Mold Wars | Part 3

Battleground 3 — Testing Your Home When You Have CIRS

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Dr. Aaron Hartman

July 5, 2023

MW Battleground 3

How can you test your environment for mold or other harmful particulates?

How do you know if the air in your home is contributing to your illness?

There is much controversy around the best way to find out if your home or office is making you sick. Today we’ll explore some differing opinions on this topic.

Camp One:

Spore Counters

In this third battleground, we’ll begin with the camp that tests by counting spores. These testing methods involve using plates that collect mold spores from the air. The problem with this method is that it only identifies the very worst cases of actual mold contamination. What do I mean by that?

As I mentioned last week, for every one spore in the air, there are over 500 particulates. So even if there are no spores collected on the plate, there could still be many harmful particulates present in the air. Let’s also remember that most of CIRS is not actually caused by mold to begin with. Spore plates don’t test for endotoxins, actinomyces, or VOCs which are also problematic and don’t give an accurate picture of the health of the environment.

Since spore plates only pick up the very worst cases of mold in the environment, they are very inaccurate when it comes to environmental testing for CIRS.

Camp Two:

ERMI and HERTSMI-2 Tests

On the other side, we have an ERMI (Environmental Relative Moldiness Index) test. This test evaluates the environment for DNA using Polymerase Chain Reaction (PCR) technology. That sounds complicated, but what it means is that it is super sensitive; if an ERMI test is normal, you know your environment is safe.

However, the problem with these tests is that they’re sometimes too sensitive. Using an ERMI, even after a remediation, it can come back positive. For example, after full remediation following a water damage event, there can still be micro particulates in carpet, on furniture, or on walls. Without throwing away your furniture, tearing up the carpet, and repainting the walls, the ERMI test can still come back positive.

The more accurate method of testing your environment involves using a test called a HERTSMI-2, along with the addition of tests that evaluate actinomyces and endotoxins. HERTSMI, which tests dust samples in a building, stands for Health Effects Roster of Type-Specific Formers of Mycotoxins and Inflammagens. That sounds complicated, but it’s a test that is very sensitive and also gives a better view of mold along with other particulates that can be problematic in water-damaged buildings.

However, even with this test for both molds and some other micro particulates, there are other chemicals and toxins, such as formaldehydes and fire retardants, that can contribute to CIRS.

Camp Three:

Bring in the Professionals

So what’s my response? Where do I fall in this battleground in which people vehemently disagree? Over the course of my career, I’ve learned that it’s most effective to start with an indoor environmental professional (IEP) who can evaluate your home. A professional can look inside your air handler at the coils, can check your ductwork, and can evaluate your crawlspace. They can find issues that you had no idea were there.

One of my patients learned from an IEP that their home was not correctly wrapped with Tyvek – in fact it was not wrapped at all. This very nice home didn’t have any protective barrier from the elements. There were humidity issues throughout the entire house, which resulted in microparticles growing and being distributed all over the home. She couldn’t see the mold, and it took an indoor environmental professional to discover the missing Tyvek.

Other patients have had issues with vapors from chemicals in their garage from paints and solvents, for example. Each time the door to an attached garage is opened, air from the garage is pulled into the home because of the Bernoulli effect. Heat rises in our homes and is vented out. When we open the door, air rushes in to replace it – like a vacuum. Air from a garage or crawlspace can be particularly problematic due to chemicals stored in a garage or particulates in a crawlspace.

My IEP told me about one of his clients that had masonite siding installed incorrectly, which led to the siding absorbing water. All of the siding – their entire house – was encased in mold, but you couldn’t see it from the outside. Without the help of an indoor environmental professional, they would have never figured that out.

I’ve Moved Into the Indoor Environmental Professional’s Camp

These are just a few examples of the many reasons that I recommend having a professional come look at your home to evaluate what’s going on with your environment, crawlspace, humidity, moisture, etc.

So, over my career, I’ve moved away from recommending lots of indoor testing. Now I usually recommend having an indoor environmental professional come and evaluate the home as a first step when CIRS is diagnosed.

For offices and workspaces, it can be more difficult to get your employer to use an IEP and to pay for that, so sometimes in that case it can be better to do testing like a HERTSMI-2.

Next week, we’ll dive into the battleground of treating CIRS. Stay tuned to learn how we treat Chronic Inflammatory Response Syndrome using a personalized functional medicine approach.

Would you like to learn more about low-cost investments in making your home or office a healthier environment? Check out this book from our recommended reading list: Healthy Buildings, by Allen and Macomber.


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