Aspergillus - toxic mold

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Aspergillus - The Mold That Wreaks Havoc in Hospitals During Construction & Reconstruction

There are more than 160 different species of Aspergillus, many of which have been documented as etiological agents of human disease. Aspergillus is most frequently found in soil, forage products, grains, nuts, cotton, organic debris, and water damaged building materials.

The diseases caused by species of Aspergillus are relatively uncommon and are rarely found in individuals with normally functioning immune systems. However, due to the substantial increase in populations of individuals with active immune suppression, such as individuals with HIV, transplant patients, neonates, patients with autoimmune diseases such as diabetes, and chemotherapy patients, contamination of buildings and hospitals with fungi, particularly Aspergillus species, have become an increasing concern. In response to the apparent increasing incidence of nosocomial infections, the CDC recently released a guideline with recommended infection control and JCAHO (Joint Commission for Accreditation of Healthcare facilities), the primary accrediting body for healthcare facilities, instituted Standard EC 3.2.1 in January of 2002, mandating infection control monitoring during any construction, reconstruction or renovation of healthcare facilities.

One infection caused by the fungus Aspergillus is aspergillosis. One route of infection is caused by the inhalation of fungal spores. In individuals with asthma or lung conditions, aspergillosis causes “localized pulmonary infections,…allergic sinusitis, and allergic bronchopulmonary disease.” In immunocompromised individuals aspergillosis can cause “invasive pulmonary infection, usually [accompanied by] fever, cough, and chest pain. [It] may also disseminate to other organs including [the] brain, skin or bone.” (CDC)

Because invasive aspergillosis occurs most frequently among highly immunosuppressed patients, the presence of Aspergillus spores in hospital air has important implications. Aspergillus spores frequently occur in hospitals due to moisture incursions, or an introduction of soil during construction. A number of severe outbreaks resulting in deaths due to aspergillosis have been reported following renovation activities in hospitals. It is critical that adequate engineering controls are implemented during renovations at hospitals or other healthcare facilities including the use of HEPA filtration units.

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