The American College of Occupational and Environmental Medicine

[Guest guest]

Dear Ms. Shah,

Please encourage the members of the ACOEM to retract the position statement

regarding indoor mold and authored by Dr. Kelman, Dr. Hardin and Dr. Saxon,

immediately.

With the Surgeon General's Workshop upcoming, it would be an excellent time

to do so in the midst of the ACOEM's peers. Many people are being

unnecessarily damaged by the misinformation this position paper has been

allowed to

present to the general public.

Sincerely,

Sharon Kramer

How two Phd’s who are principals in a company called GlobalTox, Inc., a

company known to make much income from insurance company defense support in

mold

litigation, were able to take a small study, (with uncontrolled samplings and

no measurement of toxins in spores), of a 24 hour exposure to mold in mice

and turn it into the publicly accepted position that indoor mold is not a

health threat to humans.

The National Institute of Health does not agree that Dr. Hardin’s and Dr.

Kelman’s findings are relevant in understanding adverse human health effects

from toxinogenic mold exposure in homes, schools and office environments:

Institute of Medicine, National Institute of Health, Damp Indoor Spaces

Report, May 25, 2004

Chapter 4

" ….. toxicologic studies of mycotoxins are acute or short-term studies that

use high exposure concentrations to reveal immediate effects in small

populations of animals. Chronic studies that use lower exposure concentrations

and

approximate human exposure more closely have not been done…â€

************************************************************************

Meet the 2004–2005

Society of Toxicology

PresidentDr. S. Birnbaum

President's Message

Winter 2005

(yes — they need to disclose for whom they work when they serve on advisory

panels), and a very small number of toxicologists who work for non-government

organizations (NGOs). There is a real need to include the NGOs in our SOT

umbrella, as they represent a viewpoint which often carries a great deal of

weight, and unfortunately may not be based on the latest scientific

information.

________________________________________________________________________

Ethical, Legal, and Social Issues Specialty Section

Officers 2004

G. Gilbert, INND—President

Jacques Maurissen, Dow Chemical Company,—Vice President

Spencer R. Mortensen, Syngenta Crop Protection, Inc.—Secretary/ Treasurer

Bernard Weiss, University of Rochester—Councilor

Bruce Kelman, GlobalTox—Councilor.

In the exercise of their functions toxicologists constantly face a number of

situations that may have direct or indirect ethical, legal and social

ramifications. Results from toxicological research are widely used by policy

makers, regulatory agencies, lawyers, non-governmental organizations and the

public to establish legal rules and public policy.

The new Specialty Section will provide a forum in which to discuss the

ethical implications of results from our science as well as the resulting legal

and social implications.

* To explore the contributions and implications of toxicological based

research on bioethical thinking and public policy.

*

********************************************************************************\

**

(http://www.globaltox.com/)

Bruce J. Kelman, Ph.D., D.A.B.T., is a Principal in GLOBALTOX, Inc. with

approximately 25 years experience in toxicology and has served as a consultant

and expert witness in numerous investigations across North America. He has

evaluated numerous claims of personal injury and health impacts from many

chemicals, and has presented a variety of health risk concepts to policy

makers,

government regulators, citizen groups, and individuals involved in all aspects

of the legal process.

Dr. Kelman is a member of the Society of Toxicology, American College of

Toxicology, American Society for Experimental Pharmacology and Therapeutics,

Society for Experimental Biology and Medicine, Teratology Society, American

Physiological Society, Radiation Research Society, American College of

Occupational and Environmental Medicine, and a Fellow of the American Academy

of

Veterinary and Comparative Toxicology. He served as a member of the National

Research Council/National Academy of Science Committee on Possible Effects of

Electromagnetic Fields on Biologic Systems.

GLOBALTOX's toxicologists use their knowledge of industry guidelines and

national and international regulations to characterize risks from exposure to

occupational or environmental chemicals and drugs. We have conducted

health-effects evaluations of a variety of contaminated environmental sites and

have

experience with numerous air and water quality issues.

Expert Support of Litigation

GLOBALTOX toxicologists have evaluated numerous claims of personal injury

and health impacts from many chemicals, and have presented a variety of health

risk concepts to policy makers, government regulators, citizen groups, and

individuals involved in all aspects of the legal process.

GLOBALTOX frequently provides expert testimony before hearing boards and the

courts in matters of toxicology, and environmental science.

GLOBALTOX Clinical Research services include:

· Recruitment of qualified clinical investigators; (meaning,

they hire people who will generate the air quality tests that GlobalTox will be

evaluating for their clients.)

· On-site monitoring of clinical trials and site management;

* Assistance with statistical analysis of study data;

* Provision of _Expert Review_

(http://www.globaltox.com/expertpanel.htm) and interpretation of other evidence

and scientific literature;

* Interpretation and presentation of scientific issues to regulatory

officials on behalf of our clients;

* Provision of scientifically defensible and effectively communicated

results.

GLOBALTOX will act as a client liaison on your behalf with regulatory

agencies.

D. Hardin, Ph.D., is a Principal with GlobalTox, Inc., and holds an

appointment as Adjunct Assistant Professor at the Rollins School of Public

Health,Emory University. In 1972 he was commissioned into the US Public

Health

Service with the National Institute for Occupational Safety and Health

(NIOSH), where he served in research, policy, and management roles, culminating

as

Deputy Director of NIOSH and Assistant Surgeon General in the Public Health

Service.

Throughout his career at NIOSH, Dr. Hardin was deeply involved in the

development of science-based health and safety recommendations and with risk

assessment and risk communication. Significant accomplishments include

laboratory

research that identified reproductive and developmental toxicity hazards

associated with the ethylene glycol ethers and leadership roles addressing

worker

protections against bloodborne disease, tuberculosis, and Legionnaire’s

disease. Dr. Hardin was designated to represent NIOSH to the press and the

public as well as to scientific, business, and professional communities for

numerous scientific and policy issues. As Lead Senior Scientist for the

Director

of NIOSH, and later as the Deputy Director of NIOSH, Dr. Hardin conducted or

supervised internal NIOSH scientific reviews and policy development and

implementation

******************************************************************************

*******************

(http://www.cdc.gov/)

CDC/NIOSH

Guidance for Protecting Building Environments from Airborne Chemical,

Biological, or Radiological Attacks, 2003

HUMAN-FUNGI POISON: " Toxins " Toxin categories include bacterial (exotoxins

and endotoxins), algae (blue-green algae and dinofiagellates), mycotoxins

Trichothocenes and aflatoxins). Botulinum, and plant- and animal-derived

toxins.

Toxins form and extremely diverse category of materials and are typically

most effectively introduced into the body by inhalation or an aerosol. They

are much more toxic than chemical agents.

NIOSH

Fungal Spores; Hazardous to Health? Division of Respiratory disease

Studies, National Institute for Occupation and Health, 1999 Authors: SORENSON

WG

Author Address: Immunology Section, NIOSH, 1095 Willowdale Road, town,

WV, 26505, USA. Source: ENVIRONMENTAL HEALTH PERSPECTIVES; 107 (SUPPL.

3). 1999. 469-472.

HUMAN DISABILITIES AND DISEASES; " –INHALATION OF FUNGAL SPORES INCLUDE:

TOXIC PNEUMONITIS, HYPER PNEUMONITIS, TREMORS, CHRONIC FATIGUE SYNDROME, KIDNEY

FAILURE, AND CANCER.. "

NIOSH

Health Hazard Evaluation Report No. HETA-94-0033-2552, Ladish Malting

Company, Jefferson, Wisconsin, Toxnet1997

HUMAN-FUNGI EXPOSURE LEVEL: " Operations involved the blowing and sweeping

of dust and caused the aerosolization of mycotoxin containing dust. Some

personal breathing zone and area levels of airborne grain dust were high

compared

with the OSHA permissible exposure limit of 10mg/m3 and the NIOSH

recommended exposure level of 4mg/m3. –The authors conclude that the

potential for the

development of hypersensitivity or toxic syndrome exists in this facility. "

NIOSH

Measurements of Airborne aflatoxins during the Handling of 1979 Contaminated

Corn, Toxnet, 1990 Burg WR ; Shotwell OL ; Saltzman BE University of

Cincinnati, Department of Environmental Health, Cincinnati, Ohio, Grant No.

R01-OH-00796, 20 pages, 12 references, 19821982 [NIOSH]

HUMAN; " The potential health hazard of aflatoxin (1402682) contaminated

corn grain dusts to agricultural workers was investigated. The average

aflatoxin level in all three farm areas was 42.7 parts per billion while the

average

aflatoxin level from airborne dust samples collected at the grain elevator

was 172.8ppb (settled dust average, 222ppb). The author concluded that

farmers, truckers, and grain handlers may experience significant exposure to

aflatoxin contaminated dust in regions where the Aspergillus-flavus mold

thrives,

particularly in the southern regions of the United States. They recommend

the use of respiratory protection when handling corn know to be contaminated

with aflatoxin. "

NOTE: The above report shows that there are standard tests used to test the

levels of aflatoxin used regularly.

NIOSH

Health Hazard Evaluation Report No. HETA-97-0048-2641, Cowlitz County Health

Department, Longview, Washington Authors: Boudreau Y, Perkner J Source:

Hazard Evaluations and Technical Assistance Branch, NIOSH, U.S. Department of

Healt and Human Services, Cincinnati, Ohio, Report No. HETA-97-0048-2641,

19 pages, 43 references, 1997 Abstract: (EVACUATION OF BUILDING)

HUMAN HABITAT-FUNGI POISON; In response to a request from the Service

Employees International Union, a health hazard evaluation was performed at the

former Cowlitz County Health Department Building (CCHDB) (SIC-9431) in

Longview, Washington. Concern was voiced over employee reports of upper

respiratory

problems, aches and pains in joints and muscles, and skin rashes, perhaps

related to toxins and molds in the building. After an inspection by the

Washington State Department of Health revealed the presence of fungi including

Stachybotrys, Aspergillus, and Penicillium, the building was evacuated.

NIOSH

Trichothecene Mycotoxins in the Dust of Ventilation Systems in Office

Buildings Authors: Smoragiewicz W.

Cossette B, Boutard A, Krzystyniak K Source: International Archives of

Occupational and Environmental Health, Vol. 65, No. 2, pages 113-117, 25

references, 1993 Abstract:

HUMAN HABITAT-OFFICE-FUNGI POISON; The presence of trichothecene mycotoxins

in dust samples from office buildings suspected of having sick building

syndrome was studied. Dust samples were obtained from the ventilation systems

or

drapes, carpets, and ceiling fiberboards of office spaces from three

buildings whose technical and medical records indicated the presence of sick

building

syndrome[] Dust samples obtained from the ventilation system of one of the

buildings had mycotoxins identified as T-2-toxin (21259201),

diacetoxyscirpenol (2270408), roridine-A (14729294), and T-2-tetraol (34114993)

as well as a

fifth mycotoxin that produced a trichothecene specific colored reaction. The

dusts obtained from the office spaces of the other two buildings contained

six trichothecenes which included two unknown mycotoxins.[]

NIOSH

Trichothecene mycotoxins in the dust of ventilation systems of office

buildings, Toxnet, 1994 Smoragiewicz W ; Cossette B ; Boutard A ; Krzystyniak K

International Archives of Occupational and Environmental Health, Vol. 65, No.

2, pages 113-117, 25 references, 1993 [NIOSH] HUMAN HABITAT; " –reportedly

affected by the " sick buildings syndrome " , were analyzed. The dust samples

contained at least four trichothecenes; T-2 toxin, diacetoxyscirpenol,

roridene A and T-2 tetraol. Screening of dust samples from air ventilation

systems

of reportedly affected buildings provided direct evidence of trichothecene

mycotoxins, with the detection limit estimated at 0.4-4 ng/mg dust. "

******************************************************************************

************

The primary activity of an independent medical examination (IME)… An IME of

an individual is typically requested and conduct when the individual’s

health is at issue, such as insurance claims, worker’s compensation, and

legal

proceedings.

This ACOEM statement was prepared by D. Hardin, PhD, Bruce J. Kelman,

PhD, DABT, and Saxon, MD, under the auspices of the ACOEM Council on

Scientific Affairs. It was peer-reviewed by the Council and its committees,

and was approved by the ACOEM Board of Directors on October 27, 2002. Dr.

Hardin is the former Deputy Director of NIOSH, Assistant Surgeon General

(Retired), and Senior Consultant to Global Tox, Inc, where Dr. Kelman is a

Principal. Dr. Saxon is Professor of Medicine at the School of Medicine,

University of California at Los Angeles.

“Current scientific evidence does not support the proposition that human

health has been adversely affected by inhaled mycotoxins in home, school, or

office environments.â€

1 ACOEM Evidence-based Statement October 27, 2002 Adverse Human Health

Effects Associated with Molds in the Indoor Environment Copyright © 2002

American College of Occupational and Environmental Medicine In recent years,

the

growth of molds in home, school, and office environments has been cited as

1 ACOEM Evidence-based Statement October 27, 2002 A Screening Program for

Depression Copyright © 2002 American College of Occupational and

Environmental Medicine The Occupational Mental Health Committee and the Council

on

Scientific Affairs of the American College of Occupational and Environmental

M

The American College of Occupational and Environmental Medicine (ACOEM)

represents over 7,000 physicians and is the world’s pre-eminent and largest

organization of physicians specializing in the practice of preventing,

assessing, and treating occupational and environmental health problems.

************************************************************************

___

******************************************************************************

***************

Trial testimony under oath, of Dr. Bruce J. Kelman, United States District

Court for the District of Arizona, June 22, 2004.

Question: So shall we callit the Manhattan Institute version versus the

ACOEM version rather than the translation? The words are substantially

similar, correct?

(Page 905, line 4)

Dr. Kelman’s answer: Well, the meaning certainly is.

Question: In fact, some of the language from the Manhattan Institute version

was the more argumentative language that was rejected during the peer review

process at ACOEM, correct?

(Page 905, line 12)

Dr. Kelman’s Answer: No.

Q. Are you sure of that, sir?

A. Yes.

Q. So if we held the drafts from the ACOEM up to the Manhattan Institute, we

wouldn’t find any sentences that had been removed from the ACOEM that now

appear in the Manhattan Institute version?

A. There may have been some. If there were, there certainly weren’t very

many.

Q. And that new version that you did for the Manhattan Institute, your

company, GlobalTox, got paid $40,000, correct?

A. Yes, The company was paid $40,000 for it.

**********************************************************************

Mold lawsuits have grown nearly ten fold in recent years, costing hundreds

of millions of dollars. But is mold just an unsightly fungus or a deadly

health risk? This forum discussed the implications of this issue for the

American

economy. The Chamber also released a landmark study with key findings on the

impact of mold litigation and the health risks of mold. (The Manhattan

Institute “commissioned†GlobalTox to the tune of $40,000 for this minor

rewrite)

_Watch the archived webcast from Jul 17 at 9:00 a.m. (ET)._

(http://www.chambercast.com/ramgen/video/ncf/030717.rm) _RealOne Player

Required_

(http://www.real.com/realoneplayer.html)

The Growing Hazard of Mold Litigation

“Thus, the notion that " toxic mold " is an insidious, secret " killer, " as so

many media reports and trial lawyers would claim, is " junk science "

unsupported by actual scientific studyâ€

***********************************************************************

The NATIONAL ASSOCIATION OF REALTORS®

_Moldy Claims_

(http://aolsearch.aol.com/aol/redir?src=websearch & requestId=8fbe77ed144e030e & cli\

ckedItemRank=1 & userQuery=moldy+claims+nar & clickedItemURN=http

://www.realtor.org/GAPublic.nsf/Pages/moldyclaims?OpenDocument)

(http://aolsearch.aol.com/aol/redir?src=websearch & requestId=8fbe77ed144e030e & cli\

ckedItemRa

nk=1 & userQuery=moldy+claims+nar & clickedItemURN=http://www.realtor.org/GAPublic

..nsf/Pages/moldyclaims?OpenDocument) - ... Moldy Claims: The Junk Science of

" Toxic " Mold. This report was sponsored by the US Chamber of Commerce. NAR

is publishing this report with permission of the US ...

_http://www.realtor.org/GAPublic.nsf/Pages/moldyclaims?OpenDocument_

(http://www.realtor.org/GAPublic.nsf/Pages/moldyclaims?OpenDocument)

“…current scientific evidence does not support the idea that human health

has been adversely affected by inhaled mold toxins in home, school, or office

environments. Thus, the notion that " toxic mold " is an insidious, secret

" killer, " as so many media reports and trial lawyers would claim, is " junk

science " unsupported by actual scientific study.â€

The NATIONAL ASSOCIATION OF REALTORS® is widely recognized as one of

America's strongest, most effective lobbying organizations. In fact, Fortune

Magazine has ranked NAR among the 25 most powerful lobbying groups in the

nation

four years in a row.

******************************************************************************

************************

(Published in the International Journal of Toxicology)

Risk from Inhaled Mycotoxins in Indoor Office and

>> Residential Environments

>>

>> Bruce Kelman A1, Coreen Robbins A1, Lonie Swenson A1,

>> Hardin A1

>> A1 GlobalTox, Inc., Redmond, Washington, USA

>> Abstract:

In this article, the authors

>> model a maximum possible

>> dose of mycotoxins that could be inhaled in 24 h of

>> continuous exposure to a

>> high concentration of mold spores containing the maximum

>> reported (in mice)

>> concentration of aflatoxins Bm1and Bm2, satratoxins G and

>> H, fumitremorgens B and C,

This model is

>> further evidence that human mycotoxicoses are implausible

>> following

>> inhalation exposure to mycotoxins in mold-contaminated

>> home, school, or office

>> environments.

The Insititute of Medicine, National Institute of Health,

Damp Indoor Spaces Report, May 25, 2004

Chapter 4

" ….. toxicologic studies of mycotoxins are acute or short-term studies that

use high exposure concentrations to reveal immediate effects in small

populations of animals. Chronic studies that use lower exposure concentrations

and

approximate human exposure more closely have not been done…â€