Conclusions

Prudent public health practice then indicates removal from exposure through clean up or remediation, and public education about the potential for harm. Not all species within these genera are toxigenic, but it is prudent to assume that when these molds are found in excess indoors that they are treated as though they are toxin producing. It is not always cost effective to measure toxicity, so cautious practice regards the potential for toxicity as serious, aside from other health effects associated with excessive exposure to molds and their products. It is unwise to wait to take action until toxicity is determined after laboratory culture, especially since molds that are toxic in their normal environment may lose their toxicity in laboratory monoculture over time (Jarvis, 1995), and therefore may not be identified as toxic. While testing for toxins is useful for establishing etiology of disease, and adds to knowledge about mold toxicity in the indoor environment, prudent public health practice might advise speedy clean-up, or removal of a heavily exposed populations from exposure as a first resort.