Fatigue and exposure to mold and/or dampness: A systematic review of the literature from 2011-2018

This review expands upon prior work, which established that 112 out of 114 (98.2%) epidemiological articles published between 2011 and 2018 supported an association between exposure to elevated indoor mold/dampness and various single/multi-system health symptoms. Focusing on fatigue, our review rigorously examined these studies for statistically significant associations with mold and dampness exposure. We analyzed six articles involving a collective cohort from five cross-sectional studies with 40,933 participants, and a case-control study comprising 95 cases and 110 controls. We introduced a six-point ranking scale to assess the evidence, categorizing the studies from very low to very high support based on their methodological rigor and findings. Our evaluation revealed one study with very low support, one with moderate support, three with moderately high support, and one with very high support. Two studies were considered reference only. Our systematic review supports the assertion that fatigue is associated with exposure to indoor mold and dampness, highlighting the need for enhanced awareness and interventions in affected environments.