Commentary on cognitive impairment with toxigenic fungal exposure

Abstract

Recently, Gordon et al. (2004) published an article entitled "Cognitive Impairment Associated with Toxigenic Fungal Exposure: A Replication and Extension of Previous Findings." That article claims that neurocognitive deficits are pervasive in persons self-diagnosed with "toxic" mold exposure relative to historical norms. Further, Gordon et al. argue exposure to household molds causes brain damage similar to closed head injury. Examination of their methodology reveals unfounded and unreliable conclusions due to deviations from sound epidemiological principles, bias in participant selection, misleading data analysis, and implausible causal reasoning. The purpose of this critique is to outline the specific design and reasoning flaws that, if not addressed, would lead to unwarranted conclusions regarding the effects of mold exposure.