Re: Letter from Senator Carper/Delaware Bullet points.

[Guest guest]

Haley,

You asked: " Would you mind throwing out some bullet points for us to send to

our representatives, please? I have yet to write my new folks now that I'm in

Texas and I'd like to be on point with what you will be talking about. "

Yes, of course. Good idea.

I think it is best to fax a letter to your Senators requesting an

investigation into the conflicts of interest of the American College of

Occupational

and Environmental Medicine over the mold issue. That way, you can also fax the

Wall Street Journal article, which makes it easy for them to understand what

has occurred.

Specifically, in the fax,

1. I would start out by saying you deeply concerned that so many are

seriously ill from mold exposure, yet are not able to obtain medical treatment

because of the misinformation being promoted by ACOEM that these illnesses are

not

plausible to occur from indoor mold exposure. And you feel strongly that a

Senate investigation is warranted into the matter.

2. I would then give a one paragraph of the difficulty you have experienced

because the physicians are being intentionally misinformed.

3.Then I would paraphrase the following words and end your letter with the

sentence, " SENATOR ________, WILL YOU SUPPORT AND INVESTIGATION INTO THE

ACTIONS OF THE AMERICAN COLLEGE OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE?

4. I would attach the WSJ article.

Here is what I would paraphrase:

On January 9, 2007, the Wall Street Journal ran a front page article

entitled “Court of Opinion, Amid Mold Suits Experts Wear Two Hatsâ€, by

Armstrong. The gist of the article is of how the governing body of the

American

College of Occupational and Environmental Medicine (ACOEM) betrayed the

American public when they specifically brought into their organization, experts

witnesses for the defense in mold litigation, to write the organization’s

position paper regarding their interpretation of the state of the art

understanding of mold induced illnesses.

ACOEM is a trade organization made up of physicians, whose primary function

is to evaluate injured workers on behalf of insurers and employers. They are

influential on a national level at determining how workers will be treated

for illnesses. They are influential in determining if workers will be able

to obtain workers compensation insurance for their injuries. With regard to

mold induced illnesses, the organization’s so called evidence based document

is

entitled “Adverse Human Health Effects Associated with Molds in the Indoor

Environmentâ€. As noted within the WSJ article, it has been used extensively

as

an authoritative source within mold litigation to deny financial liability

for stakeholders of moldie buildings. It has been used extensively to deny

workers compensation claims. It has caused many, who have been injured by mold

exposure, to be unable to obtain proper medical treatment from misinformed

physicians. To quote from the WSJ article, " 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. "

Specifically, the non-scientific, non-sequitur finding of the ACOEM Mold

Statement that is discussed above, and has caused harm to the lives of so many,

states:

" Levels of exposure in the indoor environment, dose-response data in

animals, and dose-rate considerations suggest that delivery by the inhalation

route

of a toxic dose of mycotoxins in the indoor environment is highly unlikely

at best, even for the hypothetically most vulnerable subpopulations.â€

Yet, when one examines the paper in detail, none of the 83 papers supposedly

being reviewed support the finding of the implausibility of human illness

from the situation. Only the authors themselves make this conclusion.

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. This non-sequitur is an affront to anyone with even the most basic of

logic skills. Yet, ACOEM betrayed the American public and endorsed it as

legitimate science.

The ACOEM authors, who made the prior calculations, have backgrounds in

toxicology and mathematics. One 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.

In essence, the ACOEM Mold Statement is courtroom defense argument disguised

as science. The amount of misery and lack of proper medical treatment

caused for thousand of US citizens, who have been made serious ill from mold

exposure, by the false findings of this authoritative paper, is immeasurable.

Even more alarming, the ACOEM has been given the charge to write evidence based

treatment protocols for workers injured by various work related illnesses. In

the state of California, under Senate Bill 889, the word of ACOEM is the

gospel regarding injured worker treatment protocols.

Even though the key finding within the document, that denies the

plausibility of serious mold induced illnesses from moldie building exposure,

has now

been outed by the Wall Street Journal, as unscientific; the paper is still used

to deny financial responsibility for these illnesses. ACOEM refuses to

retract. Unless our government steps in to stop the deceit of the matter, this

insidious situation will be allowed to continue. More lives will be forever

ruined.

It is a serious situation with national significance on many levels. A

Senate investigation is warranted into the genesis and usage of the ACOEM Mold

Statement. This association has betrayed the public trust by giving the

interests of industry undue influence into diagnostics and treatment protocols

for

the sick. The ramification of this undue influence is far reaching and has

caused harm to countless US Citizens.

" SENATOR ________, I AM ASKING YOU AS A CONSTITUTE OF THE STATE OF _______,

WILL YOU SUPPORT AND INVESTIGATION INTO THE ACTIONS OF THE AMERICAN COLLEGE

OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE REGARDING THE MISINFORMATION THEY

ARE PROMOTING REGARDING SERIOUS MOLD INDUCED ILLNESSES?

Below is the actually WSJ article:

PAGE ONE

Court of Opinion

Amid Suits Over Mold,

Experts Wear Two Hats

Authors of Science Paper

Often Cited by Defense

Also Help in Litigation

By DAVID ARMSTRONG

January 9, 2007; Page A1

Soon after moving into a New York City apartment, Colin and Pamela Fraser

say, they began to suffer headaches, rashes, respiratory infections and

fatigue. They attributed it to mold.

But their lawsuit against the cooperative that owns the building hit a

roadblock when the court wouldn't let their medical expert testify that mold

caused their problems. This is " unsupported by the scientific literature, " the

state trial judge said.

She relied in part on a position paper from the American College of

Occupational and Environmental Medicine, or ACOEM. Citing a substance some

molds

produce called mycotoxins, the paper said " scientific evidence does not support

the proposition that human health has been adversely affected by inhaled

mycotoxins in the home, school, or office environment. "

The paper has become a key defense tool wielded by builders, landlords and

insurers in litigation. It has also been used to assuage fears of parents

following discovery of mold in schools. One point that rarely emerges in these

cases: The paper was written by people who regularly are paid experts for the

defense side in mold litigation.

The ACOEM doesn't disclose this, nor did its paper. The professional

society's president, Tee Guidotti, says no disclosure is needed because the

paper

represents the consensus of its membership and is a statement from the society,

not the individual authors.

The dual roles show how conflicts of interest can color debate on emerging

health issues and influence litigation related to it. Mold has been a

contentious matter since a Texas jury in 2001 awarded $32.1 million to a family

whose

home was mold-infested. That award, later reduced, and a couple of mold

suits filed by famous people like Ed McMahon and Brockovich helped trigger

a

surge in mold litigation. Insurers and builders worried it would become a

liability disaster for them on the scale of asbestos.

The number of suits hasn't been as big as anticipated. One reason appears to

be the insurers' success in getting many states to exclude mold coverage

from homeowner's-insurance policies. But also helping turn the tide, lawyers

and

doctors say, is the ACOEM report. Building groups and the U.S. Chamber of

Commerce have cited it to rebut the notion that mold in the home can be toxic.

Craner, a Nevada doctor who has testified for scores of people who

claimed ill effects from mold, says the paper " has been used in every single

mold case. The lawyer asks, 'Isn't it true the American College of Occupational

and Environmental Medicine concluded that there is no scientific evidence

that mold causes any serious health effects?' "

The result, Dr. Craner maintains, is that " a lot people with legitimate

environmental health problems are losing their homes and their jobs because of

legal decisions based on this so-called 'evidence-based' statement. "

Dr. Craner says a majority of his work is on the plaintiff side and he is

paid when he testifies, but he says he currently is an expert for the defense

in a case where he concluded the plaintiffs' health issues weren't related to

mold.

Two other medical societies have also published statements on mold written,

in part, by legal-defense experts. The societies didn't disclose this when

they released the papers, although one later published a correction saying two

authors served as expert witnesses in mold litigation.

READ MORE

• Read the full text of Dr. Borak's September 2002 email to the leaders of

the American College of Occupational and Environmental Medicine about his

struggles in drafting their position paper on mold.

• Read the official position statements of the American College of

Occupational and Environmental Medicine and of the American Academy of Allergy,

Asthma

and Immunology, as posted on their Web sites.

Mold reproduces through tiny spores. These can float into homes through

windows and vent systems or be carried in on clothes or shoes. Indoors, mold

grows when moisture is present.

There's debate about how much this matters. Plaintiffs attribute ills

ranging from asthma to cognitive problems to inhalation of mold. The Institute

of

Medicine, a largely federally funded nonprofit, reviewed the research in 2004

and said " studies have demonstrated adverse effects -- including immunotoxic,

neurologic, respiratory and dermal responses -- after exposure to specific

toxins, bacteria, molds or their products. " But it added that the dose

required to cause adverse health effects hasn't been determined. The U.S.

Centers

for Disease Control and Prevention, for its part, says on its Web site that

mold can cause wheezing and eye or skin irritation, but a link to more serious

conditions " has not been proven. "

'Highly Unlikely'

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. "

Dr. Ammann, a recently retired toxicologist for Washington state's health

department, recently helped the plaintiff side in a mold case. She says this

was the only time she has done so for pay. In the Fraser lawsuit in New York,

after the judge barred testimony that mold caused health problems, Dr. Ammann,

on her own and without pay, provided an affidavit filed with the appellate

court saying the judge misinterpreted the research.

The ACOEM, a society of more than 5,000 specialists who investigate indoor

health hazards and treat patients with related illnesses, first moved to

develop a position paper on mold in early 2002. Dean Grove, then the medical

society's president, asked the head of its council on scientific affairs, Yale

medical professor Borak, to set the process in motion.

He turned to a retired deputy director of the National Institute for

Occupational Safety and Health -- part of the CDC -- to spearhead the project.

Dr.

Borak says he wanted someone with " no established background record of

litigation related to mold. "

For the Defense

The person he chose, Hardin, says he hadn't worked on any mold lawsuit

at that point, though he was a consultant on other matters for GlobalTox

Inc., a firm that regularly worked for the defense in mold cases. And Dr.

Hardin

says he consulted for the defense in a mold case while he was helping write

the ACOEM paper.

In a Feb. 27, 2002, email, Dr. Borak told Dr. Hardin: " That position paper

would be prepared by you and your GlobalTox colleagues. " Dr. Borak says he

believes he didn't know at the time that GlobalTox did mold defense work.

A GlobalTox colleague who aided Dr. Hardin was Bruce Kelman, now president

of the firm, which recently changed its name to Veritox Inc. Drs. Kelman and

Hardin, now principals at the firm and entitled to a share of its profits,

were two of the ACOEM paper's three authors. They are paid $375 to $500 an hour

for work on mold cases, court records say.

EXPERT WITNESSES

• The Situation: Mold defendants rely on medical-society position papers

that reject a link to serious ills, but papers were written by scientists who

often work for defense side in mold cases.

• The Debate: Whether courts get accurate or skewed view of possible health

effects of indoor mold.

• What's at Stake: Outcome of widespread litigation over mold.

The paper's third author was Saxon, then chief of clinical immunology

and allergy at the medical school of the University of California, Los

Angeles. He, too, has served as a defense expert in numerous mold suits. Dr.

Saxon

says he is paid $510 an hour for his help. If called to testify in court,

his rate rises to $720 an hour, according to a deposition he gave.

Until he retired from UCLA in September, money he earned as a legal-defense

expert was paid to the university, and he says UCLA then gave him a little

less than half of it. Dr. Saxon estimates he generates $250,000 to $500,000 a

year from expert defense work, which includes non-mold cases.

The ACOEM knew about mold defense work by the authors of its paper. Dr.

Hardin informed the society in a Sept. 23, 2002, document under his letterhead.

Labeled " confidential " and " share only with the ACOEM board of directors, " it

told of his work as a defense expert on one mold case.

The letter said the other two authors, Drs. Saxon and Kelman, " have been

retained by both the defense and plaintiff bar in litigation relating to indoor

mold. " Both say they work mostly for the defense in mold cases.

Internal ACOEM documents indicate that as the paper was being written in

August 2002, there was concern within the society that the paper was too

friendly to defense interests. Its authors were asked to modify the first

draft's

tone " because of the concern about possible misinterpretation of 'buzz words'

and phrases such as 'belief system,' 'adherents may claim,' 'supposed

hypersensitivity,' and 'alleged disorder,' " according to a June 2002 email to

Dr.

Hardin from the society's communications director. (The email was obtained by a

plaintiff's attorney in a mold case, Kahn.)

Dr. Borak, the head of the society's council on scientific affairs,

suggested sending a draft for review to one particular mold authority,

Hodgson, director of the occupational safety and health program at the U.S.

Veterans Health Administration. Dr. Hardin objected. He said it would be

" inappropriate to add ad hoc reviewers who are highly visible advocates for a

point of

view the draft position paper analyzes and finds lacking. " The draft

ultimately wasn't sent.

'A Defense Argument'

In September 2002, Dr. Borak emailed colleagues that " I am having quite a

challenge in finding an acceptable path for the proposed position paper on

mold. " He said several reviewers " find the current version, much revised, to

still be a defense argument. "

The society released a paper two months later, and its authors, as well as

ACOEM officials, say it accurately reflects the science on indoor mold

exposure. The authors' " views, if prejudicial, were removed, " Dr. Borak says.

" It

went through a dramatic change of top-heavy peer reviews. " He says objections

come mainly from " activist litigants " who find it " annoying. "

Drs. Hardin and Kelman say the paper has been controversial because it

challenged " a belief system " that mold can be toxic indoors. " A belief system

is

built up and there is anger when the science doesn't support that belief

system, " Dr. Kelman says.

The Manhattan Institute, a conservative think tank, paid Veritox $40,000 to

prepare a lay version of the paper. That version said " the notion that 'toxic

mold' is an insidious, secret 'killer,' as so many media reports and trial

lawyers would claim, is 'junk science' unsupported by actual scientific

study. " Its authors were the three writers of the longer paper plus a fourth,

who

also is a principal at Veritox.

Lawyers defending mold suits also cite a position paper from the American

Academy of Allergy, Asthma and Immunology. This paper says it concurs with the

ACOEM that it is highly unlikely enough mycotoxins could be inhaled to lead

to toxic health effects.

Among the academy paper's five authors is Dr. Saxon. Another, Abba Terr, a

San Francisco immunologist, has worked as a defense expert in mold cases. The

academy published the paper in its Journal of Allergy and Clinical Immunology

last February, not citing the mold-defense work of either man. The

publication later ran a correction disclosing their litigation work.

The academy's president says officials were aware Dr. Saxon was an expert

witness. " We should have published their [disclosure] statements with the

paper, " says the official, Platts-Mills. He says the lapse resulted from

a

variety of factors, including confusion about whose responsibility the

disclosure was.

Unhappy Author

A third author of the academy's paper, Jay Portnoy, chief of allergy, asthma

and immunology at the Children's Mercy Hospital in Kansas City, Mo., says he

" felt that there was an agenda " -- the effort " seemed very biased toward

denying the possibility of there being harmful effects from mold on human

health. " He says he considered removing his name from the paper, but it was

published before he could decide.

Dr. Portnoy says a section he contributed was rewritten by Dr. Saxon to be

" a lot more negative. " He says the paper wrongly says mold isn't proven to

cause allergic rhinitis, with symptoms like wheezing, sore throat and sneezing.

Dr. Saxon denies the authors had a bias but says they applied a high standard

for proving mold causes a particular effect. He says he didn't skew the

content of Dr. Portnoy's section but rewrote it because it was " too diffuse. "

Dr.

Terr in San Francisco didn't return a call seeking comment.

In New York, the Frasers are appealing the refusal of the trial judge, state

Supreme Court Justice Shirley Werner Kornreich, to let their expert testify

that indoor mold caused their health complaints. The Frasers had moved into

the East Side Manhattan apartment in 1996. Their 2002 suit said they

repeatedly complained to the co-op's board of dampness and leaks as their

health

deteriorated.

Their appeal attacks the credibility of mold position papers drafted by

scientists who work for defendants. " What you have here is defense experts

authoring papers under an official guise, " says their attorney,

Eilender.

Justice Kornreich declined to comment.

Write to Armstrong at _david.armstrong@..._

(mailto:david.armstrong@...)

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