Breaking the Mold: Kramer vs. Corruption

[Guest guest]

Breaking the Mold: Kramer vs. Corruption

IndoorEnvironmentConnections online

http://www.ieconnections.com/archive/nov_06/nov_06.htm#article5

Carl Grimes

President

Healthy Habitats

Denver, Colo.

Sharon Kramer has become one of the more active participants on the

IE Quality discussion board, much to the outspoken chagrin

and outrage of a few and the background cheers of others. Her basic

complaint is quite simple: Despite increasing evidence to the

contrary, the courts, public health and mainstream Western medicine

have taken the position that severe and debilitating health effects

from indoor exposure to mold is not plausible.

Her investigations have led her to what she claims is an intentional

campaign by the principal drafters of the American College of

Occupational and Environmental Medicine " Evidence-based Statement "

of Oct. 27, 2002, " Adverse Human Health Effects Associated with

Molds in the Indoor Environment. "

IE Connections: Sharon, what do you mean by " not plausible " ?

Sharon Kramer: It's not what I mean. It's what the ACOEM means. They

are the ones that are making the claim of " not plausible. "

IEC: Okay, so what does the ACOEM mean by " not plausible " ?

SK: They mean by " not plausible " or " implausible " as " highly

unlikely at best, even for the most vulnerable of subpopulations. "

Specifically, they are claiming that their review of the scientific

literature leads them to deduce that it is implausible that

mycotoxin exposure within an indoor environment could ever reach a

threshold level that would cause human illness.

IEC: What is wrong with that? That's what I've been hearing for

several years now.

SK: What is wrong with it is that this position is not based on

science or a review of scientific literature by any stretch of the

imagination. None of the 40 papers cited within the toxicity section

of their report make this conclusion. No other document before or

since the ACOEM mold statement purports to be able to make this

conclusion. No other experts that I have read or talked with before

or after the ACOEM statement even implies that conclusion.

IEC: If none of the papers that are the basis of the ACOEM mold

statement makes the " not plausible " conclusion, then where did it

come from?

SK: It did not come from any of the studies supposedly being

reviewed. The authors of the ACOEM mold statement reached the

conclusion all on their own.

IEC: Again, I don't see a problem. Did the research they conducted

meet contemporary scientific standards?

SK: That's one part of the problem. The authors did no scientific

research on their own. Instead, they selected a single rodent study

conducted by other researchers and, after the fact, applied

mathematical calculations to the data. Then, while referring to the

original study, they state, " The preceding calculation suggests

lower bound estimates of airborne S. chartarum spore concentrations

corresponding to essentially no-effect acute and subchronic

exposures. "

IEC: I'm confused. Which calculation are you referring to – the

original or their retroactive calculation?

SK: I am referring to the ACOEM mold statement authors' math

calculations. No calculations within the supposed reviewed papers

make the findings of " not plausible. " ACOEM is the one that is

making the claim. And they word it in such a way that it appears the

conclusion is based on the calculations of the original study. So, I

went back to the original study, and it made no such calculation or

claim. I looked through all of the papers being reviewed. None make

that claim. In fact, the concluding sentence of the study that

the authors' chose to base their math upon, reads quite to the

contrary to what the authors claim to have scientifically

concluded. The ending sentence of the foundation study reads: " The

consequences of low-level chronic exposure remain to be

investigated, as does the relevance of the rodent data to human

exposure. "

It is the later calculations, retroactively applied by the ACOEM

authors, that [are] the basis for their conclusion of " not

plausible. " That is it. Nothing else.

It takes a careful reading to detect the intentional interweaving of

evidence. Most doctors just trust the conclusion because it is

coming from a reputable medical academy. Defense lawyers and defense

expert witnesses tend to take it at face value for the same reason.

No one has carefully analyzed the two documents to detect the subtle

subterfuge.

IEC: I want to go back to another phrase you used in your first

statement of the problem. The phrase, used as a qualifier,

was " within an indoor environment. " Is that your phrase or theirs?

SK: That qualifier is used by ACOEM. They don't refute that

mycotoxin exposure sufficient to cause illness in humans is

possible. Extremely high levels have historically occurred in

agriculture and with foods. But ACOEM concludes, based on their

calculations, that it is not plausible that humans can be exposed to

enough mycotoxins within an indoor environment to cause illness.

In other words, the determining factor of causation is the location

of the exposure.

IEC: Your statements on the IE Quality group have alluded to a

connection to the tobacco industry and the methods they used quite

successfully for years. Are you claiming the same tactics are being

used in the debate about health effects from mold exposure?

SK: Absolutely. The tobacco industry tried to limit proof of

causation by attacking and distorting scientific studies. Also, they

funded research and reports to defer and distort factors other than

secondhand smoke, such as allergies to cockroach and dust mites, as

responsible for health complaints and illness.

IEC: So, it appears that somebody observed the tobacco tactics and

adapted them to mold. How did you discover this?

SK: I'll explain my expertise and my discovery in a moment, but

first I want to say that the comparisons are much more than

imitation. I have found that some of the people and companies deeply

involved with the tobacco defense are now involved with the mold

defense.

Further, this is an intentional and very deliberate campaign. But it

is not a conspiracy. It's more of a well orchestrated marketing of a

concept that exploits the unwary and the trusting.

IEC: Before we get into those details, how did all this start for

you?

SK: My family and I had a two-year nightmare that is all too

familiar with an increasing number of people. In 2001, we had a leak

in the water line to the icemaker. Our insurer sent to us an

untrained and uninsured remediation company. They let the water sit

for six weeks before drying it out. Mold grew.

The remediation company had no clue as to how to set up a proper

containment area. Instead of repairing our home, their large blowers

spread airborne mold spores all over our house. We were living

elsewhere during the remediation and knew nothing about water damage

and mold. For all we knew, they were doing a professional job. When

they said they were finished, the insurer hired a lab that said our

home was clear. We moved back in.

IEC: What was that like?

SK: At first, it was great. We were glad to be back home! But after

just a few days, we all started having problems. My husband and

younger daughter complained of a stuffy nose. No big deal. I am a

normal, healthy person but was having difficulty breathing and

concentrating, which concerned me. But not as much as what was

happening to our older daughter.

She is not a normal healthy person. She has been medically diagnosed

with cystic fibrosis and allergic bronchiopulmonary aspergillosis.

CF is a potentially fatal illness, often from aspergillosis. She was

extremely vulnerable.

IEC: Were her health complaints similar to those of the rest of the

family, or were they an intensification of her medical condition?

SK: Both. She had similar complaints such as sinus problems, but

also headaches and lethargy. Then, she became more and more ill.

During our ordeal, she was hospitalized three times and had sinus

surgery. I was extremely concerned for her, and our doctors were not

well educated as to the dangers our home posed for her health. I

began doing my own research and asked them about our water damage

and mold problem. I was told mold could not be responsible and I

should just go home and take some Prozac.

IEC: You mentioned during our phone conversations that you

eventually sued the insurance company, the lab and the remediator.

Surely, your daughter's obvious illness helped your case.

SK: Yes and no. Yes, because through the litigation process, it

became blatantly obvious her symptoms were resultant from the

excessive exposure to Aspergillus within our home. But no, because

the increased financial liability from the matter caused the insurer

to dig in their heels farther and try to run us through an endurance

contest so they would not have to pay as much money for their errors.

Let me tell you how she was treated. She was forced to give her

deposition two days after being released from the hospital. She

still had an IV PICC line in her arm because she needed an IV drip

every two hours.

IEC: What evidence did you have that the remediator, insurer and lab

were at fault?

SK: The insurer's broker or agent selected and sent the remediator

and the company collecting mold samples. The remediator did not use

proper procedures to prevent cross-contamination. When we asked for

the lab report that confirmed the clearance, no one could find even

the chain of custody. The person who said she did the testing

couldn't remember being at our house. The additional testing

conducted a week after clearance – because we had moved back in and

had become aware that something wasn't right – measured mold levels

that were twice as high as the initial testing used as the basis for

remediation.

IEC: How did your case turn out?

SK: We had never been in litigation before and have never thought

the courts were the best route to resolve problems. So, we continued

trying to work with our insurer. After nearly a year with no

progress, they sued us for not accepting a $30,000 settlement. We

had to get an attorney and we countersued. Our two-year nightmare

finally concluded with a confidential settlement from all three

parties.

IEC: How is your daughter now?

SK: We are all better, and she is much improved. But I had to find a

fungal specialist before we found treatment that helped. That was a

considerable expense because he was outside of our HMO and we had to

travel a considerable distance to another part of the state.

But the greater cost was the degradation at the hands of the

traditional medical community. It was an inexcusable insult to an

already devastating injury.

IEC: How did you decide to become an advocate? Caring for yourself

and your family is one thing, but taking on an entire industry

complex is quite another.

SK: While going through our nightmare, I began researching and

communicating with others who were experiencing much the same thing.

As I heard the stories of those that were having much greater

struggles, I came to understand that we had been quite lucky. We had

a strong marriage, wonderful children, lots of supportive friends

and family, and the financial means to weather the storm. I came to

appreciate that if they could wreak such havoc on our family, what

damage were they capable of against those less fortunate?

I had no intention of becoming a long-term advocate, but I knew I

had to do something. If I just walked away after learning what I

knew, I would be just as guilty as those that had mistreated, misled

and harmed us.

IEC: Is that when you went to Washington, D.C.?

SK: Yes. In the summer of 2004, my intent was to go to D.C. with

other advocates, tell our legislators what was occurring – because

surely they just didn't know – and then walk away. We went to D.C.

We told our legislators our experiences. They did nothing.

[Kramer participated in a press conference on Sept. 22, 2004,

calling attention to this topic. The conference also brought human

rights advocate Bianca Jagger to the Rayburn House Building at the

conference, organized by the staff of Rep. Conyers Jr. (D.-

Mich.)]

IEC: You said earlier that you would tell us your expertise and

discovery. Is this when you learned the science necessary to

understand the ACOEM statement?

SK: My expertise is not science, and it isn't the science I'm

questioning. That is best left to the scientists. But many assume

I'm attacking the science, so they attack me with statements that

I'm just a victim that wants revenge, I have no scientific

credentials, so I have no right to speak. They want me to just shut

up and go away.

I don't make scientific claims, and I don't evaluate the science

itself. What I evaluate is the marketing and spin within the ACOEM

statement, how the document is being used and the verification of

sources.

I have a marketing degree with graduate level training from NCR

Corp. and 25 years of experience. I have learned how to verify

claims within documents by tracking them back to the original

reference. Unscientific or unsubstantiated claims and spin sentences

are revealed when they cannot be verified by the expressed or

implied source.

IEC: What has your training and experience revealed about the ACOEM

statement?

SK: I have read thousands of newspaper articles, court documents and

peer-reviewed papers regarding the mold issues. While the vast

majority of documents are indicative that mold is causing some very

serious health and financial ramifications, there is a strain of

documents authored by a small number of the same names that take the

opposing view.

They characterize their work as position statements derived from a

critical review of documents written by thousands of members of

medical associations. Therefore, they carry great weight with busy

doctors who trust their authoritative sources. Defense lawyers and

expert witnesses appreciate the authoritative support of their

position.

These types of documents, written by the same small group of people,

are not derived from a broad base of scientific literature. They all

rely on the ACOEM conclusion derived from a retroactive math

calculation, and are usually written by several of the very same

people who wrote the ACOEM statement.

IEC: Are there clues that help initially identify potential spin

that should be subjected to closer scrutiny?

SK: Once you know what to look for, they become easier to find. They

project themselves as the last word, state of the art, the result of

extensive research. They tend to [imply] that what they promote is

sound science and others with different conclusions are junk

science. They tend to be very aggressive in their intent and manner

of writing.

Their citations are by and large other review papers. But even when

they cite actual studies, they tend to pull out key phrases they

find beneficial and oftentimes disregard the true focus of the paper

cited.

Legitimate papers with verifiable sources tend to look at actual

studies to form their conclusions. They more readily note the

shortcomings of where more research is needed. They do not call out

specific papers as junk science. They are not aggressively promoting

one school of thought. These types are science. They others are

courtroom defense.

IEC: You have made some very strong statements. What is the basis

for your claims, especially that they are intentional rather than

appear intentional?

SK: The e-mails from when the statement was drafted were subpoenaed

and are in court transcripts. I have read them. I have read how this

ACOEM document is being used by defense attorneys and expert

witnesses in the courtroom as a scientific finding that these

illnesses are not plausible. I have read medical documents with

the " not plausible " claim based solely on the ACOEM statement.

Within the courtroom, the finding of " not plausible " often gets

translated to " could not be. "

According to subpoenaed e-mails from the overseer of the peer review

process, it had been decided during the drafting of the document

that the ACOEM statement would be a defense argument. The ACOEM

brought into their organization a former expert

witness for the defense and his business partner to write the

toxicity section. Both have a Ph.D. but not an M.D. or other medical

public health degree. Neither has experience diagnosing and treating

people nor do they have a laboratory background in mycotoxin

research. Yet they are quite adept at creative math and experience

defending Big Tobacco.

The UCSF Tobacco Legacy Library and the recent RICO [Racketeer

Influenced and Corrupt Organizations Act] case against Big Tobacco

[united States v. Philip USA] reveal the deceit and marketing

used. Similar techniques by some of the same people were used to

write the ACOEM statement of Oct. 27, 2002, and subsequent position

papers.

IEC: Have you compared the ACOEM position with the National Academy

of Science's Institute of Medicine report " Damp Indoor Spaces and

Health " ? As a governmental body, they would carry quite a bit of

authority.

SK: Yes, I have, and the contrasts are astounding. In addition to

the above noted selection process, tone, and lack of accusations

that contrary opinions are junk science, the IOM contains these

concise statements:

In vitro studies, as explained below, are not suitable for human

risk assessment. Risk can be extrapolated from animal studies to

human health effects only if chronic animal exposures have produced

sufficient information to establish no-observed-adverse-effect

levels (NOAELs) and lowest-observed-adverse-effect levels (LOAELs).

Extrapolation of risk exposure from animal experiments must always

take into account species differences between animals and humans,

sensitivities of vulnerable human populations, and gaps in animal

data.

The ACOEM statement does exactly what IOM says is not suitable.

Except for a few studies on cancer, 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 except

for a small number of cancer studies.

The ACOEM statement uses a single rat study with a conclusion that

includes low-level, long-term exposure not related to cancer. Two

years later, the IOM report says no such studies have been conducted.

Thus results of animal studies cannot be used by themselves to draw

conclusions about human health effects.

The ACOEM statement uses an animal study by itself – a single study

no less, rather than a body of science – and they do draw a

conclusion about human health effects, that they are not plausible.

Even more egregious is the promotion of the ACOEM mold statement as

consistent with the IOM " Damp Indoor Spaces and Health " report.

IEC: What last words would you like to leave with our readers?

SK: Mold is not the problem I'm fighting. The manner in which the

mold issue is being addressed is the problem. Those defensors, who

intentionally stifle the progress of science, are the root cause of

the contention and confusion over the issue. Their actions fuel the

misunderstanding, the fear from both the physical and financial

aspects and keep this issue in the courts where the defensors

generate the most income. They actually increase the costs to those

they are hired to protect by obstructing timely and appropriate

medical care that will eventually catch up with them in the form of

greater court awarded damages. That's what happened with exploding

gas tanks on cars and to Big Tobacco.

The way to solve this problem is to train the physicians how to

recognize, diagnose and treat mycotic diseases so that the physical

damages are lessened by early detection and treatment. But we first

must dispel the unscientifically founded myth that serious illness

is not plausible from excessive exposure to mold within an indoor

environment. It may be not yet determined, but that is not the same

as not plausible.

IEC: One last question, Sharon. What if the ACOEM calculations and

conclusion eventually prove to be correct?

SK: Great! But that's the point. They haven't been. Should someone

choose to, it could be done quite simply by subjecting the ACOEM

conclusion to the appropriate scientific scrutiny afforded any other

scientific or medical claim. Until it has been independently

challenged and verified, it should not be granted a status any

greater or less than any other working hypothesis.

But, again, my point is that nothing justifies the marketing a

litigation defense argument disguised as science. The serious harm

from propagating misrepresented and distorted scientific facts is

not limited to the victims who are turned away. It corrupts and

violates the most basic trust for the professionals we rely on for

life-and-death decisions.

Carl Grimes is president of Healthy Habitats LLC, an indoor-

environmental consulting firm in Denver, Colo. He is the author of

the book " Starting Points for a Healthy Habitat " and serves on the

Editorial Advisory Board of IE Connections. Grimes can be reached by

e-mail at grimes@... or by phone at (303) 671-9653.