Remediation FAQ

6 Total Items

Question Volume 1

What do you consider sufficient remediation for tricothecenes? I have a patient with severe depression, migraines, fibromyalgia (narcotic rx) and panic attacks who lives in a home remediated for “black mold” last year. No one ever informed her that black mold could cause physical illness (this is a true story). I am of course working her up for biotoxin illness. However since nothing was done for the furniture or clothing during the remediation I am assuming that tricothecenes can still be present. What do you think?

Answer

I don’t assay for mycotoxins as there is no way to say that any one kind of inflammagen can cause the CIRS-WDB. I shoot for ERMI < 2. Trichothecenes, or any mycotoxins, must not be considered to be the sole or primary focus of Rx. Don’t forget all the other “baddies” in the air. The entire “chemical stew” found inside WDB is much more diverse. I use a “HERTSMI-2″ value of < 10 as “likely safe,” understanding that we can’t measure everything. This is a new roster (see the PP on this subject on the site) that is a derivative of ERMI. It is far more accurate than ERMI alone. Please take a quick look at the appendices in Surviving Mold that review how to clean, clean, clean after remediation.

Question Volume 1

In a dry area where the ERMI is high because mold was blown in by the HVAC, such as the floor above a water damaged basement, can items such as paper and cardboard be salvaged by HEPA vacuuming or must they be disposed of as if they had been in the basement?

Answer

Unfortunately, other than making copies of documents, I know of no way to salvage paper products.

Question Volume 1

If someone goes through remediation including sealing moisture breaches and removing all active areas of mold growth, but doesn’t do much to clean floors, walls, furniture, etc, will you see improvement in HERTSMI-2 scores compared to pre-remediation or will the scores remain quite high?

Answer

Cleaning all reservoirs of small particulates really is important, so no; I don’t expect much budge in labs if cleaning is incomplete.

Question Volume 1

If there is a 2×4 area of mold growth in an attic, do you usually recommend having all the insulation removed along with the affected area? To clarify, a patient has a moldy attic door from a roof leak. The leak has been sealed and the rest of the attic appears dry and without mold growth. In addition to removing the door, would you recommend removal of the surrounding insulation?

Answer

Use the inspection by the CIH to guide you. Usually insulation in an area of microbial growth is also contaminated.

Question Volume 1

How high can an ERMI/HERTSMI-2 be if someone moves into a new non-water damaged building but they did not know that their possessions were contaminated by their previous residence which they did not know was water damaged?

Answer

The question is not clear to me. Can cross contamination occur? Yes. I know of no way to judge the expected change in building indices from the data you supplied.

Question Volume 1

Do you have a sense of what proportion of your patients are unable to bring their ERMI/HERTSMI-2 scores to safe levels despite thorough cleaning, removal of contaminated building materials, and correction of moisture problems by a quality remediation company following IICRC S520 guidelines? I ask because some of the mold docs in my area say that in addition to remediation, their patients often need to have HEPA systems installed and fogging to bring levels down enough.

Answer

I have not analyzed proportion of patients that can not clean their homes. At one time I use to say that failed remediation was one word, meaning that cleaning never worked. Having said that, strict attention to precise detail is required to clean. Fogging has no role to help rehabilitate homes. Think about it. Say you have some magical fog that kills all bacteria, fungi and actinomycetes with a single application (there is no such product for sale). What will that action do to the extant fragments of fungi or bacteria? Nothing. Where does the problem with WDB come from? Fragments by about 500 to 1. What possible logic would support trying to kill what isn’t alive and then not cleaning compulsively? We are looking at the need to clean at to computer room safety for those who have HLA susceptibility. Trying to kill chemicals that are not alive is not logical. Selling such fogging products to uninformed patients is fraud in my opinion.