Re: American College of Medical Toxicology Position Statement Mold

[Guest guest]

So here is my question: With so many people - children - literally crying for help from serious illness brought on by exposure to microbial contaminants in WDB's, what motivates some to promote the false concept that it has been scientifically proven these serious illnesses indicative of poisoning are not plausible to occur from exposure in WDB's? How can medical professionals do such a horrid thing to their fellowman?

Sharon Kramer

The ACMT statement only refers to dose-response effects of inhaled mycotoxins and irritant effects of MVOCs. It mentions ODTS and HP while acknowledging that the mechanisms of causation are poorly understood. Conspicuously absent from the statement is an acknowledgment that individual sensitization to bioaerosols and MVOCs can produce the symptoms that the authors say are not produced by inhaled mycotoxins. This is what reading between the lines in the ACMT statement should tell you.

The statement is blatantly a defense argument based on staying within the parameters of classic toxicology and dose-response exposure relationships. Where they do address allergic effects, they do not define or elaborate on what constitutes an "allergic effect". They minimize the significance of chemical hypersensitivity reactions, which is what allergic effects are, after all.

My question is: "What is the ACMT's position on chemical sensitivities?" This will give you an idea of where they create the illusion that allergies and chemical sensitivities are completely different things. They aren't. You can't talk about ODTS and HP without getting into HOW -- NOT WHICH -- people get these diseases. To say that these diseases only occur in farmers or some other occupation and not in people in schools, homes and offices is pure nonsense. School teachers do have a high incidence of HP and work-related asthma as a recognized occupational hazard. What do the toxicologists say about that?

I think it's safe to say that toxicologists are definitely the wrong type of professional to explain mold health effects because they can't seem to think beyond dose-response. Anyone can see that when one or two people get sick when a large number of people are similarly exposed, it isn't a dose-response cause -- it is an individual reaction. Duh!

And for the plaintiff experts who say that because Asp/Pen or Stachy was found, all health effects were caused by mycotoxins, they are expressing only their unfounded beliefs. They are not even close to proffering a scientific opinion.

New research should focus on the mechanisms of sensitization and resultant sites of inflammation.

Since work-related or occupational asthma seems to be at the frontier of medical science's accepting of microbial and chemical sensitization as a cause of inflammatory reactions, this should be a good starting point for studying other environmental sensitizing exposures.

http://www.state.nj.us/health/eoh/survweb/wra/documents/wraguide.pdf

Steve Temes

[Guest guest]

Steve,

What you say makes MUCH sense to me. I don't know about you all, but I am not happy in the LEAST that my tax dollars are going to further a litigation defense argument among those medical associations that are being government funded to advance the understanding of environmental illnesses, not lie about it for the sake of private interest money.

From fedspending.org: We have given ACMT over $1.3 million in the past 6 years. Who are these guys that we are funding? I am not impressed with what they are promoting as science.

Federal Assistance to Recipient(s) matching "american college of medical toxicology", FY 2000-2006, list of recipients

And..below is a quote from a Gerberding letter, June 2007, referring to CDC funding and telling an MCS group that ACMT is just the end all be all:

WHY IS THE CDC GOVERNMENT FUNDING AND PROMOTING AN UNSCIENTIFIC LITIGATION DEFENSE ARGUMENT OVER THE MOLD ISSUE????????

Sharon

In a message dated 2/11/2008 10:14:17 AM Eastern Standard Time, snk1955aol writes:

So here is my question: With so many people - children - literally crying for help from serious illness brought on by exposure to microbial contaminants in WDB's, what motivates some to promote the false concept that it has been scientifically proven these serious illnesses indicative of poisoning are not plausible to occur from exposure in WDB's? How can medical professionals do such a horrid thing to their fellowman? Sharon KramerThe ACMT statement only refers to dose-response effects of inhaled mycotoxins and irritant effects of MVOCs. It mentions ODTS and HP while acknowledging that the mechanisms of causation are poorly understood. Conspicuously absent from the statement is an acknowledgment that individual sensitization to bioaerosols and MVOCs can produce the symptoms that the authors say are not produced by inhaled mycotoxins. This is what reading between the lines in the ACMT statement should tell you.The statement is blatantly a defense argument based on staying within the parameters of classic toxicology and dose-response exposure relationships. Where they do address allergic effects, they do not define or elaborate on what constitutes an "allergic effect". They minimize the significance of chemical hypersensitivity reactions, which is what allergic effects are, after all.My question is: "What is the ACMT's position on chemical sensitivities?" This will give you an idea of where they create the illusion that allergies and chemical sensitivities are completely different things. They aren't. You can't talk about ODTS and HP without getting into HOW -- NOT WHICH -- people get these diseases. To say that these diseases only occur in farmers or some other occupation and not in people in schools, homes and offices is pure nonsense. School teachers do have a high incidence of HP and work-related asthma as a recognized occupational hazard. What do the toxicologists say about that?I think it's safe to say that toxicologists are definitely the wrong type of professional to explain mold health effects because they can't seem to think beyond dose-response. Anyone can see that when one or two people get sick when a large number of people are similarly exposed, it isn't a dose-response cause -- it is an individual reaction. Duh!And for the plaintiff experts who say that because Asp/Pen or Stachy was found, all health effects were caused by mycotoxins, they are expressing only their unfounded beliefs. They are not even close to proffering a scientific opinion.New research should focus on the mechanisms of sensitization and resultant sites of inflammation.Since work-related or occupational asthma seems to be at the frontier of medical science's accepting of microbial and chemical sensitization as a cause of inflammatory reactions, this should be a good starting point for studying other environmental sensitizing exposures.http://www.state.nj.us/health/eoh/survweb/wra/documents/wraguide.pdfSteve Temes

Who's never won? Biggest Grammy Award surprises of all time on AOL Music.

[Guest guest]

Hi Wei,

Those statements you quoted are regarding "mycotoxins". There are evidences that significant amount of "mold (fungi)" exposure in indoor environemnt can cause human health effects. However, it's much harder to prove that it is caused by mycotoxins alone. In reality, it may be the combination of many fungal cell components/byproducts.

EXACTLY. They keep just focusing on ONE mycotoxin at a time and then denying all illness from the myopic info.

Whatever happened with ERMI?Delicious ideas to please the pickiest eaters. Watch the video on AOL Living.

[Guest guest]

Sharon, Those statements you quoted are regarding "mycotoxins". There are evidences that significant amount of "mold (fungi)" exposure in indoor environemnt can cause human health effects. However, it's much harder to prove that it is caused by mycotoxins alone. In reality, it may be the combination of many fungal cell components/byproducts. Personally, I believe SOME people CAN become very sensitive to fungal cell comonents/byproducts and ALSO many other biological and chemcials (natural or systhetic) agents. The medical community should more widely recognize that SOME people CAN get sick from biolgocial and chemcial agents in the concentrations way below those that the majority of people have reactions to. Before we have more conclusive research data, if someone is sick from exposure of significant amount of fungal biomass or byproducts (which

including mycotoxins and many others things), I would just stick to that instead of trying to tie the cause to mycotoxins alone. Actually, even after we have more data on mycotoxins exposure, the fact that people may get sick from the combination of many different fungal cell components/byproducts (including mycotoxins) still stands true. I still wouldn't focus on mycotoxins alone. Wei Tang QLabsnk1955@... wrote: Dear All, It has recently been brought to my attention that the American College of Medical Toxicology (ACMT) has accepted the writings of Dr. Sudakin and Dr. Kurt of the ACMT Practice Committee, to be their position statement on mold. Dr. Sudakin and Dr. Kurt are both nationally recognized prolific expert defense witnesses in mold litigation. The title of the ACMT Mold Position Statement is: "Institute of Medicine on Damp Indoor Spaces and Health." It may be read at http://acmt.net/cgi/page.cgi?aid=12 & _id=52 & zine=show A key finding of the document is:"With respect to mycotoxins in indoor air, exposure modeling studies have concluded that even in moldy environments, the maximum inhalation dose of mycotoxins is generally orders of magnitude lower than

demonstrated thresholds for adverse health effects.(3,7,8)" The three references cited for the above statement are: (3.) American College of Occupational and Environmental Medicine. Evidence Based Statement: Adverse Human Health Effects Associated with Molds in the Indoor Environment. 2002. http://www.acoem.org/guidelines/article.asp?ID=52 Outed on the front page of the WSJ for it's conflicts of interest and unscientific methodology in determining the implausibility of toxicosis from indoor microbial contaminents. (7) "Risk from inhaled mycotoxins in indoor office and residential environments. Int J Toxicol 2004 January;23" Thrown out of court in Ca April 14, 2006, as an unscientific "huge leap" when determining the implausibility of human

illness from indoor mycotoxin exposure. [note; this court case was just two months prior to the drafting of this ACMT paper and the IOM Report was the primary document used to discredit this study] (8) Satratoxin G from the black mold Stachybotrys chartarum evokes olfactory sensory neuron loss and inflammation in the murine nose and brain. Environmental Health Perspectives. A rodent study that was a breakthrough in determining olfactory and cognitive difficulties caused by mycotoxins. The study ends with the sentence, "Ultimately, all such information must be framed against accurate quantitative assessments of human exposure to satratoxins using both state-of-the-art sampling and analytical methods and relevant biomarkers." meaning, NOWHERE does this paper conclude that, "the maximum inhalation dose of mycotoxins is generally orders of magnitude lower than demonstrated thresholds for adverse health

effects."...in humans. http://www.ehponline.org/members/2006/8854/8854.pdf NOWHERE does it acknowledge that "exposure modeling studies" cannot be used by themselves when determining human health or that they are simply addressing one hypothetical mycotoxitoxin exposure for one hypothetical time. NOWHERE has this ever been considered accepted scientific methodology when determining human illness from mycotoxin exposure. NOWHERE has this concept ever been reproduced except by Dr. Sudakin's employers in the two papers cited above (references 3 & 7). SCIENTIFICALLY, EXPOSURE MODELING STUDIES HAVE "CONCLUDED" NOTHING ABOUT HUMAN HEALTH FROM INDOOR MYCOTOXIN EXPOSURE. So here is my

question: With so many people - children - literally crying for help from serious illness brought on by exposure to microbial contaminants in WDB's, what motivates some to promote the false concept that it has been scientifically proven these serious illnesses indicative of poisoning are not plausible to occur from exposure in WDB's? How can medical professionals do such a horrid thing to their fellowman? Sharon Kramer Who's never won? Biggest Grammy Award surprises of all time on AOL Music. Wei Tang, Ph.D. Lab Director QLab5 DriveCherry Hill, NJ

08003 Faxwww.QLabUSA.com

[Guest guest]

Exposure is much more substantial when people live in a building or when it has been flooding off and on for a very long time. For example, the building I got sick in was 100 years old. Modifications had been done which left it stting in water for months out of every year. Repairs were nonexistant or postponed, and some were only done when they were under exteme duress. (they were ordered to by the city)

I have heard this multi-year wetting and drying situation described by scientists as a " mycotoxin worst case scenario "

[Guest guest]

Sharon:

1. Regarding:

'NOWHERE does it acknowledge that " exposure modeling studies " cannot be used

by themselves when determining human health or that they are simply

addressing one hypothetical mycotoxitoxin (sic) exposure for one

hypothetical time.'

Q1: Cannot or Can? Does it say they cannot?

Q2: Is there a consensus document that says they can or cannot be used?

Q3: Where does it say it is addressing " one " exposure for " one " time?

C1: Exposure modeling and risk estimates are used in Europe and in the

US to determine acceptable ingestion (in the household) in foods. Same

ACCEPTED methodology, but different Route of exposure (citations withheld on

purpose; do your own research). [Note: EPA and state environmental agencies

use Oral data for risk determination by inhalation every day on chemical

cleanup sites]

C2: One-time exposure derivation is used and accepted by the EPA for

one-hit cancer models. National Research Council (NRC) through EPA mandate

has also used one-time exposure modeling to derive acute exposure guideline

levels (AEGLs). The AIHA ERPG values have also been derived in this manner.

See also Standing Operating Procedures for Developing Acute Exposure

Guideline Levels for Hazardous Chemicals, Nat Acad Press, 2001.

C3: The use of a single exposure model with a single study and a single

endpoint is termed applying a point of departure for exposure limit

determination.

2. Regarding:

" NOWHERE has this ever been considered accepted scientific methodology when

determining human illness from mycotoxin exposure. "

C4: It has, see comment C1 above.

3. Regarding:

" NOWHERE has this concept ever been reproduced except by Dr. Sudakin's

employers in the two papers cited above (references 3 & 7). "

C5: Basis recalculated (with more data than Kelman, like Aspergillus

mycotoxin data in animals, spore extract data, lung deposition data, human

exposure to sensitized people [double blind placebo at >1E6 spoes/m3],

actual data from airborne mycotoxin in visibly moldy spaces, and other data)

in:

Havics: " Exposure Limits for Bioaerosols: An Example of How to Set a

Numerical Point Estimate Mold " , presented at the American Industrial Hygiene

Conference & Exposition (AIHCE), 2007, June 4-7, 2007, Philadelphia, PA.

(June 7, 2007; Audio available on tape or MP3 through AIHA)

Bottom line - the mycotoxin exposure in a typical living environment by

itself is red herring. Immunology - asthma & sensitization are the limiting

factors.

C6: Basis for mycotoxin dose supported by sen in a 1997 epi

article (withheld citation on purpose; do your own research)

C7: Foundation elucidated in:

Robbins, et al: Health Effects of Mycotoxins in Indoor Air: A Critical

Review. JOEH 15(10): 773-784, 2000.

4. Regarding:

" SCIENTIFICALLY, EXPOSURE MODELING STUDIES HAVE " CONCLUDED " NOTHING ABOUT

HUMAN HEALTH FROM INDOOR MYCOTOXIN EXPOSURE. "

Sharon, I cited 3 " mycotoxin in air " studies (actual data from real sites)

indicating several orders of magnitude difference between actual and known

effect levels. Even assuming a lognormal distribution, it isn't likely.

5. Regarding:

" So here is my question: With so many people - children - literally crying

for help from serious illness brought on by exposure to microbial

contaminants in WDB's, what motivates some to promote the false concept that

it has been scientifically proven these serious illnesses indicative of

poisoning are not plausible to occur from exposure in WDB's? How can medical

professionals do such a horrid thing to their fellowman? "

Bottom line - the mycotoxin exposure in a typical living environment by

itself is red herring.

Immunology - asthma & sensitization and irritation from MVOCs are the

limiting factors - e.g., look at another endpoint besides mycotoxin as the

basis doesn't explain the effects.

And more importantly - WDB have other allergens and agents - not just mold

(bacteria, viruses, protozoa, algae, insect, etc.).

I'll recommend a session at the 2008 AIHCE in Minnesota in June on Bacteria.

Tony

.......................................................................

" Tony " Havics, CHMM, CIH, PE

pH2, LLC

5250 E US 36, Suite 830

Avon, IN 46123

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