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Managing building-related Aspergillus exposure.

Aspergillus exposure is difficult to avoid. Indoor dust contains spores and thermotolerant molds may colonize damp or water-damaged building materials or components. Dust control should be part of diligent maintenance since disturbing dusts, especially during building renovation, can expose occupants to spores. Colonization of HVAC systems can shed spores into a building and expose occupants. Mold colonization warrants prompt and effective remediation, including removal of the colonization with associated debris and dusts without unduly exposing remediation workers, and while controlling fugitive dusts. Cleaning may suffice for non-porous surfaces, but colonized porous materials typically must be removed. Determining successful remediation can be challenging; the objective is not to sanitize, but a building in a 'normal and typical' state, a state that is often poorly defined. This is even more troublesome for colonized HVAC components and for health care facilities. Practical remediation assessment emphasizes inspection and then environmental monitoring. Air sampling may prove useful after inspection and monitoring, assuming prior consensus on the purposeof sampling and interpretation of results. Thoughtful design, careful construction and renovation, and diligent operation and maintenance of a building are all needed to minimize the exposure of building occupants to mold.