The Benefits and Limits of ERMI Testing
There are several testing methods used for diagnosing mold issues. As in all things in the world, there are advantages and disadvantage to each type of testing. That means that each type of testing is useful in its own way….and often not appropriate for other applications.
ERMI (Environmental Relative Moldiness Index) is one test that is not often used or understood. ERMI is the product of the modern miracle of DNA technology. The EPA owns the patent on the process and limits its use to approved labs. The EPA also states that their approval of the technology is only “experimental.”
However, there are many studies and anecdotal evidence of the benefit of the test results for patients with CIRS (Chronic Inflammatory Respiratory Disease) There are also some very interesting, but limited studies that high ERMI scores correlate with high lactate in the brain. High lactate correlates with cognitive problems. It may be that identifying high ERMI score conditions may be useful in treating some diseases. These are still very preliminary studies and require more research.
Let’s do the Pros and Cons before we talk about how this technology works.
Pro:
ERMI can give very targeted specific specialization for target molds that can have an influence on health
ERMI can give evidence of the historic (new or old mold contaminations) mold conditions in a building.
Historic evidence of long term exposure vs short term exposure can be useful for medical practitioners
Con:
ERMI does not quantify mold, it only identifies the 36 species of targeted molds
ERMI requires old carpet that was not regularly cleaned to provide the source of dust to give that historic record
ERMI is still an evolving science in terms of correlation of ERMI results and health implications
ERMI does not help to isolate the source of the mold contamination to aid in any required remediation
Overview of the process
A sample of dust is taken using a specialized dirt trap. The dirt/dust/debris is to be collected by using a vacuum cleaner hooked up to a specialized air filter. An alternative system is a smaller cassette and a standard air sampling pump. The sample is supposed to be drawn from a roughly 2 square yard carpet area in either a living room or bedroom.
The sample is sent to an EPA licensed lab. The lab takes the dust from the dirt trap and puts it through a filter to isolate the small, mold size particles. (Think spaghetti in a strainer, only microscopic in size)
Those particles are put into a tube with a known amount of Geotrichum candidum
and the DNA is beat out of the mold spores with microscopic beads called “bead pellets.” That mush is then filtered and the sifted genetic stuff is mixed with a buffer solution. It is then dumped into a solution called “Master Mix” and put through a series of temperature controlled reactions.
If you are wondering the technical name for the magic chemistry we are doing, it is MSQPCR
Mold Specific Quantitative Polymerase Chain Reaction
Now remember that known quantity of Geotrichum candidum that was in the mix? That is the reference basis that can be used to compare the assays (checking process) for each of the target molds (molds that they are looking for). The checking process is done with a “Sequence Detector” (which is identifying DNA sequences)
The reason for the look at the ratio of the two is that the exact quantity of each mold is not determined by this test. That is the result of several factors. Our size of sample could be small or big, based upon the amount of dirt we swept up. We can’t figure out by counting pieces of DNA if there is a little or a lot of mold in the building. You get the point. We do not know how much mold is in the building from an ERMI test.
What we do know is that if most of the mold DNA is the outdoor molds, then there is less mold growing in the house. If there is a whole bunch more of the indoor mold than the exterior, oops, there is a lot more mold growing IN the house than coming in from the OUTSIDE.
Scoring is done on a scale of -10 to 20. The higher the number, the more mold that is from growing inside the house in the tested building area. That ERMI Score number is a “sort of number,” not an exact measure. It is based on a limited number of tests from a limited geographic area. Hence reference to it as a “Relative Score.”
That folks, is what this ERMI testing is about. It is amazing technology, but has a very limited application. It can’t quantify mold contaminations or the success of any remediation efforts. According to the EPA, ERMI is an “emerging technology”. They further state that ERMI is still in the experimental stages and is not approved for medical diagnostic use.
Sick Building Syndrome is real, it is personal and in many instances, it can be devastating to a person, family, friends and employers.
SBS is widely misunderstood, often by well-meaning or misinformed people. It is often disbelieved and the victims of this serious affliction are often left without help and may even be ridiculed for their illness.
There was a time that the link between smoking cigarettes and lung cancer was considered pure fiction created by greedy attorneys. Asbestos was considered the miracle fiber that made schools and hospitals safe from fire. It took time and education to get past those education barriers to providing the necessary help for the victims of those environmental issues.
Now is the time and here is the place to start that process of getting help and advice for victims of Sick Building Syndrome.
This is an important mission for us. It is not lost on us that environmental work is not just a job, a healthy home can be life changing for the clients we serve and their loved ones.
Solving the riddle of what the cause or the remedy for Sick Building Syndrome can become a lifetime struggle. If you ask what is the relationship between our bodies and the environment, the answer is the same as many relationships in life: Its complicated! Too often we do not get to the bottom of “complicated”.
It is Tough to Figure Out What Makes Us Ill
The first barrier to solving the healthy environment problem is that most environmental reactions happen in time delay. Our brain wiring is much better looking at things as cause-effect when they are occurring together. If we touch a burner on the stove, we feel pain. If we hit our thumb with hammer, we immediately feel the consequences of that action. We learn in real time that for those actions there is a predictable , consistent reaction. We also figure out to not do those things again.
Environmental exposures usually take time. We walk into a contamination, and may not feel ill for the first hours, days or weeks. Often we do not become ill from an exposure for years until our immunity is affected by another illness or aging.
Our bodies work hard to keep us from having health problems from short term or low level exposures to toxins. As an example, most municipal water authorities have traces of arsenic in the water we drink. Our bodies can usually process the small amount of arsenic and we get on with life with little disruption. Our liver and kidneys can push small amounts of the arsenic out of our bodies and lives. If we open a jar of arsenic and consume a large amount of arsenic at one time, we can become very ill if not dead.
“Time loading” is how environmental illness often occurs. What that means is that if we have a little arsenic each day, and we start accumulating more in our bodies so that the liver and can clean up that chemical mess, we will become ill. By the way, this explains why a person who spends more time in a sick building can become sick and others who spend less time there are not affected