CPSC Statement on Mold and Mycotoxins Health Effects
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CPSC Staff Statement on Toxicology Excellence for Risk Assessment (TERA) Report “Review of the Health Risks of Mold, Health Effects of Molds and Mycotoxins”1 July 2015 The report titled, “Review of the Health Risks of Mold, Health Effects of Molds and Mycotoxins,” presents basic mold characteristics and was performed by TERA under Contract CPSC-D-12-0001, Task Order 0013. A second report, “Review of the Health Risk of Mold, Basic Mold Characteristics,” can be found under a separate cover. Consumer exposure to mold on a product may be more frequent and direct than exposures that might occur in a building setting, making remediation even more important for products with mold contamination. Therefore, this contract was initiated for staff to gain a better understanding of these hazards and the new information that has been developed over the past several years on mold characteristics and toxicity. The available data on health effects associated with mold in each genus are reviewed in the first section. For each genus, the uptake and system spread and health effects in humans and/or animals are discussed. Following that is a discussion of the health effects associated with key mycotoxins produced by the genera of interest. The physical and chemical characteristics, toxicokinetics, and animal and human hazard information are included in these discussions. Historically, much of the documented human exposure to molds and mycotoxins has been via food. This means that most of the available experimental data for mycotoxins are for the oral route, often in the context of dietary exposure; parenteral dosing studies are also often available. Generally speaking the data available for the inhalation and dermal routes are very limited. In contrast to the mycotoxins, inhalation and dermal exposure to the mold (e.g., spores) may also occur. In this report, Table 1 summarizes the key information on the basic mold characteristics (see the Basic Mold Characteristics report for more details), together with the health effects associated with each genus. The summary of the toxin effects (irritation, kidney, liver, developmental, cancer) is based primarily on animal data, and human data were used when available. Information on irritant effects is from testing of the mycotoxins in animals, or reports from human exposure to the mold or mycotoxins; controlled animal testing for irritancy was not done for the molds themselves. 1 This statement was prepared by the CPSC staff, and the attached report was produced by TERA for CPSC staff. The statement and report have not been reviewed or approved by, and do not necessarily represent the views of, the Commission. Health effects associated with these different molds in humans include: allergic reactions, sensitization, asthma, neurotoxicity, sinusitis, otomycosis, onychomycosis, keratitis, respiratory infections, skin infections, and systemic infections. Determining which mycotoxins are produced by which genus is difficult. This reflects differences in toxin production by different strains or species within a genus and data gaps, or the tendency of review articles to focus on primary toxins and classes of toxins, rather than identifying each toxin (or each major toxin) produced by a genus. Health effects associated with mycotoxins in humans include: hepatic toxicity, cancers (liver, esophageal, lymphoma, skin, and gastric), nephrotoxicity, hypertension, hyperlipidemia, immunosuppression, and nasal irritation. Review of the Health Risks of Mold Completed Under Contract CPSC-D-12-0001 Task Order 0013 Lead Scientists: Lynne Haber, TERA Brandolyn Thran, Perspective Scientific Consulting Chris Chaisson, The Lifeline Group Health Effects of Molds and Mycotoxins Final Report, July 13, 2015 Lead Scientist, Lynne Haber Table of Contents 3 Effects of the Mold as an Organism ........................................................................................ 9 3.1 Introduction ...................................................................................................................... 9 3.2 Alternaria ........................................................................................................................ 17 3.2.1 Uptake and Systemic Spread .................................................................................. 17 3.2.2 Health Effects in Humans ....................................................................................... 17 3.2.3 References ............................................................................................................... 19 3.3 Aspergillus ..................................................................................................................... 21 3.3.1 Uptake and Systemic Spread .................................................................................. 21 3.3.2 Health Effects in Animals ....................................................................................... 26 3.3.3 References ............................................................................................................... 27 3.4 Chaetomium ................................................................................................................... 30 3.4.1 Uptake and Systemic Spread .................................................................................. 30 3.4.2 Health Effects in Humans ....................................................................................... 30 3.4.3 Health Effects in Animals ....................................................................................... 32 3.4.4 References ............................................................................................................... 32 3.5 Cladosporium ................................................................................................................. 33 3.5.1 Uptake and Systemic Spread .................................................................................. 33 3.5.2 Health Effects in Humans ....................................................................................... 33 3.5.3 Health Effects in Animals ....................................................................................... 35 3.5.4 References ............................................................................................................... 36 3.6 Dicyma ........................................................................................................................... 39 3.6.1 Uptake and Systemic Spread .................................................................................. 39 3.6.2 Health Effects in Humans ....................................................................................... 39 3.6.3 Health Effects in Animals ....................................................................................... 39 3.6.4 References ............................................................................................................... 40 3.7 Epicoccum ...................................................................................................................... 40 3.7.1 Uptake and Systemic Spread .................................................................................. 40 3.7.2 Health Effects in Humans ....................................................................................... 40 4 3.7.3 Health Effects in Animals ....................................................................................... 42 3.7.4 References ............................................................................................................... 42 3.8 Malassezia ...................................................................................................................... 43 3.8.1 Uptake and Systemic Spread .................................................................................. 43 3.8.2 Health Effects in Humans ....................................................................................... 43 3.8.3 Health Effects in Animals ....................................................................................... 46 3.8.4 References ............................................................................................................... 46 3.9 Penicillium ..................................................................................................................... 48 3.9.1 Uptake and Systemic Spread .................................................................................. 48 3.9.2 Health Effects in Humans ....................................................................................... 48 3.9.3 Health Effects in Animals ....................................................................................... 50 3.9.4 References ............................................................................................................... 51 3.10 Phoma ............................................................................................................................. 53 3.10.1 Uptake and Systemic Spread .................................................................................. 53 3.10.2 Health Effects in Humans ....................................................................................... 53 3.10.3 Health Effects in Animals ....................................................................................... 55 3.10.4 References ............................................................................................................... 56 3.11 Stachybotrys ..................................................................................................................