Feb ACOEM President Responds to Wall Street Journal & Rebuttal by Mrs. Kramer.

[Guest guest]

From Your President: Ambush Above the Fold

The American College of Occupational and Environmental Medicine (ACOEM)

performs a great, unrecognized service to medicine and to the community as a

first line of defense against questionable practice. Because people tend to

project their fears and beliefs about health onto perceptions of their

environment, our practices and clinics disproportionately attract the worried,

the

obsessed, people who disagree with science and medicine, and “true

believers.â€

This comes with the territory, given our commitment to environmental medicine

and to evidence-based medical practice. Our thankless role, when confronted

with unsupportable beliefs, is to review the evidence, to explain patiently, to

say “no†when it is required, and not infrequently, to take abuse. We took

a lot of abuse last month.

On 9 January 2007, the Wall Street Journal ran a front-page story on the

2002 ACOEM statement on _Adverse Human Health Effects Associated with Molds in

the Indoor Environment_ (http://www.acoem.org/guidelines.aspx?id=850) . The

article was highly misleading. The reporter, Armstrong, misreported key

facts, insinuated a conflict of interest, and misrepresented similar

statements by other groups with which ACOEM was compared. Within hours, blogs

and

legal web sites had picked up the story in what bore all the earmarks of a

coordinated, but not very effective, campaign. Your College officers answered

as

best we could, posting after posting. Remarkably, interest in the story did

not last long, even on the web. Of course, the seeds of distrust were sown

widely, if not deeply, on the Internet for future eruptions.

Your officers submitted a letter to the editor (_posted on the ACOEM web

site_ (http://www.acoem.org/moldresponse.aspx) ) well within the time the WSJ

allowed, but they declined to publish it. No reason was given. Last week we

filed a complaint. Our prediction is that they will ignore it.

By now, it should be obvious that there is an agenda at work and that the

WSJ was, in fact, used. The ACOEM _statement_

(http://www.acoem.org/guidelines.aspx?id=850) is well-researched, well-written,

and clear in its conclusions,

although it is becoming dated. Over the last five years, it has been

introduced many times into evidence in court cases and (we now realize) became

perceived by the plaintiff bar as a major obstacle. What we experienced in

January

was a campaign to discredit the statement (and by extension ACOEM) so that it

could not be used in court. An activist in the “toxic mold†community has,

in fact, now taken credit for planting the story.

We feel sure that our statement was the focus of the attack because it was

the first and most detailed of four statements that have come to similar

conclusions regarding the lack of evidence behind “toxic mold†as a theory.

ACOEM

probably seemed an easier target than the American Academy of Asthma,

Allergy and Immunology, the American Academy of Pediatrics, and the Institute

of

Medicine (part of the National Academy of Sciences), each of which produced

their reports after ours.

However ACOEM, as a professional organization, is proving to be no pushover.

We are vigorously defending the statement within the professional community.

We are currently pushing out our message in every way we can. We have fully

documented the statement development process (if needed for discovery, which

happens occasionally when ACOEM is subpoenaed in lawsuits where the statement

is introduced).

Turning to substantive issues, let me remind ACOEM members of the background

to the statement. We are not talking about the association of mold and mold

spores with invasive, allergic, infectious, or irritating conditions. The

statement is perfectly clear that these are known and accepted medical

conditions. Likewise, the statement, although it was written well before the

Institute

of Medicine’s report Damp Indoor Spaces, does not suggest that damp or moldy

living environments are acceptable. Not at all.

The issue at hand is whether the metabolic products of mold known as

mycotoxins, absorbed through inhalation of spores and vegetative fragments in

indoor

air, are responsible for systemic human disease under conditions encountered

in homes and offices, an unproven theory called “toxic mold†in the

vernacular. The WSJ article implies that there is an extensive scientific

debate on

this topic. The reality is that few scientists embrace the theory of “toxic

mold†and many who do (including some of our members) are interested in it as

a theory to be tested, not as a belief. The mainstream of medical opinion,

ACOEM included, has decided that so far the weight of evidence, despite years

of investigation, does not support the theory.

The WSJ reporter, Armstrong, used selective quotes out of context from

the Institute of Medicine’s report, Damp Indoor Spaces, to give the

impression that the Institute’s statement is at odds with ACOEM’s

statement.

However, that is simply wrong. Put the two side by side and it is clear that

they

both conclude that the evidence for the existence of a “toxic mold†effect

is

“inadequate or insufficient,†to use the IOM’s term of art.

The WSJ also implied that the statement was created for purposes of

litigation. It was not. The statement was initiated by your College precisely

because

the topic is important in environmental medicine.

The WSJ article insinuated that the “authors†of the ACOEM statement were

in conflict of interest. Let’s set the record straight – The lead author

chosen to develop the statement was a retired Assistant Surgeon General,

eminently credible. He had no conflict of interest at the time – none. In the

course

of developing various drafts, he asked two colleagues experienced in the

issue to supply information and analysis he needed to develop some of his

points –

nothing wrong or unusual in that. He was generous enough to acknowledge

them with authorship credit and it is actually their history of sometimes

testifying in mold litigation that is being attacked. For the record, however,

the

lead author was always the responsible party. Authorship of an ACOEM

statement is not the same as authorship of a paper: the end product is not the

author’

s property and can be – and often is – changed without the author’s

agreement. ACOEM credits authorship of statements for the purpose of giving

recognition for work done on its behalf, not to assign responsibility or for

disclosure. Incidentally, all this is documented.

In this case, your College adhered to its own rigorous statement development

process (developed in 2000 and available on the ACOEM web site). The mold

statement was substantially revised four times, in a process closely managed by

the chair of our Council on Scientific Affairs. It then underwent three

levels of review (Council, Board committee, full Board) before finally being

approved by your elected representative governing body, the Board of Directors

of

the College. All this is also documented.

We take allegations and insinuations against the integrity of the College

and you, our members, very seriously. This whole episode has made us realize

just how important a role we play in challenging unscientific medical beliefs.

Seen another way, this attack was a backhanded tribute to the growing

influence of your College and its dedication to evidence-based medicine. It

would

not have happened if your College had not taken a stand on something important.

It would not have failed if your College had not done the right thing and

backed it up with documentation and rigor.

Tee L. Guidotti, MD, MPH, FACOEM

ACOEM President

Rebuttal to the statement of Dr. Tee Guidotti Regarding the ACOEM Mold

Statement:

Within his response to the Wall Street Journal article " Court of Opinion,

Amid Mold Suits Experts Wear Two Hats " Dr. Guidotti, President of the American

College of Occupational and Environmental Medicine (ACOEM), failed to mention

a few key facts about how the ACOEM Mold Statement came to be. He failed to

mention that many members of ACOEM were questioning the conflicts of

interest of the authors that ACOEM chose, throughout the entire process. But

the

most egregious aspect that Dr. Guidotti failed to address in his response to

the Wall Street Journal article, is that there is a key finding within the

ACOEM mold position paper that is not based on accepted scientific methodology.

Nor, would it be logical to assume that the governing body of ACOEM

physicians thought this key finding was based upon sound science when they

accepted

the document to become their position statement regarding the understanding of

mold induced illnesses. It is a finding that has caused great harm to the

lives of many innocent US Citizens, including our nation's children. It is a

finding that has confused our courts and our medical communities.

To accomplish their feat of scientific wonder establishing lack of human

illness from indoor mold/mycotoxin exposure - that no others before or since

have replicated - the ACOEM authors simply borrowed data from a single rodent

study in which mold was forced into the trachea of rats. They then applied

mathematical calculations to the borrowed data to make the unscientific leap

that humans could not plausibly be exposed to enough mycotoxins within an

indoor environment to cause symptoms of ill health. There were no mycotoxins

even

evaluated within the rodent data to which they added their math. Only mold

spores.

The PhD authors with backgrounds in toxicology and mathematics cannot

logically and ethically claim they ‘scientifically’ applied math to data

from a

single mold rodent study to substantiate/conclude anything of relevance

regarding human mycotoxin illness from an exposure indoors. Furthermore, the

rodent

study to which the ACOEM authors chose to apply math, ends with the sentence,

“The consequences of low-level chronic exposure remain to be investigated,

as does the relevance of the rodent data to human exposure.†The leap from

limited rodent data to absence of human illness is an unethical non-sequitur,

never replicated. The premise does not fit the conclusion. It is an affront to

anyone with even the most basic of logic skills to promote that it does.

To quote from the Wall Street Journal article:

" The ACOEM paper goes further. It says not only is there no evidence indoor

mold causes serious health effects, but even if mold produced toxic

substances, it's " highly unlikely at best " that anyone could inhale enough to

cause a

problem. The paper reaches this conclusion by extrapolating from animal

studies in which rodents' throats were injected with molds.

The paper's authors say their conclusions are validated by the Institute of

Medicine's paper. But the author of the Institute paper's mold toxicity

chapter, Harriett Ammann, disagrees, and criticizes the ACOEM paper's

methodology:

" They took hypothetical exposure and hypothetical toxicity and jumped to the

conclusion there is nothing there. "

In October of 2002, the American College of Occupational and Environmental

Medicine betrayed the public trust bestowed in them by endorsing this false

concept. The situation is deplorable. It is insulting to one's intelligence

that ACOEM would still attempt to defend the false science, even after being

outed on the front page of the Wall Street Journal. The situation is

embarrassing for many of the honorable physicians of ACOEM. And spinning of

words can

no longer hide the TRUTH. To this day, the key false finding of the ACOEM

mold statement continues to harm the health, lives and safety of the American

public.

Subpoenaed emails from ACOEM at the time the document was drafted and five

years worth of under oath testimony from various " experts " in mold litigation,

clearly show the document was a defense argument from its very inception. It

was meant for the purpose of limiting the financial liability for

stakeholders of moldie buildings at the expense of occupants who became ill

from mold

exposure.

Dr. Guidotti may protest the Wall Street Journal article as much as he

likes. He may feign ignorance and innocence on the part of ACOEM. But Dr.

Guidotti cannot undo the past, redefine science or erase the record of what

really

occurred when ACOEM put their blessing and therefore added credibility to

false science that has harmed the lives of so many.

It is a paper: That has caused the sick to go untreated by their misinformed

physicians. That has caused the sick to become unnecessarily sicker because

of lack of proper treatment. That has caused families to be ruined by

illness, loss of ability to work and resultant poverty. That has caused

mortgagors

to be stuck with uninhabitable properties when the sick can no longer pay

their mortgages or rent. That has caused owners of moldie buildings to lose

everything because they did not know the mold would make their tenants so sick

and are now paying for the unawareness promoted by ACOEM.

When mold is caught early, it does not do severe damage to buildings or

human health. Mold is not the problem. The false teachings of the American

College of Occupational and Environmental Medicine IS the problem.

Additionally concerning, if the ACOEM Mold Position Statement is an example

of Evidence Based Medicine as interpreted by ACOEM, then the problem is far

deeper and far more insidious than even their false mold teachings. ACOEM has

been given the charge to decide what is Evidence Based Medicine for several

states. In California for example and under Senate Bill 889, ACOEM decides

what is the Evidence Based Medicine guidelines that rule the treatments

offered to injured workers for a variety of illnesses and injuries. The

guidelines

of ACOEM decide what treatments will and will not be offered to injured

workers. The guidelines of ACOEM decide how injured workers will or will not be

compensated by worker's comp insurers.

For the good of the American public, The American College of Occupational

and Environmental Medicine needs to retract their false mold position

statement, immediately. For the good of the American worker, perhaps it is time

to

re-examine if we have given the proverbial Foxes the keys to the Evidence Based

Medicine Hen House.

Mrs. Sharon Noonan Kramer

<BR><BR><BR>**************************************<BR> AOL now offers free

email to everyone. Find out more about what's free from AOL at

http://www.aol.com.

[Guest guest]

Does anyone else see some irony here ?

Perhaps they might reflect that this kind of situation is what we have been

dealing with

for years thanks to people like them. Is it really right for 'doctors' who

might have had

experience treating diseases (but always filtering patients observations

through a filter of what they

want or are allowed to hear) to have their opinions weighted so much more

highly

than the real-life observations of patients who have actually lived in these

situations,

at oftentimes for years?

They can dish it out but they don't have a clue about what our lot in life

as less than bit players in their agenda-ed 'movie'

until now, when predictably, they are ignored. Not because of bias but in

more probability because they have started to lose their scientific 'cred'

due to their own arrogance and INABILITY TO LISTEN TO OTHERS.

What goes around comes around..

>Your officers submitted a letter to the editor (_posted on the ACOEM web

>site_ (http://www.acoem.org/moldresponse.aspx) ) well within the time the

WSJ

>allowed, but they declined to publish it.

>No reason was given. Last week we filed a complaint.

>Our prediction is that they will ignore it. By now, it should be obvious

that

>there is an agenda at work and that the WSJ was, in fact, used.

------

Also,

Read this:

> Turning to substantive issues, let me remind ACOEM members of the

background

to the statement. We are not talking about the association of mold and mold

spores with invasive, allergic, infectious, or irritating conditions. The

statement is perfectly clear that these are known and accepted medical

conditions. Likewise, the statement, although it was written well before the

Institute

of Medicine's report Damp Indoor Spaces, does not suggest that damp or moldy

living environments are acceptable. Not at all.

OH, WELL SURPRISE ME - THEY WOULD HAVE TO BE FOOLS NOT TO SEE

THAT THAT IS EXACTLY HOW THEIR STATEMENT IS USED....

Its used to FORCE poor people and poor employees to breath in TOXIC mold

and get sick. If they don't like it, they are WELCOME to OF THEIR OWN FREE

CHOICE

quit their jobs and lose their pensions.. or leave their affordable rented

homes, or sell their

BOUGHT homes, pocketing huge losses and facing financial ruin...

These people just make me sick...

>The issue at hand is whether the metabolic products of mold known as

mycotoxins, absorbed through inhalation of spores

NOTE HIS VERY TELLING USE OF THE WORD 'SPORES'...

What about fungal fragments? What about dermal absorbtion?

What about the ever strengthening films of mycotoxins that persist a long

time and COAT THINGS

in moldy buildings.. making things so toxic that they still cause ILLNESS

months or YEARS later?

What about people absorbing these things through their skins from their hair

in baths or showers, after the

application of the common shampoo additives like sodium laureth sulphate

that have been used in biowarfare to carry YELLOW RAIN THROUGH the skin? And

KILL people, BTW.

>and vegetative fragments (don't ask me what I think of his euphemism here

or what it tells us about his sense of scientific integrity or honesty)

>in indoor

air, are responsible for systemic human disease under conditions encountered

in homes and offices, an unproven theory called " toxic mold " in the

vernacular.

Oh, impress us with those BIG WORDS now... we bow to your intellectual

prowess..

>The WSJ article implies that there is an extensive scientific debate on

this topic. The reality is that few scientists embrace the theory of " toxic

mold "

Translation: " give the opposition anything to help them and we ruin your

career "

>and many who do (including some of our members) are interested in it as

a theory to be tested, not as a belief.

>The mainstream of medical opinion,

As JK Galbraith called the " conventional wisdom " to illustrate its lack of

integrity and validity, often.

>ACOEM included, has decided that so far the weight of evidence, despite

years

of investigation, does not support the theory.

Well, in private, your members often tell a different story..

When they can't be quoted - or retaliated against.

[Guest guest]

I definitely see the irony. A while back I posted (I think) a link to

information about a book written by a doctor which explains why/how

doctors DO NOT listen to patients and interrupt within the first 18

SECONDS of a visit. Here is is again?:

http://v.mercola.com/blogs/public_blog/New-Book-Exposes-the-Mistaken-

Medical-Assumptions-Doctors-Often-Make-4840.aspx

--- In , LiveSimply <quackadillian@...>

wrote:

>

> Does anyone else see some irony here ?

>

> Perhaps they might reflect that this kind of situation is what we

have been dealing with for years thanks to people like them. Is it

really right for 'doctors' who might have had experience treating

diseases (but always filtering patients observations through a filter

of what they want or are allowed to hear) to have their opinions

weighted so much more highly than the real-life observations of

patients who have actually lived in these situations,

at oftentimes for years?

>

> They can dish it out but they don't have a clue about what our lot

in life as less than bit players in their agenda-ed 'movie'

> until now, when predictably, they are ignored. Not because of bias

but in more probability because they have started to lose their

scientific 'cred' due to their own arrogance and INABILITY TO LISTEN

TO OTHERS.

>

> What goes around comes around..

>

> >Your officers submitted a letter to the editor (_posted on the

ACOEM web site_ (http://www.acoem.org/moldresponse.aspx) ) well

within the time the WSJ allowed, but they declined to publish it.

No reason was given. Last week we filed a complaint.

Our prediction is that they will ignore it. By now, it should be

obvious that there is an agenda at work and that the WSJ was, in

fact, used.