The German guideline on medical clinical diagnostics for indoor mold exposure: key messages, 2024, Hurraß

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Hurraß, J., Wiesmüller, G.A. The German guideline on medical clinical diagnostics for indoor mold exposure: key messages. Allergo J Int (2024). https://doi.org/10.1007/s40629-024-00294-9

Abstract

The AWMF S2k guideline “Medical clinical diagnostics for indoor mold exposure” was introduced in 2016.

The guideline is based on a standardized procedure of the AWMF including a systematic literature search involving several medical disciplines.

The expert group has updated this guideline in accordance with AWMF specifications.

For this purpose, a new Medline search was carried out for the current version of the guideline up to June 2022 with additional search terms.

The search results were evaluated and further narrowed down by means of abstract screening and, where applicable, evidence-based evaluation of the full texts.

Medical guidelines on related topics were also taken into account.

The updated guideline is available since October 2023.

This is intended to close the existing knowledge gap for rational and efficient medical diagnostics for indoor mold contamination and provides 26 core statements and recommendations, which are presented in detail.

 

"Chronic fatigue syndrome (CFS)

In contrast to the previously discussed syndromes, only a few studies address a possible link between indoor dampness/mold exposure and CFS [24, 214, 662].

Here, too, is assumed that CFS etiologically has multifactorial genesis with biological, social and psychological factors [375]. In addition, the Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Board on the Health of Select Populations, Institute of Medicine has issued a 304-page statement on the subject of myalgic encephalomyelitis/CFS [109], in which terms such as mold, mycotoxins, or MVOCs are not mentioned.

To date, there is insufficient evidence of a causal link between the environmental medical syndromes SBS, MCS, and CFS and indoor exposure to moisture/mold [286].

In summary, there is sufficient evidence for an association between indoor dampness/mold exposure and disease patterns that can be correctly classified as BRI (building-related illness) by definition, if there is a clear exposure-related association [366]. This conditionally includes the diseases listed in Table 4 in chapter 2.3 under “Sufficient evidence for an association”.

However, there is inadequate or insufficient evidence for a link between indoor moisture/mold exposure and the environmental medical syndromes SBS, MCS, and CFS (see Table 4 in chapter 2.3).

Newly coined terms such as biotoxicosis and mold and dampness hypersensitivity syndrome (MDHS) [719, 728] or volatoxins [47], suggest a nosological specificity of a pathophysiological connection for which there is no evidence to date."

 

I think mould exposure will certainly come out as a risk factor for worse “CFS” outcomes because people with CFS are people, and people are humans and mould in buildings is bad for humans so if you’re someone susceptible to CFS or whatever other illness you’re going to be disadvantaged by the extra assault on your immune system of mould.

Also plenty of people have been diagnosed with CFS or ME because they have the symptoms of this but they later discover that the can largely recover by relocating away from the toxic moulds and treating their bodies for the mould poisoning.

I don’t think ME is mould poisoning but I am sure that mould poisoning plays a part in the condition, as people with ME or the vulnerability to getting it will be less robust in their ability to function with this extra assault on their bodies. But mould kills people so as above it’s not just a chronic illness issue, it’s an everyone issue.