Most discussions of mould and health focus on asthma and allergies, and while these are the most common mould-related complaints, they are not the whole picture. For the growing number of Illawarra residents living with chronic obstructive pulmonary disease (COPD), bronchiectasis, or chronic sinusitis, mould exposure in the home creates risks that go beyond a flare of symptoms. The Illawarra has a significant ageing population, Wollongong’s median age is above the national average, and a history of industrial work in coal mining, steel manufacturing, and port operations that has left many residents with compromised respiratory function. This guide explains how mould interacts with these conditions and what practical steps can reduce risk. See also our guide on mould and asthma in the Illawarra.
Quick Answer (BLUF)
For people with COPD, bronchiectasis, or chronic sinusitis, indoor mould exposure can trigger exacerbations, worsen lung function decline, and, in severe cases, contribute to fungal colonisation of the airways (Aspergillus). Professional mould remediation and post-treatment air quality verification are warranted, not optional, where mould is found in a home occupied by someone with these conditions.
COPD and Mould
Chronic obstructive pulmonary disease affects approximately 1 in 14 Australian adults and is disproportionately represented in Illawarra communities with a history of occupational dust and fume exposure, coal miners from the Western Coalfields, steel workers from BlueScope’s operations in Port Kembla, and dock workers from Port Kembla Harbour.
For people with COPD, indoor mould creates two distinct problems:
1. Inflammatory airway response Mould spores are typically 2-10 microns in diameter, well within the range that penetrates the lower airways of someone with impaired mucociliary clearance (a hallmark of COPD). The immune response to spore inhalation triggers bronchospasm and airway inflammation, which in COPD manifests as an acute exacerbation, worsening breathlessness, increased sputum production, and possible hospital admission.
2. Fungal airway colonisation People with advanced COPD, particularly those with bronchiectasis as a comorbidity, have structurally abnormal airways that can be colonised by Aspergillus fumigatus, a ubiquitous mould species found in high-humidity indoor environments. Sensitisation to Aspergillus (ABPA, Allergic Bronchopulmonary Aspergillosis) is a serious complication that can accelerate lung function decline. Any COPD patient who experiences unexpectedly worsening control should discuss Aspergillus sensitisation testing with their respiratory physician.
Bronchiectasis and Mould
Bronchiectasis involves permanent, irreversible widening and scarring of the airways, often caused by repeated infection or inflammatory damage. The dilated airways accumulate mucus and are highly prone to bacterial and fungal infection.
Indoor mould exposure for someone with bronchiectasis:
- Increases the risk of Aspergillus and other fungal infections in the dilated airways
- Can trigger infective exacerbations when spores introduce fungal or co-occurring bacterial pathogens into the already-compromised airways
- Worsens quality of life and haemoptysis (coughing blood) frequency
If you manage bronchiectasis in the Illawarra and have mould in your home, even what appears to be minor bathroom or ceiling mould, a professional mould inspection is warranted. Post-remediation air testing confirms that spore counts in living areas have returned to normal before the patient returns to or remains in the home.
Chronic Sinusitis and Mould
Chronic rhinosinusitis (CRS) affects a substantial proportion of the population and is frequently exacerbated by indoor mould exposure. The mechanisms are well-established:
- Mould spores landing on the nasal and sinus mucosa trigger an immune response, histamine release, eosinophil activation, and mucosal swelling
- In sensitised individuals, this maintains the chronic inflammatory state of the sinuses even when there is no active infection
- A subset of CRS patients have fungal involvement directly in the sinus cavities (fungal ball sinusitis, eosinophilic fungal rhinosinusitis), both of which are worsened by ongoing high mould spore exposure in the home environment
Wollongong’s coastal humidity means outdoor spore counts are already higher than inland areas. A mould problem indoors adds a continuous indoor exposure load that is difficult for a CRS sufferer to escape.
What to Do
If a household member has COPD, bronchiectasis, or CRS and you have identified mould in the home:
- Get a professional mould inspection, a qualified mould assessor will identify all sources (including hidden mould in wall cavities, roof voids, and subfloors) and provide an air quality baseline.
- Arrange professional remediation, professional mould remediation with proper containment prevents the remediation process itself from spiking indoor spore counts. DIY removal without containment is genuinely dangerous for a person with impaired lung function.
- Consider antifungal fogging, antimicrobial fogging treatment after primary remediation reduces residual spore counts on all surfaces, including upholstery and soft furnishings where spores accumulate.
- Post-remediation air testing, confirm indoor spore counts have returned to acceptable levels before the patient returns to normal activity in the home. See our indoor air quality testing guide.
- Manage ongoing humidity, mechanical ventilation, exhaust fans on timers, and a whole-house dehumidifier where indicated all reduce the ambient humidity that supports mould growth in the Illawarra’s coastal climate.
FAQs
Should someone with COPD leave the home during mould remediation?
Yes. A person with COPD or bronchiectasis should not be present during active mould remediation or in the building for at least 24 hours after the work is complete, until post-remediation air testing confirms acceptable spore levels. Arrange alternative accommodation for the duration.
Can mould permanently worsen COPD?
Repeated mould-related exacerbations accelerate the decline in FEV1 (forced expiratory volume) that characterises COPD progression. Reducing mould exposure is one of the few modifiable factors in the home environment that can slow this trajectory. There is also evidence linking mould sensitisation to poorer long-term COPD outcomes.
Is there a specific mould species most dangerous to COPD patients?
Aspergillus fumigatus is the species of greatest clinical concern due to its thermotolerance (it grows at body temperature), small spore size (allowing deep lung penetration), and its role in both sensitisation and invasive infection. However, multiple Aspergillus and Penicillium species found in Illawarra homes can cause similar sensitisation.
How can I verify that air quality has improved after remediation?
A post-remediation air quality test, either air sampling or surface sampling, conducted by a qualified mould assessor independent of the remediation contractor gives an objective, documented result. This is recommended for any home where a vulnerable household member is present.