Newer Molecular Methods Bring New Insights into Human- And Building-Health Risk Assessments from Water-Damaged Buildings: Defining Exposure and Reactivity, the Two Sides of Causation of CIRS-WDB Illness

Scientific disciplines dependent on accurate analytics invariably evolve due to advances in technical aspects of measurement. In disciplines in which adequate measurement is not available for applications to public health policy, the impact of new paradigms in measurement can extend far beyond scientific thought. Both of these concepts apply to the effect of exposure to water-damaged buildings (WDB) on human health. What causes the putative illness and what government should do to make buildings safe for use, have been impacted by development of molecular methods, particularly Next Generation Sequencing (NGS) and transcriptomics. The impact of human exposure to Actinobacteria, for example, and identification of immune reactivity specific to these bacteria are now revolutionizing: (i) both detection and quantitation of newly recognized pathogenic organisms; and (ii) the approach to the genomic basis of diagnosis and treatment of disease as manifested by differential gene activation. NGS permits quantitation of exposure and confirmation of risk associated with the threshold of exposure, using defined human health biomarkers, that in turn has led to advances in the metabolic and inflammatory issues in WDB illness, called CIRS, both from molecular hypometabolism and activation of TGF beta-1 signaling that defines immunoreactivity to Actinobacteria. Current recommendations for assessment of exposure/reactivity to fungi and methods of remediation based on fungi alone do not support continued use, now that endotoxins and Actinobacteria are found to be the major causes of human illness from exposure to WDB.