Is this some sort of sick joke?

[Guest guest]

" Let's hope that there will always be a culture of protecting babies in

our society. " UNC list-serv Tee Guidotti, Christmas Eve 2010

From Craner's A Critique of the ACOEM Mold Statement, IJOEH Oct 2008

" The 2007 Wall Street Journal article, “Experts Wear Two

Hats,†focused on exposing the conflict of interest of

the Mold Statement’s authors “who regularly are paid

experts for the defense side in mold litigation†with the

result that the Statement became a “defense argumentâ€

that “has become a key defense tool wielded by

builders, landlords and insurers in litigation.â€42 The

Wall Street Journal article explained how the “dual rolesâ€

of the Mold Statement’s authors “show how conflicts of

interest can color debate on emerging health issues

and influence litigation related to it.â€42

ACOEM’s president, Tee Guidotti, MD, MPH,

responded to the Wall Street Journal by defending the

Mold Statement’s development as a “formal and

accountable process by which the statement was prepared

and finally approved,†stating that “the lead

author who was chosen (a retired Assistant Surgeon

General) had no conflict of interest at the time.â€42 Dr.

Guidotti asserted that a conflict of interest disclosure

was unnecessary “because the paper represents the

consensus of its membership and is a statement from

the society, not the individual authors.â€42

Dr. Guidotti also responded to the Wall Street Journal

article by issuing a press release, “Ambush above the

Fold,†to the ACOEM’s membership and the media.117

A corresponding letter was submitted to (but not published

by) the editor of the Wall Street Journal, co-signed

by ACOEM’s then president-elect, Dr. McLellan, as well

as Dr. Borak. ACOEM’s leadership adamantly denied

any wrongdoing or organizational impropriety, either

ethical or scientific. The letter alleged that the Wall

Street Journal article was “highly misleading, with key

facts misreported and a pervasive insinuation of conflict

of interest.â€117

The ACOEM Ambush letter asserted that the organization’s

members were offered an opportunity to participate

through a “notice†that was published in the

ACOEM member newsletter in Fall 2002, as well as

through notice of a “session†that was to be held at

ACOEM’s annual conference in May 2003.117 ACOEM’s

internal documents,69,83,86,99–101 however, show that the

Mold Position Paper/Statement was already in its final

form for release by the organization, and unaltered in

form for publication in JOEM, at the times these

member “participation†events were alleged to have

occurred.

The Ambush letter further disclaimed any misconduct

by dismissing the possibility that the adverse

health effects of mold could be exerted on a toxicological

basis, prognosticating that the scientific evidence

set forth by the ACOEM Mold Statement “seems

unlikely to shift with new findings.â€117 The basis of this

exculpation was the 2004 Institute of Medicine’s (IOM)

publication, Damp Indoor Spaces118 and the aforementioned,

highly criticized allergists’ position paper coauthored

by Dr. Saxon.109 The IOM chapter, “Human

health effects associated with damp indoor environments,â€

however, actually concludes that “There is sufficient

evidence of an association between exposure to

a damp indoor environment and upper respiratory

tract symptoms,†and “There is sufficient evidence of

an association between the presence of ‘mold’ (otherwise

unspecified) in a damp indoor environment and

upper respiratory tract symptoms—as well as similar

associations for cough, wheezing, and other (presumed)

lower respiratory symptoms.â€119 These associations

are not contained or even implied in the ACOEM

Mold Statement.3

Righting the Wrongs:

Will ACOEM Do the Right Thing?

According to some of its critics, the ACOEM is a professional

association that is unduly influenced by industry

interests.119,120 The ACOEM Mold Statement provides

an illustrative example of how industry money

and influence pervade occupational and environmental

medicine.

The history of the Mold Statement’s creation, development

and distribution points to a serious problem

within ACOEM, with implications that go well beyond

this particular occupational and environmental health

issue. Through its perhaps well intended but ultimately

deeply flawed process of producing an “evidence basedâ€

guideline on mold, ACOEM has undermined its

organizational credibility. “Harm to the patient†has

been the inevitable outcome as ACOEM recommendations

have been put into practice in the courtroom,

workplace, home, and in the physician’s office.1,2

ACOEM members should be disappointed and concerned,

if not alarmed, about the process the ACOEM

deployed in developing and implementing its Mold

Statement. Little substantive reform will happen, however,

unless at least some of the membership takes decisive

corrective action. Those businesses, professional

and trade organizations, institutions and government

agencies which have relied upon the ACOEM Mold

Statement to guide or justify their policies and practices

should similarly demand accountability and meaningful

reform.

RECOMMENDATIONS

ACOEM as an organization should not continue to

defend its Mold Statement. Instead, it should acknowledge

its wrongdoings and retract both the original

Statement88 and the JOEM publication of it,3 as well as

its “Ambush†response.117 If ACOEM is to salvage any

respect as an organization, it must create an open

process within its membership to address mold and

other controversial issues in a much more balanced

manner, consistent with the stated ACOEM mission

and generally accepted methods for evidence-based

guidelines and peer review.5–7,47–49

The events that led to the Mold Statement’s publication

justify the need for a review and overhaul of

ACOEM management and policies. Important questions

must be asked from within and outside the organization.

As an organization that represents the majority

of OEM physicians, ACOEM must find leadership and

management that embraces a willingness to accept

meaningful, substantive reform to deal with the serious

ethical and professional problems of OEM. The following

measures would begin the necessary steps toward

achieving such reform:

VOL 14/NO 4, OCT/DEC 2008 •

_www.ijoeh.com_ (http://www.ijoeh.com) Conflicts

____________________________________

From: tee.guidotti@...

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CC: Occ-Env-Med-L@...

Sent: 12/24/2010 9:19:42 A.M. Pacific Standard Time

Subj: Re: [occ-env-med-l] Night shifts and pregnancy

Let's hope that there will always be a culture of protecting babies in our

society.