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Summer 2009 CDC Asthma Program Focuses on Air Pollution’s Effect on Asthmatics A New Approach to Mold in Our Homes Getting What You Need from the Medicare Prescription Drug Plan AARC Member Tudy Giordano Helps Troops Stay Connected to Their Kids
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 A New Approach to Mold in Our Homes by Carolyn M. Kercsmar, MD, and Dorr Dearborn, MD, PhD The Institute of Medicine confirmed that molds can cause asthma symptoms. Every home contains some mold, but what is too much mold exposure for asthmatic children? As you probably guessed, there is no simple answer to this question. However, a new approach, developed recently, just might help. The first step involves a better mold analysis called the Environmental Relative Moldiness Index, or ERMI for short. The ERMI analysis allows any home to be tested for mold content and the result compared to those obtained from a random sampling of U.S. homes conducted by the Department of Housing and Urban Development. The ERMI values for the 1100 survey homes were assembled from lowest to highest mold content to create a scale which ranges from about 10 to 20 or higher (Figure). The higher the ERMI value, the greater the mold contamination in the home. So how does ERMI work? The unique DNA “fingerprint” of each mold gives the ERMI its accuracy and objectivity. Add to that a simple, standardized sampling procedure and the ERMI becomes a powerful tool. To determine the ERMI value in a home, dust from the living room and child’s bedroom is collected by an inspector with a small filter device that fits on the end of a vacuum cleaner hose. The dust can be collected in about 15 minutes and then sent to a commercial laboratory for analysis. The report you will receive from the laboratory, in as little as 24 to 48 hours, will provide the ERMI value for the home as well as a detailed listing of the results for the 36 molds that make up the ERMI. The commercial laboratory as well as your inspector can help you to understand the ERMI. Let’s look at couple of examples.
Let’s say the ERMI is 15. If you go to the ERMI scale (see Figure) and look for where a 15 falls, you will see that this ERMI places the home in the top quarter of homes for mold contamination. On the other hand, let’s say the ERMI value is 2. This ERMI value places the home in the second quarter, with relatively low mold contamination. Studies of children with asthma have demonstrated that higher ERMI values are associated with increased likelihood of asthma problems for the children living in these mold-contaminated homes. The second part of this new approach to mold is the targeted removal of the moisture and mold from asthmatics’ homes. When this was done in a study conducted in mold-damaged homes in Cleveland, we measured a 10-fold reduction in the need of the asthmatic children for either emergency room visits or hospitalizations. The average cost for the remediation was about $3,000, with a range of $500-$6,500. Using the ERMI to measure the mold problem, when combined with mold removal when the ERMI is high, offers the possibility of significant improvement in the asthmatic child’s condition. Remember that mold is just one of many triggers for asthma, so your child may not see these same benefits from the ERMI analysis and home remediation that we saw. Always consult your primary care doctor or asthma specialist for help in managing difficult to control asthma symptoms. However, this new approach to evaluating and eliminating mold in our homes may help some of the millions of asthmatic children avoid asthma symptoms and trips to the emergency room. Carolyn M. Kercsmar, MD, and Dorr Dearborn, MD, PhD, work at Cincinnati Children’s Hospital Medical Center in Cincinnati, OH, and Case Western Reserve University School of Medicine in Cleveland. 
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