Eugene C. Cole, DrPH – Research to Practice: Water Damage, Sewage, Mold & Public Health

Air Date: 4-12-2019|Episode 542

This week we look forward to our interview with Eugene C. Cole DrPH. Dr. Gene Cole is Director of Research for LRC Indoor Testing & Research, Cary, NC; and formerly Professor of Environmental Health Sciences at Brigham Young University, Provo, UT. He has 35 years of research experience, with a primary focus on the ecology of indoor and work environments, with special emphasis on identification and reduction of pollutant reservoirs and sources, bioaerosols, human exposure assessment and control, product evaluation, cleaning and restoration, mold and sewage remediation, and biocides.

Since 2000, he has continued to conduct research on the relationship between the use of antibacterial cleaning and hygiene products in the home, and antibiotic resistance; as well as on the effectiveness of cleaning to reduce the transmission of disease agents in schools. He has also worked with national and international organizations to address environmental health and infectious disease concerns such as medical waste management in Central Europe and South East Asia, hygiene promotion in Africa, and healthy homes and buildings in the U.S. and Asia.

Dr. Cole is a member of the Scientific Advisory Council of the Cleaning Industry Research Institute (CIRI), and a Fellow of the American Industrial Hygiene Association. He holds a Master of Science in Public Health Microbiology and a Doctor of Public Health in Biohazard Science and Occupational Health, both from the University of North Carolina at Chapel Hill.

Z-Man’s Blog:

Research to Practice: Water Damage, Sewage, Mold & Public Health

Dr. Gene Cole is Director of Research for LRC Indoor Testing & Research, Cary, NC; and formerly Professor of Environmental Health Sciences at Brigham Young University. He has 35 years of research experience, with a primary focus on the ecology of indoor and work environments, with special emphasis on identification and reduction of pollutant reservoirs and sources, bioaerosols, human exposure assessment and control, product evaluation, cleaning and restoration, mold and sewage remediation, and biocides.

Nuggets mined from today’s episode:

For 10 years, prior to attending graduate school, Dr. Cole was a clinical microbiologist where he identified infectious agents that cause disease. His interest widened and he began also considering exposure scenarios and risks. He became interested in public health in grad school where he gained experience in research and investigation. After the legionella outbreak in Philadelphia, PA he began investigating legionella. He found that bacteria in airborne dust from soil found its way into cooling towers where it colonized and proliferated.

His first home inspection was for a Chapel Hill professor who was debilitated and couldn’t work. His symptoms included muscle aches, fatigue, and respiratory problems. After 2 years of medical treatment he was feeling better when he became hypersensitive and was reacting to his home environment. He had a violent reaction to his daughter’s new hair spray. The professor’s lung disorder progressed to where it became life threatening. Along with a team, Dr. Cole moisture mapped the home, inspected the crawl space, HVAC system, etc. They found that the plumber never soldered the water pipe connection to the shower head. Unbeknownst, when showering water was being sprayed into the wall cavity. When the wall cavity was opened the drywall was black with mold and bacteria. When Dr. Cole suggested that the professor consider moving, the professor wasn’t agreeable. Notable challenges are association and causation and behavioral changes (stubbornness).

Formaldehyde emission from building materials and products.

“Asbestos guns” hair dryers from the 1970s-80s that contained asbestos.

We learn as we go along from one another, from science, research, and practical experience. He has a unique ability to glean from science what the general population needs to know and then translate that information into good general advice on issues such as: moisture management, HVAC, carpeting, reducing cancer risks (diet, sunscreen).

When a damage related structural drying is considered complete should be based upon the regional climate and the accepted norms for acceptable moisture levels in materials.

While at BYU he supervised a study of 25 owner occupied homes which had been occupied by the owners for a minimum of 10 years. The team looked at both the exteriors and interiors of the homes. Home owners were queried about history of moisture incidents, leaks, sewage backups, respiratory problems, etc. The team was answering the question “where does the water go?” The team found problems which homeowners weren’t aware of such as:sewage leaks, flooding, ineffective landscape grading, gutter and downspout installation errors, pooling of water, lawn sprinklers spraying on building facades, aquarium acting as humidifier, etc.

In an upcoming webinar for the EPA on the subject of post remediation verification by water damage remediation done by homeowners, Gene will advise: 1) does it look clean? 2) does it feel dry? 3) does it smell?

Trying to standardize cleaning protocol to protect kids in school, the CIRI/ISSA study evaluated 27 schools using ATP as a marker. ATP is the energy source of living cells. The researchers are still struggling with adopting standardization of ATP for use in evaluating cleaning efficacy. There was variability within the study. There was no correlation between ATP values and actual bacterial counts. The study has established an approach for use in schools. School data would not be appropriate for use in hospitals, or after water damage or catastrophic flooding.

Regarding ATP, progress has been made, we aren’t there yet.

Article in CIRI Science on sewage composition. It’s not your father’s sewage which was just human waste. Today’s sewage includes a widely expanded list of chemicals, hygiene and medical compounds. Most Americans use antibiotics 1-2 times per year. We excrete them partially broken down. Microbes are becoming more resistant to antibiotics. For some health issues doctors may be limited to only 1 antibiotic which may or may not be effective. Emerging pathogens: A strain of Staph is resistant to all antibiotics. TB is re-surging including strains of antibiotic resistant TB. Toxigenic E. Coli.

Mental health drugs, chemo therapy drugs, birth control pills, hormones find their way into the sewer system. There are male fish with ovaries in the Potomac river; which provides drinking water to 5 million people. Drugs aren’t broken down by the sewage treatment process. What’s in our sewage becomes our drinking water. Sewage is sprayed on crops. Parasites live in sewage. Industrial chemicals while useful, are misused when disposed of in sewage systems.

The gut flora of some sewage workers has been studied and found to be abnormal reflecting what is found in the plant.

There are increases in breast cancer and human infertility. Is this caused by the environment, food or water?

Remediation workers need both PPE and immunizations. NIOSH research funds are focused on the largest number of workers effected.

The media driven public fear of “toxic black mold” resulted in Industry overreach and some scams. He recounted the story of a California homeowner who had a mold problem. For which one contractor’s proposal was to open the moldy wall cavities and a window and use a leaf blower to blow all the mold out of the home.

Dr Cole is impressed by the restoration industry with whom he has interacted since the late 1980s.

Pete Consigli:

Complimented Dr. Cole on the great work he did with the industry in the late 1980s and 1990s. Suggested that John Downey had put up a fence corralling Gene and Steve Spivak from retiring. Opined that CIRI should consider resurrecting Cleaning for Health Symposiums in 2020. Opined that Gene should steer the CIRI Science Advisory Council. Recalled that Gene had participated with him in 2 MEHRC Cleaning for Health seminars.

At a Cleaning for Health event, Doctor Peter V explained that in Europe cleaning people are considered building caretakers and are held in high regard. In the US where cleaning and maintenance are deferred and frequent target of cost cutting. The US will always have IEQ problems until they change hearts and minds.

Richard Shaughnessy’s Tulsa University Cleaning for Health events were groundbreaking stuff.

Dr. Cole’s final comments:

Cleaning for Health means maximizing physical removal while minimizing chemical and moisture residues.

Dr. Cole will be participating in a panel discussion on cleaning and disinfection in long term care facilities. These facilities have susceptible populations and serious superbugs. Candida auris is a species of fungus first described in 2009, which grows as yeast. It is one of the few species of the genus Candida which cause candidiasis in humans. Often, candidiasis is acquired in hospitals by patients with weakened immune systems. Wikipedia C diff Clostridioides difficile (also known as C. diff) is a bacterium that causes diarrhea and colitis (an inflammation of the colon).It’s estimated to cause almost half a million illnesses in the United States each year.About 1 in 5 patients who get C. diff will get it again within a month of diagnosis, 1 in 11 people over age 65 died of a healthcare-associated C. diff infection.

Dr Cole is pro-biocide and opines that most work well. He opines the EPA should require end use testing. He said that botanical thyme oil biocides are effective, popular, liked by consumers and contractors, and are appropriate for Cat 3 losses.

Biocides should be used according to label instructions.

Biocides are part of the solution, NOT the solution.

Z-Man signing off


Name the heterogeneous group of gram-positive, generally anaerobic bacteria noted for a filamentous and branching growth pattern that results, in most forms, in an extensive colony, or mycelium?


Actinomycete, (order Actinomycetales)

John Lapotaire, IAQsolutions Florida