Exposure to molds can cause human disease through several well-defined mechanisms. In addition, many new mold-related illnesses have been hypothesized in recent years that remain largely or completely unproved. Concerns about mold exposure and its effects are so common that all health care providers, particularly allergists and immunologists, are frequently faced with issues regarding these real and asserted mold-related illnesses.
Exposure to certain fungi (molds) can cause human illness. Molds cause adverse human health effects through 3 specific mechanisms: generation of a harmful immune response (eg, allergy or hypersensitivity pneumonitis [HP]), direct infection by the organism, and toxic-irritant effects from mold byproducts. For each of these defined pathophysiologic mechanisms, there are scientifically documented mold-related human diseases that present with objective clinical evidence of disease. Recently, in contrast to these well-accepted mold-related diseases, a number of new mold-related illnesses have been hypothesized. This has become a particular issue in litigation that has arisen out of unproved assertions that exposure to indoor molds causes a variety of ill-defined illnesses. Many of these illnesses are characterized by the absence of objective evidence of disease and the lack of a defined pathology and are typically without specificity for the involved fungus–fungal product purported to cause the illness.
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