The text of the letter:

Dear Mrs. Brinchman,

Thank you for your letter of September 15, 2009.

I understand that you have spoken with Dr. Paul Garbe, Chief of the Air Pollution and Respiratory Health Branch at the National Center for Environmental Health. As Dr. Garbe stated, the CDC recognizes the importance of mold as a public health concern, particularly for vulnerable individuals, such as individuals with asthma and other respiratory diseases or with other underlying conditions. We appreciate that you share this concern, and thank you for bringing your specific suggestions to our attention.

As Dr. Garbe explained on your October 9 call, we are reviewing the new World Health Organization (WHO) guidelines on indoor air quality, dampness, and mold to determine if those findings are at significant variance with the Institute of Medicine (IOM) review/Damp Indoor Spaces and Health that CDC sponsored in 2004. We feel the WHO authors' conclusions and their recommendation for "prevention or remediation of dampness and mold-related problems to significantly reduce harm to health" are in agreement with the IOM report and with what we have posted on our website. We are still reviewing the evidence for WHO's characterization of mold as a "major cause of morbidity and mortality" and will adjust our recommendations as needed based on that review.

In the meantime, we have provided a link to the WHO report on our mold website, www.cdc.gov/mold, as a "Key resource" (on the right side of the page), and as a "Nonfederal" resource on our mold "resources" page (http://www.cdc.gov/mold/links.htm), as you suggested. Also, in response to one of your emails on this matter, we have clarified some of the recent redesign of our website to improve our links to the IOM report. Thank you for bringing this oversight to our attention. We are reviewing how to more clearly represent the IOM findings related to exposures and health effects. In particular we will review our presentation of the IOM findings regarding "Limited or suggestive evidence" and "Sufficient evidence of an association". (page 1)

I would also like to respond to two additional concerns you have raised.

1. The US Government Accountability Office (GAO) Audit on Mold, found inconsistencies among federal agencies addressing mold. This problem is being addressed by the Federal Interagency Committee on Indoor Air quality (CIAQ), which is chaired by the U.S. Environmental Protection Agency. Inquiries on the CIAQ process should be addressed to the CIAQ. You may contact the CIAQ at the following address: Philip Jalbert, Executive Secretary, Federal Interagency Committee on Indoor Air quality (CIAQ) U.S. EPA, Indoor Environments Division (6609J), 1200 Pennsylvania Avenue, N.W., Washington, D.C. 20460 or via email at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

2. You asked about email correspondence from Vangent Inc. CDC has used Vangent Inc. to assist with public inquiry responses since 2005. The information provided by Vangent in response to question about is prepared by the CDC's Air Pollution and Respiratory Health Branch.

Again, thank you for sharing your concerns with us.

Sincerely,

 

Howard Frumkin, M.D., Dr.P.H.

Director, National Center for Environmental Health/Agency for Toxic Substances and Disease Registry 

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The sequence of communications has been as follows, in Chronological Order, culminating in the receipt of the letter above. We have not yet responded, but will, shortly.(SMH)

1. Several letters were sent, in Jan and March 09 to HHS Secretary-Nominee Thomas Daschle regarding The Center for School Mold Help's concerns about the impact of damp buildings and mold on health in the United States, particularly on the economy and deriving in great part, from the schools. It was mentioned that physicians are largely uninformed, the gov't agencies are not consistent in their information, conflicts of interest have been noted, and we felt the CDC may have been playing politics with the mold issue. We asked that Secretary-Nominee Daschle inform President Obama and contact our organization for more information. Letters were also sent to President Obama, various members of Congress and the US Surgeon General.

2. We received a letter, in March, 2009, from Dr. Richard E. Besser, Acting Director, Centers for Disease Control and Prevention, and Acting Administrator, Agency for Toxic Substances and Disease Registry, at the request of Mr. Daschle. This letter summarized the CDC's actions to date on mold research and education (which we felt to be inadequate). We waited as a new directors of agencies were appointed by the Obama administration. Meanwhile, the World Health Organization published its WHO Guide to Indoor Air Quality: Dampness and Mould, in July, 2009, a very welcome, extensive document that pronounced indoor mold and dampness to be major public health threats, worldwide.

2. The following email was sent to the CDC on Sept. 8, 2009 - a request for the United States Centers for Disease Control to update its mold information to correspond with that produced by the World Health Organization, July, 2009. Previous communications with the CDC have resulted in the receipt of a listing of the CDC's information links, all of which are inadequately describing the health effects of mold. Since the WHO is doing the work, we want the CDC to report it and inform the nation's healthcare professionals, health departments, and the general public regarding the serious health threat caused by dampness and mold. Our site visitors may wish to add their voices and emails to this effort, by writing the CDC at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it . (SMH)

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To: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Dear CDC Info Administrator,

 

I am writing, as the Director of The Center for School Mold Help, a national, 501c3, educational nonprofit, to request that the Centers for Disease Control website information on mold and health be updated to correspond with and include the WHO guidelines for indoor air quality: dampness and mould (July 16, 2009).

Millions of Americans are unnecessarily subjected to and sickened by dampness and mold, without help or recognition of the environmental illnesses that often develop. School children suffer in moldy, leaky, damp schools throughout the United States - chronically sickened while trying to obtain an education. The school staff suffer and may die from exposures within these buildings. Homeowners and renters alike find their health and finances destroyed by preventable mold exposures.  Physicians, health departments, and the public are misinformed by your current information, which is dated and inaccurate - the CDC is, sadly, the primary source of the poor information.

 

This misinformation, in turn, helps overwhelm our healthcare system and damages our nation's economy and productivity by causing millions to be sickened by a preventable cause. Now that the WHO has provided the vital planning and improved information regarding the very harmful health effects and mortality caused by mold and dampness, this should be included in an improved, updated informational section on mold and health on your website. The CDC must not continue to downplay this public health threat. The CDC must fully inform and warn physicians and the public about the health effects of mold and dampness.

 

The US GAO Audit on Mold (Sept., 2008) found that the US gov't health agencies were not consistent in their information on mold. In fact, the US EPA and Federal OSHA both warn the public far more about the health effects of dampness and mold. This report, a year ago, has not yet improved your website information. I trust that the WHO Guidelines will assist in providing that which is missing, going beyond what any of our United States agencies have provided.

 

 

Exposure to damp and moldy environments may cause a variety of health effects, or none at all. Some people are sensitive to molds. For these people, molds can cause nasal stuffiness, throat irritation, coughing or wheezing, eye irritation, or, in some cases, skin irritation. People with mold allergies may have more severe reactions. Immune-compromised people and people with chronic lung illnesses, such as obstructive lung disease, may get serious infections in their lungs when they are exposed to mold. These people should stay away from areas that are likely to have mold, such as compost piles, cut grass, and wooded areas.

 

A link between other adverse health effects, such as acute idiopathic pulmonary hemorrhage among infants, memory loss, or lethargy, and molds, including the mold Stachybotrys chartarum (Stachybotrys atra), has not been proven. Further studies are needed to find out what causes acute idiopathic hemorrhage and other adverse health effects. (CDC, Mold)

 

Note the contrast with the WHO information, below:

WHO guidelines for indoor air quality: dampness and mould

published July, 2009

From the WHO Foreward

"Indoor air pollution – such as from.   dampness and mould, chemicals and other
biological agents – is a major cause of morbidity and mortality worldwide."

"The guidelines were developed and peer reviewed by scientists from all over the
world, and the recommendations provided were informed by a rigorous review
of all currently available scientific knowledge on this subject."

From the WHO Executive summary
X I I I
"Exposure to microbial contaminants is clinically associated
with respiratory symptoms, allergies, asthma and immunological reactions."

"There is strong evidence regarding the hazards posed by several biological
agents that pollute indoor air; however, the WHO working group convened
in October 2006 concluded that the individual species of microbes and other biological
agents that are responsible for health effects cannot be identified. This is
due to the fact that people are often exposed to multiple agents simultaneously,
to complexities in accurately estimating exposure and to the large numbers of
symptoms and health outcomes due to exposure. "

"The presence of many biological agents in the indoor environment is due to
dampness and inadequate ventilation. Excess moisture on almost all indoor materials
leads to growth of microbes, such as mould, fungi and bacteria, which
subsequently emit spores, cells, fragments and volatile organic compounds into
indoor air. Moreover, dampness initiates chemical or biological degradation of
materials, which also pollutes indoor air. Dampness has therefore been suggested
to be a strong, consistent indicator of risk of asthma and respiratory symptoms
(e.g. cough and wheeze). The health risks of biological contaminants of indoor
air could thus be addressed by considering dampness as the risk indicator."


"Sufficient epidemiological evidence is available from studies conducted in different
countries and under different climatic conditions to show that the occupants
of damp or mouldy buildings, both houses and public buildings, are at
increased risk of respiratory symptoms, respiratory infections and exacerbation
of asthma. Some evidence suggests increased risks of allergic rhinitis and
asthma. Although few intervention studies were available, their results show
that remediation of dampness can reduce adverse health outcomes.
There is clinical evidence that exposure to mould and other dampness-related
microbial agents increases the risks of rare conditions, such as hypersensitivity
pneumonitis, allergic alveolitis, chronic rhinosinusitis and allergic fungal
sinusitis."


"Toxicological evidence obtained in vivo and in vitro supports these findings,
showing the occurrence of diverse inflammatory and toxic responses after
exposure to microorganisms isolated from damp buildings, including their
spores, metabolites and components."

"Microbial growth may result in greater numbers of spores, cell fragments, allergens,
mycotoxins, endotoxins, β-glucans and volatile organic compounds
in indoor air. The causative agents of adverse health effects have not been
identified conclusively, but an excess level of any of these agents in the indoor
environment is a potential health hazard."

"Microbial interactions and moisture-related physical and chemical emissions
from building materials may also play a role in dampness-related health effects."

"The authors conclude that occupants of damp or mouldy buildings, both private and public, have up to a 75% greater risk of respiratory symptoms and asthma. The guidelines recommend the prevention or remediation of dampness- and mould-related problems to significantly reduce harm to health...In damp conditions, hundreds of species of bacteria and fungi grow indoors and emit spores, cell fragments and chemicals into the air. Exposure to these contaminants is associated with the incidence or worsening of respiratory symptoms, allergies, asthma and immunological reactions. Children are particularly susceptible." (WHO Press Release, 7/16/09)

This World Health Organization report, published July 16, 2009, verifies that which suffering millions and The Center for School Mold Help have been reporting, which the United States Centers for Disease Control, health departments, and most US physicians have downplayed and denied - that mold and dampness cause serious health problems, including respiratory and immunological. The WHO emphasizes that mold should be avoided as a major health risk, explains how to prevent and address indoor mold, and points out that building owners have the responsibility to provide healthy indoor air. This document will begin the changes needed to rescue the world population from the devastating impact of indoor mold (mould) and dampness, especially within our schools and homes. We expect that the United States Centers for Disease Control will quickly follow with a position on mold and dampness, in step with the WHO.  There is no more doubt - mold and dampness harms and can kill. We cannot tolerate this in our schools and buildings.

I would like to be informed about your plans to update your mold and health information, on an urgent basis.

Sincerely,