WorkCompCentral~12/1~Group Petitions ACOEM 4 Transparency~Mold Paper Revisions

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The below article is shared in its entirety with permission from

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For further detail and to view videos of testimony given before the CA

Insurance Fraud Assessment Comm regarding this issue, Nov 16, 2010 go to:

_http://KatysExposure.wordpress.com_ (http://KatysExposure.wordpress.com)

Sharon Kramer

WorkCompCentral – Group Petitions ACOEM for Review of Mold

Guidelines

By Greg , reporter

December 1, 2010

A group of physicians, attorneys and concerned citizens is

asking the American College of Occupational and Environmental

Medicine to allow the public to review and comment on

proposed revisions to the college’s position paper on the

health effects of mold exposure.

More than 90 individuals have signed the petition, which was

submitted to ACOEM and a number of governmental officials,

including President Barack Obama, Health and U.S. Human

Services Secretary Kathleen Sebelius, U.S. Attorney General

Holder and the chairpersons and ranking members of the

House and Senate labor committees. The petition calls for a

two-week review period before revisions are finalized.

“I feel almost certain that if public comment is not allowed,

what they’re going to continue to attempt to promote is that

moldy workplaces are not a source of injury for workers who

were not immunocompromised prior,†said Sharon Kramer, a mold

activist who organized the petition. “The spin in this

document is going to be that prior healthy workers are not at

risk from mold.â€

Kramer said the paper amounts to “aiding and abetting

interstate insurer unfair advantage in workers’ comp claim

handling practices,†and that it also “legitimized a

litigation defense argument.â€

Dodd Fisher, an attorney with the Fisher firm in Grosse

Pointe, Mich., who handles toxic tort and mold exposure

cases, said the paper is commonly cited by defense attorneys

and courts tend to give it greater credit than they should.

“It makes it sound like 5,000 or 6,000 doctors are backing up

this statement, at least from the appearance of a scientific

consensus statement,†he said. “The argument the defense

makes is this is a universally accepted position document

that expresses the general or universal acceptance of

environmental physicians.â€

Kramer, Dodd and the other signatories claim that ACOEM’s

position paper on mold wasn’t properly reviewed and isn’t

based on scientific evidence.

ACOEM confirmed that it is revising the 2002 position paper,

but did not return calls asking for additional information

about the reasons for the revisions, when the revisions will

be finalized or who is involved in the revision process.

The ACOEM position paper, titled “Adverse Human Health

Effects Associated with Molds in the IndoorEnvironment,â€

relied in part on a test in which mice were exposed to a

specific strain of mold and suffered no significant health

effects. That test was extrapolated to reach the conclusion

that exposure to mold will have no effects on humans.

The paper states that exposure to mold, and specifically

secondary metabolites they produce called mycotoxins, does

not harm human health. It urges treating physicians to

evaluate other possible diagnoses when a patient claims to

suffer from a health condition caused by exposure to mold.

Additionally, it says the possibility that mold exposure

caused a symptom should be entertained only after all other

possible causes are excluded “and when mold exposure is known

to be uncommonly high.â€

The paper says mold exposure is a problem only for people

with severely impaired immune systems, and concludes with the

claim that “scientific evidence does not support the

proposition that human health has been adversely affected by

inhaled mycotoxins in home, school or office environments.â€

That conclusion is challenged by a study by the Institute of

Medicine (IOM), published in 2004, reporting a link

between “mold and other factors related to damp conditions in

homes and buildings to asthma symptoms in some people with

the chronic disorder, as well as to coughing, wheezing and

upper respiratory tract symptoms in otherwise healthy

people.†The IOM report does caution that there is not

sufficient evidence to draw conclusions about other health

implications related to mold.

Kramer agreed that the research into the health effects of

mold exposure is incomplete, but that doesn’t mean that there

are no effects.

“Absence of evidence is not the same thing as evidence of

absence,†she said. “While it is perfectly acceptable to say

this is plausible and more research is needed — that would be

absence of evidence — what is not science is to take math,

add it to a rat study and profess to prove evidence of

absence.â€

The U.S. Government Accountability Office (GAO) also looked

into the issue in 2008 and determined that additional

research was necessary, but that there was some evidence to

link adverse health effects with exposure to mold.

Dodd, the Grosse Pointe attorney who also teaches a toxic

torts class at the University of Detroit Mercy School of Law,

said his concern is for attorneys and clients unaware of all

the articles criticizing the ACOEM paper. Without knowing

about the alleged deficiencies, an attorney will have a hard

time overcoming the apparent weight of themold statement, he

said.

The International Journal of Occupational and Environmental

Health and Wall Street Journal published articles critical of

the ACOEM mold statement, which Dodd says has helped his

cause.

“Since the Wall Street Journal article and since the IJOEH

articles, it’s not as difficult for me to deal with the

issues, but if you’re a litigator and you don’t have the

information I have to combat that position statement, you’re

going to have a very difficult time addressing the court,†he

said.

The articles questioned the use of Bruce Kelman and

Hardin to author the ACOEM paper, because they were

toxicologists and defense witnesses who testified that there

was no health effect caused by exposure to mold.

Additionally, ACOEM was criticized for not disclosing this

fact.

The Wall Street Journal article, published in September 2007,

notes that Ted Guidotti, president of ACOEM at the time, said

there was no need to disclose that information because doing

so would suggest that the paper expressed Hardin and Kelman’s

position rather than a consensus opinion of the organization.

Hardin and Kelman now work for Washington-based Veritox, an

expert witness and toxicology consulting company. Calls to

Veritox were not returned.

The company went by the name GlobalTox before it was called

Veritox.

In an article in the International Journal of Occupational

and Environmental Health, Dr. Craner, a boardcertified

occupational and environmental medicine practitioner based in

Reno, Nev., notes that the focus of GlobalTox and its expert

witnesses “was on dismissing mold as a toxicological hazard.â€

The article, titled, “A Critique of the ACOEM Statement on

Mold,†published in 2008, concludes with a call for a

transparency policy at ACOEM and a more rigorous system of

peer review at ACOEM’s Journal of Occupational and

Environmental Medicine, where the mold statement was first

published.

Craner, who is an ACOEM member, told WorkCompCentral that the

overall tone and focus of the mold statement is incorrect and

it should be withdrawn and completely rewritten.

“The foundation of the writing of that paper is so corrupt

that to quote-unquote rewrite it is almost an impossible

task; it’s almost an insult,†he said. “Developing

organizational guidelines and position statements needs to

start with the constituent holders.â€

In a lawsuit against the Roswell (N.M.) Independent School

District, the San -based law firm of Chunn, Price and

, relied on these articles as part of a motion to

exclude or limit the testimony of an expert who relied on the

ACOEM paper.

, a partner with the firm, said on the morning he

and Lonnie Chunn were expecting to argue the motion to

exclude, the judge dismissed the case. The judge said Paige

, the student claiming exposure, would graduate by the

time the court could issue an order and because was

not seeking monetary damages, the court would lack

jurisdiction to issue an injunction in that case.

“If I ever get on the plaintiff’s side again, I feel very

confident that anyone who tries to rely on the ACOEM paper,

they’re just going to be in for a world of hurt,â€

said. “It’s just nonsensical the extrapolations that were

made.â€

Kramer said she does not expect ACOEM to respond to her

petition or to calls for more transparency in the drafting of

position papers. She said the occupational medicine field is

conflicted because it has to balance the interest of patients

while also limiting liability for employers and insurers.

“One way to do that is to make the workplace safe for the

workers so there is limited injury, but another way to do

that is to write papers that deny the workplace is causing

injury,†she said. “Occupational physicians sit on a fence

and have to look at what’s in the best interest of the

workers and the employer. With the mold statement, they fell

off the fence.â€

The 2002 ACOEM mold paper can be viewed here:

http://www.acoem.org/guidelines.aspx?id.

To read the 2008 GAO report, click here:

http://www.workcompcentral.com/pdf/2010/misc/GAOreport.pdf.

To read the 2004 IOM report, click here:

http://www.workcompcentral.com/pdf/2010/misc/IOM2004Report.pdf

..

To view the letter that accompanied the petition, click here:

http://katysexposure.wordpress.com/2010/11/29/citizens-

taxpayers-and-concerned-scientists-urge-transparency-in-

workers-comp-medical-association-guidelines-used-to-determine-

environmentally-injured-workerscomp-insurer-benefits-request/.