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Identifying Mould Illness with Amie Skilton

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Identifying Mould Illness with Amie Skilton

What are the key ways to identify whether mould is an underlying factor in your patient's ongoing health issues?

In this podcast, recorded in an FX Live interractive session, we were joined by Amie Skilton who shared with us her personal journey through mould illness and how she has gone on to study Environmental Medicine so she can help others navigate this life-altering, and often under recognised area of health care.

Covered in this episode

[01:08] Welcoming back Amie Skilton
[01:43] Amie shares her story of CIRS
[08:31] The prevalence and problem of water damage in buildings
[16:34] Listener question: how long can mould biotoxins continue to remain in your body?
[18:40] Environmental and regulatory issues leading to a high prevalence of mould in Sydney
[22:21] Listener question: what is the significance of a positive test for micro toxins?
[24:00] Signs of a water damaged building
[32:54] Listener question: what mould detection instrumentation is available and where can you purchase it?
[34:34] Listener question: how much moisture do mattresses contain?
[37:07] Sense of smell and mould
[39:27] Listener question: what to look for in a dehumidifier? 
[40:41] Listener question: what if moving out of a mouldy environment is not an option?
[42:57] Listener question: are old homes or new homes more likely to contain mould?
[44:56] How patients with mould sickness present clinically
[51:11] Genetics and susceptibility to mould sensitivity
[53:16] Hoarding as a symptom
[56:42] Goal setting for patients
[01:01:48] How to find a CIRS practitioner
[01:03:33] What can you do if you have water damage?
[01:05:56] Listener question: what does your course cover regarding remediation?
[01:06:31] Listener question: can you seal mould in by painting over it?
[01:09:16] Listener question: will running a heater in the winter months affect mould?
[01:10:23] Resources for building biologists and mould testing
[01:13:47] Thanking Amie and closing remarks

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook. Amie Skilton has been in clinical practice for more than 17 years. However, after developing CIRS from water damage in her building in 2017, she's now studying building biology, and is particularly passionate about raising awareness of environmental influences like mould on health. 

Today, we'll be discussing the prevalence, the pathology, and the effects of WDB. Welcome, Amie Skilton. How are you?

Amie: Thanks for having me.

Andrew: My pleasure, absolute pleasure. Now, this is a confounding...it's not a condition. It's a satellite of conditions, isn't it? But we'll delve into that in a second. 

First of all, I think the best way for us to get a handle of how frustrating and how perplexing these issues are, is to get a handle on your story. So, could you take us through your story? How did it happen, and how did it unfold for you?

Amie: So, it was quite a year. I know you know some of the details from me, obviously, a huge turning point in my life. So, at the end of 2016, I decided to move to The Northern Beaches of Sydney, moved into Manly, to a beautiful two-bedroom apartment within walking distance of the Fairy Bower. 

And I had actually taken a year off my job to pursue all the passion projects that I had really not managed to get to. And what had happened just prior to moving into that property was the owners had done a renovation. And unbeknownst to us and them at the time, something had gone wrong with the bathroom renovation and the shower cavity, specifically.

So, what ensued was, over a five-month period, every time the shower was being used, the water was actually seeping under the carpet and throughout the whole apartment. And if you ever looked at the litreage of an average shower, that is an awful lot of water to be entering a building and having nowhere to go, essentially. 

And of course, carpet is very easily digested by mould. And so, naked to the invisible eye, underneath the carpet, some pretty serious fungal and in fact microorganism growth began to take hold. Certainly, over those summer months, we had plenty of sun, plenty of fresh air. The windows and doors were always open. So, it wasn't initially obvious to us at all that it was even remotely a problem in the property.

But after having a summer break, I sat down at my desk on February 1st, 2017, ready to start creating all of these things that I'd always wanted to produce and never had the time or the energy to do. And at the time, I was exhausted. I was mentally unable to get any traction. I found it difficult to concentrate. I felt exhausted even though I just had three months of doing nothing but reading books and lying at the beach and enjoying myself. 

And this is probably one of the tricky things about CIRS is it doesn't just sort of come on like a cold. You don't go from feeling great to feeling terrible in the space of a day or two. It's very subtle and it's very insidious. So, I thought, "Okay. Obviously, I actually was really burnt out. Some degree of adrenal fatigue is still lingering. I'll just move my start date by a month. But what I will do is I will set up a bit of a structure and a routine, and I'll get back into an exercise programme and start getting myself some sort of schedule."

And then what happened was every time I did a workout, I felt so exhausted. I had to go back to bed and sleep for four hours. And so, at that point, I started to think, "Gosh. This isn't good." And then in the middle of February, I had a styling session done by a girlfriend who went through everything in my wardrobe. Again, entirely ignorant that we were disturbing all these mould spores. And from that day forward, my health went down the toilet quite rapidly because my exposure was increased quite dramatically. 

So, I ended up having to take antihistamines every day. I began to have insomnia at night, but was exhausted during the day. I realised on that day, actually, I had gained a fair bit of weight. But again, I wrote that off to, "Oh, I've just had a few months off. And I've obviously been having a very good time.” So, a lack in discipline. It's this and it's that.

And it was only actually when I started to become incredibly unwell when we moved into autumn — and so, it was less sun — that I started to notice things didn't smell that good. And it was really out of sheer luck when we found it. We had to request a plumber to come through because there was leak in someone's garage below our property. And they identified it, actually, in December. 

So, about four or five months before I didn't realise things were quite seriously wrong in the apartment that the leak was indeed coming from my place. But that was all we ever heard. And I assumed that the leak was sort of below our floor and that we were fine. That actually wasn't the case.

And it was when I sort of put two and two together — I think it was about April that the penny finally dropped for me — that I engaged a building biologist and also a practitioner who I knew had been through this themselves, actually and recovered. 

So, it was about a five-month gradual decline that really picked up the pace in February when my exposure was increased. But it wasn't immediately obvious. Each one of these symptoms appeared almost independent of the others. And I just really wrote it off as, “I'm older, I'm worn out, I'm overextending myself.” You know, we justify these things to ourselves and they're perfectly legitimate and obvious reasons, also. But actually, this wasn't the case.

Andrew: I've gone through, not a CIRS sort of thing. I've gone through a water-damage building exploration, experience, just last week. And it's plainly evident to me now, now that we've ripped open walls where water was seeping. And thankfully, this was just a catastrophic failure of a water heater. So, it was like...

Amie: Obvious. 

Andrew: ...heck, quick, get it out. But the exploration that we did, it's amazing what is behind walls. We had no idea about what's behind there because it's out of sight, it's out of mind.

What’s perplexing to me, though, is that these symptoms can be easily attributed to so many other conditions. Like you mentioned, having the styling session getting your clothes out and dusting them off. That's so typical of just getting out last winter's jumpers and having that dust explosion. But what you had was something that just went further.

Amie: Yes. Well, what was happening, there was all this fungal overgrowth, bacterial overgrowth under the carpet, which of course, as you're walking around, it's getting kicked up into the air space. And, you know, when you're sitting on the couch, your face is closer to the source, lying in bed at night close to the source. Those spores are spreading. 

And of course, if there's elevated humidity in a home, which can occur very easily from cooking and cleaning, or your local microclimate. Like here in Sydney, for example, relative humidity is often over 70% for much of the year-round. So, that is perfect for mould to grow, regardless, irrespective of a water leak.

And so, over time, it was just spreading and being amplified throughout the property. But because of the good airflow and the sun, no mould was ever visible on the surface of the carpet. 

Andrew: Right.

Amie: And the characteristic odour of it was undetectable for those first three or four months as well. And so, it was just chipping away at my health without any really obvious indications that there was a problem. It was really only later actually, when the carpet staining started to come through that you could pinpoint where it was, but for a long time, it wasn't apparent. 

And as you said, these things happen in the subfloor. They happen in the wall cavities. They happen in the roof. And all of that fungal growth is trapped, in the insulation, in the framing. And it takes a long time or extended periods of water intrusion before it becomes obvious to the naked eye.

And so, many people are living in water-damaged buildings or working in them. And there aren't any obvious indications, like you think there might be.

Andrew: Yes, that's right. I want to make just a comment here because Anthony Briggs has made a great comment about the fantastic resources that are on the Mindd Practitioner Training on their forum. And the work of Leslie Embersits — forgive me, Leslie — is unsurpassed. That woman is truly dedicated. 

But Amie also has a course, and we can direct people to that course if you want to talk about or if you want learn about biotoxin exposure and how that might be one of the causes of CIRS. As we know, CIRS can be caused by many different factors. We're talking today, or concentrating on water-damaged buildings. 

So, for more information, click on that link that should be up on your page. And there's a module course that's going to be available for you.

Now, just one thing, a point that you made about mould eating carpet. I was recently made aware of a recent study. Excuse the tautology. And they found bacteria can eat Styrofoam. Certain bacteria. So, it's really... 

We have these set axioms that we know to be true, and they're true. And then suddenly, they're not true. There's so much more to learn. So, it's really interesting that we think that once mould is contained and dried, that that's the end of it. But there's so much more to it. 

So, can we go into... Oh, forgive me. Sorry. One more thing I needed to do, and that was that I was alerted to water-damaged buildings and the prevalence of that, from speaking with Nicole Bijlsma.

Amie: Yes.

Andrew: And I went, "Nah. Our house is fine." And then I noticed things. Really interesting, isn't it?

Amie: It's a little bit terrifying, actually, when you start looking. And I always feel like the bearer of such bad news in letting people know just how prevalent it is and the kinda things that might bring your attention to the fact that you have a problem. 

But unfortunately, first of all, in a water-damaged building, it's not just mould. As soon as you add water to what is effectively paper or pre-digested products that are easily able to be consumed by microorganisms, you end up then living in a toxic soup of microorganisms. It's not just mould, and it's not just bacteria. But it is also all of the things that those microorganisms produce.

And, you know, building biologists refer to our homes as “our third skin.” And our home, just like our gut and our skin, has its own microbiome. And managing and maintaining a healthy microbiome in your home is really not something that people are taught other than to regularly clean. 

Although I have to say, with many commercial products, we're also compromising the health of our home and everyone that lives inside it. And so, there is a fundamental gap, I think, for the average human who doesn't know how important that is. And sadly, when the health of the home begins to decline, it starts to make the people who live inside it sick. And that can look any number of ways, and we'll talk about what that looks like in a minute.

Andrew: Yeah.

Amie: But short-term, it can be allergies and infections, chronic sorts. But long-term with nephrotoxic, hepatotoxic, neurotoxic, and carcinogenic microtoxins, it’s diagnoses of kidney cancer, liver cancer, brain cancer, skin cancer. And you might be doing all of the other things right and then you get this diagnosis out of the blue, so to speak. And yet, you've been inhaling and absorbing and ingesting poisons from your property over years, maybe decades.

And so, it's not something you want anyone to remain ignorant of. And the prevalence of water-damaged buildings depends on where you live, actually, but it's much higher than you think. 

So, the best statistics that we have in sort of data-wise is for the U.S. So, one in two properties are water-damaged. So, 50% of buildings, offices or homes, have some degree of water damage. In Australia, estimates put it between 10% to 50%. I think it depends on the city. I think it's way higher in Melbourne, Sydney, and the Central Coast. 

Certainly, in one experience I had looking for a rental property...I looked at 300 properties, just over, and 98.3% of them were obviously water-damaged. And what's terrifying about that, if 98.3% doesn't scare you, is that 80% of the time it's not obvious.

Andrew: Yeah.

Amie: Yeah. More often than not, you can walk in and there's nothing that might sort of… but to the untrained eye, anyway, immediately pique your interest and make you think, "Gosh. We will... This is obviously a problem or not." So, it's very concerning. So, that means, you know, probably that half of us are either working in an office that's had water intrusion, that's not been fixed properly, or we're living in a home.

There’s a question here from Susan. We will talk more about the impacts of health on the body shortly. But the question is, once removed from the mould source, how long can the biotoxins continue to persevere in your body?

That depends, Susan. It depends on your genetic makeup and whether you are a mould susceptible individual or not. And it depends on whether you were actively trying to clear the biotoxins using binders and other liver support or not. So, I can't answer that specifically. 

But broadly speaking, if you are not genetically susceptible... Actually, sorry. It also depends on how long you lived in that property. It also depends on how much adipose tissue you are carrying because that's where it gets stored in your body.

So, if you are slender, you're not carrying too much body fat and you are not genetically susceptible, and your liver is working... No, you are not in trouble. Just kidding. Moving to a healthy home, your body should be able to clear them relatively quickly. And that might be weeks or months before they're completely out of your body.

If you are someone, however, who is heavier, you have a lot more of a storage facility, if you've been in that property for some time, you're going to be fairly loaded up. And if you are genetically susceptible, then your body's capability of clearing biotoxins is severely compromised, and you're going to need a lot of support. 

It can take months to years for some people to clear biotoxins out of the body. So, it's really something... Avoidance is absolutely the key, and minimising exposure is the key. And once you've had exposure, you really want to be much more vigilant about where you go and what kind of properties you live and work and play in, because you are more susceptible to injury from those biotoxins once you've had a significant exposure.

Andrew: Just to follow on a little about how do you know if you've got a water-damaged building. I mean, I live in a 1970s, or late ‘70s, home on the Gold Coast with — you know, we jokingly say — the 1970s Gold Coast building spec. And that was incorrect placement of walls, incorrect placement of sheeting, dubious water-proofing in the bathroom which is… In one of the bathrooms, which is being redone. And certainly, the bathroom downstairs, that's been affected recently. Totally and utterly inadequate, totally and utterly. 

Amie: Yeah.

Andrew: It looked like it was a home reno done by a weekend warrior.

Amie: Yeah. That's also part of the problem as well. In fact, I'm just going to bring something to everyone's attention. Carol Parr, who, by the way, is the building biologist who came to my rescue in Manly.

Andrew: Right. Oh, Carol.

Amie: Yes. Carol is a Sydney-based building biologist. Her business is called Mitey Fresh. And she was able to get to me really quickly. At that point, I was very, very ill. And we were renting, and we were in a battle with the property manager who was denying that there was a leak and that there was a problem. And fortunately, we knew from that plumber coming in five months earlier that it actually likely was that.

But she's on the ground here in Sydney, which is of course, one of the mouldiest cities in Australia. And she's saying 8 in 10 properties for Sydney she has seen had water damage. And that figure doesn't surprise me at all because you've got... Obviously, Sydney, for example, you've got high relative humidity around the clock. 

So, you've got a geographical bowl where we're built on an aquifer and the heat causes all of the moisture to rise into the air. So, if you're not controlling the microclimate inside your home, you can have a mould problem without ever having a leak. But we're also an old city, we’ve got old plumbing.

But in addition to that, you've got a building code that falls well short of adequate in a number of areas. Waterproofing being one of them. But the move towards more energy-efficient homes, we're creating buildings that can't breathe. And therefore... There was a study done by... Oh, gosh. I forget his name now, but he was able to show that new apartments built in Tasmania, 85% of them had a mould problem by their first winter because they were too water-tight. We need to get that balance of preventing external water intrusion, but allowing moisture vapour to leave because each person on a daily basis...

Andrew: Breathes.

Amie: Well, it's your breath, it's your sweat, it's your cooking, it's your washing. There is, on average, 10 litres per person generated inside the home each day. 

Now, if you are not extracting that with a dehumidifier or the humidity is low outside and you can open the windows to let the water vapour go out, then it's going to be absorbed by your pillows, by your mattresses, by your couch cushioning, into the plaster board of your walls and the insulation behind it, where it's going to rot everything very, very slowly from the inside out. 

And so, it's something that, as home occupiers, we aren't taught. And so, there are some key things, I think, people do need to be aware of, monitoring the humidity in your home and managing it. And also, being aware of common points of moisture intrusion and having just a basic moisture meter at home so you can pick things up much earlier than they tend to be identified as well.

Andrew: So, another question from Susan. Thanks, Amie. If we have a positive reading for microtoxins, does this mean you actually have the mould, e.g. the Aspergillus inhabiting your system, or can you have microtoxin exposure coming from the environment without endogenous infection? That's a good question.

Amie: We will be getting to sort of the patient side of things shortly. But in answer to this, a positive microtoxin result doesn't give you a lot of information at all. And so, it's not a test I ever use or recommend. 

It is entirely possible that you have ingested microtoxins. Although, if that was the case, you're probably going to be quite unwell. It is also possible that you have a fungal infection in your body, but generally speaking, most microtoxin results are generated from microtoxins produced in your immediate environment. 

And so, that could point to a water-damaged building or mould in your car and things like that. So, it doesn't help you identify the source, but if someone's run that test and it's shown up, you can identify by what microtoxins come up, what species you're being exposed to. And that might assist you in identifying where to start looking for the mould that you're clearly cohabiting with somewhere along the line.

Andrew: So, I was going to ask the next question about differential diagnosis, but do you want a go into that after our next question, which is how do patients present?

Amie: Yeah...

Andrew: When do you want to...

Amie: I want to cover off how you know if you've got a water-damaged building.

Andrew: Okay. Great. All right. So, let's do that. Because, like, for me, I thought, "No, we didn't have a problem." And then I noticed... Thank you, Nicole. Noticed, you know, little spots of mildew on, like, the soffit. Meaning that the drains were being overwhelmed. The gutters, forgive me, were being overwhelmed, and it was leaking back in. 

And, of course, the real evidence there didn't come to fruition until we had a torrential rain and I punched a hole in the soffit. The whole lot came falling down. And in there was just this rotten wood. But the thing was that I haven't been affected by CIRS, where somebody else might be. So, then you get from the water-damaged building to how the patient reacts.

Amie: Yeah. Yeah, yeah.

Andrew: So, let's go a little bit further into the water-damaged building and the detective work, and then we'll segue into patient presentation. How does that sound?

Amie: Yeah. That sounds good. And Graham has made a timely point about water intrusion points being quite difficult to find from time to time. 

Andrew: Tracking.

Amie: Because with capillary action through building materials...

Andrew: Just tracks to you…

Amie: Water can defy gravity usually by about one meter. If you've seen water coming up in a moisture meter sort of above a meter from the flooring, it's probably coming from somewhere up top and not from the bottom. 

But, we've seen water run uphill. We've seen it move in all kinds of ways that are difficult to explain. And so, you really do need to call upon a lot of different tools and methods to identify where the moisture is. But if you've got a mould problem, you have a moisture problem, and finding the moisture source is the key.

A building biologist is highly skilled to do that, but occasionally, you might need to get a leak detection specialist to assist. We've got a colleague, actually, who's...with a brand new home and the builders had struggled to even find where the moisture is coming in. And yet, she's had waterfalls coming through her walls. 

But, yes, certainly moisture mapping, checking relative humidity in every room will give you an idea of which end of the house the problem is. And then you can use a moisture meter to actually track where it's moving along building materials.

But in terms of other ways, I think some of the key things are, first of all, smell. Now, smell, obviously, no tool and no test is completely foolproof. And it also depends on what kind of moisture problem you have and how intermittent it is. So, for example, if you have a roof leak, when there's moisture there, you get microbial and fungal growth, which produces VOCs, which give the characteristic odour of a problem. So...

Andrew: Forgive me, Amie. Sorry. VOCs, volatile...

Amie: Organic compounds. So, basically, Professor Marc Cohen calls them fungi farts.

Andrew: I love Marc.

Amie: Yeah. It's, like, a very apt way of describing, basically, you know, just like when we consume foods that we struggle to digest properly, we can get a little gassy. Mould, as it's chewing through plasterboard or insulation or whatever it is, can end up with some gas out the other end. And that can smell like any number of things. It is obviously the characteristic musty smell that we associate with mould. 

But what I want to impress upon everyone listening to this is that your home shouldn't smell like anything. It should smell just fresh, clean nothingness. And so, anytime there's a smell that smells like anything, then you've got a problem.

So, it might smell a bit yeasty, it might smell like vomit, dirty socks, wet cow, wet dog. It might smell like alcohol or fermenting mushrooms. There's a VOC that smells like marijuana. So, anything that just smells a bit off. Sorry.

Andrew: You'd just see a lot of people blaming, "Ah. It's the fungi. Don't worry about it."

Amie: It is the fungi. It's definitely not me. It's not my farts. 

So, smell is number one. But the smell is indicative of active fungal growth, which means there's active moisture intrusion. So, that means if you go through a dry period where the mould dies down, the smell will disappear for a period of time. And then when another leak happens, you'll smell it. 

Whereas, if you've got a pipe leak that's consistent, the smell will remain. And certainly, for us, once the musty smell became obvious, it didn't disappear again because the water flow was consistent. So, smells are a big thing. And same with items that have been stored. If they come out smelling a bit funny, probably some sort of growth on them.

Andrew: Yes.

Amie: Obviously, if you see mould, you have a problem. But because it's so difficult to see, I would say, changes in texture. So, if you start to see rippling in the ceiling or bubbling underneath the paint or the wall paint, you start to see warping or cupping of timber or skirting boards or bulging of wall cavities, they're all big, red flags. 

Stains or unusual colours. Obviously, when a house first gets built or renovated, it looked fresh. Everything was a uniform colour and a uniform texture. So, any time you start to see, you know, a bit of a shadow or a bit of yellowing or a bit of speckling, you know that there's a problem.

If any rooms feel damp. And that might feel, in summer, they might feel hot and stuffy, but in winter, they might feel clammy going into them. That's a sign of moisture in there and, of course, if you've got mould on any of your personal items. So, you start to see your shoes sprouting a bit of mould or your leather jacket starts to get, like, a white, powdery substance on it or your handbags start to get a little furry. 

I must admit. The mould that was growing on my handbag just looked like white, powdery dust. That would have been Aspergillus, but I thought, "No. Mould looked like, you know, brown, dark stuff." And so, I was just, like, brushing that off, thinking it was dust. And it was actually mould. 

Andrew: No. Yeah.

Amie: So, it can be quite unexpected. So, if you're getting mould or your items are smelling mouldy or yeasty, you've definitely got a moisture problem, which means you have a mould problem that you can't yet see.

Andrew: Didn't you have a different coloured stain on your carpet or something?

Amie: So, here's what happened that was really interesting. So, obviously, the water was coming underneath the carpet. And the two bedrooms were either side of the bathroom. And I think it was more heading into our bedroom. One day, I accidentally spilled a bit of water off my nightstand onto the carpet. And I dried it, but then it went...it sort of bloomed into this lovely orange colour. 

We had cream carpet. And I can’t remember how many days or weeks later it was, and at the time, because I was ignorant to what was going on, I thought, "Gosh. Did I spill a cup of tea or something?" It looked like I'd spilled tea. And it turns out it was Wallemia sebi that was like...which is an orange-looking mould had just sprouted because of the extra water that had dropped in that particular spot. 

And, certainly, in the patch right by the bathroom it started to go a darker colour. But again, it didn't look obviously mouldy. It was only when we lifted it that we could actually see there was a problem. So, yeah. Any sort of weird colours, stains, smells.

But I have to say, if you don't already have a thermo hygrometer, we need a couple around at different aspects of your house. Get yourself one so you can keep an eye on your relative humidity. You want to keep it between 45% and 55% to avoid any problems. 

And in all likelihood, especially if you live in the cooler parts of Australia or the damper parts, you're going to need a dehumidifier. And I think a cheap moisture meter is probably one of the best investments you can make because that way you can check very quickly, or even regularly around the bathroom areas just to make sure that nothing has occurred that you're going to miss for the next few months before it becomes a bigger problem.

Andrew: How much are these hygrometers?

Amie: Thermo hygrometers are cheap. They're a little LED battery-operated thing that are about $20, $25 each. I've got two. I've got one here in my office, and I've got one out in the living area. And we just keep an eye on that and turn the dehumidifier on when we can. And I haven't changed the batteries since 2017. So, that sounds great, huh?

Andrew: Now, a question from Bernie there, who's also in New Zealand. Thanks for joining us, Bernie. But what brands are available, or can you recommend? We're not normally branded in FX Medicine, but I think this is important to sort of get a handle on what's available. 

Amie: Of course.

Andre: So, what sort of instruments can people purchase, and where?

Amie: So, here in Australia, you can get them from Jaycar. You can order them online. You can... I got from scienceinstruments.com.au. But I think, Bernie, Mitre 10 would probably have them. That's a Bunnings equivalent here, just a hardware store. But yeah, I bought mine online very cheaply.

Andrew: And it's a hydrometer.

Amie: A hygrometer.

Andrew: It's a hygrometer.

Amie: Yes. So, thermo, T-H-E-R-M-O, and hygrometer, H-Y-G-R-O-M, meter.

Andrew: There you go, Graham.

Amie: Yeah.

Andrew: Bec's onto it. Thanks, Bec.

Amie: Yeah. So, very easy. I think it's one of the best investments you can make. And this will allow you to see the shifts in humidity when you're cooking, if you're drying clothes inside, if you've had, like, a run on a steamy, you know, shower after shower after shower, and then actively do something about it. 

Because within 48 hours of elevated humidity or water intrusion, you're going to have mould growth. And it only takes 12 hours of moisture for bacteria to start growing. And so, it's really not something you want to look at once a week. It's really a daily thing that you want to stay on top of, for sure.

Andrew: Okay. So, a double question here. You mentioned mattresses earlier. From my dust mite days, I was of the mind that the mattress can contain something like 10 litres of humidity. Is that correct?

Amie: Sorry. Say that again. I was reading a question on the chat.

Andrew: Let's say a number of litres of moisture in your mattress. And you indeed had a particular issue with your mattress, didn't you?

Amie: Yeah. Yeah. So, the mattress was a very good example of how moisture and mould can bunny-hop around the home, and also how tricky it can be to monitor. So, our mattress... We didn't have a futon. We had, I guess, what you'd consider a normal bed, whatever centimetres off the ground. It also had a mattress cover on it that had a plastic bottom, but it did have ventilation holes. 

And because it wasn't immediately on the ground and in contact with the water, we thought it'd be okay. We did test it. We tested it for ATP, which indicates active microbial growth, and it came up okay. But that was on the surface on the mattress cover. And it was only when the whole leak got fixed and a new carpet went in and we moved everything back and I just thought, "I'm just going to clean everything I can clean."

Andrew: I'm cringing.

Amie: Oh, man. It was a shocker. And I think, “ Thank God, I thought to do this." Because you know what? We moved... When we realised what the problem was and where it was coming from, we moved the bed out into the lounge room. But even out there, my lungs were on fire. It was like I was inhaling fire. My tissue was burning. And I didn't realise that our mattress was completely mouldy. 

And because we were cleaning everything before we moved it back in, I thought, "Oh, I'll just wash the mattress cover. I'll HEPA vacuum the mattress." And when I peeled back the mattress cover, oh my goodness. What we couldn't see from the outside was where the ventilation holes had been, mould had gotten in. And it had grown in columns up through into the mattress. We were literally sleeping on a mould pit at night. And, of course, as you lie on it and the air pops out, all of that was going into our airways at night. And so, yeah. Porous things are sadly very, very easily and quickly impacted by a mould problem.

Andrew: And you also mentioned the first sense of ours that is normally affronted with the smell of mould. And indeed, I've walked into my wife's work and I am immediately affronted by this musty, mouldy smell. And yet, Leigh can't smell it. She doesn't have any health issues from it. 

But interestingly, I took a teacher down there that I was discussing this with. They work for the school. And she said, "What smell? I can't smell anything?" So, I took this teacher down there, and then she said, "Oh, yeah. Now, I can." What's interesting to me is why could she not before? Is this part of the genetic susceptibility of people to...or certain patients to have this incredible reaction to mould, whereas other people just go, "Hey, it's mouldy."

Amie: I'm not clear on the relationship between susceptibility and ability to detect the smell. 

Andrew: Right.

Amie: So, for example, my husband does not have a mould-susceptible gene. And his sensitivity to smelling it is better than mine. But that being said, I also live and work at home. And so, I'm never refreshing my senses. And our senses can become dulled. They become dulled to constant pressure. They become dulled to constant stimulation. This is why I think they say you can only smell like six different essential oils or perfumes before your ability to actually pick up all the notes dies off and you've got to sniff coffee beans to redo it.

Andrew: That’s the only reason I have so much coffee, Amie. To keep my nose attuned.

Amie: The other thing, though, is there are specific microtoxins that damage the olfactory bulb, and potentially this is a survival mechanism by mould in order to evade detection. And so, for anyone, the longer you're exposed, the less likely you are to pick it up. And certainly, if you are constantly in that property, you won't...you just get used to it. You adjust to your immediate environment. 

Whereas, you might go out all day running errands and then come home and then go, "Oh, okay. I can smell something now." So, yeah. It's very...a bit of a mixed bag. But certainly, by refreshing your nasal passages, you'll be able to pick things up more easily.

Now, there was a question there about a dehumidifier. I'll just answer that now. There are two main different types of dehumidifier. And the best kind to get really depends on where you live, your microclimate, the needs of your property. So, I encourage you to get a recommendation from a building biologist who can base that on your own geographical location and challenges with your property.

But the other thing to bear in mind is the capacity of the dehumidifier and whether you're going to plumb it in or not. So, I work from home. So, even though mine is, like, quite a small bucket, like four litres, I think, I can empty it. But it kind of needs emptying, I don't know, once every 24 hours, sometimes slightly more frequently. And that works for me. 

But if I was in a damper place and was unable to control the climate like I do, I'd probably need a bigger container or to plumb it in so it can permanently drain down the bath or something.

Andrew: I can just see that... You know, if you weren't on top of it, I could see that adding to the problem.

Amie: Mm-hmm. Yeah, totally. Yes, absolutely, it could. Especially if you just leave it sitting in there and then you've got all of this moisture sitting there. 

Some question here from Ben. For someone who can't move but is suffering from serious mould-related symptoms like severe rhinitis and eczema, can these symptoms still improve significantly if you don't remove the mould source? No. Sorry. No.

The best thing you could do if you can't move at this stage is set up a tent in your backyard. But the tricky thing with camping, especially at this time of year assuming you're in Australia, is the dampness outside. So, you'd have to be very careful with the kind of things that you buy. 

So, if you own it, then you need to get a good building biology assessment done so that you can claim on insurance for water damage and have it remediated. If you're a CIRS patient, sometimes even a medical grade remediation might not be enough to improve the home, but it should be enough to improve rhinitis and eczema symptoms. 

If you rent and there's a moisture problem there, you can't at this stage legally force the landlord to do the right thing. But you can, however, get out of your lease and get compensation to some degree or another. That's something I help clients with quite regularly. But, yeah, there's no way you can live in a mouldy property and expect it to improve without doing something about it. So, either way, you've got to take action.

But if you're stuck somewhere for the time being, I know with COVID and restrictions on movements and things, it's very difficult. I'm going through this right now myself. And it's very stressful. A camper van or a tent or something outside and come in to do, you know, washing, cooking, cleaning, stuff like that. But improve your air quality as much as humanly possible. If it's limited to a room in the house, you could possibly seal off the room and do some basic remediation on the rest of your home. But wherever you sleep...

So, during the day, you can obviously get out of the house. Right? You know, in the daylight hours, you can spend time somewhere else unless you're in Melbourne, actually. Gosh, I hope you're not in Melbourne.

Andrew: There's a few.

Amie: Yeah. But wherever you're sleeping, you need clean the air and not to be exposed to mould. I'll just check if there's any other good questions here.

Andrew: Just an interesting one from Milva: Are older homes worth the new ones or does it not matter? It's amazing the variance in building code and then regardless of code, you've got the tenacity, if you like, of the builders to stick to that code.

Amie: It's honestly a dog's breakfast. 

Andrew: Yeah.

Amie: It’s heartbreaking, actually, when you look under the hood of the building industry. It varies state by state, the Australian, the national building code. They're trying to improve it, but you know, these things don't improve quickly. And then you've got all these existing buildings that have problems. Milva, it's a bit of a mixed bag. It's kind of, like, which problem are you up for? 

If it's a new build and let's say no one has lived in it and it's not in Sydney and therefore been exposed to humidity, you have the opportunity to control the internal microclimate. Know that it's probably been sealed up too tightly, and that moisture is not going to get out properly. You can go in with your thermo hygrometers and your dehumidifier and keep it completely dry. Great.

What you don't have control over, though, if it's an apartment, is what everyone is doing next door and above and below you. An older home, the more drafty homes, actually, tend to be better on occasions, the double bricks. But then the older a home is, the more likely you've had earth subsidence, maybe pipes shifting, breaking, springing a leak. And so, there's no magical answer unless you are lucky enough to have an unlimited budget to build your own building.

Andrew: We could talk for hours about this. So, I could tell you about the five layers of waterproofing I did and I exceeded the building code to make my bathroom renovation a fishbowl. There was no way that I was going 30 centimetres outside of the wet area. It's a fishbowl.

But we have to move on because we're running out of time. These patients, indeed, you, like...you're a resilient, strong woman and yet it crumbled you. How do these patients present when, particularly when it's the first time you've ever seen them? Like, we saw the changes in you. So, we were well aware that something was wrong, something was amiss. 

But this is the first time that somebody presents to you. How do you think water-damaged building and an immune reaction from that, CIRS, or when would you think chronic fatigue? 

So, from tick bites, multiple chemical sensitivity. There's so...pernicious anaemia. What about psychological causes? There's so many... It's such a... Talk about rabbit holes. It's a spider web. So, how do you unravel that?

Amie: So, depending on the patient's genetic susceptibility, it will depend on what seems to be the prominent feature. We know that because of all the microbes and their metabolites that one of the biggest red flags is atopic presentation, chronic allergies. 

So, they don't appear to be relative to the season. They're on antihistamines all the time. They've got eczema. Anyone with severe eczema, child or adult, is likely to be living in a water-damaged building. If it's severe, especially if it's adult eczema, almost guaranteed. Same with asthma, asthma that's not well controlled. So, if someone is coming to you saying, "My allergies are out of control. The antihistamines aren't working," or, "I'm having a lot of asthma attacks and the medications are not helping me enough,” those are all big, red flags.

Questions to ask might be, “Do those symptoms improve when you're away from home?” Because these tend to be related to direct mould exposure. Whereas, if you've got CIRS, you don't feel better leaving the mouldy building often, because your genes mean you can't detox the mould. 

But, yeah, allergies, asthma, eczema. Also, chronic respiratory tract infection. So, if you've got...keep getting pneumonia, always have a cold or a sniffle. They get a cold and then it goes straight to their chest with bronchitis. Because of all the microbes that are festering in a water-damaged building, respiratory tract infections and skin infections are very common, weird rashes.

A massive red flag is coughing up blood and bleeding noses. Obviously, there's other sinister reasons you might have those symptoms. Of course, as clinicians, we're always sort of... You know, it's a process of elimination from the worst to the least problematic. But one of the metabolites that Stachybotrys produces actually causes haemolysis. So, that's a very common red flag for me. If I've walked into a building that has Stachy, I'll have bloody nose or bloody mucous as a result. So, that's sort of the obvious acute things.

Also, patients that feel better on a gluten-free diet, so non-coeliac gluten sensitivity is another common red flag. The mould susceptible genetic haplotypes or the coeliac gene susceptible haplotypes. And so, whilst they might not have coeliac disease, antibodies or any other indications of coeliac, gluten makes them feel bad and they feel better avoiding it.

But other symptoms that can, not be misdiagnosed, but can be a result of CIRS or living in a water-damaged building are chronic fatigue syndrome, fibromyalgia. So, anyone with a diagnosis, either of those two, you've got to investigate what the cause of the cause is. So, someone might say, "Oh, you know, I'm tired all the time," or "It's this.” or  “I'm in pain." And you're like, "Oh, the cause is you've got chronic fatigue syndrome." Well, you haven't looked at the cause of that. And more often than not, it is a water-damaged building. I had both of those things. I had both of those things, and I don't when I'm not in a water-damaged building.

So, microtoxins, of course, cause damage throughout the body. But one of the main things it does is impact your brain. And so, changes in cognitive function, mood, even to the point of developing dementia symptoms. You know, I had full-blown inhalational Alzheimer's. I couldn't even remember my own name at one point. I struggled to hold a conversation. I couldn't work out how to get dressed. Like, the process of which item you put on first and then after just was beyond me. At the age of 37, couldn't figure it out until my brain healed.

So, those things...

Andrew: That totally answers superheroes. Underwear on the outside.

Amie: Maybe it does. So, yeah. If you've got a patient presenting with any of those things... I actually cover this in depth in module four of the CIRS course, all the red flags that you might see in a case history. All of the questions you should about the patient and their home or office to kind of figure out whether they're being exposed or whether their symptoms are caused by that.

And, of course, there's the obvious CIRS symptoms as well, as defined by Ritchie Shoemaker. So, you know, those would of course pique your interest. But sometimes, if they don't have the genetic susceptibility, you won't get those. And so, it'll be these ones that you see instead.

Andrew: Now, we've put up a little placemat there before for Nicole Bijlsma, an interview that I did with Nicole very early on, which blew my mind. And indeed, it was before, I think, her book was published, which is brilliant. I would say... That's the reason... Forgive me. I was looking around because it's down there. 

Amie: Okay.

Andrew: But, of course, you'll be covering sequential information in the various modules in your course. Forgive me. Can't remember my name, can't remember how to speak.

There were so many things. You've mentioned genes a few times. 

Amie: Yes.

Andrew: Can we go into which genes are we talking about here?

Amie: So, basically, there are a set of haplotypes associated with the mould gene or coeliac gene that are indicative of someone's susceptibility to becoming much sicker much quicker on exposure to biotoxins. And in this case, we're talking about microtoxins produced by mould, but there are other biotoxins that can also have an impact. 

Ultimately, what that means is it represents a system that is less able to, immunologically speaking, recognise biotoxins to tag them for clearance. And so, it's like the innate immune system kicks in. For anyone listening who's not a clinician, we've got sort of two arms to our immune system, the innate immune system and the adaptive immune system. The innate immune system is like the first responder that's sort of dive in, all guns blazing, you know, who cares what damage we make? We're going to make a big ruckus to get on top of the bad guy. And then the adaptive immune system rocks up later with a bit more of a measured approach, looking for the bad guy and targets them only.

But in someone who's susceptible, that second part never kicks in because the immune system can't recognise and tag the biotoxins. So, the first guys, the cowboys, have to keep going and causing inflammation and pain and all kinds of disruption in the whole body. And so, microtoxins will make everyone unwell. Microtoxins will damage everyone's organs and tissues. But if you're able to clear the biotoxins, it'll take a long time before you register something's wrong and you're being poisoned by your environment. 

Whereas, someone like myself who's genetically susceptible, you know… the canaries in the coal mine, so to speak. We are the early warning signs of an unhealthy environment, and therefore, all humans need to vacate the immediate surroundings.

Andrew: Right. Now, there was one other symptom that you and I were discussing previously, a weird symptom that some people present with.

Amie: That was hoarding.

Andrew: Yeah.

Amie: And it's a conversation I've had a couple of times, actually, and the propensity I noticed in myself. And I'm sure there are lots of reasons people end up hanging on to stuff that they just really don't need. But I think a common thread that links it all is brain inflammation. And what I've determined since obviously coming out of this...because I started holding on to crap, absolute garbage, actually, on reflection once I was well.

Here's my take on it. When your brain is inflamed, your ability to discern becomes challenged, and that includes the ability to, first of all, remember stuff and also work out what's important and what's not. So, another red flag is... I used to write on my hand all the time. I mean, you'll leave notes upon notes to remind yourself to look at that note. You'll set alarms on your phone. You're forgetful. You know, it took me three hours to leave the house once because I couldn't find my keys. And when I found my keys, I couldn't find my wallet. Then I find my wallet and then I'd lost my keys again. It's honestly ridiculous.

So, that whole brain inflammation and, yeah, the... And it also causes a lot of anxiety as well. Everything feels very uncertain and unstable. So, hanging on to stuff gives a sense of security and stability and familiarity when everything else feels very wobbly. And it's also very hard to work out what's important. And because you can't figure out what's important to keep and what you should let go of, you keep everything. 

Andrew: You keep everything. Right.

Amie: You think, "Oh, I might need that." And so, it was really interesting.

I guess my personal thing was... Well, first of all, way too many clothes. That's why I had that styling session in the first place with my friend because I had too much stuff, but I didn't know what to get rid of. But also, for me, my personal tell was I used to design and make jewelry in my spare time for gifts and things. And I would often collect or keep broken jewelry or things I'd found and refashion into other stuff. 

It got to a point where I was keeping actual garbage, and I didn't... Not actual garbage. It wasn't like plastic bags or anything…

Andrew: Eww.

Amie: …but you know, just broken and damaged stuff that was really beyond repair or repurposing, but it was like I was trying to save it, reuse it, didn't want to go on the landfill.

And then once I sort of healed and started going through all of my stuff again, I was looking at it with fresh eyes, or I suppose a fresh, less inflamed brain. And I'm looking at it going, "What was I thinking hanging onto this?" 

But of course, if you never recognise you're in a toxic environment and your brain remains inflamed, this behaviour is simply going to escalate. It would have for me. Like, if I didn't know what I know, I could have ended up one of those people whose homes is full of newspapers from the last 15 years just in case I might want to read it.

In fact, I had magazines that were over 10 years old that I hadn't gotten around to reading and I was...

Andrew: What's wrong with that?

Amie: Well, look...

Andrew: I've got National Geographic from 1966. What's wrong with that?

Amie: You know what I mean. There's a limit. There's a limit.

Andrew: There are so many awesome questions here. And, guys, a lot of these will be answered in Amie's course. There's so much to go through. We're running out of time, so, I need to move on. 

But I want to just cover about expectations for patients that you help, that building biologists help, and other people who specialise in CIRS and chronic fatigue and water-damaged building and their effects. And that is, how do you set goals for these people when very many times they can't afford to move?

They’re not billionaires. They can't afford to build their dream home with the perfect building spec. How do you make adequate remedy to a toxic situation, living situation, and also look after their health? What goals do you set in place, and what length? How do they respond? How do they get better?

Amie: Far out. 

Andrew: In ten words.

Amie: I’ve got three minutes to answer this.

Andrew: You've got three minutes, two minutes.

Amie: I'll just say that this is probably one of the most heartbreaking and challenging things to navigate and recover from. Even as someone who's a health professional, who's now studied mould testing, finding a safe home has been difficult. I'm lucky to have access to supplements very easily at the drop of a hat and an amazing network. And it was soul destroying for me.

The answer depends on whether you own or rent, of course, because if you own, you've got to decide whether it's easier just to sell and move somewhere else or remediate. If you rent...rentals, you've got to just get out of there immediately. But then how do you know you're not stepping into...out of the frying pan into the fire? 

So, I actually specifically help train people what to look for in a rental or probably their own. In an ideal world, you'd get a building biologist, but it's a competitive rental market. You've got 50 other people going through. A building biologist might not be available at that time, and it's costly. And so, you want to be 95% sure it's going to be good before you take that. Obviously if you're buying it's a different story because you're investing a lot of money. But for a rental, there's a lot of things you can do to avoid the heartache of accidentally going into a mouldy property.

But number one is to actually get into a safe environment. And often, that means people end up living in cars, camping, and it can take a long time. I mean, it took me three properties to find a home. And that was looking every Wednesday and Saturday, and knowing what to look for.

The treatment process as far as recovery goes, again, depends on the genetics. If you're not genetically susceptible, getting into a healthy environment might be all you need. You'll feel better within a couple of weeks. You might be fully recovered after a couple of months, but if you are genetically susceptible, you'll need to work with a CIRS-literate practitioner to not only detoxify all of the biotoxins that your body's holding on to, but also restore balance to all of the hormones and the immune system that have become dysregulated as a result of your exposure. And that can take months, sometimes years, depending on your environment and how quickly or slowly you can move someone through the process.

I suppose, the good news is that there is a very well-worn path, a well-worn protocol, a step-by-step process, and lots of flexibility in those steps, too, in which to restore someone back to full health. And I think it's quite rare that you're unable to do that. Usually, the hold-up is the environment and people continuing to be exposed. 

Obviously, if you've got a good home but your office is mouldy, that's unfortunate. If you have to get public transport — well, buses and trains are notoriously mouldy — that's another challenge that someone might have to deal with. But that's why I've put this course together for practitioners because there's limited options to learn about this. And I think, knowing that roughly a third of the population have mould susceptible genes, and that roughly half of properties, generally, Australia-wide, are water-damaged.

One in two patients that we're seeing is likely to be impacted by a water-damaged building in some way, shape or form. 30% of them are likely to be quite significantly unwell because this isn't something that, as practitioners, we can afford to not know about.

Andrew: We didn't get time to go into the issues of work sites being the source of the water damage. And it'll just be very interesting to see over a period of time with so many more people working from home in this time of COVID-19 whether these patients get better, or indeed, if their issue is the home and if they then present with CIRS and they get worse.

Carol, brilliant words from you. She says, "Take one step at a time and breathe." Hopefully, less toxic air.

Amie: Yeah.

Andrew: One last question. Is there a list of CIRS practitioners?

Amie: Yeah. So, certainly, everyone who does my course will then be tagged in the BioCeuticals database as a CIRS-literate practitioner. But in addition to that, there's a couple of other places you can go. 

Anyone who's trained directly with Richard Shoemaker, who's the U.S.-based doctor who identified this condition and worked out how to treat it, he has on his website, survivingmold.com, a list of certified practitioners. That being said, there's a lot more practitioners who have done his training or done training from CIRS-literate practitioners here in Australia that are not on that list. 

So, I think the best place I could point people to is there's a Facebook group called Toxic Mould Support Australia. They have a website also. I might get this wrong, toxicmouldsupport.org. They actually have a much more comprehensive list on their website that also includes functional medicine practitioners, not just GPs. There's a combination of both there, too. 

So, you can certainly find help on those two sites. And we'll also be, of course, turning out some well-educated practitioners at the end of the course as well.

Andrew: Is it the English spelling of mould or is it the American spelling of mould? M-O-U-L-D?

Amie: So, Toxic Mould Support is UK English because it's an Australian site.

Andrew: M-O-U-L-D.

Amie: Yeah. But for the Shoemaker site, survivingmold.com, it's M-O-L-D.

Andrew: Got you. Now, we did a poll while you were answering that last question, and 100% of people said, "We'd love to keep going for an extra 5 or 10 minutes."

Amie: Well, okay then.

Andrew: Okay.

Amie: Sure.

Andrew: So, can we quickly delve into what patients can do, let's say, when they realise they've got water damage? What is the best step? Do you just rip down walls? Do you get a building biologist in? Do you get a builder in, a plumber in? What's the first step?

Amie: Look. I think the first step is you've got to find the source of the moisture intrusion, which a building biologist...

Andrew: They, or do they enlist somebody?

Amie: Yeah. A building biologist is probably the best unless you've got some sort of building experience. It can be very hard. I think Graham pointed that out earlier. It can be tricky, even for a professional. 

My in-laws currently have got water intrusions. They've had a plumber there for three days trying to find where it's coming from, and he can't. So, please get a professional immediately. A building biologist is ideal because not only can they help you find the source or sources of moisture intrusion, they can also assess how bad your place is, and give you recommendations on who can remediate it and how it should be done.

Now, depending on how extensive it is, you might need to seal off parts of your home and you can live in the better part, the healthy part. But remediation needs to be done according to IICRC standards, which involves containment to stop contamination in the rest of your home. So, please, for the love of all things healthy, don't rip down anything. Don't rip up anything. Don't disturb anything until you've had professional advice. I know you...

Andrew: There's a conundrum.

Amie: I know. I know. Look. If it’s recent water intrusion, let's say, something's burst. You've got 48 hours to dry it. And by all means, lift up the carpet, lift up the underlay. Run the dehumidifier fans, heaters, etc. 

But if it's been an ongoing issue, then don't touch it. Seal it up if you can. Get as far away from it as possible, and get a professional in to give you a scope of works. And then from there, you obviously need to get the leak fixed before anything else can be done, and then everything else can be sorted out afterwards. It can be a bit of a process. You might want to check yourself into an Airbnb or stay with a friend if it's quite extensive. That's what we do because our whole property was impacted.

There’s a question here from Susan. Does your course cover both water-damaged building remediation and personal remediation? 

Yes, it does. I've got a whole module dedicated to how building biologists assess things and the way in which remediation needs to be done on porous, semi-porous, non-porous things. Obviously, you don't come out a certified remediator because that is an entire profession in and of itself, but it does educate you on how things need to be done and who to call. And some of the basics that you can do yourself for, say, the non-porous things that are glass and metal, for instance.

Leanne is asking, "Can it be sealed by painting over?" 

No, that's not how remediation is done and that's, unfortunately, what a lot of property managers do with mould in bathrooms, for example. They just paint over it and think it's just magically disappeared. No, it hasn't and it will continue to make the occupants sick if that is done.

Andrew: Can you contain, though... Obviously, you must remediate the cause of the water damage. So, let's say it's a gutter that's overwhelmed and flowing inside or dripping inside. 

Amie: Yeah.

Andrew: Once you remediate that, with this new plastic-like paint, is it possible to...once you've done a remedial cleanup of the internal surface of plasterboard, can you effectively create a closed bubble, if you like, by painting everything, the cornices…?

Amie: No.

Andrew: No?

Amie: You can't clean mould off plasterboard. 

Andrew: Damn.

Amie: The hyphae get in and all your cleaning is the surface presentation. And you've got to realise there's a cavity on the other side for the insulation. And you might be able to control the moisture in the bathroom, but you can't control the moisture in the cavity. 

Andrew: Right.

Amie: That’s just going to continue to grow and poison you through the airspaces, and you no longer have a visible proxy for where it is. So, unfortunately, no. You have to remove mould. You can't clean it off. You have the cut the plasterboard out. You've got to remove the insulation. If you've got timber framing, you may need to remove that and replace it. You might be able to media blast and seal that, possibly. But only a building biologist can tell you the degree of damage and how far you'll have to go. And then a remediator can kind of take it from there.

Andrew: And in your course, will you be covering the new types of building materials that are available, like water block cement sheeting? And you've got water-resistant...I'm going to say it's not waterproof, but water-resistant plasterboard nowadays. They're a little bit more expensive, but, jeepers, in my bathroom, give me the water block board. I bought it.

Amie: Yeah. That’s a specialist area of building biology, and most building biologists are trained to some degree or another around that stuff. So, you can get advice from them. There's one in particular, Narelle McDonald, who specialises in healthy home renos and building. But it's outside the scope of the CIRS course to talk about renovations in building, I'm afraid.

Andrew: Bunnings would make too much money off you.

Amie: Yeah. There's a question here from Jilana, should I answer it now? What's your advice during winter months when you have the heater on during the day and night? Will it add to the humidity and mould buildup? 

It depends what kind of heater you have. If you are using an oil-filled heater or you've got, say, a fire, for instance. Those are dry heats. Warm air holds more moisture than cold air. So, you can actually drop the relative humidity in your home by warming up the air. However, gas heaters, especially if they're not flued, they can actually be very dangerous. Don't use those. You've got to look out for carbon dioxide as well. But they increase the moisture content of your home.

Warming your home is a good idea because that reduces the opportunity for condensation. But you still have to solve the problem of where does the moisture go? And so, the dehumidifier has to be a part of that as well and monitoring the relative humidity. And at least with thermo hygrometer, if you do have the gas heater and you notice that moisture level starting to climb, you can get the dehumidifier on, or maybe consider an alternative form of heating for your property.

Andrew: Right. Carol, thank you for lending a hand. There's been some questions about finding some people to help them in various parts of Australia. 

Obviously, you can get the sense that this is just a bigger than Ben-Hur issue and that the people attending today's session aren't just concerned for themselves but so many patients of theirs as well. So, this is obviously a bigger issue that we really need to have a quorum for.

Amie: Indeed, we do.

Andrew: And, yes, Sandeep Gupta was mentioned there. So, he's up on the Sunshine Coast.

Amie: Yes, Dr Sandeep Gupta. He was the first Shoemaker-trained CIRS-literate GP in Australia. He's amazing. He provides a lot of support in the toxic mould support group, too. He's got a course as well, which I think he's upgrading. We're actually interviewing him. We're trying to lock him down for an interview for the course.

Andrew: He's finishing his course first.

Amie: Yeah. But he's lovely and very insightful. In fact, he just recently did the mould testing technician course with Nicole Bijlsma. So, he now has a really powerful understanding of what to look for in a water-damaged building. And I'm sure all of his patients are just going to benefit so much from that, too. 

But for anyone looking for a building biologist, the Australian Society of Building Biologists has a database, geographically arranged. So, if you go to asbb.org.au, you can actually search by state and find someone in your area.

Now, I will say, mould testing is a very specialist elective within building biology. I think it'll eventually become a core subject. But for now, when you're scanning the list, any building biologist who's done mould testing has a little asterisk by their name. Carol's has one. So, that way you know that they're equipped to do what you need them to do. There's a link that's just been popped up there. Thank you, Mel. And this will assist you in finding someone local to you.

Now, if you are somewhere that's rural or you can't get someone to you, some of the building biologists also offer online stuff. Carol, let us know if you do. But I know Nicole Beringer, who's actually based in Melbourne, does phone consultations. And she can help guide you to do an EMRI test on your own home or moisture mapping and things like that. 

So, don't think if there's not someone in your local area or you can't get someone that they can't help you in other ways. But obviously, yeah, Carol does Zoom consults, too. Amazing. Thanks, Carol. So, there are other ways you can get their support and help and do assessments that doesn't have to involve them coming to your house. But yeah, obviously…

Andrew: And if people want to learn just a little bit more about what a building biologist does, and indeed the breadth of people that they have with ASBB, FX Medicine was honoured to attend the ASBB Conference. Gosh, was that three years ago or two? Amie, you spoke there, didn't you?

Amie: Yes, I did. Yeah.

Andrew: And that was where Marc Cohen, on my signoff said, "This is FX Medicine. I'm Andrew Whitfield-Cook," and he poked his head around and said, "And I'm Marc Cohen." Funny guy. 

So, with that, I think we need to wrap up. Everybody, thank you so much for your questions. There's obviously so much more to cover here. Amie will endeavour to cover this and more in her course, of course. I do it all the time. Carol, thank you for your help as well. There's the link for Amie's course, which will undoubtedly give you and your patients some answers.

And Amie, I've got to thank you. From a devastating thing that really did crumble you a little bit, you've come strength to strength, and you've not just unravelled the pieces or the web, but you've put the pieces back together not just for your life, but you've figured out a way to help so many others. 

So, thank you for your input and your work with regards to CIRS and water-damaged buildings, WDB. Thanks, everybody, for joining us today.

Amie: Thanks, everyone.

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook. Marc Cohen is nowhere to be seen.



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