Why the typical "mold inspection" misses the problem
When you call a standard mold inspector, you typically get an air sample. Air sampling catches actively releasing spores at the moment of the test. It misses:
- Dormant water damage (most chronic exposures)
- Mold inside walls, under floors, in HVAC
- Hyphal fragments and mycotoxins that don't aerosolise
- Cumulative exposure history
That's why patients with raging CIRS get "your house is fine" reports.
What ERMI and HERTSMI-2 actually measure
Both are dust-based quantitative PCR tests that detect DNA of specific mold species. Because dust accumulates over months-to-years, these tests give a much better picture of total exposure history than air sampling.
ERMI (Environmental Relative Moldiness Index)
- Measures 36 mold species — 26 "Group 1" (water-damage-associated) and 10 "Group 2" (common indoor mold)
- Calculates a single index score: Group 1 minus Group 2
- Best for: initial investigation, understanding the full mold ecology, real-estate decisions
- Cost: ~$290
HERTSMI-2 (Health Effects Roster of Type-Specific Formers of Mycotoxins and Inflammagens)
- Measures 5 species Dr. Shoemaker identified as most strongly linked to CIRS: Aspergillus penicillioides, A. versicolor, Chaetomium globosum, Stachybotrys chartarum, Wallemia sebi
- Generates a 0–15 score
- Best for: re-test after remediation, deciding whether a building is safe to re-occupy
- Cost: ~$160
How to choose
- First test: ERMI. Better picture of the full landscape.
- Post-remediation re-test: HERTSMI-2. Cheaper, faster, focused on the species that matter for health.
- Multiple buildings to triage (e.g., picking a new rental): HERTSMI-2 across all candidates.
How to collect
Both use a Swiffer cloth wiped across surfaces in a specific pattern — typically 2 sq metres of horizontal surfaces in 2–3 rooms, including HVAC vents. Follow the lab's instructions exactly; sampling technique drives accuracy more than test choice.
How to interpret
ERMI: Above 2 is moderately concerning, above 5 is high. Negative scores (more Group 2 than Group 1) are typically safe.
HERTSMI-2:
- 0–10: low-risk for re-entry by CIRS patient
- 11–15: do not re-occupy without further remediation
These thresholds are conservative for CIRS-susceptible patients. Healthy people tolerate higher loads.
Where the building work fits
Testing the building is layer 1 of the mold treatment sequence. Patient detox without environmental work fails.
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