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Indoor Mold Summary White Paper

What is indoor Mold and how does it affect us? 

Overgrowth of mold in the home can produce high levels of mycotoxins and microbial volatile organic compounds (mVOCs), causing illness.  

While there is much more for the scientific community to explore, thankfully there is a growing focus on mold in our environment with a significant amount of new research being conducted on these topics.  

What are mold, mycotoxins and mVOCs?

Mold includes various types of fungus that grow on damp or decaying organic matter.  Mold can grow outdoors or indoors; it only needs moisture and a carbon source. 1  Outdoors, moisture from the ground and decaying leaves or wood provide the perfect habitat for mold.  Indoors, moisture from the air (excess humidity) or from a leaking pipe or roof will saturate a substrate such as wood, cardboard or even dust, and provide the moisture and carbon food for mold to grow. It produces particulate pollution (physical spores that replicate and spread) as well as various chemical byproducts. 

Mycotoxins are secondary metabolites, which are organic compounds that are produced by various organisms that are not directly involved in the growth, development, or reproduction of the organism but are essential in the ecological and other activities (contrasted with primary metabolites, which are directly involved with these activities).2  These are chemicals that are specifically toxic to humans, which scientists believe the mold produces to cause plant disease, defend the mold from other microbes, or simply when the mold is stressed. 

Mold can cause two broad types of disease, mycoses and mycotoxicoses.

(1) Human mycoses3:

• Are caused by growth of the fungi on or in our bodies, which can be treated with antifungals.  (Mycotoxins produced while the mold is in the body cause a secondary reaction).

• are mainly caused by opportunistic fungi, which produce illness by taking advantage of debilitated or immunocompromised hosts 

• are frequently acquired via inhalation of mold spores from an environmental reservoir or by unusual growth of a commensal species that is normally resident on human skin or the gastrointestinal tract

• portal of entry can be through the pulmonary tract or direct contact with the skin

• are largely diseases of the developed world, usually occurring in patients whose immune systems have been compromised by advanced medical treatment.

(2) In contrast, mycotoxicoses: 

• Are caused by dietary, respiratory, dermal, and other exposures to the mycotoxins, causing “poisoning by natural means” similar to the pathologies caused by exposure to pesticides or heavy metal residues.3

• Can be successfully treated by regimens of mycotoxin antigens, sauna, oxygen therapy, and nutrient..4

• Are common in underdeveloped nations due lack of resources to harvest and store foods properly.3 However, it is hypothesized that mycotoxicoses in the Western World are mainly due to inhalation of mycotoxins from mold growing in indoor environments (our inference from mold experts). 

As a company focused mainly on air quality, HypoAir has focused on mycotoxins that cause illness due to inhalation (which are mainly mycotoxicoses), as a result of mold growing indoors and releasing conidia (entire spores or fragments of mold or its spores) that contain mycotoxins.  In samples collected from water-damaged indoor environments in Sweden in 20075, here are the main mycotoxins found:

• Trichodermol and Verrucarol are trichothecenes. Trichothecenes are a very large family of chemically related mycotoxins produced by various species of Fusarium, Myrothecium, Trichoderma, Trichothecium, Cephalosporium, Verticimonosporium, and Stachybotrys molds. Trichothecenes inhibit protein synthesis in human and animal cells. 6,7

• Sterigmatocystin is also generated by Aspergillus molds.  It is structurally and biologically related to aflatoxins and is regarded as a precursor of aflatoxin B1 (see below). Therefore, the acute toxicity and carcinogenic properties of this mycotoxin are similar to those presented by aflatoxins, although less potent, and Sterigmatocystin has been recognized as a group 2B carcinogen.8

• Satratoxins G and H are produced by the black mold Stachybotrys chartarum.  Neurotoxicity and inflammation within the nose and brain are potential adverse health effects of exposure to satratoxins and Stachybotrys in the indoor air of water-damaged buildings.9

• Gliotoxin is produced by the common indoor mold genus Aspergillus and is immunosuppressive (it can dampen the body's ability to ward off disease and infection). To do this it impairs the activation of T-cells and induces cell death in monocytes, a type of white blood cell.10

• Aflatoxin B1 (AFB1) is one of the most potent carcinogens in foods, and it was postulated to account for the prevalence of hepatocellular carcinoma (HCC) in high exposure areas. 11

Volatile Organic Compounds (VOCs)

VOCs are gasses and can be anthropogenic (produced by human activity) or biogenic (produced by living organisms, but more specifically plants and animals).   A subclass of biogenic VOCs is microbial VOCs (mVOCs), which are gasses produced by bacteria or fungi.  Indoors, mVOCs diffuse through and sometimes accumulate in the air.  Some mVOCs are responsible for that “musty” odor that is the telltale sign of mold growth (such as geosmin and 1-octen-3-ol), but others can be odorless. Compounds with eight carbon atoms, such as 1-octen-3-ol, 3-octanol and 3-octanone are among the most common fungal VOCs, and among fifteen of the most prevalent mVOCs in water-damaged buildings (thse are 2-methyl-1-propanol, 3-methyl-1-butanol, 3-methyl-2-butanol, 2-pentanol, 3-octanol, 1-octen-3-ol, 2-octen-3-ol , 3-methylfuran, 2-hexanone, 2-heptanone, 3-octanone, 2-methylisoborneol, 2-isopropyl-3-methoxy-pyrazine, geosmin, and dimethyl disulphide).12  Although these mVOCs have not been tested for carcinogenicity, DNA damage was detected for all fifteen of the common mVOCs. 13  Low concentrations of the vapor form of several C-8 compounds including 1-octen-3-ol are toxic to larvae and adult fruit flies.  Moreover, 1-octen-3-ol (octenol for short and also called mushroom alcohol) selectively affects dopaminergic neurons in adult Drosophila (fruit fly) brain and induces Parkinson’s-like behavioral alterations in a fly model for this disease.14,15  Volatile phase 1-octen-3-ol was 80 times more toxic than the volatile phase of toluene in stem cells studies.16  Unfortunately, due to studies mostly conducted on the liquid phase of octenol, the FDA has approved it for use in foods and perfumes, and the EPA has approved it for use in insect lures. The problem with the vapor phase octenol is, like other VOCs, concentrations can build up in enclosed spaces like basements, attics, and even whole homes if they are not ventilated.

Image source: (17) 

How do mycotoxins and mVOCs overlap?

Mycotoxins are only found in solid or liquid form, while mVOCs are gaseous.  However, mycotoxins and many mVOCs are both toxic products of mold.  Therefore, overlap exists in the toxic category, but the science community doesn’t think that mVOCs should be called mycotoxins.   Why?

1. The condition of secondary metabolites: mycotoxins are all secondary metabolites, encoded by clustered genes that are easy to detect in genomic data. Only some fungal volatiles (e.g., the terpenoids) are secondary metabolites. 18 

2. There already are other classes of toxic metabolites made by fungi that are not called mycotoxins. Terms like “antibiotic,” (compounds toxic to bacteria), “mushroom poison” (compounds made by mushrooms) and “phytotoxin” (compounds toxic to plants, or confusingly, made by plants19) are used to label certain other categories of fungal products with toxigenic properties. 18 

3. Since many of the VOCs that have been studied are breakdown products of fatty acids, mediated by lipoxygenases, or are made by simple biotransformation steps from amino acids, we are not certain whether the VOCs we detect in profiles from growing fungi are the direct products of fungal metabolism or are merely incidental breakdown products.18

For these reasons, one article proposes the name “volatoxin” for those mycotoxins which are volatiles.18  Whatever they are officially named, mVOCs have the potential to be harmful to humans, especially if they are allowed to accumulate in a closed space.

Mold Naturally found outside vs trapped indoors

Mycotoxins and mVOCs found outside are normally diluted due to the abundant circulation of fresh air around and through them.  It is entirely different indoors.  Just as CO2 can build up from exhalation of inhabitants in a closed space, mVOCs from mold can also become concentrated in closed atmospheres, and mycotoxins become airborne whenever mold is disturbed, even from the airflow created when a window or door is opened.  

Where are these high concentrations found?  Spaces like the following are ripe for “biohazard” conditions concerning mVOCs and mycotoxins: 

• Damp basements

• Enclosed crawl spaces

• Attics with leaky roofs or otherwise high ambient humidity

• Backyard sheds

• Non-climatized storage units

• Vacation homes that are closed up without air conditioning or ventilation

• Homes damaged by natural disasters or neglect, that are abandoned

• Commercial buildings that have not been occupied or climatized in some time

The combination of lack of ventilation (for dilution) and excess humidity and darkness makes these spaces the perfect environment to grow mold and all of the toxins it emits.

How does Polar Ionization affect mycotoxins and mVOCs?

Our Polar Ionization uses Carbon Brush style Needlepoint Ionization to split the normal water vapor (H2O) in the air into millions of positive Hydrogen ions and negative Oxygen ions, without the production of ozone.  These natural ions are in proper balance and are stable enough that they can last a minute or longer as they travel in the airflows of an HVAC system or room giving them sufficient time to interact with air and surface contaminants in large buildings. Ions are any molecule or atom where the number of electrons does not equal the number of protons. These ions are very effective against a wide range of particulate, biological and chemical contaminants.  

Due to their type and stability they:

• can provide purification for large areas with reasonable upfront costs and no ongoing replacement parts 

• can react with both airborne and surface based contaminants opening up many new applications for safe active sanitization of occupied spaces.

• Remove static electricity, and as such are able to travel much further than negative ions.  

• Due to their balanced nature, they do not create unwanted ozone unlike devices that produce negative only ionization

Ability of Polar Ionization to protect against Mycotoxins and Mold Related Particulates

Mycotoxins can be transmitted through ingesting contaminated food, or they can become airborne, attached to spores of mold (conidia) or fragments of conidia.  According to a 2005 study 20, mycotoxins from Stachybotrys Chartarum (specifically trichothecene mycotoxins) were found on intact spores, which are larger (about 5 microns in diameter) as well as fragments of mold and other smaller particles (1.2 microns and below). These mycotoxins are known to react primarily with mucous membranes of the upper respiratory tract and eyes, leading to irritating erythema, inflammation, and pain. 20  In an earlier study, Trichothecene mycotoxins were found on Stachybotrys atra conidia of 5 micron diameter on average, indicating that these mycotoxins are easily respirable.21

The term PM2.5 is often used to refer to particulates 2.5 microns and less in diameter. For reference, a human hair is around 50-100 microns (μm) in diameter.  The human body has many natural defenses against large particulates like these.  In general, we consider extremely small PM2.5 contaminants to be far more dangerous and difficult to remove than larger particulates. Even smaller, 0.3 microns are considered the Most Penetrating Particle Size (MPPS) due to their difficulty to capture.  A HEPA filter's efficiency rating is specifically tested at 0.3 microns (not larger or smaller particles) because it is addressing a variant of the filter's minimum efficiency. 

Polar Ionization removes particulates from the air primarily through making them group together making them larger, heavier, and often with a negative or positive charge.   Those same larger, heavier, and charged particles can not stay airborne for long and are relatively easy to trap in a mechanical filter or easily vacuumed up from the ground after they settled.   Polar Ionization can quickly remove well over 95% of airborne particulates (including spores) without any physical mechanical filtration whatsoever (HEPA).  Due to its mode of action, it can also improve the filter rating of any mechanical filter used in the same space by several levels.  The use of mechanical filtration in addition to Polar Ionization is often unnecessary, however it can improve the speed of removal of particulates especially with those with high sensitivities.  At HypoAir we are quick to recommend redundancies in air purification where the needs of the occupants require faster removal of particulates and when finances allow. 

Numerous case studies conducted by independent labs show how mold spore counts (and thus by inference, mycotoxins carried on the mold spores)  were dramatically reduced in the air of closed environments by employing HypoAir’s Polar Ionization without additional filters.22 

Ability of Polar Ionization to break down mVOCs

The Polar Ions are also effective at breaking down VOCs & odors at a molecular level, specifically gasses with electron volt potential below 11. This is by design as the power output is capped at 12.07eV in order to prevent the formation of ozone since oxygen has an electron volt potential of 12. Formaldehyde (CH2O) for example has 10.88 as its electron volt potential and can be dismantled down into harmless carbon dioxide (CO2) and water vapor (H2O).  Similarly Ammonia (NH3) with an electron volt potential of 10.07 is broken down into harmless nitrogen (N2) and water vapor (H2O) (nitrogen naturally makes up about 78% of earth’s atmosphere).   Due to the method of production and stability of the ions, no ozone is produced in this process and the theoretical issue of incomplete oxidation or unintended byproducts is addressed with net VOC reduction.  One example showing proof of these breakdown reactions was obtained by measurement before and after installation of a bi-polar ionization device in the HVAC system of Houston Methodist Hospital, which reduced Total VOCs (TVOCs) to acceptable levels with activation of the device after many months of poor air quality complaints and failure of carbon filters to adequately clean the polluted air intake.23

The following are electron volt potentials of some of the most common mVOCs in water-damaged buildings24:  

Additional efficacy against more complex chemical compounds and high concentrations of odors can be found with our products that combine Polar Ionization with Activated Carbon, AHPCO and/or our TotalClean i2 spray.

Ability of Polar Ionization to Neutralize Biological Contaminants on Surfaces and in the Air

Polar Ionization has been well tested in our products and in other devices that produce the same type of ions to neutralize certain bacteria, mold, and viruses in the air and on surfaces.  Polar Ionization & Mold Spores in particular have been tested many times, including a 99.50% kill rate tested by GCA over a 24 hour period. 25 The Polar Ions are effective at disrupting these biological contaminants by breaking down their surface proteins which results in inactivation or lysis.  The efficacy of Polar ionization on viral (Feline Coronavirus, Coxsackie Virus, Polio Virus, SARS Coronavirus) and other biological threats (TB, MRSA, VRE, C. Diff) has been proven for years by a wide range of independent studies with more information, sources, and studies found on hypoair.com.

For more info about our proprietary products and technologies, please visit www.hypoair.com

References:

1. Indoor Environmental Quality: What is Mold? (n.d.). Retrieved from https://www.cdc.gov/niosh/topics/indoorenv/whatismold.html

2. Sapkota, A. (18 January 2022). Primary vs Secondary Metabolites- Definition, 12 Differences, Examples. Retrieved from https://microbenotes.com/primary-vs-secondary-metabolites/

3. Bennett, J. W., Klich,  M. (2003). Mycotoxins. Clinical Microbiology Reviews, 16(3), 497–516.  https://doi.org/10.1128%2FCMR.16.3.497-516.2003

4. Rea, W.J. (2018). A Large Case-series of Successful Treatment of Patients Exposed to Mold and Mycotoxin. Clinical Therapeutics, 40(6), 889-893. https://doi.org/10.1016/j.clinthera.2018.05.003

5. Bloom, E., Nyman, E., Must, A., Pehrson, C., Larsson,  L. (2009).  Mycotoxins produced by molds in water-damaged indoor environments.  Journal of Occupational and Environmental Hygiene, 6(11), 671–678. http://dx.doi.org/10.1080/15459620903252053

6. Trichodermol (T3D3717). (n.d.). Retrieved from http://www.t3db.ca/toxins/T3D3717

7. Verrucarol (T3D3723). (n.d.). Retrieved from http://www.t3db.ca/toxins/T3D3723

8. Vieira, T., Cunha, S., Casal, S. (2015). 25.3.3 Sterigmatocystin. In V.R. Preedy (Ed.), Coffee in Health and Disease Prevention (pp. 225-233). Elsevier Inc.

9. Islam, Z., Harkema, J.R., Pestka, J.J. (2006). Satratoxin G from the black mold Stachybotrys chartarum evokes olfactory sensory neuron loss and inflammation in the murine nose and brain. Environmental Health Perspectives, 114(7), 1099-1107. https://doi.org/10.1289/ehp.8854

10. Gliotoxin. (n.d.). Retrieved from https://healthmatters.io/understand-blood-test-results/gliotoxin

11. Ferk, F., Speer, K., Mišík, M., Nersesyan, A., Knasmüller, S. (2015). Chapter 66 - Protective Effects of Coffee Against Induction of DNA Damage and Cancer by Aflatoxin B1. In V.R. Preedy (Ed.), Coffee in Health and Disease Prevention (pp. 587-596). Elsevier Inc.

12. Korpi, A., Järnberg, J., Pasanen, A-L. (2009).  Microbial volatile organic compounds.  Critical Reviews in Toxicology, 39(2), 39-193. https://doi.org/10.1080/10408440802291497 

13. Kreja, L., Seidel,  H-J. (2002). Evaluation of the genotoxic potential of some microbial volatile organic compounds (MVOC) with the comet assay, the micronucleus assay and the HPRT gene mutation assay.  Mutation Research, 513(1-2), pp. 143-150.  https://doi.org/10.1016/s1383-5718(01)00306-0

14. Inamdar, A.A., Masurekar, P., Bennett, J.W. (2010).  Neurotoxicity of fungal volatile organic compounds in Drosophila melanogaster. Toxicological Sciences, 117, pp. 418–426. https://doi.org/10.1093/toxsci/kfq222

15. Inamdar, A.A., Hossain, M.M., Bernstein, A.I., Miller, G.W., Richardson, J.R.,  Bennett, J.W. (2013). The fungal derived semiochemical 1-octen-3-ol disrupts dopamine packaging and causes neurodegeneration. Proceedings of the National Academy of Sciences USA, 110, 19561–19566. https://doi.org/10.1073/pnas.1318830110

16. Inamdar, A.A., Moore, J.C., Cohen, R.I., Bennett, J.W. (2012).  A model to evaluate the cytotoxicity of the fungal volatile organic compound 1-octen-3-o1 in human embryonic stem cells. Mycopathologia, 173, 13–20.  https://doi.org/10.1007/s11046-011-9457-z

17. Morse, R., Acker, D. (22 February 2017). Indoor Air Quality And Mold Prevention Of The Building Envelope. Retrieved from https://www.wbdg.org/resources/indoor-air-quality-and-mold-prevention-building-envelope

18.  Bennett, J.W., Inamdar, A.A., (2015). Are Some Fungal Volatile Organic Compounds (VOCs) Mycotoxins? Toxins (Basel), 7(9), 3785–3804. https://doi.org/10.3390%2Ftoxins7093785

19.  A.Graniti (1972). “The evolution of the toxic concept in plant pathology.” In: Wood R.K., Ballio A., Graniti A., editors. Phytotoxins in Plant Diseases (pp. 1–18). Academic Press.

20. Brasel, T. L., Douglas, D. R., Wilson, S. C., Straus, D. C. (2005).  Detection of Airborne Stachybotrys chartarum Macrocyclic Trichothecene Mycotoxins on Particulates Smaller than Conidia.  Applied and Environmental Microbiology. 71(1),  114–122.  https://doi.org/10.1128%2FAEM.71.1.114-122.2005

21. Sorenson, W. G., Frazer, D.G., Jarvis, B.B., Simpson, J., Robinson,  V.A. (1987). Trichothecene Mycotoxins in Aerosolized Conidia of Stachybotrys atra. Applied and Environmental Microbiology, 53(6), 1370-1375. https://doi.org/10.1128%2Faem.53.6.1370-1375.1987

22. Milburn, D. Case Studies, Mold Focus_Part 1. (n.d.) Retrieved from https://docs.google.com/presentation/d/1RSgZYhSq0M_-fzlPUP1Q8z2btVuDi8so/edit#slide=id.p1

23. Schurk, D. Houston Methodist Hospital Test Study Results Needle Point Bi-Polar Air Ionization for VOC Remediation. (n.d.). Retrieved from http://www.victordistcontrols.com/wp-content/uploads/2014/03/Methodist_Hospital_VOC_Remediation_Project_Test_Results_2014.pdf

24. Electron Volt (eV) Potential Chart for Industrial Gases: UNDERSTANDING eV POTENTIAL PAPER. (n.d.). Retrieved from https://egeda.be/wp-content/uploads/2020/11/Electron-Volt-potential-chart.pdf

25. Waddell, C. GPS Reports on Pathogen Testing,(n.d.) Retrieved from https://gpsair.com/uploads/customer-resources/Service-Logic/White-Paper-GPS-Reports-on-Pathogen-Testing-03-2020.pdf

What are Endotoxins and Exotoxins and where do they come from?

The word “toxin” causes my ears and eyes to perk up, because these are the types of substances that cause illness and even death.  Thankfully, it is increasingly possible to avoid toxins by understanding where they live and how they’re spread.   Science is advancing very rapidly to show us how to manage our environments, food, lifestyle and even our bodies to live more healthfully.   Endotoxins come from Gram-negative bacteria, and Exotoxins can come from either Gram-positive or -negative bacteria so we’ll start with what the “Gram” test means. 

Bacteria can be classed into two different groups: “Gram-negative” or “Gram-positive”.  These classes are based on a test developed by scientist Christian Gram in 1884, which differentiates the bacteria using a purple stain.   According to webmd.com, bacteria either have a hard outer shell, or a thick, mesh-like membrane called peptidoglycan.  The hard outer shell will resist the purple stain, and show up as a red color.  These are called “gram negative” because the purple stain did not show.  Bacteria with the peptidoglycan absorb the purple stain much more easily and are called “gram positive”.  The stain also tells more characteristics about the bacteria and the way it interacts with treatment. 

The peptidoglycan layer of Gram-negative bacteria is much thinner than that of gram-positive bacilli; instead Gram-negative have a hard, protective outer shell, making them harder to kill because of their harder cell wall.  When their cell wall is disturbed, or the bacteria are dead or dying, gram-negative bacteria release endotoxins that can make symptoms of illness worse.  In contrast, exotoxins are produced inside the bacteria and may be released while the bacteria cell is living, or during its death.

Here is a diagram that shows how the exo- and endo-toxins are released (source: microbiologyinfo.com).  (I distinguish them by remembering that endotoxins are only emitted at the “end” of life of the bacteria):

Here are some examples of gram-negative bacteria diseases (webmd.com):

• Vibrio cholerae (Cholera, a serious intestinal infection)
• E. coli (E. Coli infection)
• Yersinia pestis (Plague, an infection of the lymph nodes and lungs)
•  Bartonella henselae (Cat-scratch disease)
• H. Pylori (gastritis, peptic ulcer disease, gastric lymphoma, and gastric cancer)
• Campylobacter (campylobacteriosis, an infection that usually affects the digestive tract)
• Legionella bacteria (Legionnaire's disease, a lung infection)
• Salmonella (salmonellosis, a digestive infection caused by contaminated food)

Here are some Gram-positive bacteria (and the infections they cause): 

• Staphylococcus aureus (MRSA, toxic shock)
• Streptococcus group A (strep throat, toxic shock)
• Clostridium botulinum (botulism)
• Bacillus anthracis (Anthrax) 

As you can see, endotoxins and exotoxins are a serious matter!  Here are some of the other important differences between them (byjus.com):

(A toxoid is a chemically modified toxin from a pathogenic microorganism, which is no longer toxic but is still antigenic and can be used as a vaccine (Oxford languages).)

There is so much to study about bacteria, however since we at HypoAir mainly focus on air quality, we’ll try to limit this post to the toxins that can be transmitted through the air.  

Endotoxins (Endotoxins: Small But Very Significant):

• Are pyrogens, that is, they often cause a pyrogenic reaction (fever).

• Cause fatigue, a common characteristic of sick building syndrome. 

• Don’t produce immunity, but only a temporary resistance known as “Monday fever”. Workers in industries with significant endotoxin levels have been found to be most afflicted on Monday, with reduced effects through the week. Endotoxin resistance is lost over the weekend, with the illness beginning anew the following Monday [5]

• Are “adjuvant”, meaning that they can amplify the effects of other harmful substances. 

• Are associated with sepsis, an extreme immune response by the body that often ends in death.  

• The presence of pets in indoor spaces can represent an important source of air contamination and can be linked with the level of indoor endotoxins. The presence of dogs and cats can be the main predictors of endotoxin levels in house dust [1, 4-7]. Other predictors are the presence of vermin, such as mice, and infrequent cleaning, which indicates poor hygienic conditions in the home [1]. Storage of organic household waste indoors also increases bacterial contamination in the indoor environment [1]. (intechopen.com)

Here are some more details about endotoxins.  Although it’s a little in-depth, this article gives a good explanation of what endotoxins are and how they are released (shed) from bacteria.  Basically, endotoxins are small molecules of lipopolysacchride (LPS), which comprise approximately 70% of the outer membranes of gram-negative bacteria. They are responsible for maintaining structural integrity and have been shown to be essential for bacterial survival.  Lipopolysacccharides vary in their structure, but all share three distinct regions:

• O antigen repeats are found on the outermost domain of the LPS molecule and are responsible for host immunogenicity (the ability of the endotoxin to provoke an immune response in human cells).

• Core domain is composed of sugars and other non-carbohydrates.

• Lipid A is the lipid component of LPS, whose hydrophobicity (repels water) facilitates membrane anchoring. Lipid A is responsible for toxicity of the endotoxin.

Here is a diagram of this structure:

Source: What are endotoxins?

Endotoxins are naturally shed at low levels during bacterial growth, but are released in much larger quantities upon cell death when their cell membranes rupture and disintegrate.  A single E. coli cell can release up to 2 million LPS molecules!  As lipids, endotoxins are naturally hydrophobic, which gives them a strong affinity for plastics and hydrocarbon-based materials (vinyl flooring, polyurethanes and coatings on many new products).  

The Limulus Amebocyte Lysate (LAL) test detects endotoxins.  It comprises blood cells (amebocytes) from the Atlantic horseshoe crab (Limulus polyphemus) that clot when they encounter bacterial endotoxin lipopolysaccharides.  The LAL may be used to test in three different ways: to provide a yes/no (qualitative) answer to whether a sample contains a specified amount of endotoxin, or to obtain the quantity of endotoxin via how fast the clotting takes place (turbidimetric) or how intensely the color changes (chromogenic). (Bacterial Endotoxins Testing)  In the qualitative test, equal amounts of a test sample and the gel clot LAL are mixed in a test tube and incubated at 37 °C for 60 minutes.  After the incubation, the tube is inverted.  If sufficient endotoxin is present in the test sample, the solution would have clotted during the hour incubation and a gel will remain in the bottom of the inverted tube (see image below).  If the sample does not contain detectable endotoxin, no clot will form and liquid will run down the side of the inverted tube.  (LAL/TAL Endotoxin Detection Test Methods)  The enzymatic reaction between the endotoxin and lysate produces a yellow color, the intensity of which is directly linked to the quantity of endotoxin present in the sample.   

How can we reduce exposure to endotoxins?

• Reduce Dust: According to EMLab, a commercial IAQ laboratory in North America, “ Endotoxin exposures are mainly through the air.”  “Endotoxins do not float freely, but instead are attracted to dust particles. Reduction of dust is essential for controlling endotoxin levels. Dust reduction requires both fresh air filtration and filtered air recirculation. Continuous, low flow fresh air ventilation systems without recirculation do not effectively manage indoor particulates. Endotoxin levels and dust levels are not strongly correlated indicating that they come from independent sources. A single dust particle in the 2 to 10 micron range has sufficient surface area to hold a million or more endotoxin molecules (approximately 0.1ng of endotoxin). Therefore, reduction of dust is important regardless of whether one lives in a dusty or relatively dust-free environment.” (this and following points from buildequinox.com).
• Removal of food sources: “Coupled with proper ventilation is reduction of source generation of endotoxins. In the home environment, it is clear that kitchens are one source of endotoxin generation. Removal of food wastes and standing dishwater will reduce bacterial growth with subsequent production of endotoxins. Even a bowl of standing water will grow bacteria in a home. Bacteria and nutrients are ubiquitous indoors and outdoors, and they will land in water or moist regions where bacterial growth will occur.” Kitchens have the highest level of endotoxins, followed by living rooms and bedrooms.
• Avoid use of misting humidifiers: “Cold temperature (misting) humidifiers are strongly linked to high endotoxin levels. Vaporizing humidifiers that heat water to boiling have not been found to produce high levels of endotoxins.” An alternative method for achieving sanitized, cold temperature humidification in a home is through plant transpiration. Plants can reduce toxins in homes [12]. The plant-root matrix releases sanitized water into the air (assuming proper plant care that does not form a wet mass promoting fungal and bacterial growth).

Exotoxins are (from textbookofbacteriology.net unless otherwise noted)

• part of a defensive system of bacteria to avoid capture and killing by leucocytes (part of our body’s immune system). (sciencedirect.com)
• Produced by both Gram-negative and Gram-positive bacteria 
• More highly poisonous by mass than endotoxins, strychnine, or snake venom 
• Can be “super-antigenic” or cause stimulation to the immune system 
• are often encoded by mobile genetic elements, including bacteriophage (phage). Phage can transfer genetic information to the bacteria they infect. (study)
• Can produce illness even when the microbes that produced them have been killed. (skybrary.aero)

What are the sources of exotoxins? (from intechopen.com)

• Actinobacteria (especially Streptomycetes), Bacillus species and various other bacteria grow in moist building materials together with fungi. Elements from bacterial structures released in air include bacterial cells, bacterial spores, peptidoglycans, microbial volatile organic compounds, exotoxins, and other bacteria growing metabolites.
• Gram-positive bacteria with exo- and endospores like Streptomyces and Bacillus can grow on moist building materials. Their spores are very resistant and can survive even if the air humidity is low.
• Humans are an important source of indoor bacteria. The upmost layer of the normal human skin is continuously renewed, and skin scales containing bacteria are shed into the environment. Bacteria in the respiratory airways are eliminated through Pflügge droplets while talking, coughing, or sneezing. The level of air contamination is dependent on the number of persons inside a room and the efficiency of the ventilation system (natural or artificial ventilation). Bacteria that can be identified in indoor air are micrococci, staphylococci, streptococci, and corynebacteria.

How can we reduce exotoxin exposure?

• Maintain your home so that there are no active leaks and humidity stays between 40-60%.  This will reduce actinobacteria that produce exotoxins.
• Practice good hygiene by covering your mouth and nose while coughing or sneezing.  This reduces the amount of small particles in the air that can contain bacteria and exotoxins.  Dispose of tissues in the trash and wash hands with soap and water. 
• According to the WHO, if exposure to the toxin via aerosol inhalation is suspected, additional exposure to the patient and others must be prevented. The patient's clothing must be removed and stored in plastic bags until it can be washed thoroughly with soap and water. The patient should shower and be decontaminated immediately. 
• Most exotoxins can be destroyed by heating, (wikidoc.org), so eating thoroughly cooked food often eliminates the danger of ingesting the exotoxin. The WHO recommends these five strategies in food safety:
  • keep clean
  • separate raw and cooked
  • cook thoroughly
  • keep food at safe temperatures
  • use safe water and raw materials.

Use of a HEPA filter can reduce aerosols and fine particles containing bacteria, endotoxins and exotoxins, although some of the smaller phages may slip through.  This is where a healthy immune system and abstaining from smoking pick up.  Cigarette smoking is a substantial risk factor for important bacterial and viral infections. For example, smokers incur a 2- to 4-fold increased risk of invasive pneumococcal disease. (2004 study).  In addition, exposure to cigarette smoke causes MRSA bacteria (just one bacteria studied) to become even more resistant to killing by the immune system. (UCSanDiego Health News)  Of course, smoking through a dirty water pipe (bong) is inviting disaster!  Here are the details (mooselabs.us):

Bacteria, endotoxins and exotoxins are all around us (and even in us), but with good judgment and  precautions, you can avoid being one of the infection statistics!

Enduring the Rainy Season

Many kinds of climates may exist in your state, from hot and dry to cool and humid, depending on your elevation, weather patterns, proximity to water, etc.  Although mold can grow anywhere (even in the desert!), more water definitely means more mold.   Your “rainy season” can come in January or July…but it matters most that you are ready for it and know what to expect!

Taken from somewhere that REALLY gets their share of rain, in the Philippines it is common for people to get sick during the rainy season and even while transitioning from one season to the next.  The following advice from the Philippines could go a long way in the US, as well!

1. Pack your rain gear.  An umbrella is a must on days that it might rain, which includes some that start out sunny!  We’re not saying that getting wet automatically makes you sick, but here’s the connection: wet clothing can lower your body temperature.  Lowered body temperature causes the blood vessels in the nose to constrict, which in turn limits the number of white blood cells that can come to your mucous membrane to fight off infections.  This is the type of lowered immune response that leaves you susceptible to viruses and microbes!
2. Warm up quickly after you get wet by taking a warm shower, or at least changing into warm dry clothing.  Making a habit of washing your hands after traveling also helps!
3. Drink lots of clean water!  This is another part of keeping your body’s immune system healthy.
4. Use mosquito repellant: It seems like new mosquito-borne diseases are discovered every year, so if you’re going to be outside, make sure they don’t target you by applying a non-toxic repellent like Wondercide Insect Repellents. 
5. Make sure that mold is not creeping into your home with water intrusions.  More water outside running over your home can lead to small or major leaks, which can go undetected if you aren’t vigilant!  Keep bedroom doors open for ventilation and check unused rooms at least weekly for any signs of leaks.  You may want to also leave ceiling fans running to increase air circulation, which has a drying effect.  Mold spore counts will increase outdoors during the rainy season, but you can keep them down indoors by:
   1. Using a HEPA air cleaner:  Medify has a great selection of air purifiers that are simple to use and a good value for the size of room purified. 
   2. If you believe that mold spores are increasing in your home’s air, there are several ways to deactivate them. Plugging in a Germ Defender, Upgraded Air Angel Mobile or installing a Whole Home Polar Ionizer, all of which use bipolar technology, kills mold in the air and on surfaces. Alternatively, Air Purification Candles actually lower the spore count.  They don’t have fragrance so you don’t have to worry about nasal irritation.  You can check out our article on them here!
   3. Keep a close eye on humidity levels in your home with these inexpensive humidity sensors–place them in several rooms so you don’t have to look too long to know what’s going on with the humidity!  If you see it creeping up, it may be time to research dehumidifying settings on your HVAC system or add a dehumidifier.

Your environment may make you feel like you’re living underwater, but do your best not to let it affect your health or the health of your home.  Where there’s moisture, there’s life–just make sure it’s the beneficial, beautiful kind by preventing mold  and microbe growth.

Do Air Purifiers in Classrooms Reduce Illness?

Ahh, this is certainly one time when I’m glad to be working remotely!  As my co-workers send their children back to school, the illnesses (from the common cold to COVID-19) ramp up again in their families as germs get passed back and forth in classrooms.

In 2021, there was a lot of discussion about how to keep students and teachers safe from COVID-19.  Many school districts rushed out to purchase and install air purifiers, with ensuing debate on which purifiers were effective, or in fact, which were dangerous.  It can be a bit confusing, so I headed online to find studies on what works.  I found that across a wide spectrum of experts, the following three solutions to reducing illness and increasing classroom performance are, in order, 

1. Fresh air ventilation

2. HVAC system filter maintenance

3. Air purifiers

This list really is in order of importance.  First of all, air purification technology is great, but we at HypoAir are always in favor of the most natural option first, one that replicates the outdoors, and that will be fresh air VENTILATION.  That’s right, you can put an air purifier in a classroom, but without a continual supply of fresh air to increase oxygen and dilute rising CO2 and virus and bacteria levels, the air purifier can only do so much.  Fresh air can be supplied through an open window if the weather or outdoor air quality is nice, but there should be fresh air ventilation built into every HVAC system so that air quality outside doesn’t limit the quality of air indoors.  Many buildings in the U.S., especially schools, do not meet recommended ventilation rates. The quantity of ventilation depends on how many people are in the room; it should be 15 cubic feet per minute per person. In one study coauthored by Rengie Chan, a research scientist at Lawrence Berkeley National Labs, 85 percent of the California classrooms included failed to meet the minimum standard of 15 CFM per person. Other studies show many American classrooms have an average ventilation rate of only 6 to 11 cfm per person.(wired.com). 

The problem with estimating actual fresh-air ventilation to a room by HVAC is that unless there is an intake from the outside in the system, air blown into the classroom is just being recirculated through the ducts and maybe only filtered once, not adding any fresh air at all.  This type of estimation requires a person knowledgeable about the building’s HVAC system.  If fresh air intake is included, then one expert (Joseph Allen, a professor at Harvard’s School of Public Health) estimates that for reducing Covid-19 risk, the air in the room should be completely replaced at least five times an hour. In a Boston school, the sensor registered about 400 cfm of fresh air coming in through the unit ventilator in one classroom. The room measured 1,010 square feet and had 9.5 foot ceilings: It had 9,595 cubic feet of air. Multiply 400 cubic feet per minute by 60 minutes, divide it by the volume, and you find that the air only gets turned over 2.5 times an hour, which was not sufficient. (wired.com)  However, when conducting another experiment in the same school, they found they could boost air changes to 17 to 20 air changes per hour by opening windows and doors.

An easier way to determine if ventilation is sufficient is by monitoring the CO2 level.  To demonstrate the effect of reducing CO2 levels on disease transmission,  researchers in Taiwan reported on the effect of ventilation on a tuberculosis outbreak at Taipei University. Many of the rooms in the school were underventilated and had CO2 levels above 3,000 ppm. When engineers improved air circulation and got CO2 levels under 600 ppm, the outbreak completely stopped. According to the research, the increase in ventilation was responsible for 97% of the decrease in transmission.(theconversation.com)

Since the coronavirus is spread through the air, higher CO2 levels in a room likely mean there is a higher chance of transmission if an infected person is inside. Based on the study above, experts recommend trying to keep the CO2 levels below 600 ppm. You can buy good CO2 meters for less than $100 online (check out our post including them); just make sure that they are accurate to within 50 ppm. (theconversation.com) What can it hurt to donate (or get together with other parents to donate) several CO2 sensors with remote readings, in order to check the levels of CO2 in your childrens’ classrooms?  

After fresh-air ventilation has been established, let’s look at air cleaning.  In any HVAC system, there should be at least filters in the air returns and they should be changed regularly.  By increasing the MERV rating on these filters to MERV 13, smaller particles like viruses can be filtered out to reduce illness transmission rates.  Changing the rating of the filters should be done in cooperation with the facilities manager in order not to overload the HVAC system, but it is quite possible even if filter box sizes need to be enlarged (see our post on Air Filter Thickness for how to increase MERV rating without increasing pressure drop). 

Third, air purifiers can be considered.  If the school has done what they can to provide adequate ventilation and HVAC filter maintenance, then air purifiers can add another layer of protection by filtering or killing the germs that get by these first two conditions.  In order to be effective, an air purifier must either:

• pull all of the air in the room through a filter unit several times an hour, OR

• Send out a non-toxic disinfectant that disperses to all areas of the room.

The first of these can be accomplished with units that include high-powered fans, but these can be noisy.  Noise in a classroom, just like in your home, can be distracting and debilitating for the teacher and students!  For this reason, air purifiers that depend upon air throughput for efficacy need to be evaluated for noise when running at the optimum fan speed for the size of classroom considered.  Also, replacement parts such as filters need to be considered in the total cost.  The cost of a HEPA filter (and possibly UV lamp) for every purifier, for example, can quickly add up to thousands of dollars a year when changes are needed in a school with dozens of classrooms.  Maintenance of these units will fall on the school’s facilities staff, who are likely already over-burdened with an increased cleaning schedule.  

The second option is one that HypoAir promotes because it really is akin to what goes on naturally outdoors.  Ions are one of nature’s cleaning devices, because positive and negative ions are continually floating through the air and reacting with allergens, viruses and bacteria, deactivating them.  These ions are naturally produced by natural phenomena in the air such as sunshine, lightning, crashing water like at the seashore or a waterfall, and plants.  Indoors, we produce them by passing a small electrical charge through stainless steel “needles” to produce positive and negative ions, which get distributed through the air to every part of the room (like adding drops of dye to clean water, soon every part of the water is changed!).  This is done nearly silently, because powerful fans are not required for distribution (any fans already in use in the room will boost circulation of the unit’s small fan).  In addition, maintenance on HypoAir ionizers is virtually nil, because no filters are required and there are no replacement parts.  The cost of running our ionizers is very small, as they use minimal electricity. 

So what about real world testing of these methods?  The CDC released a study on 123 elementary schools in Georgia in 2021.  The schools included did one of three things:

1. Nothing

2. Increased ventilation by opening doors, windows or using fans 

3. Added HEPA filters to classrooms.

In schools that improved ventilation through dilution methods alone, COVID-19 incidence was 35% lower than the schools that did nothing, whereas in schools that combined dilution methods with filtration, incidence was 48% lower than the schools that did nothing.  The takeaway here is that ventilation and HEPA filtration work, even with some added cost for ventilation modification or filter replacements!  Doing nothing, on the other hand, increases the cost of lost school days, makeup time and medical costs for students and teachers substantially.   

It’s a new world with viruses and allergens challenging young and old alike everywhere, but the wisdom of fresh-air ventilation combined with the technology of purification can make it significantly easier to bear!

Fiberglass: the air quality problem you didn’t consider

With extreme weather issues such as storms and fires in the news, we can become very focused on mold from water damage and particulate matter (PM) from air pollution like smoke, but another problem has been silently causing lung and whole-body issues for decades: fiberglass insulation.

Fiberglass insulation, also known as glass wool, was accidentally invented in the 1930’s and patented in 1938 as Fiberglas.  It became a popular insulation for building and comes in batts, with a paper or plastic backing, or is available in loose form in bags, that can be blown into place.  Now fiberglass is used in: 

• Appliances like dishwashers, refrigerators, ovens, exhaust fans, clothes dryers
• Kerosene heaters and wood-burning stoves
• roof shingles
• Beds (also known as a silica sock)
• Cigarette filters
• HEPA and HVAC filters
• Light fixtures
• Carpets
• Packing tape
• And even some brands of toothpaste!

Children may be especially vulnerable to potential effects from fiberglass particle inhalation. “We’ve seen a substantial increase in air quality concerns from homeowners with young children experiencing chronic cough and eye irritation,” says Jeffrey Bradley, president of IndoorDoctor LLC. Bradley says fiberglass is often the culprit. (iqair.com)

Like most materials, fiberglass insulation degrades over time, and water speeds up the degradation process.  Therefore, although blown-in insulation is a popular choice for insulating attics and walls, leaving fiberglass exposed to humid air can cause the fibers to break and become airborne.  Typically, most manufacturers warn about wearing masks if you manually “disturb” the insulation by pushing past it or cutting into it.  However, loose fiberglass that is exposed to air currents can pick up these small fibers without manual disturbance, resulting in unhealthy PM2.5 levels in homes where it gets entrained into the air conditioning system.  

One woman has detailed her family’s project to remove all the fiberglass from their house after it was determined that fiberglass dust was making her sick.  Fiberglassawareness.com is a very useful website with many photos of where fiberglass is used in homes, and even cars and other buildings where you may not suspect it.  That pink (or yellow or white or green) stuff that you thought remained in the attic, doesn’t always stay where it belongs!  Wherever you can see exposed fiberglass, it may be emitting small particles into the air.  That means if it is peeking out of the ends of wrapped ducts, or falling (sometimes imperceptibly) out of can light fixtures, or being sucked into your AC system through small leaks in the ducts, it is in the air you breathe and can cause a myriad of health issues.  This page details a long list of fiberglass-exposure symptoms which overlap with mold-exposure symptoms, fibromyalgia symptoms, and auto-immune disorder symptoms, so the main culprit can be hard to diagnose.  In addition, many fiberglass insulation products use:

• Phenol formaldehyde to bind the fiberglass fibers together (iqair.com), and the off-gassing of formaldehyde can cause similar symptoms. Formaldehyde is a carcinogen and exposure to fiberglass insulation formaldehyde causes brain cancer. According to John D. Spengler et.al., in the "Indoor Air Quality Handbook," residents of mobile homes who are exposed to fiberglass insulation are at increased risk of brain cancer. 
• Styrene or Vinyl-Benzene is found in fiberglass insulation, and because benzene is used in many home other consumer products like water bottles, convenience food trays and wrappers, and feminine products, it contributes to a thick low-lying VOC cloud in some homes. According to Teresa Holler in the book "Holler for Your Health," styrene is toxic to the nervous system and exposure to styrene in fiberglass insulation causes behavioral changes, concentration problems, depression, tiredness, headaches, memory problems and weakness.  According to Andre E. Baert in the book "Biomedical and Health Research," long-term exposure to styrene in fiberglass insulation causes brain tumors and cancer. (ehow.com)
• Methyl-ethyl-ketone (MEK) is used as a binder in some fiberglass.  Nick H. Proctor et.al., in the book "Proctor and Hughes' Chemical Hazards of the Workplace," list methyl ethyl ketone as a neurotoxin and exposure to MEK in fiberglass insulation as a cause for dizziness, nausea, headaches, depression and unconsciousness. (ehow.com)

According to the California Department of Public Health, frequent exposure to fiberglass insulation causes permanent changes in the central nervous system, the symptoms of which include personality changes, poor coordination, fatigue and poor concentration.(ehow.com)

How do you get rid of fiberglass in the air?  In some cases “encapsulation” can be an answer, which means that you can add a layer of protection over it.  We should never see exposed fiberglass (the brown paper side is supposed to be installed on the “warm” side, which in southern climates leaves the fiberglass exposed to the inside of the attic).  This real estate inspector wrote an article on encapsulation from the point of view that fiberglass is a poor air barrier and therefore should have a proper air barrier on both sides.  However, he notes at the end that a homeowner should not try to encapsulate any fiberglass himself, because of the risk of causing mold if moisture cannot escape.  

Here’s how you can minimize your exposure to fiberglass: 

• Repair damaged sections of fiberglass insulation with proper foil duct tape.
• If you have blown-in fiberglass in your attic or walls, seal all penetrations such as ceiling fixtures, wire and plumbing penetrations, light switches, and cracks in drywall
• Check the internal condition of any “duct board” ducts or ducts internally insulated with fiberglass.  Unfortunately these degrade over time and cause the fibers to become entrained in the air.
• If your health issues have not resolved, consider removing some or all of the fiberglass that could be causing them. 
• Replace fiberglass insulation with ducts that are insulated with air bubble wrap, and walls and ceiling insulation with spray foam or cellulose insulation (however, be aware that cellulose insulation is treated with fire retardants to make it safe, which can cause other health issues to those who are sensitive). (nachi.org)

If you know or suspect that your health problems are being caused by fiberglass or VOCs that come from the fiberglass, keep a journal of how you feel during the day at different times, including where you are, what you are doing,  if the building’s HVAC is running, what you are wearing, eating, working with, etc.  It’s possible that you can find the link by putting the pieces together from your experiences, and from others’ experiences.  Research sites of others with environmental and chemical sensitivities, such as Fiberglassawareness.com, mychemicalfreehouse.net, and nontoxicforhealth.com (the latter two have a lot of scientific research on them), and don’t give up!