ANSI Approves IICRC Standard on Water Damage

House Panels Favor Regulating Fla. Mold Industry

Breaking the Mold: Causation of Disease -- RIP?

Monitoring for Other Contaminants Besides Mold

HVAC Humidifier Contamination in Unsold Homes

VOICES

“Katrina’s flood waters had left grass up above our heads on the exterior walls of the house. Video tapes and an ATM card were found in the walls, presumably belonging to the house’s owner. It was so haunting to realize that people with real lives had inhabited this home ...”

— Judy Wang, a University of California-Berkeley student, writing for the university’s NewsCenter on March 26 about her experience volunteering over spring break to clean up houses in Biloxi, Miss., that were ravaged last year by Hurricane Katrina

Word on the Street 

ASHKIN GROUP, NEETF AMONG AWARD WINNERS
Stephen Ashkin’s consulting firm received a Children’s Environmental Health Excellence Award last month. The Ashkin Group, based in Bloomington, Ind., was one of 15 programs or organizations honored during an April 20 awards ceremony for their efforts to “protect children from environmental health risks at the local, regional, national and international level.” Issuing the award to The Ashkin Group, the U.S. Environmental Protection Agency cited the company’s success in a pilot project that turned the Chicago public school district onto green cleaning. The district then developed green-cleaning guidance they hope will help other school districts to learn about the feasibility of this way to reduce toxin exposure. Ashkin himself was honored as Green Building Advocate of 2005, a recognition bestowed in November at the U.S. Green Building Council’s Greenbuild Conference in Atlanta.

Other Children’s Environmental Health Excellence Award winners last month included programs dedicated to topics like lead hazard reduction and secondhand smoke, as well as the National Environmental Education and Training Foundation. The D.C.-based nonprofit NEETF was honored for its Health Care Provider Initiative, which intends “to incorporate environmental health into health professionals’ education,” according to the EPA. The overall initiative includes focuses on childhood asthma and pesticides. Accepting the award on behalf of NEETF was Leyla Erk McCurdy, senior director of the foundation’s health and environment programs. NEETF was established in 1990 by an act of Congress.

JOURNAL’S FAILURE TO DISCLOSE
The Web site of the Journal of Allergy and Clinical Immunology last month posted an “important correction to the February 2006 issue,” in which it said information about conflicts of interests of two authors “was inadvertently omitted at the time of publication.” The article in question was a position paper called “The Medical Effects of Mold Exposure,” which reviewed scientific literature on the relationship and concluded, among other things, that “evidence does not support the contention that mycotoxin-mediated disease (mycotoxicosis) occurs through inhalation in nonoccupational settings.”

Omitted from the position paper were the declarations by authors Dr. Andrew Saxon and Dr. Abba Terr that they had received compensation for serving as expert witnesses in mold litigation. According to the correction notice, Saxon and Terr provided the journal with the information about their conflicts of interest. Terr was included on an expert witness list for Allstate Insurance Company in a case in Sacramento, Calif. Another court document shows that Saxon received $54,362.57 for his role in a lawsuit in which the defense prevailed over an Arizona woman, Kari Kilian, who claimed her exposure to mold had caused a neurocognitive disorder and other symptoms. The journal’s correction said this information “should have appeared” in print alongside declared conflicts of interest for two other authors and a statement that a fifth author had no conflict of interest.

The Integrity in Science Project, which is part of the Center for Science in the Public Interest, reported in a newsletter on April 24 that the journal would strengthen its requirements on the disclosure of conflicts of interest. Earlier in the month, Merrill Goozner, director for the Integrity in Science Project, had sent a letter to Dr. Donald Leung, journal editor, urging him to publish all conflicts of interest disclosed to the journal. The April 24 Integrity in Science newsletter quoted Leung as saying that under the journal’s change in policy, “All published manuscripts will carry a conflict of interest statement regarding each author.”

AIHA LABS’ ADVERTISING
The American Industrial Hygiene Association believes that advertisements in which laboratories claim “that they analyze 100 percent of the trace of spore trap samples” are misleading, according to the March/April 2006 issue of LQAP News, an AIHA newsletter. “AIHA has found that many labs either will analyze 100 percent of the trace up to a certain stopping point, or have procedures in which their slide traverses do not allow for them to analyze the entire trace,” a newsletter article states. “AIHA interprets advertising that states 100 percent of the trace is analyzed as implying that every spore is counted. It is unlikely that each fungal spore is counted and identified in heavily loaded samples. However, the advertising in question does not mention this fact.”

AIHA said it “will be monitoring advertising in [AIHA’s magazine, The Synergist] for such claims and contacting laboratories to confirm their procedures before allowing the advertising to be included in the magazine.” IE Connections is planning to announce its own policy on such advertisements appearing in its pages.

The LQAP News article concludes with a word to advertisers: “Please be aware if you advertise analysis of 100 percent of a spore trap sample that you should either indicate that this is being done for every sample or include a disclaimer in the advertising making the exception for heavily loaded traces.” AIHA’s contact for more information about this information is Pete Dragasakis, who can be reached by e-mail at pdragasakis@aiha.org or by phone at (703) 846-0799.

IAQA CALL FOR PAPERS
The Indoor Air Quality Association announced a call for papers for its October 2006 conference. Persons interested in giving technical presentations must submit an abstract including the title of the presentation and a brief description of its contents. Descriptions should be limited to 300 words. Submissions must also include the speaker’s biography and distinguish whether the presentation will be 45, 60 or 90 minutes in length. Final selections are to be made by the Convention Steering Committee. Submissions are due May 31 and should be directed to Kristy Lee, IAQA technical director, by fax at (301) 231-8321, by e-mail at kristymlee@ev1.net or by regular mail to IAQA’s headquarters (Attn: Kristy Lee, 12339 Carroll Avenue, Rockville, MD 20852). This year’s IAQA conference is scheduled to be held Oct. 4–8 in Baltimore, Md. For more information, call IAQA at (301) 231-8388.

ANSI Approves IICRC Standard on Water Damage
By Steve Sauer

The American National Standards Institute last month approved the newly edited “Standard and Reference Guide for Professional Water Damage Restoration,” marking the national organization’s first-ever approval of any standard targeted directly for the cleaning and restoration industry.

ANSI’s acceptance of the S500 standard on April 17 closely followed the conclusion of a 45-day public review of the standard that ended one week earlier without generating even a single comment, according to Larry Cooper, who is a standards consultant to the Institute of Inspection, Cleaning and Restoration Certification.

“I was quite surprised, because especially in the mold arena, there’s many organizations looking at mold standards,” Cooper told IE Connections in a phone interview shortly after IICRC broadcast its announcement of the S500’s approval by ANSI. By comparison, he said the standard had spawned about 1,700 line-item comments from around 75 selected stakeholders some months ago when IICRC voluntarily conducted a separate peer review of it.

“For the last four months, we have been steadily editing the S500,” said Cooper. “It has been mostly formatting and style.” He added that an editing committee of five people worked with committee chairs to put what the finishing touches on the standard before it was made available for public comment.

The public review period mandated by ANSI, which concluded April 10, began Feb. 24 evidently without any public announcement by IICRC. A call for comment on standards proposal was placed in Standards Action, a weekly newsletter listing the comment deadlines for new standards proposals. Stacy M. Leistner, director of communications and public relations for ANSI, said this is true of all standards being presented for public review. He added that beyond ANSI’s announcement, the developers of standards are typically responsible for publicizing the availability of their standards for public review.

While IICRC did not publicize the ANSI comment period in February, the organization did advertise in several industry periodicals last year, alerting readers that they could request to be included in the peer review that was taking place.

“Since this document is extremely technical and industry specific, the IICRC did not expect many comments during the public review process,” said a statement from PR firm Edelman on behalf of IICRC. “This is why the IICRC added the extra step of the peer review in order to ensure that there was a consensus among the cleaning and restoration industry,” it said.

IICRC, which became an ANSI-accredited standard-writing organization in September, issued a press release on April 17 announcing IICRC’s plans to publish and sell copies of the revised and ANSI-approved S500 standard as early as this month.

The release also carried remarks from IICRC President and Chairman Carey Vermeulen. “We are pleased to complete this part of the process,” he said in the statement. “It wasn’t always easy, but the benefit of increasing the credibility and integrity of the cleaning and restoration industry makes it well worth it in the end.”

ANSI/IICRC S500-2006 is expected to be nearly four times the size of the second edition, which IICRC published in 1999. A March 18 report by CM e-News Daily cited Cooper as saying that the standard would have nearly 400 pages, compared to 110 pages – a reflection of “the many changes in the water damage industry,” according to the report.

The S500 outlines procedures for water-damage restoration to be carried out by contracted restorers. At press time, hard copies of the standard’s 1999 edition were still listed for sale on the Web sites of both IICRC and ANSI, which also sell hard copies of the IICRC S100, S300 and S520 standards published by IICRC.

Hard copies of ANSI/IICRC S500-2006 are expected to be available this month from ANSI for the list price of $125. IICRC said it would offer electronic versions of the standard for $195, marking the first time IICRC would publish and sell a standard in an electronic format.

IICRC’s press release last month also provided an update on the progress of revising the S520 “Standard and Reference Guide for Professional Mold Remediation,” which the organization says will follow a path similar to the one S500 has taken. The S520 “is undergoing edits and should be submitted to ANSI later this year,” IICRC said in the press release. Its first edition was published in December 2003, the result of three years of cooperation among IICRC and two co-authoring organizations, namely the Indoor Air Quality Association and the Indoor Environmental Institute.

Cooper said that although IICRC would conduct a peer review of the S520 just as was done with the S500, he said the S520 peer review would coincide with the public review mandated by ANSI, rather than be offset from the peer review by a number of months. “In the future, we’ll be doing both at the exact same time,” said Cooper. “We’ve learned a lot about the process as we’ve done it and how this whole thing should run.”

Prior to the September announcement of IICRC’s newly achieved status as an ANSI-accredited standard-writing organization, IICRC officials frequently stated that each of the organization’s standards was intended to serve as a “living document.” The comment highlighted the group’s determination for each standard to be continually revised as newer information became available to restoration professionals.

The development of IICRC standards was predominantly the work of volunteer committees, and input on the standards was gathered from selected sources within the industry. The most extensive collaboration for any IICRC standard was the committee of 28 volunteers and 14 subcommittees that contributed to the S520 between 2001 and 2003.

The organization’s ANSI accreditation added a higher level of visibility to the development of its standards. No longer would public review be limited to those the organization selected. The rules of the American National Standards process for the creation of standards hold openness not only as a virtue but also as a requirement.

“The open and fair ANS process ensures that all interested and affected parties have an opportunity to participate in a standard’s development,” according to a statement on ANSI’s Web site. “It also serves and protects the public interest since standards developers accredited by ANSI must meet the Institute’s requirements for openness, balance, consensus and other due process safeguards.”

While the ANSI procedure requires all comments generated during the public review of a standard to be acted on or responded to, ANSI does not require all comments and response actions to be publicly disclosed.

“The ANSI process is complicated, but it’s great for getting people involved in the overall development of a standard and allowing people to comment and buy in on it,” said Cooper.

He said that when he received notification on April 17 from ANSI that the S500 had been accepted, he immediately called IICRC Standards Committee chair Barry Costa, who was then in a classroom where he was teaching a class, and proceeded to tell him that he was the second within IICRC’s ranks to know about the ANSI approval. “You could just hear him screaming and hollering in the classroom,” said Cooper. “We all worked really hard to get this done.”

They could barely contain their excitement in a letter sent that day, in which those two and S500 chair Howard Wolf informed IICRC’s Board of Directors of the good news. The last line of text in the letter, preceding an image of a colorful fireworks display, read: “Oh Yeah – YAHOO!”

Another organization serving the IAQ industry, the Indoor Environmental Standards Organization, became an organizational member of ANSI in November. IESO, which in 2002 first published a volume of standards related to mold inspection and microbial samples, is likely to apply for ANSI accreditation later this year.

Last year, IESO unified and consolidated with IAQA and the American Indoor Air Quality Council. IESO emerged as the only group of the three that would develop industry standards. David Fetveit, president of IESO, told IE Connections in November that the organization would ultimately seek to have its standards reviewed as necessary for ANSI approval.
 

House Panels Favor Regulating Fla. Mold Industry
By Steve Sauer

State legislation that would give Florida the ability to regulate mold remediation and assessment advanced favorably through the committee process, with unanimous support for the measure among all House committee members who voted on it last month. House Bill 161 passed the Insurance Committee on April 5, the Administration Appropriations Committee on April 17, and finally the Commerce Council on April 20.

On March 23, Rep. Bruce Kyle (R) became the only House member to cast a vote against the bill during a vote in the Business Regulation Committee. At this point, he remains the only House member to vote against it.

These four House committees are the only ones to which the bill was assigned in October, five weeks after Rep. Carl J. Domino (R) filed it in the House. Domino spoke in October at the Indoor Air Quality Association’s conference in Orlando, as part of a panel discussion on “the Future of State Legislation for Mold Assessors, Remediators and IAQ Practitioners.”

The companion bill in the Senate, SB 1046, proceeded in February and March through two of four prescribed committees. It passed the Senate’s Regulated Industries Committee unanimously on Feb. 7 and the Commerce and Consumer Services Committee on March 8. Two committees – Criminal Justice and General Government Appropriations – are to hold hearings on the bill before it proceeds in the Senate.

The House and Senate bills would give the state the capability to regulate mold remediation and assessment without issuing licenses. They are the follow-up to legislation that passed the Senate and House last year but failed to become law when Gov. Jeb Bush vetoed it in June.

While lawmakers in other states endorse self-funded government licensing programs, the legislative solution in Florida remains unique because it would not establish government-mandated licenses. Instead, the state would recognize existing mold remediation and assessment certifications that are accredited by entities such as the Council of Engineering and Scientific Specialty Boards or the American National Standards Institute.

These provisions, now contained in the bill, were added to the legislation after an industry lobbying group, the Florida Coalition on Healthy Indoor Environments, worked to have them included. The state Department of Business and Professional Regulation worked beginning last year to ensure that a new version of the bill would satisfy concerns Bush expressed in his June veto letter. The Florida Coalition, which consists of some organizations in the IAQ industry, worked to ensure the credibility of the certifications that would be recognized as a result of the bill’s passage and implementation.

Domino, the sponsor of the House legislation, can be reached by phone at (561) 625-5176.

The Senate legislation is sponsored by Sen. Michael S. “Mike” Bennett (R), who can be reached by phone at (941) 727-6349.

Colorado

• In a cause publicly endorsed by the Association of Specialists in Cleaning and Restoration members and officials, House Bill 1006 would prohibit insurers and agents from specifying a business that would be required to perform an appraisal or repair on personal property.

  ASCR International issued a news release early last month, with President Brian Spiegel proclaiming that “consumer freedom of choice” triumphs over a perceived “conflict of interest” in the bill. The association made the argument that “consumers are frequently better equipped than insurance companies to evaluate their circumstances and make the best choice when it comes to selecting a local contractor.” “Passage of HB 06-1006 will advance the interests of consumers by assuring competition in the restoration marketplace and delivering optimum value to buyers of property insurance,” explained Spiegel. “In addition, the bill will help to protect the many small businesses and employees of Colorado’s restoration industry from artificially imposed market constraints.”

  ASCR Executive Director Don Manger in March urged interested parties to find ways to help advance the bill in the state legislature. The association directed those wishing to contribute to send an e-mail to NewsbreakDEM@ascr.org for more information.

  The legislation is sponsored by Rep. Dorothy Butcher (D), Dorothy.butcher.house@state.co.us, (303) 866-2968.

Connecticut

•  Legislators acted last month to incorporate Senate Bill 577, a piece of mold-related legislation, into a broad bill dealing with a number of Department of Public Health statutes. The pertinent section of Senate Bill 317 orders the Department of Public Health to establish a mold-remediation protocol that all contractors would be required to follow. According to the legislation, “Such protocol shall include, but need not be limited to, specific, acceptable methods for performing mold remediation or abatement work.” The Senate is expected to vote on the bill soon.
  The legislation is co-sponsored by Sen. Joan V. Hartley (D), who can be reached by e-mail at hartley@senatedems.ct.gov or by phone at (800) 842-1420.

Primary reliance on cause and effect of disease for indoor exposure complaints should stop. It should stop not only due to its abuse by those with self interest but also because it isn’t valid.

And never has been, some claim.

Mold is the prime example with the debate and controversy surrounding recent studies and position statements from authoritative bodies such as the Centers for Disease Control and Prevention; American College of Occupational and Environmental Medicine; the American Academy of Allergy, Asthma and Immunology; and the popular press response to the 2004 Institute of Medicine report “Damp Indoor Spaces and Health.”

Without offering an exhaustive description of each, the confounding factors of all or detailing the claims of bias and outright deception by some, their conclusions can all be summed up with the phrase: “There is insufficient evidence that mold causes …”

No need to complete the sentence because what mold, or anything else, does or doesn’t cause isn’t the point. The point is the use of the word cause.

At issue are the claims by an increasing number of people that indoor exposures are “causing” everything from allergic reactions and asthma attacks to migraine headaches and disabling neurological conditions. Although mold receives the most accusations, additional multiple sources range from pollen to pet dander to fragrances.

When I say something like “Mold causes my headaches,” I mean it in a general way, not a medical or precisely academic way. If my headaches become persistent and severe enough, I’ll seek medical help. I report to the doctor that I have headaches every time I’m around mold. If my doctor is familiar with the above organizations and their published statements, then he will inform me that mold won’t cause headaches, and his diagnostic process will reflect that professional opinion.

If I persist with my claims, especially if his treatment plan doesn’t provide relief, then he may relent and conduct allergy testing. Whether or not I test positive to mold allergies, he will continue to tell me that mold does not cause my symptoms. If I continue in my claims, he will either drop me as a patient or refer me to a psychiatrist. Either way, the harm continues.

Because I see the mold and I smell the mold, I hire a consultant to test for mold. He can see and smell the mold also, but his lab samples indicate the indoor levels and types are nearly identical to the outdoors. His professional opinion is that mold is not a problem. The harm continues.

I ignore both my doctor and the consultant and hire a remediator. Because I was accidentally fortunate to find one with expertise and integrity, the mold was successfully removed without cross-contamination or other complications. My headaches stop.

If I report this to my doctor, then he will most likely respond with “Your relief was coincidental” or “You are better because you believe; it’s called the placebo effect.”

I am now faced with a dilemma. If I believe my experience was true, then I can no longer trust the experts. But if I believe the experts, then I must deny my own experience. Talk about psychological issues! How am I to function with such uncertainty and contradiction about both myself and the experts?

But I digress. Those concerns are for another time and another column. The real issue is this: What does it mean when we say A causes B? More importantly, what does it mean when authorities say that A does not cause B?

A fascinating Environmental Health Perspectives article was recently made available online, called “Causality and the Interpretation of Epidemiological Evidence.” The abstract and full article are available at www.ehponline.org/docs/2006/8297/abstract.html without any charge. The author is Dr. Michael Kundi, a professor with the Center for Public Health’s Institute of Environmental Health at the Medical University of Vienna in Austria. He discusses what has been called the “criteria of causation” for disease. His logic, revelations and conclusions are quite eye-opening.

He begins with a brief history of the principles of causality and its importance to the foundation of scientific advance. In a commonsense manner, causality is easy to understand: If we throw a ball into the air, we cause it to go up, and gravity will cause it to come down. We also understand that we can’t cause the ball to go up by mental willpower. Specific physical actions are required on our part.

Easy stuff, right? Simple science.

The next section, “Defining Cause and Causality,” begins with this startling sentence: “The most advanced sciences, physics and chemistry, have altogether abandoned the concepts of cause and effect.”

Kundi isn’t talking about Einstein and his theory of relativity or quantum mechanics and wormholes. He is instead describing Sir Isaac Newton, who – 300-some years ago – replaced cause and effect with “functional relationships.” He still used the terms cause and effect, but he defined and described them as functional relationships.

So, what is causation? Surely, something as concrete as causation would be easily defined. They are actually short and simple definitions, but the problem is that there is not just one. There are five. And each has a fatal flaw.

The first definition is “A cause is something that produces or creates an effect.” The rebuttal is because “production” or “creation” are synonyms of “causation,” the argument is circular. It isn’t really saying anything.

The second is “A cause is a condition without which the effect cannot occur.” The rebuttal is only a very few diseases could then have a cause. The definition is too restrictive because it eliminates too many confirmed diseases with unknown causes.

The third is “A cause is made up of a number of components, no single one of which is sufficient of its own, which taken together must lead to the effect.” The rebuttal is it introduces unnecessary complexity for the simple ones, such as dose-response.

The fourth is “A cause is a condition that increases the probability of occurrence of the effect.” The rebuttal is this is a definition of association, not of cause.

Finally, “A cause is a condition that, if present, makes a difference in (the probability of) the outcome.” The rebuttal is this is not provable because it is not repeatable for both with and without the causative condition.

So, we are left with no useable definition of cause and effect for either disease or even the hard sciences such as physics and chemistry. But that doesn’t mean we can do nothing.

Kundi offers what are commonly called the “Bradford-Hill criteria,” the fundamental basis for most evaluations of causation of disease. It consists of nine issues to address “when deciding whether an observed association is a causal relationship.” I will neither bore nor confuse you with the nine issues. I will only emphasize that, according to Kundi, neither can they prove a cause (only strengthen support of a relationship) nor can they dismiss a factor as a cause (only weaken support of a relationship).

It is that last contention – that the Bradford-Hill criteria cannot be used to dismiss the assumption of a causal relationship – that is grossly ignored by the major public health authorities when they deny effects of mold and other indoor exposures. (Except that the Institute of Medicine report got it mostly right.)

Keep in mind Kundi’s arguments as you read the documents for yourself. Either they mildly support the better known and already accepted causes, or they dismiss a claim for lack of evidence. That violates the simple logic and integrity of their own foundation for determining “causality” of disease.

More simply put, the lack of evidence of harm is not the same as the lack of harm. Consider it, instead, an unsolved mystery: Something happened, it was real rather than occult, and we don’t know why or how.

Inform yourself, including information from the experts, but decide on a course of action. Observe the results and make corrections as best you can. It’s far from perfect but may well result in less harm than blindly following professional opinions based on unscientific, illogical and indefensible misinterpretations of “causation.”

Doesn’t that make more sense? Especially from a scientific point of view that requires adherence to physical laws and processes rather than unsubstantiated conclusions of intervention by non-scientific (occult) forces?

Finally, Kundi doesn’t leave us out on a limb with no definition or plan. He concludes his article with an outline of a pragmatic approach with specific criteria. Key points include “It is not necessary to demonstrate a mechanism of action” and “We are either dealing with less obvious hazards or those that occur only rarely or in a small proportion of the population.”

Sound familiar? Doesn’t that accurately describe complaints with environmental exposures? Anything is better than the “Katrina cough” pretense.

Public health, what age are you in? In the present with us in 2006, or in the 1600s before Sir Isaac Newton?

Carl Grimes is president of Healthy Habitats LLC, an indoor-environmental consulting firm in Denver, Colo. He is the author of the book “Starting Points for a Healthy Habitat” and serves on the Editorial Advisory Board of IE Connections. Grimes can be reached by e-mail at grimes@habitats.com or by phone at (303) 671-9653.

Many people enter the IAQ industry due to the rapidly expanding demand for mold assessment. However, an IAQ professional will often become involved in projects requiring assessment of issues other than mold. I get a lot of inquires about mysterious odors in buildings. For some reason, unexplained odors are usually assumed to be due to mold. In my experiences, mold is usually not the source of unexplained odors. Determining the true source of the odors can be a complex and difficult task, presenting professional opportunities outside the scope of mold investigations. In fact, there are numerous types of environmental maladies that can affect indoor air quality. Investigating these other problems can present good business opportunities for IAQ professionals.

To appreciate the possibilities for assessment procedures, we must first understand the variety of contaminants that can exist in the indoor air space. For example, these can be biological contaminants, non-biological particulates, chemical contaminants, and abnormal water vapor conditions. Some of the more common contaminants are described below.

Biological Contaminants
Bacteria: Biologically and structurally different from fungi, bacteria are the fastest growing of all biological organisms. Wild type E. coli has an average doubling time of about 20 minutes under ideal conditions. This results in growth of billions of cells overnight. Bacteria require high water concentrations for optimum growth but can grow in any moist environment. Bacteria are not typically recognizable when growing in buildings. Bacteria can produce exceedingly strong odors and are responsible for the smell of rotting meat. While some bacteria produce spores, bacterial spores have significantly different physical characteristics than fungal spores. Most bacteria do not produce spores. Bacteria can cause significant human infectious diseases or severe food poisoning.

Fungi: The organisms we call “molds” are fungi. Filamentous fungi are much slower growing than bacteria. Filamentous fungi are divided into “perfect” and “imperfect” fungi. Most common mold colonies are imperfect fungi and are initiated by a single germinated spore. These organisms are not true species as they are reproductively defective (anamorphic) variants of perfect fungi. Names like Aspergillus and Penicillium are given to these organisms as a convenience but are not scientifically valid. Perfect fungi, such as mushroom fungi, are created by the mating of hyphae from two sexually compatible spores. Hyphae from spores of perfect fungi cannot survive without this mating process and will quickly die. Perfect fungi tend to produce spores only during specific reproductive cycles. Imperfect fungi tend to produce spores continually.

Viruses: Viruses are not living organisms and are therefore not assigned genus and species names. Viruses cannot grow on surfaces in buildings. Viruses are basically small fragments of genetic material (DNA or RNA) contained in a protective coat. Viruses are absorbed into host cells by contact. The viral genetic material inserts into the host genetic material resulting in abnormal function of host cells. Reproduction of viruses occurs inside the host cells where they are protected from the host immune system.

Non-fungal Particulates
While much attention is given to fungal particulates in buildings, fungal particulates account for a very small proportion of the total particulate load. Normal, non-contaminated buildings in my geographical area commonly contain concentrations of 300 to 1,500 fungal spores per cubic meter of air. Total particulates measured by a laser particle counter can commonly exceed 100 million particles per cubic meter for particles sized over 0.3 microns. Concentrations of particles similar in size to mold spores commonly range from 75,000 to 300,000 per cubic meter. The variety of particulate materials is vast, including many substances such as carpet fibers and fragments, skin cells, and fragments of insects. In fact, almost any solid substance of light to moderate density that can be pulverized into very fine particles can easily become airborne with agitation or exposure to air currents.

Chemical Contaminants
Gaseous and volatile chemical contamination can have numerous sources and consist of thousands of different substances. Common causes of chemical infiltration into buildings include flawed sewer lines and drain traps. In unoccupied buildings, water can evaporate from drain traps providing a direct conduit of sewer gases into the building. Odor from this infiltration can be extraordinarily strong. While this source of gaseous infiltration is obvious, other sources can be more elusive. Cracks and leaks in sewer lines can result in migration of contaminated liquids into concrete pads or other non-visible areas. Gaseous infiltration can occur through the concrete pad and flooring at low levels resulting in less noxious odors.

Infiltration of chemical substances can occur by less obvious means. Holes drilled in concrete pads for electrical assemblies or retrofitted plumbing can create a breach in the vapor retardant and allow water, water vapor or chemical intrusion from the substrata. Negative pressurization of the interior air space can have a dramatic effect on influx of gases, volatilized chemicals or water vapor into the structure. Negative pressurization creates a pulling force that encourages influx of substances from the foundation, wall cavities, exterior air, and air from the attic.

Chemical infiltration can originate from interior sources too. These include fugitive gas emission from air-conditioning systems, gas lines, defective exhaust flumes, ozone generators, electrical generators, fumes from chemical storage areas, and other sources. Many sources of interior chemical contamination are possible depending on the use of the building and stored substances.

Water Vapor
As previously referenced, water vapor can infiltrate buildings from a wide variety of sources. Most of us are familiar with typical sources of water vapor, which include diffusion from the exterior, cooking, showers, evaporation from toilets, respiration and perspiration from animals and people, potted plants, etc. Air-conditioning systems are designed to accommodate these normal sources and remove resulting water vapor.
Abnormal sources come from leaks in the building envelope, flawed site drainage, water leakage from air-conditioning systems, plumbing fixtures, etc. In these cases, liquid water can vaporize, and the air-conditioning system may not be capable or removing the high levels of water vapor present. High interior water vapor levels can cause an elevated dewpoint, resulting in widespread condensation on surfaces at normal temperatures. (The reader is encouraged to consult “Moisture Control in Buildings” from ASTM Press to learn more about psychrometrics and water vapor science. A detailed discussion is beyond the scope of this article.)

Monitoring for These Problems
Now that we have defined some of the common sources of IAQ problems other than mold, how do we go about monitoring for these problems? Lightweight monitoring devices are available for a wide variety of environmental conditions. Most are handheld or small devices, but some can be quite large. For contaminants, monitoring devices can give presumptive or preliminary indications that may be confirmed by sampling for subsequent lab analysis. Other devices can provide immediate precise results. Monitoring devices can be quite expensive, and the IAQ professional should assess the potential return on investment prior to spending significant sums of money for these devices. Of course, there are numerous rental sources for these devices which provide a viable alternative to purchasing when one has a single project requiring such a device. Renting is also a good way of trying out a device prior to purchase. Keep in mind, however, that equipment that is expensive to purchase tends also to be expensive to rent.

Monitoring for biological contaminants: Most devices used for monitoring biological contamination do not provide anywhere near the precision or detail of results obtained from biological sampling. At the Indoor Air Quality Association’s expo in Orlando last year, one company displayed a type of sniffer or mVOC detector, claiming it could confirm the presence of biological organisms by detecting unique mVOC signatures. While this device was apparently targeted for fungal colonies, similar devices could be used for bacterial detection. Since this is not a show report or equipment review, I will not be identifying manufacturers or models. I have not used these devices and cannot comment to their efficacy, but they do appear to be readily available.

Another device used for on-site detection of bacteria is a luminometer, a device that detects light resulting from the reaction of bacterial cells with a specific chemical. A positive reaction is alerted to the user by the machine and the intensity of the positive reaction is proportional to the concentration of bacterial cells present. While not as accurate at culturing/enumerating procedures, these devices can provide a rapid on-site method of estimating relative concentrations of bacteria and other organisms. One well advertised device specific for mold utilizes a generally similar procedure.

In medical testing, the presence of viruses is generally been detected through collection of blood, body fluids, serum or other biological samples with the subsequent analysis for antibodies (serological techniques) specific for the virus or viral group in question. Culturing of viruses has historically been done by inoculating live chicken embryos with biological samples from a patient. I am not aware of any environmental monitoring devices that can detect the presence of viruses in buildings. (I have included this section on viruses due to many questions I have been asked from IAQ professionals.)

The detection of total particulates in buildings has some usefulness in IAQ investigations and can provide an additional professional opportunity for investigators. Cleanroom assessment has been an industry for many years. There have been federal standards for many years for cleanroom evaluation, and, more recently, international ISO standard 14644 has been adopted, replacing the earlier federal standards. Formulating pharmacies, critical-use manufacturing plants, some hospital applications and other specialized facilities utilize particle-monitoring services. Specialized particle counters with specific flow rates are used for these applications. These devices may be different than particle counters used for general IAQ investigations. The reader is encouraged to research the criteria necessary for certification for professional cleanroom monitoring.

Particle counters can be helpful for IAQ investigations, but their use in predicting fungal spore counts remains uncertain. Ongoing research is being performed to assess the applicability of using particle counters as a rapid method for establishing mold-sampling protocols. Results are forthcoming.

Detection of chemical substances is possible with a variety of handheld monitors. These include specific gas detectors, photoionization detectors, confined space monitors, flame ionization detectors, chemical sensitive badges, sorbant tubes and portable gas chromatographs. The most versatile of these devices for use in IAQ investigations is the photoionization detector, or PID. This device ionizes air pumped across a high-intensity light source. The electrical charges resulting from ionization of the air are counted by a detector. While these devices cannot specifically identify chemical substances present, total ionizable gases can be quantified against a known standard. Traditionally used for detecting airborne concentrations of known chemicals from spills or releases, PIDs can be used in IAQ investigations. These devices allow the user to obtain real-time data and to travel between areas in a building to detect hot spots and specific problem areas.

However, PIDs cannot detect all VOCs. Only those substances whose ionization potential is at or below the energy output of the lamp can be detected. While most PIDs detect parts-per-million levels of gas concentrations, parts-per-billion-level machines would be most applicable in general IAQ investigations.

A precise understanding of the operational theory of PIDs and their proper calibration is essential to providing accurate and useful information. I have reviewed IAQ reports in which total VOC levels have been reported in buildings without any mentioning of the limiting factors or calibration standards used; one person actually claimed to have calibrated a parts-per-billion-level PID with 100 parts per million isobutylene. An excellent source of information regarding the use of PIDs can be referenced at www.raesystems.com/AppTech_Notes/.

While a detailed explanation of all chemical detecting monitors is too lengthy for this article, readers are encouraged to familiarize themselves with the various devices. Chemical-detection services are often requested as an adjunct to mold testing and represent an opportunity with strong demand.

Water vapor monitoring: While many IAQ investigators perform cursory humidity measurements when doing mold inspections, detailed psychrometric analysis of buildings is a science of its own. For those who may not have detailed knowledge of psychrometric principals, I strongly recommend the aforementioned “Moisture Control in Buildings” from ASTM Press. This is a serious, engineering-level academic publication with mathematical theory. However, the layperson can also learn very much about how moisture behaves in buildings and apply this to professional moisture-monitoring in buildings. Condensation is the largest risk factor related to water vapor.

A variety of moisture-monitoring devices are available for moisture detection in building materials, and for analysis of airborne water vapor. Thermal infrared imaging cameras are very good devices for scanning large or inaccessible areas for thermal anomalies that may indicate moisture. These anomalies can be verified by moisture meters. Water vapor characteristics include relative humidity, which is an estimation of the saturation level of water vapor in air; absolute humidity, which is a measure of the concentration of water vapor in air; dewpoint, which is the temperature at which, for a given water vapor concentration, air will achieve 100 percent relative humidity; and temperature. Other water-monitoring processes can be performed as well. The moisture level contained in concrete (or other materials) is known as the equilibrium relative humidity. It can be measured with some electronic handheld devices but also with small humidity tents or other devices loaded with water-absorbing materials such as calcium chloride. Equilibrium relative humidity is used to assess the readiness of slabs for floor coverings and other applications.

This article has covered some of the more obvious and common monitoring applications beyond mold. Others areas of monitoring/sampling not covered are asbestos, radon, allergens, building-pressure differentials and other issues. Unfortunately, space does not permit detailed explanations of these issues. Interested readers should perform their own research about the technical aspects of these monitoring procedures as well as state or federal regulations that may apply to these procedures.

Jeff Deuitch is a microbiologist and mycologist with significant background in affiliated scientific disciplines as well as real estate and construction services. He is owner of Int’l Microbiology & Mold Group, an IAQ company performing biological assessment, building inspections and thermal IR imaging. He is also owner of Manatee Appraisal & Valuation Services, which provides construction cost estimating and real-estate valuation services. Both companies are located in Palmetto, Fla. Deuitch can be reached by e-mail at moldgroup@aol.com or by phone at (800) 261-8132.

It is well known that commercial and institutional HVAC humidification systems require acceptable water quality to function properly. Many use steam generated from filtered and deionized water.

In homes, however, proper water quality for humidifiers is not as well controlled and can be a significant health issue. The health literature contains numerous cases of “humidifier fever” in residential and commercial buildings. This is generally a health condition caused by exposure to various bacteria, endotoxins and fungi that are found in humidifier water reservoirs, in air-conditioning system evaporator coil drip pans and even in some aquariums.

My firm was recently called in on what might be considered the worst-case scenario for residential humidifier water quality. The factors that created this scenario are not uncommon, and it disturbs us greatly that cases like this might be occurring nationwide. An old adage says a rolling stone gathers no moss, and I have found that an unused water supply inside a vacant house can grow all kinds of things.

The Scenario
Frequent use of a plumbing system generally keeps the level of microorganisms in check. Since potable water is not sterile, a background concentration of bacteria will be present in the water. Water system operators are aware of this, and they chlorinate the water supply to help curb bacterial growth. The minimum level of free chlorine typically entering a home from the municipal water system is about one part per million, which is usually adequate. So, how can water quality be a problem in newly constructed homes?

Many builders never pay attention to the water quality inside water pipes while a home is under construction. It is assumed that the home will sell quickly and what has grown or been left in the water pipes will just flush out once the new homeowners use the water systems. However, what happens if the homes do not sell? What if the home is a model home for a community or is on the market for months or years? How bad can the water quality get?

When a new home is built, it is not unusual for a certain amount of dirt and debris to find its way into the water piping. These elements provide food for significant bacterial growth if adequate chlorination is not present.

Unfortunately, chlorine in the incoming water supply can dissipate through various chemical reactions and lose its disinfecting properties in as little as 24 hours. This means that bacteria growth can begin in an unused potable water system after just two days of inactivity.

Bacterial growth can also accelerate in the new hot water tank. During manufacturing of a new water heater, dirt and debris will often collect in the tank. This debris is not an issue after installation if the water in the tank is maintained above 110 degrees Fahrenheit and properly flushed before use. But what if someone left the hot water heater on at a minimal setting of 100 degrees? Now, you have food and water at an ideal temperature for microbial growth.

[Editor’s note: Many references recommend a water temperature of 120 degrees to prevent Legionella growth, but the author maintains the lower temperature is not only preferable due to the risk of burns but also more than sufficient to prevent significant microbial growth.]

Next, we add another complication: Let’s hook up the humidifier in these new homes to the hot water line. This “microbial brew” from the hot water tank is now being piped directly into the humidification system for the home. (If the humidifier had been hooked up to the cold water line, which is standard practice, then the level of bacterial growth would not have been as elevated.)

Finally, the homes are used as model homes for the new development. The heating and air conditioning are functioning so that they can be viewed by prospective buyers, but the water is seldom used. These homes sit unsold for a number of years. What you now have is a dechlorinated plumbing system full of bacteria, a not-so-hot water heater full of millions of bacteria, and a humidifier that is aerosolizing millions of bacteria into the airspace of a home for years on end. Then, after all the other homes in the community are built and sold, the crowning jewels – the model homes – are finally sold.

New occupants are exposed to high levels of bacteria in three ways:

1. Bacteria from the humidifier are deposited in the home through the HVAC system. The bacteria become aerosolized by normal human traffic walking across carpeting and other surfaces.

2. The bacteria in the hot water system become aerosolized any time the occupants take a hot shower or a bath.

3. The occupants ingest large amounts of bacteria when they consume water from the tap or refrigerator water dispenser.

When the homeowners turn on their showers, there is a terrible smell. The water from the tap tastes awful and smells bad. Shortly after occupying the home, one homeowner comes down with a gram-negative bacteria infection in his lungs. His condition worsens, and he begins using a home nebulizer and steroids.

This homeowner told a new neighbor about his condition. The neighbor said that after moving into her home, she also developed a gram-negative bacterial infection and has been on antibiotics for months. She also reported that her children would get severe abdominal cramps after drinking the water.

Both of these homeowners decided to talk to two others. These third and fourth homeowners also reported at least one family member becoming ill after moving into their new homes and that when friends would come to visit, they would become ill too. The homeowners contacted the builder, saying they believed the water quality was making them sick.

The builder hired an environmental consultant to test the water. After the test results came back, the builder informed the new homeowners that “traces” of Legionella were found in the hot water tank. He said it was nothing to worry about but suggested everyone leave their homes, go to the hospital for checkups and move into a hotel at the builder’s expense.

The builder’s environmental consulting firm then continued to test the homes for mold and bacteria. The data given to the homeowners on these follow-up tests did not appear to find anything significant. Nevertheless, the builder told the homeowners he will replace the hot water tanks, replace all the carpeting in the homes, and clean and disinfect the homes.

The homeowners began to wonder why all this remediation work was being done at the builder’s expense when the reports claimed virtually no contamination problems exist. The homeowners, becoming skeptical as their illnesses continued, consequently decided to contact a lawyer and to hire their own environmental consultant for a second opinion.

By the time these homeowners contacted their consultant, six months passed since the start of this situation. Can one assess microbial contamination months to years after it has occurred, as in this case?

Analysis
One of the best indicators of previous levels of microbial contamination is vacuum cleaner dust. Three studies – one from Canada in 2004, another from Germany in 2002, and a third from Minnesota in 1952 – provide guidance on this subject, showing similar results: A count of less than 100,000 culturable mold spores per gram is associated with the unhealthy or symptomatic homes.

The Minnesota study, published in the Journal of Allergy in 1952, also looked at bacteria levels and was therefore the most useful. Its authors, Beate et al., found an average of 10 million (with a maximum of 20 million) colony-forming units of bacteria per gram of dust – about 100 times higher than the mold spore levels. Such a level is associated with unhealthy homes or symptomatic occupants.

It was fortunate that all three families had put new vacuum cleaner bags into their vacuum cleaners before moving into their new homes. The new homeowners were in these homes for only two to three months, and the new vacuum cleaner bags were now full of house dust. Three of the four families involved in this situation agreed to have the dust from their vacuum cleaners sampled and analyzed. The vacuum cleaner dust was analyzed for both culturable mold and bacteria. Not surprisingly, the samples were grossly contaminated. Both the bacteria results, shown in Table 1, and the mold results were also extremely high.

The newest home’s bacteria count was slightly below the “normal healthy limit” of 10 million, while the older homes were from 20 to about 44 times the “average” home level discussed above.

The next piece of evidence was the water quality in the homes. Only two of the homeowners participated in this sampling due to cost limitations. In performing tests of water quality, the methods have somewhat changed in the last 10 years. Historically, water was tested using the standard plate count method, or SPC. However, this method and its type of agar allowed certain fast-growing bacteria to spread over the plate and to potentially hide other colonies of bacteria that were slower-growing. Hence, a newer method called the heterotrophic place count, or HPC, was developed, using AR-2 agar. This agar slows down the fast-growing bacteria to get a more accurate count of the actual number in the water system. This is the preferred method in use today.

Table 2 shows the tests of the water from these homes.

To establish the significance of these waterborne bacteria levels, Table 3 shows some applicable standards for potable water.

Clearly, in this situation, the total bacteria level in the potable water exceeds the maximum recommended levels. Also, a majority of the bacteria found were gram-negative species. This is troublesome because gram-negative species are generally associated with disease in humans. Immunocompromised persons are at a greater risk of infection from these strains of bacteria.

The next piece of evidence was the initial laboratory analysis reports, from the builder’s environmental consultant, claiming only “traces” of Legionella.

The reports were unusual in that the level of Legionella in the hot water heaters was shown as less than 1,000 colony-forming units per milliliter, and in the water systems it was less than 100. It was also reported that the city found Legionella in the water main, but the city did not supply the homeowners with their data. Since the limit of detection for Legionella is near one colony-forming unit per milliliter, this reporting format was unusual. Looking at these data, one could surmise that the actual Legionella concentrations were probably in the range of 50 to 900 or more colony-forming units per milliliter.

In order to provide some perspective on interpreting these levels of Legionella in water, Table 4 shows the U.S. Occupational Safety and Health Administration’s recommended limits for Legionella, as noted in “Technical Manual, Section III: Chapter 7, Legionnaires’ Disease.” The most usual is the limits for humidifiers. Based on these OSHA numbers, the Legionella present in the hot water system clearly represents a significant exposure risk.

These findings indicate that Legionella posed a potential health risk to the occupants of these homes. Further, the levels listed in Singapore’s regulations state they apply to healthy individuals. They are not designed to protect immunocompromised individuals, which include the elderly.

Clearly, the decision to recommend leaving these homes was a prudent one.
The last part of this situation was what to do with the homes, the humidifiers, and the water systems to correct the problems. It was recommended that they be thoroughly cleaned and HEPA-vacuumed, including the HVAC system. The humidifier, hot water tank and carpeting were also replaced. The challenge then became how to clean the water system.

It was recommended to reconfigure the hot water system into a recirculation loop with a recirculation pump – a common design in custom homes, hotels and hospitals – and then to insulate the piping fully, which should have been done by the builder to save energy.

Then, the system should be super-chlorinated (because the biofilm was so thick it did not respond to chlorine treatment). The amount of bleach to be added would be calculated for the total volume of water to super-chlorinate the system. The water temperature would then be increased to the maximum setting of 150 degrees, and the system would be constantly recirculated for 48 hours. This should adequately disinfect the piping system and kill off the biofilm.

Then, following instructions from Edwin E. Geldreich in his 1996 book, “Microbial Quality of Water Supply in Distribution Systems,” “the new line should be flushed to remove the holding water used to disinfect the line, followed by introduction of fresh water supply into the entire new section. If the laboratory results indicate no coliforms present per 100 ml and the [heterotrophic place count] is less than 100 organisms per milliliter, the line is considered acceptable for use. ... [I]f the HPC density within 48 [hours] of holding at room temperature increases to 1000 or more organisms per milliliter, another line flushing is in order to dislodge protective sediments in some pipe joints.” If, however, the system failed the test due to excessive biofilm retention inside the pipes, then the entire piping system may have to be replaced.

What this case showed was that hooking up a home humidifier system to a hot water system set on a low temperature unused home an extended period of time can result in extensive microbial contamination of a home.

Secondarily, potable water systems in homes that are unused for an extended period of time can develop microbial contaminated in both the hot and cold water systems that can pose health risks upon reoccupancy, especially for immunocompromised individuals such as the elderly persons and very young children.

Bob Brandys is president of Occupational and Environmental Health Consulting Services Inc., located in Hinsdale, Ill. He holds a doctorate degree in occupational safety and health, a master’s degree in public health, and dual undergraduate degrees in thermo-mechanical engineering and environmental engineering. He is a registered professional engineer, a certified industrial hygienist, a certified safety professional, and a certified microbial remediator. He has over 30 years of experience dealing with microbial contamination in the safety and environmental field in the pharmaceutical, medical device, biosafety research, cleanroom and mold remediation industries. His most recent books deal with mold, bacteria and post-remediation verification. Brandys can be reached by e-mail at bobb@safety-epa.com or by phone at (630) 325-2083.