To the Editor.
—The Medical News & Perspectives article by Mr Marwick1 on toxic mold disease makes note of recent studies that demonstrate an association between adverse health effects and occupation of a water-damaged building environment. The recent demonstration2 of a significant association between pulmonary hemosiderosis in infants and higher levels of exposure to S atra is an important development in our understanding of an emerging public health issue. The importance of this observation is that a specific diagnosis has been found to be associated with S atra.In a recent case-control study of health and immunology in a sample of adult occupants of a water-damaged building, Johanning and colleagues3 found significant differences in respiratory, dermatologic, and chronic fatigue symptoms reported by inhabitants of a building in which S atra was isolated. The study design did not include testing of control environments for the presence of S atra (the hypothesized