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12:05:11 From cliff zlotnik : TRIVIA name the small organic molecules which only stimulate antibody production when combined with a bigger molecule?
12:24:06 From Victor Cafaro : hapten or haptene (www.britannica.com)
12:24:37 From cliff zlotnik : correct Vic well done!!!!
12:28:55 From Linda Wigington : Is the issue with mold with stacked units primarily a blocked condensate line, and/or leaks from the condensate pan or lines?
12:32:08 From Linda Wigington : Thanks!

Episode 667| June 17, 2022 | 12:00 PM EST

Bill Sothern, DrPH, CIH, LEED AP
Chris Mikrut
Michael Berg, PhD

Misalignment between Clinical Mold Antigen Extracts and Airborne Molds Found in Water-damaged Homes

The study received NO financial support.

Did the study receive financial support? No financial support for the study was received.

The study authors are a diverse group including: practitioners, scientists, and medical clinicians.


Microecologies, Inc. is closely aligned with the clinical medical community from which it receives client referrals. The clinical community bases patient testing and treatment on antigen and serum testing results which are more focused on fungi found outdoors rather than on the unique set fungi found in water damaged properties.

Bill and his group found mold problems in large costly pristinely maintained homes that were not readily obvious to occupants.

When mold problem could be identified and remediated, occupants were able to see improvements and substantial recoveries.

Current antigen testing is prone to false negatives. No antigen extracts available for water damage related molds.

Bill Sothern pitched Michael Berg on the idea of using Eurofins large bank of culture data. Culture data is valuable because it determines the species. Ben Devine sifted through Eurofins data, analyzed and developed a list of common fungi found in homes in which occupants complained.

According to Chris Mikrut, physicians were brought into the research project to interpret and characterize data.

There is a need to do valid mold antigen testing internationally.

Study Table 1-Indicators for the Primary Reason for Investigation
Health Concerns 58%
Visible Fungi 10%
Water damage or dampness 16%
Musty odors 12%
Proactive evaluation 4%


Full speciation lab analysis data is important.

Full speciation sampling reveals that in damp buildings Penicillium is 3 times more likely to be found than Aspergillus. Penicillium is a major cause of allergy, asthma and hypersensitivity pneumonitis.

Condensation is a common cause of hidden molds: back sides of ceilings, walls, HVAC system, cooling coils, blower, PTAC units, etc.
Mold problems in HVAC systems are often maintenance, installation and/or material driven. Lack of maintenance, installation which makes inspection and maintenance difficult or impossible and lined ductwork which is prone to gross fungal contamination.

Bill Sothern- Pipe leaks and condensation are primary moisture sources indoors. Interior lined insulated ductwork is a curse.

Chris Mikrut performs physical inspection using meters and thermal imaging. Special concentration used in areas of complaint. Findings then used to create a sampling plan.

Study- Misalignment Table shows that the alignment between molds found outdoors and those found indoors in water damaged buildings isn’t good. The mold antigens currently in use are 40-50 years old. New mold antigens need to be reformulated to accurately reflect fungi growing in damp buildings. There is only 1 antigen extract available for clinical use.

Bill Sothern- Surprised that penicillin was more predominate than aspergillus in water damaged buildings.
It’s well established that mold exposure higher probability of asthma. Mold remediation is essential.
Must ID the problem before remediation. Physician referrals- based on current allergic sensitivity reports are deficient.

Bill Sothern- Antigen extracts match up better with outdoor molds than indoor molds. Allergists and pulmonologists using antigen extracts designed for outdoor molds for testing people exposed to water related mold indoors is likely to result in a false negative test.

Changing antigen manufacturers’ thinking will take time and effort.
Working with allergists and pulmonologists to meet with antigen manufacturers and labs and explain the study’s indications.

Michael Berg- Antigen manufacturers require clinical evidence on culture activity and potential allergic reactions. Bill Southern added see page 752 of report not a lot of potential for cross activity.

Chris Mikrut- Antigen change will come about through advocacy.

Bill Sothern- Feedback from medical community has been positive. Need research money and knowledge to develop more reflective allergy extracts.


Z-Man signing off

Sometimes you are not sure how a show is going to go until you do it. This week was no exception and in the end it came out exceptional. The last day inclusion of Dr. Michael Berg was very helpful and his contribution along with Dr. Sothern and Chris Mikrut made for a great show.

This is an important topic that we have known is an issue for years. Maybe this paper and spreading around its results will help. It may also help a lot that Dr. Berg works for a large corporation that has an interest in developing appropriate extracts. We shall see.

I got an email from Jeff May after the show answering my question about stacked fan coil units. His answer follows:

"In answer to your question, in some condos, each Whelan fan coil drains into the pan of the fan coil below so everyone in the vertical condo stack has a drain pan full of crud from everyone above."

Thanks Jeff and thanks to this week's guests!!