James Craner, M.D., M.P.H.

Consultant in Occupational & Environmental Medicine, Verdi, Nevada,

The clinical presentation and course of individuals and families who developed illnesses related to non-infectious fungal exposures inside their homes is described. Occupants developed their illnesses shortly after their homes had been water damaged. A few occupants had a specific building-related illness, such as hypersensitivity pneumonitis or asthma exacerbation, but most had a "sick building syndrome" symptom complex involving irritation/inflammation of the mucous membranes, respiratory tract, and skin; fatigue; and/or neurocognitive dysfunction. All cases required months or years to correctly diagnose. Air, surface, and/or bulk microbiological sampling in most of the homes yielded high concentrations of toxigenic fungi, including Stachybotrys chartarum and Penicillium and Aspergillus species, emanating from water-damaged building materials. Most of the ill individuals had complete clinical improvement shortly after their removal from the contaminated indoor environment, but a few individuals continued to experience symptoms in response to a variety of environmental irritants. The author proposes a new clinical syndrome entity to describe the non-infectious, mold-related, building-related illness.