{"hq_id":"hq-p-hom-000213","name":"Immunocompromised Home Environment (Mold, Legionella, Food Safety)","category":{"primary":"household","secondary":"medical","tags":["immunocompromised","transplant","chemotherapy","mold","Legionella","food safety","home"]},"product_tier":"HOM","overall_risk_level":"high","description":"Home environment modifications for immunocompromised individuals (organ transplant recipients, chemotherapy patients, HIV/AIDS, primary immunodeficiency). Mold: Aspergillus inhalation causes invasive aspergillosis (20-40% mortality). Legionella: hot water system colonization causes pneumonia (15-25% mortality in immunocompromised). Food safety: Listeria, Salmonella, Toxoplasma — standard food safety rules are insufficient for immunocompromised. Pet exposure: Toxoplasma from cats, Salmonella from reptiles, Cryptococcus from bird droppings.","synthesis":{"derived_risk_level":"extreme","synthesis_confidence":0.757,"synthesis_method":"compound_composition","context_used":"human_child","context_source":"product_users","exposure_modifier":1.4,"vulnerability_escalated":false,"escalation_reason":null,"compounds_resolved":1,"compounds_total":1,"synthesis_date":"2026-05-09","synthesis_version":"1.2.0","methodology_note":"exposure_modifier and adjusted_magnitude are computed from ALETHEIA-calibrated heuristics (route × duration × frequency multipliers, clamped to [0.5, 1.4]). Multipliers are directionally informed by EPA Exposure Factors Handbook (2011) and CalEPA OEHHA but are not regulatory consensus. See /api/methodology for full disclosure."},"hazard_summary":{"sensitive_populations":"organ transplant, chemotherapy, HIV, primary immunodeficiency patients","overall_risk":"high","primary_concerns":["Aspergillus invasive aspergillosis: 20-40% mortality in immunocompromised","Legionella pneumonia: 15-25% mortality in immunocompromised","Listeria/Toxoplasma food safety — standard rules insufficient","Environmental exposure that healthy individuals tolerate can be lethal"],"exposure_routes":"Inhalation (mold, Legionella); oral (food pathogens); contact (pet-associated)"},"exposure":{"routes":["inhalation","oral"],"contact_types":["inhalation","oral_direct"],"users":["adult","child"],"duration":"continuous","frequency":"daily","scenarios":["Aspergillus mold inhalation causing invasive aspergillosis (20-40% mortality)","Legionella from hot water system (pneumonia — 15-25% mortality)","Listeria, Toxoplasma from improperly handled food","Toxoplasma from cat litter (organ transplant contraindication)"],"notes":"CDC immunocompromised guidelines: HEPA filtration in bedroom, avoid construction/renovation dust, hot water >60C for Legionella prevention, strict food safety (no raw meat/fish/eggs, no unpasteurized dairy/juice), someone else should clean cat litter (Toxoplasma), avoid bird droppings (Cryptococcus). These are not general public guidelines — they are specific to immunocompromised status and should be followed under physician guidance."},"consumer_guidance":{"usage_warning":"Follow CDC immunocompromised home environment guidelines: HEPA filtration, hot water >60C, strict food safety (no raw/unpasteurized), someone else cleans cat litter, avoid construction dust. These guidelines are physician-directed — not general public recommendations.","safer_alternatives":["HEPA air purification in bedroom (Aspergillus prevention)","Hot water heater >60C with mixing valve (Legionella prevention)","Strict food safety protocol (CDC immunocompromised guidelines)","Another household member handles cat litter, bird cage, reptile care"],"red_flags":[{"indicator":"Product not tested for or labeled for specific vulnerable population","meaning":"Standard safety data may not apply to your specific condition.","action":"Consult specialist physician for population-specific guidance."}],"green_flags":[{"indicator":"Physician-recommended or specifically tested for vulnerable population","meaning":"Safety evaluated for your specific condition/life stage.","verification":"Check for condition-specific certifications or physician guidance."}],"what_to_ask":[{"question":"Is this product safe for my specific health condition or life stage?","why_it_matters":"Safety varies dramatically by genetic background, life stage, and health condition.","good_answer":"Evaluated for your specific population with physician input.","bad_answer":"Generic safety data without population-specific consideration."}],"alternatives":[{"name":"HEPA air purification in bedroom","notes":"Aspergillus prevention"},{"name":"Hot water heater >60C with mixing valve","notes":"Legionella prevention"},{"name":"Strict food safety protocol","notes":"CDC immunocompromised guidelines"}]},"regulatory":{"applicable_regulations":[{"jurisdiction":"USA","regulation":"CDC Guidelines for Preventing Opportunistic Infections","citation":"CDC/IDSA 2024","requirements":"Evidence-based guidelines for home environment, food safety, water safety, and animal exposure for immunocompromised patients.","compliance_status":null,"effective_date":null,"enforcing_agency":"CDC","penalties":null,"source_ref":null}],"certifications":[],"labeling":{"required_disclosures":[],"prop65_warning":{"required":null,"chemicals":[],"endpoint":null,"notes":null},"ghs_labeling":{"required":null,"signal_word":null,"pictograms":[],"hazard_statements":[],"notes":null},"hidden_ingredients":{"trade_secret_protected":null,"categories_hidden":[],"estimated_count":null,"known_concerns":null,"notes":null},"notes":null},"recalls":[],"regulatory_gap":null,"notes":null},"lifecycle":{"recyclable":false,"disposal_guidance":"N/A — home environment management.","hazardous_waste":false,"expected_lifespan":"varies"},"formulation":{"form":"varies","key_ingredients":[{"hq_id":"hq-c-org-000011","name":"Formaldehyde","role":"mold_metabolite","concentration_pct":"trace"}],"certifications":[]},"materials":{"common":[],"concerning":[],"preferred":[]},"compound_composition":[{"hq_id":"hq-c-org-000011","compound_name":null,"role":"mold_metabolite","typical_concentration":"trace"}],"identifiers":{"common_names":["immunocompromised home environment (mold, legionella, food safety)"],"aliases":[],"manufacturer":null,"brands":[]},"brand_examples":[{"brand":"Scotts","manufacturer":"ScottsMiracle-Gro","market_position":"mass_market","notable":"Market-leading lawn fertilizer"},{"brand":"Miracle-Gro","manufacturer":"ScottsMiracle-Gro","market_position":"mass_market","notable":"Plant food brand leader"},{"brand":"Espoma","manufacturer":"Espoma","market_position":"premium","notable":"Organic fertilizer brand"}],"brand_examples_disclaimer":"Representative branded products of this category. Concerning ingredients listed in materials.concerning[] apply to the category, not necessarily to every named brand. Specific formulations vary by SKU and may have changed since this record was written; consult the brand's current ingredient label before drawing brand-level conclusions.","sources":[{"type":"expert_curation","name":"ALETHEIA Safety Database","date":"2026-03-25"},{"type":"regulation","title":"CDC Guidelines for Preventing Opportunistic Infections (CDC/IDSA 2024)","jurisdiction":"USA","citation":"CDC/IDSA 2024","id":"src_e806787b"},{"id":"iarc_100f_form","type":"regulatory","title":"IARC Monographs Volume 100F: Formaldehyde","year":2012,"inherited_from_compound":"hq-c-org-000011"},{"id":"epa_form_iris","type":"regulatory","title":"US EPA IRIS Assessment: Formaldehyde (draft)","year":2010,"inherited_from_compound":"hq-c-org-000011"},{"type":"report","title":"US Centers for Disease Control and Prevention (CDC)","jurisdiction":"USA","id":"src_08f06b18","extraction":"description_reference"}],"meta":{"schema_version":"4.0.0","last_updated":"2026-03-25","timestamp":"2026-05-14T01:27:45.726Z"}}