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Proving Mould Related Claims for PI - Dr Mark Burgin

07/10/21. Dr. Mark Burgin BM BCh (oxon) MRCGP explains that the medical expert approaches causation in mould related illness by comparison with the approach in RTA cases.

Experts shy away from public liability cases dealing with disrepair partly due to lack of confidence in identifying mould related illness and often because it is not considered in clinical practice.

There is a public view that whiplash and mould related illness are both inventions of lawyers rather than proper diseases that affect real people.

The WHO confirms that most people in the UK will never suffer from mould related illness and they do not have to replace their carpets every year because their houses are damp proofed.

Experts have a crucial role in legal cases that provide a financial incentive for all landlords to maintain their properties to the most basic standard.

Pattern of injuries

Mould causes an increase in respiratory and ENT symptoms and an increased risk of bacterial infection, skin rashes and some rare syndromes.

The expert documents the injuries the claimant disclosed (in a similar way to RTAs) taking particular interest in the pattern of symptoms over the year.

Symptoms like post-nasal drip, cough and itchy skin may occur for months each year worse after wet and cold weather when the mould is more active.

The claimant may have psychological symptoms from inter alia having to wear clothes that smell of damp and the stress of living in substandard accommodation.

Other relevant issues

Mould has a greater impact in those who are exposed to smoke because the toxins in cigarettes make their airways more susceptible.

Those with allergic conditions will also typically react to a wider range of moulds and to a greater effect but the expert should recognise that they will likely have baseline symptoms.

(Pre-existing wear and tear changes can make a claimant more likely to suffer from soft tissue injury in a road traffic accident but only the worsening is claimable.)

Many of these claimants will have some symptoms in any event and can only claim for the worsening due to the exposure so the expert must record other relevant issues.

Role of additional testing

RAST tests for allergy to mould (and MRI tests for injury in RTAs) have a narrow role in specific clinical situations and are not required generally.

In both circumstances additional testing is limited to the most severe cases where a positive result would change clinical practice.

Although a large part of the reason for limiting tests is proportionality, other issues include the harm of false positives (for instance getting rid of an innocent pet or anxiety).

Although the basic RAST tests are readily available at low cost to NHS GPs the skills required to escalate investigation and interpret the results are mostly limited to immunologist experts.


To a medic mould and road traffic accidents have nothing in common but the legal principles are no different – duty of care – breach – harm.

Breach is established (in RTA by the lawyers and the engineer before the doctor sees the claimant) when the surveyor provides evidence of significant damp.

The WHO states that damp causes harm so the surveyor can provide proof that there has been a breach of the duty of care (and any contributory negligence by the claimant).

The medical expert has the rather simpler task of documenting the symptoms, considering whether on balance they were caused by mould related illness or other diagnoses.

Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register.

Dr. Burgin can be contacted on This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website

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