Easy on the peanut butter, specialist in mold illnesses advises

Molds are commonplace in virtually every modern environment, and are even present in the everyday jar of peanut butter sitting on the kitchen counter in most children's homes. The advice of Lynnette J. Mazur, MD, MPH, presented Saturday at a seminar at the AAP National Conference and Exhibition, was simple: Eat a balanced diet!

"Aflatoxin is a natural inhabitant of peanuts," Mazur said. "How much or how little is present in peanut butter varies from jar to jar. To address that, tell your patients not to eat it every day."

Dr. Mazur reviewed the range of types of mold that can cause illness. She said that such factors as changes in new building construction are contributing to mold growth. New homes, for example, are made of soft woods that do not contain the tannins and oils of harder woods that inhibited mold growth?woods used in older construction. And new homes have become more energy-efficient, which, in turn, causes air exchange to be lower, also encouraging mold.

There is more: A soon-to-be-released AAP policy statement, Dr. Mazur reported, advises against the use of humidifiers for the management of respiratory tract infections. The resulting increase in ambient humidity that is considered a benefit in such circumstances can also encourage the growth of mold growth indoors.

When should you consider mold-related illness in a patient? According to Dr. Mazur, several scenarios should arouse suspicion: When a patient has chronic respiratory infections of unknown cause, poorly controlled asthma, recurrent flu-like symptoms, or suspected (or diagnosed) hypersensitivity pneumonitis, allergic bronchopulmonary aspergillosis, or fungal sinusitis. The symptoms may also subside or become worse at a particular location or time, or during a particular activity.

In a case in which mold-related illness is suspected, a home inspection may be warranted. Visible signs of mold, a moldy odor, or old water damage can indicate a problem. Where there are no visible signs of mold, air sampling may be appropriate.

Getting rid of mold is tricky. Porous materials that have been wet, including carpet, ceiling tiles, mattresses, pillows, and upholstery, must be discarded. Nonporous materials, such as floors, countertops, metal object, plastic, and glass can be cleaned with soap and water, followed by a dilute mixture of bleach. Bleach is not recommended by all organizations, however, for addressing a mold problem, Dr. Mazur pointed out; the US Environmental Protection Agency advocates its use but it is not recommended by the US Occupational Safety and Health Administration.

Raised public awareness regarding molds has brought questions by parents about the potential for mold-related illness at schools, Dr. Mazur concluded. Faced with such a complaint or worry by parents, you should advise them to contact the local health department and school board with their concern.