Good afternoon. My name's Dr. Cameron Jones and I'm an environmental microbiologist, and we're doing this live stream from my office. We are currently in Melbourne Australia, and we are undergoing our second lockdown. In any case, I hope everyone's keeping safe. I hope you're all wearing masks. Today, however, we're going to take a break from discussing the infection control issues surrounding SARS-CoV-2, and we're going to revert to mould and water damage.
And specifically, in today's show, I wanted to take a very close look at a range of symptoms and exposure issues that can occur inside water damaged buildings, which can be defined as multiple chemical sensitivity (MCS). The reason I want to focus on this, is that I increasingly come upon clients who have been exposed to water damaged buildings, and they describe a constellation of symptoms which are well described by multiple chemical sensitivity. So I've gone into the research literature and I found not one, but two papers published in the last six months that focus on those individuals in the workplace who have been exposed to water damaged buildings, and then go on to develop a whole range of symptoms that can be described under the umbrella of multiple chemical sensitivity. So that's what we're going to do today.
This is the topic of today's show: The Ugly Truth about Multiple Chemical Sensitivity and its Relationship to Dampness and Mould. Why am I focusing on this? Well, here's an example of a building that we were called in to inspect literally in the last two weeks. And obviously you can see that this is a new home undergoing construction, and look at all of that timber. Now, here in Melbourne, we're in the middle of winter now. And so a lot of this timber, the timber framing is getting excessively damp and wet. And we were actually called in by a building inspector who had noted that not only were there some defects that went along with the building process, but a lot of the framing timbers were significantly water damaged and mould affected, and the family were concerned for their health.
And so when I was combing through the recent research literature, I came upon these two outstanding papers that we're going to spend some time talking about this afternoon. And one of them introduces a brand new terminology, which I think is in many ways superior to what we currently use for water damaged buildings and mould exposure, such as chronic inflammatory response syndrome, biotoxin illness, mould related illness and allergy. And this new term introduced in these two publications, which are going to be referenced in the show notes is called DMHS or dampness and mould hypersensitivity syndrome. And essentially this is a new catch-all term for mould exposure illness.
Now, if your new home or even an older home has suffered from an unexpected water damage issue, well, you should consider using this new terminology, dampness and mould hypersensitivity syndrome. I'm going to explain why, also I’m going to be presenting some facts and figures, which I hope you'll be able to take advantage of and use because the reason I'm doing this live stream today is all too often, I come into contact with individuals who need to explain to others that their fears around water damage and mould are real. And they usually say that they're concerned about the long-term health implications, and we're going to be going through some excellent research that I mentioned in these two publications, which demonstrate the very strong association between adverse health symptoms and exposure to water damaged buildings.
Now, again, here's a photograph from an inspection I did a couple of weeks ago where the property owner had had water damage, not from rainfall, but due to normal sprinkler maintenance of the fire sprinklers in her apartment or on the floor. And something went wrong and they went off for a period of 15 minutes inside her apartment. And as you can see, all the floorboards are cupped. She has a very strong smell of dampness. She currently continues to live in this apartment because we're essentially under lockdown here in Victoria, and there's a serious mould problem here.
And this brings me on to this next new term called indoor air dampness microbiota (DM). And for all of you who followed my live streams, you know that I'm a microbiologist and I've spent a good deal of my career actually sampling from these water damaged buildings and culturing them onto Petri plates to see what will grow. And so this concept of DM or indoor air dampness, the microbiota that refers to the microorganisms, which are different to the normal microorganisms which you find out in the wild or in the normal air space that is not contaminated. We're specifically focusing on what those types of microorganisms can do to people to elicit or what can be shown to be associated with adverse health symptoms.
So when individuals are exposed to these indoor air dampness microorganisms, this can lead to multiple chemical sensitivity, brain fog, cardiac arrhythmia, and a range of nervous system dysfunctions. We're going to be going through what this research shows. Now, in that particular lady's apartment, the mould was actually growing through the plasterboard. So if you can imagine sprinklers overhead flooded, they flooded not only the ceiling cavity, but the wall cavities. And this is just one of the walls where mould was found to be growing on the external surface facing into the habitable parts of the home.
And appropriately, the body corporate for this particular building had been very quick to apply as a make-safe - plastic contact film over the visibly mould affected areas. And that's a really good idea to minimize the aerosolization of these mould spores and cell wall fragments into the apartment as a whole. But the thing about the exposure to the microbiota or the microbiology of the organisms that are found growing on the water damaged building elements is that this leads to exposure. And the exposure is primarily through inhalation, not just of intact mould spores, but all of the micron and sub-micron cell wall fragments that easily get stirred up within a building, especially when it is decaying under the impact of unexpected water damage and then microbial growth.
Now, the first paper I want to focus on came out on the 29th of January, and this was focusing on a range of hospital workers in Finland, and the URL is up here on the screen. Again, it's in the show notes. I urge you to download this paper and read for yourself and use this in any correspondence you need to undertake to explain to other parties why you're concerned about water damage and mould and why you think this needs to be taken seriously. Because the information in these publications is very recent, very well done, and explains quite clearly the positive association between the mould microbiota and adverse health symptoms. And we're going to drill into these symptoms in a minute.
The next paper came out more recently on the 16th of June, 2020. This is focusing on a range of police officers in a police building that had had water damage over a long period of time. So I said I wanted to focus on multiple chemical sensitivity, where multiple chemical sensitivity has been known pretty much for the last 70 years. And essentially this is where a person experiences a range of recurrent and possibly nonspecific symptoms, which occur when they are exposed to very low doses of a chemical that is usually well tolerated by most people. And typical examples of the elicitors or the inciting chemicals include of course, deodorants, perfumes, hair care products, tobacco, any type of smoke, even barbecue smoke, cooking smells, fresh printed materials, paints and varnishes and lacquers, glues, spices, and honestly the range goes on and on.
Now, the medical underpinning to this is usually that this multiple chemical sensitivity has a central nervous system component. And that is a significant component to the pathology of this syndrome. And it is usually associated with chronic exposure to this dampness microbiota. And of course there are other reasons why individuals become chemically sensitive because they essentially can become chemically sensitive to a high concentration of a particular chemical in a high risk workplace. But for the most part in urban environments, the experience of multiple chemical sensitivity is increasingly being linked to exposure to water damaged buildings. And that's what we're focusing on today.
The other important thing I need to mention is that the experience of multiple chemical sensitivity is definitely a dose dependent exposure relationship with the amount of mould that is present in a water damaged building. And so I'm now going to lead into a summary of the findings from the 29th of January, 2020 paper. And yes, it's a table. Now, don't be too scared off by this because I've highlighted two of the rows that I want to focus your attention on. Like most tables, there is a range of symptoms on the left-hand side and in the experiment that was done in both of these publications, essentially you have the group of workers who were working within the building, and this is the first paper, which is focusing on those workers in a hospital environment, which had water damage for a long period of time and was remediated.
We don't know a lot about the remediation effort. However, the scientists were able to undertake an examination of these individuals, which are broken down into two groups, the exposed group that are working within the hospital, and then a non-exposed group, which weren't exposed to this water damaged building. And you can immediately see a couple of things from the two columns of the exposed versus non-exposed individuals. Both columns are in percentages. So you can see for central nervous system symptoms, the first line of the table, 62% of people exposed to water damaged buildings have that as a symptom factor. Whereas only 11% of people who were not in the water damaged building have this symptom problem.
Now, of course, we know that exposure to water damaged buildings and mould and the mould microbiota leads to asthma. But what about multiple chemical sensitivity or MCS? Alarmingly, 40% of people exposed to this water damaged building had multiple chemical sensitivity, meaning that this is induced by the environment that they find themselves in, compared to only 9% of those not exposed to the water damaged building. But it gets even worse: cardiac arrhythmia, a serious complication to an organ no less, comes in at 57% for those individuals exposed to the water damaged building. Whereas only 2.4% of the non-exposed individuals have that particular complaint.
Now, isn't that compelling evidence? I would suggest that if you are having trouble explaining your risk or concerns about water damaged buildings, be it to a rental property manager, be it a property that you are leasing in a residential or a commercial context, you want to get this paper. You want to highlight some of these values, some of the values in this table. You want to show this to people who may not believe the serious implications of being exposed to mould and water damaged buildings.
I want to now move on to the other paper. The next one came out on the 16th of June, and I want to go through some of the key research findings from this paper. But before I do, I just want to give you a little bit of background as I describe what I've put up on the screen now. Now, in this paper, this refers to people who work in a police station and this building was significantly water damaged. Dust samples were taken by the researchers. Now, these dust samples were analyzed. They were centrifuged. They were spun down. And then they importantly used those dust samples because remember, dust contains in a sense, a time history of what's occurred in the air space and what the police and all the other individuals who came into contact with this police building would have been exposed to.
They took those dust samples and they were able to do something which is very novel and very important. We've touched on it before. But what I have in front of you is some cells. I'm going to tell you what these cells are in a minute, but what I want you to take away from these images is that on the first panel, you can see that these particular cells have a green and a yellow dye that has been applied to them. So what happened is they took the dust from the police station and they exposed that dust to a particular type of sperm cells. And these sperm cells are very easy to visualize under the microscope. And when you use a fluorescent stain, the mitochondria, that is the organelles that are involved with respiration - this is the ability of the cell to respire - and this is what then produces energy for the cell.
On the left-hand side, you can see the unexposed sperm cells and the mitochondria region is the yellow fluorescent region. And as you move through the exposure to the dust containing the microorganisms from the water damaged building, you can see a complete loss of mitochondrial activity. We've talked about mitochondrial dysfunction before, and its intimate relationship to exposure to water damaged buildings and this new paper that just came out (and there is a forthcoming paper) focusing on the sperm cell results is very compelling evidence for the impact, not only to the symptomology like multiple chemical sensitivity and fatigue and central nervous system disruption, but also to interference with mitochondria.
And so what did this study show? Well, again, central nervous system complaints, 30% in the exposed cohort versus only 11% in the non-exposed cohort. What about multiple chemical sensitivity? Here, for the police a little bit lower than for the hospital workers, 22% versus 9%. But again, the symptom of cardiac arrhythmia, this is not just a runny nose or an asthma reaction or a cough. This is something happening to your heart. 23% in the mould exposed individuals versus only 2% for those who are not in the water damaged building. I think that that is very significant and compelling evidence.
Now, what do you want to look for when you're describing this DMHS or dampness and mould hypersensitivity syndrome? Well, the first thing you need to know what the history of exposure is to the water damaged building. Whenever I am referred clients from various different health practitioners or medical practitioners, their number one question is, is there any evidence of exposure to those patients to water damaged buildings? So that's something which is fundamental to establish right at the outset.
Secondly, do the individuals notice a re-occurrence of infections, especially in the early stage of a disease, and the disease in this case is asthma or allergic rhinitis or chronic fatigue or something which the individual or patient is presenting to the health practitioner with. So again, I'm the environmental microbiologist tasked with determining the impact of the building on the individual, but the issue of dampness and mould hypersensitivity syndrome is inextricably linked with the medical symptomology. And hence why I am highlighting the summary conclusions taken directly from the paper.
The third point about DMHS is that there should be some evidence of sick building syndrome, either in the definition or diagnostic or description of the building or the symptomology of the client or patient complaining about symptoms occurring more or less during attendance inside versus outside the building. And is there, or isn't there any evidence of multiple chemical sensitivity? Do normal chemicals in the environment, in cleaning products, in fragrances, do these now produce a uncharacteristic or an inflammatory type reaction? Do they now cause a problem where no problem may have existed before? And is there increased scent sensitivity? For example, many people who are now sensitive and demonstrate this dampness and mould hypersensitivity syndrome state that they can smell mould regularly on other people in other environments, not just in their own, meaning that they are in a sense hyper aware of the presence of mould.
And the really important thing I want to emphasize in this live stream, which is the entire point of both of these publications. We'll just get to the conclusion and read this out here, because this is really the crux of everything. On the basis of the presented results, the authors propose that there is a causality between exposure to the DM or the dampness microbiota and a high prevalence of multiple chemical sensitivity with a plethora of neurological symptoms, chronic fatigue syndrome, CNS symptoms, fatigue in persons exposed to the dampness microbiota in buildings. And this is the key finding. This is by no means neither medically unexplained nor a functional disorder. Let me just repeat that. The findings that I've just presented to you cannot be dismissed as a functional disorder and cannot be dismissed as something with no medical basis. That's the importance of these publications.
“On the basis of presented results, we propose that there is causality between the exposure to DM and high prevalence of MCS with a plethora of neurological symptoms. CNS symptoms, dysautonomia, MCS, and fatigue in persons exposed to DM in the buildings by no means are neither medically unexplained syndromes nor functional disorders.”
I would hope that if you were having trouble explaining to other parties your fears or concerns regarding water damage exposure, that you get these papers yourself, search them up on PubMed, get copies of them, share them with others and use them as the foundation to explain to others why your fears and concerns about potentially living and working in a water damaged building are not unfounded, do not demonstrate an aberration or an overreaction or a fear to something that others might consider to be trivial. Mould and water damage is not a trivial problem. And these scientists and researchers are bringing to the table very credible research on which to make their representation regarding the symptoms between those who are exposed to mould and those that aren't.
In any case, we're living through extremely strange times with COVID-19. All of us are spending more and more time at home, and therefore, the potential exposure to mould in the home needs to be taken very seriously. If you can smell water damage or mould, you need to find the source, eliminate the source as quickly as possible - and any porous building elements that have become wet must be remediated, assessed and potentially discarded depending on the amount of mould growth or cross-contamination that may have occurred. In any case, reach out to me if you want to discuss the specifics of your own circumstance. My name's Dr. Cameron Jones. I'll be back next week. Stay safe, wear masks, do social distancing - and that's all I have to say. Bye for now.
Hyvönen S, Lohi J, Tuuminen T. Moist and Mold Exposure is Associated With High Prevalence of Neurological Symptoms and MCS in a Finnish Hospital Workers Cohort. Saf Health Work. 2020;11(2):173-177. doi:10.1016/j.shaw.2020.01.003
Hyvönen S, Poussa T, Lohi J, Tuuminen T. High prevalence of neurological sequelae and multiple chemical sensitivity among occupants of a Finnish police station damaged by dampness microbiota [published online ahead of print, 2020 Jun 16]. Arch Environ Occup Health. 2020;1-7. doi:10.1080/19338244.2020.1781034