Does mould harm children's health?

Hello, and thanks for joining me for the first The Mould Show for 2022, and I thought with many of us still on school holidays or certainly here in Australasia, many of us are probably wondering about the impact of indoor air quality and potentially water damage on the health of our children. So today, we're going to be talking about some of the key pieces of research, which explore how water damage, and mould, and mycotoxins can affect your children.

Without further ado, we'll get straight into this. So does mould harm children's health? That's the topic that we need to be talking up about today because it is a serious topic. We cover at length in these live streams and podcasts all the range of adverse health symptoms and problems that can occur to adults, but what about children because most of us have families? In many cases, the built environment is a perfect reservoir for not only mould spores, but a buildup of toxic allergens, chemicals, and mycotoxins. What are these? What's the difference between an illness caused by exposure to mould spores from an illness caused by mycotoxins? So we're going to jump into a lot of these questions and answer those today.

So, obviously, it's important for me to catalog the range of symptoms that are most commonly associated with exposure to mould. Now, this is a bit of a boring list. I'm going to race through this because I have a better way for you to conceptualize, and understand, and really take away with you today with a much better understanding of how mould affects your health. So rather than going through all of the bullet points on this slide such as brain fog, or sneezing, or skin prickling, which are very real symptoms, but in a sense, this is just a bucket list. Really, to understand mould exposure, what I'd be much happier with you taking away with you today is a mnemonic or an easy-to-understand way of how mould affects your health, and so I've prepared this emoji visual guide to mould and indoor air quality to explore this concept.

So the primary cause of mould is obviously water. Water contributes to the presence and overgrowth bacteria, yeast, and fungi in the built environment. Water damage can affect new and old homes, and it impacts on indoor air quality. Indoor air quality is really fundamental to understanding mould problems. It's certainly different because not all mould problems impact on indoor air quality, and similarly, not all adverse indoor air quality problems are caused by mould because indoor air could be impacted on by things like chemicals, formaldehyde, in the built environment, which can be added into your airspace from the use of cleaning chemicals, for example, or paints in the home, or even new furniture, which liberates these gases. In many cases, these are present in very high concentrations, but just tracking through the top line of this particular slide, you can see that water affects both new and old homes, impacting on indoor air quality, leading to a buildup of bacteria, yeast, fungi, and even virus pathogens.

Now, not all of these germs are able to cause an acute illness, but some certainly can. Most of you will have heard about aspergillosis or meningitis, which are very severe complications, which in many cases are caused by fungi that are growing into your body or into your bloodstream. But the majority of people who have a problem with mould are reacting to the air quality challenge by a buildup of the actual cell or the spores that they produce, or even the fragments that are liberated when these cells break down and are sheared as they naturally float and all out of the atmosphere in our homes.

Now, the most common symptoms of mould exposure is usually detected with your nose. That's right. If you've ever smelled a musty or a mould-affected water-damaged building, you're probably first going to smell it before you see it. Obviously, this gives you a clue for the dominant sensitive cells inside your nose, which can detect the presence of these spores, or maybe even the mycotoxins that might be present in the built environment, and affecting the nose means that it's affecting your respiratory. Meaning, that you may end up with sneezing. You might have coughing. You may even develop adult onset asthma, but again, we're focusing on children now. So this would be new development, early stage, early life stage asthma symptoms in young children. Again, over time, exposure of mould and water damage leads to anxiety, and increase in depression symptoms, and even more feelings of sadness. There are some really interesting research out there focusing on the connection between bad indoor air quality and anxiety, depression, and sadness.

Now, the dominant physiological effects are going be affecting your respiratory system, your lungs, and your upper and lower airway system. This then impacts on your heart health. Again, there are some excellent research showing that exposure to fine and coarse particulate matter, some of which contains biological cells, over time increases things like blood pressure and has a damaging effect on the heart muscle, which is not a good thing. Also, mould exposure can definitely have neurocognitive impacts as well, affecting the way in which you relate to the world and whether or not you're able to, for example, word find or solve problems. There are some unfortunate research showing that there are connections with mould exposure and some very serious neurocognitive conditions like autism and multiple sclerosis. We're going to get into some of this research today because it's really important.

In any case, all of the references are going to be available in the links in the description and the show notes to this because this is really important that you're able to retrieve this, and actually do your own research, and verify and validate exactly what I'm saying, but I just want to finish off with this slide to also say that some of the effects also lead to inflammation, and this can affect various different organs in the body.

We know about inflammation, that it has a significant impact on our... how we're able to fight off germs. So inflammatory conditions have a real significant impact, and it's an immune-challenging impact. If we have a reduced ability to fight off infections, that makes us susceptible to a range of different pathogens in the built environment. So what are we going to be looking at today? Again, I said that I wanted to pick up some of the key papers from the literature. So, firstly, you can download these and educate yourself. But in many cases, you may have to explain to third-parties why mould is definitely a risk factor for your children, and I'm going to get to the first publication right now.

First publication is entitled Mould, Mycotoxin, and their Effects in Children. Again, all the links are going to be in the show notes, but the introduction to this is that obviously, unexpected weather, or unexpecting plumbing problems, or some type of way in which buildings become damp leads to mould problems and adverse indoor air quality indoors. Now, moulds obviously grow on these wet surfaces, and in order for those moulds to exploit the host building, they sporulate, and this spore material becomes easily airborne and impacts on air quality inside the home.

Now, remember that mycotoxins are different to mould spores. Mycotoxins are aspects of the cell membrane, cell wall, or cell constituents that in many cases are toxic, and it allows the mould to exploit its own ecological niche, and mycotoxin levels also become volatilized. So there's something which is like an odor-forming molecule, and they are released into the air space, and they can build up to very high concentrations inside water-damaged buildings. The research suggests that often, the levels of mycotoxins are up to a thousand fold higher than the mould count. So mould counts are an excellent quantitative way of estimating what the concentration of mould is indoors, but it does not pick up the concentration of mycotoxins.

Even the EPA in the United States states that 50% of fungal growth is essentially hidden, and that is a huge concentration. Of course, it makes sense because you can't always see what's growing under the floor, inside walls, or in your roof void. These are all elements of the built environment which you may not be aware can be the dominant reservoir of mould inside your home. In any case, we are now going to go and track through what this publication by Dr. Andrew Campbell and co-authors said.

Now, he quotes in this paper a study from Harvard University that looked at a bit over 13,000 children between the ages of 8 and 12, and they found that there was mould growing in between 22% to 54% of the homes, and that in these homes, between 3% and 11% of the children had asthma. Similarly, a study from Russia showed that for just under 6,000 children with home mould and water damage, there was a positive association with adverse health symptoms like asthma, dry cough, wheezing, and bronchitis.

Good evidence, isn't it? If you are in a rental property or in your own property, and have water damage and mould problems, and are potentially in dispute with someone like a builder or your insurer who are dismissing your fears about water damage and mould, this livestream and podcast is for you because it's not just impacts on the amenity of the property, there are some very significant toxicological findings in the research literature, which impact on your children's health. We're going to go to another paper, which you need to be aware of. Again, all of this is going to be in the show notes. You'll be able to retrieve this from my website, biologicalhealthservices.com.au, and from, of course, the social media links where this podcast and livestream are going to end up.

We're now going to get on to the next slide, and this is focusing on a publication again by the same author, Dr. Andrew Campbell, and the paper is entitled The Brain and Mycotoxins. This paper is outstanding because it lays the groundwork as a review to explore the health effects of the mycotoxins on the brain, and the literature cited in this publication talks about the impact of mould and mycotoxins on the autism spectrum disorder and the research which suggests that many young people who are dealing with autism spectrum disorder, that there is an inflammatory component from mycotoxins.

Similarly, we know that dementia and Alzheimer's disease affects older individuals, but the same type of impacts on the neurocognition pathways affect young people as well, and multiple sclerosis is a condition which is characterized by changes in gait and locomotor ability. A lot of the research that Dr Campbell cites shows that mycotoxins affect the brain in a very significant manner. But what is important about this publication and why I would like you to be aware of it is that he talks about how your clinician, your medical healthcare provider needs to be considering using blood serum testing for mycotoxin antibodies using enzyme-linked immunosorbent assay or the ELISA test.

Now, he also says that urine testing for mycotoxins does not mean the person suffering from any disease or disorder is linked to mould and mycotoxins, and this is really important for you to understand because I'm very familiar with my own clients and patient referrals that often show me their file notes from their doctor where there has been a urine mycotoxin panel done. Again, I'm always more persuaded, like Dr. Campbell, by the serum antibody tests. So really, it's something that you should be aware of. There are differences, and they do detect different aspects. As the doctor mentions in the paper, the urine mycotoxin panel is rightly often going to detect these metabolites being excreted from our physiology as you would expect because moulds affect our food stuffs, and you can imagine that they are excreted over time.

We can't banish mould from our food stuffs. They are all around, and we are ingesting them, but the issue is that you don't want to be exposed to them in massively high concentrations. So the take-home message is talk to your doctor about the range of options that he or she has available to him or her to help you get to the bottom of whether or not mould and mycotoxins are a challenge in your home or workplace.

Now, I want to get on to the next publication at this point in time, and this one is talking about whether or not moulds have an ability to impact your child's intelligence. I've essentially saved the best publication for last because this is looking at whether or not the cognitive function of six-year-olds exposed to mould-contaminated homes has an impact on their IQ. But before we jump into how this experiment was conceived and applied, I need to explain something called the odds ratio because the odds ratio is going to come up in this publication, and it is going to be fundamental for you appreciating the impact that mould has on intelligence or IQ.

So a little bit of theory here. The odds ratio is a way to present the strength of association between risk factors or exposures and outcomes. Now, bear in mind, if an odds ratio is equal to one, the exposure does not affect the odds of the outcome. Whenever the OR is greater than one, the exposure associated is with a higher odds of outcome, and so the hypothesis here is essentially does mould exposure contribute to higher or lower IQ? Just say we suggest that the hypothesis is that it impacts adversely, leading to lower scores on an IQ test. We would be interested in what the OR value was. Similarly, if you frame your experiment as an OR less than one, the question then becomes... or when you drill into the data, the exposure associated with lower odds of the outcome.

So in summary, if the OR is less than one, the odds are decreased for the outcome, and when the OR is greater than one, the odds are increased for a given outcome. You will often always see as well something that is the range of your data, and often, this is the 95 percentile. What does that mean? Well, it means that most of your data, excluding the smallest and largest variables, fall within 95% of the mean or the middle of your data, and that is really important to understand there.

Now, we're going to get straight into the results of this exciting study because this is the paper that you would want to cite again if you're in dispute or even just trying to make a decision about whether that unwanted odor that you know is caused by water damage and mould, could it be affecting your child's health? Now, they don't have to have asthma, or runny nose, or the sniffles to have any of those hidden adverse health impacts that I covered with the emoji mnemonic that I showed you earlier because that mould and that mycotoxin challenge could be impacting on their intelligence, and we're going to get in to that data right this second.

So what did the scientists in this paper do? They wanted to determine the exposure effect for living with mould on cognitive development in children. So they assessed 277 babies right up to six years of age. Visible mould was assessed on indoor walls and monitored at intervals over the gestation period and after birth up to five years, and they used the Wechsler Intelligence Scale for children, which they administered at age six. So, just so you understand this, the scientists wanted to work out whether or not there was a connection between exposure to mould and IQ. To do this, they tracked the babies from birth right through to six years of age, and I'm now going to show you what the results found.

To do this, I'm just going to jump ahead because I noticed that we have missed out a slide. Here we go. Sometimes this happens. So, what did they find? The adjusted IQ deficit attributed to longer exposure to indoor moulds two years was significantly lower on the IQ scale. Meaning, that exposure to mould and water damage tripled your risk of having a low IQ. How do I summarize this? The odds of having a lower IQ is 3.4 times higher if the child experienced mould during early life for more than two years as opposed to not experiencing mould.

Now, I'm going to go back to this slide because how do you work out when you're not part of a study like this whether or not you've got mould. Now, I mentioned your nose. You obviously can see mould in some situations, but in many times, it's hidden. Remember the statistic from the EPA is saying that 50% of mould is hidden. These scientists used a very broad definition of mould exposure, and their definition was in the last six months, have you noticed any problem in your home like leaky pipes, mould on walls, or holes in ceilings and more walls? If you have, if the mould patches on the internal walls are present, you only make it positive if it exceeded one square meter.

Now, that's really a large amount of mould. So, therefore, when you're looking at the conclusions, one square meter of mould for two years triples your risk of having a lower IQ. The conclusion to this study is that there are harmful effects of early postnatal exposure to indoor mould on children's cognitive development, and this is yet more evidence of the important role of the environment in impacting the cognitive development of children.

I think these few or handful of studies are something which you need to be aware of. You will be able to download and retrieve these studies as I said on my social media, on Facebook, on YouTube as links under this podcast and also on my website at biologicalhealthservices.com.au. Moulds cause a range of adverse health to adults as well as children. We have covered the neurocognitive impacts today because... or I've ended with this because this is something that you really do need to be aware. It's not just the sniffles with mould exposure. It can have significant impacts on intelligence.

So next time you're considering whether to do something about the mould in your home or office, think about your children. If they're at home with you, it's really important. You shouldn't underestimate the impact of adverse indoor air quality, the impact of mould exposure, the impact of mycotoxins on your health. In any case, thanks for watching, and I'll see you next week. Bye for now.

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REFERENCES:

Campbell AW, Watson P. Mold, Mycotoxins, and their Effects in Children. Altern Ther Health Med. 2021 Jan;27(1):8-10. PMID: 33609089.

Campbell AW, Decena K. The Brain and Mycotoxins. Altern Ther Health Med. 2020 Nov;26(6):8-11. PMID: 33609092.

Campbell AW. Molds and Mycotoxins: A Brief Review. Altern Ther Health Med. 2016 Jul;22(4):8-11. PMID: 27548484.

Theoharides TC. Mold and Immunity. Clin Ther. 2018 Jun;40(6):882-884. doi: 10.1016/j.clinthera.2018.05.005. Epub 2018 May 30. PMID: 29859636.

Spengler JD, Jaakkola JJ, Parise H, Katsnelson BA, Privalova LI, Kosheleva AA. Housing characteristics and children's respiratory health in the Russian Federation. Am J Public Health. 2004 Apr;94(4):657-62. doi: 10.2105/ajph.94.4.657. PMID: 15054021; PMCID: PMC1448314.

Jedrychowski W, Maugeri U, Perera F, Stigter L, Jankowski J, Butscher M, Mroz E, Flak E, Skarupa A, Sowa A. Cognitive function of 6-year old children exposed to mold-contaminated homes in early postnatal period. Prospective birth cohort study in Poland. Physiol Behav. 2011 Oct 24;104(5):989-95. doi: 10.1016/j.physbeh.2011.06.019. Epub 2011 Jul 8. PMID: 21763705; PMCID: PMC3758954.

Szumilas M. Explaining odds ratios [published correction appears in J Can Acad Child Adolesc Psychiatry. 2015 Winter;24(1):58]. J Can Acad Child Adolesc Psychiatry. 2010;19(3):227-229.

Wong CT, Wais J, Crawford DA. Prenatal exposure to common environmental factors affects brain lipids and increases risk of developing autism spectrum disorders. Eur J Neurosci. 2015 Nov;42(10):2742-60. doi: 10.1111/ejn.13028. Epub 2015 Sep 19. PMID: 26215319.