EMMA

The Environmental Mold and Mycotoxin Assay (EMMA) by RealTime Laboratories is a specialized test designed to assess the presence of mold and mycotoxins within indoor environments. By analyzing dust samples collected from a living or working space, EMMA identifies 10 of the most toxic molds and 16 harmful mycotoxins they produce. 

This test is useful for identifying environments affected by potentially hazardous mold exposure: mycotoxins can be detrimental to human health, causing a wide range of symptoms and conditions. [8., 13.]

Who should get an EMMA test?

The Environmental Mold and Mycotoxin Assay (EMMA) test by RealTime Laboratories is particularly useful for individuals and professionals concerned with indoor air quality and its impact on health. Here are some groups who should consider getting an EMMA test:

Individuals with Unexplained Health Symptoms: People experiencing chronic symptoms such as fatigue, headaches, respiratory issues, skin irritation, and cognitive impairments without a clear diagnosis, especially if they do not respond as expected to medical treatments, might benefit from the EMMA test. These symptoms can sometimes be attributed to mold and mycotoxin exposure. [13.]

Homeowners and Tenants: If you live in or are considering purchasing a home that has a history of water damage, visible mold growth, or a musty odor, the EMMA test can help assess the risk of mold and mycotoxin exposure in your living environment. [5.]

Real Estate Professionals: Before buying or selling property, especially those with known issues of dampness or water damage, conducting an EMMA test can provide valuable information about the presence of mold and mycotoxins, potentially affecting the property's value and livability.

Healthcare Professionals: Doctors and healthcare providers treating patients with chronic, unexplained illnesses that could be related to environmental exposures may recommend the EMMA test to rule out or confirm current mold and mycotoxin exposure as a contributing factor. [13.]

Environmental Health Specialists: Professionals tasked with assessing and improving indoor air quality in homes, schools, offices, or public buildings can use the EMMA test to identify specific mold and mycotoxin threats and guide remediation efforts. [5.]

Schools and Childcare Facilities: To ensure a safe environment for children, who are particularly vulnerable to the adverse health effects of mold and mycotoxins, these facilities may undergo testing, especially after incidents of water damage or when indoor air quality concerns arise. [5., 8.]

Occupational Health and Safety Officers: In workplaces with potential mold exposure risks, such as older buildings, industrial sites, or those affected by water leaks, the EMMA test can help in assessing the environment and implementing safety measures to protect employees.

The EMMA test is a tool for anyone concerned about the potential health impacts of mold and mycotoxin exposure in their environment. By identifying the presence of toxic molds and mycotoxins, individuals and professionals can take informed steps towards mitigation and remediation, thereby improving health and safety.

What does the EMMA test for?

The Environmental Mold and Mycotoxin Assay (EMMA) test by RealTime Laboratories is designed to detect the presence of specific molds and mycotoxins in indoor environments. This test focuses on identifying 10 of the most toxic molds and 16 harmful mycotoxins produced by these molds, offering a detailed assessment of the potential health risks associated with mold-contaminated environments.  Here's a brief overview of what the EMMA test screens for:

Toxic Molds

The EMMA test targets 10 toxic molds known for their adverse health effects. These molds are commonly found in water-damaged buildings and can cause a variety of health issues, ranging from respiratory problems to more severe conditions affecting the nervous system, immune system, and more. The specific molds tested are chosen based on their toxigenicity and prevalence in indoor environments; their toxigenicity is determined by the type and toxicity of the mycotoxins they produce.  The EMMA tests for the following molds:

Aspergillus fumigatus

Aspergillus ochraceus

Aspergillus flavus

Aspergillus terreus

Aspergillus niger

Penicillium brevicompactum

Aspergillus versicolor

Candida auris

Chaetomium globosum

Fusarium solani

Stachybotrys chartarum

Penicillium chrysogenum

Harmful Mycotoxins

The test also identifies 16 mycotoxins, which are toxic substances produced by molds. These mycotoxins include:

Zearalenone: Known for its estrogenic effects and potential to cause reproductive issues. [11.]

Ochratoxin A: Associated with kidney damage and carcinogenic effects. [7., 10.]

Verrucarin J: Potentially involved in immune system suppression. [4.]

Isosatratoxin F: A potent mycotoxin with immune-altering and cytotoxic properties. [5., 6.]

Roridin H, A, L-2, E: Part of a group of mycotoxins known as trichothecenes, which inhibit protein synthesis and can cause a wide range of health effects.  [4., 9.]

Aflatoxin B1, G1, G2, B2: Considered among the most carcinogenic substances, primarily affecting the liver. [2.]

Verrucarin A: Another trichothecene with toxic effects on cells and the immune system. [5.]

Gliotoxin: Suppresses the immune system and is commonly associated with exposure to Aspergillus species.  [12.]

Satratoxin G, H: Highly toxic trichothecenes that can cause severe respiratory and immunological effects. [3., 9.]

These mycotoxins are significant because they can persist in the environment even after the molds that produced them are no longer present. Exposure can occur through inhalation, ingestion, or skin contact, leading to a range of health problems depending on the type and level of exposure.

Sample type and collection instructions

For the Environmental Mold and Mycotoxin Assay (EMMA) test by RealTime Laboratories, the sample collection process is straightforward, requiring dust samples from your environment. Here's a simplified guide on how to collect your samples and prepare them for shipping:

Sample Type

Dust samples are needed for the EMMA test. These samples can be collected from various sources within your living or working space to test for mold and mycotoxins.

Preparation & Timing

No special preparation is needed before collecting the samples.

Collection Instructions

Wear Latex Gloves: To avoid contaminating the samples, put on a pair of latex gloves before starting the collection process.

Number of Samples: You may collect 1-3 samples depending on the areas you wish to test. Ensure to record the number of samples on the Chain of Custody form.

Sample Options

Visible Mold: Use the provided swab or gauze to collect a sample of the mold. Place the collected sample into the provided biohazard bag.

Dust from Air Conditioner Filters: Gather 1-3 grams of dust (roughly the size of a cotton ball) and place it into the provided biohazard bag or a clean ziplock bag.

Dust from Vents: Dampen the provided cotton swab or gauze with tap water. Swipe it over the vent to collect 1-3 grams of dust, then place it into the provided biohazard bag or a clean ziplock bag.

Chain of Custody Form: Complete this form, noting the number of samples collected, and include it with your shipment.

Requisition & Payment

The test kit is prepaid, so no additional payment is needed. Make sure to fill out the Chain of Custody form but skip the payment information section.

Shipping Instructions

Prepare Package: Place the sample bag(s) and the completed test forms into the provided shipping envelope. Seal it securely.

Tracking: Note the tracking number on the return label for your records.

Drop Off: Take the package to the nearest FedEx location. Do not use a drop box for sample submission.

Results

Your test results should be available 7-10 business days after the laboratory receives your samples. Please note that processing times may vary, and Rupa Health cannot guarantee a specific timeframe.

Following these steps ensures your samples are collected and submitted properly for accurate analysis by RealTime Laboratories.

References

[1.] Brewer, J., et al. Detection of Mycotoxins in Patients with Chronic Fatigue Syndrome.Toxins 2013, 5, 605-617; doi:10.3390/toxins5040605 

[2.] Dhakal A, Hashmi MF, Sbar E. Aflatoxin Toxicity. [Updated 2023 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557781/

[3.] Gottschalk C, Bauer J, Meyer K. Detection of satratoxin g and h in indoor air from a water-damaged building. Mycopathologia. 2008;166(2):103-107. doi:https://doi.org/10.1007/s11046-008-9126-z

[4.] Hughes BJ, Hsieh GC, Jarvis BB, Sharma RP. Effects of macrocyclic trichothecene mycotoxins on the murine immune system. Arch Environ Contam Toxicol. 1989 May-Jun;18(3):388-95. doi: 10.1007/BF01062363. PMID: 2786385.

[5.] Jarvis BB, Sorenson WG, Hintikka EL, Nikulin M, Zhou Y, Jiang J, Wang S, Hinkley S, Etzel RA, Dearborn D. Study of toxin production by isolates of Stachybotrys chartarum and Memnoniella echinata isolated during a study of pulmonary hemosiderosis in infants. Appl Environ Microbiol. 1998 Oct;64(10):3620-5. doi: 10.1128/AEM.64.10.3620-3625.1998. PMID: 9758776; PMCID: PMC106476.

[6.] Lee MG, Li S, Jarvis BB, Pestka JJ. Effects of satratoxins and other macrocyclic trichothecenes on IL-2 production and viability of EL-4 thymoma cells. J Toxicol Environ Health A. 1999 Aug 13;57(7):459-74. doi: 10.1080/009841099157548. PMID: 10494915.

[7.] Malir F, Ostry V, Pfohl-Leszkowicz A, Malir J, Toman J. Ochratoxin A: 50 Years of Research. Toxins. 2016; 8(7):191. https://doi.org/10.3390/toxins8070191

[8.] Mustonen K, Karvonen AM, Kirjavainen P, Roponen M, Schaub B, Hyvärinen A, Frey U, Renz H, Pfefferle PI, Genuneit J, Vaarala O, Pekkanen J. Moisture damage in home associates with systemic inflammation in children. Indoor Air. 2016 Jun;26(3):439-47. doi: 10.1111/ina.12216. Epub 2015 May 23. PMID: 25924948. 

[9.] Pestka JJ, Yike I, Dearborn DG, Ward MDW, Harkema JR. Stachybotrys chartarum, Trichothecene Mycotoxins, and Damp Building–Related Illness: New Insights into a Public Health Enigma. Toxicological Sciences. 2007;104(1):4-26. doi:https://doi.org/10.1093/toxsci/kfm284

[10.] Pfohl-Leszkowicz A. Ochratoxin A and aristolochic acid involvement in nephropathies and associated urothelial tract tumours. Arh Hig Rada Toksikol. 2009 Dec;60(4):465-83. doi: 10.2478/10004-1254-60-2009-2000. PMID: 20061248.

[11.] Ropejko K, Twarużek M. Zearalenone and Its Metabolites-General Overview, Occurrence, and Toxicity. Toxins (Basel). 2021 Jan 6;13(1):35. doi: 10.3390/toxins13010035. PMID: 33418872; PMCID: PMC7825134.

[12.] Stanzani M, Orciuolo E, Lewis R, et al. Aspergillus fumigatus suppresses the human cellular immune response via gliotoxin-mediated apoptosis of monocytes. Blood. 2005;105(6):2258-2265. doi:https://doi.org/10.1182/blood-2004-09-3421

[13.] Straus, D.  Molds, mycotoxins and sick building syndrome. Toxicology and Industrial Health.  2009; 25(9-10) 617-635. Doi: 10.1177/0748233709348287.