A Accredited Mold Inspection Service, Inc.
Mold Allergy Inspectors Certified Allergen Testing
Do you suffer from a mold allergy Testing by Certified Florida inspectors, We also Conduct Dust Mite Allergen, Roach, Cat and Dog Allergen Testing Professional, Detailed, Non-Bias Mold and Allergy Testing Reports No conflict of interest; we inspect only!!! Post Remediation Clearance Testing Spore Analysis Remediation Protocol MEMBER: IAQA And AmIAQ Certified
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A Accredited Mold Inspection Service, Inc. is a professional and certified Florida toxic mold inspection company. Daryl Watters, our Florida toxic mold inspector, has 14 years of experience in the testing and inspection of dust mite allergens, cat and dog allergens, mice and rat allergens, cockroach allergens and mold. We test and investigate the sources of and solutions to such problems. If you’re looking for the very best Florida toxic mold inspectors, contact us today and put our experience to work for you. Just let us know in advance what you need, and our Miami mold inspector will be happy to serve you.
Mold Allergy And Other Mold Related Health Issues
Mold allergy The leading cause of health problems associated with mold is the common mold allergy. Many who believe they are being poisoned by toxic molds are actually experiencing a mold allergy. Allergenic responses to molds as well as to other bio-allergens such as dust mite allergens, cat and dog allergens, and cock roach allergens can nevertheless be a serious concern and can result in mild to severe reactions that often get worse over time. Mold allergy symptoms include: runny nose, watery eyes, coughing, sneezing, itchy nose, itchy throat, and skin rashes. The institute of Medicine (1993) estimated that one in five Americans suffers from allergic rhinitis, the single most common chronic disease experienced by humans. Additionally, about 14% of the population suffers from allergy-related sinusitis, while 10 to 12% of Americans have allergically-related asthma. About 9% experience allergic dermatitis. (Institute of Medicine, 1993) and (Washington state Department of Health). We sometimes find that our clients are suffering from debilitating mold allergy reactions when living in moldy homes or working in moldy environments. People often realize after suffering for a few months or a few years, that it may be the mold causing their mysterious prolonged illness and that the situation is getting worse not better and that either they have to leave, or the mold has to go and the condition that caused the mold has to be revealed and corrected. Mold allergy is not the only problem.
MOLD INFECTIONS Certain molds are known for causing infectious tissue diseases by invading and infecting human and animal tissues and mucous membranes. Mold-related sinus infections appear to be common in many persons living in mold contaminated homes. Eyes, ears, nose, throat, lungs, heart, brain and skin systems have documented infections due to molds. However, infections in these tissues typically only occurs in persons with a compromised immune system.
MOLD TOXICITY Many molds also have been shown to produce very scary toxic substances known as mycotoxins; mycotoxins are located primarily in the mold spores. These mycotoxins are produced by molds to help them compete with and kill other molds and microbes. It's a type of biological warfare between molds and their competitors. "Mycotoxins are believed to result in headaches, sore throats, hair loss, flu symptoms, diarrhea, fatigue, dermatitis, general malaise (tiredness) and psychological depression." (Croft et al, 1986, Jarvis, 1995). "Other reported responses to mycotoxin exposure includes skin rashes, lesions of the skin and gastrointestinal tract, and interference with blood cell formation." (Sorenson 1993). Many of the above are the results of lab animal and cell culture studies on toxic black mold also known as stachybotrys, and human and horse exposure to stachybotrys mold infested hay. It is very important to not panic and keep in mind that to accomplish the above serious detrimental effects toxic molds like Stachybotrys and others may have to be either: 1. Consumed in mold contaminated foods. 2. Physically handled so that excessive physical contact is made between human skin and the mold. 3. Or the mycotoxins have to be exposed to living cells in the laboratory.
It may or may not be likely that toxic molds can cause the above detrimental effects when humans breathe in mold spores in the home. It is very difficult to gather scientifically reliable proof on the effects of breathing toxic mold spores in the home.
MUCOUS MEMBRANE AND TRIGEMINAL NERVE IRRITATION Molds produce waste products made up of volatile organic compounds (VOC) such as alcohols aldehydes and acidic molecules after breaking down and absorbing food materials in our homes such as moist dust, and water damaged drywall paper, and wood. Exposure to volatile organic compounds may result in irritation to the eyes and the respiratory system. Volatile organic compounds and moldy pungent odors can also initiate avoidance reactions from the trigeminal nerve such as breath holding and discomfort. Odd sensations may also be noted including itching, burning, and skin crawling. Changes in sensation, swelling of mucous membranes, constriction of respiratory smooth muscle, or dilation of surface blood vessels may be triggered in response to trigeminal nerve stimulation. Decreased attention, disorientation, diminished reflex time, dizziness and other effects can also result from such exposures( Otto et al., 1989)
This web site is designed for informational purposes only. It is not intended for diagnosing or treating a health problem or disease. It is not a substitute for professional care. If you suspect you have a health problem, contact your doctor. The presence of a small amount of even very toxic mold in your home is not necessarily need for immediate or irrational fear. It seems that most homes from my experience have some potentially toxic mold spores as do most outdoor environments. If unwarranted fear takes over, people become vulnerable to be taken advantage of by dishonest mold inspectors and dishonest mold remediators. It is wise to have your property tested and inspected by a non-biased professional mold allergy inspector to determine if concern is warranted and if and what corrective measures are needed.
About the Author:
Daryl Watters is president of A Accredited Mold Inspection Service, Inc. He provides home, mold, and indoor air quality investigations in South Florida. He is also the creator of MIR forms designed to aid inspectors in the production of computer generated indoor air quality and mold inspection reports. For more information visit www.floridamoldinspectors.us www.florida-mold-inspection.com www.freemoldinspectionreporting.com www.moldinspectionreport.com
Fungal Glossary
Absidia sp. A zygomycete fungus. Reported to be allergenic. May cause mucorosis in immune compromised individuals. The sites of infection are the lung, nasal sinus, brain, eye and skin.
Acremonium sp. (Cephalosporium sp.) Reported to be allergenic. Can produce a trichothecene toxin which is toxic if Fungus is ingested. It was the primary fungus identified in at least two houses where the occupant complaints were nausea, vomiting and diarrhea.
Alternaria sp. Aw - 0.89. Conidia dimensions 18-83 x 7-18 microns. A very common mold allergen with an IgE mediated response. It is often found in carpets, textiles and on horizontal surfaces in building interiors. Often found on window frames. Outdoors it may be isolated from samples of soil seeds and plants. It is commonly found in outdoor samples. The large spore size 20 - 200 microns in length and 7 - 18 microns in sizes, suggests that the spores from this fungi will deposit in the nose, mouth and upper respiratory tract. It may be related to Baker's asthma. It has been associated with hypersensitivity pneumonitis. The species Alternaria alternata is capable of producing tenuazonic acid and other toxic metabolites which may be associated with disease in humans or animals, a common cause of extrinsic asthma (immediate-type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema.
Aspergillus caesiellus This species is only occasionally pathogenic.
Aspergillus candidus Aw 0.75. Conidia dimensions 2.5-4 microns. Found in warm soils, grain and in the secondary decay of vegetation. Associated with respiratory complaints in a recent house investigation.(MAC) Can produce the toxin petulin which may be associated with disease in humans and other animals.
Aspergillus carneus This species is only occasionally pathogenic.
Aspergillus clavatus Conidia dimensions 3-4.5 x 2.5-4.5 microns. Found in soils and animal manure. Can produce the toxin petulin which may be associated with disease in humans and other animals. This species is only occasionally pathogenic.
Aspergillus deflectus This species is only occasionally pathogenic.
Aspergillus flavus Aw 0.78.Conidia dimensions 3-6 microns or 3-5 microns. It grows on moldy corn and peanuts. It can be found in warm soil, foods and dairy products. Some strains are capable of producing a group of mycotoxins - in the aflatoxin group. Aflatoxins are known animal carcinogen. There is limited evidence to suggest that this toxin is a human carcinogen. The toxin is poisonous to humans by ingestion. It may also result in occupational disease via inhalation. Experiments have indicated that it is teratogenic and mutagenic. It is toxic to the liver and reported to be allergenic. Its presence is associated with reports of asthma. It can be found in water damaged carpets. The production of the fungal toxin is dependent on the growth conditions and on the substrate used as a food source. This fungus is associated with aspergillosis of the lungs and/or disseminated aspergillosis. This fungus is occasionally identified as the cause of corneal, otomycotic and naso orbital infections.
Aspergillus fumigatus Aw 0.82; Optimum 0.97. Conidia dimensions 2-3.5 microns. Major cause of aspergillosis. Both invasive and allergic aspergillosis are caused by this organism. Aspergillosis affects individuals who are immune compromised. It is considered a human pathogen. It grows well at 35 degrees C. It is commonly found outdoors in compost piles with temperatures higher than 40 degrees C, in mild to warm soils and on cereals.
Aspergillus glaucus Conidia dimensions 5-6.5 microns. Common outdoor fungus in the winter. It is reported to be allergenic. This species is only occasionally pathogenic. It can grow on leather. This fungus can grow at low moisture levels on grains, sugary food products, meat and wool. The ascomycetous state is Eurotium sp.
Aspergillus nidulans Aw 0.78. Conidia dimensions 2-4 microns. Found in mild to warm soils and on slowly decaying plants. Can produce the mycotoxin sterigmatocystin. This toxin has been shown to produce liver and kidney damage in lab animals. This fungus is associated with aspergillosis of the lungs and or disseminated aspergillosis. This species is only occasionally pathogenic.
Aspergillus niger Aw 0.77; Optimum 0.97. Conidia dimensions 3.5 - 5 microns or 4 to 5 microns. Less common cause of aspergillosis. It has a musty odor. It is commonly found in the environment on textiles, in soils, grains, fruits and vegetables. It has been reported to cause skin and pulmonary infections. It is a common cause of fungal related ear infections-otomycosis. Common cause of mold allergy.
Aspergillus ochraceus Aw 0.77. Conidia dimensions 2.5 - 3 microns. Found in grains, soil and salted food products. It is not usually associated with decaying vegetation. Can produce a kidney toxin ochratoxin A which may produce ochratoxicosis in humans. This is also known as Balkan nephropathy. The toxin is produced at optimum growth conditions at 25 degrees C and high moisture conditions. The ochratoxinmay also be produced by other Aspergillus sp. and Penicillium sp. Other toxins which can be produced by this fungus include penicillic acid, xanthomegnin and viomellein. These are all reported to be kidney and liver toxins.
Aspergillus oryzae This species is only occasionally pathogenic.
Aspergillus parasiticus Some strains are capable of producing a group of mycotoxins - in the aflatoxin group. Aflatoxins are known animal carcinogen. There is limited evidence to suggest that this toxin is a human carcinogen. The toxin is a poisonous to humans by ingestion. Experiments have indicated that it is teratogenic and mutagenic. It is toxic to the liver. The production of the fungal toxin is dependent on the growth conditions and on the substrate used as a food source.
Aspergillus penicilloides Conidia dimensions 3-3.5 x 4-5 microns. Can grow in areas with low water activity. It is found in house dust and food.
Aspergillus restrictus This species is only occasionally pathogenic.
Aspergillus sp. Aw 0.75 - 0.82 Reported to be allergenic. Members of this genus are reported to cause ear infections. Many species produce mycotoxins which may be associated with disease in humans and other animals. Toxin production is dependent on the species or a strain within a species and on the food source for the fungus. Some of these toxins have been found to be carcinogenic in animal species. Several toxins are considered potential human carcinogens. Common cause of extrinsic asthma (immediate-type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema.
Aspergillus sydowi This species is only occasionally pathogenic.
Aspergillus terreus Aw 0.78.Conidia dimensions 1.8-2.4 microns or 2 - 2.5 microns. Aleurospores 6 - 7 microns in diameter are also produced. Found in warmer soil and in grains, straw. cotton and decomposing vegetation. Can produce the toxin patulin and citrinin which may be associated with disease in humans and other animals. This fungus is associated with aspergillosis of the lungs and or disseminated aspergillosis. Found as an isolate from otomycosis - ear infection and onychomycosis - infection of finger or toe nails.
Aspergillus ustus This species is only occasionally pathogenic.
Aspergillus versicolor Aw 0.78. Conidia dimensions 2-3.5 microns. It is commonly found in soil, hay,cotton and dairy products. It can produce a mycotoxin sterigmatocystin and cyclopiaxonic acid. These toxins can cause diarrhea and upset stomach. It is reported to be a kidney and liver carcinogen. This species is only occasionally pathogenic.
Basidiomycetes Fungal spores which are from mushrooms. The specific mushroom species can not be identified on the culture plate. Many mushroom spores are reported to be allergenic.
Bipolaris sp. A fungus with large spores which would be expected to be deposited in the upper respiratory tract. This fungus can produce the mycotoxin - sterigmatocystin which has been shown to produce liver and kidney damage when ingested by laboratory animals.
Blastomyces sp. Human pathogen. The fungus is commonly found in soil. It is a dimorphic fungus which has filamentous fungus when grown at 25 degrees C and a yeast form at 37 degrees C.
Botrytis sp. Aw 0.93. Conidia dimensions 7-14 x 5-9 microns. Reported to be allergenic. It is parasitic on plants and soft fruits. Found in soil and vegetables. Possibly associated with allergic symptoms.
Candida sp. Part of the normal flora of mouth and other mucous membranes in the body. Thrush and other diseases caused by Candida albicans usually occur after prolonged treatment with antibiotics or steroids. The environment is not a likely source of exposure for this fungus. Cells from the organism are usually not airborne. Reported to be allergenic.
Cephalosporium sp. (See Acremonium sp.)
Chaetomium sp. Large ascomycetous fungus producing perithecia. It is found on a variety of substrates containing cellulose including paper and plant compost. It has been found on paper in sheetrock. It is reported to be allergenic. Canproduce an Acremonium like state on fungal media.
Cladosporium fulvum (Fulvia fulva) Conidia dimensions 12-47 x 4-10 microns. It is found on the leaves of tomatoes.
Cladosporium herbarum Aw 0.88. Conidia dimensions 5-23 x 3-8 microns. It is found on dead plants, woody plants, food, straw, soil, paint and textiles.
Cladosporium macrocarpum Conidia dimensions 9-29 x 5-13 microns. It is found on dead plants, woody plants, food, straw, soil, paint and textiles.
Cladosporium sp (Hormodendrum sp.) Aw 0.88; Aw 0.84. Most commonly identified outdoor fungus. The outdoor numbers are reduced in the winter. The numbers are often high in the summer. Often found indoors in numbers less than outdoor numbers. It is a common allergen. Indoor Cladosporium sp. may be different than the species identified outdoors. It is commonly found on the surface of fiberglass duct liner in the interior of supply ducts. A wide variety of plants are food sources for this fungus.It is found on dead plants, woody plants, food, straw, soil, paint and textiles. It can cause mycosis. Produces greater than 10 antigens. Antigens in commercial extracts are of variable quality and may degrade within weeks of preparation. Common cause of extrinsic asthma (immediate-type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema.
Cladosporium sp haerospermum Conidia dimensions 3-4.5 microns. It is found as a secondary invader of plants, food, soil, paint and textiles.
Conidobolus sp. Can cause a chronic inflammatory disease of the nasal mucosa (entomophthoromycosis).
Cryptostroma corticale Conidia dimensions 4-6.5 x 3.5-4 microns. Found on the bark of maple and sycamore trees and on stored logs.
Cunninghamella sp. Can cause disseminated and pulmonary infections in immune compromised hosts.
Curvularia sp. Reported to be allergenic. It may cause corneal infections, mycetoma and infections in immune compromised hosts.
Dreschlera sp. Conidia dimensions 40-120 x 17-28 microns. Found on grasses, grains and decaying food. It can occasionally cause a corneal infection of the eye.
Epicoccum sp. Conidia dimensions 15-25 microns. A common allergen. It is found in plants, soil, grains, textiles and paper products.
Epidermophyton sp. Can cause infections of skin and nails.
Fusarium solani Aw 0.90. Macroconidia dimensions 27-52 x 4.4-6.8; Microcondia dimensions 8-16 x 2-4 microns. Found in plants and soils. Can produce trichothecene toxins which may be associated with disease in humans and animals.
Fusarium sp. Aw 0.90 A common soil fungus. It is found on a wide range of plants. It is often found in humidifiers. Several species in this genus can produce potent trichothecene toxins. The trichothecene (scirpene) toxin targets, the following systems: circulatory, alimentary, skin and nervous. Produces vomitoxin on grains during unusually damp growing conditions. Symptoms may occur either through ingestion of contaminated grains or possibly inhalation of spores. The genera can produce hemorrhagic syndrome in humans (alimentary toxic aleukia). This is characterized by nausea, vomiting, diarrhea, dermatitis, and extensive internal bleeding. Reported to be allergenic. Frequently involved in eye, skin and nail infections.
Geotrichum sp. Aw 0.90. Conidia dimensions 6-12 x 3-6 microns. Aw 0.90 A common contaminant of grains, fruits, dairy products, paper, textiles, soil and water, and often present as part of the normal human flora. The species Geotrichum candidum can cause a secondary infection (geotrichosis) in association with tuberculosis. This rare disease can cause lesions of the skin, bronchi mouth, lung and intestine.
Gliocladium sp. A fungus which is structurally similar to Penicillium sp. It is reported to be allergenic.
Helminthosporium sp. Reported to be allergenic.
Histoplasma sp. A fungus which has filamentous growth at 25 degrees C and yeast growth at 37 degrees C. It is reported to be a human pathogen. It may be associated with birds.
Humicuola sp. Grow on products with a high cellulose content. These fungi are also found in soil and on plant debris.
Hyaline Mycelia Sterile mycelia which is white or transparent. No fruiting structures are produced by the mycelia. Visual identification of these organism is not possible. Often associated with allergic symptoms.
Microsporum sp. Causes ringworm in humans.
Monilia sp. Reported to be allergenic. This fungus produces soft rot of tree fruits. Other members produce a red bread mold. It is infrequently involved in corneal eye infections.
Mucor sp. Often found in soil, dead plant material, horse dung, fruits and fruit juice. It is also found in leather, meat, dairy products, animal hair and jute. A Zygomycetes fungus which may be allergenic (skin and bronchial tests). This organism and other Zygomycetes will grow rapidly on most fungal media. May cause mucorosis in immune compromised individuals. The sites of infection are the lung, nasal sinus, brain, eye and skin. Infection may have multiple sites.
Nigrospora sp. Reported to be allergenic.
Paecilomyces sp. Commonly found in soil and dust, less frequently in air. P. variotii can cause paecilomycosis. Linked to wood-trimmers disease and humidifier associated illnesses. They are reported to allergenic. Some members of this genus are reported to cause pneumonia. It may produce arsine gas if growing on arsenic substrate. This can occur on wallpapers covered with paris green.
Papulospora sp. This fungi is found in soil, textiles, decaying plants, manure, and paper.
Penicillium sp. Aw 0.78 - 0.88 A wide number of organisms have been placed in this genera. Identification to species is difficult. Often found in aerosol samples. Commonly found in soil, food, cellulose and grains. It is also found in paint and compost piles. It may cause hypersensitivity pneumonitis, allergic alveolitis in susceptible individuals. It is reported to be allergenic (skin). It is commonly found in carpet, wall paper, and in interior fiberglass duct insulation (NC). Some species can produce mycotoxins. Common cause of extrinsic asthma (immeadiate type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema.
Periconia sp. No information available, more to come.
Phoma sp. A common indoor air allergen. It is similar to the early stages of growth of Chaetomium sp. The species are isolated from soil and associated plants (particularly potatoes). Produces pink and purple spots on painted walls. It may have antigens which cross react with those of Alternaria sp. It will grow on butter, paint cement and rubber. It may cause phaeohyphomycosis a systematic or subcutaneous disease.
Pithomyces sp. Grow on dead grass in pastures. Causes facial eczema in ruminants.
Rhizomucor sp. The Zygomycetous fungus is reported to be allergenic. It may cause mucorosis in immune compromised individuals. It occupies a biological niche similar to Mucor sp.. It is often linked to occupational allergy. May cause mucorosis in immune compromised individuals. The sites of infection are the lung, nasal sinus, brain, eye and skin infection may have multiple sites.
Rhizopus sp. The Zygomycetous fungus is reported to be allergenic. It may cause mucorosis in immune compromised individuals. It occupies a biological niche similar to Mucor sp.. It is often linked to occupational allergy. May cause mucorosis in immune compromised individuals. The sites of infection are the lung, nasal sinus, brain, eye and skin. Infection may have multiple sites.
Rhodotorula sp. A reddish yeast typically found in moist environments such as carpeting, cooling coils and drain pans. In some countries it is the most common yeast genus identified in indoor air. This yeast has been reported to be allergenic. Positive skin tests have been reported. It has colonized terminally ill patients.
Saccharomyces sp. Reported to be allergenic. Baker's Yeast.
Scopulariopsis sp. It may produce arsine gas if growing on arsenic substrate. This can occur on wallpapers covered with paris green. It has been found growing on a wide variety of materials including house dust. It is associated with type III allergy.
Serpula lacrymans Common cause of extrinsic asthma (immediate-type hypersensitivity: type I). Acute symptoms include edema and bronchiospasms, chronic cases may develop pulmonary emphysema.
Sporobolomyces sp. Reported to be allergenic.
Sporothrix sp. Can cause sporotrichosis. Usually only in populations which are immune compromised.
Sporotrichum sp. Reported to be allergenic. See also Sporothrix sp. there is some taxonomic confusion between these two genera. This genera does not cause sporotrichosis.
Stachybotrys sp. Aw - 0.94 , optimum Aw -0.98. Several strains of this fungus (S. atra, S. chartarum and S. alternans are synonymous) may produce a trichothecene mycotoxin- Satratoxin H - which is a poisonous by inhalation. The toxins are present on the fungal spores. This is a slow growing fungus on media. It does not compete well with other rapidly growing fungi. The dark colored fungi grows on building material with a high cellulose content and a low nitrogen content. Areas with relative humidities above 55% and are subject to temperature fluctuations are ideal for toxin production. Individuals with chronic exposure to the toxin produced by this fungus reported cold and flu symptoms, sore throats, diarrhea, headaches, fatigue, dermatitis, intermittent local hair loss and generalized malaise. The toxins produced by this fungus will suppress the immune system affecting the lymphoid tissue and the bone marrow. Animals injected with the toxin from this fungus exhibited the following symptoms, necrosis and hemorrhage within the brain, thymus, spleen, intestine, lung, heart, lymph node, liver, and kidney. Affects by absorption of the toxin in the human lung are known as pneumomycosis. This organism is rarely found in outdoor samples. It is usually difficult to find in indoor air samples unless it is physically disturbed or if there is (speculation- a drop in the relative humidity). The spores are in a gelatinous mass. Appropriate media for the growth of this organism will have a high cellulose content and a low nitrogen content. The spores will die readily after release. The dead spores can still result in mold allergy and are toxigenic. Percutaneous absorption has caused mild symptoms.
Stemphylium sp. Reported to be allergenic. Isolated from dead plants and cellulose materials.
Syncephalastrum sp. Can cause a respiratory infection characterized by a solid intracaitary fungal ball.
Torula sp. Reported to be allergenic.
Trichoderma sp. It is commonly found in soil, dead trees, pine needles, paper, unglazed ceramics. It often will grow on other fungi. It produces antibiotics which are toxic to humans. It has been reported to be allergenic. It readily degrades cellulose.
Trichophyton sp. Can cause ring worm, athlete's foot, skin, nail, beard and scalp. Reported to be allergenic. Found on soil and skin.
Trichothecium sp. Aw 0.90. Conidia dimensions 12-23 x 8-10 microns. Found in decomposing vegetation, soil, corn seeds and in flour. The species Trichothecium roseum can produce a trichothecene toxin which may be associated with disease in humans and other animals. Reported to be allergenic.
Tritirachium sp. Reported to be allergenic.
Ulocladium sp. Aw 0.89. Isolated from dead plants and cellulose materials found on textiles.
Verticillium sp. Conidia dimensions 2.3-10 x 1-2.6 microns. Found in decaying vegetation, on straw, soil and arthropods. A rare cause of corneal infections.
Wallemia sp. Aw 0.75.Conidia dimensions 2.5-3.5 microns. Found in sugary foods, salted meats, dairy products, textiles, soil, hay and fruits.
Yeast Various yeasts are commonly identified on air samples. Some yeasts are reported to be allergenic. They may cause problems if a person has had previous exposure and developed hypersensitivity's.
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