What about Mycotoxin testing?
January 2018: By Susan Browne Rosenberg, CIH, CIEC (expired 02/2020), CHMM
President, Desert Cities Indoor Air, LLC
A few recent clients have asked me if I did mycotoxin testing, as their doctors told them they had “ elevated ” levels in their blood or urine.Part of my ongoing education is on the Art and Science of testing for environmental toxins which is constantly updated with the latest research and laboratory techniques.Although mycotoxin testing is not one of my areas of expertise, I am familiar with the chemicals that can be produced from fungal spores.
Mycotoxins can be found in moldy foods and grains and can kill or cause cancer in animals and humans who eat these foods. Aflatoxin is one of the more common compounds sometimes found in raw peanuts. There are many food laboratories that can test foods for these mycotoxins, but in my research, the challenge was finding an environmental lab that could test air or bulk samples. And it was unclear how to best interpret the testing results.
According to the Centers for Disease Control (CDC) there was a lot of exposure to molds and mycotoxins after Hurricanes Katrina and Rita in 2005. In a paper published in the CDC Morbidity and Mortality Weekly Report (MMWR) Series in June of 2006, the CDC presented their findings in the New Orleans area. It was written, “In recent years, increased concern has arisen about exposure to specific molds that produce substances called mycotoxins. Health effects related to mycotoxins are generally related to ingestion of large quantities of fungal-contaminated material. No conclusive evidence exists of a link between indoor exposure to airborne mycotoxin and human illness. Many molds can potentially produce toxins given the right conditions. Some molds that produce mycotoxins are commonly found in moisture-damaged buildings; research related to the importance of these findings is ongoing. Although the potential for health problems is an important reason to prevent or minimize indoor mold growth and to remediate any indoor mold contamination, evidence is inadequate to support recommendations for greater urgency of remediation in cases where mycotoxin-producing fungi have been isolated.”¹
They go on to note that, “Mycotoxins were prematurely proposed as the cause of a disease outbreak of eight cases of acute pulmonary hemorrhage/hemosiderosis in infants in Cleveland, Ohio, in 1993 and 1994. The cluster was attributed to exposure to mycotoxins produced by Stachybotrys chartarum. Subsequent reviews of the evidence concluded that insufficient information existed and no such association was proven.”
Regarding occupational cases, the CDC noted that, “Certain case studies of agricultural and remediation workers have described adverse health effects such as skin irritation, skin necrosis, cough, rhinitis, and bloody nasal exudate after inhaling or touching materials with heavy fungal contamination. Whether these effects resulted from exposure to mycotoxins or from a general overload of organic material is unknown. No commercial clinical diagnostic tools are available to determine whether a person’s health effect is related to exposure to mycotoxins. Because of the lack of information about non-ingestion mycotoxin exposure and adverse health effects in humans, precautions should be taken when handling heavily contaminated building materials.”
The latest CDC report² from 2015, reiterates their position that “CDC does not recommend biologic testing of persons who work or live in water-damaged buildings nor routine environmental sampling for mold. To identify possible mold contamination, visual inspection is the first step.”
There are a growing number of medical practitioners making a living testing their patients for mold and mycotoxins in their blood. In some cases, this may be useful when a patient has chronic fatigue or other non-specific symptoms when general practitioners (GPs) cannot find a cause. The problem with testing blood and urine is that it cannot tell you when or where you were exposed. There is also much debate in the medical arena and the legal system as to what levels cause disease. The CDC states “Persons using direct-to-consumer laboratory tests that have not been approved by FDA for diagnostic purposes and their health care providers need to understand that these tests might not be valid or clinically useful.”
I have been reading and listening to Dr. Harriet Burge with EMLP&K labs for over 20 years. She is considered by many (including myself) to be a very “level head” in the mold business. Her opinion on mycotoxins can be found on the internet on her Ask Dr. Burge page.³ In February 2011, she stated that “The fact remains that no research has documented that anyone has ever been exposed to enough mycotoxin from exposure to indoor fungal growth to actually cause any of his/her symptoms with the possible exception of agricultural environments. In fact, there are no publications that I can find that actually document the amount of mycotoxin exposure in a moldy indoor environment.” In summary Dr. Burge says the studies she read “conclude that mycotoxins CAN cause many of the types of effects that are part of indoor symptom syndromes. They don’t say that they DO cause these effects.”
So, I suppose my final answer is, “no, I do not test for Mycotoxins”. I can provide a visual inspection as recommended by the Centers for Disease Control.