Dampness and Mold Assessment Tool

General Buildings

Form & Instructions

 This document is in the public domain and
may be freely copied or reprinted.

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date.

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Suggested Citation
NIOSH [2018]. Dampness and Mold Assessment Tool for General Buildings - Form & Instructions. Cox-
Ganser J, Martin M, Park JH, Game S. Morgantown WV: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and
Health, DHHS (NIOSH) Publication No. 2019-115, https://doi.org/10.26616/NIOSHPUB2019115.
 Instructions
Dampness and Mold Assessment Tool

Contents

About the Form

Background.................................................................................................................................................................................4

Dampness and Mold Assessment Form..........................................................................................................................5

Assessment Cycle.....................................................................................................................................................................6

Notice to Users..........................................................................................................................................................................7

Using the Form

General Building Information...............................................................................................................................................8

Room/Area Type.......................................................................................................................................................................8

Mold Odor...................................................................................................................................................................................9

Room Components..................................................................................................................................................................9

Nothing Found..........................................................................................................................................................................10

Assessing Damage and Scoring..........................................................................................................................................10

Component & Assessment Notes......................................................................................................................................12

Appendix

Scoring Example 1....................................................................................................................................................................13

Scoring Example 2....................................................................................................................................................................14

Scoring Example 3....................................................................................................................................................................15

Special Notes..............................................................................................................................................................................16

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 Instructions
Dampness and Mold Assessment Tool

About the Form
Background
The health of those who live, attend school, or work in damp buildings has been a growing concern
through the years due to a broad range of reported building-related symptoms and illnesses. Research
has found that people who spend time in damp buildings are more likely to report health problems such
as these:

• Respiratory symptoms (such as in nose, throat, lungs)

• Development or worsening of asthma
• Hypersensitivity pneumonitis (a rare lung disease caused by an immune system response to
repeated inhalation of sensitizing substances such as bacteria, fungi, organic dusts, and chemicals)
• Respiratory infections
• Allergic rhinitis (often called “hay fever”)
• Bronchitis
• Eczema

Exposures in damp buildings are complex. They vary from building to building, and in different places
within a building. Moisture allows indoor mold to multiply more easily on building materials or other
surfaces, and people inside buildings may be exposed to microbes and their structural components, such
as spores and fungal fragments. Mold may also produce substances that can cause or worsen health
problems, and these substances vary depending on the mold species and on conditions related to the
indoor environment. Moisture can also attract cockroaches, rodents, and dust mites. Moisture-damaged
building materials can release volatile organic compounds that can cause health problems.

Researchers have not found exactly how much exposure to dampness-related substances it takes to
cause health problems. Research studies report that finding and correcting sources of dampness is a
more effective way to prevent health problems than counting indoor microbes. Therefore, NIOSH
developed a tool to help assess areas of dampness in buildings and to help prioritize remediation of
problems areas.

NOTE: NIOSH uses the term “mold” to refer to fungi in the

indoor environment, which can include multicellular fungi
that produce hyphae, unicellular yeasts, and in some
excessively damp environments, mushroom producing
Photo by NIOSH

basidiomycetes.

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 General Buildings Form
Dampness and Mold Assessment Tool Use one form per area being assessed.

General Information Room/Area Type: Describe below the type of room/area you are assessing.
Date:
Observer:
Building:
Floor:
Room/Area Identification:

Mold Odor: Fill in the bubble for mold odor. Be sure to smell for mold odor when you first walk into the room/area.
None Mild Moderate Strong Describe source of mold odor:  Source Unknown
Check Check Check
Check if
See scoring below Damage if near Visible if near Wet or if near
nothing
or Stains exterior Mold exterior Damp exterior Component Notes Assessment Notes
for . found
wall* wall* wall*

Check if component See scoring See scoring See scoring Fill in the bubbles for the Fill in the bubbles for additional detail.
 is in the room/area.  below  below  below  type of material that is affected. Describe if “Other”

 Ceiling tile Plaster Concrete  Peeling paint Rust

 Ceiling     Sheet rock Metal Wood Other:

 Sheet rock Plaster Concrete  Peeling paint Efflorescence

 Walls     Block Brick Tile Wood Other:

 Wood Carpet Vinyl  Buckling

 Floor     Ceramic Concrete Other:

 Peeling paint Condensation

Windows     Exterior Interior Skylight
Other:
 Furniture Mechanical Sink  Peeling paint Rust
Furnishings     Toilet Copier Other:
 Radiator Forced-air Fan  Peeling paint Rust
HVAC systems     Unit ventilator Window unit Other:

 Wrinkled pages Crumpled boxes

Supplies & Materials     Books Boxes Equipment
Other:
 Peeling paint Rust
Pipes     Plumbing Gas
Other:

General Notes

* Within 3 feet of exterior wall.

Scoring: = none < or = the size of a sheet of paper > than a sheet of paper to the size of a standard door > than the size of a standard door
 Instructions
Dampness and Mold Assessment Tool

About the Form

Assessment Cycle

1. Assess
Use the
Dampness and Mold Assessment Tool
in all rooms and areas of your
building(s).

4. REPEAT 2. Identify
Schedule regular building Determine the source(s) of
assessments to prevent new or dampness or mold identified in
worsening problems and STEP 1 by further investigating
repeat STEP 1. where the moisture is
coming from.

3. Repair &
Remediate
Facilities staff or trained
professionals should repair all
identified sources of dampness and
mold and remediate damaged areas
following proper guidelines.*

*Mold Remediation in School and Commercial Buildings—Environmental Protection Agency (EPA)

www.epa.gov/mold/mold-remediation-schools-and-commercial-buildings-guide
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 Instructions
Dampness and Mold Assessment Tool

About the Form

NOTICE TO USERS
Building assessments using the Dampness and Mold Assessment Tool will likely be done in areas
that may pose health problems for some people. Use caution if you have asthma, allergies, or are
having current respiratory health symptoms.

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 Instructions
Dampness and Mold Assessment Tool

Using the Form

1) General Information

Complete the top of the form by entering the following information.

Date: Month, day, and year of the assessment.

Observer: Name of the person that is performing the assessment.
Building: Unique reference of the building (such as main, annex, portable).
Floor: Floor number or level.
Room/Area Identification: Room number or title.

Example:
General Information
Date: 8/20/2017
Observer: Jon Snow
Building: Whitehall Administration
Floor: 2
Room/Area Identification: 2027

2) Room/Area Type

Describe the room or area you are assessing.

NOTE: It is important to keep room/area titles standardized. For example, rooms with more than one
title (e.g., bathroom, washroom, men's & women's facilities) should be referred to as the same title
each time an assessment is conducted. This will help with data consistency.

Example: Room/Area Type: Describe below the type of room/area you are assessing.
Room 2027 is the office directly across from the staff kitchen on the

second floor.

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 Instructions
Dampness and Mold Assessment Tool

Using the Form

3) Mold Odor

If you detect a mold odor, assess it. Be sure to smell for mold odor when you first walk into each room.
Determine subjectively whether a smell is mild, moderate, or strong, and identify the odor's source.

Example:

None Mild 
Moderate Strong Describe source of mold odor: flooring Source Unknown

If you cannot determine the source, fill in the Source Unknown bubble.

4) Room Components

Place a check () in the first (blue) column for all of the room components found in the room you
are assessing. Because all areas must have a ceiling, walls, and a floor, those components are
automatically checked. Assess components systematically in the order given from top to bottom.

Example:

 Check if component
is in the room/area.
• Windows includes internal, external, and skylights.
 Ceiling

Automatically • Furnishings includes furniture, sinks, toilets, printers and

checked
 Walls
copiers.

 Floor
• HVAC systems includes all systems used to heat/cool the
Windows room or area including unit ventilators, radiators, forced-
air systems, window units, and fans.
 Furnishings • Supplies & Materials includes books, paper, boxes, gym
 HVAC systems equipment, kitchen supplies.

 Supplies & Materials • Pipes includes any exposed pipes in the room.
Pipes

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 Instructions
Dampness and Mold Assessment Tool

Using the Form

5) Nothing Found

Look closely at all components identified in the room for any damage, mold, or wetness. Place a
check () in the third (gray) column for all of the room components where no issues are identified.

Example: Check if
nothing
found

 Check if component
is in the room/area. 
 Ceiling

 Walls

 Floor
 In this example, no damage, mold, or wetness
was found on the floor, the furnishings, or
Windows
supplies & materials.
 Furnishings 
 HVAC systems
 Supplies & Materials 
Pipes

6) Assessing Damage and Scoring

Assessing Damage

Use the three different columns of damage types for the assessment.

1) Damage or Stains

This refers to any water-related damage or stains identified per component.

• Damage could include peeling paint, efflorescence, rust, warping,

and deteriorated or crumbling building materials.
Damage to wall caused by
flooding.
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 Instructions
Dampness and Mold Assessment Tool

Using the Form

• Stains could include discoloration caused by possible water leaks, flooding

or condensation.

2) Visible Mold

Note if you see visible mold growth or suspect mold growth. Water stained ceiling panels.

• Mold can include patches or spots that are colored differently than the
underlying material (typically gray, brown, or black). Mold can appear
fuzzy and can have a musty or earthy odor.

3) Wet or Damp
Mold on a wall.
Note any areas of wetness or dampness that are visible.

• Wet or damp conditions could include visible signs of moisture, such

as water beads or condensation, humidity, water leaks, or flooding.

Wet area on floor and side

of wall.
Scoring

Scoring is based on the size of all affected areas combined. Individual sizes of each affected area are
added together to obtain a combined size. Scoring examples are provided in the Appendix (pages
11–13).

 = No problem areas identified.

 = The combined area of damage is the size of a standard sheet of paper
(8½ inches X 11 inches) or smaller.

 = The combined area of damage is greater than the size of a standard sheet of
paper (8 1/2” x 11”) and less than the size of a standard interior door (32” x 80”).

 = The combined area of damage is greater than the size of a standard interior door Interior door
(32” x 80”).

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 Instructions
Dampness and Mold Assessment Tool

Using the Form
Score each component by filling in the appropriate assessment score in the Damage or Stains, Visible
Mold, or Wet and Damp columns. If the affected area is within 3 feet of an exterior wall, place a check ()
in the yellow column after each scoring column.

Example: Check Check Check

Damage if near Visible if near Wet or if near
or Stains exterior Mold exterior Damp exterior
wall* wall* wall*

See scoring
below  See scoring
below  See scoring
below 

 
  


These evaluations are subjective, so you should try to be consistent in the way you observe the
conditions and then score each assessment.

A score of 3 for Damage or Stains, Visible Mold, or Wet or Damp should trigger immediate attention to
identify problem sources and to remediate. Likewise, a score of 3 for Mold Odor should trigger
attention to identify areas of hidden mold. Scores should also be used for comparison of rooms/areas
over time to see if remediation works or if problems get worse.

7) Component & Assessment Notes

This section collects more information that you observe for each of the room components:

• "Component Notes" includes information on the material or location affected.

• "Assessment Notes" includes information on common indicators of dampness.

Fill in the bubble(s) that most accurately apply to your observational assessment.

Example:
Component Notes Assessment Notes

Fill in the bubbles for the Fill in the bubbles for additional detail.
type of material that is affected. Describe if “Other”

Ceiling tile
 Plaster Concrete Peeling paint
 Rust
Sheet rock Metal Wood Other:

Sheet rock 
Plaster Concrete Peeling paint Efflorescence
Block Brick Tile Wood Other: rt corner crumbling
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 Instructions
Dampness and Mold Assessment Tool

Appendix
Scoring Example 1

Combine both stained

areas to get one score.

In this assessment, these two stains are the only problem areas identified on this room's ceiling.
Therefore, combine the size of both stained areas to determine a score.

Damage or Stains Visible Mold Wet or Damp

The stains on these ceiling tiles are There does not appear to be any Both areas were formed after a
very visible. A score for this would be mold growth on these two stains recent rain and appear wet.
a 2 because both stains combined at this point. The visible mold score Together, they are larger than the
are bigger than the size of a standard would be 0. size of a standard sheet of paper but
sheet of paper but smaller than an smaller that the size of an interior
interior door. Both stains are not within 3 feet of an door. This example would have a score
exterior wall. of 2.
Both stains are not within 3 feet of an Both stains are not within 3 feet of an
exterior wall. exterior wall.

Check Check Check

Damage if near Visible if near Wet or if near
or Stains exterior Mold exterior Damp exterior
wall* wall* wall*
 Ceiling 
 
 

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 Instructions
Dampness and Mold Assessment Tool

Appendix
Scoring Example 2

Damage in this area is severe and includes two wall sections that meet at the corner. Determine scores
based on the combined size of this entire area.

Damage or Stains Visible Mold Wet or Damp

The damage to this wall is extensive, The visible mold on this damaged The damage to this wall is very
and the area is larger than the size of wall area is larger than the size of an discolored and likely wet.The size of
an interior door. Therefore, the score interior door, so the score should be the dampness is larger than an
should be a 3. a 3. interior door, so the score should be
a 3.
This area is within 3 feet of an This area is within 3 feet of an
This area is within 3 feet of an
exterior wall. exterior wall.
exterior wall.

Check Check Check

Damage if near Visible if near Wet or if near
or Stains exterior Mold exterior Damp exterior
wall* wall* wall*

 Walls 
  
  
 
Note this damage in the "General Notes" section of the form for immediate attention. 14
 Instructions
Dampness and Mold Assessment Tool

Appendix
Scoring Example 3

This entryway carpet is visibly saturated along the edges. Therefore, combine the size of the wet edges
for scoring.

Damage or Stains Visible Mold Wet or Damp

This entryway appears extremely The carpet does not seem to have As with the Damage and Stains
wet. The size of the sides combined any visible mold. The score would be score, this extremely wet carpet is
are larger than a sheet of paper, but a 0. larger than a sheet of paper, but
smaller than an interior door, so the smaller than an interior door, so the
score would be a 2. This area is within 3 feet of an score would be a 2.
This area is within 3 feet of an exterior wall.
This area is within 3 feet of an
exterior wall. exterior wall.

Check Check Check

Damage if near Visible if near Wet or if near
or Stains exterior exterior exterior
Mold Damp
wall* wall* wall*

 Floor 
  

 
  15
 Instructions
Dampness and Mold Assessment Tool

Special Notes
Is it a stain or is it mold?

Many times this is difficult to determine. If you are not certain what you see is mold:

1) Score as 0 in the Visible Mold column.

2) Write a note in the General Notes section of the form for further evaluation.

Pipes   

General Notes Not sure if mold or something else?

Photographs can be useful for documenting conditions. You may consider

taking a photograph of an area that seems severe and referring to the
photograph in the General Notes section of the form.

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Questions? Contact NIOSHBreathe@cdc.gov.