The Mold Mystery - Ron Got's town Univ. Mold Conference

[Guest guest]

http://www.mnrealtor.com/Mold%20Summary.pdf

The Mold Mystery

By Dioury, Director of Government & Regulatory Issues

(The scientific, medical and legal information contained in this document

were taken directly from

speakers who presented at two separate conferences:

Mold: The Litigation Blossoms by MN Defense Lawyers Association

Mold Medicine & Mold Science: Its Practical Applications for Patient Care,

Remediation & Claims

by the International Center for Toxicology and Medicine and the Department

of Pharmacology at

town University. I have noted the speakers who presented the

information in the endnotes

to this document.)

If you haven't heard it already, " toxic mold " seems to be the new

environmental scare affecting

real estate brokers and agents. There are cases being litigated throughout

the country with

accusations that toxic mold is causing adverse health problems to

residential occupants. The

number of articles on this subject are countless ranging from the $32

million dollar settlement in

Texas against an insurance company for mold claims (Ballard case) to Ed

McMahon's dog dying

from mold exposure. Even the legislators in Washington DC are jumping on the

" toxic mold "

bandwagon. U.S. Representative Conyers of Michigan has stated that he

will be

introducing legislation that aims to " protect consumers from the effects of

toxic mold. " Is mold

suddenly causing serious illness? How is it affecting your business?

The Science

Although it is clear that some fungi can cause human and animal disease,

there is currently no

scientific basis that breathing mold spores can cause " neuropsychological "

effects.i Mold or

" fungi " are ubiquitous. They can be found outdoors and indoors both in the

air and on surfaces

however all fungi ultimately are from outdoor sources and comprise of 25% of

the earth's

biomass. Therefore, human exposure to mold is inevitable. If one is not

exposed to it inside

their home, they will most certainly be exposed to it once they walk

outdoors.

There are four types of fungal agents; infectious, irritants, allergens and

mycotoxins.

Infectious: Indoor fungi do not usually cause infection. Although, systemic

infections

can be caused by bird droppings near air intakes which can be a source of

Histoplasma

capsulatum and Cryptoccoccus neoformans if disturbed. Local infections such

as

ringworm and thrush are also fungi infections.ii

Irritants: Fungi can cause skin irritation and irritation of the eyes and

nose.

Allergens: To an allergist, Fungi are at the bottom of the list for allergic

sensitization.

House dust mites, cats, dogs and birds, cockroaches and rodents would all be

considered

before fungi.iii Generally an allergic reaction to fungi occurs in people

who are

genetically predisposed to it. There has been no proven case of allergy to

Stachybotrys.

Sensitization to the mold Alternaria, which is an outdoor fungi, is a risk

for asthma.

Mycotoxins: All fungi produce one or more mycotoxins, so the term " toxic

mold "

makes no scientific sense. Potent cytotoxins cause cell disruption and

interfere with

cellular processes. Some are carcinogenic, induce tremors or other central

nervous

system effects, or damage the immune system or specific organs (e.g. heart,

liver, kidney,

lungs, etc.). There are many unanswered questions pertaining to mycotoxin

exposure and

human disease. We know that some fungi do produce mycotoxins on some indoor

materials and Stachybotrys toxins have been measured in substrate materials

but not in

the air. Even if a toxigenic fungus is present, it does not necessarily mean

that the mold

is producing toxins. Identification of mold on a wall or in an air duct,

even a type of mold

that has the ability to create mycotoxins, does not provide evidence of

exposure. There

are still questions as to whether or not toxin-containing particles are

entering the

breathing zone and are being inhaled, and what dose would have toxic affects

on humans.

iv

The argument being made by " mold victims " is the mold found growing behind

the walls in their

home is " toxic " ; in particular Stachybotrys seems to be the alleged culprit

which can produce the

mycotoxin Tricothecene. Stachybotrys is no different from any other mold.

Stachybotrys is a

greenish-black, slimy mold. Constant moisture is required for its growth but

it also needs

warmth and nutrients such as wood, wallpaper, wallboard, fiberboard, gypsum

board, cardboard,

ceiling tiles, paper, dust and lint. The symptoms associated with this mold,

the plaintiffs argue,

include common, non-specific symptoms such as headaches, fatigue,

irritability and difficulty

concentrating or brain damage, toxic encephalopathy, cognitive deficits,

neurobehavioral

deficits, and neuropsychological impairment.

The first problem with this argument is that the toxins made by

Stachybotrys are not neurotoxins.

There are only a few reported cases of human disease from Tricothecenes. It

was first reported in

Russia from 1942-1947. It was often fatal and it was characterized by

vomiting, skin

inflammation, hemorrhaging of the GI tract and mucous membranes,

immunosuppression, and

pancytopenia. The disease was attributed to eating overwintered grain that

was contaminated

by Fusarium; a different type of fungal species which also has the ability

to make the toxin

Tricothecene.v The toxins made by Fusarium can be neurotoxins.vi

In 1987 there were GI's in India that became very ill after eating bread

made from wheat that

was contaminated with Aspergillus and Fusarium. A similar illness was

reported in China after

consuming moldy rice.

There have been reported cases of veterinary stachybotryotoxicosis. Russians

also reported

stachybotryotoxicosis in humans that had contact with straw or hay in areas

where

stachybotryotoxicoses was found in horses. The symptoms included severe

dermatitis, chest

pain, sore throat, bloody rhinitis, cough and leukopenia. The mold placed on

the skin did

reproduce the clinical syndrome described.

In 1977 there were 23 workers loading moldy hay that developed a sore

throat, bloody nasal

discharge, burning and watering eyes, swollen, crusted skin on the face and

dermatitis. The

symptoms manifested within 24 hours of exposure and the affected workers

recovered within

one week after cessation of the exposure to the moldy hay.vii

You will notice that all of the above cases were outdoor, occupational

exposures or ingested. It

is documented that exposure occurs when moldy food is eaten, mold is handled

or mold spores

are inhaled. However, occupational exposure (sawmills, landscapers, mushroom

farmers, horse

farmers) to many molds, including Stachybotrys, can be in the millions of

spores per m³, which

is significantly higher than measurements found in indoor air environments,

even in mold

contaminated homes. For example, as measured by the NAB of the American

Association of

Asthma, Allergy, and Immunology (AAAAI), in St. Louis, summer mold spore

levels are

routinely 30,000 and sometimes as high as 75,000 spores/m³. Some mold

promoters encourage

homeowners to evacuate their residences when indoor levels reach 1,000-5,000

spores/m³.viii

All of the relevant scientific articles found on the study of mycotoxins

created by Stachybotrys in

indoor environments have been found to be scientifically flawed.

The majority of the legal cases being considered surrounding the argument

that Stachybotrys

found in homes is causing neuropsychological effects are based upon these

scientifically flawed

studies. To add to the mold scare, an investigation by the Center for

Disease Control (CDC) of

pulmonary hemorrhage in infants was performed in Cleveland. There were 8

cases of acute

pulmonary hemorrhage resulting in death among infants from January 1993 to

November 1994.

The cases were more likely to reside in homes where parents reported water

damage in the 6

months prior to the hemorrhage. Aggressive air sampling detected

Stachybotrys more often and

in greater quantity in the case homes however it was not found in all of the

homes. Aerosols of

Stachybotrys spores were virtually non-existent. The Stachybotrys spores are

very large to

penetrate infant airways and other fungi in reservoirs were not considered.

The cases were more

likely to be black, male, live with a relative who coughed blood, exposed to

tobacco smoke, not

to be breast-fed and had significantly lower birth weight. Originally, the

CDC concluded that

Stachybotrys was the cause of the infant deaths however the CDC recently

released the detailed

findings of both internal and external reviews which concluded that a

possible association

between pulmonary hemorrhage in infants and exposure to molds, specifically

Stachybotrys, was

not proven.

Facts to remember:

Scientific evidence is lacking showing that mycotoxins in indoor

(non-industrial)

environments cause symptoms or illness among the building occupants.

If air sampling is done to measure mold spore counts, it cannot be used to

assess whether

the amount " caused " symptoms or illness.

There is currently no medical or scientific determination on how much mold

will cause

adverse health effects in any given person.

Mold Remediation/Water Intrusion

Now that we know what the specific health risks are, or limited health

risks, the important focus

should be on remediation of mold growth in homes. It is the role of fungi to

break down organic

materials. If fungi did not exist, our planet would be covered with dead

trees, leaves, etc.

Needless to say, you do not want mold to eat away at the wood foundation of

your home. The

best way to detect if you have mold in your home is a visual inspection.

Testing, or air sampling

is usually not necessary. The common objectives of mold remediation are to

restore building

conditions (repair water damage, control musty odor, etc.), establish

conditions acceptable for

the general population (minimize minor allergic reactions, etc) and protect

extremely sensitive

individuals (e.g., minimize the potential for fungal infection in

immuno-compromised

individuals).ix It is important to be very cautious about who you select to

provide for

remediation of mold. Many Industrial Hygienists are unfamiliar with the

science of mold and are

making radical, unsubstantiated medical statements and recommendations

regarding what is

necessary to remove the mold. Some uneducated consultants will perform

unnecessary sampling

for mold and make interpretations from them that are misleading, at best,

resulting in fear,

enormous remediation costs and often litigation. Use common sense when

trying to rid of mold

in a home. If possible, prevention is the first step. If you are aware of

water intrusion into a

home, dry out the water and clean the surfaces within 24-48 hours. This is a

critical time frame

to prevent mold growth in the first place. Obviously, one cannot build a

home that does not

contain some organic material which is one nutrient mold needs to grow. What

you can stop is

water intrusion; the other nutrient mold needs to grow. Mold cannot grow

without moisture. If

you have small amounts of mold, simply clean the mold with a bleach

solution. Beyond that, the

extent of caution taken to remove mold growth in a home will depend upon the

current health

condition of the occupant(s) (e.g., immuno-compromised) and the amount of

mold found (e.g.

removal of drywall). A noted source for mold remediation guidelines is the

New York City

Department of Health (NYCDOH) mold remediation guidelines.

(http://nyc.gov/html/doh/html/epi/moldrpt1.html) Guidance has also been

issued by American

Conference of Governmental Industrial Hygienists (ACGIH)

(http://www.acgih.org/home.htm)

and the Environmental Protection Agency (EPA).

(http://www.epa.gov/iaq/pubs/moldresources.html#Homes%20and%20Molds)

Legal

Federal and state courts are dealing with the issue of mold and personal

injury inconsistently

mainly because science has not disproved a link between mold and the alleged

health effects. To

have such a case, there obviously must be some " scientific experts " who will

testify that mold is

causing serious and permanent health problems in humans. To date, California

is the only state

that has adopted substantive law regarding exposure to mold in its Toxic

Mold Control Act of

2001. In respect to procedural law, most states have adopted the Frye

standard, for scientific

testimony which was based on the case Frye v. United States, 293 F.1013,

decided in 1923.

Generally, the Frye standard holds that once a scientific expert establishes

that the theory he or

she bases his/her opinion on is " generally accepted " in the relevant

scientific community, the

opinion is deemed to be permissible or admissible and its ultimate validity

is then to be

determined by a jury. In addition, the U.S. Supreme Court abandoned the use

of the Frye

standard in favor of a new rule governing scientific testimony which is

known as the Daubert

standard based upon the case Daubert v. Merrill Dow Pharmaceuticals, Inc.,

509 U.S. 579

(1993). The Daubert analysis requires the court to act as a " gatekeeper " . x

Minnesota has adopted the Frye-Mack standard which is based on the Frye case

noted above and

the case Steve v. Mack, 292 N.W.2d 764 (Minn. 1980). The Minnesota Supreme

Court recently

affirmed the use of the Frye-Mack standard for determining the admissibility

of novel scientific

testimony in Goeb v. Tharaldson, 615 N.W.2d 800 (Minn. 2000). The Court

specifically

rejected the Daubert criteria in the Goeb case. The Frye-Mack standard

requires a two-pronged

analysis:

1. The scientific methodology, technique or principle must be generally

accepted in the

relevant scientific field. That is a question of law that the appellate

courts review de

novo. 615.N.W.2d at 815.

2. The proponent of the scientific evidence has the burden to establish the

proper foundation

for the admissibility of the test (or opinion) by showing that the

methodology used is

reliable and in the particular instance, produced reliable results. 615

N.W.2d at 816. The

trial court's assessment of the second prong of the Frye-Mack test is to be

reviewed by

the appellate courts under an abuse of discretion standard. xi

Conclusion

In conclusion, it is clear the scientific community is not in agreement as

to whether exposure to

mold or mold spores causes severe, permanent, adverse health effects. Many

of the experts in

this field have clearly stated that there is insufficient evidence to jump

to this conclusion and are

extremely skeptical that the ubiquitous fungi that we experience everyday is

suddenly a serious

health problem.

As a real estate practitioner, be aware of the mold hype and instead of

feeding the frenzy, act

rationally and with common sense. The Minnesota Association of REALTORS®

added the

question of Mold? under the Environmental section of the MAR Seller's

Property Disclosure

Statement. If you have knowledge that a property has had significant mold

problems in the past

and/or mold remediation has occurred, disclose that as a material fact. If a

consumer questions

you regarding significant mold remediation, be sure to contact a

well-educated Industrial

Hygienist or other expert that has been well trained on the issue of mold.

Be cautious of testing

for mold, particularly if litigation may be the result. Although we don't

want mold to take over

and destroy our homes, remember that mold is also a good thing. If you like

wine, cheese and to

feel better after taking your penicillin, don't mangle the mold!

i R. Lees-Haley, Ph.D., A.B.P.P., Neuropsychology Consultant, Health

Education Services

ii Elena H. Page, M.D., M.P.H., F.A.C.O.E.M., Supervisory Medical Officer,

CDC, NIOSH

iii Emil J. Bardana, Jr., M.D., Professor of Medicine, Division of Allergy &

Clinical Immunology Oregon Health &

Science University

iv Harriet A. Burge, Ph.D., Associate Professor of Environmental

Microbiology, Harvard School of Public Health

v Elena H. Page, M.D., M.P.H., F.A.C.O.E.M., Supervisory Medical Officer,

CDC, NIOSH

vi E. Gots, M.D., Ph.D., Principal, International Center for

Toxicology and Medicine

vii Elena H. Page, M.D., M.P.H., F.A.C.O.E.M., Supervisory Medical Officer,

CDC, NIOSH

viii E. Gots, M.D., Ph.D., Principal, International Center for

Toxicology and Medicine

ix Ed Light, C.I.H., President, Building Dynamics, L.L.C.

x R. Larson, Esq., Pepper & Shefelman PLLC

xi E. Varpness, Esq., Gislason, & Varpness, P.A.