1. WATER DAMAGE INVESTIGATIONS MORE THAN SUCKING AIR Connie A. Morbach, M.S., CHMM, CIE, ASCS Sanit-Air, Inc. 1311 North Main/ Clawson, MI 48017 248 435-2088 connie@sanit-air.com

2. IS Mold New? Mold is not new, awareness has increased Changes in building construction  Tighter  Porous Materials =Good Nutrients  Construction to allow high moisture  Better testing methodologies  Physician Awareness  Link previously unexplained illnesses

3. Tight Construction Focus on energy conservation resulted in tighter buildings with less natural ventilation –75 years ago, cracks in the building envelope allowed for 5 - 10 air changes per hour (ACH) –Now building codes permit 0.35 ACH Contaminants are not diluted out Higher concentration results in greater exposure and opportunity for amplification on building materials The solution is to build tight / ventilate right

4. New Building Materials Are Good Nutrients Materials high in cellulose content that are porous retain moisture and provide good nutrient material for mold amplification –Drywall –Oriented Strand Board (OSB) –Plywood –Ceiling Tiles Hasty construction with less detail to preventing water intrusion and providing mechanisms for removal

5. MOLD IS NOT NEW Leviticus 14:33-48 This passage describes mold contamination. Instructs priests to inspect homes and scrape off mold if it is present. After 14 days, the home should be inspected again, if the mold returns, its a “destructive mildew” and the house must be torn down - its stones, timbers and all plaster - and “taken out of town to an unclean place”.

6. MOLD FACTS  Mold Spores are Ubiquitous in Nature  Indoors, Mold is not a Problem Until it Amplifies  Mold Requires Water to Amplify (colonize)  During Periods of Growth and Metabolism, Mold Cells Produce Volatile Organic Compounds and Mycotoxins  Under Stress (Drying Out), Mold Produces Spores  Spores Become Airborne When Disturbed by Airflow, Disruptions, Pressure Differentials  Mycotoxins Become Airborne by Attaching to Spores

7. ASPECTS OF A MOLD EVALUATION Visual Evaluation Moisture Measurements Environmental Parameters Development of Hypothesis Development of Sampling Plan Sampling

8. Visual Evaluations Most important aspect of investigation Evaluate water stains and visible growth –Ceilings, walls, floors, floor coverings Hidden damage is often more severe than damage on the outer surfaces Access ports, boroscopes, and other invasive techniques might be necessary –Ventilation systems filters, duct lining

10. Surface Moisture Measurements Non-penetrating –Calibrated for different materials Drywall Wood Concrete Probes –Hard to reach areas –Sub-surface with long probes

12. A w : Minimum water activity level at 25°C ERH: Equilibrium relative humidity A w < 0.80, ERH <80% A w < 0.80-0.90, ERH <80-90% A w >0.90, ERH >90% water

13. A w : Minimum water activity level at 25°C Aspergillus versicolor A w 0.74-0.79 Ulocladium chartarum A w 0.89 Stachybotrys chartar um A w 0.94

14. Evaluate Hidden Damage Mold that is hidden and visible is equivalent to visible mold and must be evaluated US EPA cautions that mold on the backside of walls and behind wallpaper is frequently more severe than mold on the painted side of walls Precautions must be taken to prevent cross- contamination during invasive evaluation

21. Environmental Parameters Temperature Relative Humidity Carbon Dioxide Air flow –Smoke pens Pressure relationship

22. Carbon Dioxide Produced by people and combustion appliances OSHA PEL 5000 ppm Previous recommendation of 1000 ppm Outdoors in MI typically 350 - 450 ppm Can provide information on tightness of a building Can provide information on ventilation relative to industry guidelines

23. When is Testing Indicated Illnesses associated with biological contaminants –Aspergillosis –Hypersensitive diseases Diagnostic tool to assist in the development of a remediation scope Baselines before remediation Verify remediation effectiveness Litigation support

24. Interpretation of Data No regulatory limits (PELS, TLV’s) Case by case basis Build your own database Rely on published studies

25. Air Sample Interpretation Indoor vs. Outdoor –Predominant indoor organisms different than outdoors Complaint vs. non-complaint Indicator organisms –Stachybotrys, Memnoniella –Penicillium –Aspergillus Persistent and consistent presence of organisms

26. Source Sample Interpretation Do predominant surface contaminants match air contaminants Affected vs. non-affected Are hyphae present Do post cleaning samples improve

27. Common Testing Mistakes 1. Too little emphasis on visual evaluation Essential to establish test sites Moisture meters Staining Deterioration Visible growth Evaluation of hidden growth

28. Common Testing Mistakes 2. Poor Quality Control Sterile techniques not implemented Inaccurate calibration Mislabeling of samples Media not subjected to QC No temperature control during shipping

29. Common Testing Mistakes 3. Too Much Emphasis on Total Concentrations No PEL’s TLV’s - dose response too complex to establish Interpretation should be based on: – Types and relative concentrations compared to outdoors or non-complaint/non-affected areas –Identification of “signature organisms” for water damaged building materials

30. Common Testing Mistakes 4. Too Little or Too Much Concern Relative to “Signature” Organisms Fungi associated with water-damaged building should incite remediation and/or additional investigation Examples Stachybotrys Penicillium Aspergillus Acremonium Trichoderma

31. Common Testing Mistakes Two Common Methods for Air Samples –Spore trap Measures Countable spores Example: Air-O-Cell cassette –Culturable Measures organisms that will grow in a selected culture media Example: Andersen impact sampler 5. Reliance on One Type of Air Sample

38. Air Samples Culturable Fungi and Bacteria Enumeration Identification of genus and species Necessary for profile comparisons Can underestimate Selective media Samples must culture Countable Spores Enumeration only Identify some genera Cannot differentiate species Can identify some particles and pollen Can underestimate if high particulate matter present Immediate results

39. Example of Inconclusive Testing Spore trap results –Inside 2000 c/m 3 Penicillium/Aspergillus –Outdoors 2000 c/ m 3 Penicillium/Aspergillus Do not know if Penicillium or Aspergillus is present Could have Penicillium inside and Aspergillus outside, which would indicate an indoor source Could be the same indoors, which would suggest outdoors is the source Culturable Samples –Inside 500 cfu/m 3 Aspergillus versicolor 1500 cfu/m 3 Penicillium chrysogenum –Outside 500 cfu/m 3 Aspergillus versicolor 1500 cfu/m 3 Aspergillus fumigatus Apparent indoor source of Penicillium chrysogenum

40. Common Testing Mistakes 6. Failure to Collect Air Samples Under “Normal” Operating or Living Conditions Can produce ‘false negative” Documentation of normal conditions could include: –Quiescent sampling –Semi-aggressive –Aggressive

41. Common Testing Mistakes 7. Failure to design a well thought out sampling strategy Testing should be conducted to answer a question (hypothesis) Sufficient samples must be collected to evaluation the hypothesis A poorly designed sampling plan with too few samples can raise more questions than it answers

42. Summary Indoor mold amplification is undesirable and should be avoided. Air sampling for mold is prone to false negatives and should only be conducted if a well designed plan is developed to answer a specific question Sampling is only one piece of the puzzle. Visual inspection, building history, and patient history are important to a case.

43. CONSENSUS DOCUMENTS Bioaerosols: Assessment and Control American Conference of Governmental Industrial Hygienists (ACGIH), 1999 Guidelines on Assessment and Remediation of Fungi in Indoor Environments New York City Department of Health, 2,000 IICRC S500, Standard and Reference Guide for Professional Water Damage Restoration Institute of Inspection Cleaning and Restoration Certification, 1999 Mold Remediation in Schools and Commercial Buildings US EPA, 2001

44. New Testing Methodologies VOC (Volatile Organic Compounds Mycotoxins Endotoxins Particle Counters PCR

45. RESOUNDING CONCLUSIONS  A Poorly Developed Sampling Plan Can Raise More Questions Than It Answers  An Investigator Can Not State That Something Is Not Present Unless Appropriate Testing Is Conducted