The Importance of Understanding Exposure Risk When Testing an Indoor Environment for Mold

by Catherine Fruechtenicht

If I had to choose only one way to test an indoor environment for mold, I would pick Environmental Mycotoxin Testing, hands down. That is a BOLD, definitive, controversial statement, I know, but I have solid, science-backed reasons for it which I will do my very best to illustrate in today’s article.

A Shift in Thinking

To begin, I think it is safe to say that I have come to a different way of thinking about testing an indoor environment for mold from when I began my personal mold journey over 6 years ago: Instead of thinking about mold testing as a nebulous and scary exercise, where many different testing methods are used to come up with if there is a mold issue, and WHERE or WHAT is causing the issue, I now think of mold testing as a definitive exercise that should determine whether or not an indoor environment has the potential to make you sick. With mold, its illness- and disease-igniting potential is really the bottom line for me. Thus, for simplicity’s sake, I think of mold testing more like a pregnancy test. I know, you are thinking, “Mold testing is nothing like a pregnancy test!” But, hear me out, because when you decide to take a pregnancy test, you are usually doing it for the following reasons:

1.) You have a REASON to think that you might be pregnant. Mold is the same. You are testing usually because you are sick or have been sick in the past from mold, you know of water damage, you smell something musty, or you are seeing areas of mold growth or staining.

2.) You want to know IF you are pregnant so that you can take proper health and planning measures. With mold, you want to also know IF there is a problem so that you can go about fixing it.

3.) You want to know if you need to shift your lifestyle and healthcare to find the proper professionals to help you in your journey. Mold is similar in that dealing with it requires different, mold-literate contractors, remediators, and health practitioners for the best outcomes.

So, you see, testing for mold truly fits all of the same parameters! Further, any mold testing should just be the beginning. Like a pregnancy test, it should be used as a starting point to understand the seriousness of the situation so the next steps can then be planned accordingly and with intention.

Mycotoxins: The Elephant in the Room

Now that we are thinking about mold testing within the context of testing that provides more definitive answers, let’s also consider the components of mold that cause deep sickness and disease: Mycotoxins. If you have read any of my other articles or my blog, you know that one of the biggest issues with mold testing is the fact that there are no established values or parameters in the mold testing world that define safe or unsafe exposure levels. Mycotoxins are a different ballgame because exposure to mycotoxins and mycotoxin-producing molds has been clearly established as unsafe for humans in the scientific and medical literature. In fact, mycotoxins are known to be dangerous to ALL vertebrates.

For the sake of this article, let’s define mycotoxins as metabolites or chemical byproducts produced during the metabolic processes of some molds. In other words, mycotoxins are only produced when needed and molds use them to defend their territory or when breaking down organic material. And, as you can well imagine, a chemical produced to defend and consume, can also cause harm and destroy—especially when inhaled on a daily basis. Hence, detectable, and measurable amounts of mycotoxins in your indoor air are not conducive to good health. As a matter of fact, scientists have actually known this for a very long time. While we were not always aware of or looking for mycotoxins inside homes and buildings as vectors of illness, we have been aware of the dangers to both livestock and to humans from exposure to the inhalational effects of mold and mycotoxins in feed and hay inside barns and silos. For example, farmer’s lung is a known pulmonary disease caused by inhaling fungal spores and has been cited since the 1700s.

Exposure Risk

That brings me back to testing. When mold is on the table, you really need to know your exposure risk. The only current way of testing that considers exposure risk is a way of testing that actually measures mycotoxins in the indoor environment. No spore trap or air testing can do this. Some dust collection testing that uses PCR detection can determine the mold types, like the ERMI test for example, but the problem with just doing this testing alone is that it says nothing about whether or not mycotoxins are being produced by those molds and at what levels. I personally find that problematic, because, while an ERMI can identify whether or not the home has ever had a mold problem, it gives you zero idea as to whether or not the mold issue is current, historic, or if the mold is still flourishing and producing mycotoxins. Additionally, an ERMI test alone cannot always illuminate the true source of the exposure. The need for identifying the ground-zero source of the mold making you sick became extremely apparent to me when reading the work of some scientists and doctors in the 1980’s who were researching Chronic Fatigue Syndrome (CFS). These doctors and scientists were actually studying a group of people who were identified as having the CFS in Truckee High School, North Tahoe High School, and the Hyatt Regency Hotel & Casino in Incline Village. Many of the affected employees complained about the buildings feeling toxic and having a moldy smell. When it was finally determined that these teachers were suffering from sickness caused by the “toxic black mold”, Stachybotrys Chartarum, it was also determined that the exposure was occurring in their place of work or the school, NOT their homes. Why does this matter? Because you would not want to spend thousands on remediation or moving when the actual exposure scene is somewhere else, right?!!! As far as I am aware, the only true, scientific way to connect the dots of the mycotoxins present in a patient’s body (serum or urine testing) with mycotoxins exposure in an indoor environment is to actually test for mycotoxins. I know this concept seems to almost make too much sense, but it is quite possibly THE MOST IMPORTANT PIECE OF THE PUZZLE. You cannot get well if you are still exposed to the toxins that are making you sick. Right?!!!! It may also be something to speak with your practitioner about if you are periodically doing urine mycotoxin testing and your levels are not decreasing as you feel they should be or have spiked back up. When this sort of rebound effect occurs, it might be time to add environmental testing of mycotoxins to the mix to see if you are missing a key exposure source at work or somewhere else.

Mycotoxin Testing and Remediation

Finally, if I have not convinced you of the importance of environmental mycotoxin testing yet, I would also like to call your attention to the lack of understanding when it comes to mold remediation and cleaning. When mold is removed, even by the best remediation company doing everything right, mycotoxins are NOT removed. Let that sink in. You cannot kill mycotoxins. Mycotoxins are chemical compounds. The only way to properly address mycotoxins during mold remediation is to first properly identify them. If you know that mycotoxins are present in a home, that home is going to need a different level of cleaning and remediation to be safe for the inhabitants. In my opinion, not properly testing for, identifying, and remediating mycotoxins is why many remediations fail, especially when people are very sick. As a matter of fact, from my personal experience, I can very honestly say that it took a good year of consistently controlling our indoor humidity, purifying and filtering our indoor air, HEPA vacuuming, dusting and cleaning using the EC3 products to get our home back after the mold. It was not because the remediation wasn’t well done, or because something was missed. It was because we had to also account for the chemical residue and mycotoxins that still lingered. I will also tell you that once we tested, we found that the airborne spore counts in our home were really quite low–causing mold inspectors to tell us everything was fine, while our environmental mycotoxin levels of Ochratoxin were very high and indicative of the major problem we had going on in our HVAC system.

Environmental Mycotoxin Test Options

There are currently two tests available that test for mycotoxins in the indoor environment, the Environmental Mold and Mycotoxin Assessment (EMMA for short) and the Environmental Mycotoxin Test both tests, both by RealTime Labs, the only CAP- and CLIA-accredited lab that does environmental mycotoxin testing that I know of in the world. The EMMA test only requires small amounts of dust or material from AC or heater filters to look for the presence and relative abundance of 10 of the most toxigenic molds and detects 16 of the most poisonous Mycotoxins using its patented Mycotoxin detection test. Molds tested for include Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus, Aspergillus versicolor, Aspergillus ochraceus, Aspergillus niger, Stachybotrys chartarum, Chaetomium globosum, Fusarium species, and Candida auris. The Environmental Mycotoxin Test detects the 16 Mycotoxins also included in the EMMA, but does not provide info on the presence and abundance of molds. The mycotoxins tested for in both tests include Aflatoxin B1, B2, G1, and G2, Ochratoxin A, Satratoxin G and H, Isosatratoxin F, Roridin A, E, H, and L-2, Verrucarin A and J, Gliotoxin, and Zearalenone, Instructions are provided with the pre-paid return kit that is sent to you upon order. Results will be sent to you within 10 business days from receipt of your sample.

To conclude, mold is the factory that produces what I consider to be the true enemy–mycotoxins. If you have a mold problem in your home, you need a mycotoxin assessment to know your exposure risk. Without the information on whether or not mycotoxins are an issue, it will be more difficult to initiate the proper course of remediation or treatment to get your home, your health, and your life back.

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