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Geomedicine with Nicole Bijlsma

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Geomedicine with Nicole Bijlsma

Geomedicine. Sounds like a futuristic medical term…and maybe it is? 

We're now learning that our geographical environment can have dramatic impacts on our health, particularly when dealing with chronic, insidious and recalcitrant conditions. To truly understand what geomedicine is, we are joined once again today by leading Australian building biologist, Nicole Bijlsma. From putting on her detective hat to find the issues facing patients with chronic conditions, to teasing apart the research to reveal deficiencies and cover-ups, Nicole knows how to peel back the layers to find the real culprit plauging those with chronic health issues. A pioneer for this field of medicine, Nicole has a wealth of knowledge to share. 


Covered in this episode

[00:49] Welcoming back Nicole Bijlsma
[01:50] Understanding "Geomedicine"
[06:18] Chemicals: the enemy of the microbiome
[11:44] Being clean, but not too clean
[13:35] The growing issue of lead exposure
[17:16] The rise of electromagnetic fields (EMF)
[20:45] The ripple effect of mould illness on neurotransmitters and gut health
[28:12] Dustmites: the most common allergen in the world
[31:08] Exposure zones and risks
[33:12] Nicole's PhD research - what is it aiming to uncover?
[39:36] Advice for dealing with mould


Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook. Joining us on the line today is Dr. Nicole Bijlsma. The healthy home expert, Nicole is a building biologist. She's a bestselling author of, Healthy Home Healthy Family, a Ph.D. candidate, and principal of the Australian College of Environmental Studies. That's ACES, which she established in 1999 to educate people about the health hazards in the built environment. 

Nicole is an accomplished naturopath and acupuncturist who has published in peer-reviewed journals and lectured at tertiary institutions for 30 years. She's written extensively for, "Body and Soul" newspaper and is regularly consulted by the media to discuss mould, electromagnetic fields, and toxic chemicals. She also lectures in Australia and abroad about environmental health issues. 

Welcome back to FX Medicine. How are you, Nicole?

Nicole: Really good. Thanks, Andrew.

Andrew: Now, Nicole, I've got to say you're one of the few people that you constantly blow my mind with things that I never knew about. And today we're talking about ‘geomedicine.’ Firstly, what are we talking about? What's geomedicine?

Nicole: Geomedicine looks at where people live, where they work, and where they play. So it's really taking a thorough place history and examining the health hazards that they may be exposed to as a result of this.

Andrew: The first thing that comes to my mind is more of a workplace environment. You know, I remember in the past there was a cluster of diseases. I thought it was breast cancer? At, you know, ABC TV Station. And I've heard of other places where there's been perhaps some, you know, contamination with dioxins and things like that where they get spikes in hormonally-related cancers. 

But we're talking also about the home environment. So how does that play out? Do you wait until there's a community outcry that, you know, their kids are getting sick all the time? How is this discovered?

Nicole: That's an interesting point. In fact, just going back to that breast cancer cluster in the Brisbane ABC studio at Toowong, was in 2004. And it was interesting because the electromagnetic field consulting firm that was involved failed to measure AC magnetic fields, which the World Health Organization classified as possibly carcinogenic in 2002. 

Andrew: Ahh. 

Nicole: So this is the problems going on.

Andrew: Don't look and you won't find.

Nicole: Yeah. Exactly right. So there are a lot of... We're now starting to realise, as we know, genetics loads the gun, the environment pulls the trigger. And the environment as to where you live is a huge, big part of the pie that clinicians need to address. Because we're getting a good understanding now as to how water-damaged buildings and biotoxins, like mould, can affect people from asthma and allergies, recurrent colds and flus and pneumonia in people who don't create antibodies to these microbial antigens that can result in chronic fatiguing issues. 

So we also know that the symptoms are almost identical to electromagnetic field exposure. In my book that I just published this year, I cross-check electromagnetic sensitivity with chronic inflammatory response, with chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivity, etc., and they're virtually the same. They're the same illness. It's a low grade, systemic, chronic inflammation that affects the brain, various neuropeptides are involved and neurotransmitters. It affects endorphin release, it affects multiple hormones, leptin, obesity. So there's lots of connections here to a lot of the chronic fatiguing illnesses.

A good example is, a couple of weeks ago, I talked just before, we launched a film in Melbourne and.. Generation Zapped, it was. And this woman came up to me and said, "I've been diagnosed with MS. My daughter has chronic fatigue syndrome and my youngest daughter has asthma, allergies and was hospitalised for pneumonia twice in the last five years. We have a significant damp and mould-related issue in the home. We've been there for 20 years and we've all been sick. Do you think there's a connection?" 

Can I say there's a connection or not? Well, I mean, I didn't go to audit her home. But these are the type of things we regularly faced as building biologists, that you look at the symptoms of MS, it's identical to chronic inflammatory response, and, you know, it’s because we spend 90% of our time in a building, where we are and where we live has significant impacts on human health. And it's the big elephant that's not being addressed from a clinical perspective.

Andrew: I can't believe that these researchers, for instance, you mentioned the ABC Radio, they employed a consultant to do testing and they didn't test a certain frequency that was already shown to be suspect. So were they ignorant of that or are they mischievous of that fact? What do you think is the issue here? Do you think people are turning a blind eye actively? 

Nicole: Yes, yes. And in the first chapter of my book, The True Cost of Progress and The Four Dog Defence, I explain how chemical electromagnetic fields are regulated, how there's huge conflict of interest with the industries involved, that are creating the source, but also involved in setting of exposure standards. Which are not health-based standards. The money, we're talking multi-trillions of dollars.

Andrew: Trillions, yeah.

Nicole: And really, this is what I say at a lot of the conferences that I speak at is evidence-based medicine has kept medicine in the dark. It takes 17 years approximately to translate from scientific evidence to the clinician's bench, and that's too long. Especially in the explosion of information on the human genome, and in particular how it influences the microbiome. 

We know, for example, that the first two years are critical for child's risk for asthma and allergies, and it appears that the gut microbiome may be significantly influenced by the household dust. And that's not surprising because they have a high hand to mouth ratio, they're crawling all over the floor. We know that the greater the bacterial diversity in the household dust, the lower the risk for asthma and allergies. And the quickest way to get rid of that diversity is to use chemical cleaning products or pesticides because pesticides are antibacterial. 

So, therefore, it's important that we take our shoes off before we go into the house to reduce our pest load. But in particular, not use chemical pesticides in the house. Now, in the research, they looked at why the Amish community in the U.S. that don't have electricity, don't use chemicals, etc. Why they have such a low rate of asthma and allergies? What they discovered is they have very high levels of bacterial diversity in their household dust and high levels of endotoxins that the bacteria create. And this is because of their exposure to things like livestock and animals and the high levels of siblings. Siblings reduce your risk for asthma and allergies. But they don't use chemicals. And, of course, many of the chemicals we're using in our homes contain preservatives, which are often pesticides and, of course, they're antibacterial. 

So we're starting to get a much better idea as to how the household dust could be a risk for allergies, especially in western children.

Andrew: When we’re talking about this diversity, you know, like the initial thought that was going through my head when you were explaining the first bit was; dust is bad. But what you're saying is, dust needs diversity. One of my issues is, we tend to blame, as humans, we like things to be simple. So we'd like to blame bacteria or we'd like to blame mould. Could it be the balance of mould and bacteria and the diversity as well?

Nicole: We are bacteria.

Andrew: Oh, that's a great answer.

Nicole: So, where do we stop? Where do we stop and the environment ends? We are in symbiotic relationship with our environment. So when we chlorinate our water and kill our bacteria off, which affects our gut microbiome, when we reduce our diversity to the household dust, which is where the bacteria should be coming from for a child who's crawling all over the floor, this is a huge problem. 

We've been conned into thinking with propaganda and marketing campaigns to use chemicals to create a healthy home, when in fact, the opposite is true. We need to go back to basics. We need to stop using products that are affecting our microbiome. And that includes personal care products and moisturisers loaded with preservatives. Which are, actually, just antibacterial. 

Because we're starting to realise that the microbiome on our skin, like staphylococcus, for example, micrococcus, pseudomonas, can actually transform and change cigarette smoke as it lands on our skin before it even gets into the systemic circulation.

Andrew: Staphylococcus and what else?

Nicole: Micrococcus and pseudomonas are involved with breaking down the cigarettes. Say, for example, cigarette smoke lands on your skin, bacteria naturally found on your skin starts to break it down into different metabolites before it even gets into the systemic circulation. 

So, we now know that the microbiome on our bodies is effectively more effective than the liver at detoxing chemicals. And a lot of this research is coming from pharmacometabolomics and trying to explain why people react to drugs like paracetamol and chemotherapeutic agents. Because their microbiome is influencing how these chemicals are detoxed in the body.

Andrew: What you've said is really important for not just firsthand smoke which is inhaled, but sorry, not firsthand smoke which is inhaled, but secondhand, third-hand smoke. 

So where I'm going with this is things like sudden infant death syndrome, SIDS. I'm not aware of the exact current research, but I do remember in the past that people who smoked had an increased risk of causing SIDS in an offspring. Could this be one of the factors involved in that, apart from, you know, sleeping position and things like that?

Nicole: Well, we’d certainly know, you know, some mothers smoke during pregnancy that that can increase the risk for sure. I guess the point here is that the microbiome on our skin, in our mucous membranes, in our gut, have a significant impact on how we relate to our environment and how we detox the chemicals in our environment.

You can't separate yourself from the air and the water and from the dust because it's this synergistic, symbiotic relationship. So, we need to understand that we are bacteria first, and therefore, using products like pesticides, which are naturally antibacterial, preservatives in skincare products that you're lathering all over your body every day, that are potentially affecting your skin microbiome, which are involved with detoxing many of these chemicals is something that's probably not a good idea.

Andrew: We've got to be clean. We've got to present to work and interact with other people in our environment, and they have certain expectations of us having a reasonable aroma around us. What sort of things can we actively do, that are friendly, not just to others, but also to ourselves. When we're cleaning ourselves?

Nicole: Well, we still need to wash. There's no doubt about it. Because water contains huge amounts of microbiome. You can't get away from it.

Andrew: Yeah. 

Nicole: You’ve got bacteria everywhere. The bacteria in your house actually is there because of everyone that's ever walked into it. Every hour you emit between 14 and 37 million bacterial genome copies in the air. Your animals do it. Your pets do it. You do it. 

So, the bacterial load, it's like an archaeological dig site of the history DNA of everyone that's ever walked into your home, etc., which is why I often say to people, "When you move in, if you're asthmatic, etc., remove the carpet. Because the whole DNA of everyone who's been there and the pets is going to be sitting there.” 

Fungi is generally going to be there because of what's coming from the outside. But bacteria, fungi, they need to be there. We've had this symbiotic relationship with these organisms for many, many years. They program our immune responses. They're very important. 

So water, when we bathe, water can actually contain some microbiome as well. Just when it's chlorinated that a lot of people, a lot of my patients I’ve found, were reacting to bathing and showering because it's the chlorine that's a very strong antibacterial that affects their skin and their skin microbiome and, of course, their lungs. 

So, we still need to bathe. There's no doubt about it. And our microbiome, vary significantly depending on which part of our body we're looking at. But it's having this relationship of understanding that you are bacteria first. So anything that kills bacteria that's a biocide or ‘cide’ that kills life is probably not a good idea to bring into your home.

Andrew: Let's talk a little bit more about the dust that you said. Things that create dust in the house, one of my thoughts is renovations. And I know that you and I previously have spoken about lead, for instance. Now, this came up recently in a piece of research, and it was just this massive issue of lead contamination in our current environment. And I was pondering it going, "Well, hang on. The lead was taken out of the paint in the sort of mid to late 70s. Why have we got such an issue?" And then I realised that people can't afford to build, so they're renovating older homes, therefore, they're causing dust. Tell me how big an issue is this in Australia, if not the rest of the world. But what's the issue and what can we do about it?

Nicole: All right. There are several sources of lead in homes. If your house is built before 1970, then the lead content in there is going to be about 50%. In 1965, they changed the regulations for lead content in paint. But they allowed whatever stocks existed to be able to be sold. So we would say as building biologists, you know, up until 1970, if the house was built prior to that time, it's likely to have a lead content of 50%. 

And, of course, if you're going to renovate and it becomes a dust, then it becomes a health issue. And a significant health issue, especially for fertility, but also for children's IQ, cognitive function, learning behavioral disorders. And unfortunately, that accumulates in the mother's bones, and when she gets pregnant, that's the time when she can detox her lead best is to get pregnant, pass it through the placenta and breastfeed, unfortunately, that happens in quite a few cases. 

But lead can also come from lead solder in copper pipe or galvanised pipe. You know, until the 1980s when they were using copper pipe, they used lead solder.  So as that copper pipe is corroding, it will release small amounts of this lead into the water supply. So that's something we're also mindful, as building biologists, is to give people recommendations on water filtration systems. 

But you're right. Lead is a huge problem if it's disturbed, like asbestos and if it becomes a dust. So it's really important if people are going to renovate a home built before 1970, that they get someone like the Australian Dust Removalist Association to come in with Tyvek suits, full face respirators, and HEPA filters to actually scrape it off and get rid of it so you don't contaminate the entire house with this toxic metal.

Andrew: And, of course, that can be quite a huge cost for somebody renovating. But then, I guess my other thought is, "Well, hang on. What are the costs going to be to the rest of their family and health care costs that you can't see yet?"

Nicole: That's exactly right. And let's face it, to detox, to get toxic metals out of a child comes at a massive risk to kidney failure, liver failure. Because the chelating agents are incredibly toxic.

Andrew: I just realised where I saw that article, or what the point of the article was. And that was that previously, it was thought that anything over 10 was not desirable, but under 10 parts per billion was an issue for neurological development. But now they're finding that even as low as under 5 parts per billion is a real issue. So they're sort of getting down. And the question that's being asked is, what's the safe level of lead?

Nicole: There is no safe level for lead. There is no safe level. No, it's zero. And I think most people in the scientific...researchers would agree to that. They've lowered the levels. However, yes, definitely there's no safe level for a toxic metal like lead, in the body.

Andrew: So onto electromagnetic energy. And this is the one that I have most problem understanding because I guess my question is how do you tease apart electromagnetic issues compared to issues from other sources? 

Nicole: EMF is just the one that is shrouded with controversy because its impact is very diverse on the body. We know it affects melatonin, suppresses melatonin. Many clinicians are aware that blue light suppresses melatonin especially if people use digital devices an hour before bed. 

However, we know that many electromagnetic fields using building wiring and in wireless technologies also suppress melatonin, which is your anti-cancer hormone. It's a neurotransmitter involved in multiple functions. I bought a book a couple of years ago on melatonin, it was 400 pages long.

Andrew: Wow. 

Nicole: 400 pages! So it just gives you...it makes turmeric look like it's not doing anything. Your antioxidant, you know what I mean? 

Andrew: Yeah.

Nicole: The quickest way to suppress it is to use mobile devices next to your head and enhance the permeability of the blood-brain barrier. 

So in my book, I look at all the symptoms of electromagnetic sensitivities and the first of those is often headaches, occipital headaches that are persistent. You often then have numbness and tingling, like Raynaud’s phenomena. You have sleep disturbances, really common. And tinnitus. 

You know, I had a couple recently. I did an audit of their home and she developed Ménière's syndrome and was on pharmaceutical drugs because it was so bad. Her balance related problem. And six months later her husband develops Ménière's syndrome and gets diagnosed by a GP with that condition. And they said it all started when they renovated their home in inner city of Melbourne and put a second storey on. And when I went to do the audit of the house, she had glass in a master bedroom upstairs. It was glass in all three walls. And I could say five mobile phone towers within 400 meters, 200 to 400 meters off her home. And, of course, when I point my antenna towards those mobile phone towers, the readings are quite high, in the thousands of microwatts per square meter.

And I said, "Whatever I'm picking up now is nothing compared to what's going to happen at night because where you live, you know, just 100 meters away, is a very, nightlife street's, it’s got discos and pubs, and things like that. So more people are going to be using their cell phones during that time. Which means the readings are going to be a lot higher than when I'm here during the day."

Andrew: Right. 

Nicole: And she said, "The reason we called you in is because we haven't slept, we've developed Ménière's syndrome, we've got also tinnitus. But when we're in our house along the beach, on our, you know, our holiday house, the symptoms almost disappear.

Andrew: Right. That was my next question. Like, do you, you know, use a control, if you like, by taking them out of an environment, seeing if their symptoms improve? And then you've got to look back at where the situation would be, i.e. the geomedicine. The place is the culprit.

Nicole: Yes. And the most important questions to ask as a clinician is, how long have you had these symptoms? What was going on at the time? Did you move home there or did you relocate your bedroom? Do you find your symptoms get better when you're away from the room or from the home? Like, for example, when you're on holidays, etc.? And that's often the key to seeing if the home or the workplace is actually causing or affecting their health.

Andrew: Let's recap the type of hazards and illnesses of geomedicine sources that patients can develop as a result of where they live. So we've gone through, you know, the toxicant heavy metals. We've gone through electromagnetic, we've touched on bacteria, but what about mould?

Nicole: Wow. How many hours do you have? Well, water-damaged buildings is really what we refer to. Because now we're realising it's not necessarily just the fungi and the mycotoxins. What happens in a water-damaged building is you get a predominance of gram-negative bacteria, like actinobacteria as opposed to gram-positive bacteria in a healthy environment. And the gram-negative bacteria contain lipopolysaccharides in their wall that trigger the innate immune response. 

And so, of course, 24% of the population who can't create antibodies to these antigens, that results in chronic inflammation in their brain, brain fog, fibromyalgic-type symptoms, gut problems, etc. In fact, I think a lot of the digestive intolerances that we are seeing, could actually be due in some part, by inhalation of biotoxins in a water-damaged building. 

Because when people inhale these biotoxins, the way the body gets rid of it is it puts it in...goes through the body, eventually gets through the enterohepatic circulation. It gets dumped into the bile. When it goes into the bile, into the bowels, it then affects the gut microbiome. And then you get pathogenic bacteria like clostridia difficile, creating a huge amount of metabolites which block all your sulphation pathways in the liver.

And, of course, if you've got a traffic jam in sulphation, now your neurotransmitters like dopamine, adrenaline, noradrenaline, melatonin, serotonin, can't get through. It means the chemicals that you're exposed to from your perfume, your shampoos, conditioners, from your pesticides in your home and general chemicals you could tolerate before, now can't get through this pathway and are forced to go through other pathways like glutathione conjugation. 

So I believe that water-damaged buildings and mould is actually a chemical sensitivity. Because when people are in this environment long enough, they develop chemical sensitivities to their food and also to the environment.

Andrew: In America, you'll hear Stachybotrys chartarum mentioned quite extensively, particularly with, you know, CIRS. But I have not seen any reports of that in Australia. Have we got Stachybotrys chartarum?

Nicole: Yes, we do. And we do find it in some homes, but it's unusual. Because you can't generally find it on an air sample because it's different to other fungi in the way it's sporelates. So unless you take a surface sample, you're not going to identify it a lot of the time. And if we do find it on air sample then we're really worried. 

I think the reason why mould has been ignored by the medical profession for so long is because they're looking for fungi in the body… 

Andrew: Yeah. 

Nicole: ..To match the fungi in the environment. And that's not what happens in a water-damaged building. It's not just the fungi and the mycotoxins, and the microbial VOCs, it's the gram-negative bacteria which appear to be causing this innate immune response.

So we have this chemical stew of microbes trying to out-compete and produce chemicals to out-compete and kill off one another to take over the site because that's what nature does. 

Andrew: Yeah, yeah. 

Nicole: So I think we've moved away from going, "This fungi causes this disease," apart from, you know, the obvious things like histoplasmosis and candida. We're starting to realise, in a water-damaged building, which, by the way, is about one in two Australian buildings, one in two Australian buildings had water-damage and one in four people can't create antibodies. You can see that's a pandemic that we're only starting to get an awareness of.

Andrew: Yeah. And you know what? Like, I remember you totally rocked my world when you said that statistic in our first podcast. And I went back and checked our home. And, of course, what did I see under the eaves? There was mould and mildew coming through the soffit. And then I checked in other areas of the home and I saw that there was moisture around the brickwork. And I went, "Wow, it only takes a cursory look to realise just how prevalent water damage is." 

Now, of course, you've then got to say, "Oh, what's growing there?" And then, of course, "Is it affecting me?" Like, "Is that the thing that's affecting me or is it something else that's affecting me?" So there's your clinical stew. How do you tease that one apart?

Nicole: Well, yeah, that's true. You have to exclude a lot of other pathology and corners before you get to this. And people come to us as a last resort. Most of the work we get now is from integrative doctors who refer their patients with chronic fatiguing illnesses. Whether it's MS, motor neurone disease, chronic fatigue syndrome, fibromyalgia, chemical sensitivity, blah, blah, blah. I actually see them in the same light. They come to us because they've had no results anywhere else. 

And what we're doing is we're examining the built environment for where they spend time and what they're exposed to from the air, from their drinking water, electromagnetic fields, and of course, biotoxins and toxicants in their environment.

The home is where all the elephants live, but, you know, no one's really trained to look at these elephants, which is why I wrote the book to help clinicians get a better perspective of this. And suddenly, we get a much better idea why many people have these chronic fatiguing issues because the elephants been there. 

For example, recently, I took a group of my building biology students to do field trips, because we do lots of field trips to help them learn. And I'm standing there in the middle of a child's room and there's an aviary that's taking up 25% of the child's room.

Andrew: Wow!

Nicole: An aviary!? With birds' pooped, etc.

Andrew: Wow, psittacosis, anybody? Yeah.

Nicole: I said, "Guys, what do you think is wrong with this room?" And I thought, "If they don't pick up the aviary, they're all failing." There’s so many examples where I've walked into spaces and people go, "Well, there's water damage in the middle of that child's bedroom in the corner, but there's no sources of water." And the patient will say, "Oh no. That's where the dog likes to urinate." You have no idea, Andrew. 

Andrew: Wow. 

Nicole: The elephants are in all of our homes. I am shocked. I'm not shocked anymore, I've been doing this too long. But if clinicians actually walked into their patients' home, they'd probably discover why so many of them are sick.

Andrew: Would not the simplest way to tease apart coincidence versus possible cause of many of these illnesses be to move, at least for say, four or five nights, just go on a holiday to somewhere different, and see if your symptoms resolve?

Nicole: Yes and no. With asthma and allergies, for example, we have a histamine response that can take days before they react. With electromagnetic fields, systemic histamine is often involved. So we find that two weeks is really important if they notice an improvement in their health after moving after two weeks. However, where do you go? A lot of the homes they move into, if one in two in Australia and one in two in the U.S., one in three in Canada are water-damaged, where do they go?

Andrew: Yeah. You sure as heck don't go to a tropical paradise because that's full of mould and mildew. Go to the Simpson Desert.

Nicole: Well, a lot of like people with sensitivity, they go to Outback Australia, to remote areas where it's dry and hot and it reflects more a Mediterranean style climate, which is what a healthy home should be.

Andrew: What about things like dust mites? You know, quite a simple remedy, not necessarily easy, get rid of soft furnishings and soft toys. Encase your mattresses and your pillows. Get rid of all carpets, which we indeed have done in our home. But the other thing was there's dust mite sprays about. So would you, say, recommend that as a first line and say, "Let's see if your asthma improves and then we'll look further?" Or do you now have the experience that, you know, I know what to go to now?

Nicole: House dust mites is interesting because it's actually the most common allergen in the world. Affects around 21% of the world's population. And they are wherever you are. The more dust there is, the more visible dust there is in a home, the greater the risk for exposure because, of course, that's what they're feeding off. They don't have mouths and they completely rely...they don't have eyes and they can't drink. So they rely specifically on the water in the air, the humidity to be able to survive. So the key to dealing with dust mites is A) to reduce the dust load and also to reduce humidity levels to between 45% and 55%. You'll find most allergies and asthma will be...you won't have allergies and asthma if you can keep the humidity levels within 45% to 55% in the home. 

So humidity is the key. Old Mattresses and old pillows that are, you know, pillows that are more than 18 months old, mattresses that are more than 10 years old, especially if they have any urine in there, or chemotherapeutic drugs or someone who's had a lot of sweating, it's going to have huge amounts of dust mites. So it's important that that's aired regularly. Vacuuming is one of the most important and it needs to have a HEPA filter and a motorised head to make sure that you actually suck up those dust mite allergen, which is, of course, the protein, the p1 in the dust mite poo.

Andrew: In the poo, that's right. I remember something about sunlight kills dust mites but vacuuming does very little to dust mite populations. Indeed, it might aerosol, not just the dust mites but the feces. And so you've really got to be careful about the type of vacuum cleaner that you vacuum the room or whatever with.

Nicole: Absolutely. And the two things I recommend in my book to buy is a water filter and a vacuum cleaner fitted with a HEPA filter. The HEPA filter will filter everything down below 0.3 microns. All your allergens start at 2 to 50 microns. So that's why a HEPA filter is absolutely critical, and I've listed the top 10 vacuum cleaners on my website.

Andrew: Oh, good. I'll have to read that because one of my criticisms of these, you know, HEPA filters that you get commonly in vacuum cleaners now, and that's fine that they take the particles out of the air. That's wonderful. Then you've got to empty the bag. Try and do that without creating dust. It's like...

Nicole: Yeah. And that's an important point. You don't want a bag that's reusable, you want a disposable bag.

Andrew: Disposable bag, yeah.

Nicole: Disposable electro-static bag. That's what you want.

Andrew: So, again, we've gone through a few questions that clinicians should ask when undertaking a place history. What other things do we need to really consider to tease apart what might be the cause of their illnesses with regards to geomedicine?

Nicole: Well, with geomedicine, you're looking at proximity to known toxicants like traffic-related air pollutants. Traffic-related air pollution like particulates, noxious gases, chemicals emitted from vehicle exhausts, especially diesel are very strong contributors to asthma and allergies and can sensitise people to allergies. So living within 500 meters downwind from heavy traffic is a big trigger for those illnesses. 

So when I think of asthma and allergies, I think of proximity to traffic, I think of dust mites, I think of pet dander, I think of pests like cockroaches and rodents and its impact on those types of symptoms. Which, of course, you can only get by asking patients questions about the age of their carpets and their furnishings and in particular, their mattresses and their bedding. With exposure zones, the thing that I love most about studying this as part of my Ph.D., is looking at what are the actual exposure zones? How far does the patient need to live or work away from known hazards? For airport it's about seven kilometers. When they're decelerating and accelerating, that's when they release most of the fumes. 

Andrew: Yep. 

Nicole: Cell phone towers, you're looking at about 400 meters. At least 400 meters away, you want to be away from those. From mining, it can be, an open-cut mine could be 70 kilometers. Very interesting. Vehicle exhaust, I mentioned you don't want to be 500 meters downwind or within 200 meters around high traffic. Tramlines, you don't want to be within 5 meters of a tramline. High voltage transmission lines, you don't want to be within 400 meters from those things because of the magnetic field.

Andrew: That's it. I need to read your book and learn for myself. And I would urge every listener out there, if you're interested in this at all, Healthy Home Healthy Family, please get that book and learn. 

But I want to ask you a final question, Nicole. Can you please tell us about your Ph.D. research, interviewing these top doctors in environmental medicine and creating this healthy home survey? What did you find out and what can we do? Like, if you talk about one in two homes are water-damaged, are you moving out of the frying pan into the fire? What can we do to remedy the situation within, you know, our budget, within our pocket, our hip pocket?

Nicole: Sure. Look, it's rare that we ask people to move. Because once we can identify the source of the moisture, we can then address that by either getting rid of it or HEPA vacuuming it, etc., in order to reduce it. So there's lots of things that can be done before we get to that stage. 

In terms of my research, I interviewed the top 16 environmental doctors in Australia and New Zealand and asked them how they dealt with chemicals in their patients. And, you know, I was hoping to get a list of lab tests and things that they used, hair mineral analysis, bioscreens, OATs test, etc. And in the end, what I actually got was, because I interviewed occupational and environmental physicians and integrative physicians, they were very different in what toxicants they were even concerned about.

Obviously, with occupational physicians, they were looking at workplace exposures, and primarily men. Because to employ an occupational physician, you've got to be a large to, you know, medium to large business. And it's often mining or manufacturing that are hiring these doctors and they're identifying, looking at the safety data sheets at that workplace and they're mainly male-dominated industries. 

Whereas, integrated physicians, it's primarily children and women that they're treating, very different. And they were mainly concerned about toxicants in food and its impact on human health. And some of them were saying things like, you know, especially if they have a Scottish or Irish background, they were far more sensitive to environmental toxicants, etc., and food sensitivities. And I looked that up in the research and that certainly validates that in terms of gluten intolerances and things like that. 

But some of the doctors were giving me a lot of information about place history and about, "Look at where the patient lives. Go on Google maps. Go one kilometer above and below and two kilometers out, and look at the petrol stations, mining, manufacturing, airports, all of these areas. Look at how the prevailing winds are and if it's actually bringing in these toxicants into the patient's space," and then, of course, to ask about their homes.

What I found really interesting was that all of them agreed, they didn't agree on much. But all of them did agree that the most effective way to deal with toxicants and address toxicants was to take an effective exposure history and that this takes about 90 minutes in the first consultation. So to identify potential causes of patients' illnesses, they need to take an effective and comprehensive exposure history. And when I asked them where they got it from, they all said, oh, they had to make it up because they weren't trained in that in their undergraduate course or postgraduate training that they did anywhere.

Andrew: Oh. 

Nicole: So, that's what instigated me and my professor, Mark Cohen to look at developing a validated exposure history questionnaire. Correlating it with health symptoms and seeing is there are correlations with certain illnesses and how many people see visible mould or live within 200 meters of heavy traffic or all of those things? 

Because we're about to have an explosion of data coming onto our apps on mobile phones that we can use as monitoring, that we will be able to link in with our surveys to see are people exposed to these toxicants, EMFs etc. and does it correlate with human health effects?

Andrew: Did you see a vast divergence of health issues from the orthodox male-dominated patients which were presenting, compared to the integrating females and children?

Nicole: Yes, definitely. The occupational physicians did not want to acknowledge chemical sensitivities and environmental sensitivities because they were very much, unless there's enough evidence to indicate cause, we're not going to acknowledge it. 

The integrated physicians are going, "We're listening to our patients and we believe that there are these environmental sensitivities," and then asking them about their diet especially and where they live. Now, one of the doctors I interviewed had over 35 years experience with chronic fatiguing illnesses said to me, "Do you know in 35 years of full-time practice how many patients with chronic fatigue syndrome develop cancer?" I said, "No." And he said, "Less than a handful." Less than a handful of patients, because remember, one in two of us are going to die of cancer, or be diagnosed with cancer by the age of 80. 

Andrew: Yep. 

Nicole: And he said, "I have less than five in 35 years who developed cancers. And I said, "Why do you think that is?" And he said, "Because they smell the poison. They move away from the chemicals. Whereas, all of us stay there and think we're not affected, but we are affected and we just die suddenly of heart, cardiovascular disease or cancers, and these patients don't." 

And he said, and it made me think, which is why I talked about it in my book. Maybe the most important biomarker we have as clinicians are the canaries in the mine, the 24% of the population who are sensitive, who are the ones that smelled the dinosaur meat and went, "Oh guys, that's off. Don't eat that." You know what I mean?

Andrew: Yeah,

Nicole: Who we valued in the past. And now, we've chucked a mental health label over them and ostracised them because we're not listening to the fact there's something drastically wrong with our environment in the last 40 years since the introduction of pesticides, electromagnetic fields and all these chemicals, which are having effects on human health. And many of them are documented associated with neurodegenerative disorders like Parkinson's and learning and behavioural disorders and autism and ADHD. And we're just not correlating the dots. 

So putting this together, we need as many clinicians and their patients to do this to see if we can validate the survey. We're currently putting it through Qualtrics, which is a software platform that has algorithms in place, and we're looking at June at launching this on the healthyhomesurvey.com website.

Andrew: Yeah. Oh brilliant. So we can direct people there and they can enter the data there to give you more information. Is that right?

Nicole: Yeah. And it'll come up with reports of how...we're like a traffic light system of how healthy is your home?

Andrew: Ahh, brilliant.

Nicole: Are there issues that are coming up? And it'll flag it as a traffic light system.

Andrew: Okay. One last question, Nicole, because I have friends who are in the industrial testing arena, more asbestos and things like that, but they also do a lot of mould. And one of the microbiologists and indeed, my friends’ and colleagues, say vinegar. Vinegar, vinegar, vinegar is the only thing that will keep the mould at bay and not bleach. Tell me more about this. What's the play with vinegar? Why won't bleach work?

Nicole: Okay. First, the thing that's causing the mould or chemical stew of biotoxins in water-damaged buildings is water and moisture. You have microbes on every surface and it's meant to be there. When you have moisture sitting there for more than 48 hours, that's when the microbes are going to compete and produce toxins in order to take over that space. So moisture is the key. 

If you actually look at the IICRC guidelines, which is considered to be the world guidelines on water-damaged buildings and mould, they say, "Don't use anything." Ideally what you do is you address the source of the moisture and you physically remove it with microfibre cloth. If it's more than the size of a door and/or the clients have chronic inflammatory response or any chronic fatiguing issues that can't be explained through other means, then you may want to get a mould remediator into...

Andrew: Cut it out.

Nicole: Exactly.

Andrew: So, things like for instance, on the soffit board, which is probably asbestos, you know, getting an appropriate removalist and get that out. If it's something like plasterboard, you need to cut that contaminated peace out?

Nicole: Yes. If it's porous and it's been wet for more than 48 hours, you need to get rid of it. So in my book, I go into detail. Depending on the material, if it's porous, water-damaged for more than 48 hours, it generally needs to be removed and replaced. If it's non-porous, hard surface metal, stone, for example, you can physically wipe it with some microfibre cloth and potentially HEPA vacuum that.

Andrew: Right. Okay. And then cleaning, like, for instance, stone, you know, you'll still get some embedding of spores and things like that. So do you have to be on the ball and clean it regularly, regularly, regularly with vinegar? You know, what do you do?

Nicole: No. The moisture, where is the moisture coming from?

Andrew: That's it.

Nicole: You won’t have to clean it regularly if you don't get to the moisture. That's the key.

Andrew: That's it. Take away the food.

Nicole: Exactly.

Andrew: Got you. Nicole, I've got to say, I love the way that you enlighten me about things that you've researched, you've dug into. What is the evidence showing? It's not just a whim. You really look for the science behind this. Thank you so much for taking us through yet another one of these building biology issues that we've investigated today. Thanks so much.

Nicole: Thank you for having me on.

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook.

Additional Resources

Nicole Bijlsma
Building Biology
Book: Healthy Home, Healthy Family
Australian College of Environmental Studies
EMF: World Health Organization
Documentary: Generation Zapped
Australian Dust Removalists Association

Research explored in this podcast

Stewart B. The ABC breast cancer cluster: the bad news about a good outcome. MJA 2010 Jun 7;192(11):629-631

Other podcasts with Nicole include:


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