Chronic Inflammatory Response Syndrome (CIRS). For some individuals this is a familiar term.
CIRS is a response certain individuals have to exposures of toxins, antigens, and inflammagens found in the interior environment of Water Damaged Buildings (WDB). WDB are loosely defined as any building/structure that has experienced a previous or current water intrusion. Roof leaks, plumbing leaks, floods, and overflows are just a few examples. In many of those cases, there is the potential for microbial growth to occur. And this growth presents a potentially hazardous indoor environment if left unaddressed.
Presented at the CIRS, Mold, and Wet Buildings Conference in November of 2015, a group of medical professionals released their official Medical Consensus Statement (MCS), Medically sound investigation and remediation of water-damaged buildings in cases of CIRS-WDB.
Abstract taken directly from the MCS
Evidence supports a cause-effect relationship between exposure to the air and dust in water-damaged buildings (WDBs) and a chronic inflammatory response syndrome (CIRS) that is linked to certain HLA genotypes. CIRS-WDB is mediated by an over-reactive innate immune response to the toxins, antigens, and inflammagens found in the interior environment of WDBs. Dose-response relationships in this condition are neither linear nor threshold in nature because the immune response depends on defective variables in the susceptible human host. For patients with CIRS, current methods of WDB investigation and remediation are often not sufficient to prevent a relapse of symptoms with re-exposure. CIRS-WDB is a growing public health hazard best addressed by a team of experts in construction, indoor air quality and remediation, working together with medical care providers with specialized training in CIRS-WDB to develop a collaborative plan that ensures ongoing safe habitation. Assessments of human health effects before and after remediation are mandatory to ensure adequacy of remediation efforts1.
Environmental Analytics (EA) has helped hundreds of CIRS patients across the country. EA’s knowledge CIRS, and the advanced testing methods and approaches used to assess buildings to determine whether they are truly WDB, has helped make EA a leader in this unique field.
EA has a comprehensive and in-depth understanding of the various types of ERMI2 and HERTSMI-2 (a derivative of the ERMI method created by Dr. Ritchie Shoemaker) sampling using Quantitative Polymerase Chain Reaction (QPCR)3 to analyze the samples. Beyond the analysis method/s is the interpretation of the field data collected; beyond the ERMI/HERTSMI-2 scores. EA offers a forensic look at the data to help determine whether the likely source of potential mold growth and/or mold contamination is coming from an inside source, or an outdoor. This involves much more than simply looking at the scores (although the scores are helpful and in some situations is all the client needs), it involves a thorough understanding of the applicable building science fundamentals (Learn more here: https://buildingscience.com/), combined with an ability to detect problem areas in the building that other “professionals” might overlook or simply ignore.
The ability to interpret this data has a significant effect on the decisions patients will make involving remediation and environmental-cleaning efforts to their home, and even steps to help prevent the entry of unwanted contaminants in their home in the first place!
If you are feeling lost or are looking for help out of a seemingly endless struggle, please contact us.
Sara Gottfried MD, a client of Environmental Analytics, spent time with Michael Schrantz learning more about the subject of CIRS-WDB. Part of that learning involved the approach of Indoor Environmental Professionals to clients and water-damaged buildings that focuses on key questions such as: is there a “mold problem?” Take a look at three of her videos sharing her new insights with all of us.
- MOLD 101 Discussion with Dr. Sara Gottfried
- Dr. Sara’s Quick Mold Tip: Drop the Cheese!
- Symptoms of Mold Sensitivity (with Dr. Sara Gottfried)
Please check out this podcast to learn more about the following:
- 4:16 What industrial hygienists do
- 8:35 Common myths about testing for mold
- 20:02 Chris’ personal experience with mold
- 46:02 Where to start if your house needs inspecting
RHR: How To Test Your Home for Mold, with Mike Schrantz
If you or someone you know feels they may be affected by CIRS, EA recommends contacting a Shoemaker Protocol Certified (SPC) physician by visiting:
Dr. Mary Ackerley is a local SPC physician in the Tucson, Arizona area. You learn more about Dr. Ackerley by visiting the following sites:
- Berndston, Keith, Scott McMahon, Mary Ackerley, Sonia Rapaport, Sandeep Gupta, Ritchie Shoemaker. Medically sound investigation and remediation of water-damaged buildings in cases of CIRS-WDB. Medical Consensus Statement presented at the CIRS, Mold, and Wet Buildings Conference. 2015: Nov 18-22.
- Lin, King-Teh, and Ritchie Shoemaker MD. Inside Indoor Air Quality:Environmental Relative Moldiness Index (ERMI) (http://www.mycometrics.com/articles/ERMI_Lin_Shoemaker.pdf) Monmouth Junction: www.filtnews.com, 2007. Online PDF.
- Mycometrics.com,. “Mycometrics: From Research To Diagnostics”. N.p., 2016. Web. 17 Feb. 2016.