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In this episode, you will explore mold and consider how Pathways testing might be a helpful tool in an environmental exploration.

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About My Guest

My guest for this episode is John Banta.  John Banta, CIH, BA is certified by the American Board of Industrial Hygiene as a Certified Industrial Hygienist with a Bachelors degree in Environmental Health Science and 35 years of experience in Indoor Environmental Quality.  For the last 27 years John has specialized in mold and water damage problems in buildings. He conducted investigations and supervised crews in water damage and flood and mold remediation throughout the United States.  He trained workers in restoring water damaged buildings, contaminated water clean-ups, mold remediation, and worker health and safety programs throughout the United States and Canada; as well as England, Australia, and New Zealand.  John currently specializes in medically important investigations with 85% of his clients referred to him by their physician.  John is the co-author of the book titled Prescriptions for a Healthy House, 4th Edition: A Practical Guide for Architects, Builders and Homeowners and author of Extreme Weather Hits Home, Protecting Your Buildings from Climate Change. John’s upcoming book Mold Controlled is about recovering buildings from mold and other water damage organisms, finding, avoiding and fixing problems.

Key Takeaways

  • What is the five step process to investigation, mitigation, remediation, and maintenance?
  • How might MSQPCR or ERMI be used and interpreted?
  • What is inhibition and how might it lead to false negative MSQPCR results?
  • Are there concerns with diffusion of essential oils in an environment?
  • When might the outdoor environment lead to issues with mold indoors?
  • Why are portable dehumidifiers recommended over whole house systems?
  • What are some key considerations with doing basements, crawlspaces, and attics right?
  • What is the Pathways process?
  • How might one approach drain cleaning to optimize the environment?
  • Should antimicrobials and encapsulants be used as part of a remediation effort?
  • How much of a concern is lumber yard mold?
  • Is there a place for fogging or misting as part of a remediation effort?
  • What is the Effective Cleaning process?

Connect With My Guest


Related Resources

Prescriptions for a Healthy House, 4th Edition: A Practical Guide for Architects, Builders and Homeowners

25 Days of Investigation, Mitigation, Remediation, and Maintenance in 25 Minutes 

Effective Cleaning Practices

Pathways™ Presentation

Interview Date

October 3, 2023


Transcript Disclaimer: Transcripts are intended to provide optimized access to information contained in the podcast.  They are not a full replacement for the discussion.  Timestamps are provided to facilitate finding portions of the conversation.  Errors and omissions may be present as the transcript is not created by someone familiar with the topics being discussed.  Please Contact Me with any corrections.    


[00:00:01] ANNOUNCER: Welcome to BetterHealthGuy Blogcasts, empowering your better health. And now, here's Scott, your BetterHealthGuy.

The content of this show is for informational purposes only and is not intended to diagnose, treat or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice or as information to facilitate self-treatment. As always, please discuss any potential health-related decisions with your own personal medical authority.

[0:00:35] SCOTT: Hello, everyone. And welcome to episode number 190 of the BetterHealthGuy Blogcasts Series. Today's guest is John Banta. And the topic of the show is Exploring Mold.

John Banta is certified by the American Board of Industrial Hygiene as a Certified Industrial Hygienist with a bachelor's degree in Environmental Health Science and 35 years of experience in indoor environmental quality.

For the last 27 years, John has specialized in mold and water damage problems in buildings. He conducted investigations and supervised crews in water damage, flood and mold remediation throughout the United States. He trained workers in restoring water-damaged buildings, contaminated water cleanups, mold remediation, and worker, health, and safety programs throughout the United States and Canada. As well as in England, Australia, and New Zealand.

John currently specializes in medically-important investigations with 85% of his clients referred to him by their physician.

John is the co-author of the book titled Prescriptions for a Healthy House, 4th Edition: A Practical Guide for Architects, Builders, and Homeowners, and is the author of Extreme Weather Hits Home: Protecting Your Buildings from Climate Change

John's upcoming book Mold Controlled is about recovering buildings from mold and other water damage related organisms. Finding, avoiding, and fixing problems. And now my interview with John Banta.


[0:02:05] SCOTT: I am very excited today to have John Banta back on the podcast. We did our first podcast together in episode 14, over six years ago. Today we're going to talk more about all things healthy home and John's work with a new testing methodology called Pathways. Thanks for being here today, John.

[0:02:23] JOHN: Thank you for having me.

[0:02:25] SCOTT: First, talk to us about why you do the work you do today. What was your personal journey? Your personal connection to mold? To water-damaged buildings? How have these affected you or your family?

[0:02:39] JOHN: Well, mold and water damage grew or presented itself rather slowly in terms of awareness. When my wife and I got married, we moved into a home that had all kinds of water damage, and mold, and just number of problems. But really did not recognize it at that point – it wasn't until about 14, 15 years later that my wife had her health crisis. And it was just one thing after another that just kept building up until the point where she developed these sensitivities. Wasn't sure what it was that was making her so sick. Eventually was able to figure out that it was mold and water damaging buildings.

And so, we started on the journey trying to figure out what was going on. And I started doing full-time environmental investigations to try to help her. And it ended up being that I figured out that it was our home. We were avid campers. Off in the woods camping all the time. And when we'd get there and go for two weeks, she'd get better over the course of the first week and we'd have a great second week. So, was hoping that that was the cure. Just get her out into the woods. But we'd get back home and within minutes she'd start having her symptoms again.

Eventually, about 27 years ago, was able to purchase a home that did not have water damage, that did not have mold problems. And that was really the place where she did most of her healing. Of course, back then, the medical information and the various types of help just weren't out there. So, we were pretty much on our own. But that house was quite a healing sort of place.

[0:04:30] SCOTT: In the related resources section of the show notes, listeners will find links to a number of your recent informative resources including the “25 Days of Investigation, Mitigation, Remediation, and Maintenance”. And while we're not going to be able to go into every detail of that entire process, it is going to be the source of many of the questions that we're going to talk about next.

The basic steps in your process are understanding the problem. Number two, determining the issues. Number three, remediation. Number four, evaluation and revision. And number five, reconstruction and maintenance. And I urge listeners to explore that 25-minute video to really learn more about John's overall process.

Part of determining if there is a problem is looking at the history of water damage. Looking for mold growth. Any musty, damp or wet odors. Considering the patient and their diagnosis. And then collecting environmental testing samples.

Let's talk a little bit about testing. MSQPCR, which many know as ERMI, has many pros and cons. And the interpretation of the testing is often not as black and white as we would like. I recall that you had expanded upon the ERMI the 36 molds to explore potential molds that maybe were more specific to the Northern California geography at the time. Wondering if you still work with or recommend an expanded ERMI. Or are the commercially available ones adequate as part of an exploration looking for mold?

[0:05:59] JOHN: Well, I continue to use a 36-organism panel when I'm interpreting results that people are sending me from other labs. But when I have my choice, I'm still going with an expanded panel. And that's with my clients worldwide. The extra organisms that we've added in I think have been important. Because they do show up in water-damaged situations.

One of them that doesn't occur on a typical ERMI is Fusarium. And Fusarium is known to be a real problem for people with water damage. And that's not based on any particular borders. I'm using an expanded version. And you can't get that just anywhere, unfortunately.

[0:06:44] SCOTT: And it is surprising that Fusarium is not one of them. If I'm remembering correctly, that's one of the trichothecene producers that we're often looking at, right? So, the fact that we have that blind spot in the traditional ERMI is certainly a concern for some of us.

When you interpret MSQPCR, what are some of the things you're looking for to gauge the potential health of the sampled environment? Do you think the ERMI score matters? Do you look at the HERTSMI-2 score? Kind of walk us through how your brain views the results of MSQPCR testing. What are maybe some of the more concerning things or red flags for you? And what matters most in terms of the molds that are health-impacting?

[0:07:26] JOHN: Before we get into that, in terms of the toxins produced by Fusarium, one of the ones that is most widely recognized is zearalenone. And, again, your typical ERMI panel doesn't cover that. I like to be able to make modifications to what we're doing as well depending on my client.

Not all of my clients are affected with chronic inflammatory response types of syndromes. And so, if somebody has Aspergillosis that has colonized their lungs or other organs in their body, there are other organisms that will cause those types of conditions. I may choose to add in Aspergillus terrestris or Aspergillus imitans. As well as focusing in on Aspergillus fumigatus in that case. It's a very individual thing that really does depend a lot on the personal needs of the patient.

But with regards to the ERMI panel, I like it very much. I like mold-specific quantitative PCR. And I think that it's gained a lot more recognition as a technique because of COVID-19. PCR is a methodology that's been used for testing for the RNA for COVID-19 virus. And it's become more widely used and more widely accepted from that perspective.

And so, even though ERMI was developed 20 years ago, it's taken us until this last three years for EPA to actually issue a new guidance document that goes into things much more in line with my personal expertise and opinions.

What it now says is that MSQPCR as a technology was developed by EPA at the urgings of the World Health Organization. Basically, they go into some of the various factors about DNA testing that it's going to find organisms that are alive, dead or dormant to a species level. And that those are some of the reasons that World Health Organization encouraged EPA to do this.

Where they then draw the line is they say that the ERMI score should be used for research purposes only. And I actually agree with that. The ERMI score, I wish that they had never developed it. Because what it does is it takes the 36 organisms that are a part of ERMI and it combines it down into one single number. And that's supposed to represent everything that's going on with mold in the building.

And mold is just too complex. We call it mold, but it's actually made up of so many different organisms and everyone has different environments or environmental conditions under which they like to grow and causes different things to happen.

One of the things that I think a lot of people don't recognize is that the ERMI testing, the organisms that are present are not all related to health. And so, when the ERMI score was developed, it was also not developed with regards to health. It was developed with regards to moldiness.

If you've got several hundred or several thousands buildings that you're looking at all at once as a part of a research study, then, yeah, maybe you can statistically combine it into a single number. But when I'm looking at individual homes, I want to know each of the different types of organisms and what quantity is there. And I'm going to be looking at that and then comparing that to data that was developed by EPA originally almost 20 years ago. They went out and they studied 1,097 buildings throughout the United States. Ran the 36-organism panel on it and then use that to develop their statistical charts with regards to what type of prevalence we could expect to see. And that gives us a real good idea of what a normal building should look like. But it's individual for each and every one of those 36 organisms.

EPA also repeated that about five years ago on another 703 buildings. And I was real pleased to see that the results of that repetition were largely the same. There's always going to be some variation when you do research. But it was largely the same. And I think it's also led to the greater acceptance of DNA types of testing.

Of course, we still have the objections on the part of the insurance industry. They don't want it being used. But, basically, when it comes to medically important investigations for people that have health problems and health issues going on in buildings, I don't know any other methodology that gives us as much information most of the time. It doesn't always tell us what we need to know. There are some inhibiting types of factors that I think we're planning on talking about that a little bit more later on.

[0:12:49] SCOTT: When you then look at an ERMI, we know the score is not probably that helpful for people with medical conditions. What are some of the things that stand out to you? What do you look for that makes you say, "This building is potentially a concern."

[0:13:03] JOHN: Well, EPA developed what's called the geometric mean. It's a statistical factor that they combined the results for each of the different organisms for those 1097 buildings and then came up with the statistics for that particular organism.

For example, Aspergillus flavus. Normal, according to the geometric mean, would be two. For Aspergillus fumigatus, normal would be three. For Aspergillus penicillioides, which is commonly recognized now as inflammagen, normal is 91. And that's in fact for the most part because Penicilium, Aspergillus penicillioides can come in from the outdoor environment. And so, it can tend to have higher levels.

Doesn't mean that it's going to make everybody sick at that normal level. But it can certainly have an influence that when you combine it with other organisms may tip the scale. And, really, there are different ways of looking at it. When I'm looking at the specific 39 organisms, I'm trying to figure out where is the issue? What's going on with this particular building?

One of the other things that EPA did when they developed this methodology was they focused in on 500-square-foot increments for the buildings. That's what the statistics were based on and what we often times will see if somebody only does a single sample and they do it throughout the entire building. They get an average for that entire building, which may not give them a very good idea of what's going on. Usually the average ends up making the whole set of results look better than it would be for a specific area.

For example, if your bedroom has a high level of mold and the other areas are not as high, you're going to be spending eight hours every night in bed being exposed to a much higher level with potentially bigger problem types of organisms. I like, whenever my client is able to afford it, to break the building into approximately 500-square-foot increments. I'm willing to go with a thousand square feet. 500 to 1,000 square feet. And I can take that into consideration if I know that that's what's happened by mentally adjusting a little bit to decide is there likely to be an issue.

But by having multiple samples collected throughout the building, what we can do is we can compare different portions or sections of the building. If I see that Stachybotrys is at a level of, let's say, 200 in one-quarter of a 2,000-square-foot building and I've got 50 or less in the other three areas, that's a pretty good indication that the area with 200 is going to be the area where we're going to be likely to have our issue.

If I see it at a high level in the master bedroom, I'm going to be thinking master bathroom or other adjacent bathrooms. If I see it in the kitchen, family room, dining room area, I'm going to be thinking maybe we've got a problem with one of the water-based appliances in the kitchen. The dishwasher. Maybe the kitchen sink has leaked. Something of that nature.

[0:16:33] SCOTT: Kind of building then on the Stachybotrys comments. When an ERMI or MSQPCR shows any Stachy or Chaetomium, I tend to interpret those as kind of red flags. Given that it's very possible that Stachy is hiding behind a wall, producing mycotoxins, where then the mycotoxins are really making it into the breathing space and leading to health conditions. But the Stachy itself may not be as readily found in the sampled areas. Would any amount of Stachy or Chaetomium on an MSQPCR test be a potential red flag for you? Or are there acceptable levels?

[0:17:14] JOHN: Well, it depends on what your goals are. And, certainly, acceptable – if we look at the HERTSMI scoring system that was developed by Dr. Richie Shoemaker, he doesn't start assigning Stachybotrys points until it gets up to five spore equivalents per milligram of dust.

And so, I mean, it's one of those things where if all you had in the home was an elevated Stachy level of five, you probably would not have a person who was reacting to that from the standpoint of Chronic Inflammatory Response Syndrome.

One of the things that I've done as a research project over about the last five or six years is looked at the issues with outdoor Stachybotrys as well. And what we found is that one of the recommendations that has been made by people that really want to help the environment by recycling has ended up creating some real nightmares for people that have hypersensitivities to mold. And that is the use of cardboard or newspaper as a weed block.

And so, we've had several cases where Stachybotrys levels were high throughout the indoor environment, but were unable to narrow down where a source might be. And have taken outdoor samples and it's turned out that the source has been an outdoor source. Putting down cardboard instead of using the synthetic weed block type of paper can lead to very high levels of growth.

And I'd love to do some more research on that, but research is not cheap. I haven't been able to define it as far as I would like to. What I suspect is that there may be certain times of the year when it's more likely to be a problem putting it down. For example, Stachybotrys likes higher temperatures. It generally doesn't grow very well below room temperature. And at warmer temperatures, it grows really well. It also tends to need chronic moisture.

If you're putting it out in a desert in an area that's not being irrigated, maybe it'll be okay. But on the other hand, in the deserts, we have monsoon season almost daily with some pretty hefty rains that could keep the area of cardboard wet long enough for it to grow outside. So we're continuing to do samples of outdoor areas to try to figure out where the issues might lie. 

On my first few clients that had this type of situation occur, it turned out that they had put the cardboard down themselves in an unintended consequence of wanting to do good. But we had one case where the cardboard was laid almost 300 feet away from the house of the person who is having the problem.

And, fortunately, the neighbor who had done that, she went out canvasing the neighborhood and the neighbor was willing to remove it. But once the buildup had occurred, it wasn't something that instantly got taken care of by doing the outdoor removal.

[0:20:48] SCOTT: I mean, that's a really interesting thought that we normally think of CIRS as an indoor mold problem. Not an outdoor mold problem. But if there are pockets of Stachybotrys, for example, that are near the home that then are coming indoors, that may make that thought process not completely accurate.

And I think that's something I had heard about that from your work. I don't think most people really talk about that much or consider that. I think it's a really interesting concept that we need to be thinking about.

I want to come back to the concept of inhibition, which is also something that I learned about from you but had not heard about in any other context. And so, do the commercially available ERMIs or MSQPCR tests, are they considering this inhibition potential? And are there materials then that lead to inhibition that maybe are increasing the chances of a false negative result where these inhibitors are making the ERMI results look really good, but at the end of the day we may still have a problem? What are some of these inhibitors and how commonly do you think they might impact MSQPCR test results?

[0:22:05] JOHN: Again, a number of years ago, I started researching this. I had come across some information in the literature for some of the other fields that are out there. And in terms of medicine, they've done a really good job figuring out what inhibitors they have that may impact medical samples. Three of them are blood, bile, and urine.

And so, I mean, usually, blood and bile are not going to be a problem in a home. But it occurred to me, if human urine is acting as an inhibitor, what about cat and dog urine? Could that be creating an issue? And in fact, it does. Well, we have not yet tested dog urine. We've tested cat urine. And cat urine can certainly cause inhibition.

But there are other things that can cause inhibition like clay. And so, most kitty litter is made up of clay. Heck, we use clay as a binder to help reduce the level of biotoxins under certain circumstances. It makes sense that the clay could absorb the various types of molds and then act as an inhibitor so that we get back results that look too good.

One of the clues – well, you asked if labs were doing the quality control measures. And, unfortunately, most of the commercial labs out there are either not doing the quality control. Or if they're doing it, they will not talk about it. I've asked the questions and I get told it's proprietary, "Oh, yes, we do it." And then I'll ask the question, "So, what is your Geotrichum control value? How many cycles are you using?" and things like that. And the answers that I tend to get are, "It's proprietary."

Our company has made a habit of only working with labs that are willing to be open about what's going on with regards to things. As a scientist, I think we have an obligation to answer questions when we're asked. And I don't like getting hit with, "It's proprietary," or, "We're not going to share that information with you." I think that's inappropriate. It's a question that you can ask. I'm certainly happy to help people by consulting with them to point them in the right direction and things like that. But that's one of the first things that I look at on the lab results when I get them in.

Now there is a method that you can use to give you a better idea of whether something is inadvertently inhibited. And that is – well, you have to use ERMI. You can't go with just the five organisms for HERTSMI, or EMMA, or any of the DNA tests that are supposed to figure things out with lesser amounts of organisms.

You can do it with the 36 organisms. And what you're doing is you're looking at the group two organisms. The common outdoor types of molds or sometimes they're referred to as common indoor molds. I wish they called them common outdoor molds that come indoors. But you should be seeing Cladosporium, Cladosporioides 1 and 2, and Cladosporium herbarium at normal levels. They're the most common outdoor molds. And, therefore, they're going to be the most common indoor molds. We know what the geometric mean published by EPA is for those values. And so, we can get a good idea of whether a number that we're seeing on a result does have validity.

When I get back tests using DNA such as ERMI, if I'm not seeing several hundred Cladosporium, Cladosporioides 1 and 2, and the herbarium, then I'm scratching my head and wondering if there's an inhibition going on. Partial inhibitions are a little bit harder to detect that way than total inhibition. With the total inhibition, you're going to get non-detects, or 1, 2, or maybe up to 10 for these various organisms. But with partial inhibition, maybe you'll get 50. And maybe that's an indication of an inhibition or maybe it's an indication of something that's normal.

One of my biggest concerns with inhibition is the various types of antimicrobials and biocides that are being promoted for killing mold. This is something that I've been pretty opposed to since the beginning. And the authoritative references that are out there, American Conference of Governmental Industrial Hygienists, EPA, the S520 standard and reference guide for professional mold remediation, basically all of them say that the use of biocides for mold mediation is not recommended.

Unfortunately, they allow for some exceptions that have been latched on to. There are so many companies out there that are promoting products to kill mold. And some of them are making claims about them being absolutely safe. For example, essential oils. What I learned with my research was that tea tree oil was an inhibitor.

And so, if you have tea tree oil present in the environment that's been fogged or sprayed, it may overcome the results such that you get back results that look really normal. Except, again, if that Cladosporium, Cladosporioides 1 and 2 isn't showing up, then I would be very suspicious of that.

What I know now, once you start on a path, it turns out that you're not the only one. There are a lot of other research projects that have been done and not always in the in the same field of endeavor. Veterinarians have become very interested in the use of essential oils not only for treating animals, but also from the standpoint of what causes problems for them.

And, typically, when an essential oil is used for treatment, it's not a huge quantity. People are not bathing themselves in concentrated levels of these types of antimicrobial biocides. They're using a little bit here or a little bit there. And when you start using it at concentrations capable of killing mold, apparently, it's causing all kinds of problems with poisoning pets.

Tea tree oil, basil oil, thyme oil, citrus oils are all substances that are not being used by veterinarians that specialize in essential oils very much just because of the risks of them. Or if they're using them, they understand just how tiny a dose is appropriate under those circumstances.

And here we have companies that are coming in and fogging gallons of these antimicrobial products that can create problems with adverse reactions on the part of people that have multiple chemical sensitivities. We've seen homes that have been ruined that way.

But in addition, we've also seen instances where, after use, the DNA results come back showing that everything is perfectly fine. And maybe that's because people just don't understand this about DNA. I would like to think that nobody out there is doing the various things. But we get involved with a number of homes where the use of different chemicals has created problems.

Some of the others – well, more specifically, phenolic-based anti-microbial or biocides are problems. And most of the natural essential oil-based ones are phenolic compounds, chlorine compounds, chlorine bleach, chlorine dioxide. These are all things that we're finding are being published on with regards to other fields of endeavor. I think anybody that's watched any of the crime scene investigator series will know that chlorine bleach is used by the crooks to basically get rid of the DNA.

One of these days, some sharp scientist is going to figure out a way to overcome the inhibition. And there's going to be all these cold cases that are going to end up being opened up and chlorine bleach will no longer be the problem that it is for us. But I find that I have to be really careful when we get involved with certain types of situations.

Like an adobe house. Adobe is made out of clay. If the clay is shedding into the house um, or if the house has been painted with a clay-based product, or if there's been demolition in the home with gypsum drywall that has had clay as a binder. These are all things that can result in the place looking great, but actually not being great. And so, in those cases, when we have a discomfort that maybe the results are not valid, then we do have plenty of other ways that we can go about figuring things out.

The Geotrichum control test that was done by EPA when they developed this method, that it was actually suggested in the literature by EPA. And that is used by labs that I like. Basically, what they do is they spike the sample with a known quantity of this organism Geotrichum candidum. And then they run the DNA testing on it for that organism. And at the end, they're comparing the values. And if the value of the Geotrichum that they spike the sample with doesn't match the volume or the amount that's determined by the results, then there's something not quite right there. And those are the types of things that really concern me.

I'm also not very fond of laboratories that are charging full price for results that come back with everything non-detected. The lab that we work with, their fees are based on them doing the Geotrichum controls first. And if it comes out that things are elevated in terms of inhibitors, in other words not natural or not normal types of levels that we're looking for, you still end up paying for the results.

Some of the labs will say that they will redo it for you if you think you might have had inhibition. But it's one of those things where I think that we probably need to do a lot more research to figure these things out. I'd love to test 200 different compounds, but it's about $100 per compound to test. And so, $20,000, I don't have it.

But by looking at what other industries are finding with DNA and PCR, I think we're getting a better idea of how we need to be careful. And the bottom line, I'm a bau-biologist first. That was my initial training 35 years ago. And bau-biology is looking at a more natural way of dealing with these things and killing is not the answer. And so, I'm always looking at it from the perspective of first do no harm. And what are the unintended consequences that we may not be thinking about?

[0:33:50] SCOTT: I'm sure many listeners are going to ask which lab you do like for MSQPCR testing. Are you uh open to sharing that?

[0:33:59] JOHN: I am. I like Lis Biotech. There may be others out there that are good. But that's the one that we're currently using right now. I guess one of my problems also is that people are being left to interpret the results themselves. Some labs are offering some interpretations. But most of the interpretations are by people that really don't get out in the field and don't understand buildings. And so, that concerns me too.

I have an advantage. Dr. Bonnie Passmore with our company spent 10 years working at the University of California Davis doing PCR before the automated computerized thermocyclers were available. And in fact, she bench-tested some of the original ones. She really understands the process very well and has helped me to understand it better than most environmental consultants out there.

But I don't go out and do microbiology. That's not my area of expertise. And I wish the labs wouldn't step into the role of pretending that they're environmental consultants.

[0:35:09] SCOTT: I want to dig just a little deeper into the essential oil conversation. We understand now that essential oils can be inhibitors. Meaning that subsequent testing can look good when, in fact, it may not really be good. We understand that there's some potential impact to pets with essential oils. But there's some brilliant doctors, practitioners out in the mold illness arena that do suggest diffusing essential oils into the home to help make the home a healthier environment. It sounds like there are some potential concerns. What are some of your general thoughts on diffusion of essential oils in the environment? Are there other reasons why that might not be a good thing to do?

[0:35:50] JOHN: Well, it makes my job harder. And I don't want to do battle with the doctors. You know what I mean? If it is helping patients, then it's helping patients. But it often times makes it much more difficult to figure out what's going on in a building.

I mean, one of the things that I believe we're going to be talking about later is why I'm such a proponent of using mild detergent solutions for cleaning. And so, if you're covering surfaces with oil and then you're using detergents to clean it up, sure, we can overcome those situations where it might create some issues for what I'm trying to do. But, man, you can end up spending an awful lot of money.

I guess my feeling is if essential oils are going to help people, you're better off focusing on the person with them. I'm the same way with regards to humidifiers. There are times when a humidifier and being able to inhale that damp air is going to be beneficial for the person. But I have seen so many cases where people use the humidifier to humidify the entire room. And now, all of a sudden, they're dealing with mold problems within that room. And so, we need to I think be more focused in terms of the way we use these types of things.

And there's medical precedence for this. I mean, you don't take an entire room and you oxygenate the whole room. That creates a fire or explosion hazard. You instead concentrate the oxygen at the appropriate levels to work with the patient.

[0:37:39] SCOTT: When you first come into an environment and start your exploration, is MSQPCR the starting point? And then if there is an issue found, you maybe then bring in the Pathways testing that we're going to talk about? Or are there other types of tests that you use in an initial assessment?

[0:37:55] JOHN: Well, I think that the tried and true things really make a lot of sense. Is there visible mold? Do you have a musty odor in a particular area of the building? What about a history of remediation? When you compare the way that the place was remediated to the ways that medically important remediation should be conducted, does it match up? Or are there potential issues? What is the doctor saying about the diagnostics? Those are all I think really first steps before you ever start testing. Find out where all of that information is pointing. Because that can then help to focus in on what type of testing to do.

As I mentioned earlier, if somebody's immunocompromised and suffering from Aspergillosis, I'm going to take a completely different approach to the DNA type of testing. I'll probably do the stuff that I always do, but I'm going to add some other types of things in.

And so, I get it why people want to do these things themselves, especially considering the way that the environmental consulting arena is so split. There are some that certainly are doing medically important investigations. But then every time I end up in court defending a case, there's going to be experts on the other side that are still basically not of the opinion that mold is causing anything more than maybe exacerbating some symptoms of allergies or asthma.

It's one of those things where the pendulum has swung back and forth multiple times over the last decades. And I think that we're getting closer to the point where the recognition is there. But it's still a real problem. And for the 1% to 4% of the population that is actively expressing their genotype with regards to mold sensitivities, it can be a real nightmare.

[0:40:13] SCOTT: Coming back to the humidity conversation. Indoor humidity, can itself be a source of water intrusion that leads to microbial growth? Generally, I think people talk about 45% to 55% or lower. When it comes to dehumidifiers, you prefer portable options over those that are built into the HVAC system. Talk to us about why that's the case. And then expanding on that, what are some of the key issues that you see with HVAC systems that we need to think about? And are those problems generally solvable? Is it the case that the HVAC system being kind of the lungs of the home are the core source of the problem? Or is it more of a concern that it's spreading mold from other sources in the home?

[0:40:58] JOHN: Well, starting with the second first. Yes, mold can be spread by the HVAC system from one area of the building to another. That doesn't mean that mold growth is being spread and that it's actively growing. But you can have the spores and the fragments distributed about via the HVAC system.

Now with regards to built-in dehumidifiers and HVAC systems, I am not a huge fan of putting buildings on life support. But just like with people, if somebody needs that kind of medical treatment, then they need that medical treatment. That doesn't mean that I would favor putting them on permanent life support even once their condition has resolved. And that's what putting a dehumidifier into an HVAC system does. It puts that building onto a permanent life support.

And the way that dehumidifiers work, they're pulling moisture out of the air and then it's supposed to drain out of a collection pan and out of the building. Or it collects in a pan that you have to physically empty by hand if you're using portable ones. The problem with the dehumidifiers that are built into the HVAC systems is they're usually very difficult to service. They're difficult to get to. And if it goes back, it's not only difficult to change it out, but it's also very expensive.

I would rather see – the other thing is that a single system inside an HVAC system is not really reaching out and taking care of the whole building the way that it needs to. With portable dehumidifiers, you can focus the attention in the area or areas where it's needed. You can more easily service them to keep them from having mold that starts to grow.

If mold does grow, it may be more easy to disassemble it and clean it to get the mold out. And if you can't, then it's certainly going to be a lot less expensive to replace it as a portable dehumidifier instead of having to deal with it inside of an HVAC system.

Those are some of the primary reasons that I like portable dehumidifiers. I want that dehumidifier where people are going to have to look at it and recognize that it's there and deal with it on a regular basis. Because, I mean, if we have a relative or a friend who's in ICU on life support, they need constant monitoring. And that's what we need to do with our dehumidifiers whether they're installed or portable. But with portables, it increases the likelihood that it's going to be taken care of the way that it needs to.

Anytime you have an area of a system or a dehumidifier that is staying continuously wet, it's going to potentially end up with biofilms that are going to start allowing mold to grow. And so, it's very easy for an HVAC system to be out of level. Or maybe when it was installed, it was installed in such a way that it did additional settling so that it's no longer in level. And instead of draining the water out of the building the way it's supposed to, you can end up with some of it remaining in that condensate pan and not draining from the building.

And what a lot of people don't realize is the HVAC system will typically have a condensate pan. And then there will oftentimes be a second one underneath the system, which is the one that you see. And so, if the one below the system is full of water, then you've got real problems. If the one above in the HVAC system is full of water, then you've got unseen conditions that are not necessarily going to alert you to the problem until the system does overflow and creates water damage.

And because of the way we build our buildings, the water may be absorbed into insulation, or gypsum drywall, or other materials for an extended period of time before it gets discovered and taken care of. These are just some of the things that can lead to problems.

[0:45:27] SCOTT: It sounds like the HVAC system can itself be part of the core problem or it can just be that it's spreading mold spores’ fragments from other places where it's actually growing. It sounds like both of those scenarios are fairly common.

[0:45:43] JOHN: Yeah. I mean, sometimes the solutions are pretty straightforward and simple. If a company that manufactures the equipment has put a paper label inside the equipment in an area where it's going to get damp, that needs to be cleaned up. That needs to be removed before it gets moldy in the first place.

I saw one system where the system was leveled by using layers of cardboard in a condensate pan under the system. And when that system started to malfunction and water started getting into that secondary condensate pan, you just ended up with a huge amount of mold growing on that cardboard.

And in addition, the system shifted as the cardboard deteriorated, so that it was out of level. So, there was other stuff starting to occur inside the system with water draining into places that it didn't belong.

[0:46:41] SCOTT: When we have water damage in an indoor environment, how often are basements, crawl spaces, and attics playing a significant role? Are those very commonly where you find issues? What are some of the key considerations in doing basements, crawl spaces, and attics right and minimizing their potential contribution to a sick building?

[0:47:03] JOHN: Well, the first thing is to realize that water doesn't necessarily stay in the basement or the crawl space. Water vapor can penetrate through permeable materials. It can also travel through cracks and crevices and come up into the living space.

I worked on a home years ago in Ketchum, Idaho. Basically, every spring – they had purchased the home two years earlier. And in the first spring, they saw a few drops of moisture forming on the ceiling in the kitchen. On the second spring, it actually came through enough that mold was starting to grow on the ceiling in the kitchen. And that was when I happened to be there doing some investigations on other houses. Small enough community that word spread that I was there.

And so, I got called in to look at this place. And when I went crawling through the crawl space, what I found was that the soil was exposed. That it was damp. That the cold water and gas pipes that were running through that crawl space area had a lot of water that was condensing on them and dripping down onto the soil in those areas. But there was no polyethylene moisture control barrier on the soil. Every other home that I had looked at in that area had one. And this one home didn't.

After I got out of the crawl space, I told the family that I thought what was happening was that, every winter, excess moisture was coming up from the crawl space and was passing through the floor, passing through the ceiling in the kitchen and was freezing on the underside of the metal roof that they had up in the attic space.

The metal roof was not insulated in any way. The insulation was on top of the gypsum board ceiling. And so, basically, it was kind of the principle that you would see with an ice cube or with an ice maker in an old-fashioned refrigerator where the frost builds up and forms this chunk of ice. And when you defrost it, it plunk. It falls down and then continues to melt.

Well, I believe that the ice was falling down melting into the insulation. The insulation was then holding that moisture for an extra period of time up against the area where the gypsum drywall was. And the next thing you know, you ended up having mold growing up in there. It finally soaked through the drywall enough that it was actually dripping into the kitchen area. And then the second year, the visible mold appeared.

I finished telling the couple that owned the home that because the vapor barrier wasn't on the soil, that I perceived that that was probably the problem. And as I was saying that, the wife was getting rather agitated, I could tell. She was not happy. And so, I stopped and I said, "What happened? Tell me what you know?"

And so, she looks at her husband and crosses her arms and she says, "Tell him, dear." Apparently, when they had moved into the house, they had come from another part of the country that was much drier and didn't need barriers on the soil. But when he got there, he saw the barrier on the soil. Noticed that it was somewhat damp underneath and decided that he wanted the soil to be able to dry. And so, he removed about $150 worth of plastic and caused about $15,000 worth of damage.

And his explanation was he was afraid that that moisture under the polyethylene plastic was going to cause mold to grow on the dirt that was under that poly barrier. Well, the types of molds that would grow on the dirt under that poly barrier are the types that would grow out in nature.

I mean, every home is surrounded by hundreds and hundreds of acres of soil. Even if they're in cities, it's still got plenty of soil that's going to support those types of organisms’ growth. And they're just not the kind that we worry about from a construction or building standpoint.

Having said that, I see plenty of cases where workers will take a bunch of cardboard down into a crawl space with them and they'll lay it out and they'll lay on it instead of on the soil. And then they don't remove the cardboard afterwards. And we end up with conditions getting warm enough at times and damp enough at times that Stachybotrys or other molds will grow down there.

We'll see insulations being installed that have paper moisture control barriers on them. And that insulation will end up falling down onto the soil and start to grow. It's real important that those vapor or moisture control barriers be installed in the right location. Because moisture flows from hot to cold. They're supposed to be touching the warm side of the floor, or wall, or attic. If they're touching the cold side, then you end up with condensation moisture forming. And that can end up being a huge problem. And this is a little bit off the subject, but close enough.

I had one client, a homeless shelter, that brought me in because one of their residents had fallen through the floor into the crawl space down below. And it turned out that they had had a moisture control barrier installed in the crawl space, but they didn't put it on the soil where it belonged. They stapled it to the underside of the floor joist, so that moisture was actually getting trapped in that area. The floor joists were rotting. The wood floor was rotting. And it eventually was discovered when somebody fell through.

It's really important that these barriers be installed properly so as not to end up creating an additional nightmare. Sometimes I get into crawl spaces where various types of barriers have been installed and they've wrapped them up over the bottom part of the pier so that the wood is covered with it or the foundation on the sides is covered with it. And that's just acting like a channel to put that moisture right up into the wood, which can end up causing rot and grow under those circumstances. So, we want it to be covering the soil. We want it to be covering concrete, but not going up into sensitive types of materials.

[0:53:43] SCOTT: Yeah. I mean, I think it's unfortunate that lots of building professionals just are not educated on some of these concepts. I recently dealt with some water intrusions myself and I was told they were coming from the roof. And I was told that it wasn't possible for water coming through the roof to come into the living space because water cannot move through gypsum drywall, which I clearly saw that it does. It was an interesting conversation.

While we're still in stage two of your process and determining issues, we have the new Pathways swab testing is a potential tool without being disruptive or destructive like some other testing methods may require where we're poking holes into walls and things of that nature.

Talk to us about where the name Pathways comes from. How this testing might help us to identify the pathways or travel patterns within an environment? And then tie the Pathways conversation into how you use a floor plan of the home to come to conclusions on potential sources or hotspots.

[0:54:48] JOHN: Okay. First and foremost, Pathways is not there to replace the traditional methods. If you see mold, if you smell mold, if you've got moisture measurements that are showing you that an area is wet or thermal imaging that's indicating that there may be moisture that's accumulating, these are all very valuable techniques. And I would use them first and foremost in terms of trying to figure things out.

The role of Pathways is for those situations where you don't know about any types of mold conditions. You can't see them. You can't smell them. You're not sure what's going on. And it can help to identify hidden locations. In order for Pathways testing to work, you have to have three things. You've got to have the mold or the contaminant. You've got to have a pathway that the mold or contaminant can escape from the hidden area. And that's why we call it Pathways testing. Because they're always has to be a pathway for it to get from where it's grown out into the living space.

And then you have to have a pressure differential. If something is not drawing it out if the house is positively pressurized and pushing it in, it may be going someplace completely different. And so, most homes are depressurized. Most homes have Stack Effect that creates a negative pressure in good portions of the home.

But, basically, you have to understand those types of dynamics in order to get an idea of whether it's giving you valid results or not. And it's actually giving you valid results. It's not finding it if it's not being pushed in the direction of the pathway and the pressure differential. It's just that that information is not helpful from the standpoint of figuring out whether there's a problem.

Pathways testing does not test for mold. It tests for proteins and peptide bonds. And we use proteins and peptide bonds as an indicator that there may be potential mold. But it may be other things too. It could be dust mite feces. It could be rodent urine. Rodent urine's loaded with proteins. It could be somebody dropped an egg and broke it on the floor and didn't clean it up very well. Eggs are loaded with proteins.

And so, all of these are things that could give us high protein levels, which is what it's looking for. But when mold starts to grow, when you have a wet material and mold spores are present on it and the material is a nutritive material that it can use for food, the mold will soak for a few days. Usually about 2 to 3 days. And then it germinates. And when it germinates, the hyphae, or root-like structures, will exude from that spore and will start to emit enzymes to begin the digestion process.

You've got to have the right amount of moisture. If you've got too much moisture, it's too dilute and the enzymes can't digest. And if you don't have enough moisture, the enzymes can't be in a liquid form. And enzymes have to be in a liquid form in order for them to start to digest the materials. You've got to have it just right.

When the enzymes start their digestion, they allow new growth to occur. And the spores, and the fragments, and the hyphae, and all the various parts of molds are protein-based. Same is true with actinomycetes. Same is true with bacteria. But mold has one additional thing. And that is that, when it's bathing in the moisture, the enzymes are also protein-based.

And so, we can get a much earlier indication of when there's a problem that's starting to develop based on the presence of the elevated levels of enzymes. And so, we're using that to help guide us to where we might need to do some additional investigation.

I do not encourage people to start tearing out wall cavities based on a single round of Pathways testing that comes back positive. I mean, there are all kinds of other things that can put mold indoor homes than hidden types of conditions. I mean, one of the biggest culprits is our refrigerators. They have a condensate pan under them that grows mold when they get dirty. And, unfortunately, the manufacturers have changed their designs. It used to be that the old condensate pans were really easy to remove a panel from the front of the refrigerator, slide them out, take them outside, clean them up real well and not have the growth being released into the indoor environment.

With the newer refrigerators, what they're doing is they're bolting them in place right in the area where the compressor or condenser is. And, usually, you're going to have a fan underneath that area too that's supposed to help to dry these things down so that they don't stay wet long enough for mold to grow.

But over time, you end up with dirt accumulating in the pan and dust. And it forms – almost, it felt like mat. And when that gets wet, it's not able to dry quickly enough to prevent mold from growing. And so, we'll frequently find not the same kinds of molds that grow on gypsum drywall paper and in cellulose materials like wood. But types of molds that like skin cells and various types of fabric dust. And they will start to grow in that pan and create issues that way.

Pathways doesn't tell us what type of mold it is. It doesn't even tell us that it is mold. It doesn't separate it out from anything. But all of the allergens that are out there are protein-based. And so, when you hit an area that is showing higher than normal levels, that can be an indicator that something is going on.

Now, Pathways can be of various sizes. And so, if you've got a big hole, it's going to allow a whole lot more to come out a whole lot more quickly. If you've got a little tiny hole or a crack, it comes out much slower. A crack the size of a human hair is like a freeway for mold to work its way out of a wall cavity. but at the same time, we're talking about things on a microscopic level. It's not like as soon as there's a crack the size of a human hair that all the mold that's in the wall comes out immediately and spreads out throughout the whole house. Instead, it comes out slowly over time. Sometimes it takes a while for the fragments and hyphae to break down and actually turn into dust.

We will find mold growth inside of wall cavities sometimes that might be 40, 50 years old. The spores are all gone, which are what we typically would have the lab use for identification. It's all dead. Because even the most resilient molds like some of the Penicillium and Aspergillus molds, they have a half-life of about a decade.

And so, after 30 or 40 years, it may be pretty much dead, but you're still going to have the potential for some residuals to still be there. And the spores, they tend to move out first. They're the ones, the structures that are more aerodynamic. But the root-like structures start to fall apart and they can become aerosolized and come out of those same openings and start traveling around too.

When we know we have a problem, because our testing using PCR or culturable testing to a species level tells us that there's still an issue, then Pathways can help us to figure out which part or parts of the home are most likely to be highly affected with it. And what do we need to be thinking about in terms of additional investigations to take care of it?

Most typically, we're not going with a single round of Pathways testing. We will almost always follow up the initial test with effective cleaning. A lot of cleaning to get things under control. Testing immediately after the cleaning to see whether or not the cleaning was effective. And then testing again a couple weeks later to see how quickly new proteins and peptide bonds are working their ways out of those hidden types of locations where we had an elevated level originally.

The other thing about it is it's not always coming out along the bottom edge of the baseboard. This is one of the places that we're routinely testing where the top of the floor meets the bottom edge of the baseboard. There's almost always a very tiny crack in that area. But you could have can lights or cracks around the HVAC system ducting where the register comes through the ceiling or other types of things that are shedding. And that becomes a little bit different in terms of the ways that we interpret that.

If we find a high level of particles on the floor and it's coming from up above, as it comes out, it spreads out. It becomes more diffuse. And so, testing cracks and openings around on various areas of the ceiling can often times guide us to understand what's going on in area like that.

When it comes out down near the floor, we have molecular forces and we have electrostatic forces that cause the spores and particles to actually stick to the floor close to where it first came out. As it continues to come out, it builds up more and more in that area and moves out further and further, so that it's collecting on those surfaces and we're able to find it that way.

But, eventually, you end up with enough that has come out that it's no longer being attracted by the molecular forces or by the electrostatic forces. And that's when those particles coming from down below get aerosolized and become airborne. And when it's coming from up above is when an air purifier for the room can help a lot. Because it's being trained back up into the air.

[1:05:25] SCOTT: It sounds like with the Pathways testing, then some of the areas that we can test are baseboards, the HVAC system, duct –

[1:05:33] JOHN: Bottom edge of the baseboard. Not the top. I mean, you could do the top, but it's not going to answer the questions.

[1:05:39] SCOTT: Electrical outlets, can lights, sprinklers, carpets. You mentioned that –

[1:05:46] JOHN: Not so much carpets. Carpets are a real tough one. I like to test where the carpet tucks into the wall cavity. There's a gutter there and you can oftentimes fit a swab into that space and collect some samples from along the edge of the seal plate. This is what the swab looks like. It's paddle-shaped. We always do the exact same area each time. And carpets make it tough. And carpets are tough to deal with in moldy environments. They tend to take a whole lot more work to clean them and maintain them. I prefer not to have carpets in environments. If you need something that's carpeted, I would much rather have you have an area rug that you can remove.

[1:06:32] SCOTT: When we find these proteins and peptide bonds, they could represent mold, rodent urine, bacteria, dust mite feces, other proteins. You mentioned like eggs, for example. Based on the work that you've done with Pathways, do you have some sense for how commonly these proteins and peptide bonds might represent mold in an environment?

[1:06:56] JOHN: Well, it's often enough. I mean, the closer you are to your kitchen, the greater the likelihood that there's something that's food-related. But, again, by cleaning everything really well, testing immediately after the cleaning on those surfaces that were tested earlier, you can get an idea whether the cleaning was successful. And then by monitoring it, in a building that's got a higher level than what we would like, we're typically seeing some sign of it coming out after about two weeks. And a week and a half to two weeks is when we're usually retesting those areas that we have a suspicion of.

If it's rodent urine, you clean it up. It stays gone until you have new mice coming through and peeing on the surface. With sewage-related organisms, they tend not to become aerosolized the same way that mold wood. The bacteria tend to stay put more so. And so, when you clean it, you're less likely to have it coming out and you're less likely to find it building up again over that course of couple of weeks.

[1:08:02] SCOTT: Given some of the recent discussions on Actinos, and these often being related to drain pipes, is there any value in swabbing the drains in our bathrooms, for example? Or would those already have proteins and peptide bonds from human hair and skin, for example?

[1:08:21] JOHN: Well, it may not just be from human hair and skin. I mean, bacteria and all kinds of things grow in our drains. I think that drain cleaning should become a routine part of the practice of getting things taken care of.

The problem is, when you've got an open drain that's got this gunk up near the top of it, you are likely to be disrupting it and putting it up into the air and aerosolizing it as a part of the cleaning. The technique that I like to use for drain cleaning is to get one of the natural enzyme-based drain cleaners.

Using the bathroom vanity as an example. I'll run the water to flush water through. I'll turn the water off and I'll let it establish in the ute, in the – well, they oftentimes call it a P-trap or a U-trap. You've got the water in there. I will add my enzyme-based cleaner in there and then I'll immediately put a plug in there. You want to plug up that drain. Because when you're using those enzymes, they're going to start cooking. They're going to start breaking things down and they're going to start releasing gases that, if you have sensitivities, it's not pleasant.

But then what I'll do immediately after I put the plug in is I'll turn on the water and I'll fill the basin most of the way. I don't fill it all the way. We don't want to run the risk of it overflowing or something like that. But by doing that, turning it off, letting it sit overnight, now what we've done is we've created a water break.

And so, the next morning I can go in I can pull the plug up, the plunger out, without actually releasing those gases. The water's flowing down. I turn on the hot water and just let it fill and flush for a couple three minutes. And what that does is it flushes that gunk down the drain instead of allowing it to come back into the home.

And if you haven't done this type of thing often, I usually recommend doing it once a day for a week. And usually, you'll do it at night. If it's a bathroom near where you're sleeping, you may want to leave the vent fan on, or shut the door, or even sleep someplace else just in case there is a little bit of gas that leaks its way out. But once a day or once a night for a week. Once a week for a month. And then monthly thereafter.

[1:10:47] SCOTT: Extending on the Actinos conversation, since our bedrooms, our sleep locations can be another source of exposure, I know you've done some research on mattresses. What problems have you found in our bedrooms where we spend a significant amount of our time? And what are some tips you have for how to improve our sleep location in support of our health?

[1:11:07] JOHN: Well, first and foremost, you need to have your mattress up off the floor. We would perspire about three and a half ounces of water per person every single night. Over time, that can build up in a mattress and get to the point where it can support growth.

If you have a mattress sitting on a cold concrete slab, or even on a tile, or vinyl, or vinyl laminate, or any of those types of things, that cold from the concrete can come up to the bottom side of the mattress. And, again, just like with walls, moisture flows from hot to cold. So, you've got these warm bodies in bed perspiring. The water then seeks out the cold surface, which is right where the bottom edge of the mattress sits on the floor. And that's where you're going to end up with mold starting to grow.

If you put a sheet of plastic under your mattress, the same thing is going to happen. If you put it up on a stand to raise it up with slats and you put a sheet of plastic on there, you're going to have that perspiration accumulating on the plastic and you're going to start growing mold. We need to install our mattresses so that they can release that water vapor from both sides. We want it to be able to dry during the times that we're not sleeping in it. And then it can handle that moisture during the times that we are sleeping in it. But doing anything that traps that moisture can lead to some real significant types of issues.

With regards to mold-contaminated mattresses, one of the studies that I did was to look at various types of barrier cloth. The recommendation has been made to use dust mite covers and things of that nature. And those come in one of two types. One type is tightly woven, so that water vapor can escape through it. And the other kind, unfortunately, has polyethylene plastic or other impermeable materials built into it.

And so, if you're putting an impermeable mattress cover on the mattress and it's been slept on for a while, that's just trapping that perspiration in there. And that can lead to issues. I much prefer breathable materials. And what we find with mold is that cotton or other types of fabrics, silk, even though they breathe, they're not as good as Tyvek,

And so, Tyvek is a material that is used to make those protective suits that you see. COVID workers running around in the white suits that have the hoods and everything like that. It allows water vapor to escape through it. It has a permeability that is about 40 times greater than what you would have with polyethylene plastic, than a sheet of polyethylene plastic.

And so, the moisture is no longer being trapped by it. I like to wrap the mattresses with that. If you have a child that has an accident in the bed, the Tyvek doesn't let the liquid urine go through. But if there's water in the mattress, it'll let that escape. And the pores of the Tyvek are small enough that it protects against contaminants in the environment getting into the mattress, but also contaminants in the mattress getting out into the living space.

Now h there is one issue that you have to be aware of, and that is if you go jump on your mattress, the Tyvek isn't going to let the air out quickly enough and it can rupture the Tyvek. What I like to do is get a MERV 11 or 13 furnace filter and tape that into the bottom side of the mattress so that it acts as a pressure relief valve. Let’s air come out when it's needed.

The type of Tyvek that we use for that is the Tyvek 1443R. It's not the same as the building wrap. Tyvek building wrap is crinkly. It's uncomfortable. And if you make the mistake of using that to wrap your mattress, you're not going to have a good night sleep.

Now you could wrap your mattress if you were going to store it for a while in the building wrap, which is a little less expensive. But you wouldn't want to use it for nightly sleeping.

[1:15:29] SCOTT: Coming back to the Pathways conversation, if we think of about MSQPCR testing, we have the potential that Stachybotrys, for example, could be behind a wall, could be releasing mycotoxins. The mycotoxins coming into our breathing space affecting our health. But maybe not so much the Stachybotrys. How often might Pathways miss the presence of a mold issue for a similar reason?

[1:15:55] JOHN: Well, a human hair typically is about 100 microns in cross-sectional diameter. A typical Stachybotrys spore is about 10 microns. You could fit 10 of them end-to-end and still have them coming through that crack. Not only that, but Stachybotrys, when it dies off, the particles and fragments, they break down and they can be released too.

The older the condition, the more likely it is that stuff is going to be coming out. DNA results will pick up on that. Culturable to a species level won't be able to pick up on it once it's dead. Culturable can only find that, which is alive or dormant. DNA can find alive, dead, or dormant.

With regards to the mycotoxins, most of the mycotoxins are actually attached to the particles. And so, when you do a good job of controlling and cleaning up the particles, you do a good job of cleaning up the mycotoxins. The exception to that is the biotoxins that are fat soluble. And Stachybotrys, Satratoxin, and a number of the trichothecene biotoxins are fat soluble.

And our buildings are covered with oil films. I mean, our fingerprints. Every time we touch a surface, we're leaving oil behind. It's not very much, but it's enough. And so, the spores and the fragments can stick to the oil films, but the toxins can diffuse into those oil films.

And this is one of the reasons that I love using disposable microfiber, cleaning clothes that have been dampened with five drops of dish detergent to a quart of water. Basically, that small amount of detergent in the water will act as an emulsifying agent and be able to clean up those residual oil films that we leave behind.

I mean, if you've been using uh essential oils and fogging them all over the place, then you may need to use more detergent in order to dissolve those films. If you're deep-fat frying, you may need to use more detergent. But the problem is if you use too much detergent, then you have to rinse. Then you have to go back over it to clean the detergent back off. And five drops seems to be the right amount for being able to not have to go back and rinse it afterwards. And yet, it allows the byproducts to be picked up and collected.

And so, the microfibers are picking up the particles. The water is helping to emulsify and pick up the water-soluble toxins. And the dish detergent is emulsifying the fat soluble biotoxins so that they can be picked up by the microfibers as well.

Important that we don't dip our microfiber clothes into the cleaning solution. The way that the fibers work at picking up the particles is they're finely divided particles that have spaces between them. And if you're dipping the towel into the water and trying to ring it out, you're just loading it up with water and there's less space to collect the particles that we want to collect.

I find that dipping it just doesn't work as well. You're better off having it in a spritzer bottle and spritzing your wipe. Usually, I find about three sprays per wipe is about right. If you find that you're not getting at least some dampness that remains on it, then you might have to do a couple more. But, usually, never more than five.

[1:19:24] SCOTT: And we'll link in the show notes to your Effective Cleaning process. Very helpful. I personally have certainly benefited from it as have many others. What is the cost per swab to do the Pathways testing? And is that something that anyone can do? Do they need to consult with you first? Is there then an additional cost for the consultation? How does that work if people are interested?

[1:19:43] JOHN: The cost per swab is $10 per test. Now the thing is sometimes we do a lot. I mean, when you're really trying to figure out where an issue is, you might end up doing as many as a hundred per thousand square feet of residence. And you might have multiple rounds. Although, as we get into this, we try to cut back with each round on those areas that clearly are not the issue, so that it would be less than that.

But what we've been working with now for several months and becoming more familiar with it is this idea of going in and testing with four swabs per every room. And when I do four swabs in a room, first I want to be sure that I'm testing at least one area that's not likely to have a mold problem. But with the other three, I want to do under windows. I want to do walls that are common with water sources.

If I have a master bedroom closet which shares a wall with a master bath shower, then I want to be testing inside that closet. Because bathrooms are usually pretty well sealed up. There aren't that many Pathways in them because the grout and the cocking that gets used. And in a case like that, it's going to be more likely to be coming through to the other side of the wall into the closet and migrating into the master bedroom.

We want to focus on areas where there's water close by. And then if you have an area that has had previous remediation and you want to know whether that remediation is likely to have done what it needed to do, then those would be good areas to do additional swabs.

If you smell a mustiness, then focusing in on the area where the mustiness is. You may be able to track it down a little bit better that way. Sometimes, for example, you'll notice a musty odor coming from windows. And if you look closely around the window, you'll see that there are places where there are event openings throughout, or around them, or cracks around them the way that they were installed.

And so, those might be good places to swab as well. A negative result doesn't mean that you don't have a pathway. It just means that it's not exhibiting at that particular time. But by doing four swabs in a room that has not had any extensive cleaning or has not had the effective cleaning that we've already talked about, you're more likely to pick up on problem buildings that way.

When a place has been cleaned a lot initially and then the testing is done, finding an issue usually requires a lot more swabs. We do have a 20-swab minimum. $200 is the minimum. Basically, it costs more to set the swabs up and everything than to do them. We find that 20 swabs is the minimum amount that we can make pay.

[1:22:49] SCOTT: And then is the consulting piece with you, is that part of the swab purchase? Or is that an additional? How do you kind of guide them through interpretation of the results?

[1:23:01] JOHN: Right now, I am acting as a consultant and helping people interpret what their results mean. And so, yes, I do work for an hourly consulting rate. We're making Pathways available to other environmental consultants. And we have a number of them throughout the United States. Not as many as I would like, but probably about five or six that are using Pathways on a relatively regular basis.

And in that case, when they understand it well enough, then they would be the ones that would be consulting with you. But I'm happy to consult with them and you at the same time until they get to a comfort level. Just because they get to a comfort level doesn't mean they'll stay there. They may end up with additional questions.

I'm willing to answer those. But one of the things that our company is doing right now – and I don't know how long that's going to continue. But every other Tuesday, I am doing a free question and answer session.

We started out – the first 15 minutes, we show the Pathways video, the 15-minute one that you're providing the link for. But then after that is over, then I spend 45 minutes answering questions. And this is all at no charge. Typically, there's been maybe a half a dozen people at a time showing up. And I've been able to pretty much get to everybody's questions. If we end up with a whole bunch of people showing up all at once all of a sudden and might not be able to get all the questions answered. But by being there and listening to the questions that people are asking, oftentimes, you'll hear your answer too.

[1:24:43] SCOTT: How often is the Pathways testing used to then determine potential areas of remediation versus areas to enhance our cleaning processes? Can the results lead to an adjustment in our cleaning and that then be enough? Or do you find that remediation is still commonly needed? Can we clean enough to keep ahead of any potential hot spots?

[1:25:08] JOHN: If remediation were needed every time that mold was present, that would not serve our clients that are renters very well and it would not serve our clients who have decided that they want to move from a building that they want to sell and they're just not able to find a new replacement place quickly enough.

And so, using Pathways to help monitor for cleanliness is what we're seeing being done more and more. I initially started off thinking that it was going to do a great job of finding the hotspots. And it does find them. But, usually, working from a cleanliness standpoint is actually I think being a lot more productive with it.

Again, we're encouraging everybody to continue using the regular methods. Do you have visible mold? Does it smell musty? Is there an area where you've had a problem before that maybe you know it wasn't remediated properly or you suspect that it wasn't? I think that those – there are oftentimes less expensive ways even than Pathways to figure stuff out.

I mean, if you can see mold, if you can smell it, that kind of answers that question. And it allows you to then narrow down even more. And maybe you'll decide that you want to do some other form of testing that is costing $100 a test or more to basically confirm for you that it's actually mold and not some other type of protein or peptide bond.

But I think as a screening tool, that's the way it was intended and that's the way we're seeing it used a lot. Just as an example, I had one young lady who she was going for her master's degree. She had moved out of a college dorm room that was contaminated and moved into an apartment that was about 500-square-feet. And it was even worse than her dorm. And she was afraid that with her brain fog and everything, she just wasn't going to be able to finish her master's degree. She had five months to get it written and defend it, and then she wanted to be out of there. And the brain fog was interfering with her progress.

By using Pathways, we were able to figure out that the window at the front of her apartment was where the problem was. The landlord would not do remediation. He was willing to cock the outside of the window to help reduce the amount of moisture getting into it. But he would not do remediation. And she couldn't take the time to find a new place and still hope to graduate.

What we were able to do through a series of Pathways tests in her place over a period of two weeks was figure out that if she cleaned the area under that window, so a two-foot wide by 8-foot long area, every single day. Took two Swiffer wipes. She'd put a wipe on the mop pole. She'd Spritz it. She'd clean a two-foot wide by eight-foot long area. Pull that one off. Throw it away. Put a new one on. Spritz it again. Do the same thing. So, it took her two minutes a day. She was able to get that area under control to the point where the rest of her apartment she only had to clean once every two weeks. And her brain function returned. She was able to finish her degree program and graduate on time. It can be used under those circumstances as well.

[1:28:37] SCOTT: When we do have to do a remediation project from a post-remediation verification, or PRV perspective, or clearance testing perspective before containment is removed, what type of testing do you suggest to pass that remediation? Are you looking at air samples? Tape lifts? What are your recommendations?

[1:28:57] JOHN: Usually, what we're using in the area where the mold growth was, where it was contained, is Mycometer testing. Mycometer is a fungal enzyme test. It tells us whether or not there's still mold or fungi on that surface. If there's an absence of it, then we've got a clean surface. If there's not an absence, then we're going to want to see more cleaning done.

And more and more, we are doing work with Pathways outside of the contained area. One of the things that I've noticed over the years is most people, once remediation is started, even if they're living in the place, they stop cleaning. And, unfortunately, that's not the time to do that. I mean, that's the time to redouble your efforts.

By testing outside of the contained areas, four swabs per room, including halls, and closets, and bathrooms, we're able to get a better idea of how much protein and peptide bond is present in other areas of the home which are likely to indicate a buildup. If you've already done your ERMI testing in 500-square-foot areas throughout the home, you've already got a pretty good idea of which areas are issues and which areas aren't. And so, by using all this together, it can really help to speed things along and give some comfort level.

The other thing that I think that's real important is, more and more, we're finding that building memory can be a problem. After remediation is done, there are and crannies where stuff starts working its way back out. And Pathways can be a good way of double-checking for that by doing some additional testing at later times.

And what we're seeing is a pattern of about eight weeks post-remediation is commonly a period of time where if somebody was doing better immediately after the remediation and they start doing bad again, that's the time to start looking using peptide bonds and proteins.

[1:30:56] SCOTT: I want to talk a little bit about lumberyard mold, which is discussed a lot. It's very prevalent. Some suggest this is Ceratocystis and not a contributor to CIRS. Others suggest that it can be a mold of concern from a health perspective. If a concerning mold is identified in an attic, for example, what would you then do? Would you sand it? Would you use hydrogen peroxide and maybe an encapsulant, which we talked a little bit about earlier? And how might mold on framing be addressed? How much should we be concerned about it? What are your thoughts on what many call lumberyard mold?

[1:31:31] JOHN: Right. Well, the issue with lumberyard mold, first off, it only grows on green lumber. Once the lumber is cured, if it gets wet again, it will not grow. However, that's when the Penicillium and the Aspergillus can grow. And often times, they will intermingle with the Ceratocystis.

And so, we could have lumberyard mold that in and of itself isn't a problem. But the other types of organisms that are mixed in certainly could be. And so, I think it's worth paying attention to. I don't like seeing it sealed up in homes. But one of the interesting things about the lumberyard mold is it doesn't easily aerosolize. It doesn't come off the materials and float around.

And I am unaware of it ever being found in a spore trap. It's one of those things where I don't pay too much attention to the Ceratocystis unless there is an issue in that area that's showing up in one or the other ways. But if an area of wall is being opened, I don't like leaving things like that behind. I'd like them to be cleaned up right along with everything else that's present.

[1:32:38] SCOTT: But when you look at an attic, for example, and you see areas of black on the framing wood that's there, is that something that generally would still lead you to concern? Or is that generally not high on the list of priorities?

[1:32:52] JOHN: Well, attics, because of Stack Effect, the air typically tends to go up and out. Attics can still be a problem if there's duct leakage that's forcing the air in or if we're doing things that create negative pressure that's high enough to bring it down through can lights or other things like that. Every situation with an attic is different.

I would potentially do Pathways testing around can lights to see whether or not we've got pathways where it's coming down from the attic into the living space. If it is, then, certainly, it needs to be addressed in one way or another.

But one of the problems that we're seeing a lot of is spray foam insulation. Australia's had a terrible problem with spray foam. It was being used a lot over the last a decade and a half I believe it was. It's been trapping a lot of moisture behind the spray foam in ways that are leading to extensive rot to the point where buildings are having to be torn down. Not because of mold, but because of the rot that develops that's structurally impairing the building.

There are a number of things that may need to be taken care of in attics. And some attics lend themselves to figuring that out. And other attics don't. They're just not accessible in ways that make it easy. But if you don't see the right amount of ventilation for an attic, if it's not constructed in ways that are appropriate for that particular part of the country, then it's a bigger concern.

[1:34:29] SCOTT: And when you do see wood on mold framing materials in the attic, I've heard some people suggest that sanding is a good idea. I've heard others suggest that can potentially just kind of spread things further. That have suggested hydrogen peroxide and then some type of encapsulant. Where do you stand on that?

[1:34:47] JOHN: Well, if it's water-damaged types of molds, spraying peroxide on it is just going to bleach it out and potentially spread those spores around more. Mold spores has this hydrophobic coating on the outside of it, fatty types of coatings, that um basically repel water. And it has hydrophobins that you spray it or you wipe it and it's just going to go everywhere. You don't want to use a regular sander. You want to use a HEPA sander that actually has the ability to collect the contaminants as it's happening. And I would be cordoning the attic off if necessary. Creating a negative pressure in it, so it's not going down into the living space. Often times, you end up having to take all the insulation out in order to access the areas that are problematic too.

[1:35:40] SCOTT: After we've done a successful remediation, do you ever recommend fogging or misting of the entire home so that we can get some of these smaller particles that might be suspended in the air out and then use the effective cleaning process? And if so, would we be looking more at antimicrobial solutions, which you've already hinted at? Or more of coagulant solutions?

[1:36:04] JOHN: I am not a fan of fogging because it's so poorly misapplied. We don't want petrochemical fogging agents, dry fogging agents, enzymatic fogging agents, things of these natures or agents that have fragrances, perfumes that can trigger multiple chemical sensitivities. We don't want encapsulant sprays being used because they can trap moisture.

The problem we get into is that there aren't many coagulant types of cleaners available. I don't have a problem with them. But they really need to be understood and used appropriately. If you're not fogging the proper size droplet, if you're not following up with additional water sprays in order to form rain droplets so that the particles drop out of the air, it's not going to work. If you're not going in and cleaning really well all these surfaces that they fall down onto, it's just sitting there waiting to dry out and coming back up into the air. It's not a cure all. It's not something where you spray and go. You have to follow the process and understand it.

[1:37:13] SCOTT: And my understanding is that some of these ultra-fine particles, that they're not really affected by gravity. And thus, they may never settle on surfaces. So, that in some cases, we do need those types of solutions to coagulate to them in order for them to come down to a surface that we can then use your effective cleaning process with. Is that correct?

[1:37:33] JOHN: It's the type of thing that can usually be judged based on how old the conditions are. How small the particles are? There are ways of dealing with it. You can certainly collect those tiny particles if you get within that capture zone and are sucking them up appropriately. But, yeah, the fine particles are a little bit trickier. But it can be done.

[1:37:57] SCOTT: And with your Effective Cleaning process, why is it important to always move the cloth in the same direction? How often should we discard the microfiber cloth? We commonly see people cleaning floors and horizontal surfaces. But do we also need to be cleaning the walls and maybe even the ceilings with a similar process?

[1:38:18] JOHN: Spores settle downward. They tend not to stick on the walls or the ceilings near the same quantities. It can still happen. But in the video that you're making the link available for, I actually talk about that. You can use the microfiber clothes on a long pole. Stand on the ground and clean the ceiling, clean the walls. If you do 40-square-feet and look at it and it looks clean, you probably don't need to be doing the ceiling or the walls under that circumstance. Although, I would treat each room differently and do that test cleaning in each area to make those kinds of decisions.

I mean, horizontal surfaces are the most important. If you do have to clean vertical surfaces or the underside of the ceiling, what you'd probably do is you'd start out by cleaning the room first very quickly to get up the big chunks. Because if you're walking across them, you're going to be re-aerosolizing them. We want them to stay down or be picked up by HEPA vacuuming. And then I would do the ceiling first, the wall second. Then I would re-clean the floor.

Typically, I find that you need to clean the floor about three times for every time you need to do the wall. Two times for the wall and one time for the ceiling. So, a 3-2-1 pattern seems to give us the best results if our ceilings or walls need the cleaning.

As you're moving the microfiber cloth along, it's picking up the particles and integrating them in with the fibers. And it's usually doing most of that at the leading edge. And so, there can be a buildup at that leading edge. And if you go backwards, now you've just left a bunch of stuff behind.

By going in the same direction using S cleaning, edge cleaning, following in the same direction all the time, it will fill up. You can actually stop every 40-feet or so and look at the wipe and you can see, "Okay, this much is filled. But I've still got three quarterss of the wipe available."

And as you continue, you'll get to the point where you're getting close to having the whole wipe filled. And that's when you want to stop and change it up. You're going to always do one cleaning more than what you can see that you need to. In other words, as you're cleaning and it's coming back dirty, you know that you're going to have to clean at least one more time. And you do it until it comes back, so that you're not seeing any evidence of that dirt. And again, we show that in the video.

[1:40:43] SCOTT: Talk to us about your book Prescriptions for a Healthy House, 4th Edition: A Practical Guide for Architects, Builders, and Homeowners. What can the reader expect to learn from your new book?

[1:40:54] JOHN: The 4th edition, it's got about 100 additional pages. It's almost 400 pages long now. And about 75 of those new pages have to do with water damage, and mold, and things of that nature. It's just so much better than it has been during the first three editions. Every edition has gotten better and better. It's now in its fourth edition. The first edition was 25 years ago.

We were actually on Amazon's best sellers list for sustainable design and construction three weeks in a row with number one status for at least a day or two of each of those three weeks. Bouncing back and forth between number one and number five.

It's actually now been adopted by two schools of architecture as a part of their course curriculum. The subtitle is A Practical Guide for Architects, Builders, and Homeowners. And we try to balance that out.

We'd like to think that there are professionals out there that are going to be able to do a really good job of helping their client get a good home. But everybody is so different. Their needs are so different. One of my goals has been to help turn people into their own best expert. There's no way I'm ever going to know all the things I need to know about them or their situation. That's what they need to do. And if they're being impacted by medically important environmental issues, then they need to be learning as much as they can from themselves.

People like me are out there to help you sort through some of the finer points if you need it. But I find that when I consult with people, if they've already worked their way through most of the book, it's a much more productive conversation. Because they already know a lot of the basics and I don't have to go into things that might take four or five hours’ worth of consulting work to get them up to speed. Whereas, if they've read about it first, then I can say, "Remember when it talked about this? Or remember when it talked about that?" I think that that's an effective way of using it.

The other tip that I have is the index is a little bit hard to use. And so, it's available in electronic form. And then you can do a search find for keywords or phrases. And that makes it much easier to pick out where the particular issue that you're interested in is located. 400 pages is a lot of pages to remember at all.

[1:43:29] SCOTT: Absolutely. My last question is the same for every guest, and that is what are some of the key things that you do on a daily basis in support of your own health?

[1:43:38] JOHN: Well, I'm now 68-years-old. Almost 69. And I remember, one of the things that my mother-in-law used to always say was it's time to start eating like an adult. And so, I'm watching my diet much more closely than I used to. Trying to be careful to avoid the highly processed types of foods. Sticking mostly to the low-processed or unprocessed types of things.

[1:44:08] SCOTT: Excellent. Excellent. John, this has been such a great conversation. You make such a big difference. You've been tremendously helpful to me personally, but also to many people dealing with CIRS. I know you also are constantly collaborating with other indoor environmental professionals through the ICI organization and other groups. And really making a difference in moving this industry and this field forward with a focus on helping those of us that have health issues because of our environments. And so, I just want to thank you for being generous with your time today, but also for doing everything that you do that really makes a huge difference in the lives of so many. You're just incredible.

[1:44:52] JOHN: Thank you, Scott. I really appreciate it. And thanks to everybody that's watching.


[1:44:56] SCOTT: To learn more about today's guest, visit JohnCBanta.com. That's JohnCBanta.com. JohnCBanta.com.

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