Aspergillus and Aspergillosis

Aspergillus

• Aspergillus is a fungus whose spores are present in the air we breathe, but does not normally cause illness. However an individual with a weakened immune status may be susceptible to aspergillus infection.

What is aspergillus?

• Aspergillosis is a group of diseases which can result from aspergillus infection.

• Some asthma patients with very severe asthma may also be sensitised to fungi like aspergillus.

• May affect patients whose immune system may be compromised - including those with leukaemia, chemotherapy patients or those on steroids, transplant patients, cystic fibrosis, HIV or AIDS, chronic obstructive pulmonary disease (COPD), chronic granulomatous disease (CGD), severe asthma with fungal sensitivity (SAFS) and many others.

Chronic Pulmonary Aspergillosis (CPA)

• Aspergillus fumigatus is almost always the species responsible for a long term aspergillus infection of the lung.

• Sufferers have healthy immune systems which under usual circumstances would completely eradicate an infection by this fungus. Consequently the infection cannot rapidly invade the patient but inhabits areas of the body where it can find a toehold.

• Secondly it needs to evade the immune system so tends to inhabit cavities where there is less contact with the immune system such as those left by damaged lung tissue left behind by tuberculosis or similar infection/damage.

Aspergillus fumigatus

Pulmonary Aspergillosis

Allergic Broncho-Pulmonary Aspergillosis (ABPA)

• Patient develops an allergy to the spores of Aspergillus moulds. Predominantly affects asthma patients but also cystic fibrosis and bronchiectasis patients.

• There is as yet no complete cure,

• Takes up residence in the lungs and grows in the air spaces deep within. The fungus does not invade the lung tissue itself but sets up a permanent source for irritation and allergic reaction.

• Sufferers find anywhere that has increased levels of airborne mould spores can trigger severe asthmatic reactions - e.g. compost heaps, damp buildings and even the outside air in some places at particular times of the year.

How Aspergillosis Effects Humans

How Aspergillosis Effects Humans

Risk factors?

• Sources of increased risk include dirty air conditioning units, compost heaps and damp or flood-damaged housing, all of which can yield higher numbers of aspergillus spores.

• But immune suppression of an individual is the most important factor.

Damp, Condensation and Mould

• Older properties tend to suffer more than new ones, but rental properties are particularly prone.

• In the USA mould has resulted in numerous lawsuits and substantial damages awards. So much so that US insurance companies are now excluding mould related claims from their casualty, property and environmental insurance policies.

• This an exert from a US legal conference:

“Toxic mould claims are rising – some experts believe that we have only seen the tip of the iceberg in the case of commercial property claims. The toxicity of mould has become a source of complex environmental litigation, a public health issue and a trap for legal counsel acting on a purchasing or financing. The costs of remediation have escalated to unprecedented levels. Insurance coverage disputes, as well as a conflicting quilt of new legislative and regulatory approaches, make toxic mould claims even more complex”

Who is Liable?

• Causes of mould growth from straightforward building defects are without doubt the landlord’s responsibility in a residential property. This may be different in commercial properties where the tenant takes on repairing responsibilities.

• However, by far the most common cause of mould growth is condensation.

• the main cause of mould growth is often the lifestyle of the occupants – the tenants.

• Older properties, especially those with solid walls (no cavity and no cavity wall insulation) are more prone to condensation problems. It is not incumbent on the landlord to bring an old property up to modern standards, but merely to show that all reasonable precautions have been taken. This may include educating the tenants as to how to avoid creating condensation conditions.

What can a Landlord do? Controlling Condensation

• You may need to educate your tenants as to how to avoid condensation.

– After a bath or shower, the room should be ventilated to the outside, not to the rest of the house - just opening a window (and closing the door) will help. Fit an extractor fan.

– Dry clothes out of doors or in a cool area of the premises – – While drying clothes indoors, ventilate the room. Dryers should have external air

extraction. – Wet coats, they should be hung outside the living envelope to dry. A good reason

for a porch.

• Add forced ventilation/extraction to areas which produce a lot of moisture (kitchen, bathroom). Extractor fans are available with an air-moisture switch so that they operate automatically while the moisture in the air is above a set amount.

• Consider using a dehumidifier - domestic types are now available and can remove a surprising amount of water from the air.

What The ISSE Can Do To Help

• ISSE Home Log Book

• ISSE endorsed PPU ventilation system

• http://www.landlordzone.co.uk/pdf/Mould.pdf