Sick Building Syndrome
Sick Building Syndrome (also known as SBS) or Chronic Inflammatory Response Syndrome is a combination of illnesses or aliments that are in direct relation with an individual’s place of work or home environment.
A 1984 World Health Organization report indicated up to 30% of new and remodeled buildings worldwide may be related to these symptoms. Oftentimes the sick building syndrome is related to poor indoor air quality resulting from water damage inside a building.
Water damaged buildings produce microbial contaminants such as mold, fungi, bacteria, actinomycetes, and microbial volatile organic compounds to name a few. It is difficult to tell which of these contaminants are the sole cause of Sick Building Syndrome and it is sometimes referred to as “Chronic Inflammatory Response Syndrome” acquired following exposure to a water damaged building where am
plification of microbial growth is evident.
People within contaminated buildings that exhibit signs of Sick Building Syndrome or Chronic Inflammatory Response Syndrome experience a wide variety of symptoms such as irritated eyes, nose and throat. Some even experience damage to or impaired functions of nerve tissue along with general health problems including skin irritations, nonspecific hypersensitivity reactions, and odor and taste sensations.
Many patients suffering from the unexplained symptoms of an illness that causes them to lose their quality of life have found relief. Ritchie Shoemaker, M.D. Dr. Shoemaker has found that these symptoms are often caused by “Mold Illness,” which may be a result of exposure to airborne mold present in the environment of a water-damaged building.
Mold illness is not an allergy; it is believed to be an inflammation within the body caused by the immune system’s response to these foreign substances. But, it is a vicious cycle – causing the immune system to constantly fight back. In turn, this causes so much inflammation in the body that it leads to chronic illness, which insidiously takes away energy, cognition, and easy breathing. It leaves behind pain, fatigue, and often, weight gain.
♦Fatigue♦Weakness ♦Aches ♦Muscle Cramps ♦Unusual Pain ♦Ice Pick Pain ♦Headache ♦Light Sensitivity ♦Red Eyes ♦Blurred Vision ♦Tearing ♦Sinus Problems ♦Cough ♦Shortness of Breath ♦Abdominal Pain ♦Diarrhea ♦Joint Pain ♦Morning Stiffness ♦Memory Issues ♦Focus/Concentration Issues ♦Word Recollection Issues ♦Decreased Learning of New Knowledge ♦Confusion ♦Disorientation ♦Skin Sensitivity ♦Mood Swings ♦Appetite Swings ♦Sweats (especially night sweats) ♦Temperature Regulation or Dysregulation Problems ♦Excessive Thirst ♦Increased Urination ♦Static Shocks ♦Numbness ♦Tingling ♦Vertigo ♦Metallic Taste ♦Tremors
Linking the symptoms to the work place or home environment can often be difficult. Routine testing of the blood for thyroid, white or red blood cell count, lipid profiles, metabolic profiles often appear normal. It has been noted that patients with symptoms resulting from Sick Building Syndrome or Chronic Inflammatory Response Syndrome can be misdiagnosed with things like depression, stress, allergy, fibromyalgia, Post Traumatic Stress Disorder, or even somatization; which is a psychiatric disorder in which a person complains about various symptoms that has no identifiable physical origin.
Some causes have been attributed to contaminants produced by out gassing of some types of building materials, volatile organic compounds (VOC), molds, improper exhaust ventilation of ozone (byproduct of some office machinery), light industrial chemicals used within the building, or fresh-air intake location / lack of adequate air filtration. The most common biotoxin are those released by indoor mold and bacteria. When wood or drywall is exposed to a relative humidity of 60% or higher such as from a water leak or being in a humid basement or crawl space, that’s enough to start feeding the growth of mold and bacteria. The only way to solve this problem is to destroy the harmful molecules.
Dr. Mercola interviewed Dr. Jack Thrasher who has a PhD in cell biology from the UCLA School of Medicine, and is an expert on the impact of mold on human health. Here, he discusses the health effects of toxic molds and bacteria, as well as his recommendations for remediation. You can listen to the interview at https://www.youtube.com/watch?v=GQBXyuAbdjg&list=PL08AA426681517CFC.
How to Detect a Mold Problem
Clearly, the first step would be to conduct a visual inspection. A musty, mildew odor is a tip-off that you need to check the area in question for any visible signs of mold. If you can’t see any visible traces of mold, Dr. Thrasher recommends taking an air sample, and using a moisture meter to determine the moisture level in the area.
“I use a moisture meter on every wall of the building or the home looking for hidden moisture. The moisture content of wood flooring, for example, should be no more than 10 to 12 percent. I’m finding floors that have moisture content of 48 percent. Exterior walls shouldn’t have anything more than 15 percent, and I’m finding exterior walls with 40, 50, 60 percent.
… The other thing I recommend is to not rely on air samples from mold spore counts. Invariably, that will give you misinformation. The number of mold spores that are in the indoor environment and the outdoor environment vary over the day; it’s a diurnal type variation… So it’s not a very reliable test for what’s in the air.
Secondly, there are certain bacteria that do not release their spores into the air very regularly and you won’t find them in the air… So become educated as to what to look for and how to look for it, and don’t accept somebody coming in, taking an air sample and saying, “There is nothing wrong with this because the indoor counts are less than outdoor counts.” That’s wrong logic. Certain species of mold grow indoors much more regularly than they do outdoors. So you have to look at the species of mold, not just the spores.”
A better option is to do 24-hour monitoring. However, this type of testing cannot be performed by a typical mold inspector. You need to hire a high-level mold expert for this type of air testing. (I’ll list several sources for finding a qualified expert below.) Dr. Thrasher also suggests interviewing the expert in question to find out who they typically work for.
“If they’re doing work for insurance companies stay away from them,” he says. “You want somebody who is unbiased… [Also] ask them the question, “If you take the airborne mold in the indoor environment can it hurt you or cause toxic reaction?” If the person says, “No, don’t worry about it. All it can do is cause allergies,” then stay away from that person. That person is not well informed.”
After air sampling, Dr. Thrasher also takes swab and bulk samples of the mold growth; actually cutting out a piece of the affected area if necessary, for proper lab testing. Dr. Thrasher explains what he typically tests for:
“We culture for the bacteria. We culture for the mold. We do what we call ERMI (Environmental Relative Moldiness Index), which is an EPA test that was developed by a group in the EPA. This is a PCR-DNA analysis for 31 different species of mold… that is very inexpensive, relatively speaking. It costs $350 to do that test… [W]e take swab samples looking for endotoxins. We also look for… polysaccharides called 1,3-beta-D-glucans… We want to get a good idea what’s going on in the indoor environment.”
Next Step: Remediation
As soon as you’ve identified the problem, you have to stop the water intrusion and remediate the problem at its source.
“Let’s say you have an infested wall that’s in the middle of the home between the living room and say, the adjoining den; what is recommended is that the whole area must be walled off from the rest of the house… In other words, you drape them with a plastic and you have to tie the plastic down with masking tape so that that area will not, theoretically, contaminate the rest of the house,” Dr. Thrasher explains.
While you can clean affected metal objects, all organic materials (such as wood, particle board, and carpets) must be completely removed and replaced. You want to make sure that the contractor you hire for the job uses a HEPA (High Efficiency Particulate Arresting) filtration machine to trap minute particles, and that they’re meticulous when using it.
WARNING!! Be Careful How You Chose Your Remediator
There is no question that a high quality active air purifier can help control mold issues but it will NOT remediate against them. You can use the best air filters and purifiers and they will never solve the problem if you continue to have water intrusion into you home that increases the humidity and feeds the growth of the mold.
You will need to stop the water at its source and carefully remove and clean the mold infested materials. While this may superficially seem an easy task, let me assure you that it isn’t.
I recently had a leak in my basement that was improperly remediated for $10K. The cause was not addressed so the problem worsened, which more than tripled the price to properly clean it up. That is part of the reason that prompted me to contact some of the leading experts in this area and learn how to do this properly.
So let me tell you from personal experience, you need to find a qualified expert and professional that is certified by one of the agencies below. I would also suggest getting several bids for the work. You can find contractor or professional listings on the following sites. Both the IICRC and NORMI are certifying organizations for mold remediation, but the IICRC certification is perhaps the most widely used:
- IICRC (Institute of Inspection, Cleaning and Restoration Certification)
- ACAC (American Council for Accredited Certification)—a certifying body that is third-party accredited.
- The IAQA (Indoor Air Quality Association)—a membership organization with no certification program (the ACAC handles this by agreement)
- RIA (Restoration Industry Association)
- NORMI (National Organization of Remediators and Mold Inspectors)
Keep in mind that a mere certification or listing may not be enough. Also evaluate the remediator’s qualifications and insurance (liability as well as workman’s comp). With the ACAC, there are a few different levels.
How to Clean Up Minor Surface Mold
If you have just a small area of surface mold, you probably don’t have to call in an expert. However, only attempt to clean it if it’s limited to the surface of a small area. You cannot “clean” deep-rooted mold. Dr. Thrasher has one word for those of you who have bought into the home-remedy advice to “kill off mold” with ammonia or bleach: Don’t.
“What happens is you’ll kill the mold but you’ll leave the carcass behind,” Dr. Thrasher explains. “The carcass will disintegrate and release toxins into the air. So you really went from one problem (mold growth) to another problem; dead mold and the release of all of their toxins… and then once water is reintroduced in the environment, the mold will grow right back to the surface.”
However, for minor visible surface mold on say a baseboard, or on a piece of furniture, you could use a little bit of sodium bicarbonate (baking soda) and vinegar to wipe it off.
“I just use the concentrated vinegar and baking soda,” he says. “All you need is a couple of tablespoons [of baking soda] to a quart of water. The vinegar I just take straight out of the bottle… I generally do the vinegar first and then follow it with the baking soda… The vinegar will kill the mold and the bacteria but you’re going to leave residue on the surface and so you scrub the surface to try to get rid of the residue.
… I never validated that procedure, but that’s what I recommend; what I do use and it seems to work, but I haven’t validated it with research data. I have to be honest with the population out there.”
What about Ozone Generators?
While Dr. Thrasher does not recommend using an ozone generator, other indoor air experts do. Ozone generators essentially generate photocatalytic oxidation that can help destroy airborne mold. However, Dr. Thrasher strongly cautions against their use, stating that oxidizing an organic chemical of any kind will create free radicals, and he also points out that ozone can be highly irritating to your mucous membranes and lungs.
Personally, I believe the claim that ozone generators facilitate the removal of volatile organics is correct… But do beware that they should not be used when you’re in the room at levels higher than the EPA recommends, and they do pose a danger to both plants and pets. However, the ozone dissipates quickly, so after airing the area out for about 20 minutes, it’s safe to return.
Keep in mind that this is different from air filtration, as the ozone generator actually purifies the air and neutralizes any odors at the source, on the molecular level.
What are the typical Treatments?
Most doctors will simply prescribe an antibiotic for chronic sinusitis, for example. But if your sinusitis stems from bacteria- and mold growth in your home, it’s not going to clear up. The next step is typically to prescribe either prednisone or a corticosteroid, which could further worsen your condition.
“You want to stay away from the corticosteroids; you want to stay away from the antibiotics,” Dr. Thrasher warns. “What you need to do is to do a culture. Go to a good ENT physician and actually get a diagnosis of what is going on inside of your sinuses. You want to stay away from the corticosteroids because two weeks use — or even less than this — of corticosteroids will increase your risk of other infections. Corticosteroids inhibit the oxidative burst produced by macrophages… Let’s say you have mold that’s growing in your sinuses. So the macrophages in your body, called the innate immune system, are in there gobbling up the spores of the mold, correct?
Then what happens is they put you on corticosteroids, and the role of the macrophages, they’ll gobble them up, engulf them, and then produce oxidative burst that kill the spores and the bacteria. The corticosteroids do not inhibit the engulfing aspect of it so they take up the spores and the bacteria, but the corticosteroids inhibit the extra oxidative burst produced by the macrophages. Now, the macrophages contain live spores and bacteria. Now where do they go?
They go any place else in the body they want to go to. So therefore you have increased your risk of other infections particularly fungal infections. I’ve seen individuals who have been put on corticosteroids because they have been exposed to these indoor environments and then, sometime down the road, have been diagnosed with Aspergillosis.”
That’s definitely a concern. Additionally, long term use of steroids has other side effects that are well documented, including increasing your risk of osteoporosis and cataracts, and disrupting your hormone balance. So, educate yourself on indoor air quality, and particularly on mold.
We typically utilize herbals and whole food vitamins and minerals for bacteria and mold overgrowth after identifying the offending culprit through Functional Medicine and blood testing.
The most studied natural treatment for bacterial overgrowth is enteric coated peppermint oil, which is peppermint oil that has an edible, hard shell around it so that the capsule doesn’t open until it is in the small intestine. It kills bacteria in the small intestine.
Other herbal antimicrobials we have used for bacterial overgrowth are:
- Grapefruit seed extract – for people who don’t like taking capsules, grapefruit seed extract can be found in liquid form. Add a few drops to a glass of water and drink in between meals.
- Oregano oil capsules
- Berberine – goldenseal, oregon grape
- Olive leaf extract
- Pau d’arco
The course of recommended remedies is usually 3 to 6+ months depending on the severity of biotoxin levels.
If you suspect that you may suffering from Sick Building Syndrome, contact us today.