Environmentally Acquired Illness
Background & connection to climate resilience
Environmentally acquired illness broadly refers to health conditions that arise from exposure to environmental toxins. Familiar examples include tick-borne Lyme disease or the health impacts of air pollution on asthma and respiratory illness. Mold-related illness (or mold toxicity), however, is less widely known, even as it is increasingly recognized and treated by a growing number of specialized medical doctors and practitioners.
Increased flooding, humidity, and power outages associated with climate change and an outdated energy grid raise the likelihood of water damage in buildings and associated mold growth. This makes mold toxicity—and the prevention or remediation of mold through the built environment, and the financing thereof—an important but to date underappreciated aspect of climate resilience and grid modernization. This issue intersects with my academic and professional interests in sustainable development and climate finance, but it is also personal as I experienced prolonged mold exposure during graduate school that led to a severe chronic illness and years-long path to recovery.
With greater awareness of mold toxicity, there is an opportunity for policymakers, climate resilience or environmental health focused advocacy groups and philanthropies, community lenders, building owners and developers, mold remediation companies and experts, and the medical community to work in tandem to address this ‘silent epidemic’.
Facts about mold and mold toxicity
Mold exposure and mycotoxins
Mold becomes a health concern primarily in water-damaged indoor environments.
Many mold species—not just “black mold”—can produce mycotoxins, toxic compounds that can enter the body through inhalation, ingestion, or skin contact.
Mold toxicity is distinct from mold allergy: rather than an allergic reaction to spores affecting the respiratory symptom, it involves the accumulation of mycotoxins in the body and the multi-system inflammatory responses this can trigger, which can be measured and diagnosed directly through medical testing.
Genetic susceptibility and mold-related illness
Roughly 25% of people have a genetic variation in the HLA-DR and HLA-DQ alleles that affects the body’s ability to recognize and clear mycotoxins such that illness persists even after removing exposure to mold.
Especially among these individuals, prolonged exposure to mycotoxins can lead to Chronic Inflammatory Response Syndrome (CIRS), a multi-system inflammatory condition, the diagnosis and treatment of which was pioneered by Dr. Ritchie Shoemaker beginning in the 1990s.
CIRS is actively studied and treated by a growing number of specialized doctors, but it remains outside standard clinical practice and is often misdiagnosed as Myalgic Encephalomyelitis or “Chronic Fatigue Syndrome” or otherwise more colloquially as a chronic mystery illness.
Prolonged chronic illness like CIRS can result in not only negative physical but also psychological and related neurological effects, for which targeted recovery programs such as the Dynamic Neural Retraining System are increasingly emerging.
CIRS has been referred to as a ‘silent epidemic’: an estimated 50% of buildings in the US are water-damaged, and with 25% of the population having a genetic predisposition for CIRS, simple math indicates that tens of millions of people in the US are susceptible to developing mold toxicity.
Treatment access, cost, and socioeconomic implications
Because CIRS and mold toxicity are not broadly recognized within conventional medicine, many affected individuals seek care through integrative or functional medicine providers, often paying out of pocket for steep medical expenses due to limited insurance coverage.
The symptoms of CIRS can be severe enough to become disabling and thereby affect employment.
Collectively, these circumstances can disproportionately impact renters and lower-income individuals who have less control over housing conditions, less means to remediate or relocate, less flexible employment conditions, and more limited ability to absorb medical costs.
More information and resources
Policy and advocacy: Change the Air Foundation
Medical community: International Society for Environmentally Acquired Illness
Accessible texts by medical experts: Toxic by Neil Nathan, MD and Break the Mold by Dr. Jill Crista