Ontario Ministry of Health Issues Report on
Health Effects of Mould Contamination in Buildings
& Guidelines for Mould in School Facilities

The Ontario Ministry of Health convened an expert medical panel on February 11-12, 1999, to review the evidence linking mould contamination in buildings and adverse health effects. This panel was the re-convening of a panel with a similar assignment that had met in 1997. The 1999 mandate was to review the new scientific evidence available since 1997, including papers presented at conferences, research work in progress, and other unpublished information known to the participants.

The panel included physicians and scientists drawn from the University of Toronto, McMaster University, the Hospital for Sick Children in Toronto, the Ministries of Health and Labour, the Health Units of the Region of Peel and Brant County, and the Eastern New York Occupational and Environmental Health Center.

The final draft of the panel report was reviewed by two distinguished external experts, and their comments were included in the final report. The panel's conclusions represent the most current, comprehensive scientific review of this issue.

The Expert Panel was posed a number of questions regarding the potential relationship between mould contamination in buildings and adverse health effects. Some of the more important conclusions are given here:

Q1A:	"What are the health effects of exposure to moulds?"
Q1B1:	How convinced are you that the health effects as stated above are associated with mould or with environmental conditions (e.g. water damage or excess humidity) that might give rise to mould?
Q1B3:	Within these circumstances, what constitutes a susceptible individual?
Q4A:	Clarify and comment on the dose-response relationship between mould exposure and adverse human health outcomes. Identify / comment on what happens in terms of outcomes at low doses or levels of exposure?

This guideline document was produced by a taskforce assembled in early 1999 by the Ontario Ministry of Health. The taskforce consisted of representatives of three Regional Health Units with significant experience with mould concerns in schools, and Ministry of Health staff. Although the primary concern of the document was the control of the risk of mould in school buildings, the report states that the same principles could be used to address other indoor air quality concerns in other types of buildings.

The guideline begins by discussing the respective roles of the school board and the health department in the management of this issue. School boards have the major responsibility in this area, and are explicitly responsible under the Education Act for the health and safety of staff and students.

The role of the health department is secondary, to provide assistance and support where needed. The role of the Public Health Department would be to provide information and advice to the school board, and others (local physicians, parents, staff), respond to complaints regarding specific facilities, and possibly review and monitor the long-term control programs instituted by the school board. Occasionally, the public health authority may have to issue directives or orders under the Health Promotion and Protection Act for the school board to act on mould in school buildings, as has already happened.

The document recommends development of a Risk Communication Strategy that will include members of the Public Health department, school boards, parents, teachers, and other affected groups.

The more important findings and recommendations of the guideline are discussed under these topics.

1. Which School Facilities are of Special Concern Regarding Mould Contamination?
   
   
2. Invasive Testing
   
   
3. Sampling and Analysis
   
   
4. Risk Assessment and Response
   
   
5. Ongoing Inspection and Monitoring
   
   
6. Mould-Related Situations Requiring Evacuation of a Classroom

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