Abstract
Learned people have known since biblical times (NKJV, Leviticus 14:33-48) that dank, moldy buildings with musty smells pose health risks to human inhabitants. The observations about sick buildings making people sick were correct, but there was no proof of causation. Older research suggested that the building-related illness involved allergies, infections, and asthma, but cellular and immune inflammatory causes awaited proof. Yes, mold was found in water-damaged buildings (WDB), but it was also present in other areas. As time passed and cytokines were discovered, the role of resident microbes found in WDB was gradually unveiled as suspected culprits in what became to be known as Sick Building Syndrome (SBS). By 1970, indoor paint was marketed that contained benomyl, a substituted benzimidazole. The paint prevented mold from growing on the paint films, but benomyl was a potent mutagen that created a roster of mutant fungi. New isolations of azole-resistant, toxin-forming fungi followed. Given the concurrent oil embargoes from oil-rich countries, the construction of energy-saving, tight buildings boomed. Tight homes reduce ventilation, raising indoor humidity. Even worse, poorly constructed basements and crawl spaces added to the moisture problems.
The recognition of toxigenic fungi in WDB exploded in the United States (US) in 1999 when a court in Texas ('Dripping Springs') awarded an eight-figure settlement to plaintiffs who alleged that exposure to Stachybotrys made a family ill, including dense cognitive impairments. Suddenly, "Black Mold" became a buzzword for lucrative legal awards without proof of causation; association was often enough to win a personal injury/defective construction case in some courts.
Skipping forward to 2026, current academic research has shown that SBS is a Chronic Inflammatory Response Syndrome (CIRS), with specific causation indicating that 42% of cases are due to Actinobacteria, 28% of cases are due to bacterial endotoxins, 7% are due to fungi, and 6-10% are due to beta glucans. The use of Next Generation Sequencing (NGS) has revealed the complexity of microbial residence in WDB. Transcriptomics (Gene Expression: Inflammation Explained; GENIE) provides insight into the molecular pathophysiology of CIRS, while NeuroQuant® indicates that brain injury occurs in more than 50% of cases. When you read claims on the Internet of miracle mold cures, ask to see published, peer-reviewed, data-driven papers that form the basis of those claims.
We present three publications, Human Health and the Built Environment, Part A: Part B respectively, and Part C, focusing on treatment in this Perspective. We will discuss (i) what makes wet buildings dangerous and (ii) how does a building owner correct the microbial ecosystem associated with excessive moisture; (iii) how can the CIRS patients be diagnosed with transparent, medically sound protocols; (iv) how treatment, including healing brain injury, can restore health, even after years of illness in a CIRS patient.