A Research Agenda on Assessing and Remediating Home Dampness and Mold to Reduce Dampness-Related Health Effects

Background – An important proportion of human respiratory illness in the U.S. is considered attributable to residential dampness or mold (D/M), and thus potentially preventable. Developing effective public health policies for this problem has been challenging: current ability to define unhealthy levels of residential D/M and knowledge about effective remediation strategies for D/M to protect health are both limited. This report proposes a research agenda to improve understanding in these two areas, which are important components of the overall knowledge needed to reduce dampness-related health effects within housing.

Methods - This report briefly summarizes, based on recent review articles and selected more recent research reports, current scientific knowledge on two topics: assessing unhealthy levels of indoor D/M in homes and remediating home dampness-related problems to protect health. Based on a comparison of current scientific knowledge to that required to support effective, evidence-based, health-protective policies on home D/M, gaps in knowledge are highlighted, prior questions and research questions specified, and necessary research activities and approaches recommended.

Results - The suggested priority research activities include review and synthesis of the literature, epidemiologic studies, controlled intervention studies, field studies on building design and D/M, and development of improved semi-quantitative and quantitative assessment tools for D/M. The suggested epidemiologic studies would be iterative and coordinated with progressively refined D/M assessments that have increasingly stronger dose-response relationships with health.

Discussion - Available knowledge supports policies calling for remediation of residential D/M when apparent by sight or smell, not based on microbiologic measurements. However, this knowledge does not provide quantitative thresholds for action or explicit direction on the extent of needed remediation. Findings from the research recommended here would increase scientific support for evidence-based public health policies on residential D/M. Other research not covered here is also needed, to improve primary prevention of D/M through residential design, construction, and maintenance, and to improve the effectiveness of dampness-related public policies in achieving their desired goals.