REVISED MARCH 2014

Mould Assessment
Recommendations
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Chrystal Palaty (Oct 2010 version); revised by Mona Shum

Summary
• Excessive dampness and mould growth Introduction
on building material surfaces and
contents can pose health risks and This report provides Public Health Inspectors
should not be tolerated in indoor (PHIs) and Environmental Health Officers
environments. (EHOs) with recommendations for evaluating
buildings, residences, and other built
• A mould assessment determines if environments for mould. This information is
mould is present, but does not based on Mould Assessment in Indoor
determine or estimate mould exposure. Environments – Review of Guidelines &
• Health-based exposure limits for indoor Evidence, which includes available evidence
mould in residential environments have from current research papers and mould
not been established; inspecting for assessment guidelines commissioned by the
visible and hidden mould, removing National Collaborating Centre for Environmental
mould where present, and repairing and Health (NCCEH).
controlling sources of excessive
The focus of this report is mould assessment in
moisture is the best approach to
the home environment and it does not address
controlling health risks.
mould assessment or exposure in occupational
• Visual inspection is recommended as environments. Although many mould
the primary tool for assessing indoor assessment strategies contained in this report
moisture and mould. Mould sampling is can be broadly applied, the investigation of large
recommended only when the results of buildings may be complicated and will require
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a visual inspection are ambiguous or additional skills and considerations. In
when more detailed information is particular, mould growth in healthcare settings
necessary. requires special attention; individuals with
compromised health may be at additional risk
• Awareness and ongoing prevention from mould. Marijuana grow operations also
activities for mould and moisture are present special challenges and risks that are not
important strategies for building addressed in this report; refer to the NCCEH
occupants and homeowners. document, Recommendations for Safe Re-
occupancy of Marijuana Grow Operations.

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Metaphase Health Research Consulting Inc.
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AMEC Environment & Infrastructure
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 • Mould is a mixture of live and dead organisms;
Principles of Indoor Mould both can be harmful. Both live and dead mould
and mould fragments contribute mycotoxins and
Growth other mould products, which have been shown to
Mould is a type of fungi, an eukaryotic organism that retain their antigenic and toxic properties over
4,5
exists in a separate classification from plants and extended periods of time.
animals. For the purposes of this document, mould • Determining mould exposure is complex.
refers to any of the following that are present in the air or Currently, there are no scientifically validated
on surfaces in indoor environments: live or dead growth methods to measure mould exposure with accuracy.
on indoor surfaces, viable or nonviable mould spores,
mould structural components, or mould metabolic The approach endorsed by most guidelines is that the
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byproducts. visible growth of mould indoors, regardless of the
species or the amount, is inappropriate and needs to be
Key principles widely accepted in the field and removed.
supported by research include:

• Mould is everywhere. Moulds are naturally Mould Assessment:

occurring and widespread in the environment. It is
not possible to eliminate exposures to all moulds,
Determining the presence,
nor is it necessary from a health perspective. location, and amount of indoor
• Moisture is the key determinant of indoor mould mould and moisture
growth. The surfaces of most indoor environments
provide appropriate temperature conditions and The purpose of mould assessment is to: (1) determine
ample nutrients for moulds to grow; water is the only the presence, location, and extent of past and current
additional element required for mould growth. mould growth in buildings; (2) identify the source, cause,
and extent of water ingress, condensation, or dampness
• Mould is associated with human health effects, indoors; (3) determine if there are plausible and
but dose-response relationships between the significant indoor mould exposure pathways for
amount of mould in an indoor environment, the occupants; and (4) use this information to make a
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species of mould, and the level of mould exposure mould-exposure risk management decision. A mould
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and human health are not clearly defined. assessment decision process is shown in Figure 1. An
accompanying NCCEH Mould Investigation Toolkit is
• There are no recommended health-based currently being developed which provides PHIs and
exposure limits for mould. Due to a lack of EHOs with sample assessment checklists, forms, and
scientific data, most professional organizations have interpretation guides for mould reports.
not agreed upon or supported numerical limits for
1,4,7
mould in residential environments.
Figure 1: Mould assessment decision flowchart

Notes: Step 1: Information Gathering & Planning and Step 2: Visual Inspection of Premises are normally
conducted by PHIs. If additional analysis is necessary to determine the presence or absence of mould, the building
owner or occupant is encouraged to hire a qualified Specialist/Consultant to conduct a more detailed assessment
described in Step 3: Mould Sampling, and if necessary, Step 4: Investigate Suspect Hidden Areas.
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 renovations, as well as any structural defects,
Step 1: Information gathering and need to be identified.
planning • Review of the building exterior. Look for any
obvious signs of external building deficiencies,
The assessment process begins with a suspicion of
water intrusion, or failed materials or surfaces,
mould. This can be a complaint from the occupant
including missing drainage elements or staining.
about health effects, an odour, presence of visible
The area surrounding the building should also be
mould or moisture damage, excess humidity, or a
inspected for potential sources of aerosolized
specific incident, such as a leak or flood. The
mould, including water sources, landscaping, and
objective of this step is to gather as much information
digging activities.
as possible about the situation and to create an
assessment plan. Factors influencing assessment • Review of building interior. If applicable and
planning include the magnitude of the observed or appropriate, this includes a walk-through of all
anticipated problem, available resources, occupiable areas and others, such as attics,
documentation requirements, and inspector basements, crawl spaces, and storage spaces.
1,9
qualifications. Occupant interviews or Note that entry into confined spaces* requires
questionnaires can be conducted prior to or during specific training as well as appropriate protective
the site inspection, but should never replace an clothing and breathing equipment. Inspection of
inspection. Occupants concerned about health issues confined spaces is not conducted during an initial
1,7,10-12
or symptoms should be referred to a physician. building inspection, but may be conducted as part
of a more detailed assessment (Step 4).
Step 2: Visual inspection of Inspect surfaces around plumbing, under and
premises adjacent to windows, doors, and other
penetrations through the building’s exterior.
A detailed visual inspection, coupled with information Condensation observed on windows and pipes
gathered about the building history and conditions, is should be documented.
the best method to identify the cause, location, and
extent of mould within the occupiable spaces of a The number of occupants, living activities,
1,3,5-7,13
structure. Building characteristics, such as characteristics, and contents of the building need
architecture, construction quality, age, history of prior to be considered.
water issues, and condition and repair of the building
need to be considered. Personal protective • Inspection of heating, ventilation, and air
equipment (PPE) is not usually required during a conditioning (HVAC) systems. At a minimum,
visual inspection unless contamination is extensive. the furnace heating and air conditioning systems
All observations and readings obtained during the should be inspected, as well as any stand alone
inspection need to be documented in notes or or integrated humidifiers. Larger or more complex
photos; detailed instructions and checklists for systems may need to be evaluated by specially
performing visual inspections are provided in several trained individuals.
1,8,14
guidelines and the NCCEH toolkit. A visual
• Identify the source and extent of moisture.
inspection should include the following:
Moisture measurements can be used to locate or
estimate the extent of concealed or non-visible
• Identify sources of water damage and
mould contamination and can include relative
evidence of mould. Indicators include visible
humidity (RH) measurements, as well as surface
mould growth, an earthy or musty odour,
moisture measurement of building
evidence of leaks or flooding such as water 1,4,6,8,9
materials. Periodic or seasonal moisture
stains, wet areas, decayed wood, peeling paint,
sources, or those that occur within hidden areas
wrinkled wallpaper, cracks in plaster, warped
such as wall cavities, are more difficult to identify
wood, or white powdery salt crystals on the
surface of walls or masonry. In addition, signs of *
Confined spaces are defined as the following: (1) are spaces
water intrusion or chronic condensation, large enough and configured so that an employee can enter
structural damage, previous repairs and and perform assigned work; (2) have limited or restricted
means for entry or exit; (3) are not designed for continuous
employee occupancy.7 (p. 29)
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 as they may not be visible at the time of Mould sampling has many significant limitations; it
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inspection. Regardless of mould, contaminated can be time consuming, expensive, and does not
water containing soil, sewage, or pathogens may identify moisture sources or why a problem has
harm occupants, so the type of water present occurred. None of the sampling methods can
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needs to be determined. determine the duration of mould growth or provide
information about mould exposure. Disturbing mould
• Determine the presence, amount, and location growth to obtain samples may also increase the
of indoor mould. If mould growth is identified, health risk for occupants. In addition, sampling
the size or area of the visible fungal growth results can be highly variable and difficult to interpret
needs to be estimated; this will dictate the best due to a lack of standardization and objectivity; this
method for mould remediation. The most leads to inconsistent conclusions, even among
common thresholds for mould remediation are professionals.
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1 m of visible growth or less for small scale
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remediation projects, up to 10 m for moderate Both air and dust sampling are useful for identifying if
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projects, and greater than 10 m for large scale the indoor environment is contaminated from a
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remediation projects. Mould sampling is often 16
hidden mould source, and speciation of mould is
unnecessary if visible mould growth is useful for making comparisons between affected and
5,14
observed ; however, inspectors may make a control/outdoor locations and to identify “water
decision to sample based on personal experience damage” indicator species.
1,4,17,18
Mould sampling
and risk management decisions. ideally leads to one of two possible outcomes:
Visual inspections lead to one of three possible
• No evidence of mould contamination. No
outcomes:
remediation action is required, and no further
action is required by the environmental
• No evidence of visible mould growth or
consultant. Prevention activities should be
moisture damage. No remediation action is
initiated.
required, and no further action is required by the
PHI. Prevention activities should be initiated. • Clear evidence of mould contamination. If
mould is not visible, however, further
• Evidence of visible mould growth or moisture
investigative actions are required to identify the
damage. Remediation actions should be initiated
source and amount of mould present. In this
to remove the mould and address the underlying
case, a qualified environmental
cause of moisture.
specialist/consultant should be engaged to
• Unclear if mould or moisture is present. An proceed with Step 4: Investigate suspect hidden
environmental consultant/inspector should be areas.
engaged to proceed with Step 3: Mould sampling.
Step 4: Investigate suspect hidden
Step 3: Mould sampling – areas
collection, analysis, and
If a strong suspicion of hidden mould is supported by
interpretation mould sampling results, more invasive techniques
may be employed to determine the location. Because
Mould sampling should be conducted when a visual
of the complexity, as well as additional risks,
inspection reveals that unusual mould growth may be
investigations for hidden mould should only be
present but cannot be confirmed visually. Sampling is
conducted by a qualified environmental
appropriate when: (1) the presence of hidden mould 1,8
professional.
is suspected and intrusive or destructive sampling
1,2
may be required to locate it ; (2) there are surface Signs of possible hidden mould include musty odours
stains, but it is uncertain if the staining is mould; (3) and stains at the base of walls and under carpet
there is a need to judge the effectiveness of associated with possible leak locations, such as
remediation, or as part of a quality assurance windows. Minimally-invasive methods to identify
strategy, to ensure there are no additional sources of hidden mould include the use of a moisture meter,
1-3
contamination outside the remediation area. 19
boroscope, and infrared camera. Identifying mould
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in hidden areas may require small-scale destructive support mould growth and educating occupants
openings of walls or other surfaces, lifting carpets or about how their activities can contribute to indoor
flooring, and removing wallpaper, drywall, or moisture and mould. Regular indoor environmental
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paneling. More extensive destructive inspections are maintenance activities, such as use of exhaust fans
limited to situations where there is no other method to vented to the outside, use of HEPA vacuum cleaners,
locate hidden mould and moisture. Because vigilance regarding mould growth and moisture
destructive inspections may involve the dismantling of infiltration, and immediate clean up of moisture can
building structures and can compromise the integrity all contribute to better indoor environments.
of building materials, appropriate containment
strategies and the involvement of other professions
are required. Evidence Gaps
The potential for exposure to microbial contaminants The mould assessment field has many points of
in spaces such as attics, crawl spaces, exterior controversy, mostly due to a lack of objective data
sheathing, and garages is poorly understood.
1,5,20
As and the potential risk presented by mould in the
a result, qualified industrial hygienists and other built environment. Areas for future research
building health professionals do not fully agree on the include:
potential impact of hidden mould growth on indoor air
quality, as exposure pathways are often difficult to • Development of better exposure assessment
identify. methods, so health risks of mould exposure
can be determined and risk-relevant exposure
metrics can be developed.
Decisions and • Determining the impact of mould exposure
Recommendations outdoors and how this compares to mould
exposure indoors.
A mould assessment needs to be conducted in a
• Development and validation of sampling and
step-wise process (Figure 1), concluding with a
analytical methods to identify and accurately
decision about the presence of mould and moisture.
measure all microbial agents in indoor
The discovery of either mould or moisture suggests
environments.
that additional investigation and remediation should
follow.

At the end of this process, an indoor occupied space Acknowledgements

is considered to be acceptable for mould and
moisture if: (1) there is no visible mould growth on We would like to thank the following individuals for
building surfaces (excluding naturally damp areas their invaluable input and review of this document:
such as bathroom tiles and window sills); and (2) Goran Krstic, Jeff Hicks, Del Malzahn, Keith Smith,
there is no indication of hidden mould or any unusual Dennis Stefani, Vicki Wearmouth, Lesley Clements,
moisture sources identified, such as ongoing leaks, and Michele Wiens.
moisture infiltration, or excessive condensation.

Prevention and awareness activities include reducing

or controlling the sources of moisture that can

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 mold exposure and moisture indoors. Farmington, CT:
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This document was produced by the National Collaborating Centre for Environmental Health at the British
Columbia Centre for Disease Control in October 2010 and revised March 2014.

Permission is granted to reproduce this document in whole, but not in part.

Production of this document has been made possible through a financial contribution from the Public Health
Agency of Canada through the National Collaborating Centre for Environmental Health.
Photo Credits: Wildroze; licensed through iStockphoto
ISBN: 978-1-926933-66-5
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