Mould and Building Related Illness identification

There can be no doubt that mould related illness is increasing with WHO stating mould may be the great masquerade of the 21st century. Their comment revolves around the failure of the medical profession to link symptoms and invariably blame established illness without assessing possible causation.

This led to another WHO statement which identified vets as often more qualified and trained in mould illness than GPs.

These failures have led to many people trying to investigate mould exposure in their homes and a massive expansion of experts and lab services designed to assist them.

Summary

The mould investigation services and products used in the UK are generally of little or no use and provide misleading and detrimental information.

Even the best labs in the world can provide little use if the wrong type of testing or analysis is requested

Investigation into a sick building or where building related illness is suspected requires professionally competent assessments.

Mould related illness

The WHO and major international medical practitioners now recognise mould is only one of many contaminates in buildings which can affect the building occupant’s health.

Water damage either current or historic are seen as major contributors but equally other environmental issues can result in the all too common symptoms encountered. Typical symptoms include:

• Chronic Fatigue
• Brain fog
• MS and Parkinson’s
• Respiratory & skin issues
• Gynaelogical and digestive issues
• Vertigo and vision problems etc

Investigation of a sick building

Those that suffer poor health and find symptoms reduce when away from the property are said to suffer building related illness. Unfortunately, removal from the contamination is only seen as a part solution and medical treatment is usually required to reverse the effects of contamination. Equally treatment for building related illness is unlikely to be effective if continual exposure is present in the property.

Which contaminates are likely to be present?

Water damage can take various forms but is usually considered to be the major culprit of biological amplification.

Water can take several forms from solid, liquid to gas and in its gas phase can move in the air (humidity ratio)  between areas of differing temperature and saturation.

This leads to secondary damage and is best explained when a flood in the basement evaporates or disappears only to have travelled by stack effect (warm air rises) to hit the underside of the cold roof tiles and condense, drip and cause mould damage and possible health impacts.

Water acting on different materials and substrates can result in off gassing of chemicals as degradation occurs.

Volatile Organic Compounds (VOCs) and other gasses may be released and this includes formaldehyde. Environmental gases may also be present at elevated levels, these include, carbon dioxide, monoxide, Nitrogen Dioxide, Ozone etc. These gases may trigger allergic reaction or reduce immune systems too.

Elevated particles or airborne dust may be a significant issue too as it may overload the immune system.

Cockroaches, animal dander are often causes of poor health too and any pets living on straw should be removed from homes where illness is involved. This removal process should include indoor plants too.

Should the focus of inspection be on mould?

An Indoor Environmental professional will follow recognised protocols and build an investigation and sampling hypothesis based on several parameters. Mould sampling is not a major part of the inspection.

The investigation will revolve around:

1. Occupant’s symptoms and severity.
2. Visual assessments of construction or design defect.
3. Historic events and visible markers.
4. Environmental assessments.
5. Air measurement.
6. Infra-red survey.
7. Moisture mapping.
8. Airborne dust and particle size.
9. VOC testing.
10. Non-viable total spore counts including reference samples.
11. Where health impact is a concern and there is a doctor capable of interpreting a report we may often recommend a Quantitative PCR dust sample for analysis . This will provide speciation focusing on toxic moulds.

Mould is natural so what’s the problem?

There are hundreds of thousands of moulds and we know little about most of the genus or species. What we do know is that water damaged homes sometimes provide the ideal environment for the proliferation of toxic moulds.

What are toxic moulds?

Current knowledge is that all mould is allergenic but some may produce toxins when under stress.

There are around 30 species of mould that are of concern although 5 are currently seen to be synergistic with regard to health impact.

When are toxic moulds most toxic?

Toxic mould is most harmful when dead and in fragments. The human body has no defence to microscopic fragments covered in toxins which can be inhaled to the lower respiratory system where blood oxygen transfer occurs in the alveoli. It’s as if their toxins and allergens are injected straight into the blood stream.

Can I DIY test for mould at home?

Yes and you will find it, always. Mould is ubiquitous and any form of surface or air sampling is likely to provide flawed results.

The WHO state agar and swabs have very serious limitations because of the following sampling and analysis errors;

1. The air pathway from the source of mould and the aerodynamics of the spore will influence capture
2. The type of agar will influence the type of mould that can grow on it
3. You should take at least three samples on three different agars as a minimum
4. Without speciation (most labs only provide genus not species) the results are almost meaningless
5. Swabs suffer the same inaccuracies and you have to be lucky to swab the right area
6. It is pointless swabbing visible mould, whatever its species it must be removed

In recent months I have seen self-testing using ERMI but whether you get a -4 or +10 score what does it mean to you? It simply means the number corresponds to a percentage of homes tested, not how sick the people in the homes were.

In short a low ERMI score means absolutely nothing regarding health impact.

The reason mould levels are almost pointless is lab results require interpretation and most significantly a low score for some can be seen to have massive health implications while some can be exposed to high spore counts and suffer no health impact at all.

Viable or non-viable mould sampling?

Obviously only live mould will grow on a culture plate. Unfortunately according to WHO dead mould and mycelia fragments are perhaps 40 times more hazardous than viable spores. So what practical information can be gathered by culture based swabs and agar dishes?

Mycotoxins

Toxic mould produces various types of mycotoxins and these are recognised as some of the most toxic substances on the planet. If you have toxic mould growing you will probably be sick, but not from the mould growth but from sporulation and inhalation of spores and fragments which may be covered or contain mycotoxins.

The identification of mycotoxins is expensive and fraught with error. Even if you found high levels in blood or urine where else could it have originated from? Coffee, meat, grain, wheat? How much is harmful? There are no human exposure standards or guidance levels so what use is the information?

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