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.
New Radon Tech
Radon is the second leading cause of lung cancer. The leading cause is the voluntary practice of smoking cigarettes. A better way to test may be to have a professional test with high quality instruments, but this is "better than nothing"
Nah, I am serious. There are mold dogs in many part of the country. In fact, “Cody, The Mold Dog” was quite the competition for mold professionals in the Pittsburgh PA market, at least it seemed at first consideration. Let me start with a little background and then my personal story of competing with “Cody, The Mold Dog”.
Background Story on Mold Dogs and Mold Dog College
Mold dogs are specifically trained to detect up to 18 types of mold. This should not surprise you. We have dogs to search for drugs, bombs money, weapons, accelerants, and termites. Makes sense that dogs can be trained to detect mold too. According to the website http://www.mold-dog.com/about_us_detail.htm, hunting type dogs are best suited for this use. That would include Labs, Border Collies, Jack Russell Terriers, Aussies, Beagles and combinations of these breeds.
“Buddy the Sheltie” Would Not go to Doggy Mold College
Sadly, our dog, Buddy the Sheltie (Border Collie), never expressed the desire to be a mold dog and join me in the environmental profession. But then again, neither did any of our 6 children. It’s not for a lack of effort on my part. I did mention to Buddy the Sheltie that he was a breed that was well suited to being a mold dog, but that suggestion fell on deaf ears. The training for mold dogs is rigorous and a little mean, and Buddy is a lover, not a workaholic or gluten for punishment.
Pictured Above----"Buddy the Sheltie" with his friend Noah instead of attending Mold Dog College“Cody The Mold Dog” Got His Degree and Went into the Mold Business
Let’s get back to my personal story about “Cody, the Mold Dog”. I am sure you have had an occasion that during dealing with someone, you have gotten to a point where they sheepishly admit to having dealt with someone else other than you. That would be “kind a, sort a” like explaining to your friend from grade school why you are trading in a Chevy to purchase a Subaru from them, after calling upon them to give you a good deal because you go way back together. (AWKWARD)
Picture this: I am working with a client with some serious health issues.
As is the practice with good environmental professionals, I explain the test results, why the mold is present and what needs to happen to make sure the mold goes away and does not come back again. All important information for the long-term health of the client and their family. They had serious health problems, and I had his full attention.
Then came the sheepish admission by the client that is the root of this story
Client: “Ummm, ahhhh, I need to admit, I had “Cody, The Mold Dog” here before I called you.
Me: “OK, how did that work out, I have not personally met Cody”
Client: “Well, I’m very glad I called you. Cody charged me more than you did, and he didn’t talk to me.”
Moral of the Story
Detecting mold is not enough! The how, why, what, and pathway to a resolution are all important. Remediators who view their job and telling a client: “Yep, ya got mold and for $xxx. xx I will make it go away” are the real competitors to “Cody the Mold Dog”, not competitors to the quality of mold professionals you need to have a healthy home.
Another Morsel of Wisdom in This Story
By the way, in the long run, the “Cody the Mold Dog” type of remediators may even cost you more than the real professionals. That is especially true when the mold comes back and you need face the health risks of mold exposure and then pay to have the job done again. Call me, Dan Howard of Envirospect at 724 443 6653 for and assessment and testing if you suspect you have a building that is making you sick. For more information and many free articles relating to a Healthy Home, go to: www.envirpsect.info or follow on Twitter @DanHoward251
Call me, Dan Howard of Envirospect at 724 443 6653 for and assessment and testing if you suspect you have a building that is making you sick. For more information and many free articles relating to a Healthy Home, go to: www.envirpsect.info or follow on Twitter @DanHoward251
Risks for Mold in Your Home
More Contaminates than Mold can Affect Home Health
All of the at high risk patient groups mentioned above can be affected by indoor contaminants. These include formaldehyde, chemicals used in hobbies, pesticides, previous drug activity, lead, radon and asbestos.
Keeping A Home Healthy When You Have "at Risk" Patients
The amazing fact is that most organ transplant patients, and other immunosuppressed patients do not have their homes checked for mold and other contaminants that could be deadly. It is time for that to change.
The suspension of one of the nation's renowned e organ transplant program is very big news, but really..... another important story here is that mold exposure can happen in the homes, automobiles, workplaces and many other areas frequented by these and other immunosuppressed patients. Patient's home environments need checked for mold before a transplant patient is sent home.
As one of the nation's leading transplant programs, the PA and Federal Departments of Health and the CDC are involved in exploring and solving the UPMC transplant patient mold problem. This is an important issue because the very lives of many patients awaiting organ transplants are now hanging in the wind while the mold deaths are being examined.
The transplant centers like UPMC have trained professionals to monitor mold conditions and recognize the health problems mold creates when they arise. If they can miss the problem, what is a homeowner to do without that level of expertise?
The longer an immunosuppressed person is in any place with mold, the higher the chance for a serious mold related health problem to occur. Most transplant patients spend far more time in their homes than in a hospital. The risk of serious problems arising increases with the longer the time of exposure no matter where that exposure exits.
The background here is that organ transplant recipients are placed on immunosuppressant drugs. This simply means that their immune system needs to be “turned on to low” to avoid the body rejecting the organs. The good news is that with anti-rejection therapy, transplant patients can now live for decades as compared to the original outcome of many living only days after the transplant.
The Mold Health Risk Affects More Than Organ Transplant Patients
According to the Minnesota Department of Health, many other people in addition to organ transplant recipients can be affected by mold growth. These include:
The news stories indicate that the UPMC mold problem, has existed for quite some time, exposing many patients to the deadly risks. The right person to observe and test for the problem was not involved. It needs to be a program in place.
Types of Testing if you Suspect Formaldehyde or Other Indoor Air Contaminant
Air testing is conducted by drawing approximately 15 liters of air through a glass tube filled with a sorbent material using a specialized low volume air pump. This is an accurate method to determine exposure. The limits of this test is that exposure increases with higher temperature and humidity. The test results need interpreted with consideration of those factors. Cost of this type of testing is usually about $300.00 to $400.00 per test.
Bulk testing consists of submitting a piece of the material to a certified lab. One limitation of this method is that the tested piece of material can vary from other pieces of the same material in the home and not give a good overall picture of the contamination. The other limit is that we are affected by the sum of all exposures, and sampling a single piece of one material does not tell us if there are other materials or furnishings in the home adding to the total exposure. The advantage of bulk testing is if we are trying to determine if an individual product such as flooring needs to be removed from the home, we get that answer. This type of test may also be needed to enter a class action suit or other legal action. Cost of this type of testing is usually about $500.00 to $600.00 per test.
Badges These are typically used in industrial settings to monitor workplace exposure for OSHA compliance. These are simple to use and do not require any specialized equipment. These would be a low cost screening method. The badges absorb formaldehyde as easily in the home as in the workplace. The badges are then sent to a lab for interpetation. These tests are usually done in pairs and cost for this type of testing is usually between $100.00 to $175.00 for each test.
The Heath Impact of Formaldehyde can Vary from Person to Person
According to the Center for Disease Control (CDC) The impact on individuals varies based on both the time and duration of exposure. A small but constant exposure over an extended time or a large exposure in a short time can have equal effects.
They also suggest that exposure to multiple chemicals can intensify reactions. An individual's general health, age, sex, genetics, lifestyle, and diet are also factors that can affect the level that is toxic to an individual. An example of the wide variation in reactions that people can have to any environmental factor is that some children can have life threatening reactions to peanuts, but most children could live on peanut butter.