Steve Webster of the Manchester Carers Centre, UK talks about the support and services offered by the centre in Manchester and the other centres throughout the UK. Graham Atherton talks about our progress in the understanding of the health effects caused by damp homes, and how to avoid them!

1. LED BY GRAHAM ATHERTON
SUPPORTED BY
NAC CENTRE MANAGER CHRIS HARRIS
GEORGINA POWELL, DEBBIE KENNEDY & DEB HAWKER
CARER SUPPORT
NATIONAL ASPERGILLOSIS CENTRE
UHSM
MANCHESTER
Support Meeting for
Aspergillosis Patients & Carers
Fungal Research Trust

2. Programme
 1.30 Steve Webster– Carer support
 1.50 Graham Atherton – the trouble with damp homes
 2.30 Patients Discussion (Break)
 2.45 Group discussion/Requests for information
 Low – allergy gardening (Book now available)
 Artificial organs – kidney
 Food for patients meeting?
 Patients survey
 3.15 Q & A from the floor or online

3. Patients group
Saline nebulisers and their effectiveness
Media portraying aspergillosis as easy to cure
What is important to you isn’t always obvious to
your carer
When you are ill patience is inevitably shortened!

4. Damp homes
Damp is known to cause health problems – asthma,
Hypersensitivity Pneumonitis, allergy
Many with aspergillosis & asthma are particularly
effected
What else?

5. What is damp?
Damp is unwanted water, moisture that has become
persistent and is causing a problem (or going to
cause a problem) to the structure or decoration of
the building.
There are sources of water that are present in a home
that don’t cause problems eg water running down a
window isn’t a problem unless it wets constantly and
causes rot out the growth of mould.

6. What is a damp problem?
Once moisture becomes persistent it can:
Stain wall/paint/wallpaper
Cause surface coatings to lift
Damage wooden flooring
Cause mould growth!

7. Damp causes mould growth
Moulds are present in the air at all times. To grow
they need to settle on a food source
(paper/paste/plasterboard/dirt) and be provided
with some moisture.
If the moisture dries quickly ( a few hours) little
growth will occur, otherwise growth will begin,
invisibly at first
Dark, black/brown/green patched develop

8. When does mould become a problem?
If the mould is in a normal ‘wet’ room
(bathroom/kitchen) on surfaces designed to be wet
and wipe with cleaner & disinfectant as you always
have done

9. When is mould a problem?
If mould is in room which are not designed to be wet
or/and on surfaces not designed to be wet there is a
problem

10. When is mould a problem?
Difficult to give a general answer to this but a recent
study showed that the appearance of mould patches
larger than a postcard was evidence of a damp
problem than could cause health problems.

11. What do we do about it?
Identify the source of the moisture & stop it.
 Mainly – condensation
 Also check for broken guttering or downpipes leaking and
pouring water down the outside wall when its raining
 Leaking internal pipes
 Many more of these – if unsure contact ISSE
(www.isse.org.uk) for advice & good surveyor. Generally not a
good idea to call in a company you find in the yellow pages as
many are unqualified salesmen!

12. What do we do about it?
Small amounts: Superficial
 Don’t just paint over! Remove the mouldy material as it will
regrow quickly if it becomes damp again.
 Remember much of the mould is invisible so use a disinfectant
– 10% bleach is effective as are other fungicides and it helps to
add in some detergent to aid cleaning.
 If you are sensitive or have aspergillosis/asthma don’t do this
yourself and ensure the room is well ventilated to dry it out!
Large amounts: growing through material
 Use a professional company to clean & replace material– get a
recommendation from your surveyor

13. Full guidelines
http://www.epa.gov/mold/moldguide.html

14. How do we stop it reoccurring?
If there was a leak then hopefully after cleaning no
further action will be needed.
If the problem is condensation then you need to
assess how well ventilated your home is
 Ventilate more to remove moisture – open windows, install
vents, check existing vents are clear, take advice from ISSE.
 Remove / reduce sources of moisture in the air – open
windows when showering/boiling water in kitchen, dry clothes
outside or in a vented dryer.
 New homes can have very little airflow. Older homes with
fireplaces may need to have their natural vents restored.

15. What health problems can occur?
Those with aspergillosis & sinusitis & allergies may
find some symptoms worsening – it is worth keeping
moulds out of your home!
Damp homes are known to caused asthma to worsen
in children and adults
Hypersensitivity – can be brought about by flooding
in a home. Severe breathing difficulties. Can be
triggered again if you re-enter the home even after a
cleanup!
Neurophysiological symptoms (?)

16. Toxic moulds – controversial?
There seems to be a group of patients living in damp
or flooded homes that suffer from quite vague
symptoms that are difficult to measure like
headache, lethargy, aches, tingling, tinnitis and
more
Over last 10 years lots of claims & counterclaims
driven by insurance/compensation claims in the
main

17. History of Sick Buildings
From 1970’s onwards claims of illness in particular
buildings. One cause found to be damp
2000 onwards: a few research groups starting to
publish papers correlating damp & moulds with
respiratory symptoms and lots more less measurable
symptoms. A fair bit of this effort seemed to centre
around mycotoxins but this was not the only culprit
suggested

18. History of Sick buildings
2006 onwards some doctors start to offer treatments
to attempt to remove low level mycotoxins detected
in bodies of people living in damp/mouldy homes,
also treatments to attempt to protect patients bodies
from ‘oxidative damage’
Current thinking suggests an illness with many
symptoms caused by many factors – fine particles
generated by fungi when they dry out, spores,
mycotoxin, other types of toxin, odours etc.

19. Sick buildings?
As symptoms are difficult to measure, research is
difficult. Results controversial.
A lot of information is talked about in books, on
websites and in the media but much less seems to be
proven as yet.
What is published has weak points that prevent
general acceptance of these theories – we are not
even told how successful treatments are other than
one or two small papers.
Caution!!

20. How does it effect NAC?
We are here to diagnose & treat aspergillosis – newly
described illnesses that might be related to damp &
moulds are not our main area of interest.
Damp homes DO effect our patients and those of our
‘clinical neighbours’ at UHSM – CF & asthma. This is
our main area of interest.
We do however occasionally get asked for our
opinions on other aspects of health in damp homes
and our collaboration with ISSE gives us a source of
good advice on surveying side. Common interests –
assessment & remediation

21. Damp & Human Health
Damp – eliminate it and nearly all of these health
problems will be alleviated or never appear.
Until we know more about the health issues:
Treat the damp!

22. Low Allergen Gardening
Allergy-free Gardening: A Revolutionary Approach to
Landscape Planning by Thomas L. Ogren (1 Mar 2000)
£82.43 new, £30.00 used

23. Q & A
Questions?
Areas of interest online
Itraconazole toxicity – risk of heart problems
Low – allergy gardening (books purchased)
Artificial organs – kidney
Food for patients meeting?
Damp homes – do you see damp/moulds?

24. Itraconazole and Heart Failure
Patients NEW to itraconazole should be aware of the
possibility of heart problems
Patietns who have been taking itraconazole for over
6 – 12 months with no problems should not develop
problems in future
ALL should be watchful for signs such as:

25. Itraconazole and Heart Failure
The symptoms of heart failure can vary from
person to person. The main symptoms are
breathlessness, extreme tiredness, and ankle
swelling, which may extend up the legs.
These symptoms may be caused by conditions other
than heart failure, and sometimes there may be more
than one cause for them.
http://www.nhs.uk/Conditions/Heart-
failure/Pages/Symptoms.aspx
If in any doubt see your doctor

26. Regrown organs

27. Regrown organs - progress
Kidney – complex organ
Has been stripped down & rebuilt using stem cells
(rat) and then re-implanted into host
Works with 5-10% efficiency compared with original
– thought to be sufficient to avoid transplant!

28. Food for Meeting
Can’t transfer funds to research
Funds come out of NAC/NHS ‘hospitality’ funds
Could do less – tea & biscuits?

29. Patients Survey
Taken in February each year
Assessment of satisfaction of all aspects of our
service
140 answered questionnaires
 Questions about Patient information
 Questions about this meeting

30. Patients Survey

31. Patients Survey

32. Patients Survey

33. Patients Survey
Of those that answered no,
32% of them do not have a
computer or use the
internet.
Anything we can do to
improve this?

34. Patients Survey

35. Patients Survey
Can we fix this in
any way?

36. Patients Survey
Can we improve this?

37. Patients Survey
Can we improve this?

38. Thank You
“The best chance we have of beating this illness is to
work together”
Living with it, Working with it, Treating it
Fungal Research Trust