell stored the hose in his garage without completely turning off the faucet.

A seemingly minor mistake, it would have profound consequences for his family.

The hose later burst, showering the walls and ceiling. Days later he noticed small blotches of mold, but cleaned up the visible growth and didn't give it further thought.

Fibromyalgia is a condition that causes pain in the muscles, joints, ligaments and tendons. The pain occurs in areas called "tender points". Common tender points are the front of the knees, the elbows, the hip joints and around the neck.

Digestive symptoms are also common in fibromyalgia and include difficulty swallowing, heartburn, gas, cramping abdominal pain, and alternating diarrhea and constipation.

Allergies are the immune system’s incorrect response to a foreign substance. Exposure to what is normally a harmless substance, such as pollen, causes the immune system to react as if the substance is harmful. Substances that cause allergies are called allergens.

...A severe allergic reaction, known as anaphylaxis, is a rare, life-threatening emergency in which the body’s response to the allergen is sudden and affects the whole body (systemic). Anaphylaxis may begin with severe itching of the eyes or face and within minutes progresses to more serious symptoms including swelling, which could result in difficulty swallowing

Sinuses are a part of the upper respiratory system. Adults and older children have four groups of sinus cavities located within the bones surrounding the nose. Very young children have small sinus passages rather than fully formed sinuses. They may be prone to developing sinusitis because their smaller sinus passages become obstructed more easily. To work properly, the sinuses need adequate mucus drainage and a functioning immune system to fight off infections.

Magnesium and Asthma - Clinical Trials

Asthma currently affects an estimated 15 million Americans. A number of studies have found an association between low dietary magnesium (Mg) intake and increased asthma incidence and severity of symptoms. However, clinical intervention trials are necessary to directly assess whether there is a true protective or preventative causal relationship between ...

Med Help International is dedicated to helping patients find the highest quality medical information in the world today. We offer patients the tools necessary to make informed treatment decisions within the short time lines dictated by their illness or disease.

IT STARTED with a series of leaks. Within a year, Melinda Ballard's 11,500-square-foot Texas dream home was quarantined; her 3-year-old son, Reese, was on daily medication to treat scarred, asthmatic lungs; her husband, Ron Allison, had lost his memory along with his job; and the family was living out of suitcases and locked in a seemingly endless battle with their insurance company. The problem? Household mold.

Med Help International is dedicated to helping patients find the highest quality medical information in the world today. We offer patients the tools necessary to make informed treatment decisions within the short time lines dictated by their illness or disease.

SM Tarlo, L Boulet, A Cartier , D Cockcroft, J Côtè, FE Hargreave, L Holness, G Liss, J Malo, M Chan-Yeung

OBJECTIVE: To provide broad guidelines and principles to help primary care physicians, occupational physicians, allergists and respirologists with the recognition, diagnosis and management of patients with occupational asthma (OA).

2. Provoking Factors

Two factors provoke asthma: Triggers result in tightening of the airways (bronchoconstriction). Causes (or inducers) result in inflammation of the airways.

A 40-year-old woman comes to the family practice clinic for a routine annual visit. She reports a 6-month history of progressively severe episodic shortness of breath, cough, wheeze and chest tightness. You question her about associated symptoms, the timing and frequency of the symptoms, and triggering or exacerbating factors. You ask about environmental exposures in the home and workplace and any temporal associations of the symptoms with such exposures, including any change in severity of symptoms on weekends or holidays, as is your

Occupational asthma is generally defined as a lung disorder caused by inhaling fumes, gases, dust or other potentially harmful substances while "on the job." With occupational asthma, symptoms of asthma may develop for the first time in

Legal Affairs Source: Vancouver Sun With the growing awareness of the health problems associated with mould in homes and buildings, more people are starting to sue -- and win. More than 100,000 species of moulds exist; most people aren't affected by them. But when mould spores get wet, they can reproduce and grow, causing some people to suffer nasal stuffiness, eye irritation, coughing and other allergy-like symptoms. One nasty mould -- the black-coloured Stachybotrys chartarum sometimes found inside wet walls -- is linked to headaches, sore throat, nose bleeds, flu symptoms, fatigue, skin irritation, diarrhea and hair loss

By Everette Lee Herndon, Jr.

The issue of whether an adjuster has a duty to warn building occupants of the potential dangers of mold has arisen in a number of cases recently. While some may still question the duty of the insurance company and the adjuster to warn the first party insured of mold contamination and the possibility of health risks, most insurance companies and adjusters

Public health officials are struggling to classify a mold epidemic, which strikes no two victims alike. The Early Show spoke to Melissa Ballard. She and her husband Ron Allison had their own personal account to share.

Any litigator with his or her hand on the pulse of litigation trends has noticed a surge in mold contamination claims over the past several years. Today, the frequency of complaints by building occupants has resulted in a rapid rise in mold litigation centering on indoor air quality.

by Bill Duncan

Some molds present in rotting wood-frame buildings may be hazardous to your health. Although the majority of molds found in modern day structures are relatively harmless

30 nurses hit province with SARS lawsuit Seeking $200M; many still ailing `Government did not listen to us'

Thirty nurses infected with SARS are suing the province for almost $200 million, claiming the government didn't do enough to protect them during the outbreak.

"The nurses taking part in this lawsuit have been and continue to be severely affected by SARS. Most were in hospital for many days or weeks and were off work for many months. (More)

Sick Building Syndrome Survey

Your help in completing this survey would be greatly appreciated. All questions must be answered. Your personal info and e-mail address will remain confidential should you decide to include contact information and/or comments. The only results that will be shared will be state of illness, symptoms and other non-personal data.

Estelle Levetin, PhD University of Tulsa

Fungal spores, commonly called mold spores, are a normal component of the outdoor air. They are present in the atmosphere anytime that the ground is not covered with ice or snow. The spores are discharged from fungi growing as saprophytes (existing on dead or decaying organic matter is the soil or elsewhere in the environment) or

An evaluation for the presence of indoor fungi in a residence or other building usually has one of two broad goals. (Note: Indoor fungus problems are almost exclusively due to mould fungi rather than yeast fungi, and the subsequent discussion will focus on the moulds.) First, structural damage may follow from mould growth on...

The purpose of the doctorfungus Video Bank is to give you and your colleagues a repository for sharing, exchanging and collaborating on medical/scientific mycology-related video content.

These videos can represent content from lectures, news programs, CME, or just about any other interesting program.

The indoor environment is a creation of the modern era. Previously, buildings were notable for the extent to which they were really open to the outside air, a system that could be referred to as natural ventilation. But, technological advances have permitted us to seal buildings tightly, recirculate the air within them, and fill them with a variety of particle- and chemical-emitting materials and objects.

Non-Technical Introduction to the World of Fungi and Mycology

Fungi are plant-like organisms that lack chlorophyll. Fungi are one of the five kingdoms of life. Many fungi are good and useful (edible mushrooms would be an example of these) while some cause problems (some fungi can injure plants and people). There are over 100,000 species of fungi. Mycologists are the scientists who study fungus. Medical mycologists study drugs to cure fungal infections, while agricultural and research mycologists study the industrial uses of fungi.

Environmental mycology covers issues in facilities that range from industrial settings where fungi impact manufacturing processes, to home and work environments where human health may be an issue. There currently is extensive interest in understanding the health implications of fungi in indoor environments. Questions related to these issues are among the most common types of questions received by DoctorFungus.

by Everette Lee Herndon, Jr.

B.C./A.D. Leviticus 13-14. If the mildew spreads, the unclean item or property must be removed and destroyed.

1837 Stachybotrys chartarum first described by Corda from wallpaper collected in a home in Prague.

1920's Toxic effects of stachybotrys chartarum reported in Russia.

1940's Reports of stachybotryotoxicosis in humans reported in Russia.

1969 Pontiac Fever - 144 cases of building related illness, Pontiac, Michigan

1970's Yellow Rain attacks in Southeast Asia - associated with mycotoxin known as trichothecene

1970's Martin L. King, Technical Advisor to the National Institute of Disaster Restoration - On the origins of mold remediation - "Problems associated with mildew were being discussed in the 70's."

and much more...

800 – 885 West Georgia Street
Vancouver, British Columbia, V6C 3H1
www.cwilson.com

604-643-3145
hgs@cwilson.com

See their page on Environmental Law

Wednesday, February 27, 2002

BYLINE Jodie Sinnema, Journal Staff Writer PAPER Edmonton Journal

For eight years, Kathie Dermand bleached the walls in her Stony Plain house, trying to clean away the slimy black fungus spreading under the windows and in the corners.

HOUSTON -- It's a growing problem -- growing in Houston homes, schools and libraries. But is mold really dangerous or just the subject of media hype? "Oh this is no hype. This is real. This is very real. And people get very ill from this," said Elena Walker, a mold victim. Walker works at the Houston office of the Internal Revenue Service. She said her IRS job was taxing her health. "Three months after I began working, I broke out with hives. It (swelled) up my eyes. I looked like I'd been in a fight with Mike Tyson," Walker said.

Dr. Andrew Campbell of Spring, Texas, is one of only three toxicologists in the nation who specialize in treating mold-related diseases. "I have young people in their 20s with cancers," Campbell said. Campbell told News2Houston that mycotoxins from mold can cause five types of cancer: kidney, liver, testicular, esophagus and leukemia.

HEALTH RELATED RISKS:

Exposure to "toxic mold" can cause and create a multitude of symptoms and in some cases disease. These symptoms can vary greatly depending on the individual and their overall health during the time of exposure and the amount of exposure.

WHO MAY BE AT GREATER RISK FROM EXPOSURE TO TOXINS?

Individuals with existing or underlying medical conditions may be at greater risk from exposure to "toxic molds" and/or the "mycotoxins" they have been known to produce. Exposure may have a significant impact and even amplify their existing condition. In some cases if the mold is a particular pathogenic (causing or capable of causing disease), or carcinogenic (cancer causing), it can actually create the illness.

Also see this site for a list of symptoms!

Stachybotrys chartarum

February 1998

Fact Sheet Environmental Health Programs