Mold, Indoor Air Quality, and Clean Breathing, with Michael Rubino

Chris Kresser:  Yeah. How do you tell? If someone’s wondering, is my home too tight? Do I need to think about an HRV, which I’ll ask you about in a moment, or ways for improving ventilation. How do you assess that? Is there a way for a homeowner to assess that without a professional? Or is that something that has to be done professionally?

Michael Rubino:  Yeah. I mean, unless you’ve ever done a blower door test, you’re probably going to want a professional, because those are tests that need to be done accurately, otherwise, the data behind it is pretty useless. But you basically want to do an either blower door test or something called an energy audit, where they can actually understand how much pressure change is happening between outside and inside. And if it’s too tight, you already mentioned it, we can do something like an HRV or an ERV, right? Some level of bringing in mechanical, ventilation mechanically, would be all we need to do to kind of course correct. It’s just the issue is, none of us are aware of it. It’s not terribly expensive. For a few thousand dollars you can really start to bring in fresh air. It’s just that a lot of us don’t know about it, right? And so if an ERV, HRV, or just mechanical ventilation system hasn’t been part of your construction plan, you might not have it and have no idea.

Chris Kresser:  Yeah. Can you explain, for people who are not familiar with ERVs and HRVs, what they are, what the difference between an ERV and HRV is, and how this kind of addresses the problem? I’m quite familiar with them from my work, and I think we’ve talked about them once or twice on the show, but it’d be a good refresher for new listeners.

Michael Rubino:  Yeah, they’re an energy recovery ventilator, to kind of give people a layman’s term of what they really are is they bring fresh air in, and then they take the air that’s already in and exhaust it out, right? And so it is bringing that. It’s literally just exchanging the air from inside to outside. And difference between ERV and HRV is essentially, some of them have exchangers, where they literally exchange the temperature of the air as the air passes through. And so, depending on the climate you’re in, depending on the situation you’re in, you may want an HRV as opposed to an ERV. But essentially, the idea is to do the exact same thing, is to exchange the fresh air inside, well, sorry, exchange the stale air inside with the fresh air from outside, and to do it in a safe and effective manner.

Chris Kresser:  Great. Yeah, so I have one of these, and we use it, for the listeners, they’re pretty easy to work with. You can set different times, how much fresh air venting you want. You can change it at different times a year. The winter you’re bringing in cold air, and that’s where the HRV is helpful, right? So you can actually bring out cold air. So it depends on what climate you live in and what you might need there.

DIY Testing and First Steps When You Suspect a Problem

Chris Kresser:  Let’s talk a little bit about where to start, because I found in my clinical practice this was one of the biggest issues for people. They will hear a podcast like this, or hear from a friend like I don’t know, how do I know if I have a problem? I do have symptoms. I don’t know if my symptoms are related to indoor air quality. But let’s make it a little easier. Let’s imagine a hypothetical scenario, and one that I saw pretty frequently in my practice, which was like, let’s say somebody has noticed that they feel worse in their house than they do when they’re away from their house or on a vacation. A pretty common one was somebody who sleeps a lot better outside of their home versus when they’re in their bedroom, which you would kind of think would be the opposite for most people, they sleep worse in hotels and you know all that. So if somebody is sleeping a lot better when they’re not in their bedroom, that was, for me, always a kind of a red flag of like maybe there’s something going on here. What should that person do? Obviously, the best solution is to find someone like you or an indoor environmental professional to come and help. But even before that, what are some, in medicine we call it a differential diagnosis. How do you start to sort of narrow down the possibilities, or do some initial kind of testing at home, before you bring in the professionals to determine whether your indoor air quality is even contributing to your symptoms in the first place?

Michael Rubino:  Yeah, and look, and that’s exactly why I created this product called the Dust Test, because it’s literally this at-home test. We already talked about a comparative test, too, if you want another opinion, called the Ermi where you could buy those tests, collect dust from across your house. It’s super simple, you can do one and screen your entire home with one, you can do a few and kind of break your home into sections so you can get some comparative analysis of what might be going on in, let’s just say, a quadrant of the home. So you have a couple of different options, but kind of, this allows you to kind of be in the driver’s seat and really start to understand your environment a little bit. So you’re not necessarily relying on a professional to tell you, okay, do I have a problem or not? And that typically is going to be a more cost effective way anyway, of just answering the question, do I have a problem? Now, where is the problem that gets a little more nuanced, and we’ll go into that in a second. But if you just want to know where to start, I would start there, to be honest, because I think that’s what it is designed for. It’s a screening tool. What’s really interesting about that, too, is, depending on the camp that you’re in medically, right? You have different mycotoxin testing. I found really, really interesting, I find a lot of correlation. I’m not going to say causation. I’m just going to say I find a lot of correlation between certain molds in people’s homes via the Dust Test and Ermi. And interestingly enough, some of the mycotoxins they might have elevated. And there’s, mycotoxin testing has come a long way too. They’ve got the IgG and IgE ones you can do. I don’t know which tests you necessarily co-sponsor, but I’m just giving people the lay of the land of what’s out there, right? And so it’s really, it’s really interesting how you can kind of start there, and start to draw some conclusions, and then you also have, want a couple different things to take into consideration. Yeah, do I feel better when I’m not at home? Do I feel better when I’m sleeping somewhere else? You pair that with the information, looking at the geometric means, how high are some of these molds compared to the geometric means? And that can start to give you some clues as to maybe there is something at my house worth exploring, and that can give you the confidence you need to kind of take that next step, which would be, figure out where the problems are coming from.

Chris Kresser:  Right. Yeah, there’s also a couple of other things if you’re able to do this, which would be like, sleep in another bedroom in your house, and if you sleep better in that other bedroom, perhaps there’s something in your bedroom that’s more specific. I mean, obviously mold, if it’s mold and most other airborne stuff can communicate through the house and through closed doors. But sometimes, if the source is in a particular location, it’ll be worse, closer to that source. And there’s small things like that you can do to try to isolate the problem and figure it out. It sounds like Ermi is maybe the next step. And then if there’s some positive signal or not Ermi, but the MSQPCR, whether you use Ermi scoring or not. Then, if there’s some signal there, then you generally want to keep going and do more specific testing, and then start trying to identify the source of where those things are coming from.

Michael Rubino:  Yeah, you hit the nail on the head, right? The closer you are to the source, it’s no secret, the more particles you’re going to be breathing in, right? And what are those particles we’d be concerned about with mold, you have MVOCS, you have the particles and spores and fragments themselves. You’ve got, of course, the potential for mycotoxins too, depending on the type of mold, right? And so you look at all three of those things which have been studied and known to have their own sort of health risks, you want to take all that into consideration. And look, just to close the loop on mold a little bit, no one’s going to have a mold free home. You’re always going to have some level of mold, right? You just don’t want to have mold growing out of control. And that’s, all these horror stories that you hear about where people are getting sick, it’s unfortunate, but the reality of the situation is mold grew out of control. And so I always want to say that because we don’t want to be scared of mold. We don’t want to build bubbles around our houses. We’re going to have some mold. That’s okay. We just want to have it under control. And that’s really the big key here. And so when you’re doing testing and investigating, you’re trying to figure out where, what’s happening with the house, and why is there water coming in somewhere? Could be hidden, right? But where is it growing out of control? And that’s where we want to look at where the source is, eradicating that source through proper and safe remediation, and then cleaning up the byproducts. That’s where the HVAC comes into play, and removing household dust that’s been accumulating these particles and toxins over time, and that’s how you really start to kind of move that needle, reduce the burden of particles and toxins that you might be breathing in consistently, 20,000 times per day. And then, lo and behold, usually people notice a difference.

Chris Kresser:  Yeah, and it seems like people should know this, that because I’ve often heard from just, like friends of friends, or whatever, they know I’m in this field, and they know I know something about this. And they’ll order QPCR tests online, and then they’ll just do a sample in a room, and it will have some mold. As you said, inevitably, it will have some mold. And they’ll start freaking out and be like, oh my god, I have mold. I have mold. And I often tell them well we need some kind of control here. What are the levels elsewhere? Outside? You need to be able to compare so that you’re not just looking at something in isolation. Is that how you approach it with an outdoor control sample? Or what do you typically recommend to make sure you’re not chasing red herrings?

Michael Rubino:  Yeah. So I mean, usually you always want to have some level of control sample to compare it to. I was just at Sears X actually, this past weekend, and I was listening to some of the talks. And there’s some guys doing Ermi samples as controls outside. And they’re literally like, there’ll be a stop sign right near the corner of the house. They’ll collect some dust off the stop sign. They’ll send that in, and then they’ll take a couple different Ermi samples throughout different quadrants of the house. And I was getting to look at the data. They were showing it as a case study. And it’s really a smart idea, because we understand two different things. One, mold is part of our ecosystem. So it’s part of our universe. We have to live with it. What we have outside is a normal occurrence that we’re going to have inside of our homes, right? Obviously, you’re going to have less because you’ve got barriers like walls and windows and things that keep, that do keep things out. But no house is hermetically sealed. Even the super new tight ones, they have some air exchange, right? So you’re always going to have some migration from outside inside. So you want to look at that. You want to have some comparative analysis. And it’s interesting, because you don’t really see a lot from the industry itself. You don’t really see a lot of people talking about, hey, do an outside control sample using the QPCR. You normally only see that with air testing. But I do want to say that the industry is shifting, the industry that does believe in QPCR, there’s a whole other topic of conversation on some people don’t even believe that technology is useful. But that’s, we could talk about that.

Chris Kresser:  I’m familiar with that debate. I’ve been through that many times.

Michael Rubino:  It’s DNA-specific technology. It’s validated in court. So what else do you need? But at the end of the day, doing that outside control sample, I think could be very valuable, because you want to understand what are the molds that are elevated outside in the vicinity of my house that we know are going to be elevated inside my house no matter what. And I think having that comparative analysis is really brilliant, and I think that I’m really happy to see the industry moving in that direction. And I think if you’re listening to this and you ordered an Ermi, order two. Do one outside, do one inside, it’s going to be, it’s going to provide you some peace of mind for some things that, numbers that might seem scary, but now you understand, okay, this is just normal trappings coming in from outside.

Beyond Mold: Other Harmful Contaminants in the Home

Chris Kresser:  So let’s talk about some other contaminants. There’s a lot of focus on mold, appropriately so. A lot of homes are moldy unfortunately. This is just a reality that I’ve come to terms with over many years of treating patients, and two out of the three homes that we’ve owned have had a significant mold issue. Actually three. We we recently, in our current house, we remodeled the master bathroom, and a couple months after that, I was in the living room just reading a book, and then I looked up at the ceiling and saw the very telltale warping bubbles in the drywall, and the plumbers who had had done the installation of the tub in the master bathroom had, whether or not it was their fault or a faulty pipe, which is what they said, the pipe broke, and there was just water accumulating there. So, it’s all too common, right? Stuff like that happens all the time. There’s water damage that happens. There’s, even just in one of our homes, mold was just forming, because the relative humidity where we lived was quite high, and so, a bookcase that’s touching a wall, you can get mold forming in that situation. So important for sure. And we’ve talked, I’ve talked a lot about that on this show, but I want to talk to you a little bit about some of the other contaminants, like formaldehyde and VOCs, like things you might encounter in new home construction, or even just from off gassing, chemicals that are formed when you’re cooking food at high temperatures and even carbon dioxide. You talked earlier about how tightly sealed our homes have become and I have seen some reports of people finding that the CO2 levels in their bedroom were actually quite high when they measured them, and that was maybe causing some insomnia and sleep issues, because they were not, the CO2 at high levels is not good for us. So just curious if you reflect on your time spent doing all of this, and you had to sort of force rank those things I just mentioned in terms of how common they are in terms of causing people’s symptoms, how would you do that?

Michael Rubino:  That would be a tough question to answer. And I would say that mostly because it would probably be an unfair answer, only because I think that most of the time, formaldehyde doesn’t get looked at. If someone finds mold, for example, or high levels of bacteria, you typically start to go right into the water damage scenarios. You start to dive right into that. And a lot of those things get checked then only if, by addressing everything else, you still didn’t solve the problem, and there’s still something ongoing. I’ll give you an example. I was on a project once. The project had a lot of water damage, needed mold remediation. There was a lot of work that was done there. There was presence of mycotoxins that were tested in the dust in this house. The whole place needed to be cleaned. That all got cleaned up. The client walks back in, I think it was like the next day or so, and immediately just headaches, not feeling well. It was like the mold’s still here, I can tell. And we had third party testing come in. There was definitely no mold at that point. The mycotoxins all came back into normal ranges. But actually we ended up getting like an HVAC specialist over there, and the HVAC specialist found that the exhaust of the HVAC, it was installed by a family friend of the client we later found out, but it was, it was installed too close to the, the exhaust was. Sorry, the gas exhaust was installed too close to the intake. And so what ended up happening is literally, carbon monoxide was getting drawn back into the house, back into the HVAC system, and then it dispersed throughout the house. Luckily, the levels were really low, or I probably wouldn’t be here today, and so many other, so many other people wouldn’t be here today, including the clients. But they were high enough to cause symptoms, right? And so thankfully, she did get rid of the mold, and that was important. And she probably had some issues with that, in and of itself. But we also found that there was a carbon monoxide issue, right? And so I think the point is, unfortunately, especially in my field, people are very myopic on the water damage side and everybody starts there and kind of works their way backwards as needed. But that doesn’t negate the fact that we have real issues with VOCs, and it’s kind of like, when we banned BPA, we just came out with BPB, right? So that there are VOCs out there that are classified as zero VOC by the EPA that we’re finding out are harmful today, right? And so we’ve definitely got an issue with VOCs. Not every material is required to be low VOC or zero VOC, anyway. So that means that, there are some paints that have tons of VOCs, right? There are epoxy coatings that get used all the time, that off gas tons of VOCs. And it’s okay if you’re aware of it, and you know to ventilate the space and you’re controlling it, you’re not exposing yourself to it too much. It’s just that it’s one of those things that people aren’t always aware of. Now, for VOCs, for those that don’t know VOCs, they stand for volatile organic compounds. They’re essentially particles that off gas from a product as it’s curing or drying, right? But a lot of what we bring into our house these days, especially with the lovely invention of Amazon, where we just get anything we want in a cardboard box, VOCs is a real issue. Micro plastics, a lot of it comes from our clothes themselves, but we’re shedding microplastics in our environment. I saw a study recently is the average person, I think it was like four credit cards a month of plastic they consume.

Chris Kresser:  It’s crazy.

Michael Rubino:  It’s crazy, right? I mean, so these are things that, how are we consuming them? Well, mostly through our skin and by breathing them in. Because they’re shedding from our clothes and we’re wearing our clothes, we’re moving around. Things are entering through our skin and for sure, definitely, we’re breathing them in, right? And so I think that that’s a real issue. Formaldehyde is a real issue. We were seeing, if you remember years ago, it was like the Lumber Liquidators or something, that was like off the charts levels in flooring that people were putting in their homes. Formaldehyde unfortunately, it’s in a lot of our insulation and building materials. It’s just, if you’re not aware of it, and you don’t know to ask for formaldehyde-free versions, which, by the way, usually costs more money, unfortunately, those things go into your house. And when you think about formaldehyde in your floor, that’s a real concern for me, because there are two things that I think make a huge difference, your flooring, because there’s so much of it, and you’re painting. Because again, there’s so much of it, right? And so whatever you paint on your walls, you are going to be breathing in, right? And so if you have super high VOC paints. I don’t want to name any brands, but most of the brands, unless you know to go low VOC, or, zero VOC, they’re going to have quite high levels of their off gassing. And just so people are aware, your walls and your floors, they could be off gassing for years, not just like, days or weeks, right? And so I think that’s a really important thing that people need to be more aware of.

Is your home making you sick? In this episode of RHR, Chris talks with indoor air quality expert Michael Rubino about mold, VOCs, dust, and why your symptoms might be tied to the air you breathe—plus what to do about it. #chriskresser

Of course, there’s other toxins that could be in adhesives and some of these other things. But again, some of those, to me, not as big of a deal. If you’re worried about adhesives in one vanity cabinet, you could really drive yourself nuts and spend a lot of money trying to make everything perfect. I would say, think about the big ticket items that take up a lot of space, that are going to off gas a lot of particles. I think that’s really important. And then, the other thing about water damage, and we talk a lot about mold, is we don’t talk about enough is bacteria. I mean, look, I could promise you, if you have mold, you have bacteria, right? They’re going to grow in the same locations. That’s why, typically in our field, we call it microbial growth, because it kind of covers the mold on the bacterial side. But, bacteria is a real issue, too and some of the studies we’re seeing on endotoxins and their effects, and endotoxins are toxins produced by certain species of bacteria, is that dies off, those create a real human health risk too. And so, we want to think about all these different things in our house, carbon dioxide, right? Just regurgitating your own carbon dioxide and not getting enough fresh oxygen. I mean that that has some real risks too. And so I think, big takeaway, if you’re listening to this, is like all right, we need more ventilation in our homes, right? And we have options and we need to think more about what we’re breathing. Because we take 20,000 breaths per day, we’re consuming enough air, about 2500 gallons of air. So that’s about enough air to fill up a normal sized swimming pool every single day. And the amount of particles that go with that. I mean, just think about how many particles could fit in a normal sized swimming pool. Obviously, you’re not consuming enough particles to fill a normal sized swimming pool. But you got a pretty empty glass here, and a lot of particles that are coming with that glass. So you want to be mindful of that so you don’t become the adverse effect of it.

Chris Kresser:  What about, a couple other things I want to bring up for those who live in areas where there’s wildfire smoke, PM 2.5 is another consideration. And then some like when we lived in Utah, radon gas was another consideration as well. It’s not something that affects everyone in all places, but those can be contributors to symptoms as well.

Michael Rubino:  Yeah, we don’t talk a lot about radon, and we need to talk more about it. It actually is a really significant issue. It’s not a significant issue everywhere, as you pointed out, but these are gasses that get released from the ground. And it’s a real problem. A lot of people, they’re aware of it when they’re buying a house, right? And they’ll ask for, oh, do you want a radon inspection? And they’re trying to figure out what that means. But it’s one of those gasses where, if it goes below, sorry, goes above four pico liters, it’s really a pretty big health risk. And, I mean, there are serious consequences. Unfortunately, people have even died from having too much radon, right? And so I think it is something we want to be mindful of. I know, mold gets a lot of consideration, but I think radon does need to get talked about more, too. It’s not always a risk. It’s easy to deal with, if you have it, a lot easier, sometimes than even mold, because you can install a Radon Mitigation System that basically just helps release those gasses and pushes them up above the roof and away from the interior where your family spends the time. And so, thankfully, it’s something, there’s something you can do about it. It’s pretty reasonable. But again, it’s an awareness issue. You need to know about radon. I feel like a lot of people do get to hear about it in that home buying process. But if you’ve never bought a home, it’s very possible you don’t know about it, and you should because even renting a place, there’s some concerns there if the landlord hasn’t made you aware of them.

How to Find a Qualified Professional and Avoid Costly Mistakes

Chris Kresser:  So let’s, let’s kind of wrap up the conversation on diagnosis, if you will. Or talking about the various potential causes and things to look for with some tips for people who are looking for someone to help, come and do this kind of testing. So I know your company offers assessments. I don’t know if you travel and do that. So you can talk a little bit about that. But also, for some people who that’s not going to be in the cards for like, what kind of questions should they ask their local people that they talk with? Because I’ve been in this world for long enough to know that there’s just a lot of chicanery and really shady people misrepresenting themselves, who really don’t know what they’re doing. And you can go down some really expensive and even destructive rabbit holes here if you don’t really know the right questions to ask. So let’s talk about that.

Michael Rubino:  Without a doubt. So first off, I want to talk about there’s two extremes to this coin that I think everyone should be aware of. First off, there are companies out there that are in indoor air quality that do not believe that indoor air quality is a human health risk. And so those companies, I know it’s crazy or like, how are you in air quality? You don’t believe in air quality, but I wish I knew, but there’s, like tens of thousands of those companies. Those are the companies that are looking to charge you money, do very little investigation, and provide you a report that basically says everything’s fine. And that’s not necessarily the option you want to go, because that’s the left side of the extreme, because now you’ve really done not much at all. You’ve just wasted money, and you’re no better for it. Then there’s the other side of the extreme, where every single thing is a massive issue, and you need to rip your house apart and gut it and start over. And look, I’ve done cases where houses needed to be gutted so there are extreme situations where the houses are very problematic. It’s just that not every single house is that way, right? And so if you ever feel like you’re on too extreme of a side, get a second opinion, but make sure you’re getting the opinion from the right camp. Because if you’re concerned about this from a health perspective, you want to actually hire somebody who actually believes this matters from a health perspective. And I think that’s really, really important. Now, even in that one camp, you’re going to get varying opinions, and you have to kind of decide which opinion aligns more with your goals and what you’re trying to accomplish, right? Because I’ve had clients call me and say, hey, I want hospital grade air quality. I’ll spend all the money in the world. That’s what I want. This is my dream. I can make that dream a reality for you, but I’m going to tell you time and time again at some point you are chasing a ghost, right? You are opening up walls for one or two spores. I never agree with that approach. But, I would say that it’s, every single house can be dealt with like a science project. You need to be in control of that science project as the homeowner to decide really what you want to do and what your goals are. And then you want to rely on these experts to answer the question fairly and honestly, to help you align the facts of the matter with the goals that you have. And it’s one of those things where you literally can have a New Year’s resolution tomorrow, and you could go and spend $9.99 a month and join the gym, or you could go right into having a cold plunge and spending thousands of dollars on all these different amazing things and just jump all the way in, right? And so I just want to preface people with a warning that you can really go as little or as extreme as you want on this. You’re the driver, and your job is to find the right experts that are going to help you achieve your goals, right? And I know that’s really interesting to say, but to be honest, that’s where we are. I mean, the world is your oyster, and you can go as thorough as you’d like. Now in terms of, where do you start? How do you find people that you like? We have a nonprofit called Change The Air Foundation. You can go to changetheairfoundation.org and we have a really amazing resource section. If you click, start here, the first thing it’s going to tell you is, how do you vet an indoor environmental professional? That’s the first person that comes into your home. This is the person who does the assessment, who really goes in and helps try to identify the problems. And my honest recommendation is that’s the data set of things. Personally, I think if you want to understand how do you be conservative on remediating your house, the best investment you can make is actually on getting the right information. Because with with the right data, you can make data driven decisions on how do you want to tackle this project actually inside your house. Because if you don’t have the right data, sometimes you’re swinging in the dark, blind, and you start getting into that situation where you’re opening more things up, you’re spending more money opening things up because you’re just unsure. You didn’t have the data to really tell you yes or no. And so I think being data driven is actually going to save you money in the long run on the assessment side. And then when you click that website you go to the next section, it gives you really great questions to ask to basically help you vet and find a remediator. Now, why do you want to vet and find a remediator? Well, because this is the person that you’re going to trust to actually fix your home. And so this is where things, the cost side of things, this is the biggest investment out of all of it. I mean, the remediation is always going to cost more than the assessment, because you’re actually opening up walls. You’re actually getting to the root cause of the issue. And unfortunately, the root cause of the issue, it’s in the attic, it’s in the HVAC, it’s behind the wall, behind the ceiling. You have to cut things out to actually access, typically, where it’s growing. And so in order to do that, there’s going to be a higher ticket price than the inspection itself. And so you really want to find somebody that again, aligns with your goals, that’s going to be as thorough as you need it to be. I mean, when I say thorough, I mean not just the actual removal part, but just helping you understand the byproducts that mold or bacteria creates over time, and it is so you’re cleaning the HVAC, you’re cleaning the house, removing these dust reservoirs, and really looking at the project holistically, not just, I’m going to take a box cutter and cut out one thing and spray some chemicals, right? And so I think that part is also really important.

And then, to close the loop, you bring the inspector that found the problems back, and then he verifies that the remediation was successful. I hate the word successful, but it’s the best word I’ve got, because what we need to do is we need to validate that the mold is actually gone, right? And it’s been removed from the structure. And sometimes, because again, we’re looking at things at 25, 50, times smaller than what the eye could see. Sometimes we actually find out through that post-verification that it’s not all gone and more work is needed. That’s why it’s so important to have these checks and balances, because otherwise you end up closing everything up thinking everything’s all fine. But unfortunately, there’s still some mold left behind, right? How does that happen? Or why does that happen? Well, you may have thought the water traveling in this section, so you cut out, let’s say three or four feet, you actually needed to go six feet, right? And so it’s something as silly as that, but if it’s not validated and verified that you needed to go that extra two feet, then you’re potentially leaving some mold behind, right? And so I think it’s really important to understand kind of that little process. And I call it the circle of trust. You want to, your doctor, your inspector, your remediator, everybody’s all got to be on the same page. This has to be people that you trust. They have to trust each other, and everyone’s got to be on the same page as to what you’re doing, what’s the expected outcome, and that’s how you’re going to know for sure that the project’s done satisfactorily. You’ve got the best success and chance that exactly what you would hope to set out to accomplish during this project actually gets done. And I think, starting there, going to Change The Air Foundation and just having those list of questions. Because look, if everybody could hire me, of course they would. It’s not practical. It’s not feasible. There are 50,000 companies out there that do this. You just got to know which ones that you really need to find. You got to know how to vet them to find the right ones so you can trust them. And that’s part of the process.

Chris Kresser:  Absolutely, I’m glad you mentioned the retesting. I’ve seen a lot of people go through all of the hard work of identifying the source and then remediating and then skipping the confirmation, which is the absolutely critical part of determining if all of the work that you did actually had the desired effect. And I get it. I mean, this stuff is expensive. But you absolutely need to budget for that confirmation testing. Otherwise, you don’t have the peace of mind that you actually eliminated the problem.

Michael Rubino:  Moreover, if you think about all of the resources that you go through between finding the problems, opening them up and remediating them properly and then building them back, for that extra, 1500 bucks or 2500 bucks? I don’t know what the post testing costs. It obviously ranges, but it’s a drop in the bucket, because it’s definitely the lesser of all the costs. Because even the initial inspection, they’re going to take more samples, typically trying to find the problems. Once you have found the problems, though, you need less samples to validate that they’ve been actually eradicated appropriately. And so it’s kind of one of those things where I know it’s expensive, but don’t cut that corner. Even people with the best intentions can fail that post-test. I mean, I’ve failed post-testing so many times. I mean, I’ve done thousands of projects in my career. I’ve had to have failed at least 100 projects. Okay? And so, I think it’s really important, because even though myself, or anybody out there might have the best intentions, we can’t see what we can’t see. I mean, these particles, literally, are 25 to 50 times smaller than what the eye can see. So I might look around and it might look clean, but that test tells me, you know what, we got to open up a little more. And I think that’s really, really important, because you never want to skip that step and then build over it, and then, be right back where you started, potentially still not feel that well as a result. And I think then it’s almost all for nothing, right? And so just, please don’t skip that step. Super important.

Chris Kresser:  Absolutely. And I would say, I mean, this is a little depressing, but I would say at least half the time, if not more often than not, the retest will fail just because depending on the scope of the project and what’s going on, it’s easy, like you said, it’s not a simple task to eliminate all of the mold. And even a couple of times it was just due to inadequate post-cleaning, like the source of the mold was taken care of, but the post-cleaning was not quite as rigorous as it should have been. And so it’s so, so important to do that. And just like you said, is to have the peace of mind you’ve spent all that money and time, aggravation, just to know, okay, now I can cross that off the list, at least for now, and know that I have a clean environment to live in is really, really worth the extra time and money if you can swing it.

Michael Rubino:  Absolutely.

Chris Kresser:  Well, Michael, thanks so much for this conversation. It’s been really fascinating. And tell us how people can learn more about you. I know you have your own podcast, you’ve written books, you’ve got a website. Tell people how they can learn more.

Michael Rubino:  Yes, I wrote a book in 2020 called The Mold Medic, An Experts Guide on Mold Removal. If you look for it, it might be very expensive currently, because we’ve taken it offline, and a new book is on the way. And so, appreciate your patience for that, but you might be able to find a copy here or there. And it was definitely a great book for its time, and excited to kind of update with new information and provide that to the people. And if you liked anything that I said, please go over to changetheairfoundation.org, sign up for the newsletter. As a nonprofit, we have three basic pillars that we look at here. And it’s education and creating that education awareness so that people are better informed, make better decisions. Research, because there’s a lot of research out there, but I think from an environmental side of things, there’s some lacking there. So we’re hoping to be able to be a beacon for people and be able to award more research. And then, of course, policy reform is the last thing. I realized pretty quickly in my career that I wasn’t going to be able to solve this problem one house at a time. We really needed societal changes to prevent these types of issues from occurring, because it really comes down to the way we build the homes, maintain them, [and] restore them. There’s not a lot of great protections in place for everyone, and we actually passed our first law in Illinois this past year. In Illinois, there [were] no rules and regulations. There is now, thanks to the amazing volunteers that helped us get that law passed. Now they’re going to have to register to become an assessor and register to become a remediator. Prior to this law passing, you [could] go to sleep one day and be in pest control and wake up the next and be a mold expert. And part of that conundrum is actually creating a bigger hole and a bigger problem across our country. So [we’re] really dedicated to changing things from a societal standpoint. Just following our newsletter and following along and helping where you can makes a huge difference. If you want to learn more about me, you can go to themichaelrubino.com, and if you want to learn more about creating a healthy home, please check out homecleanse.com. And I do have a podcast called Never Been Sicker. I hope to have you on pretty soon to continue the conversation. And, yeah, just really grateful to be here. Thank you so much for listening.

Chris Kresser:  Great. Thank you, Michael and thanks everyone for listening [and] watching the show. Please keep sending your questions to chriskresser.com/podcastquestion, and we’ll see you next time.