Re: The Bar for Mold Exposure

[Guest guest]

Sharon:

1. Statement:

" I don't get it. "

Response:

Unfortunately not (I don't mean this in a rude way).

2. Statement:

Let's just look at the toxic effects only. Never mind the HP, asthma,

infection, etc.

Response:

Define toxic effect only, please (e.g., allergic responses are not toxic).

3. Statement:

" Microbial poisons known to be prevalent in water damaged buildings:

mycotoxins, endotoxins, beta - glucans, proteins, etc. "

Response:

Endotoxins are from recognized to be from bacteria, not mold.

Can you provide examples of measurable amounts of " microbial poisons " as

listed coincident with effects?

4. I didn't see the answers to the questions below (except part of Q2),

but then again a) I didn't expect to and the questions were for .

Q1. What is the case definition for a proposed " mold exposure "

disease/illness?

Q2. What are the clinical signs and symptoms of this proposed

disease/illness? - I assume you list was supposed to be that?

Q3: What is unique (discriminatory) in the signs and symptoms to this

proposed disease/illness?

Q4: What are the pathological findings associated with this proposed

disease/illness?

Q5: What (combination or pattern) of unique (discriminatory) pathological

findings of this proposed disease/illness?

Q6: What are the tests used to provide differential diagnosis?

Q7: What is the consistent agent (chemical, biological, or physical) of

affect for which one can attribute these to, given the reasonable removal of

the contribution of confounding factors?

Q8: What is a measured dose (chemical, biological, or physical) to the

organisms that can be related either direct or indirectly with confidence?

5. I don't really understand Your #4.

6. I have to say, your reasoning seems to imply:

a. If symptoms [A1..An] are known to be the result of Agents [b1..Bn]

b. If Agents [C1..Cn] are known to be present (not quantified) in Buildings

[D1...Dn]

c. If self-reported symptoms [A1..An] are purported by people [E1...En] in

Buildings [D1...Dn] to be caused by Agents [C1..Cn].

d. Then implied, as you never actually state it:

Agents [C1..Cn] cause symptoms [A1..An]

, based on [b1..Bn] causing [A1..An].

As Spock would say - illogical.

So -

a. If fire causes burns

b. If jalapenos are present in a building

c. If people express symptoms of burns from exposure to jalapenos

d. Then jalapenos caused the burns

Incidentally, an old friend of mine used to say " Fire is hot. Girl is hot.

Therefore, girl is fire. "

7. This is why Hill's criteria is helpful, it includes specificity and

biological gradient.

For example, I just consulted on a case where the neurotoxic effects claimed

were purported to be from two agents: Benzo(a)pyrene and Lead, both present

at low levels. It ignored the fact that BaP has no measurable neuro effects

at very high doses [NOAELs 400-1,000 mg/kg/day] - the endpoint doesn't

match, one doesn't see neurotox from BaP. As for the lead, levels were

below those allowable for children's playgrounds - so no biological

gradient.

Tony

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

" Tony " Havics, CHMM, CIH, PE

pH2, LLC

5250 E US 36, Suite 830

Avon, IN 46123

www.ph2llc.com

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90% of Risk Management is knowing where to place the decimal point...any

consultant can give you the other 10%(SM)

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