Keith Berndtson, Scott W. McMahon,Mary Ackerley, Sonia Rapaport, Sandeep Gupta, Ritchie C. Shoemaker Center for Research on Biotoxin Associated Illness, Pocomoke, MD Corresponding author: K Berndtson: firstname.lastname@example.org
ABSTRACT Evidence supports a cause-effect relationship between exposure to the air and dust in water-damaged buildings (WDBs) and chronic inflammatory response syndrome (CIRS). This syndrome has an increased relative risk associated with specific HLA genotypes. CIRS-WDB is mediated by a persistent innate immune inflammatory response to toxins, antigens, and inflammagenspresent in the interior environment of WDBs. Dose-response relationships in this condition are supralinear in nature. For patients with CIRS-WDB, current methods of WDB investigation and remediation are often not sufficient to prevent a relapse of symptoms with re-exposure. CIRS-WDB is a growing public health hazard best addressed by collaboration among experts in CIRS-WDB medicine,indoor air quality, remediation, and moisture-controlled building design and construction. Assessments of human health effects associated with exposure to WDBsbefore and after remediation are mandatory to ensure adequacy of remediation efforts.