Report from United States Government Accountability Office

Highlights of GAO-08-980, a report to the Chairman, Committee on Health, Education, Labor and Pensions, U.S. Senate

September 2008

INDOOR MOLD

Better Coordination of Research on Health Effects and More Consistent Guidance Would Improve Federal Efforts

In general, the Institute of Medicine’s 2004 report, and reviews of the scientific literature published from 2005 to 2007 that the US Government Accountability Office (GAO) examined, concluded that certain adverse health effects are more clearly associated with exposure to indoor mold than others.

For example, the Institute of Medicine concluded that some respiratory effects, such as exacerbation of pre-existing asthma, are associated with exposure to indoor mold but that the available evidence was not sufficient to determine whether mold and a variety of other health effects, such as the development of asthma, cancer, and acute pulmonary hemorrhage in infants, are associated.

While the reviews GAO examined generally agreed with these conclusions, a few judged the evidence for some health effects as somewhat stronger. For example, the American Academy of Pediatrics concluded in 2006 that a plausible link exists between acute pulmonary hemorrhage in infants and exposure to toxins that some molds produce. In addition, the 2004 Institute of Medicine report identified the need for additional research to address a number of data gaps related to the health effects of indoor mold.

The 65 ongoing federal research activities on the health effects of exposure to indoor mold conducted or sponsored by EPA, HHS, and the Department of Housing and Urban Development (HUD) address to varying extents 15 gaps in scientific data reported by the Institute of Medicine. For example, many of the research activities address data gaps related to asthma and measurement methods, while other data gaps, such as those related to toxins produced by some molds, are being minimally addressed. Further, less than half of the ongoing mold-related research activities are coordinated either within or across agencies.

This limited coordination is important in light of, among other things, the wide range of data gaps identified by the Institute of Medicine and limited federal resources.

Despite limitations of scientific evidence regarding a number of potential health effects of exposure to indoor mold, enough is known that federal agencies have issued guidance to the general public about health risks associated with exposure to indoor mold and how to minimize mold growth and mitigate exposure. For example, guidance issued by the Consumer Product Safety Commission, EPA, the Federal Emergency Management Agency, HHS, and HUD cites a variety of health effects of exposure to indoor mold but in some cases omits less common but serious effects. Moreover, while guidance on minimizing indoor mold growth is generally consistent, guidance on mitigating exposure to indoor mold is sometimes inconsistent about cleanup agents, protective clothing and equipment, and sensitive populations.

As a result, the public may not be sufficiently advised of indoor mold’s potential health risks.

For the full report, click here.