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The relationship between mold and sinuses is something I've been thinking about lately. Why do so many people after prolonged exposure to ordinary mold eventually develop sinusitis? What is going on?

This is a really interesting question because we are exposed to mold (which is actually fungi) every single day just from ordinary breathing. Fungi are all around us - in the wind, in the air, in the soil, and we always have a little in our homes. For example, in the bathroom tub or shower area, in moldy food, or around the kitchen sink. These are common molds. And we're normally just fine.

In addition, we all have some fungal species living in and on our bodies, and they are part of the normal human microbiome (the community of bacteria, fungi, and viruses living on and in us). In fact, different species of fungi live in different parts of our body, even some species that we tend to think of as harmful, such as yeast and aspergillis. In a healthy person, any potentially harmful microbes are kept in check by the other microbes in the microbiome so that they are living there harmlessly.

Yes, sometimes fungi can multiply to the point of doing harm (such as during a fungal skin infection, e.g. athlete's foot) or in an immunocompromised person, but normally fungal species live in a complex ecosystem in harmony with all our other millions of microbes.

Ordinary common molds can sometimes cause problems

But sometimes people get exposed to a lot of ordinary or common molds over a prolonged period of time. And this is where problems can develop if they breathe in a lot of the fungi.

The most important thing to know is that fungi (mold) grow in wet or moist conditions. Especially where it is not well ventilated. For example, when air conditioning systems that are not draining properly result in mold growing in the unit and the ducts. Or a water leak from the roof causes mold to grow on a wall or ceiling right in your bedroom. In both cases people are breathing it in for prolonged periods.

What kind of health problems can result? The health problems from common molds are generally of an inflammatory  or allergic nature, such as respiratory symptoms, respiratory illnesses (sinus infections), asthma, allergic responses, immunological, and other inflammatory responses. [This is according to CDC (Centers for Disease Control and Prevention), WHO, and other major associations.]

But here's another thing - responses to large mold exposure vary, with some people having big responses (respiratory infections or asthma), some minor (perhaps drippy nose), and some no effects at all.

The good news is that more extreme health effects from mold exposure are very rare according to the CDC, the World Health organization, and some other health groups, with only some individual cases reported. Whew.

Looking back on my own history of sinus infections, it all makes perfect sense! After developing non-stop sinus infections years ago, I went to an ENT specialist who, after careful examination of my nasal passages, said that I was showing a massive inflammatory response, an allergic response. And only when I figure out what was causing the allergic response would I start to improve. Which turned out to be true.

[NOTE: This post is not going into the issue of mycotoxins (of fungi that release toxins), and of molds that take over houses making them uninhabitable, for example after floods.]

Deal With A Mold Problem As Soon As Possible

The CDC says don't bother with blood tests for mold - there aren't any. There are only tests that look at allergic responses to mold. And don't worry about what type of mold is in the house. Just clean it up, replace what needs replacing, make repairs, fix whatever needs fixing, etc. as soon as possible.

Once the mold problem is fixed and mold removed, the mold exposure is gone. And any health symptoms related to too much mold exposure health can finally improve.

Final thoughts about mold and sinusitis: For a while in the 1990s it was thought that people with sinusitis all had fungal problems in the sinuses and sinusitis should be treated with antifungals. Nope. When genetic sequencing tests were developed, researchers discovered hundreds of microbial species in healthy and sick people - and they realized that we all had fungi as part of our microbiome.

Which is why physicians now generally view sinusitis as an "inflammatory process", maybe due to an allergic response. Fungal sinusitis is considered one type of sinusitis, and only in a small minority of sinusitis cases.

Indoor mold by window Credit: Wikipedia

Image result for moldy wallpaper How many people know this? That wallpaper could have fungi (mold) living on it, and this fungi can release toxins (mycotoxins) that can pollute the air and sicken people when people inhale the toxins. The releasing of toxins from the fungi (mold) into the air is called aerosolization - and when this indoor air pollution causes people  living or working in the building to become sick, it is called sick building syndrome. This study looked at 3 common indoor fungal species: Penicillium brevicompactum, Aspergillus versicolor, and Stachybotrys chartarum, and the mycotoxins they produce after growing on wallpaper.

Why does fungi grow on some wallpaper?  The researchers write that: "Many fungi can develop on building material in indoor environments if moisture is high enough". So either high humidity in the home (especially when the weather is hot) or water damage can result in mold growth. It is estimated that in Northern Europe and North America about 20 to 40 % of buildings have visible fungal growth on surfaces. How do the mycotoxins get into the air and move around inside the home? Ordinary living, with people moving around rooms, slamming doors, air drafts from opening windows, and ceiling fans all cause "air velocities" that move around the toxins. Please note that we normally breathe in fungi and bacteria, but inhaling an overload of mycotoxins from moldy wallpaper can sicken a person. From News-Medical:

Fungal toxins from wallpaper source of illness says new research

According to a new study, there are several toxins from fungi that could be released into the air indoors and the source could be fungi living in the wall papers. These may lead to serious health problems say researchers. These ordinary fungi that live with the household wallpaper are basically of three types found the study researchers. They can grow and eventually spread to the air. This leads to serious health consequences. These effects of transmission of the airborne fungi and their toxins on human health have not been studied or considered with importance till date say researchers.

The toxins released from the fungi are called mycotoxins. They can pollute the indoor air and lead to indoor air pollution – a condition called sick building syndrome. Sick building syndrome is a condition where the residents start to feel ill according to the time they have spent in a building.... Study co-author Jean-Denis Bailly, a professor of food hygiene at the National Veterinary School of Toulouse in France in a statement explained that these mycotoxins are released from moldy material of growth of the fungi. They are eventually inhaled by the inhabitants of the home. While investigating the quality of air indoors especially at homes that have higher fungal contamination, the indoor air quality also needs to be tested for fungal toxins, he explained.

According to researchers, there has been extensive study of fungal contamination of food. However there has been little work in terms of fungal toxins in air. For this study they looked at three fungi that commonly also contaminated foods - Penicillium brevicompactum, Aspergillus versicolor and Stachybotrys chartarum. A piece of wallpaper was found to be contaminated with these three fungi. A flowing stream of air was allowed over the wallpaper and samples of air of the room were then collected for testing.

On analysis of the indoor air the researchers found that the small particles of dust floating around in the house which could then be inhaled easily, contained toxins from these fungi. Also all fungi did not spread the toxins at the same rates they found. Some spread more toxins than others and this could help researchers to decide on which fungi species to concentrate on in terms of disease prevention they said.