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Pinto_A Practical Approach to Assisting Sensitized Individuals

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IAQA 18th Annual Meeting & Indoor Environment and Energy Expo (IE3) The views and opinions herein are those of the volunteer authors and may not reflect the views and opinions of IAQA. The information is offered in good faith and believed to be reliable but it is provided without warranty, expressed or implied, as to the merchantability, fitness for a particular purpose or any other matter. seem to be fitting together. Some individuals exposed to mold and other contaminants in water- damaged buildings will develop symptoms that conform to an allergic response.For those with an allergy to mold, eliminationof exposure by either leaving the structure or remediating the problem generally results in self-healing and resolution of symptoms. However, individuals who become sensitized experience ever-increasing levels of symptoms even with smaller and smaller exposures. In the worst cases, even removal of the offending contaminants does not lead to an improvement in symptoms. Once the idea of sensitization was validated,many of the difficult-to-explain symptoms made sense because they were the result of an innate immune response illness (symptoms triggered by processes in the body itself) rather thanan acquired immune response illness (symptoms triggered by an invader from outside the body). In layman's terms, exposure to water-damaged buildings causes some people's immune systems to go into overdrive and not shut off—even after the trigger contaminants are reduced to minute levels. Such responses have been labeled biotoxin illness, or more precisely,chronic inflammatory response syndrome (CIRS). Finally, in the last few years DNA sampling has been instrumental in explaining why certain people in a water-damaged building will develop CIRS and others will not. There is now solid evidencevalidating the hypothesis that nearly a quarter of the population has a genetic susceptibility towards CIRS if they have a significant exposure to mold and other contaminants in water-damaged buildings. 5 As a result, some people never get sick and others, who are genetically susceptible, get sick with seemingly trivial exposures. What Does this Mean to Occupants and Remediation Contractors? While these particulars about allergens, asthmagens, sensitization, CIRS,and WDB may seem inconsequential, they actually have a direct bearing on remediation contractors. One of the biggest issues is the realization that the standard classes of occupants thought to be most susceptible to mold probably are not. Training for fungal remediation routinely emphasizes that infants, the elderly, and those with pre-existing health problems are at greatest risk during a remediation effort. While those individuals should surely be protected, it can just as likely be healthy adultswho develop a myriad of life-altering symptoms from exposures in a water- damaged building, simply because of their genetic makeup. In these situations, professionals always look for a simple, inexpensive test to help identify who might be at the greatest risk. Incredibly, that hurdle may have been surmounted by the adaptation of a standard vision test called visual contrast sensitivity. Although the test was originally developed for identification of other diseases such as glaucoma, it was found to also be useful for diagnosing systemic illnesses such as diabetes. It has now been adapted to the point where many physicians claim that it can be an accurate assessment ofthe overall effect of neurotoxins on

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