10 PROBLEMS ASSOCIATED WITH MOLD ASSESSMENT

by
Charles and Danielle Dobbs

Many people claim ill effects due to mold exposure for a good reason - they have been affected by mold and they feel sick.   But in the absence of authority, these people are not taken seriously, and lawyers are having a good time debating their cases.

Many people are allergic to different things - pollen, perfume, certain foods, dyes, pet dander, and more.  This is why the field of allergy medicine was born - to help people suffering from allergies due to various factors.  Some people have serious reactions to mold, and they should be taken seriously, even if another person living in the same home has no reaction.  Under no circumstances should mold be growing inside a home, because it not only affects building materials, it also affects the health of the occupants.  If mold is growing it means there is a moisture problem causing mold to grow.  As soon as a water problem is discovered it should be repaired immediately and the material dried, because mold can start growing within 24 to 48 hours following water intrusion.

There are many reasons why the effects of mold on health are brushed aside.  Let us count the ways.

LACK OF MEDICAL AUTHORITY
Very little research on the effects of mold on health has been done.  Most of the research is in the form of statistics gathered from a segment of population such as people drinking beer made with moldy grains and correlating these habits with a higher incidence of cancer.  Certain historical events affecting the health of a large population can sometimes be traced to mycotoxins produced by fungi (mold).

The Mayo Clinic, a renowned research institution has pioneered several studies on chronic sinusitis to determine whether mold spore exposure and inhalation played a part in the disease.  A research project conducted in 1999 indicated a link between chronic sinusitis infections and fungus (mold) in 93% of the subjects.

 The EPA states:

Many symptoms and human health effects attributed to inhalation of mycotoxins have been reported including: mucous membrane irritation, skin rash, nausea, immune system suppression, acute or chronic liver damage, acute or chronic central nervous system damage, endocrine effects, and cancer.  More studies are needed to get a clear picture of the health effects related to most mycotoxins.  However, it is clearly prudent to avoid exposure to molds and mycotoxins.

Much research is needed, especially on chronic fungal/mold spore inhalation and how it can affect health.

NO TWO PEOPLE ARE ALIKE
People react differently to different things.  People may get severe allergic reactions to pollen, and for unknown reasons some develop migraines and are deathly sick; and some get sick when they are exposed to mold.  How much pollen or mold triggers a reaction in some people and not others is unknown, but the fact is people are different, and have different tolerance levels for different things.

Mold can be classified into three broad types as far as health effects are concerned.  The first category is allergenic molds, which cause allergic or asthmatic reactions, but do not usually cause permanent health effects in most healthy, active people.  There are pathogenic molds, which can cause serious health problems in those who are more susceptible.  And finally, there are toxic molds that can cause serious health problems in everybody.  The severity of these problems differs, depending on age, immune system, and sensitivity.  Children, the elderly, and people with depressed immune systems due to cancer, organ transplants, or AIDS, can become very sick when exposed to higher than normal levels of mold.  Even some otherwise healthy individuals happen to be very sensitive to mold and are unable to tolerate a slight elevation of mold spores.

LACK OF GOVERNMENT THRESHOLD GUIDELINES
At the moment there are no state or governmental guidelines that say that a certain level of mold spores is ok and above that threshold it’s not.  But, having a threshold would not be a good idea, anyway, because people's biological makeup is different.  The EPA should issue a statement saying that since exposure to mold can affect people differently, then a "mold exposure threshold" cannot be established. A level might be ok for one person and not for another. But, without this statement, people may interpret that effects mold are not serious and get the impression that it cannot harm them.

LACK OF GOVERNMENT REGULATIONS FOR MOLD INSPECTORS
Many states are attempting to develop regulations for mold assessment and to separate the fields of detection and remediation, but in most states there are no certification requirements for the professions of mold inspector and mold remediator. Trade schools have developed courses to teach students how to perform mold inspections and collect mold samples.

Some people object to this and feel that the inspector should have a medical background.  Let’s be real, no allergy specialist is going to leave his practice to perform a mold inspection of a building and collect mold samples.  The next best thing is an industrial hygienist who has a four-year degree in identifying health and safety problems in the work place and providing solutions.  Mold (fungi) is only a very small part of their studies.  They are no more qualified than a mold inspector who has been trained by a professional trade school to perform a mold inspection and to collect mold samples properly.  We've personally seen reports from industrial hygienists who knew half of what we knew and they had no clue about interpreting laboratory results.

As part of their training, home inspectors learn to spot red flags, which are conditions that can lead to mold growth. In essence, a good home inspector can detect red flags during their inspection, although a mold inspector may be more detailed oriented since their entire inspection is geared to detect red flags that may lead to mold growth.

Without government regulations, qualifications for mold inspectors are not identified and this can harm the public.

LACK OF GOVERNMENT REGULATIONS CREATES ABUSES
With the absence of government regulations and control, anyone can wake up one morning and call himself a mold inspector.  Not knowing any better, he buys at a local hardware store a dozen Petri dishes (for the most part useless to assess air quality in a home/building) and voila, he is a mold inspector.  He obtains a business license and he is ready to go. 

Since there are no regulations, some mold remediators test the air quality before and following their own remediation.  Thus, they design their own work and test their remediation to get a clearance.  Naturally, this creates a conflict of interest.  Clients go along with that because remediators tell them they are saving money.

EXPERTISE DIFFERS BETWEEN INSPECTORS
Becoming a mold detection “expert” does not happen overnight.  An expert in any field is a seasoned professional.  There are many things not taught in school that people learn from experience - on the job.  This is also true for mold inspectors. A mold inspector detects red flags that are conducive to mold growth, and with experience he gets better at it.  

One of the most important skills of a mold inspector or industrial hygienist is knowing when and where to collect samples. There are many factors that produce false negatives and the inspector better know what they are.  This is the case when clients are told they have no mold problem when the opposite is true.  We learned about false negative factors from experience and have developed our own list and we keep them in mind at all times. But, there are many mold inspectors who are not aware of them, which can affect their results.

CLIENT BUDGET MAY JEOPARDIZE TESTING ACCURACY
The budget of the client ultimately dictates whether a mold inspection is performed along with collecting samples.  If budget is a factor, we will always recommend collecting samples over an inspection, although both would be ideal.  Then the number of samples also becomes an issue.  The greater the number of samples, the more accurate it is insofar of identifying the location of a mold contamination and getting a true assessment of what people are breathing, but the greater the cost.  The competent inspector has to suggest a minimum and adequate number of samples without jeopardizing accuracy.

LACK OF CONSENSUS ON THE INTERPRETATION OF LAB RESULTS
At the moment there is no standard guidelines for evaluating a laboratory report.  This is pretty scary because the public turns to mold inspectors or industrial hygienist experts for answers.  In interpreting a laboratory report, some undershoot, some overshoot, and some don’t have a clue, so they overshoot to protect themselves. 

The overall consensus in testing for mold is to compare the results of an air sample taken inside a building to the results of an outside air sample.  The samples are collected by mold inspectors or industrial hygienists and then analyzed by degreed microbiologists in laboratories.  The most important part of a mold assessment is the interpretation of the results.  Unfortunately, not too many mold detection inspectors know how to interpret the results.  There are two opinions - those that look at the total amount of mold spores inside versus outside.  If the inside is greater than the outside, then they note a problem exists, if the total amount of spores inside is lower than the outside, then there is no problem.  The other school of thought is to look at both the types of mold and their amounts.  This makes much more sense in our opinion since the mold toxicity is taken into account.  The person who says that there is a little bit of Stachybotrys (known to be toxic) in the air but the overall amount is lower, therefore there is no problem, is highly mistaken, in our opinion.  This is like saying, there are a few termites but that’s no big deal.

What is alarming is when experts differ on results interpretation.  Caoimhin P. Connell, a forensic industrial hygienist, wrote a paper on the interpretation of fungal (http://www.forensic-applications.com/moulds/mvue.html).  He believes in comparing total spore counts inside versus outside, and has included statistical graphs to compare spore counts by geographical locations.  The paper is well written but, in our opinion, the entire paper is based on the wrong premise - to compare the total amount of fungal spores inside to the outside without taking into account the types of fungi present.  He states “This is not to say that species comparisons cannot be made, but they should only be performed within the limitations of the study underway.”  Who is going to define these limitations?

He goes on to say that the inspector should state to his client prior to sampling that the concentration levels found inside should be no

". . . greater than _ _ _ _ _ ? Where the blank will be filled in by the consultant prior to sampling. And typically, the blank will be: "...the corporate safety policy limit...", or "...a level considered dangerous by my physician..." or “…the normal expected concentration for non-symptomatic houses in my area” or similar. The person collecting the sample should then be able to give the numerical value, up front, that they will be using to justify the DQO and they should be able to give you, very clearly, the rationale behind the justification."

We believe there is a big problem with this approach in that both, genera (often referred to as species or types of mold) and their respective amounts should be evaluated together and compared to the outside control because both the amount and genera tells a story.

To illustrate our point consider the following scenario of a rainy day: the mold inspector must wait a minimum of two hours after the last raindrop falls, because all the mold spores are pushed to the ground resulting in a low amount of spores in the outside sample.  If it rained in the morning and we are collecting an outside sample in the afternoon, the amount of Basidiospores in the air, which are related to mushrooms, will spike and show an unusual amount of these particular spores in the air. If someone is looking solely at the total amount of spores inside versus outside, he will not get a good picture and miss a mold problem going on inside because the total amount of spores inside may look low in comparison to the outside control.   On the other hand if we find a higher amount of Basidiospores inside than outside, it is indicative of wood rot, hence a water problem exists somewhere.  What about Stachybotrys, which is known to be toxic and is rarely found outside?  If we find it inside, it is indicative of a serious water problem.  Additionally this type of mold does not aerosolize easily.  So, finding a low amount of Stachybotrys spores in the air tells us there may be a serious problem somewhere, and very often this problem is hidden from view and requires further investigation.

INSPECTORS SHOULD NOT RELY SOLELY ON STATISTICAL ANALYSIS
Some laboratories use proprietary statistical analysis tools that indicate the probability that a certain species of mold may be growing in a building.  These are excellent and they help mold inspectors.  However, these probabilities, whether low, moderate, or high, are not to be confused with quantity measured as spores per cubic meter.  Not all molds are created equal - some are more harmful than others.  Thus, quantity has to be evaluated along with species of mold.  Common molds in large quantities can be just as harmful to health as a small quantity of toxic mold. It is up to mold inspectors to combine all the facts at hand - background of the problem with the results of his inspection along with the laboratory results to provide the client with a mold assessment.

SOME PEOPLE WILL NEVER CHANGE THEIR MIND NO MATTER WHAT
We have met some people with government authority who emphatically told us "I don't believe in mold, and never will!" We have tried to talk to county officials to see if the county health department could get involved to help people living in mold infested apartment complex when the landlord does not want to fix anything. Leaving their apartment is not a choice for many people because many of them are on the poverty level and they do not have the means to get the apartment tested or to pack up and leave, also loosing their security deposit. With county officials having a denial attitude, these poor people have no way to turn to and landlords do not feel they have to do anything.

WHERE DO WE GO FROM HERE?
Ten specific problems related to mold assessment have been discussed in this article.  Several of these problems are related to a lack of research on mold and thus lack of authority.  Until we have solid research that spells out how people’s health are affected, the public will continue to wonder whether these ill-effects are real or fake.

State regulations should be implemented to separate the profession of mold inspection from that of mold remediation to avoid conflicts of interest, and to require that mold professionals obtain the proper training and certification. State regulations would also discourage wannabes mold inspectors thus clients would benefit by having qualified inspectors.

People are concerned about mold just as they are concerned about termites since both destroy building stuctures. However, termites cannot make people sick, but mold can. When homeowners are faced with a mold problem they turn to mold inspectors and industrial hygienists for answers.  Clients expect an understandable and accurate report as to whether they have a mold problem, and if so they want to know the steps necessary to remediate the situation.  Ultimately the interpretation of the results rests on the mold inspector or industrial hygienist.   Mold assessment is not an exact science, but mold inspectors and industrial hygienists should learn how to evaluate a mold report.  Often reputable laboratories offer mold inspectors and industrial hygienists classes on interpreting laboratory results and these professionals should take advantage of these.

ABOUT THE AUTHORS: Danielle Dobbs and Charles Dobbs are principals of Dobbs Enterprises, Inc. a mold inspection and sampling company based in Maitland, Florida.  They are authors of MOLD MATTERS – Solutions and Prevention, and has written many articles.  They both founded the International Institute of Professional Mold Inspectors, http://www.iipmi.com, where they offer online courses.  They give onsite and online classes to engineers and maintenance crew to teach water intrusion and mold management.  A unique telephone consulting service, a first in the nation provides homeowners and building owners with an unbiased expert opinion or guidance about their particular mold problem.