Environmental Relative Moldiness Index Values Research Articles

Higher mold levels found in in the deteriorated housing in the Sun Valley neighborhood of Denver, Colorado compared to other Denver housing and higher rates of health insurance claims for some diseases documented for the Sun Valley residents compared to other Denver residents.

The Sun Valley Homes public housing in Denver, Colorado (CO) will be replaced because of its deteriorated condition. Our goal was to document the mold contamination and particulate matter (PM2.5) concentrations in Sun Valley homes and the circulatory and respiratory health of Sun Valley compared to all Denver residents (total 2761 and 1,049,046, respectively) based on insurance claims data for 2015 to 2019. Mold contamination in Sun Valley homes (n=49) was quantified using the Environmental Relative Moldiness Index (ERMI) scale. Indoor PM2.5 concentrations were measured in Sun Valley homes (n=11) using time-integrated, filter-based samples and quantified using gravimetric analysis. Outdoor PM2.5 concentrations data were obtained from a near-by United States Environmental Protection Agency monitoring station. In Sun Valley homes, the average ERMI value was 5.25 compared to -1.25 for other Denver homes. The PM2.5 median concentration inside Sun Valley homes was 7.6μg/m3 (interquartile range - 6.4μg/m3). The ratio of indoor to outdoor concentrations of PM2.5 was 2.3 (interquartile range - 1.5). In the last five years, ischemic heart disease was significantly more likely for Denver compared to Sun Valley residents. However, acute upper respiratory infections, chronic lower respiratory diseases and asthma were all significantly more likely for Sun Valley than Denver residents. Since the process of replacing and occupying the new housing will take several years, the next phase of the study will not occur until that process is complete.

Association of Mold Levels in Urban Children’s Homes With Difficult-to-control Asthma

To assess the association of overall and specific mold levels in homes of urban children and difficult-to-control asthma.The study included 265 children from the Asthma Phenotypes in the Inner-City (APIC) study, aged 6 to 17 years old with asthma, and living in 8 urban cities across the United States. The study used 265 frozen-dust samples previously collected from the homes of APIC study-enrolled participants for analysis of mold concentrations. Although a total of 465 samples were collected during the APIC study, only the 265 samples that remained were used for post hoc analysis.The study was a cross-sectional analysis of 2 asthma cohorts: children with either difficult-to-control (DTC) and easy-to-control (ETC) asthma. DTC asthma participants required daily therapy of greater than or equal to 500 mcg fluticasone (with or without a long-acting β-agonist), and ETC asthma participants required less than or equal to 100 mcg fluticasone. Quantitative polymerase chain reaction assays were performed on frozen-dust samples that were obtained by wiping above-floor surfaces in participants’ homes using a Swiffer cloth (Procter and Gamble, Cincinnati, Ohio). The Environmental Relative Moldiness Index (ERMI) metric was used to classify mold species into 2 groups: group 1 (26 molds indicative of water damage in the home) and group 2 (10 molds commonly found indoors, even in homes without water damage). Average ERMI values and average concentrations of each of the 36 molds were compared in homes of children with DTC versus ETC asthma.No significant differences were found in average ERMI or average mold concentrations between homes of children with DTC asthma and ETC asthma. Mucor was the only mold with significantly greater average concentration in homes of children with DTC versus ETC asthma (average of 295 vs 67 cell equivalents per mg dust, P < .001). In homes with window air-conditioning (AC) units, the study found that Mucor concentration increased the probability of having DTC asthma (22% increase; 1.6 odds ratio) compared with ETC asthma.This study found that Mucor concentration is a predictor of DTC asthma, and homes with window AC units were more likely to have higher Mucor levels.Previous studies have shown an association between mold exposures and asthma. This study found that Mucor exposure in urban homes is associated with DTC asthma in a pediatric cohort with high geographic representation. Additionally, the study showed the association between elevated Mucor concentration, window AC units in urban homes, and the probability of DTC asthma. Further studies are needed to assess the role of decreasing home Mucor levels in reducing DTC asthma.URL: www.pediatrics.org/cgi/doi/10.1542/peds.10.1016/j.jaci.2021.07.047

HEPA filtration intervention in classrooms may improve some students’ asthma

Objective The School Inner-City Asthma Intervention Study 2 (SICAS 2) tested interventions to reduce exposures in classrooms of students with asthma. The objective of this post-hoc analysis was limited to evaluating the effect of high-efficiency particulate (HEPA) filtration interventions on mold levels as quantified using the Environmental Relative Moldiness Index (ERMI) and the possible improvement in the students’ asthma, as quantified by spirometry testing. Methods Pre-intervention dust samples were collected at the beginning of the school year from classrooms and corresponding homes of students with asthma (n = 150). Follow-up dust samples were collected in the classrooms at the end of the HEPA or Sham intervention. For each dust sample, ERMI values and the Group 1 and Group 2 mold levels (components of the ERMI metric) were quantified. In addition, each student’s lung function was evaluated by spirometry testing, specifically the percentage predicted forced expiratory volume at 1 sec (FEV1%), before and at the end of the intervention. Results For those students with a higher Group 1 mold level in their pre-intervention classroom than home (n = 94), the FEV1% results for those students was significantly (p < 0.05) inversely correlated with the Group 1 level in their classrooms. After the HEPA intervention, the average Group 1 and ERMI values were significantly lowered, and the average FEV1% test results significantly increased by an average of 4.22% for students in HEPA compared to Sham classrooms. Conclusions HEPA intervention in classrooms reduced Group 1 and ERMI values, which corresponded to improvements in the students’ FEV1% test results.

Asthma Prevalence and Mold Levels in US Northeastern Schools

Asthma is among the most common chronic diseases of children in the United States (US). Mold exposures have been linked to asthma development and exacerbation. In homes, mold exposures have been quantified using the Environmental Relative Moldiness Index (ERMI) and higher home ERMI values have been linked to occupant asthma. In this analysis of the School Inner-City Asthma Study 2 (SICAS 2), we aimed to evaluate the ERMI’s applicability to measuring mold in schools compared to homes, to assess the relationship between the prevalence of asthma in schools and mold levels, and to examine the prevalence of asthma in relationship to students’ demographics and the physical characteristics of school-buildings. Northeastern US schools (n=32) and homes (n=33) were selected and the 36-ERMI molds were quantified in a dust sample from each classroom or home. School building characteristics, student demographics and asthma prevalence data were collected from the SICAS 2 study or obtained from government websites. Linear regression and mixed models were fit to assess the association of current asthma prevalence and physical characteristics of the school, make-up of the student body and the ERMI metric. Levels of outdoor Group 2 molds were significantly (p<0.01) greater in schools compared to homes and higher Group 2 levels in schools were linked to higher asthma prevalence for their students. The presence of AC in school buildings correlated significantly (p=0.02) with lower asthma prevalence. Higher mold levels in northeastern US schools were associated with an increase in students’ asthma.

The Environmental Relative Moldiness Index reveals changes in mold contamination in United States homes over time

The Environmental Relative Moldiness Index (ERMI) is a scale created to compare mold contamination levels in U.S. homes. The ERMI was developed as a result of the Department of Housing and Urban Development’s (HUD) first American Healthy Homes Survey (AHHS I), which sampled 1,096 homes selected to be representative of the U.S. housing stock. In AHHS I, a dust sample from each home was analyzed using quantitative PCR assays (qPCR) for 36 common indoor molds: 26 Group 1 molds, which were associated with water damage in homes and 10 Group 2 molds, which primarily enter the home from the outside environment. In 2019, HUD completed AHHS II by sampling 695 homes. Because lead was banned from paint in 1978, a larger proportion of homes selected for AHHS II had been built before 1978 compared to AHHS I. The 36 ERMI molds were analyzed in AHHS II exactly as in AHHS I. For the 36-ERMI molds, the rates of detection, average concentrations, and geometric means were in significant concordance (p < 0.001) between AHHS I and II, indicating that the ERMI methodology was stable over time. However, the average ERMI value in AHHS II homes was greater than in AHHS I. The reason for the difference was investigated by examining the Group 1 and 2 mold populations. The average summed logs of Group 1 molds were significantly greater in homes built before 1978 than the average for homes built later. Conversely, the average summed logs of Group 2 mold populations were the same in homes built before 1978 and homes built later. Since the summed logs of Group 2 mold is subtracted from the summed logs of Group 1 molds in the ERMI calculation, the average ERMI value was higher in AHHS II homes than AHHS I. In conclusion, by using the ERMI metric, we were able to demonstrate that water damage and mold growth were more likely to occur as homes get older.

Asthma Prevalence and Mold Levels in US Northeastern Schools

Asthma is among the most common chronic diseases of children in the United States (US). Mold exposures have been linked to asthma development and exacerbation. In homes, mold exposures have been quantified using the Environmental Relative Moldiness Index (ERMI), and higher home ERMI values have been linked to occupant asthma. In this analysis of the School Inner-City Asthma Study (SICAS), we aimed to evaluate the ERMI's applicability to measuring mold in schools compared with homes and to examine the prevalence of asthma in relationship to students' demographics and the physical characteristics of school buildings. Northeastern US schools (n = 32) and homes (n = 33) were selected, and the 36 ERMI molds were quantified in a dust sample from each classroom (n = 114) or home. School building characteristics data were collected from SICAS. Asthma prevalence and student demographics data were obtained from government websites. Linear regression and mixed models were fit to assess the association of the current asthma prevalence and physical characteristics of the school, make-up of the student body, and the ERMI metric. Levels of outdoor group 2 molds were significantly (P < .01) greater in schools compared with homes. The presence of air-conditioning in school buildings correlated significantly (P = .02) with lower asthma prevalence. The prevalence of asthma in student bodies is associated with many factors in schools and homes.

Establishment and Application of an Environmental Relative Moldiness Index for Dwellings in Korea

This study aimed to develop a Korean version of the Environmental Relative Moldiness Index based on the specific distribution of fungal flora in Korea. A total of 126 dwellings were selected for mold sampling, and each was classified as, Flooded, Water leaks/condensation, or Non water-damaged. Dust on floors was sampled using a vacuum cleaner with a Dustream collector and analyzed by quantitative polymerase chain reaction for 36 types of molds included in the Environmental Relative Moldiness Index. The Environmental Relative Moldiness Index value was found to be 19.6 (-6.9–58.8) for flooded houses, 7.5 (-29.2–48.3) for water-damaged houses with leaks/condensation, and 0.8 (-29.2–37.9) for non-damaged dwellings. Significant differences were observed between flooded and non-water damaged dwellings (p<0.001) and between water-damaged and non-water damaged dwellings (p<0.032). The Korean Environmental Relative Moldiness Index consisted of 16 fungal species, which are very similar to those normally found in the Environmental Relative Moldiness Index in Korea (p=0.834). These findings indicate that Environmental Relative Moldiness Index values attributed to dust samples in Korea could be utilized for identification of flooded or water-damaged buildings. The Korean Environmental Relative Moldiness Index could also be a promising tool for inexpensive assessment of long-term fungal exposure in Korean dwellings.

Asthma Risk Associated with Indoor Mold Contamination in Hispanic Communities in Eastern Coachella Valley, California.

Indoor mold contamination has been associated in many studies with an increased risk of asthma and respiratory illness. This study investigated indoor mold contamination and the prevalence of asthma/respiratory illness in two low-income, Hispanic communities, Mecca and Coachella City, in the Eastern Coachella Valley (ECV) of California. The study consisted of a questionnaire to assess asthma/respiratory illness and the quantification of mold contamination in house dust samples using the Environmental Relative Moldiness Index (ERMI) scale. About 11% of the adults and 17% of the children in both Mecca and Coachella City met our definitions of asthma/respiratory illness. The average ERMI values in Mecca and Coachella City housing (10.3 and 6.0, respectively) are in the top 25% of ERMI values for the United States (US) homes. Overall, the homes surveyed in these ECV communities had an average prevalence of occupant asthma of 12.8% and an average ERMI value of 9.0. The prevalence of asthma/respiratory illness in the Hispanic communities of Mecca and Coachella City and the mold contamination in their homes appear to be greater than the averages for the rest of the US. The higher levels of mold contamination in their homes appear to be associated with a greater risk of asthma/respiratory illness for these low-income, Hispanic communities.

Quantification of mold contamination in multi-level buildings using the Environmental Relative Moldiness Index

ABSTRACTThe goal of this study was to evaluate the possible use of the Environmental Relative Moldiness Index (ERMI) to quantify mold contamination in multi-level, office buildings. Settled-dust samples were collected in multi-level, office buildings and the ERMI value for each sample determined. In the first study, a comparison was made between two identical four-story buildings. There were health complaints in one building but none in the other building. In the second study, mold contamination was evaluated on levels 6–19 of an office building with a history of water problems and health complaints. In the first study, the average ERMI value in the building with health complaints was 5.33 which was significantly greater than the average ERMI value, 0.55, in the non-complaint building. In the second study, the average ERMI values ranged from a low of −0.58 on level 8 to a high of 5.66 on level 17, one of the top five ranked levels for medical symptoms or medication use. The mold populations of ten (six Group 1 and four Group 2) of the 36-ERMI molds were in significantly greater concentrations in the higher compared to lower ERMI environments. The ERMI metric may be useful in the quantification of water-damage and mold growth in multi-level buildings.

Comparison of Mold Populations in Water-Damaged Homes in Australia and theUnited States

The goal of this study was to examine whether the Environmental Relative Moldiness Index (ERMI) scale created for United States (U.S.) homes was applicable in the assessment of mold contamination for Australian homes. Settled-dust samples were collected in south-eastern Australian homes (n=76) being investigated for possible water-damage and mold contamination. The 36 ERMI molds were quantified in each sample using mold specific quantitative PCR (MSQPCR) and the ERMI value for each home calculated. These homes were then matched to homes in the U.S. with nearly identical ERMI values and the average log10 concentration of each of the 36 molds statistically compared. Most of the 36 ERMI molds were found in Australian water-damaged homes in comparable concentrations to ERMI-matched U.S. homes. The U.S. ERMI scale might provide reasonable estimates of mold contamination in water-damaged Australian homes.

Comparison of indoor air sampling and dust collection methods for fungal exposure assessment using quantitative PCR.

Evaluating fungal contamination indoors is complicated because of the many different sampling methods utilized. In this study, fungal contamination was evaluated using five sampling methods and four matrices for results. The five sampling methods were a 48 hour indoor air sample collected with a Button™ inhalable aerosol sampler and four types of dust samples: a vacuumed floor dust sample, newly settled dust collected for four weeks onto two types of electrostatic dust cloths (EDCs) in trays, and a wipe sample of dust from above floor surfaces. The samples were obtained in the bedrooms of asthmatic children (n = 14). Quantitative polymerase chain reaction (qPCR) was used to analyze the dust and air samples for the 36 fungal species that make up the Environmental Relative Moldiness Index (ERMI). The results from the samples were compared by four matrices: total concentration of fungal cells, concentration of fungal species associated with indoor environments, concentration of fungal species associated with outdoor environments, and ERMI values (or ERMI-like values for air samples). The ERMI values for the dust samples and the ERMI-like values for the 48 hour air samples were not significantly different. The total cell concentrations of the 36 species obtained with the four dust collection methods correlated significantly (r = 0.64-0.79, p < 0.05), with the exception of the vacuumed floor dust and newly settled dust. In addition, fungal cell concentrations of indoor associated species correlated well between all four dust sampling methods (r = 0.68-0.86, p < 0.01). No correlation was found between the fungal concentrations in the air and dust samples primarily because of differences in concentrations of Cladosporium cladosporioides Type 1 and Epicoccum nigrum. A representative type of dust sample and a 48 hour air sample might both provide useful information about fungal exposures.

Use of Medicaid and housing data may help target areas of high asthma prevalence

ABSTRACTObjective: To determine if there was a significant difference between mold contamination and asthma prevalence in Detroit and non-Detroit Michigan homes, between newer and older homes, and if there is a correlation between mold contamination and measures of Medicaid use for asthma in the 25 Detroit zip codes. Methods: Settled dust was collected from homes (n = 113) of Detroit asthmatic children and from a representative group of Michigan homes (n = 43). The mold contamination for each home was measured using the Environmental Relative Moldiness Index (ERMI) scale and the mean ERMI values in Detroit and non-Detroit homes were statistically compared. Michigan Medicaid data (13 measures related to asthma) in each of the 25 zip codes in Detroit were tested for correlation to ERMI values for homes in those zip codes. Results: The mean ERMI value (14.5 ± 8.0) for Detroit asthmatic childrens' homes was significantly (Student's t-test, p < 0.001) greater than the mean ERMI value (2.1 ± 6.2) for the non-Detroit homes. Detroit homes > 60 years old had significantly (p = 0.01) greater mean ERMI values than Detroit homes ≤ 60 years old (15.87 vs. 11.25). The percentage of children that underwent spirometry testing for their persistent asthma (based on Medicaid data) was significantly, positively correlated with the mean ERMI values of the homes in the 25 zip codes. Conclusions: Applying Medicaid-use data for spirometry testing and locating a city's older housing stock might help find foci of homes with high ERMI values.

Populations of some molds in water-damaged homes may differ if the home was constructed with gypsum drywall compared to plaster

Starting in the 1940s, gypsum drywall began replacing plaster and lathe in the U.S. home construction industry. Our goal was to evaluate whether some mold populations differ in water- damaged homes primarily constructed with gypsum drywall compared to plaster. The dust samples from the 2006 Department of Housing and Urban Development's (HUD) American Health Homes Survey (AHHS) were the subject of this analysis. The concentrations of the 36 Environmental Relative Moldiness Index (ERMI) molds were compared in homes of different ages. The homes (n=301) were built between 1878 and 2005. Homes with ERMI values >5 (n=126) were defined as water-damaged. Homes with ERMI values >5 were divided in the years 1976 to 1977 into two groups, i.e., older (n=61) and newer (n=65). Newer water-damaged homes had significantly (p=0.002) higher mean ERMI values than older water-damaged homes, 11.18 and 8.86, respectively. The Group 1 molds Aspergillus flavus, Ammophilus fumigatus, Aspergillus ochraceus, Cladosporium sphaerospermum and Trichoderma viride were found in significantly higher concentrations in newer compared to older high-ERMI homes. Some mold populations in water-damaged homes may have changed after the introduction of gypsum drywall.

The relationship between environmental relative moldiness index values and asthma.

Indoor mold exposures have been qualitatively linked to asthma for more than 25 years. Our goal has been to turn this qualitative link into a quantitative assessment of asthma risk from mold exposures as estimated by the home's environmental relative moldiness index (ERMI) value. The home's ERMI value is derived from the quantitative PCR analysis of 36 molds in a dust sample. Six epidemiological studies of the relationship between ERMI values and asthma, in cities across the U.S., showed that both children and adults with asthma were living in homes with significantly higher ERMI values than the control or comparison homes. Based on these six studies, the accuracy of the ERMI value's link to occupant asthma was analyzed using receiver operating characteristic (ROC) curve and area under the curve (AUC) statistical analysis. The AUC was 0.69 which places the test accuracy in the "fair to good" range for a medical diagnostic test. A logistic regression analysis of the six studies was performed to generate an equation that can be used to predict occupant asthma at specific ERMI values. The ERMI metric may be a useful tool to link the quantification of mold contamination in U.S. homes to some asthma health effects.

A Citizen-Science Study Documents Environmental Exposures and Asthma Prevalence in Two Communities.

A citizen-science study was conducted in two low-income, flood-prone communities in Atlanta, Georgia, in order to document environmental exposures and the prevalence of occupant asthma. Teams consisting of a public-health graduate student and a resident from one of the two communities administered a questionnaire, inspected residences for mold growth, and collected a dust sample for quantifying mold contamination. The dust samples were analyzed for the 36 molds that make up the Environmental Relative Moldiness Index (ERMI). Most residents (76%) were renters. The median duration of residence was 2.5 years. Although only 12% of occupants reported a history of flooding, 46% reported at least one water leak. Homes with visible mold (35%) had significantly (P < 0.05) higher mean ERMI values compared to homes without (14.0 versus 9.6). The prevalence of self-reported, current asthma among participants was 14%. In logistic regression models controlling for indoor smoking, among participants residing at their current residence for two years or less, a positive association was observed between asthma and the homes' ERMI values (adjusted odds ratio per unit increase in ERMI = 1.12, 95% confidence intervals (CI): 1.01–1.25; two-tailed P = 0.04). Documentation of the exposures and asthma prevalence has been presented to the communities and public officials. Community-based organizations have taken responsibility for planning and implementing activities in response to the study findings.

Mold populations and dust mite allergen concentrations in house dust samples from across Puerto Rico

Lifetime childhood asthma prevalence (LCAP) percentages in Puerto Rico Health Regions (HR) are substantially higher in northeastern vs. southwestern HR. Higher average relative humidity in the northeast might promote mold and mite exposures and possibly asthma prevalence. To test this hypothesis, mold contamination, Environmental Relative Moldiness Index (ERMI) values were measured in floor dust (n = 26) and dust mite allergen concentrations in bed dust (n = 14). For this analysis, the eight HR were divided into those with LCAP > 30 % (n = 3) and < 30 % (n = 5). The average ERMI value was significantly greater (Wilcoxon Rank Sum, p < 0.001) in high than in low LCAP HR (14.5 vs. 9.3). The dust mite antigens Der p 1, Der f 1, and Blo t 5 were detected in 90 % of bed samples, but the concentrations were not significantly different in high vs. low LCAP HR. Mold exposures might partially explain the differences in LCAP HR in Puerto Rico.

Decreased FEV1 % in asthmatic adults in Scottish homes with high Environmental Relative Moldiness Index values.

SummaryBackgroundExposures to indoor biological contaminants have been implicated in asthma's aetiology but their effect on lung function is not well quantified.ObjectiveThe aim of this cross‐sectional study of non‐smoking, asthmatic adults in Scotland was to determine the correlation between the results from a standard spirometry test, forced expiratory volume in one‐second percent (FEV 1%), and quantitative estimates of some biological exposures.MethodsA population (n = 55) of non‐smoking, adult asthmatics in Scotland was included in this study and each completed a questionnaire that allowed the determination of the Asthma Control Questionnaire scores (ACQ) and St. George's Respiratory Questionnaire scores (SGRQ), as well as corticosteroid use. Spirometry testing was completed and the pre‐bronchodilator FEV 1% value calculated. At about the same time, floor dust samples were collected in the living room and in the bedroom. These dust samples were analysed for mould contamination, as described by the Environmental Relative Moldiness Index (ERMI) values and by (1, 3)‐β‐D‐glucan concentrations, for endotoxin, and for dust mite, cat, and dog allergen concentrations. The asthmatics' FEV 1% values were tested for correlation (Pearson) to questionnaire‐based estimates of health. Also, each biological exposure was tested for correlation (Pearson) to the FEV 1% values.Results FEV 1% results were correlated with ACQ scores (ρ −0.586, P < 0.001), SGRQ scores (ρ −0.313, P = 0.020), and weakly with corticosteroid use (ρ −0.221, P = 0.105). The ERMI values in the homes (average 5.3) were significantly correlated with FEV 1% values (ρ −0.378, P = 0.004). There was no correlation between FEV 1% and concentrations of endotoxin, (1, 3)‐β‐D‐glucan, or any of the allergens.Conclusion and clinical relevanceAlthough these results do not prove that mould exposures caused the deficit in lung function observed in this study, it might be advisable for asthmatics to avoid high ERMI environments.

Key determinants of the fungal and bacterial microbiomes in homes

BackgroundThe microbiome of the home is of great interest because of its possible impact on health. Our goal was to identify some of the factors that determine the richness, evenness and diversity of the home’s fungal and bacterial microbiomes. MethodVacuumed settled dust from homes (n=35) in Cincinnati, OH, were analyzed by pyrosequencing to determine the fungal and bacterial relative sequence occurrence. The correlation coefficients between home environmental characteristics, including age of home, Environmental Relative Moldiness Index (ERMI) values, occupant number, relative humidity and temperature, as well as pets (dog and cat) were evaluated for their influence on fungal and bacterial communities. In addition, linear discriminant analysis (LDA) was used for identifying fungal and bacterial genera and species associated with those housing determinants found to be significant. ResultsThe fungal richness was found to be positively correlated with age of home (p=0.002), ERMI value (p=0.003), and relative humidity (p=0.015) in the home. However, fungal evenness and diversity were only correlated with the age of home (p=0.001). Diversity and evenness (not richness) of the bacterial microbiome in the homes were associated with dog ownership.Linear discriminant analysis showed total of 39 putative fungal genera/species with significantly higher LDA scores in high ERMI homes and 47 genera/species with significantly higher LDA scores in homes with high relative humidity. When categorized according to the age of the home, a total of 67 fungal genera/species had LDA scores above the significance threshold. Dog ownership appeared to have the most influence on the bacterial microbiome, since a total of 130 bacterial genera/species had significantly higher LDA scores in homes with dogs. ConclusionsSome key determinants of the fungal and bacterial microbiome appear to be excess moisture, age of the home and dog ownership.

Pilot study of mold in homes of asthmatic children in Taipei, Taiwan, using the Environmental Relative Moldiness Index

The prevalence of asthma in Taiwan is one of the highest in Asia. Mold exposures have been linked to the development and exacerbation of asthma. A pilot study of mold populations in homes in Taipei, Taiwan, was conducted in the spring of 2014. Dust and air samples were collected from five homes with an asthmatic child and five from control homes. A combined, settled-dust sample was collected in the living room and bedroom in each home using a Swiffer™ cloth. The dust (5 mg) was analyzed for 36 molds using a DNA-based analysis, mold-specific quantitative PCR, and mold contamination was estimated using the Environmental Relative Moldiness Index (ERMI) metric. The ERMI values were significantly (p = 0.03) greater in the homes of asthmatic children compared to the control homes, average 26.2 versus 17.4, respectively. Aspergillus ochraceus was found in significantly greater numbers in homes of asthmatic children compared to control homes. Air samples were collected in each home for 2 min (total 63 l of air) using the Burkard portable air sampler for agar plates fitted with malt extract agar plates. The plates were incubated at 25 °C for 5 days, and the resulting mold colonies were enumerated. Significantly higher total numbers of molds were cultured from the air in homes of asthmatics compared to control homes. Although this is a pilot study, it suggests that asthmatic children in Taipei, Taiwan, live in homes with significantly greater exposures to molds.

Environmental Relative Moldiness Index and Associations with Home Characteristics and Infant Wheeze

Possible relationships between mold contamination, as described by the Environmental Relative Moldiness Index (ERMI), home characteristics, and the development of wheeze in the first year of life were evaluated among a cohort of urban infants (n = 103) in Syracuse, New York. Pregnant women with a history of asthma were recruited in 2001–2002 for the “Assessment of Urban Dwellings for Indoor Toxics” (AUDIT) study. When the infants were approximately 3 months of age, a home inspection was carried out and indoor environmental samples collected, including vacuumed house dust. ERMI levels in the Syracuse cohort homes were higher than the U.S. average, with an overall mean of 11.4. ERMI levels were significantly higher in homes with visible water problems (p = 0.023) and visible mold (p = 0.023). ERMI levels in apartments were significantly lower than the values measured in houses (p = 0.0003). While infants experiencing wheeze (38%) tended to live in homes with higher ERMI values than those without wheeze (ERMI values of 12.3 and 10.9, respectively), the differences did not reach statistical significance. A subset analysis limited to infants with living room samples who remained in the same home during the study (n = 25) was suggestive of an association between higher ERMI values and wheeze (p = 0.10). In summary, the ERMI is a standardized metric which allows for comparison of moldiness levels in homes across studies and regions in the United States. ERMI levels in Syracuse homes were skewed to the high end of the national scale. Higher ERMI levels were indicators of water problems, mold, and type of housing.