Remediation and Prevention

Part 6: Mould Remediation and Prevention

6.1 What is mould remediation?

Mould remediation is the technique of stopping moisture intrusion to a building, removing water damaged building materials and removing mould spores, mould fragments, bacteria and biotoxins so a building is safe enough for those with CIRS to enter without relapsing.

6.2 Can you do mould remediation yourself (DIY)?

The answer is “it depends”. It depends on how much water damage there is and how high the HERTSMI-2 score is. It may be possible to do remediation either partly or fully with the caveat that it should not be done by the CIRS patient personally, they should ideally not be in the home at the time of cleaning, as it can cause mould to become airborne. The main method used is the HEPA sandwich technique. This involves HEPA vacuuming all surfaces: floors, walls, ceilings, wardrobes, cupboards and all non-porous furniture. Then washing all surfaces with a solution such as vinegar (80% vinegar/20% water), or Napisan. Finally HEPA vacuum all surfaces again. Alongside washing all clothes, curtains and removable fabrics. One TMSA member reduced his HERTSMI from 22 to 0 using such a method. Your mileage may vary however.

This is primarily going to have benefit when your ERMI report shows moderate water saturation moulds such as Aspergillis penicilloides, Aspergillis versicolor and Wallemia sebi. If there is an excess of other species, particularly Stachybotrys and Chaematomium which indicate higher water saturation and possible ongoing water ingress in the house, the services of a professional remediator may be needed. In uncertain cases it is recommended to consult experts such as mycologists or indoor environmental professionals  on the best way to proceed with remediating a property.

6.3 What about professional remediation?

If there is major water damage, the source of a leak is difficult to find or there are structural problems you will most likely need a professional remediator.  See the resources section for possible remediators.

6.4 How do you know if remediation has been successful?

Whatever method you use the ERMI/HERTSMI is again your best tool to check to see if the remediation was successful. You will need to wait four weeks after remediation to repeat an ERMI to allow time for mould DNA to settle in the dust.

6.5 Areas of concern for water damage

Outside – The best location for a house is on the top of a hill so water drains away and doesn’t pool. Consider the drainage of the block and placement of plants and trees. Check guttering and drains. Make sure weatherproofing (flashing) of windows and chimneys is adequate.
Basement/Garage –
Basements are notorious for damp. Look for rising damp. Some have a dehumidifier on 24/7 in these areas.
Roof – Flat roof buildings will develop water leaks sooner or later, avoid. Look for leaks in all roofs, especially in old roofs and cement tile roofs which can be porous in little as 9 years (David Lark). USB data loggers can be used to detect high humidity levels in crawlspaces under roofs.
Attic/crawlspaces – Check for leaks coming from the roof and walls. Also for humidity and condensation in these areas.
Airflow –
Draughty buildings are often mould free. Consider ceiling fans and desktop fans, good exhaust fans in bathroom and kitchen and opening of windows as much as possible.
Air conditioners – Due to condensation can be mould havens. Check inside also piping.
Kitchen –
Around and under sink for water leaks and water splashing. Sinks are often not properly attached to bench allowing leaks to the particleboard below. Piping can develop pin hole leaks, especially plastic piping, in less than a decade from new. Check dishwasher inside (use vinegar in a wash) and pipes for leaks.
Bathroom –
Dehumidifiers and fans are useful tools here. Squidgy showers after use. Mould growth in grouting is a common problem. Aim for good ventilation.
Bedroom –
Try to make clutter free with nothing under the bed, that is slatted, to help airflow. Open wardrobe doors for airflow.
Furniture – Non-porous (leather, vinyl) can usually be cleaned and HEPA vacuumed. Porous furniture usually needs to be trashed after water damage.
Books/paper/photos –
Photos can be cleaned. Scan and throw away books and paper documents or put in storage.
Carpets –
These act as reservoirs for mould, bacteria and dust mites. If water damaged they generally need to be thrown out. If cleaned use a fast drying steam cleaning (e.g. Chemdry).
Clothes –
Can be washed with normal washing powder and then dried in sun. Some people have used borax and/or vinegar or clove oil.
Bedding – Mattresses, pillows and quilts are notorious for mould, bacteria and dust mites. Use a whole mattress protector around mattresses. Wash and air in sun blankets, sheets and quilts.
Fridges/washing machines – Notorious for low-level leaks. Should be moved and the underside and back areas thoroughly inspected. In one particularly bad case of water damage in Australia, the culprit was a water pipe to a fridge which had been gnawed by a rodent of some kind. 

6.6 Dehumidifiers

Mould and dust mites grow in relative humidity of 60% and over. Coastal Australia is renowned for having very high humidity levels so dehumidifiers can be a tool in keep household humidity at low levels, especially in damp areas such as the basement and bathroom. See Choice for a review of dehumidifiers from 2015.

6.7 Air purifiers

The role of air purifiers in cleaning air of mould spores and mycotoxins is controversial. At the minimum a filter should be HEPA rated to filter spores with the addition of generous amounts of activated carbon to filter toxins. However it is possible for the air purifiers themselves to be become reservoirs for mould and bacterial growth. If you decide to implement air purifiers regular HEPA vacuuming and regular replacement of filters is recommended. Dr. Shoemaker recommends two small purifiers in a room that are moved daily rather than one large for optimal airflow. Brands some of members have used include IQAir (USA), InnovaAir (Aus) and Blueair (Sweden).

Dr. Shoemaker is currently testing a specific brand of photocatalytic air purifier while monitoring inflammatory blood markers in a patient cohort.

Part 7: Conclusion

While CIRS, biotoxins and Dr. Shoemaker’s protocol are a relatively new concept in healthcare and may initially seem daunting the science is extremely solid and growing each year. It is backed by over 30 papers and Shoemaker’s own clinical practice of 10,000 CIRS patients, four books over almost twenty years. Feel free to ask any remaining questions you might have on the facebook group and join in the discussion. Australian mould warriors unite!

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