Part of the Shoemaker treatment protocol for Chronic Inflammatory Response Syndrome (CIRS) dictates removing potential sources of mold toxins. Toxins in the home, vehicle, workplace, or other areas where ample time is spent are all potential hurdles to successful treatment. Testing these areas for mold can help decide how best to proceed with removal/avoidance

At Appalachian Wellness, we use EnviroBiomics provides 2 specific types of household mold tests as part of our CIRS laboratory testing.  It’s up to you to choose which of these two tests you want to do.

Health Effects Roster of Type-Specific Formers of Mycotoxins and Inflammagens (HERTSMI2)

This test looks at 5 commonly toxic mold species.  This is a less expensive test but also less comprehensive.

The Environmental Relative Moldiness Index (ERMI)

This test is more expensive but provides a much more comprehensive assessment by looking for 26 toxic mold species.

It’s important to remember that you should not only test your home but any other building you spend significant amounts of time in and/or are suspicious of (even brief exposures in a building that is highly toxic/dangerous will prevent your recovery).

Remember, the FIRST RULE of treatment is to ELIMINATE exposure!

There are other thoughts regarding this test as well.  Ideally, the best way to assess a building for mold is with evaluation by an experienced Indoor Environmental Professional (IEP) who is familiar with the standards needed.  Most IEP’s are trained to the standards of the Environmental Protection Agency (EPA).

Standards for mold-certified inspectors are much more complex.  Scott Armour is one of those folks.  He has his own views on this:
“My opinion is that if these lab reports, which are usually for sampling done DIY, create panic and instill fear, they are NOT valuable to the health community – you, me, anyone and everyone.”

I agree the use of “red” scoring adds confusion also – is red bad?

The interpretation is, of course, based on the original EPA description and use of the score, as well as the statements made by Dr. Richie Shoemaker about ERMI and HERTSMI and health (per Shoemaker himself, but not replicated elsewhere).

As I explain, the “danger” Shoemaker applied to the condition is VERY limited – based on the factors of his study.

So some explanations are in order for both ERMI and HERTSMI:

In some ERMI lab reports, the red/yellow/green is simply based on the quartile cutoffs of ERMI score, here is what I provide to my clients – and anyone who needs clarification on ERMI:

“When looking at the graph of the ERMI scores, the colors are simply quartiles of the data – this means, the green range is the 25% of homes with an ERMI score under negative 4 (these are the lowest scoring homes). The yellow range is the middle 50% of scores (between -4 and 6), and the red range is the last 25% of homes, which had an ERMI score above 6 (the highest scoring homes).

The numbers do not correlate to any quantification such as species or amount of mold growth, or water damage, or illness. The EPA research did not follow up on any of its findings or methods – it was a one-time study …” – unpublished but widely distributed, by J.Scott Armour, 2016.

The HERTSMI is a bit different, it uses a logic flow chart mechanism, where four conditions MUST be met – which is because that is how Shoemaker arrived at this conclusion that above 15 is “dangerous”. in other words, if a study is based on 4 conditions, then you can only interpolate to those same conditions unless you explicitly make assumptions that the new “real world” differences (variables) will actually not create differences in outcome (i.e., conclusion).

He said, IF a patient is diagnosed with CIRS (per his criteria), AND has genetic predisposition (using the HLA criteria), AND the doc intended to treat with cholestyramine, AND the HERTSMI score was above 15, THEN the patient was unlikely to show improvement.

That’s it. The relationship for lower HERTSMI scores was not strong and hence not even reliably predictable with regard to the patient outcome – in other words, it didn’t really matter what the HERSMI score was.

THIS IS WHY sampling doesn’t matter in nearly all cases – because the range of HERTSMI scores is actually all-encompassing of “actual mold growth” conditions – if you have mold growth, remove and clean the area. and if necessary, clean all ambient dust in occupied high touch areas and surfaces. Move on. Don’t waste time and money on ERMI/HERTSMI/qPCR.”

Humidity can also be a problem.

Every little bit helps. In wet/damp basement situations, if humidity can’t get low (e.g., 45-50), then the act of lowering (using the dehumidifier to continually pull some water from one location to the device) will help slow/stop growth, even if the room is “around” 70, such as this case.

Also, the little bit of air movement (aka ventilation) from the device will also help, since airflow over wet/damp surfaces will slow/prevent growth.

The biological reason for these changes in growth is because as the surface dries, or the air vapor is lowering, the actual point of growth will not have the optimal amount of available water – so, e.g., the wall “leaks”, paint fails because brick is wet, and efflorescence appears, but the mold won’t grow because the very top surface is undergoing evaporation, or the vapor in a thin layer of air flowing over it is not sufficient. This is not 100%, nor universal, but it occurs more often than not – so the drying process does improve the overall condition (i.e., it’s better tomorrow than yesterday!)

The direction of the device output and the location of the input will make a difference also.

The output is warm, dry, and will quickly pick up vapor, and will aid evaporation of wet/damp surfaces. So tell them to point the output toward the wettest wall corner if possible. Or, put the device in that corner also.

If you put the device in the “middle” of the space, with output going to the wettest corner/surface, then you might get lucky and create a circulation pattern that pushes dry air toward the wet area, and that newly “wet” air will move back to the device to be dried again. (this is not easy, and for most people, it’s only somewhat intuitive).

In the meantime, if this person is a DIY, they should make some attempt to clean visible mold off of surfaces (walls, ceilings) and discard visibly moldy contents – in situations with chronic high humidity in a basement, inevitably there will be contents, objects, furniture with a surface haze of mold (typically white to light green and yellow, sometimes light brown). This often is thought to be house dust, or construction dust like drywall.

Scott Armour, M.S.

Armour Applied Science, LLC

Dr. Raymond Oenbrink
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