How to protect yourself from the health dangers of mould

Mould is a perennial problem in our mild, damp country. It plagues both private and social housing, according to a recent report.

In the year to April 2022, the housing ombudsman investigated 456 cases citing problems with mould and damp in local authority and social housing, compared with 195 in 2021. A total of 42 per cent of the ombudsman’s cases with severe maladministration findings – meaning a repeated failure by the landlord to deal with the issue – were related to damp and mould.

These statistics came to light in the aftermath of the horrifying death of Rochdale toddler Awaab Ishak, who turned two just eight days before he died at home in December 2020. Last week, his death made national headlines when a coroner ruled that it should be a “defining moment” for the UK’s housing sector.

Awaab died of a severe respiratory condition due to prolonged exposure to mould that was present in his family’s home, the senior coroner, Joanne Kearsley, said. The dangerous black mould had been present in the family’s kitchen and bathroom since before Awaab’s birth, but his parents had repeatedly been told by their housing association just to paint over it. “I’m sure I’m not alone in having thought, ‘How does this happen?’” Kearsley told the coroners court during six days of evidence. “How, in the UK in 2020, does a two-year-old child die from exposure to mould in his home?”

Around 450,000 homes in England are believed to have condensation and mould problems. And a 2021 report by the National Housing Federation concluded that one in five children in England are living in homes that are unsuitable for a variety of reasons, including risks to health.

Two-year-old Awaab Ishak, whose death in December 2020 following exposure to black mould at home should be a 'defining moment' for the UK's housing sector, according to senior coroner Joanne Kearsley (Photo: family handout/PA)
Two-year-old Awaab Ishak, whose death in December 2020 following exposure to black mould at home should be a ‘defining moment’ for the UK’s housing sector, according to senior coroner Joanne Kearsley (Photo: Family handout/PA)

If Britain’s mould problem is so extensive – and potentially deadly – how concerned should we be? Many of us are now looking at our own surroundings, questioning whether our exposure to mould – from mildew around the shower to blue fuzz on food – might be having a hidden impact on our health.

“Moulds are all around us, an ancient life form of fungi that need water and carbohydrate to grow,” consultant clinical microbiologist Dr Christine Peters, from Glasgow, explains. “[Moulds] spread through the air by disseminating millions of spores invisible to the naked eye that can travel vast distances on air currents or through ventilation systems.”

When mould spores land on places with the right conditions – namely moisture, warmth and a nutrient source – they settle and grow. This could be a piece of bread or cheese, for example, or it could be a damp wall or window frame.

“Unlike plants, moulds do not require UV light for growth and so can thrive in dark, damp, hidden places,” says Dr Peters. “Anywhere there is excess humidity with condensation or leaks, like window frames in winter, or poor plumbing, is an opportunity for moulds.”

There are 50 to 60 common varieties of moulds present in the UK, each behaving slightly differently and presenting different levels of risk to humans. The majority are harmless to most people, but some are considered toxic.

Black mould

Black mould is a common household problem, most often found in damp places such as in bathrooms, kitchens, or in places where clothes might be drying. As the name suggests, it can be identified by its dark colour and circular-shaped spots.

Unfortunately, the UK climate makes us particularly susceptible to black mould in our homes and buildings because of high levels of moisture present in the air, particularly in the cooler and wetter months, says Dr Apelles Econs, medical director at the Burghwood Clinic in Surrey.

“The impact that dampness has on airborne particles and spores is that it holds them up in the air, the atmosphere gets dense and they stay around us,” says Dr Econs. “Whereas in other countries, the spores tend to gravitate and be outside of our breathable space.”

Often, people suffering with their health as a result of mould find that their symptoms clear up in a matter of days if they visit a warmer, drier country, he says. “The humidity is higher behind double-glazed windows and in centrally heated homes compared to fresh air outside,” he says. “And moulds have a nasty habit of hiding themselves behind wallpaper and plaster, especially after things like flooding.”

Black mould is considered to be harmful in high quantities and can, following prolonged exposure, cause a number of health problems.

Respiratory problems

The most widely noted impact of black mould is on respiratory health, as in the case of Awaab. This is a link that has long been known, says Dr Peters, noting that the World Health Organisation (WHO) published guidance in 2009 on mould in buildings and the need to monitor and control its growth to reduce the risks of asthma and other respiratory problems.

In the guidance, the WHO states that health impacts of mould exposure can include coughs, wheezing, the development or worsening of asthma, bronchitis and more. Those with existing respiratory conditions are thought to be particularly affected, with babies and young children also at higher risk due to their smaller airways.

Usually, these conditions can be treated or managed once the mould is removed or the person is taken out of their surroundings.

Mould sickness

While less well-established than the link with respiratory problems, there is also thought to be a potential connection between black mould exposure and long-term incurable conditions such as Chronic Fatigue Syndrome (CFS) – one 2013 study published in the journal, Toxins, found presence of high quantities of mycotoxins, that are naturally produced by certain types of moulds, in the urine of people with CFS.

But this link has been difficult for experts to prove definitively, says Dr Econs, because many continue to believe that CFS and related conditions are psychosomatic, rather than caused by our environments, and because the link cannot always be proven with a straightforward allergy test.

The terms “sick building syndrome” or “mould sickness” have sometimes been used as catch-all terms to describe symptoms such as fatigue, headaches, nausea and body aches experienced following exposure to mould (the NHS says sick building syndrome can also happen due to poor ventilation or dust, smoke, and fibres in the air).

But the impact of mould may particularly affect people who already suffer other allergies and intolerances. The Centre for Disease Control in the USA reports that “moulds can trigger asthma symptoms in people with known allergies” and “studies indicate that exposure to moulds can make pre-existing asthma worse”. But also that even those without allergies can become irritated by the presence of mould.

Black mould is most often found in damp places such as bathrooms and kitchens (Photo: aquaArts studio/Getty)

“Often I treat people with unexplained symptoms and they’re not totally explicable by moulds, but mould tends to be a cofactor in a person’s immune system alongside things like chemical sensitivities to hairsprays, perfumes and so on, or things like food intolerances,” says Dr Econs.

“The [most common] symptoms are loss of energy, fatigue, respiratory problems, skin conditions, upper respiratory conditions and sometimes sinus problems. And any form of chronic fatigue has to raise a question about whether there is a mould element in that.”

Are other types of mould dangerous?

The other common type of mould most regularly seen in the home – along with black mould – is blue and green moulds found on food. Ingesting this type of mould can lead to food poisoning in some cases. UK government early years guidance notes that the immune systems of babies and young children are not as strong and developed as adults, which makes them more vulnerable to infections which can then lead to food poisoning.

And some food is riskier than others, says Jenna Brown, food safety specialist and blogger at The Food Safety Mum. Mould on hard cheese, for example, can often be cut off and the cheese salvaged. If mouldy fruit and veg has also become slimy, however, you shouldn’t eat it: “Slime is a sign of bacteria which can cause food poisoning,” she says.

And mouldy bread should not be salvaged either. “Bread is porous which means that mould can easily spread through the whole loaf as soon as mould spores appear,” says Brown. “Once mould does appear on bread, you should throw the whole loaf out as even removing the mouldy spot and surrounding area wouldn’t guarantee you have removed all of the toxins.”

If you do accidentally ingest mouldy food, though, it’s usually not a serious problem; while the bad taste might make you a little queasy, quantities are generally too small to have any effect and can usually be digested just like any other food.

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When considering whether food is safe to eat, there are two key dates to look for on labels. “Use-by dates are there for safety reasons – after the use-by date, food is not safe to eat, even if it still looks, smells or tastes good,” says Brown. “Best before dates are there for quality reasons which means it may still be safe to eat, it just might not be at its best.”

However, she says, “if food with a best before date is contaminated with mould, it shouldn’t be eaten – especially if you’re serving it to your baby or young child”.

Can you prevent health issues caused by mould?

Moulds present more health risks for some people than for others. According to the NHS, young children and elderly people may be particularly affected, as well as those with existing skin or respiratory problems, or those with a weakened immune system.

“There has also been a link between Covid-19 and an upsurge in invasive mould infections, probably driven by treatments as well as effects of the virus itself,” notes Dr Peters. “Anything that alters the delicate balance between the immune system and the plethora of organisms it is surrounded by can give moulds the advantage and an opportunity to invade.”

There are treatments available for those affected, including anti-fungal treatments, steroids and antihistamines, and there are some steps people can take in their own lives to try and mitigate the effects of moulds, says Dr Econs. “Raising the indoor temperature by four or five degrees with central heating has the effect of scorching or fumigating moulds, and air purifiers can remove spores and moulds from the air,” he says. “Sometimes they are combined with dehumidifiers to dry out the atmosphere.”

Ventilation such as opening windows and doors is also key in ensuring spores keep moving and do not settle, preventing mould.

Following Awaab’s death, many, including Levelling up, Housing and Communities Minister, Michael Gove, raised concerns about the ability of people in the UK to eradicate mould during the cost of living crisis when many are already worried about heating and energy costs. Others called for landlords to have increased responsibility for mould in their properties.

Indeed, Dr Peters says “better than [treatment] is prevention by paying attention to building standards, ventilation and rapid management of damp as encouraged by the WHO and other agencies”.

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