This guide was created by the ISEAI Indoor Environmental Professional (IEP) Committee. Please read the disclaimer at the end of the article.

When you or a loved one suffers from an Environmentally Acquired Illness (EAI) such as mold-related illness, your home/workplace are often looked at as potential sources of exposure. If exposure sources (ex: a leak inside a wall, leading to mold growth) are found during an onsite assessment by an Indoor Environmental Professional (IEP) assessor, they may suggest a plan for mold remediation to be performed by a separate company.

What is Mold Remediation?

Mold growing indoors is not normal and poses a risk of health hazards. Mold remediation is the process that physically removes microbial growth and associated contaminants. Effective mold remediation is a complex process. Although simplistic, ‘cure-all’ mold remediation services and products abound, such offerings rarely address the root causes needed to restore healthy indoor air quality. Many practices that are common in the mold remediation industry, such as using chemicals to kill mold, can be harmful to medically-sensitive individuals.

For sensitive and chronically ill patients working with an EAI physician (ISEAI’s list here), it is usually best to work with a medically-sound assessor to locate exposure sources in a more detailed way. Following a proper assessment, special remediation approaches may be suggested that meet or go above and beyond voluntary industry standards. A medically-sound remediator is experienced with these patients and their special needs and has the experience and skills to perform a more detailed remediation.

Where Can I Find a Medically-Sound Assessor and/or Remediator?

Click here for ISEAI’s list of IEP assessor and remediator members.

Also see the ISEAI IEP Committee’s Mold Testing Guide and Mold Remediation Factsheet on the Resources page.

Remediation is Typically One Step Within a Larger Framework

Assess > Remediate > Reconstruct > Small Particle Cleaning > Maintenance

Medically-sound mold remediation involves a separate company following the assessor’s written plan to physically remove mold (or other microbial growth) and contaminated building materials using specialized methods, and taking steps to ensure the sources aren’t a problem in the future.

The scope and cost of a medically-sound mold remediation project can vary greatly.

Note: “Remediate” as stated in the framework above should already include detailed cleaning within the remediation work area (according to the voluntary standard described below). “Small particle cleaning” as stated in the framework above refers to cleaning steps outside of/beyond the work area, such as a whole-house cleaning.

What is an Assessor?

Assessors (inspectors) perform on-site inspections of residential and commercial properties using visual inspection and instruments, suggest and interpret tests, create a written report with recommendations for remedy, and can also oversee a remediation plan. See Finding the Right Indoor Environmental Professional to Assess Your Home for more information.

For medically-affected people, ISEAI recommends that you always have a complete, independent assessment prior to undertaking mold remediation for the first time. People who begin a mold remediation project without a full picture of the water damage and/or air quality problems in the home commonly waste tens of thousands of dollars in incomplete, ineffective, and/or repetitive remediation work.

An Indoor Environmental Professional (IEP) is an umbrella term used in the industry to describe a professional in the field of indoor environmental assessment or remediation. It is not a specific certification.

What is a Remediator?

A trained and certified medically-sound remediation company typically works off a remediation protocol (written by an independent assessor) to address the areas affected by mold and moisture. The remediation company performs the work to physically remove mold, other microbial growth, and contaminated building materials. Proper containment during this work, and detailed cleaning within the work area are critical.

Licenses and Certification for Remediators

Please keep in mind that there are a handful of US states that require licensing in the mold industry, and they require separate licenses for mold assessors and mold remediation companies, to avoid conflicts of interest. By law, the licenses must be current with continuous education and insurance coverage.

However, having any license and/or certification doesn’t guarantee competency in working with patients with environmentally acquired illness (EAI).

Also consider that some companies tout the owners’ or founders’ credentials but they may be more of a figure-head and do not actually perform or supervise the remediation. Ideally, you want the most experienced and the most credentialed remediator to be performing or supervising the actual onsite work (often carried out by a team). So, find out who the remediation team will be for your project, what supervisor you’ll be communicating with and how often, and how involved with the job they will be (supervising in person full time vs period check ins). You want to make sure the assessor’s step-by-step remediation plan is being followed.

Defining Roles

Important: Your remediation contractors should be independent of your assessor and have no financial incentive or conflict of interest in any services. If, for some reason, the remediation contractors are not independent (e.g. they work for the same company as your assessor), this should be clearly disclosed up front in writing to minimize any conflicts.

What Standards Should Your Remediator Meet?

ISEAI endorses the ANSI/IICRC S520 Standard for Professional Mold Remediation.

It is important to understand that in most U.S. states, remediation standards are completely voluntary. Not all remediators follow or are aware of the ANSI/IICRC S520 standard.

ISEAI further states that for medically-sensitive patients, some steps above and beyond the ANSI/IICRC S520 standard are commonly needed. For example, sensitive patients tend to do better when there is a detailed, multi-pass cleaning process performed within the entire remediation work area. Most sensitive patients also do better when a small particle cleaning of the entire house is performed, following a meaningful mold exposure and remediation.

In addition to the technical work standards, medically-sensitive patients need a remediation company who is able to collaborate with them to design a process for their specific remediation that keeps them feeling well. Please see the list of questions below for important considerations in this regard.

Questions to Ask Remediation Companies When Getting Bids

If you are a sensitive patient seeking medically-sound remediation, there are some extra questions you should ask any remediation companies you’ll be working with:

  • What experience does your company have with sensitive patients and my assessor? How many jobs have been performed for sensitive patients and what were the outcomes?
  • Who will be the supervisor and point of contact for my remediation and what credentials do they and their workers carry? Will the supervisor be onsite at all times or just periodically? How often will the supervisor check in with me?
  • Will the client (me) be invited to visually review and approve work progress with the supervisor at key points prior to beginning the next phase of work?
  • Do you:
    • Follow ANSI/IICRC S520 standards or even go beyond them for sensitive patients?
    • Set up plastic containments (temporary walls around sources) for every proposed work area prior to remediation?
    • Use engineering controls such as HEPA air filtration devices (AFDs) inside containments and exhaust contaminants to the outdoors?
    • Focus on physically removing mold and contaminants? Versus using products or chemicals to treat, fog, seal, or ‘kill’ mold (including quats, phenols, or sodium hypochlorite)? Would you be comfortable using only unscented dish soap in your wet cleaning process, if asked to do so by the assessor?
    • If any chemicals are typically used, can we see a list and decide not to use some/all? Can you work collaboratively with myself, my assessor, and/or my physician, to determine what the best products are to use for remediation?
    • Perform multiple rounds of cleaning inside containments? (HEPA vacuum, damp wipe, dry wipe)?
    • Carefully follow an assessor’s step-by-step remediation plan which defines exactly what steps to take for different exposure sources? Or can you outline such a protocol, prior to performing any work?
  • What guarantees are in place?
    Note for consumers: The scope of work including all agreed-upon expectations and practices must be in writing in order to be enforceable, typically. If many guarantees and reassurances are given over the phone, please ensure that the contract that you sign contains the same statements.
  • If my assessor’s ‘clearance’ criteria (to reflect a completed, successful project) aren’t met, or containment is significantly breached, do they charge extra to complete the work correctly?
  • Are you licensed (if applicable – only applies to certain states) and insured? Can you provide a Certificate of Additionally Insured to me?
  • Can you provide a quote (bid) for the plan my assessor has outlined? (Note: You may want your assessor to review the bid or vet the contractor)

Who Created this Article?

The ISEAI Indoor Environmental Professional (IEP) Committee is a group of highly credentialed and experienced indoor environmental professionals who have specialized experience with medically-sensitive patients. The IEP Committee reports to the ISEAI Board of Directors and provides education to clinicians and the public on topics of mold, indoor air quality and contaminants.

Disclaimer:
Remediation is a complex process and involves almost infinite variables. This article should not be taken as individualized advice, because it is not. We hope the principles contained herein are useful to your research, as you undertake the hiring of your own professionals. If you are medically-affected by mold, please seek advice from your own medical and medically-sound indoor environmental professional.

Why we wrote this article:
At ISEAI non-profit, we want you to be successful in restoring health, if that is your goal. Remediation is a complex process requiring a lot of management and expertise on the part of the client. For this reason, we believe it is important for most consumers to have an advisor and advocate on your side, who is not financially tied to the remediation. This typically happens when you hire an independent medically-sound assessor. In some situations, you might ‘consult with’ an assessor without having them perform a full inspection. The details are up to you, but if possible, it is best not to go through remediation without professional advocacy and support.