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Health Concerns Associated with Mold in Water-Damaged Homes After Hurricanes Katrina and Rita --- New Orleans Area, Louisiana

Housing Assessment for Mold and Mold Exposure

During October 22--28, a team representing CDC and LDHH assessed a cross-section of the 440,269 households in the four-parish area (on the basis of the 2000 U.S. Census). Sampling was restricted to blocks with more than 20 housing units (areas with fewer housing units are likely to be sparsely populated and to contain mostly industrial buildings or parks) and areas where residents were permitted entry, yielding 239,949 potential households (Figure). Blocks were classified into three strata (mild, moderate, and severe) on the basis of Federal Emergency Management Agency flood and damage maps. Geographic information system (GIS) mapping software was used to select a random number of waypoints (latitude and longitude) proportionate for each stratum (1). A sample size of 88 homes was required to obtain estimates within 10% accuracy. Global positioning system (GPS) units were used to locate each waypoint as the random starting point to locate the nearest home at or north of the waypoint.

In the sampled areas, 141 homes were found to be occupied. A questionnaire on demographics, home occupancy, and participation in remediation activities was administered to one consenting adult from 113 of the 141 homes in which someone was in the home. One assessment was abandoned for safety reasons, resulting in a final sample of 112. A standard instrument designed for this study and pilot-tested with occupants of flood-damaged homes was used to visually assess water damage and mold growth. Air samples were collected at a subset of 20 homes; samples were collected for 36--144 minutes with 0.4 µm, 37 mm polycarbonate closed-faced cassettes at 3 L/min. The filters were analyzed for culturable fungi, (1®3,1®6)-b-D-glucan (a cell-wall component of many fungi) (2), and endotoxin (a cell-wall component of gram-negative bacteria) (3).

Of 112 homes inspected (Table), flood levels had been high (>6 feet) in 21 (18.8%) homes, medium (3--6 feet) in 19 (17.0%), and low (<3 feet) in 72 (64.3%) (including 44 [39.3%] homes with no flooding). Seventy-six (67.9%) homes had roof damage with water leakage. Visible mold growth occurred in 51 (45.5%) homes, and 19 (17.0%) had heavy mold coverage (>50% coverage on interior wall of most-affected room). The distribution of homes with heavy mold coverage was 10 (52.6%), seven (36.8%), and two (10.5%) in high, medium, and low flood areas, respectively.

Participants reported being indoors doing heavy cleaning an average of 13 hours since the hurricanes (range: 0--84 hours) and 15 hours doing light cleaning (range: 0--90 hours). Sixty-eight (60.7%) participants reported inhabiting their homes overnight for an average of 25 (standard deviation: +13.7) nights since the hurricanes.

Indoor air samples were collected nonrandomly at 20 (16%) homes; outdoor air samples were also collected for 11 of these homes. Predominant fungi indoors and outdoors were Aspergillus spp. and Penicillium spp. Geometric mean (1®3,1®6)-b-D-glucan air levels were 1.6 µg/m3 (geometric standard deviation [GSD]: 4.4) indoors and 0.9 µg/m3 (GSD: 2.0) outdoors; endotoxin levels were 23.3 EU/m3 (GSD: 5.6) indoors and 10.5 EU/m3 (GSD: 2.5) outdoors. Glucan and endotoxin levels were significantly correlated (correlation coefficient r = 0.56; p = 0.0095). The geometric mean glucan and endotoxin levels were higher indoors compared with outdoors but the differences were not statistically significant.

Survey of Residents and Workers Regarding Mold