The Science Behind Mold Litigation

TASA ID: 3216

On Tuesday, July 12, 2011, at 2 p.m. ET, The TASA Group, Inc., in conjunction with mold expert Patrick Rafferty, CIH, presented a free, one-hour, interactive webinar, The Science Behind Mold Litigation, for all legal professionals.

Despite a modest decrease of mold claims in the past few years, juries continue to find multi-million dollar verdicts for plaintiffs in some personal injury suits. New litigation regarding mold and rot damage as a result of construction defects continues as some of these defects are only now being discovered. Recent natural disasters have caused untold wind, flood, water and mold damage that may likely result in significant numbers of lawsuits.

During this program, the presenter covered the following:

• The difference between mold and mold growth.
• Why indoor mold growth must be dealt with
• Mold growth as a harbinger of substantial asset depreciation
• The types and causes of mold-related health effects
• Industry standards for mold inspections and reports
• Putting mold sampling in the proper perspective
• Goals of mold remediation

About the Expert
Patrick Rafferty is a Certified Industrial Hygienist (CIH) with 30 years of professional experience in industrial hygiene, indoor air quality investigation, public health, and risk assessment and communication, serving as a consultant to industry, property owners and managers, trade associations, and government. He specializes in indoor air quality (IAQ) studies; occupational health and safety evaluations; and multimedia industrial hygiene and public health risk assessments. He has served as an expert witness in mold litigation involving property damage, construction defects, personal injury, and insurance coverage. He has also served as an expert on cases relating to proposed OSHA regulations, workers’ compensation, and criminal sentencing. He has co-authored or edited numerous books and articles on topics related to environmental health and safety, including The Industrial Hygienist’s Guide to Indoor Air Quality Investigations, and the Report of the Microbial Growth Task Force, both published by the American Industrial Hygiene Association.

Transcription:

Matt: Good afternoon. Welcome to today's webinar, The Science Behind Mold Litigation. Despite a modest decrease of mold claims in the past few years, new litigation regarding mold and rot damage as a result of construction defects continues as some of these defects are only now being discovered. Recent natural disasters have caused untold wind, flood, water, and mold damage that may likely result in significant number of law suits.

During this program, our presenter will cover the following: the difference between mold and mold growth, why indoor mold growth must be dealt with, mold growth as a harbinger of substantial assets depreciation, the types and causes of mold-related health effects, industry standards for mold infections and reports, putting mold sampling in the proper perspective, and goals for mold remediation.

The presenter for today's webinar is Patrick Rafferty. Patrick is a Certified Industrial Hygienist with 30 years of professional experience in industrial hygiene, indoor air quality investigation, public health and risk assessment and communication. He has served as a consultant to industry, property owners, and managers, trade associations, and government. He specializes in indoor air quality studies, occupational health and safety evaluations, and multimedia industrial hygiene and public health risk assessment.

He has served as an expert witness in mold litigation involving property damage, construction defects, personal injury, and insurance coverage. He has also served as an expert on cases related to proposed OSHA regulations, workers' compensation, and criminal sentencing. He has co-authored or edited numerous books and articles on topics related to environmental health and safety, including "The Industrial Hygienist's Guide to Indoor Air Quality Investigation" and the "Report of the Microbial Growth Task Force," both published by the American Industrial Hygiene Association.

During the presentation, we'll take two question-and-answer breaks. If you have a question, please use the chat or Q&A feature found on the right-hand side of the screen. I'm pointing them out with the red arrow right now.

We encourage all attendees to submit questions throughout the presentation. Tomorrow morning, I'll send out an email with a link to the archived recording of this webinar. We do ask that you take time to fill out the survey that will appear in your screen after the presentation is over.

I'm now going to turn the program over to our distinguished presenter, Patrick Rafferty. Patrick, the presentation is all yours.

Patrick: Thank you, Matt. And good morning to everyone on the West Coast and good afternoon to everyone else. And I'm looking on how to...

Matt: It should be okay, now, Patrick. Hold on. Let me take it back and...

Patrick: Okay. We got it.

Matt: Yeah. It should be all good now.

Patrick: Thank you.

So, everyone is familiar with molds, but not everyone is conversant in some of the technical and scientific aspects of mold. And that's what we're hoping to do today is to get everyone to a level of being able to discuss some of the more important drivers and aspects of mold, particularly as they impact on litigation.

So what is mold? Mold is a member of the Kingdom of Fungi. Other kingdoms include animals, plants, bacteria, and protozoa. So, these are the largest collections of life forms on Earth.

There are two types general types of fungi: macro-fungi and micro-fungi. Macro are those that you can see with the naked eye like mushrooms and toadstools. Micro-fungi are those that you can really only see their structure with a microscope or a magnifying glass. And those include molds, which are multi-celled organisms, and yeast, which are single-celled organisms. And many times when we're talking about mold and mold growth, much of what we say, may also apply to yeast.

So, first of all, we'll talk about the structure of mold. And mold is, well, it's more like a plant than an animal. And it doesn't have any chlorophyll. It doesn't engage in photosynthesis.

But like a plant, it has a structure that has spores, which are basically seeds, has fruiting bodies, which are similar to the flower of a plant. And they have hyphae, which are analogous to the root structure of a plant. And also like plants, there are a huge variety of types of mold. It is estimated that there are nearly a half a million species of mold. Only a small fraction of which have actually been identified, grown in the laboratory, and named.

And so, what does the mold look like actually under a microscope? These are some photographs taken at somewhere between 50 and 400x under a microscope. In the upper left is a Penicillium-type mold, which consists of the round balls or spores, and they're held together by strands, and intermingled with that are hyphae, which are small roots.

Very different from that to the right of that is a fungal structure that looks more like something you might find in the garden. Below that, to the lower right and lower left, you can see masses of roots and plant-like structures and even structures that look much like flowers. And these are the fruiting bodies, which will then contain spores.

So, the tremendous variety at the microscopic level of what mold is and what molds looks like. Now, here's where an important distinction comes into play. And that is, we see in a lot of documents, people using the word mold to describe a condition in a building.

And I have found that it's extremely important to differentiate between mold spores and mold growth. And we're going to talk about this for a couple of minutes because this is so important. And it's misused not only by folks in journalism and in the law, but also in many cases by so-called mold inspectors, in some cases, even by so-called experts.

So, the universe of everything we're talking about is mold. And most of that consists of mold spores and mold growth. Mold spores, much like flower seeds and plant seeds are tremendous variety in terms of their size and their shape. Some are round, some are jagged, some are spiked, some are even tiny. Their size is about 1 to 100 microns, which means that are about a 20th of the diameter of a human hair on average.

And if you lined them up neatly on a postage stamp, you could fit about 20 million of the average fungal spores on a postage stamp one layer thick. Aerodynamically, they're very, very light and can float through the air for miles. And when they're in quiet conditions, quiet with respect to wind, they can and do settle down on all types of surfaces.

Under the right conditions, they can form mold growth. Now this is a muffin. I came down to breakfast one day and was disappointed that I could no longer eat my muffin because it had been taken over by a couple of colonies of mold growth. The largest ones here, some others on the perimeter, and even some that look distinctly different than the center. This is mold to the naked eye. It's a familiar but unwelcome sight.

But what we have here is we have mold growth, which is the result of a mold spore landing on a surface that contains some nutrients, some food source, which is always an organic source, because that's what mold does. Mold takes existing organic matter, breaks it down and uses that for energy and then uses that energy to build new growth seen in the form of these fungal hyphae and conidiophores and spores.

And the other ingredients to growth in addition to having a spore and a food source. One, you also need the correct temperature and you need the right amount of moisture. The correct temperature is basically anywhere that humans live. If there's an environment in which we can exist, say above freezing to, you know, in the low hundreds, then mold can easily grow in those conditions. And different molds will, of course, be attracted to and grow differently in different temperature ranges.

The same is true with moisture. That there is a wide range of moisture, there's always a minimum requirement of moisture, but some molds have more of an affinity or are able to grow in somewhat drier conditions. And a lot of molds like very wet conditions and some grow best right there in between.

Under a microscope, this is mold growing on drywall. And, again, you can see the analogy here to a plant and underneath that plant is a massive root system that goes into the drywall, and actually digests the drywall. Different from a plant root, which just takes nutrients that are free in the soil, and takes them into the plant. The roots of fungus, and mold in particular, actually discharge enzymes into the material which degrade the material and dissolve the nutrients so that they can be taken up by the mold.

And this is just a graphic example in animation, if you will, of mold spores. On the upper right here, we have the mold spores that have landed on a fabric surface. And you can imagine that in some cases, they've actually worked their way into the fabric by gravity and by movement.

The second picture here is mold-growing in fabric. And in this case, you can see that the roots of the mold have been intertwined with the with the fibers in the fabric, which has tremendous implications for how we clean and what's cleanable. And, you know, what needs to be disposed of versus what can be wiped and vacuumed, that sort of thing.

All of this is a bit of scientific understanding of what the words mold, and mold growth, and mold spores mean. And why it's important to differentiate among them because of spores sitting on the surface is really generally not a problem. Mold spore that has started, that has begun to grow and is degrading material and is an active of life form is much more problematic.

And the two bottom lines are that mold spores are ubiquitous indoors and outdoors. Okay. The spores are in every breath of air we take, practically, except, perhaps in the dead of winter and a snowstorm. There are mold spores that we're breathing and mold spores that are landing on surfaces indoors and outdoors. That's just a fact of life and mold growing is much more widespread outdoors, but it's generally not occurring indoors.

And here's some examples. Mold is what takes the dying plant materials. This is a dead daffodil flower. Mold has already begun to degrade this and to recycle this material. If it weren't for mold growing on plant matter that has died, a walk in the forest would have to be through leaves 10 or 20 feet deep. And it's mold and other fungi that degrade the materials and keep our forests alive.

Mold growth is almost everywhere outdoors. This is a leaf that already has, even though it's growing, it's already got mold colonization on it. And indoors, getting back indoors, we have mold in some products. Actually, it's yeast that is in vinegar, and wine, and soy sauce. But it's mold that is used to make certain cheeses and frequently it's mold that takes your fruits and says it's no longer good.

So, indoor mold growth then must be addressed for three reasons. One, it's a nuisance. The second, it is indicative of hidden damage. And the third is that they are health risks. And this is a piece of sheetrock that was exposed to a tremendous amount of moisture over a long period time. And this is quite different from a little bit of dark spots on your morning banana.

So, indoor mold growth. Again, there are three reasons why it is objectionable and needs to be addressed. The first is odor. When mold is growing, it releases what we call volatile organic compounds or VOCs. And volatile simply means that it can become airborne. So, these organic compounds that can become airborne, much like some of the compounds in our sweat and in our breath, and, again, in our cheese. There are odors that many people find objectionable in which everyone would recognize. And these VOCs are also responsible for some irritation of mucous membranes.

And again, everyone's familiar with the moldy odor that, you know, if you've gone down to the basement or crawlspace, or wherever, and pulled out a container, and there's some old shoes in it, and they've got some green fuzzy growth on them. We're all familiar with that. And it's not something that anybody looks forward to experiencing.

In terms of health effects, obviously, this is critically important in many aspects of litigation. Really, the watershed documents on health effects is a 2004 report prepared by the National Academy of Sciences, Institutes of Medicine, which commissioned to report on Damp Indoor Spaces and Health.

And the conclusions of this group is that there are health effects associated with exposure to mold. They are almost indistinguishable from the health effects of exposure to damp indoor spaces. And part of the reason for that is because there are other organisms besides mold that frequently cohabitate with mold, such as yeast, and bacteria, and certainly insects and mites.

But what the Institute of Medicine did was categorize... They took all of the
symptoms and all of the health effects that were in the literature as being possibly associated with or caused by mold growth. And they categorized them. And what they came up with was four categories: sufficient evidence of a causal relationship, sufficient evidence of an association, and then limited evidence of association, and finally, number four, inadequate evidence to demonstrate, to determine any of it.

So, under number one, there's sufficient evidence of causal relationship. There were no health outcomes that met these criteria. They did know that there is an increased risk to immunocompromised persons to fungal colonization. And that is, there are some molds, some members of the genus Aspergillus that can grow actually in the lungs of a person who's severely immunocompromised. And this is a critically important health effect. But it is not, they were trying to make associations that were to the general population.

With sufficient evidence of an association: upper respiratory (nose and throat) symptoms, asthma symptoms in asthmatic persons (not causing asthma in non-asthmatic persons but asthma symptoms in asthmatic persons), wheeze, cough, and hypersensitivity pneumonitis in susceptible persons.

Limited or suggestive evidence of association were lower respiratory illness in otherwise healthy children. And what's interesting is the list, it's a long list, it's two pages long here of those health effects where there was inadequate or insufficient evidence to determine whether an association exists. And that would include developing asthma in persons who don't already have asthma, chronic obstructive pulmonary disease, shortness of breath, mucous membrane irritation syndrome for the respiratory.

And for the non-respiratory, acute idiopathic pulmonary hemorrhage in infants. And this is where the so-called toxic black mold, the Stachybotrys, became of great interest. And the Institute said there was not sufficient evidence to determine whether there's association for that, so, fatigue, skin symptoms, cancer and reproductive effects and others.

And finally, indoor mold growth this is really important because of hidden damage that mold growth often reveals. Hidden mold growth can be a harbinger of other conditions caused by water damage inside the building. Now, this house looks great on the outside, but on further inspection, what we see is rotted sheathing. This is oriented strand board. It's a wood product, but it's already been partly digested in the making. And with water, it will easily grow rot.

And behind that sheathing, we often find framing. This rotted framing was on a residential structure that was less than five years old. It has almost no structural value left. And, of course, corrosion of structural members. In this particular case was not discovered until a wall was taken down for mold remediation.

So, at this point, I believe we're breaking for questions.

Matt: Yes, thank you so much, Patrick. And all the attendees, please use the chat feature found on the right-hand side of the screen to submit your question. Patrick, we have a couple questions already in the queue for you. "Can you explain the difference between mold and mildew, and mold and bacteria, please?"

Patrick: Well, the difference between mold and bacteria is similar to the difference between plants and animals. Bacteria have a different cellular structure. They're one-celled organisms. Some are motile, that is they can move around. And they can exist under a much wider variety of conditions. And they're much more likely to cause, say, an infection human. So, that distinction is a more of a fine point of microbiology. And it is sufficient to say that sometimes, there is some bacteria that grows where there is mold growing because the conditions are similar for some bacteria to grow or some fungi or for some molds are growing.

Difference between mold and mildew is really just a... Mildew is more of a vernacular term. It's just what people call that black stuff that grows on the shower curtain and in the bathtub. And, typically, a lot of people will refer to sort of that bathroom maintenance issue as mildew. But, in fact, it is mold. It's just we find it in bathroom.

I have found in inspecting buildings that a lot of people, when they see mold growing on say a ceiling tile or a wallboard, will refer to it as mildew just because it looks, I think, like growth on your shower curtain.

Matt: Hey, great. We have a couple of questions that have come into the queue, kind of rapid fire. So, we'll just go down the list. There is question here from David who asked, "If you have a plumbing leak behind a bathroom wall and upon removal of a sheetrock, there's some mold growth and rot. Should you be concerned or should the client be concerned about health effects of that mold behind the sheetrock?"

Patrick: There's always that concern about health effects, particularly if there's someone in the home who's predisposed to allergies and asthma. And that's why when we believe that there is hidden mold behind a wall before that wall is removed, you know, there's certain precautions may need to be taken such as isolating that room and ventilating that room and protecting the people who are working in there. So, yes, there definitely is a potential for health effects, depending on the person's sensitivities to mold.

Matt: Okay. Excellent. A follow up to that, "Do you think that it would be in the best interest of the client for them to have someone do a mold test before they proceed?"

Patrick: We're going to be talking about testing in the next section. But the short answer is no.

Matt: Okay. Excellent. We have a question here from Burke who asked, "What are the names of harmful species of mold?" And there may be a ton of them. Please let me know if you'd like me to send out a list or something like that.

Patrick: That's really an impossible question to answer completely. As I mentioned, there are an estimated half million species of mold and approximately 1 out of every 10 species of mold that may exist out there has been categorized, classified, and named. And of them, there are potential human health effects in vast numbers of them.

But most of the great, great majority of species of fungus have never been evaluated for human health effects. So, yes, we know that there are some Aspergillus species that will create an invasive fungal growth in the lungs of a person who, you know, got a severely compromised immune system, such as someone with AIDS or certain cancers and were perhaps the very, very elderly. Those who are in organ transplants are very susceptible to these.

But other than those, which are in the Aspergillus family, in the nuclear family, again, there's just not enough information to tell you which are the worst, or... Yeah. Yes, Matt.

Matt: Okay. We have a two-part question here from Dwight. First part, "Does mold produce mycotoxins? And if so, what kind of injuries are caused?" And the second part of his question is, "Can air samplings find mold spores findings one day, and not the next?"

Patrick: Okay. Again, we'll be talking more about sampling in the second section. But, yes, the results of air sampling can be vastly different from one day to another, both indoors and outdoors. And part of that is because the air constants, the concentration of spores inside of a dwelling inside the building, are strongly dependent on what's outside the building. They're also somewhat dependent, in some cases, on what's growing inside the building.

So, seeing dramatic changes from one day to another is absolutely to be expected. And anywhere that you've seen a weather station that collects spore data, you can look at that, and from one day to the next, can change by a factor of 100 or more, from one day to the next.

Matt: Okay. Great. We'll do one more question. And then, we'll move on to the presentation of content. And there have been some requests, Patrick. If you could just pick up a little. I guess the volume is faded a little bit in your voice.

Patrick: Okay.

Matt: There you go much better. Here's a question from Carolyn who asked, "Does mold have to be actively growing and throwing off spores to be problematic as opposed to old dried mold?

Patrick: No, both actively growing mold and old dried out mold can be a health problem for some people. It's much less likely that old dried out mold will have an odor problem. And for that reason, it's frequently not detected. However, you know, as we mentioned, some of the reasons or health effects for mold is because of hypersensitivity reactions, such as allergies and asthma, which are triggered by proteins in the spores and in some of the fungal structures. Those proteins are there, whether the mold is dead or alive, if you will.

Now, over time, of course, the mold degrades, the proteins degrade, and the average [inaudible 00:28:48] or the ability to cause asthma will eventually go away. But sometimes, you know, that could take a very long time, measured in years, for old mold to not have any properties, you know, that might cause someone to be allergic or asthmatic.

Matt: Okay. We have some additional questions in the queue. But I'm going to hold them until our next Q & A break so we can continue on with the presentation content. But we will get to all the questions that are in the queue. Thank you. Right.

Patrick: Great. Right now, in the second section, we'll talk about mold inspection and mold remediation. And in terms of inspections, the first issue is the qualifications of the inspector because this is...finding mold in a structure, it's not a cookie-cutter operation. It's not just a matter of taking a measurement, but it's an inspection process that is different in every building for every circumstance and needs to be tailored to each circumstance.

So, important then is the qualifications of the inspector. The inspector should have a knowledge of microbiology, indoor air quality, primarily, so that they can distinguish, you know, if a person is reporting some health effects that are inconsistent with mold or perhaps indicative of some other contaminants in the air other than mold so that they can turn their investigation elsewhere. So, other sources of air contaminants, movements in conditioning of air, how air conditioning systems function and how they malfunction, and what types of issues can cause other indoor air quality complaints.

They need to have a working knowledge of building materials and construction techniques so that they know what sort of materials might be in different spaces of a building, even though they haven't taken say, walls and ceilings apart. And they have to understand, certainly, the interpretation of sampling. And if they're going to sample, they need to understand the methodology of sampling.

In terms of documentation, the appropriate documentation of an inspection would be field notes prepared by the inspector, photograph of site conditions, which you know are absolutely valuable in many, many cases to describe the site conditions and to document what they were at the time of the inspection because of the way buildings and their environments are changed over time.

The inspection report, when one is requested, there are times when no report is...you know, where the client might not want to have a report prepared. But certainly, there are some very excellent templates out there for inspection reports. When samples are collected, it's crucial that a chain of custody be established for the sample, beginning with the collection of the sample and ending with the laboratory signing off that they've received and analyzed that sample, and of course, the laboratory report.

So, in terms of methodology of an inspection. First and often overlooked is to define the scope of work. And that is as the inspection, is it looking at a particular office in a building? Is it looking at, you know, a problem just in the basement of a house or throughout the entire house? Let's scope both in terms of the geographic and the types of issues that are under investigation. Or perhaps it was just a response to a particular event, such as flood.

Collecting background information, very important to document, to talk to somebody who's familiar with the building, when it was constructed, what kind of work has been done on, around the building, what sort of problems they've had with water infiltration. And then, to formulate hypotheses.

And these aren't necessarily written down, but they are certainly working assumptions or working guesses of what might be going wrong for the inspector that he will then use in inspection, and maybe testing, maybe sampling to evaluate those hypotheses. And then, if there's a physical inspection for mold growth, water damage, and looking at moisture dynamics, and the operation of the HVAC.

There are some industry guidelines for mold inspections. And some of these are summarized here. AIHA refers to the American Industrial Hygiene Association. They have The Indoor Air Quality Investigator's Guide. AIHA also has the Field Guide for the Determination of Biological Contaminants. This is very specific to mold inspections and mold sampling.

ACGIH stands for the American Conference of Governmental Industrial Hygienists in their Bioaerosols: Assessment and Control. And then, we have a new document by OSHA, Indoor Air Quality in Commercial & Institutional Buildings. And OSHA had considered putting out an IAQ standard several years ago, had abandoned that about 10 years ago, and now has come up with this document, which sort of summarizes how OSHA views IAQ in commercial institutional buildings.

EPA has their landmark Mold in Schools & Commercial Buildings, which has excellent guidance on how to identify or remediate mold in basically it's applicable to just about any building. And finally, a recent standard by the American Society of Testing Materials, Standard Guide for Assessment of Fungal Growth in Buildings, which gives guidelines for mold inspectors.

So, these are just some photographs illustrating some of the steps in the process: taking a history, getting familiar with buildings by looking at drawings, inspecting the exterior of the building for moisture issues, and then doing an informed inspection of the building. This is pulling back a piece of coat base where the carpet meets a wall. And the reason this was, you know, obviously, an inspection doesn't include pulling all this back in a building, but if there's an area that indicates a greater than normal amounts of moisture, this is sometimes a prudent practice to do this.

And looking behind this, what's frequently revealed or sometimes revealed on the other side of the drywall, we're looking at the painted side of the drywall here, what's seen on the other side of the drywall in what we call the wall cavity might be something like this. And, obviously, you can't, you know, an investigator can't go taking the outside off of the building, looking for this type of mold just on an initial inspection assignment. But we have surrogate measures of looking for this type of condition. Understanding that frequently what we see on the painted side of the wall is just the tip of the iceberg of what might be inside of inside of walls or ceilings.

This is an example of ceiling tiles which are great ways of, that's a really easy way of finding water stains and mold growth unless the facility operators change ceiling tiles frequently. These are moisture meters. This is a pin moisture meter which uses electrical conductivity of two pin pricks in in the wall. And the other one is a radio frequency emitter, which detects moisture in surfaces that this is placed on. It doesn't leave any marks on the surfaces.

Frequently, we need to cut holes in walls to find out what's going inside of walls. And while this is imperfect, it gives a lot more information many times that there may be or maybe some confidence that there might not be mold inside of wall cavities. And, of course, this is the bottom of an air handling unit in an apartment and this shows one example of the importance of looking inside of air conditioning systems.

So, many times when a building is flooded with clean water, such as from a sprinkler or a pipe burst, drying contractors are called in. And unfortunately, I get called in after a week or two after the drying contractor comes in many times because, sometimes the measures that are taken by the first responders are inadequate.

Now common practice when an office or home gets deluge with clean water is to suck up the water to extract the water from the carpet, to install high speed fans, dehumidifiers, and sometimes even to pull the coat base off and drill one- or two-inch holes in the bottom of walls.

In this particular case was in the headquarters of a pharmaceutical company and the contractor had even gone on every place where he had a dehumidifier had written the temperature and humidity and even the moisture content of some measurements he made of either the carpet or the wall. It wasn't clear. But he went to great lengths to do his best to dry out. And indeed, the carpet was very dry.

But when, right next to the dehumidifier, I cut a hole in the wall and examined the fiberglass inside, it was dripping wet. So this is generally, this cutting holes in walls, especially when there's any kind of insulation in the wall, is just an inadequate way of dealing with a situation. Sometimes, the mold is hidden behind structures when there's water coming from above.

This is where kitchen cabinets were removed for inspection. And yeah, there's mold growth. There was no other sign of mold growth. But this is a precautionary inspection after a water leak from the upstairs. And sometimes, inside wall cavities, we find even what we call macro-fungi growing, like we're seeing here. This is wood rot and it's seriously detracting from the structural ability of the studs that it's growing on, which means this building is no longer capable of withstanding some of the forces that might have been designed to have when it was constructed.

This is an area where a lot of mold growth is found. And this is behind vinyl wall coverings, especially when those vinyl wall coverings are on perimeter walls, the moisture can go through the bricks. I'm sorry these arrows in the wrong direction. But the moisture goes through the bricks and then through the wall cavity. It goes through the drywall, and then when it hits the vinyl layer, the moisture stops, creating a very moist environment here where any mold spores that happens have been trapped in there during construction can consume the drywall and start eating on the paste, the wall-covering paste, if you will.

So, now we'll talk about some issues regarding mold sampling. Many investigators focus their efforts on sampling. But I am here to tell you that the history and the inspections of the building are far more important than any set of samples in a building. Most or many problems can be identified and solved with few or no samples. There are a lot of investigators out there, particularly those who have less experience and some have certifications that were obtained after, say, an 8-hour course and an examination with a pass rate of 80-plus percent.

But if an investigator comes in and the first thing he does is collect mold samples, then he's probably not doing his job properly, because problems can be found with few or no samples. And in fact, sampling will identify or will suggest that there's a problem in many cases where there is none. And in many cases where there is a problem, sampling, air sampling will miss that. And I say air sampling because air sampling is clearly an area where probably the most samples are taken and the least samples are needed.

There should be a real clear reason to collect sets of air samples in buildings. And multiple outdoor samples need to be taken anytime a sample is taken indoors, Multiple outdoor samples separated by some amount of time, usually in terms of an hour or more, should be taken. And those are for comparison purposes.

But too often we see reports that are, you know, a single outdoor sample and two indoor samples. And it's just clearly not enough data to have any sort of significance. And when samples are collected, there should be a rational basis explained in the report for why those samples were collected.

These are just examples of the types of samplers that are in common use. This is called a cassette, an Air-O-Cell cassette. And air is drawn in through this tube by this pump. It impinges on a piece of, basically, adhesive tape inside of this cassette. The cassette is then taken to the laboratory and someone in the laboratory looks at the tape to count how many spores and tell what types of spores are on there. It's unable to differentiate at the species level. In fact, it can't tell the difference between Aspergillus and Penicillium, which are two of the most common molds that you will find in the air.

This is a different type of sampler. It's called an Anderson Impaction sampler. And a petri dish is placed inside of the sampling device. Again, air is pulled from a pump through this tube, air is pulled across the petri dish, spores and other fungal material impact on the gel inside the petri dish, and then that's taken to the laboratory and grown and much more information can be gleaned from this type of sample. And it is not used by the majority of people who are performing air sampling with their inspections.

And again, there are many cases, such as the mold that's growing underneath the sink, or the mold that's growing on this wall, that there's absolutely no reason to collect an air sample in a situation like this because you know that there's mold on the wall, and you know that there are mold spores in the air.

And some people will take a surface sample of this or a bulk sample of this material. But in fact, we're probably looking at 20 different species of mold growing on this wall. And unless a tremendous number of samples are taken from this wall, which would exceed the cost of remediating this wall, we really wouldn't understand all of the types of fungi that might be growing there. And all of that information doesn't really matter when it comes to cleaning up and getting the living spaces back to where they were before there was a mold problem.

And some mold inspections only find the tip of the iceberg. And what this means is that inspectors need to have sufficient humility to say, "Well, here are some things that we just don't know about what's going on." And having found a small amount of mold, we need to open up walls or ceilings or other systems and find what's lurking in the wall cavities.

And that's fine, you don't want to go and open up an entire wall during your inspection before you can have all the controls in place. Those are much more suitable to do during the remediation.

Goals of mold remediation are to isolate the area. And we do this by building plastic shells around the work area. Sometimes just by laying plastic on the floor. A lot of that depends on the amount of mold spores that may be anticipated which may be related to the to the degree of water damage or to the amount of the number of square feet of materials that are being removed. There's some great guidelines on that by the New York City Department of Health.

Also, what we see here is air blower that has HEPA filters in it that remove most of the spore-sized materials from the air. And that's used to exhaust this temporary facility and remove the spores, any spores that could be generated inside that area during remediation.

Second thing we do is we protect the workers either by disposable clothing or ensuring that clothing is laundered appropriately after use. Respiratory protection and, of course, training. These workers are using dust control method as they're cutting through this drywall. They're using a HEPA filter vacuum cleaner to suck out, to remove the dust as soon as it's generated.

This is a HEPA-type vacuum cleaner. Shop vacs do not have any place in mold remediation. Only those with HEPA filters because of with the shop vacs or other non-HEPA vacuum cleaners, more spores are likely to go out the back end of the vacuum cleaner than to be retained by the filter.

In performing remediation, one of the big questions is, you know, how are our surfaces and materials to be treated, what gets cleaned, what gets disposed. If you have a wooden surface that's got a finish on it, like a varnish or lacquer, then those can normally be wiped. If they don't have that surface and there's mold growth, then sometimes wiping will take care of the mold. Sometimes it may have to be sanded. On furniture like this, unless it's been exposed to the point of rotting, generally, it can be wiped.

But when you get to something like upholstered furniture, now we're back to the spores that have grown and the roots are into the fabric. And this would probably call for disposal, or at least, if it was of high value, treatment in a restoration facility. And frequently, we see large masses of materials that are in moldy areas. And there's always a big question about what to do with such items because, by the time you're finished let's say you know a household or several rooms have this you know the expense is significant. And the expense is significant, this is a sable coat that was that moldy in the closet and was sent away for professional restoration.

So, at the conclusion of remediation, after any drywall, carpet, ceiling tiles and the like, insulation are removed. The area is thoroughly cleaned. Surfaces are wiped. The area is thoroughly vacuumed with HEPA vacuum cleaners and restored.

And it should be understood when remediation projects are being launched, that the scope of the remediation project will often grow. It's not until you get in and start opening up walls, sometimes, that the full extent of the damage is understood. And finally, we have the clearance aspect of remediation. There are those who advocate that sampling must be done at the end of every remediation project.

I personally don't believe that's the case. I believe that the project should be inspected thoroughly to make sure that the objectives of removing all moldy materials and removing settled dusts are achieved and then the project is complete and the property can be restored and reoccupied.

And Matt, I'll turn it back over to you.

Matt: Hey, thank you so much, Patrick. We have a whole host of questions here in the queue. So, we're gonna get back to the ones that were left from the last Q & A session. Just a follow-up question that Dwight asked, he was wondering, "Does mold produce mycotoxins?"

Patrick: Some molds will produce mycotoxins. And history has shown us that when these are ingested, such as when poisonous mushrooms are eaten, that people can become ill. However, there is inadequate evidence to demonstrate that the levels of a person might be exposed to when exposed to breathing, inhaling the air near mold is growing and perhaps producing mycotoxins is sufficient to cause them harm.

Matt: Okay. Great. We have a question here from Bert who asked, "How do you accurately measure the concentration in air and all the premises?"

Patrick: Well, I did address air sampling in some detail. What's important to realize is that there is a tremendous variation from one minute to the next, one hour to the next in spore concentrations in outdoors. And that that affects the indoor environments as well. So, if you really need to understand what the air concentrations indoors are, then, you know, multiple samples need to be taken both indoors and outdoors. [Inaudible 00:52:42]

Matt: Okay. Great. We have a question here Dwight West, "When mold spores are found in an inspection, what are the essential steps or procedure to discover the source of the spores within the building, office or suite? How do you track down the source of the spores?"

Patrick: Okay. The source of the spores is really immaterial. Spores, as I mentioned, spores are ubiquitous. And so, every bit of air that comes into the facility, you know, when you open the door and walk in the front door contain spores. Those spores land on surfaces.

The important thing is not where the spore is coming. But where is the water coming from? And that's another one of the goals of a remediation project is to expose the wet material sufficiently so that the water source can be understood and the draft. So, it's really the source of the water that is at issue, not the source of the mold.

Matt: Great. We have a question here from Carolyn who asked, "Going back to one of the first slides of the second part of the presentation, you listed a whole host of resources for research. What are some good sources to research toxic mold syndrome?"

Patrick: I would have to say that toxic mold syndrome is something that should be googled. That's not a one of the illnesses that was found to be associated or caused by exposure to mold by the Institute of Medicine. So, that's kind of outside of the body of illnesses that are associated with exposure to mold growth as accepted by the Institute of Medicine.

Matt: Okay, excellent. We have a question here from Gwyneth West, "What if while removing the walls and floors due to mold, an old well was found under the floor, could that have contributed to the contamination?"

Patrick: An old well would certainly have contributed to... You know, if it were open to porous building materials such as wood or drywall it would have definitely contributed to the moisture. And it's really the moisture that will drive mold growth in a building. So, an old well would be a source of the moisture. As I mentioned, settled spores are on every surface almost on the entire planet. And given enough moisture and some food to grow, they will. So, yes, they will have very easily been the source of the problem there.

Matt: Okay. We have a question here from Burke, "Is there any way that I can get a copy of the sufficient evidence with for the connection between mold and illness?" Is there any research out there that the Burke can tap into to make that connection?

Patrick: Yes, if you get a copy of the Institute of Medicine's report called Damp Indoor Spaces and Health. If you go to my website, which is at the bottom of the page, it's showing right now. One of my pages is called Microbiological Resources or Mold Resources. And there's a link to the Institute of Medicine's report there. You can download the PDF at the IOM site.

Matt: And we'll send that link out as part of the follow up email that you'll get tomorrow morning that will have the link to the archived recording and the PowerPoint slides as well. We have another question here from Burke, and maybe [inaudible 00:56:44], but I'll let you decide that, "What are the statutes orders or rules that apply to mold risk?"

Patrick: I'm afraid that's a legal question. And I don't feel comfortable answering that.

Matt: Okay. You know, totally understood. Another question here, "Can you infrared cameras find mold inside walls?"

Patrick: Well, infrared cameras are used by some investigators to find, well, to look for places where mold might be growing. And there are some cases where these cameras are very helpful. They're not finding mold. What they're finding is different temperatures. They're looking for temperature aberrations in walls, on the surface of the wall.

So, you take a picture with one of these cameras of the, say, the exterior wall of your building. And if in the upper left-hand corner, it looks, it appears to be colder than the rest of the wall, that might be an area where water is getting into that wall system. And so, it has a different temperature profile than the rest of the wall.

Unfortunately, there are a lot of cases where this is not useful. And there are a lot of false positives with this as well. It's very good at finding cold plates and air conditioning ducts and that sort of thing, which are frequently mistaken for areas of water intrusion and mold growth.

Matt: Okay. We have two final questions for you. The first is from Caroline, "Does mold have to be actively growing?" Oh, sorry. We already asked that one. This one is from James who asked, "Given as some people have allergies or other reactions to mold, and that other people do not have, can you say that some mold can be tolerated by some people? Or is it better to get rid of or avoid all mold no matter who you are and what your reaction may be?"

Patrick: Well, I think both are true. Some people are very tolerant of mold, and it doesn't bother them a bit. That being said, it is wise and it is recommended to deal with mold growths on building structures for a variety of reasons, including, you know, what might be going on inside the walls in terms of deterioration of building systems and in terms of the health of other people, whether it be visitors or the next occupants of an apartment or people on the other side of the wall. It's a good idea to take care of mold growth. It's recommended.

Matt: Okay. Now, we have two questions. I apologize to Carolyn. I saw another question. I will get to yours. This one is from Karen who asked, "I have a client who suffered from mold infestation in school. He became very ill. Can mold cause neurological damage?"

Patrick: According to the Institute of Medicine report and a table that I showed, neurological and psychiatric issues are in the category of insufficient evidence to demonstrate an association. So, that's in the category of we really don't have enough information to say that there's an association there.

Matt: Okay. We'll end the question-and-answer session with Carolyn's question and that's, "Is symptoms of mold toxicity overlap with the symptoms of other conditions? How does one differentiate between the two?"

Patrick: Yeah. There's a tremendous overlap between the symptoms of exposure to mold in certain people and to other issues. And some of the associations drawn by the Institute of Medicine include cough and wheezing, which could be caused by, you know, an asthmatic or allergic reaction to mold. But also could be related to asthma triggered by something completely different. Or it could be the common cold, bronchitis or pneumonia.

So, there's tremendous overlap in the symptoms. And I don't believe that there's other than with the invasive Aspergillosis that we talked about, I'm not sure that there's a single symptom out there that would be characteristic of mold illness.

Matt: Okay, great. Thank you so much, Patrick. We're now going to conclude the presentation. It's minute past three. And I know that many have other things that they need to get to.

First of all, I'd like to thank Patrick. Patrick, you put together a great presentation for us, very informative. And I think you can tell by the amount of questions that it did spark a lot of inquiry. So, thank you so much for a great presentation.

I'd also like to thank those who took a time out of their day to spend with us. We know that your time is valuable. And we do appreciate you spending some time with us this afternoon. As I said, thank you.

If you'd like to speak to Patrick about a case or a project that you're working on, you can contact us here at TASA. Our telephone number is (800) 523-2319. I will be sending out the link to the archived recording of this webinar tomorrow morning. We'll also include the PowerPoint presentation, and the link that Patrick discussed in one of his answers.

The archived recording of this webinar, as well as all the other TASA webinars are can be found in the TASA Knowledge Center. Go to the TASA homepage, tasanet.com and top-level navigation Knowledge Center, you'll see a link for our webinars.

If you have any follow-up questions or comments, you can email me at mhyde@tasanet.com. I'll get back to you as soon as I can. We hope to see you at future events. You'll be receiving an email 3:30 this afternoon thanking you are attending. It'll have some very basic follow-up information. And then, as I said, I'll send a detailed email tomorrow morning, probably by 10 AM, with a link to the archived recording and the PowerPoint presentation.

Thank you so much for your time and I'm now going to end the meeting.

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