This paper reviews the electronic literature database (PubMed-MEDLINE) for all English language publications containing reference to the Environmental Relative Moldiness Index (ERMI). A total of 30 relevant studies were identified. The ERMI is a first generation genomic fingerprinting method to analyse DNA at the level of strain or subspecies and is widely used as a tool to monitor hospital infections, for epidemiological investigations or to confirm or negate taxonomic identity. Between 2006-2016, 30 articles used ERMI, principally to correlate the home living environment with asthma risk. The ERMI uses 36 moulds in a dust sample to assess hygiene as a way to index potential asthma triggers. There is general agreement between high ERMI values and child-asthma occurrence in the household, but the value of ERMI is limited to measuring mould burdens rather than offering a dichotomous classification approach into mouldy versus non-mouldy homes. ERMI is licensed as a “research-only” tool by the USA EPA. Unfortunately, many Companies in the restoration industry are being led to believe that ERMI can simultaneously provide both a taxonomic ranking and provide quantitative assessment of overall risk from mould or their aeroallergens. Dominant Genera/Species seen in high ERMI homes includes: Aspergillus niger, Aspergillus fumigatus, Chaetomium, Eurotium, Scopulariopsis, Stachybotrys, Trichoderma and Wallemia. In order to comprehensively evaluate a home having multiple spanning rooms, we propose there is a fundamental aim for source detection (hidden water/building faults) and local concentration profiling coupled with a detailed visual and analytical inspection process (moisture readings, infrared, particulate matter counts, etc.). Since water damage inspections are commonly undertaken for Insurance purposes (as well as health reasons), the ERMI with its reliance on single or limited samples is a reductionist approach not showing suitable fine-grained resolution that can already be obtained from alternative, established, viable and non-viable methods capable of identifying >36 fungi. A model for a holistic water damage inspection process with case studies from Sydney and Melbourne is presented.