Re: Dr. Shoemaker / Dr. Hudnell study is published

[Guest guest]

Thanks very much for passing the research results along! FYI, you'll find the

URL for the abstract below.

BTW, has anyone heard anything more about the Shoemaker protocol and how people

are doing on it?

Gratefully,

Ingrid

http://www.sciencedirect.com/science?_ob=ArticleURL & _aset=B-WA-A-W-A-MsSAYVA-UUA\

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DWA-AAUCAAECWA-YBEBEWVVZ-A-U & _rdoc=1 & _fmt=summary & _udi=B6T9X-4D9RB4D-1 & _coverDat\

e=09%2F1

3%2F2004 & _cdi=5126 & _orig=search & _st=13 & _sort=d & view=c & _acct=C000050221 & _version=\

1 & _urlVe

rsion=0 & _userid=10 & md5=4c4a230a0267a98831fe2dc4b0365a16

Neurotoxicology and Teratology

Article in Press, Corrected Proof - Note to users

doi:10.1016/j.ntt.2004.07.005

Copyright © 2004 Elsevier Inc. All rights reserved.

A time-series study of sick building syndrome: chronic, biotoxin-associated

illness from

exposure to water-damaged buildings

Ritchie C. Shoemakera, b, and Dennis E. Houseb

aChronic Fatigue Center, 500 Market Street, Suite 103, Pocomoke City, MD 21851,

United

States

bCenter for Research on Biotoxin-Associated Illness, 500 Market Street,

Suite102,

Pocomoke City, MD 21851, United States

Received 6 April 2004; revised 30 July 2004; accepted 30 July 2004. Available

online

13 September 2004.

Abstract

The human health risk for chronic illnesses involving multiple body systems

following

inhalation exposure to the indoor environments of water-damaged buildings (WDBs)

has

remained poorly characterized and the subject of intense controversy. The

current study

assessed the hypothesis that exposure to the indoor environments of WDBs with

visible

microbial colonization was associated with illness. The study used a

cross-sectional

design with assessments at five time points, and the interventions of

cholestyramine

(CSM) therapy, exposure avoidance following therapy, and reexposure to the

buildings

after illness resolution. The methodological approach included oral

administration of

questionnaires, medical examinations, laboratory analyses, pulmonary function

testing,

and measurements of visual function. Of the 21 study volunteers, 19 completed

assessment

at each of the five time points. Data at Time Point 1 indicated multiple

symptoms

involving at least four organ systems in all study participants, a restrictive

respiratory condition in four participants, and abnormally low visual contrast

sensitivity (VCS) in 18 participants. Serum leptin levels were abnormally high

and alpha

melanocyte stimulating hormone (MSH) levels were abnormally low. Assessments at

Time

Point 2, following 2 weeks of CSM therapy, indicated a highly significant

improvement in

health status. Improvement was maintained at Time Point 3, which followed

exposure

avoidance without therapy. Reexposure to the WDBs resulted in illness

reacquisition in

all participants within 1 to 7 days. Following another round of CSM therapy,

assessments

at Time Point 5 indicated a highly significant improvement in health status. The

group-mean number of symptoms decreased from 14.9±0.8 S.E.M. at Time Point 1 to

1.2±0.3

S.E.M., and the VCS deficit of approximately 50% at Time Point 1 was fully

resolved.

Leptin and MSH levels showed statistically significant improvement. The results

indicated that CSM was an effective therapeutic agent, that VCS was a sensitive

and

specific indicator of neurologic function, and that illness involved systemic

and

hypothalamic processes. Although the results supported the general hypothesis

that

illness was associated with exposure to the WDBs, this conclusion was tempered

by

several study limitations. Exposure to specific agents was not demonstrated,

study

participants were not randomly selected, and double-blinding procedures were not

used.

Additional human and animal studies are needed to confirm this conclusion,

investigate

the role of complex mixtures of bacteria, fungi, mycotoxins, endotoxins, and

antigens in

illness causation, and characterize modes of action. Such data will improve the

assessment of human health risk from chronic exposure to WDBs.

Keywords: Toxins; Fungi; Water-damaged indoor environments; Sick building

syndrome;

Visual contrast sensitivity; Cholestyramine; Leptin; Alpha melanocyte

stimulating

hormone

Corresponding author. Chronic Fatigue Center, 500 Market Street, Suite 103,

Pocomoke

City, MD 21851, United States.