Illnesses from indoor Mold growth: Chronic Inflammatory Response Syndrome (CIRS)

Question

Has anyone heard of Chronic Inflammatory Response Syndrome (CIRS)? Would you say it is a real illness that can be treated? It is described as a multi-system, multi-symptom illness.

There are peer-reviewed research papers written about it available here(originally published in well-known and reputable scientific journals such as PubMed and Elsevier/ScienceDirect):

https://www.survivingmold.com/legal-resources/publications/papers-by-dr-ritchie-shoemaker

Research papers written about the topic of illness caused by genetic susceptibility to various toxic molds that grow indoors start at #9 on the research paper list at the link provided. They are spread throughout the page along with papers about Pfistieria and Lyme Disease./

The illness mentioned was originally known as Sick Building Syndrome (SBS) and is now known as CIRS by its proponents and practitioners.

The ideas behind the topic (that mold can cause illnesses) are implied to be truthful based on documents from HUD and the EPA, links to such information here:

https://www.epa.gov/sites/production/files/2014-08/documents/moisture-control.pdf

https://www.huduser.gov/Publications/pdf/BuildingMoistureandDurability.pdf

I have written and delivered a short speech on the topic previously in a communications course. I would like to confirm what I spoke about is based on scientifically truthful information.

I would like feedback from well-informed individuals to know, what do you think of this?

Is it possible for molds growing indoors to cause a multi-system illness, multi-symptom illness? Are the research papers enough for those in the medical community to confirm the illness is real? And that there are proper treatment protocols in place (Shoemaker Protocol/ Surviving Mold Protocol)?

Answer 1

"Chronic inflammatory response syndrome" (CIRS) is a new term for what was (and still is) known as sick building syndrome or building-related illness. Hypersensitivity pneumonitis seems to be a similar condition.

Chronic Inflammatory Response Syndrome (CIRS)

According to how National Integrated Health Associates (NIHA) describes symptoms of CIRS, the condition seems to be very similar to sick building syndrome.

Shoemaker et al in this paper Research Committee Report on Diagnosis and Treatment of Chronic Inflammatory Response Syndrome Caused by Exposure to the Interior Environment of Water-Damaged Buildings, refer to sick building syndrome several times. All the references about the treatment lead only to Shoemaker and the co-authors. CIRS is not mentioned in the International Classification of Diseases (ICD-10).

Sick building syndrome

Sick building syndrome is still an officially recognized health condition by several health-related authorities:

• The National Institute for Occupational Safety and Health (NIOSH), 2006
• U.S. Department of Energy Office of Scientific and Technical Information (OSTI), 2009
• Environmental Protection Agency (EPA), 2002
• In the 2020 version of International Classification of Diseases (ICD-10), it is mentioned under the code Z57.39 (Occupational exposure to other air contaminants)

Articles:

• Sick Building Syndrome (The Lancet, 1997) (On Science Direct)
• The sick building syndrome (Indian Journal Of Occupational & Environmental Medicine, 2009)

The term is used when the cause in a specific case is not known; contaminants may include molds, other microbes, pollens, motor vehicle and building exhausts, etc. Symptoms may include headache, irritation of the eyes, nose or throat, dry cough, dry or itchy skin, dizziness, nausea, difficulty in concentrating, fatigue and sensitivity to odors (EPA.gov, 1991).

In most articles about sick building syndrome, there is no specific diagnostic or treatment protocol mentioned, but preventative measures, such as the removal from exposure and renovating the building, are suggested.

Building-related illness

According to MSD Manual, 2018, building-related illness is the term that is replacing the term sick building syndrome; symptoms listed are about the same. UpToDate suggests that the term should be used when it is associated with a specific illness.

Hypersensitivity Pneumonitis (Extrinsic Allergic Alveolitis)

According to MSD Manual:

Hypersensitivity pneumonitis is a syndrome of cough, dyspnea, and fatigue caused by sensitization and subsequent hypersensitivity to environmental (frequently occupational) antigens.

..which may be similar to conditions described above, but with causes including outdoor contaminants (molds, industrial gases, etc.) and with inflammation limited to the lungs. A clear diagnosis can be made with the help of imaging tests, bronchoalveolar lavage, etc, and treatment is with corticosteroids.

In summary, indoor molds could cause inflammation in the body, but except in hypersensitivity pneumonitis, there seems to be no well referenced diagnostic or treatment protocols. Symptoms seem to be reversible and may resolve spontaneously after removal from exposure.