Water Damage Assessments - PowerPoint Presentation

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Water Damage AssessmentsMold Assessments & TestingIndoor Air Quality TestingChemical & Allergen SamplingAsbestos TestingFire/Smoke ScreeningRadon (not real estate)

www.eimidwest.com

(847) 293-7554

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Occupant Air Quality Concerns

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Overview

Overall investigation process

Sensitivities

AllergiesImmune system dysregulationChemical SensitivitiesSensory SensitivitiesEmotional SensitivitiesIndoor ContaminantsPsychosomatic symptoms

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Investigation Process

Occupant interview

Determine if overall problem or sensitive person

Locate cause/contaminant

Follow-up interview

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Occupant Interview

Ask everyone,

separately

, the following questions:

List symptoms

Are symptoms continuous or intermittent

If intermittent, when?

How quickly do symptoms abate? Do they occur at other locations?

“What do you think is occurring?”

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Occupant Interview

Percentage

with Symptoms

Possible

Contaminants

>50%

Combustion

products

Chemical release

Dust

Temperature/humidity

25%-50%

Same as >50%

Group

dynamics or social issue

<25%

Allergen

Dampness/mold

<5%

Hyper-sensitivity

Psychosomatic

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Occupant Interview

Sensitivities

Allergies & Asthma

Autoimmune

Sensory Sensitivities

Chemical Sensitivities

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Allergies and Asthma

Most common of all sensitivities

Allergies

25% of population

Allergen specific

10-15% mold allergies

Mold specific

Immediate reactions

Delayed reactions

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Autoimmunity

: immune system attacks selfGeneral Inflammation: low-level, body-wide immune activityExamples include:LupusMultiple sclerosisCrohn’s DiseaseRheumatoid arthritisDepression

Autoimmune and General Inflammation

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Acute sensitivity to a specific, group, or a range of chemical compounds.

Labels:Chemical SensitivityChemical IntoleranceMultiple Chemical Sensitivity (MCS)Idiopathic Environmental Intolerance (IEI)Toxicant-Induced Loss of Tolerance (TILT)Can be combination genuine or somatic components

Chemical Sensitivities General

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Symptoms

HeadacheNauseaGastrointestinal changesShort term memory problemsDifficulty concentratingIrritabilityOthers

Reported Symptoms

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12-16% sensitive

80% womenHead trauma, severe infection, initial exposure to pesticides, concentrated VOCs, or moldy buildingsTypically responds to fragrances, gasoline, diesel, smoke

Statistics

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Katerndahl

and Miller 2005Women in waiting room of health center approached, 40 with diagnosis of panic attacks chosen73% met criteria for chemical intolerance (QEESI)78% childhood abuse6% of controls met criteria for chemical intolerance

Brain-Body connection

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Dr. Claudia Miller

1999 QEESI introducedSelf-report survey of symptoms and impact on lifeTakes into account masking of symptoms by daily activities

QEESI

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Anatomy of Sensitivities

Trigeminal Nerve

Senses chemicals and sensations

Operates muscles in jaw

Over-communication with brain – sensitivities

Can be tested with capsaicin

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Perception

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Newer Hypothesis – Sliding Scale

Purely Organic

Purely Psychosomatic

Organic and psychogenic components

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Sensory sensitivities

TouchSoundVibrationLightsTemperature/humidity

Sensory Sensitivities

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Common Indoor Contaminants

Mold

Radon

Dust & mold mitesPestsCombustion gasesVOCs & chemicalsPet danderIndoor particulate matterLack of ventilation

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Common Outdoor Contaminants

Pollen

PollutionOther organic debris & particulate matter

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Mold

MildewRotBrown rotWhite Rot

Fungi

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1.Cladosporium2. Penicillium3. Aspergillus4. Chaetomium5. Stachybotrys6. Ulocladium7. Trichoderma8. Alternaria9. Epicoccum10. Aureobasidium

Fungi

Red

= Dominant

Outdoors

CLK estimates ~30 molds common

indoors

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1994: Acute

Ideopathic Pulmonary Hemosiderosis in Infants – CDC Report by Ruth Etzel, MD, PhD.Mold hits media1999: Melinda Ballard lawsuit2000: CDC report retracted

History

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2001-present: Continued research by CDC, EPA, universities, physicians verifying health effects to damp buildings and

microbialy-contaminated buildings

History Cont.

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Allergies

~10% of populationDelayed (vs. immediate) allergies prominentSpecific for mold speciesAsthmaRareInfectionRare – immunocompromised onlyIrritation to mucous membranes

Health Effects

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~2% Chronic inflammation

short-term memory impairment“fogginess”fatiguemuscle achesOthersLikely not mycotoxinsMultiple inflammagens the cause

Health Effects – Toxic?

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Dust Mite:

Dermatophagoides farinaeD. pteronyssinusDer f 1, Der p 1, and Der P 2Mold Mite: Tyrophagus putrescentiae

Dust and Mold Mites

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Combusting gas produces

Irritant gasesMoistureCarbon dioxideCarbon monoxide

Combustion Products

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Unvented gas ovens

Backdrafting water heaters or boilersBackdrafting furnacesCracked heat exchangers

Combustion Products Cont.

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Many sources of volatile chemicals

Cleaning agentsPressed and composite woodCarpeting on damp concreteScented air freshenersIndustrial processesCombustion sources

Volatile Chemicals

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Charcoal tubes and air pumps

Suma canistersPhotoionization detector0-500 microgram per cubic meter of air (µg/m3) is normalEquivalent to ~250 parts-per-billion (ppb)

Measuring Volatile Chemicals

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Thank you!

Cassidy Kuchenbecker

(847) 293-7554

CK@eimidwest.com

$475 site assessments

with free sampling for many projects

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Somatization Disorder

HypochondriasisObsessive Compulsive DisorderPanic/Anxiety DisorderMajor Depressive DisorderBipolar Depressive DisorderPsychotic Disorders

Psychological Influences

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Not hypochondriasis

Recurrent or chronic symptoms complaint with no biological triggerAlso called Briuet’s SyndromeOften changes doctors~1% of women exhibit disorder<1% of men exhibit disorder

Somatization Disorder

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Clues:

Have long, detailed history supporting their beliefTakes many medicationsDifficulties in social relationshipsOften self-centered attitudeOften excitableOften symptoms presented with gusto –“I wake up stiff as a board”

Somatization Disorder

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Hypochondriasis is the fear that the person has a serious illness

Difference from somatization is that hypochondriacs are obsessed with health, not focused on specific recurring symptoms.

Hypochondriasis

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Clues:

Usually describe fear versus symptoms on phoneLong conversation on what the internet saysOften will just say “I’m a hypochondriac”Relatively easy to help…if you act confidently

Hypochondriasis

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Panic/Anxiety Disorders

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Clues

Hyper vigilantEasily startledOver activation of autonomic nervous systemSweatingDizzinessCold and clammy handsPounding heartFrequent urination

Anxiety Disorders

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Psychotic disorder

Alters perception, thoughts, or consciousnessAlterations are called delusions or hallucinationsTypical example – SchizophreniaDelusional Disorder

Psychotic Disorders

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Delusional disorder

Often paranoidDelusions more mild than schizophrenia Feeling followedBelief in being poisoned

Psychotic Disorders