Vermont’s flooded buildings are ripe for mold growth

Lauren Tessier, a naturopathic physician, did not start her career in primary care with a special interest in the health effects of mold exposure. But she began working in downtown Waterbury in early 2013, less than 18 months after Tropical Storm Irene had severely flooded the surrounding neighborhoods.

She began to see patterns in the symptoms of many of her patients that she believes could be traced back to that catastrophic event.

“Pretty much everyone was having this recalcitrant fatigue, myalgia, brain fog. They were really struggling,” she said. “Waterbury is what started my mold practice.”

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Now Tessier specializes in mold-related health concerns. Although she cannot offer specific medical advice to non-patients, she wants Vermonters to be aware of the potential impacts, which can include mild to severe allergic reactions, infections and, from more prolonged exposure, chronic fatigue and joint inflammation, she said.

State health officials and local service organizations, too, are trying to get the word out, distributing flyers about how to protect against mold growth after a flood, alongside free buckets, brushes and cleaning supplies. The main message: Be safe, work as quickly as possible, but be thorough.

There are tens of thousands of species of mold, which are a type of fungi, and dozens that are common even in drier times in both the indoor and outdoor environment. Health problems arise when things get wet and mold grows, particularly inside a closed space with minimal airflow.

“If your home or building was flooded, if it stays wet for a day or two, you can assume that you have some mold in there,” said Sarah Owen, state toxicologist with the Vermont Department of Health. There is no need to do any kind of special testing, she said.

A common misperception is that mold of a particular color is most dangerous, but that is wrong, according to Owen. “All molds can be hazardous, whether or not it’s black, green, red, yellow, white,” she said.

Every person has a different level of sensitivity to mold, also called mildew, but generally the higher the concentration, the greater the effect, Owen said. And every type of mold will multiply given moisture and organic material to feed on.

Health officials and other experts urge people impacted by the recent flooding to take precautions while cleaning up and ensure that areas are completely dry before disinfecting and starting to use them again.

The American Lung Association issued a warning immediately after the recent flooding. “Standing water and dampness is a breeding ground for bacteria, viruses and mold,” the organization’s chief medical officer, Albert Rizzo, said in the statement.

“These can become airborne and inhaled, putting people at risk for lung disease. In fact, mold has been associated with wheezing, coughing, and in some cases asthma attacks, and some evidence links mold with respiratory illness in otherwise healthy children,” Rizzo said.

People living and working in affected environments after the cleanup and restoration is complete should be alert to the possibility that new health symptoms may be related to exposure to mold, according to both Owen and Tessier.

“We can never say for sure that just because there is mold there that it is toxic, but we do know that when there’s mold, it is possible to have health issues,” said Tessier.

There are time-tested strategies for managing a mold cleanup, but not everyone should take part.

Both state and federal health departments warn against the very young, the very old and the immunocompromised helping to clean out areas with likely high mold concentrations. People not in those categories should still take precautions, experts say.

The state health department recommends that people at minimum wear N95 masks and thick gloves, Owen said. Masks should be replaced several times over the course of a day of work and clothes worn should be removed quickly and washed in hot water separately from other laundry.

Tessier supports an even higher level of protection if possible. She suggests those cleaning up wear Tyvek-type disposable coveralls and gloves made of nitrile, a synthetic rubber. Safety glasses or goggles and a fitted half-face respirator with replaceable HEPA filters will be more durable and prove more reliable than a mask, she said.

Tip sheets advise that a professional should be hired to clean up where a space of more than 100 square feet has been impacted. Tessier strongly advises that for anyone who can afford it.

“I’ve just seen too many people get in over their heads or, as they’re going, get fatigued,” she said. In that state, people will skip important remediation steps. “As they’re ripping out their basement walls, the moldy air is being pushed up to the living spaces in the rest of the house,” she said.

Hiring a professional right now is challenging. Out-of-state contractors have come to the state in droves, particularly to Montpelier. But there are simply not enough trained professionals to meet the widespread demand, said Ken Williams, who owns Paul Davis Restoration of Northern Vermont, a franchise based in Hardwick.

Williams and his son, Christopher, who focuses on mold-related issues, are providing advice for their neighbors while they work to clean out flooding from the Lamoille River in their own office and warehouse.

There is no state or federal licensing required for disaster remediators. The Williamses recommend checking references and having a clear contract or work order. Tessier has more detailed recommendations, including looking to third-party licensors if the visit is prompted by health concerns.

But for most people, the biggest issue is the cost — thousands of dollars at minimum and the work would only be covered if you have flood insurance. A special mold rider also might be required as well, depending on how advanced the problem is.

The steps to clean up thoroughly to reduce the likelihood of mold growth are the same, whether done by homeowners, volunteers or professionals, though pros will have more powerful equipment.

First, remove everything you can from the building that got wet. Many items, including cardboard boxes, paper, upholstered furniture, carpet and drywall will harbor mold and should be discarded.

“Grandpa’s chair, those types of things, there is nothing you can do,” Ken Williams said. “There is not much you can save.”

The goal is to expose the surfaces of materials that will release water, such as wood and concrete, into the air. That is why, if there was standing water, the carpet and any kind of flooring underneath should be fully removed in order to allow moisture to evaporate from the sub-flooring.

“You can dry one layer,” he added. “You can’t dry three inches of stuff.”

Other materials such as metal and glass can be hosed down and washed with soap and water.

Once that demolition and removal is done, any silt and mud remaining also needs to be removed, the Williamses advised. Counterintuitively, often the easiest way to do this is to wet down dirty surfaces, because once dry the dirt will become dusty and spread through the air.

During this entire process, the space should be under negative pressure, they said, so mold does not spread within the house. That means at minimum box fans in the windows blowing the air out. You should also put up a plastic sheath or other impermeable barrier between the flooded area and the rest of the building.

To be thorough, you should scrub every inch of surface, including every nail head. “Sometimes you have to wet wash it and sand it and disinfect it, and that is all before you can dry it,” Chris Williams said.

After the place is clean, the air should be aggressively dehumidified, which takes longer than most people realize, he said. Even a commercial-strength dehumidifier can take a full week to fully remove moisture from a flooded space. A humidity meter is an important tool, and it should read below 40% to ensure mold will not return, he said.

Otherwise, a few weeks later the problem will be back. “Putting things back together quickly is the worst thing you can do,” he said.

Chris Williams said he has seen some industrious neighbors rip sodden things out and then try to rebuild the next day. “I’m just worried that they may have long-term issues that they are unaware of because they were just trying to reset,” he said.

If it’s a low-humidity day outside, creating air flow through the space by opening all the doors and windows and running fans will work in a pinch. “Mother Nature is the biggest dehumidifier there is … if she’s cooperating,” Ken Williams said.

After the area is fully dry, you should do a final round of deep cleaning and disinfection.

Soap and water and a bleach solution (no more than one cup of household bleach to one gallon of water) will work, according to the U.S. Centers for Disease Control and Prevention.

Then the entire area should be gone over again with a high suction vacuum outfitted with a filter that can capture very small particles, also known as a HEPA vacuum, the Williamses said.

The work is very labor intensive, but “you can’t cut corners with this stuff,” Ken Williams said.

Over the longer term, as people rebuild and return to living and working full-time in flood-impacted buildings, it is important that they be alert to new health concerns that may be caused by unseen mold, according to health officials and other experts.

Even conscientious cleaning can miss locations where mold may have settled and could start to grow again. Exposure to previously flooded locations should be something you mention to any health professional you see, Owen said.

The most frequently cited symptoms are allergic reactions, such as constantly itchy eyes or running nose. But an allergy can also present as asthma and other respiratory distress, coughing, dizziness or headaches, Tessier said.

Allergy is just one of four groups of health effects from mold exposure that she says “can all overlap like a four-petal Venn diagram.”

Some mold can cause an infection, which can result in a fever, chills and fatigue. Certain people may experience mold toxicity, which “can result in a lot of different and varying symptoms from person to person,” she said. At its most extreme, that can look like chronic fatigue, sleep disruption or muscle and joint pain. Finally, Tessier sees people with chronic inflammation throughout the body.

Those last two impacts may be less broadly accepted by mainstream medical practitioners due to a lack of clinical research, Tessier said. But she believes this is changing.

Testing for mold is expensive and the results are often difficult to interpret. If you think you might be suffering from mold exposure, the best first step is to arrange to spend time away from where you think the mold might be, she said.

“It’s not foolproof, but it’s certainly a place to start for people,” Tessier said. Notice if your symptoms improve. This can happen after just a day or two, though if there has been long-standing mold exposure, it might take a week or two to see improvement, she said.

If that is not possible, then another option is to try to increase airflow and ventilation, she said.

The good news is that in most cases, once the mold is removed or people remove themselves from the mold, they do recover.

“You can feel better. Things can change,” Tessier said. “My biggest thing is try to stay positive and try to find a community or a team that is going to listen and support you and help you take the steps that you need to be safe.”

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VTDigger's health reporter. More by Kristen Fountain