|
For physicians and other health care providers faced with a rapidly growing number of
patients troubled by indoor contaminants, there is a new primer to guide them, entitled
Guidance for Clinicians on
the Recognition and Management of Health Effects Related to Mold Exposure and Moisture
Indoors, published by the Center for Indoor Environments and Health at
UConn Health Center with a grant from the Environmental Protection Agency.
"It's a manual for primary care physicians," says Eileen Storey, MD, MPH,
chief of the Division of Occupational and Environmental Medicine and one of the authors
of the book. "We give them an approach to use with their patients. We help them
identify patients and the illnesses or complaints that may be related to mold or other
indoor contaminants. We give them assessment tools for those patients. We tell them how
to counsel their worried well-patients and guide them to resources their patients can
use to reduce moisture and mold in their homes, " says Storey.
|
|
 |
|
For example, the book contains a questionnaire physicians can use to evaluate a patient
when an environmental problem is suspected. It can be filled out by a patient in a few
minutes and contains questions that help explore moisture and mold in the patient's home,
school, or work environment. Any positive response may indicate uncontrolled moisture
with a potential for biological growth and begins a helpful dialog between patient and
health care provider. The book provides a list of references to specific books or pamphlets
that patients can use to eliminate problem moisture.
"We know that exposure to mold and other contaminants in indoor environments may
diversely affect a person's health," says Paula Schenck, MPH, another author of the book.
"We spend nearly 90 percent of our time indoors. Asthma has increased substantially in
recent years, so we suspect the indoor environment plays a role. But not everyone is sensitized
to indoor environments, and different people become sensitized in different ways." The
book provides approaches to use for assessing indoor environments and gives physicians
strategies to recognize environmentally related clinical problems, says Schenck.
"Something is going on in our indoor environment that is making us sick, " says
Storey. "We see it in office workers. We see it in school teachers. Their illnesses range
from chronic runny nose to sinusitis or more serious conditions like asthma and hypersensitivity
pneumonitis. Their symptoms often diminish when they leave the workplace for the weekend or the
summer, but we don't know what is actually causing their illness," says Storey. In recent
years, a tremendous amount of attention has focused on architecture, construction materials,
and ventilation systems trying to figure this out, according to Storey. "We use wallboard
instead of plaster. We don't build with wood and bricks as much; instead we use steel and
concrete. Modern materials don't shed water as well. When water comes into contact with
wallboard and wall-to-wall carpeting, it can create a beautiful environment for growing mold,
" she says.
"The book is designed to provide primary care physicians with the tools they need to
address environmental illnesses because primary care physicians are the point of contact. If
a patient presents with persistent respiratory symptoms, physicians should inquire about the
presence of chronic moisture in the home, workplace, or school, says Storey. "It's like
tobacco. Thirty years ago, doctors did not think of tobacco as an issue for them in their
practice. Now it's standard health care practice for physicians to ask their patients about
tobacco use and provide counseling for it. We hope this book will do the same thing for indoor
air quality. We want them to ask their patients about environmental issues that might be related
to their illnesses and be able to provide counseling about them."
Besides Storey and Schenck, authors are Kenneth H. Dangman, MD, PhD, MPH; Robert L.
De Bernardo, MD, MPH; Chin S. Yang, PhD, Anne Bracker, CIH, MPH; and Michael J. Hodgson,
MD, MPH.
The book presents illustrative case reports, briefly discusses fungal ecology, reviews
current literature on health effects from mold and moisture and outlines principles that
underlie a professional environmental assessment.
The University of Connecticut Health Center includes the schools of medicine and dental
medicine, John Dempsey Hospital, the UConn Medical Groups and University Dentists. Founded
in 1961, the Health Center pursues a mission of providing outstanding health care education
in an environment of exemplary patient care, research and public service. To learn more about
the UConn Health Center, visit their
website.
|
