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E Page 16 weakened immune system are those who have an underlying immunologic defect induced by drugs, physical agents, infections, cancer, or autoimmunity that predisposes them to infection.14 Examples of persons with weakened immune systems include those with AIDS,- cancer IDS;cancer and transplant patients who are taking certain immunosuppressive drugs; and those with inherited diseases that affect the immune system (e.g., congenital agammaglobulinemia, congenital IgA deficiency).15 The leading pathogenic fungi for persons with non-impaired immune function,Blastomyces, Coccidioides, Cryptococcus, and Histoplasma, may find their way indoors via outdoor air, but normally do not grow or propagate indoors. None of these fungi were identified in the environmental sampling conducted to date at the Indian River County Fire Stations. c) Toxicity Mycotoxins (mold-produced secondary metabolites) are natural products often produced in response to environmental stimuli only by specific groups of organisms and only during part of their life cycle.16 Mycotoxins are responsible for the toxic effects of mold. They can be injurious to people upon ingestion, inhalation, or dermal (skin) contact but only if the dose is sufficient to cause injury. Human toxicity from molds (mycotoxicoses� has been documented only following ingestion of molds and mycotoxin-contaminated food. It is well known that the presence of mold does not mean mycotoxins are present. An exhaustive review of the scientific literature indicates there is agreement that mycotoxins are only sometimes produced by molds.18 Thus, exposure to molds does not mean exposure to mycotoxins. Adverse effects of molds and mycotoxins have been recognized for centuries following ingestion of contaminated foods. Occupational diseases (such as Organic Toxic Dust Syndrome and Hypersensitivity Pneumonitis) are also recognized in association with inhalation exposure to very high concentrations of fungi, bacteria, and other organic matter, usually in industrial or agricultural settings (such as grain silos and industrial composting operations). 14 Stites,D.P. et al. (1994). Basic&Clinical Immunology,8th.Appleton&Lange,Norwalk, CT.,p. 579 and 706. 15 Centers for Disease Control and Prevention.General Information for Immunocompromised Persons. Date last reviewed and updated: 3/20/15.Accessed at hM://www.cdc,gov/parasites/crypto/gen info/infect ic.html on 5/28/15. 16 Rao,C.Y.(2001).Chapter 46:Toxigenic fungi in the indoor environment.In(Spengler,J.D. et al.), Indoor Air Quality Handbook McGraw Hill,New York,NY. 17 Council for Agricultural Science and Technology.(2003). Mycotoxins: Risks in Plant,Animal, and Human Systems,Task Force Report No. 139.Council for Agricultural Science and Technology(CAST),4420 West Lincoln Way, Ames, IA 50014-3447. 18 Burge,H.A.(2001).Chapter 45: The Fungi. In(Spengler,J.D. et al.),Indoor Air Quality Handbook McGraw Hill.;Dalcero,A. et al. (1989).Aflatoxins in sunflower seeds: influence of Alternaria alternata on aflatoxin production by Aspergillus parasiticus.Mycopathologia. 108(l): 31-35.;Rao,C.Y. (2001).loc. cit.;Ren,P.et al. (1999). Comparative study of Aspergillus mycotoxin production on enriched media and construction material.J Ind Microbiol Biotechnol.21: 209-213.;Tuomi,T.et al. (2000).Mycotoxins in crude building materials from water-damaged buildings. Appl Environ Microbiol.66(5): 1899-1904. 58