United States house dust Pb concentrations are influenced by soil, paint, and house age: insights from a national survey.

BACKGROUND: Lead (Pb) in house dust contributes significantly to blood lead levels (BLLs) in children which may result in dire health consequences. Assessment of house dust Pb in the United States, relationships with Pb in soil and paint, and residential factors influencing Pb concentrations are essential to probing drivers of house dust Pb exposure. OBJECTIVE: Pb concentrations in vacuum-collected house dust are characterized across 346 homes participating in the American Health Homes Survey II (AHHS II), a US survey (2018-2019) evaluating residential Pb hazards. Connections between house dust Pb and soil Pb, paint Pb, and other residential factors are evaluated, and dust Pb concentration data are compared to paired loading data to understand Pb hazard standard implications. RESULTS: Mean and median vacuum dust Pb concentrations were 124 µg Pb g-1 and 34 µg Pb g-1, respectively. Vacuum-collected dust concentrations and dust wipe Pb loading rates were significantly correlated within homes (α < 0.001; r ≥ 0.4). At least one wipe sample exceeded current house dust Pb loading hazard standards (10 µg ft-2 or 100 µg Pb ft-2 for floors and windowsills, respectively) in 75 of 346 homes (22%). House dust Pb concentrations were correlated with soil Pb (r = 0.64) and Pb paint (r = 0.57). Soil Pb and paint Pb were also correlated (r = 0.6). IMPACT: The AHHS II provides a window into the current state of Pb in and around residences. We evaluated the relationship between house dust Pb concentrations and two common residential Pb sources: soil and Pb-based paint. Here, we identify relationships between Pb concentrations from vacuum-collected dust and paired Pb wipe loading data, enabling dust Pb concentrations to be evaluated in the context of hazard standards. This relationship, along with direct ties to Pb in soil and interior/exterior paint, provides a comprehensive assessment of dust Pb for US homes, crucial for formulating effective strategies to mitigate Pb exposure risks in households.

A national survey of lead and other metal(loids) in residential drinking water in the United States.

BACKGROUND: Exposure to lead (Pb), arsenic (As) and copper (Cu) may cause significant health issues including harmful neurological effects, cancer or organ damage. Determination of human exposure-relevant concentrations of these metal(loids) in drinking water, therefore, is critical. OBJECTIVE: We sought to characterize exposure-relevant Pb, As, and Cu concentrations in drinking water collected from homes participating in the American Healthy Homes Survey II, a national survey that monitors the prevalence of Pb and related hazards in United States homes. METHODS: Drinking water samples were collected from a national survey of 678 U.S. homes where children may live using an exposure-based composite sampling protocol. Relationships between metal(loid) concentration, water source and house age were evaluated. RESULTS: 18 of 678 (2.6%) of samples analyzed exceeded 5 µg Pb L-1 (Mean = 1.0 µg L-1). 1.5% of samples exceeded 10 µg As L-1 (Mean = 1.7 µg L-1) and 1,300 µg Cu L-1 (Mean = 125 µg L-1). Private well samples were more likely to exceed metal(loid) concentration thresholds than public water samples. Pb concentrations were correlated with Cu and Zn, indicative of brass as a common Pb source is samples analyzed. SIGNIFICANCE: Results represent the largest national-scale effort to date to inform exposure risks to Pb, As, and Cu in drinking water in U.S. homes using an exposure-based composite sampling approach. IMPACT STATEMENT: To date, there are no national-level estimates of Pb, As and Cu in US drinking water collected from household taps using an exposure-based sampling protocol. Therefore, assessing public health impacts from metal(loids) in drinking water remains challenging. Results presented in this study represent the largest effort to date to test for exposure-relevant concentrations of Pb, As and Cu in US household drinking water, providing a critical step toward improved understanding of metal(loid) exposure risk.

Comparison of ERMI results for dust collected from homes by an electrostatic cloth and by the standard vacuum method.

The Environmental Relative Moldiness Index (ERMI) is a scale used to compare mold contamination levels in U.S. homes. To create the ERMI scale, a nationally representative set of U.S. homes was selected (n = 1,096). From each of these homes, a standard vacuum-dust sample was collected and then 36 common molds, the 26 Group 1 and 10 Group 2 molds, as grouped for forming the ERMI metric, were quantified using quantitative PCR assays. However, in investigations of mold in homes, it is not always practical or even possible to collect dust using the standard vacuum method. Therefore, we performed a comparative study of dust samples collected in the same homes (n = 151) by the standard vacuum method and by an electrostatic cloth (EC) method. First, floor dust was collected by vacuuming a 2 m2 area in the living room and a 2 m2 area in a bedroom, directly adjacent to the sofa or bed, for 5 min each with a Mitest sampler-fitted vacuum. Second, immediately after the collection of the vacuum dust sample, an EC dust sample was collected by wiping above-floor horizontal surfaces in the living room and bedroom. Then, the ERMI analysis of each sample was performed by a commercial laboratory. The results showed the average concentrations of 33 of the 36 ERMI molds were not significantly different in the vacuum and EC samples. Also, the average summed logs of the Group 1 molds, Group 2, or ERMI values were significantly (p < 0.001) correlated between the vacuum and EC samples. Logistic regression indicated that an EC sample could identify homes in the highest ERMI quartile 96% of the time by using the same ERMI value cutoff as vacuum sample ERMI value cutoff and 35% of samples proved to be false positives. When it is not practical to obtain the standard vacuum-dust sample, an EC sample can provide a useful practical alternative for ERMI analyses.

The Environmental Relative Moldiness Index reveals changes in mold contamination in United States homes over time.

The Environmental Relative Moldiness Index (ERMI) is a scale created to compare mold contamination levels in U.S. homes. The ERMI was developed as a result of the Department of Housing and Urban Development's (HUD) first American Healthy Homes Survey (AHHS I), which sampled 1,096 homes selected to be representative of the U.S. housing stock. In AHHS I, a dust sample from each home was analyzed using quantitative PCR assays (qPCR) for 36 common indoor molds: 26 Group 1 molds, which were associated with water damage in homes and 10 Group 2 molds, which primarily enter the home from the outside environment. In 2019, HUD completed AHHS II by sampling 695 homes. Because lead was banned from paint in 1978, a larger proportion of homes selected for AHHS II had been built before 1978 compared to AHHS I. The 36 ERMI molds were analyzed in AHHS II exactly as in AHHS I. For the 36-ERMI molds, the rates of detection, average concentrations, and geometric means were in significant concordance (p < 0.001) between AHHS I and II, indicating that the ERMI methodology was stable over time. However, the average ERMI value in AHHS II homes was greater than in AHHS I. The reason for the difference was investigated by examining the Group 1 and 2 mold populations. The average summed logs of Group 1 molds were significantly greater in homes built before 1978 than the average for homes built later. Conversely, the average summed logs of Group 2 mold populations were the same in homes built before 1978 and homes built later. Since the summed logs of Group 2 mold is subtracted from the summed logs of Group 1 molds in the ERMI calculation, the average ERMI value was higher in AHHS II homes than AHHS I. In conclusion, by using the ERMI metric, we were able to demonstrate that water damage and mold growth were more likely to occur as homes get older.

Populations of some molds in water-damaged homes may differ if the home was constructed with gypsum drywall compared to plaster.

Starting in the 1940s, gypsum drywall began replacing plaster and lathe in the U.S. home construction industry. Our goal was to evaluate whether some mold populations differ in water- damaged homes primarily constructed with gypsum drywall compared to plaster. The dust samples from the 2006 Department of Housing and Urban Development's (HUD) American Health Homes Survey (AHHS) were the subject of this analysis. The concentrations of the 36 Environmental Relative Moldiness Index (ERMI) molds were compared in homes of different ages. The homes (n=301) were built between 1878 and 2005. Homes with ERMI values >5 (n=126) were defined as water-damaged. Homes with ERMI values >5 were divided in the years 1976 to 1977 into two groups, i.e., older (n=61) and newer (n=65). Newer water-damaged homes had significantly (p=0.002) higher mean ERMI values than older water-damaged homes, 11.18 and 8.86, respectively. The Group 1 molds Aspergillus flavus, Ammophilus fumigatus, Aspergillus ochraceus, Cladosporium sphaerospermum and Trichoderma viride were found in significantly higher concentrations in newer compared to older high-ERMI homes. Some mold populations in water-damaged homes may have changed after the introduction of gypsum drywall.

Higher Environmental Relative Moldiness Index (ERMI) values measured in homes of asthmatic children in Boston, Kansas City, and San Diego.

OBJECTIVE: Mold in water-damaged homes has been linked to asthma. Our objective was to test a new metric to quantify mold exposures in asthmatic children's homes in three widely dispersed cities in the United States. METHODS: The Environmental Relative Moldiness Index (ERMI) metric was created by the US Environmental Protection Agency, with assistance by the Department of Housing and Urban Development (HUD), to quantify mold contamination in US homes. The ERMI values in homes of asthmatic children were determined for the three widely dispersed cities of Boston, Kansas City, and San Diego. RESULTS: Asthmatic children in Boston (n = 76), Kansas City (n = 60), and San Diego (n = 93) were found to be living in homes with significantly higher ERMI values than were found in homes randomly selected during the 2006 HUD American Healthy Homes Survey (AHHS) from the same geographic areas (n = 34, 22, and 28, respectively). Taken together, the average ERMI value in the homes with an asthmatic child was 8.73 compared to 3.87 for the AHHS homes. In addition, Kansas City homes of children with "Mild, Moderate, or Severe Persistent Asthma" had average ERMI value of 12.4 compared to 7.9 for homes of children with only "Mild Intermittent Asthma." Aspergillus niger was the only mold of the 36 tested which was measured in significantly greater concentration in the homes of asthmatic children in all three cities. CONCLUSION: High ERMI values were associated with homes of asthmatic children in three widely dispersed cities in the United States.

Geographic distribution of Environmental Relative Moldiness Index molds in USA homes.

OBJECTIVE: The objective of this study was to quantify and describe the distribution of the 36 molds that make up the Environmental Relative Moldiness Index (ERMI). MATERIALS AND METHODS: As part of the 2006 American Healthy Homes Survey, settled dust samples were analyzed by mold-specific quantitative PCR (MSQPCR) for the 36 ERMI molds. Each species' geographical distribution pattern was examined individually, followed by partitioning analysis in order to identify spatially meaningful patterns. For mapping, the 36 mold populations were divided into disjoint clusters on the basis of their standardized concentrations, and First Principal Component (FPC) scores were computed. RESULTS AND CONCLUSIONS: The partitioning analyses failed to uncover a valid partitioning that yielded compact, well-separated partitions with systematic spatial distributions, either on global or local criteria. Disjoint variable clustering resulted in seven mold clusters. The 36 molds and ERMI values themselves were found to be heterogeneously distributed across the United States of America (USA).

Correlation between ERMI values and other moisture and mold assessments of homes in the American Healthy Homes Survey.

The main objective of this study was to evaluate the correlation between the Environmental Relative Moldiness Index (ERMI) values in the Department of Housing and Urban Development American Healthy Homes Survey (AHHS) homes and an alternative analysis frequently used in mold investigations, i.e., the inspector's "walk-through" assessment of visual or olfactory evidence of mold combined with occupant's answers to a questionnaire about mold odors and moisture. Homes in the highest ERMI quartile were in agreement with visual inspection and/or occupant assessment 48% of the time but failed to detect the mold in 52% of the fourth quartile homes. In about 7% of lowest ERMI quartile homes, the inspection and occupant assessments overestimated the mold problem. The ERMI analysis of dust from homes may be useful in finding hidden mold problems. An additional objective was to compare the ERMI values in inner city east-Baltimore homes, where childhood asthma is common, to the AHHS randomly selected homes.

Screening tools to estimate mold burdens in homes.

OBJECTIVE: The objective of this study was to develop screening tools that could be used to estimate the mold burden in a home which would indicate whether more detailed testing might be useful. METHODS: Two possible screening methods were considered for mold analysis: use of vacuum cleaner bag dust rather than the standard protocol dust samples and reducing the number of molds needed to be quantified resulting in the creation of an alternative mold burden scale. RESULTS: Vacuum bag dust analysis placed the estimate of mold burden into the upper or lower half of the Environmental Relative Moldiness Index scale. Mold burdens estimated by only 12 species produced an index, the American Relative Moldiness Index, with a correlation of rho = 0.80 with the Environmental Relative Moldiness Index. CONCLUSIONS: Two screening tools were developed for estimating the mold burden in homes.

Development of an Environmental Relative Moldiness index for US homes.

OBJECTIVE: The objective of this study was to establish a national relative moldiness index for homes in the United States. METHODS: As part of the Housing and Urban Development's American Healthy Homes Survey, dust samples were collected by vacuuming 2 m in the bedrooms plus 2 m in the living rooms from a nationally representative 1096 homes in the United States using the Mitest sampler. Five milligrams of sieved (300 mum pore, nylon mesh) dust was analyzed by mold-specific quantitative polymerase chain reaction for the 36 indicator species in 1096 samples. RESULTS: On the basis of this standardized national sampling and analysis, an "Environmental Relative Moldiness Index" was created with values ranging from about -10 to 20 or above (lowest to highest). CONCLUSIONS: The Environmental Relative Moldiness Index scale may be useful for home mold-burden estimates in epidemiological studies.