OUTDOOR ALLERGIES: MOLD ALLERGY

What Is Mold?

There are thousands of types of molds and yeasts in the fungus family. Yeasts are single cells that divide to form clusters. Molds are made of many cells that grow as branching threads called hyphae. Although both can probably cause allergic reactions, only a small number of molds are widely recognized offenders.

The seeds or reproductive pieces of fungi are called spores. Spores differ in size, shape and color among types of mold. Each spore that germinates can give rise to new mold growth, which in turn can produce millions of spores.

What Is Mold Allergy?

When inhaled, tiny fungal spores, or sometimes pieces of fungi, may cause allergic rhinitis. Because they are so small, mold spores also can reach the lungs. In a small number of people, symptoms of mold allergy may be brought on or worsened by eating certain foods such as cheeses processed with fungi. Occasionally, mushrooms, dried fruits, and foods containing yeast, soy sauce or vinegar will produce allergy symptoms.

Where Do Molds Grow?

Molds can be found wherever there is moisture, oxygen and a source of the few other chemicals they need. In the fall, they grow on rotting logs and fallen leaves, especially in moist, shady areas. In gardens they can be found in compost piles and on certain grasses and weeds. Some molds attach to grains such as wheat, oats, barley, and corn, which makes farms, grain bins and silos likely places to find mold.

Hot spots of mold growth in the home include damp basements and closets, bathrooms (especially shower stalls), places where fresh food is stored, refrigerator drip trays, house plants, air conditioners, humidifiers, garbage pails, mattresses, upholstered furniture and old foam rubber pillows. Molds also like bakeries, breweries, barns, dairies and greenhouses. Loggers, mill workers, carpenters, furniture repairers and upholsterers often work in moldy environments.

What Molds Are Allergenic?

Like pollens, mold spores are important airborne allergens only if they are abundant, easily carried by air currents, and allergenic in their chemical makeup. Found almost everywhere, mold spores in some areas are so numerous they often outnumber the pollens in the air. Fortunately, however, only a few dozen different types are significant allergens.

In general, Alternaria and Cladosporium (Hormodendrum) are the molds most commonly found both indoors and outdoors in the United States. Aspergillus, Penicillium, Helminthosporium, Epicoccum, Fusarium, Mucor, Rhizopus, and Aureobasidium (Pullularia) are common as well. There is no relationship, however, between a respiratory allergy to the mold Penicillium and an allergy to the drug penicillin, which is made from mold.

Are Mold Counts Helpful?

Similar to pollen counts, mold counts may suggest the types and number of fungi present at a certain time and place. For several reasons, however, these counts probably cannot be used as a constant guide for daily activities. One reason is that the number and types of spores actually present in the mold count may have changed considerably in 24 hours because weather and spore distribution are directly related. Many common allergenic molds are of the dry spore type — they release their spores during dry, windy weather. Other fungi need high humidity, fog or dew to release their spores. Although rain washes many larger spores out of the air, it also causes some smaller spores to be propelled into the air.

In addition to the effect of weather changes during 24-hour periods on mold counts, spore populations also may differ between day and night. Dry spore types are usually released during daytime, and wet spore types are usually released at night.

Are There Other Mold-Related Disorders?

Fungi or organisms related to them may cause other health problems similar to allergic diseases. Some kinds of Aspergillus may cause several different illnesses, including both infections and allergies. These fungi may lodge in the airways or a distant part of the lung and grow until they form a compact sphere known as a "fungus ball." In people with lung damage or serious underlying illnesses, Aspergillus may grasp the opportunity to invade the lungs or the whole body. In some people, exposure to these fungi also can lead to asthma or to a lung disease resembling severe inflammatory asthma called allergic bronchopulmonary aspergillosis. This latter condition, which occurs only in a small number of people with asthma, causes wheezing, low-grade fever, and coughing up of brown-flecked masses or mucus plugs. Skin testing, blood tests, X-rays, and examination of the sputum for fungi can help establish the diagnosis. Corticosteroid drugs usually treat this reaction effectively. Immunotherapy (allergy shots) is not helpful.