Hurraß, Julia, Heinzow, Birger, Walser-Reichenbach, Sandra et al. · Pneumologie (Stuttgart, Germany) · 2024 · DOI
This guideline reviews what we know about indoor mold exposure and health problems. While mold in homes can be a health concern, the evidence shows it definitely causes respiratory allergies and asthma problems, but there is currently insufficient evidence to link mold exposure to chronic fatigue syndrome (CFS) or many other conditions.
For ME/CFS patients, this guideline is important because it provides authoritative evidence synthesis on whether indoor mold could be a contributing factor. The explicit classification of CFS as having 'inadequate or insufficient evidence' for mold causation may help patients and clinicians avoid misdirected investigations into environmental exposures while still acknowledging mold as a legitimate health hazard for respiratory conditions that can co-occur with or complicate ME/CFS.
This guideline does not prove that mold exposure never affects CFS patients, only that current scientific evidence is insufficient to establish a causal relationship. It does not address whether mold might indirectly worsen ME/CFS through respiratory infections or immune activation. The absence of evidence for causation reflects inadequate diagnostic methods and the ubiquitous presence of fungi, not necessarily absence of risk.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Hurraß, Julia, Heinzow, Birger, Walser-Reichenbach, Sandra, Aurbach, Ute, Becker, Sven, Bellmann, Romuald, et al. (2024). [Medical clinical diagnostics for indoor mould exposure - Update 2023 (AWMF Register No. 161/001)].. Pneumologie (Stuttgart, Germany). https://doi.org/10.1055/a-2194-6914
BibTeX
@article{mecfsatlas-hurra-2024-medical-clinical,
author = {Hurraß, Julia and Heinzow, Birger and Walser-Reichenbach, Sandra and Aurbach, Ute and Becker, Sven and Bellmann, Romuald and Bergmann, Karl-Christian and Cornely, Oliver A and Engelhart, Steffen and Fischer, Guido and Gabrio, Thomas and Herr, Caroline E W and Joest, Marcus and Karagiannidis, Christian and Klimek, Ludger and Köberle, Martin and Kolk, Annette and Lichtnecker, Herbert and Lob-Corzilius, Thomas and Mülleneisen, Norbert and Nowak, Dennis and Rabe, Uta and Raulf, Monika and Steinmann, Jörg and Steiß, Jens-Oliver and Stemler, Jannik and Umpfenbach, Ulli and Valtanen, Kerttu and Werchan, Barbora and Willinger, Birgit and Wiesmüller, Gerhard A},
title = {[Medical clinical diagnostics for indoor mould exposure - Update 2023 (AWMF Register No. 161/001)].},
journal = {Pneumologie (Stuttgart, Germany)},
year = {2024},
doi = {10.1055/a-2194-6914},
note = {PubMed: 39424320},
url = {https://www.mecfsatlas.com/evidence/hurra-2024-medical-clinical},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/hurra-2024-medical-clinical
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