Hostname: page-component-669899f699-7xsfk Total loading time: 0 Render date: 2025-04-26T11:12:21.375Z Has data issue: false hasContentIssue false
  • English
  • Français

Diagnosis Codes for Mold Infections and Mold Exposure Before and After Hurricane Harvey Among a Commercially Insured Population—Houston, Texas, 2016–2018

Published online by Cambridge University Press:  17 March 2023

Kaitlin Benedict Open the ORCID record for Kaitlin Benedict [Opens in a new window] ,
Brendan R. Jackson  and
Mitsuru Toda
Kaitlin Benedict*
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA, USA
Brendan R. Jackson
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA, USA
Mitsuru Toda
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA, USA
*
Corresponding author: Kaitlin Benedict; Email: jsy8@cdc.gov.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Indoor mold after flooding poses health risks, including rare but serious invasive mold infections. The purpose of this study was to evaluate use of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes for mold infection and mold exposure in Houston, Texas, during the year before and the year after Hurricane Harvey.

Methods:

This study used data from MarketScan, a large health insurance claims database.

Results:

The incidence of invasive mold infections remained unchanged in the year after Hurricane Harvey; however, the incidence of diagnosis codes for mold exposure nearly doubled compared with the year before the hurricane (6.3 vs 11.0 per 100 000 enrollees, rate ratio: 1.7, 95% confidence interval 1.0–3.1).

Conclusions:

Diagnosis codes alone may not be sufficiently sensitive to detect changes in invasive mold infection rates within this population and time frame, demonstrating the need for more comprehensive studies.

Keywords

floodshurricanesmoldsmycosesTexas
Type
Brief Report
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e504
Creative Commons
This is a work of the US Government and is not subject to copyright protection within the United States. To the extent this work is subject to copyright outside of the United States, such copyright shall be assigned to Society for Disaster Medicine and Public Health and licensed to the Publisher. Outside of the United States, the US Government retains a paid-up, nonexclusive, irrevocable worldwide license to reproduce, prepare derivative works, distribute copies to the public and display publicly the Contribution, and to permit others to do so. Published by Cambridge University Press on behalf of the Society for Disaster Medicine and Public Health.
Copyright
© Society for Disaster Medicine and Public Health, Inc, 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Blake, ES, Zelinsky, DA. National Hurricane Center Tropical Cyclone Report: Hurricane Harvey (AL092017). National Oceanic and Atmospheric Administration. Published May 9, 2018. Accessed February 10, 2022. https://www.nhc.noaa.gov/data/tcr/AL092017_Harvey.pdf Google Scholar
Oluyomi, AO, Panthagani, K, Sotelo, J, et al. Houston Hurricane Harvey health (Houston-3H) study: assessment of allergic symptoms and stress after Hurricane Harvey flooding. Environ Health. 2021;20(1):9. doi: 10.1186/s12940-021-00694-2 CrossRefGoogle ScholarPubMed
Kontoyiannis, DP, Shah, EC, Wurster, S, et al. Culture-documented invasive mold infections at MD Anderson Cancer Center in Houston, Texas, pre- and post-Hurricane Harvey. Open Forum Infect Dis. 2019;6(4):1-5. doi: 10.1093/ofid/ofz138 CrossRefGoogle ScholarPubMed
Rao, CY, Reed, D, Kemmerly, S, et al. Assessing invasive mold infections, mold exposures and personal protective equipment use among immunocompromised New Orleans residents after Hurricane Katrina. Presented at: Society for Healthcare Epidemiology of America 17th Annual Scientific Meeting; 2007; Baltimore, MD.Google Scholar
Wurster, S, Paraskevopoulos, T, Toda, M, et al. Invasive mould infections in patients from floodwater-damaged areas after Hurricane Harvey—a closer look at an immunocompromised cancer patient population. J Infect. 2022;84(5):701-709. doi: 10.1016/j.jinf.2022.03.009 CrossRefGoogle Scholar
Barbeau, DN, Grimsley, LF, White, LE, et al. Mold exposure and health effects following hurricanes Katrina and Rita. Ann Rev Public Health. 2010;31:165-178. doi: 10.1146/annurev.publhealth.012809.103643 CrossRefGoogle ScholarPubMed
CDC. Health concerns associated with mold in water-damaged homes after Hurricanes Katrina and Rita—New Orleans area, Louisiana, October 2005. Morb Mortal Wkly Rep. 2006;55(2):41-44.Google Scholar
Gandhi, P, Malone, L, Williams, S, et al. Perceptions, knowledge, and communication preferences about indoor mold and its health implications among persons affected by Hurricane Harvey: a focus group analysis. BMC Public Health. 2022;22(1):1194. doi: 10.1186/s12889-022-13603-0 CrossRefGoogle Scholar
Chow, NA, Toda, M, Pennington, AF, et al. Hurricane-associated mold exposures among patients at risk for invasive mold infections after Hurricane Harvey—Houston, Texas, 2017. Morb Mortal Wkly Rep. 2019;68(21):469-473. doi: 10.15585/mmwr.mm6821a1 CrossRefGoogle Scholar
The Community Assessment for Public Health Emergency Response (CASPER)—Hurricane Harvey. Houston Health Department. Published May 17, 2019. Accessed February 10, 2022. https://www.houstonstateofhealth.com/content/sites/houston/Disaster_Preparedness/NE_Quadrant_Kashmere_Final_Report_CASPER_May_2019.pdf Google Scholar
Reponen, T, Levin, L, Zheng, S, et al. Family and home characteristics correlate with mold in homes. Environ Res. 2013;124:67-70. doi: 10.1016/j.envres.2013.04.003 CrossRefGoogle ScholarPubMed
Rayens, E, Rayens, MK, Norris, KA. Demographic and socioeconomic factors associated with fungal infection risk, United States, 2019. Emerg Infect Dis. 2022;28(10):1955-1969. doi: 10.3201/eid2810.220391 CrossRefGoogle Scholar
Hartnett, KP, Jackson, BR, Perkins, KM, et al. A guide to investigating suspected outbreaks of mucormycosis in healthcare. J Fungi. 2019;5(3):69.CrossRefGoogle ScholarPubMed
Vonberg, RP, Gastmeier, P. Nosocomial aspergillosis in outbreak settings. J Hosp Infect. 2006;63(3):246-254. doi: 10.1016/j.jhin.2006.02.014 CrossRefGoogle ScholarPubMed
Chang, DC, Burwell, LA, Lyon, GM, et al. Comparison of the use of administrative data and an active system for surveillance of invasive aspergillosis. Infect Control Hosp Epidemiol. 2008;29(1):25-30. doi: 10.1086/524324 CrossRefGoogle Scholar
Gold, JAW, Revis, A, Thomas, S, et al. Clinical characteristics, health care utilization, and outcomes among patients in a pilot surveillance system for invasive mold disease—Georgia, United States, 2017–2019. Open Forum Infect Dis. 2022;9(7):1-10. doi: 10.1093/ofid/ofac215 CrossRefGoogle Scholar