title: Higher Environmental Relative Moldiness Index (ERMI) values measured in homes of asthmatic children in Boston, Kansas City, and San Diego.
abstract: OBJECTIVE
  Mold in water-damaged homes has been linked to asthma. Our objective was to test a new metric to quantify mold exposures in asthmatic children's homes in three widely dispersed cities in the United States.
  
  
  METHODS
  The Environmental Relative Moldiness Index (ERMI) metric was created by the US Environmental Protection Agency, with assistance by the Department of Housing and Urban Development (HUD), to quantify mold contamination in US homes. The ERMI values in homes of asthmatic children were determined for the three widely dispersed cities of Boston, Kansas City, and San Diego.
  
  
  RESULTS
  Asthmatic children in Boston (n = 76), Kansas City (n = 60), and San Diego (n = 93) were found to be living in homes with significantly higher ERMI values than were found in homes randomly selected during the 2006 HUD American Healthy Homes Survey (AHHS) from the same geographic areas (n = 34, 22, and 28, respectively). Taken together, the average ERMI value in the homes with an asthmatic child was 8.73 compared to 3.87 for the AHHS homes. In addition, Kansas City homes of children with "Mild, Moderate, or Severe Persistent Asthma" had average ERMI value of 12.4 compared to 7.9 for homes of children with only "Mild Intermittent Asthma." Aspergillus niger was the only mold of the 36 tested which was measured in significantly greater concentration in the homes of asthmatic children in all three cities.
  
  
  CONCLUSIONS
  High ERMI values were associated with homes of asthmatic children in three widely dispersed cities in the United States.
authors.affiliation: National Exposure Research Laboratory (NERL), United States (US) Environmental Protection Agency, Cincinnati, OH 45268, USA. vesper.stephen@epa.gov
authors.forename: Stephen
authors.initials: S
authors.lastname: Vesper
authors.forename: Charles
authors.initials: C
authors.lastname: Barnes
authors.forename: Christina E
authors.initials: CE
authors.lastname: Ciaccio
authors.forename: Alan
authors.initials: A
authors.lastname: Johanns
authors.forename: Kevin
authors.initials: K
authors.lastname: Kennedy
authors.forename: Johnna S
authors.initials: JS
authors.lastname: Murphy
authors.forename: Arcela
authors.initials: A
authors.lastname: Nunez-Alvarez
authors.forename: Megan T
authors.initials: MT
authors.lastname: Sandel
authors.forename: David
authors.initials: D
authors.lastname: Cox
authors.forename: Gary
authors.initials: G
authors.lastname: Dewalt
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ashley
mesh_terms: D000391:Air Microbiology; D001249:Asthma / Q000382:microbiology*; D002648:Child; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D005658:Fungi / Q000235:genetics / Q000276:immunology*; D006798:Housing / Q000592:standards; D006801:Humans; D053208:Kaplan-Meier Estimate; D016133:Polymerase Chain Reaction; D014481:United States; D014484:United States Environmental Protection Agency
chemical_list: D004271:DNA, Fungal