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2013-04-29 19:59:09 UTC
Sociological Analysis of Mold Problems
Ronald G. Corwin obtained his Ph.D. degree in sociology from the
University of Minnesota and is now a Professor Emeritus of Sociology
at Ohio State University
The Mold Wars
A seller failed to disclose water intrusions from a leaking ice maker
and washer shut off valves, and also said he could not explain stains
around the kitchen island. His realtor dismissed an odd odor
throughout the house, saying it was coming from an air purifier. After
the sale, the buyers (age 74) and their physically impaired adult
daughter became sick with headaches, coughing up blood, bleeding
through the nose, and related respiratory and pulmonary illnesses. One
of them was hospitalized for “atypical” chest pains, tightness in the
chest, and breathing problems, all diagnosed as stress related. A
certified mold inspection company found massive amounts of toxic mold
in three places throughout the house. The inspection report stated
that the presence of Stachybotrys and Aspergiallus is indicative of
moisture, and that Stachybotrys emits a mycotoxin that may cause a
sensitive individual to react with the symptoms the buyers had been
experiencing. The sellers refused to take any responsibility for
exposing the buyers to health risks. And they could get away with it
if the mold advocates have their way.
_______________________________________________________________________________
OVERVIEW
Maybe it is because so many lawyers and scientists make money working
for defendants in toxic mold cases. Maybe it is because otherwise
unbiased studies of mold’s effects on human health have been flawed.
Or, maybe it is because science is simply incapable of answering the
tough questions being put before it. For whatever reason, scientific
credibility, and with it justice, have become casualties of the mold
wars. Though not always deliberate, the ultimate victims are
plaintiffs who have been harmed by mold. Influential skeptics are
orchestrating attacks on credible evidence that clearly shows black
mold is harmful. Courts are using fanciful visions of science to erect
unattainable standards of proof. Science is being misused,
misconstrued, or simply misunderstood, and the realities involved in
applying it to mold cases are being blithely ignored. As a result,
some mold victims are being denied evenhanded justice.
There are abundant reasons for believing that exposure to some
types of mold is positively linked to human disease even though the
causal chains cannot be fully explained. Yet mold advocates and other
skeptics—among them some prominent scientists and health officials, as
well as steadfast special interests—continue to question that there is
a scientifically proven link between mold and illness, or at least
serious illness, in otherwise healthy people. Apparently persuaded by
some critics who are labeling research on mold “junk science,” some
courts seem to be inappropriately applying a test that attempts to
separate good from bad science, to the detriment of mold victims.
Science is being misused, misconstrued, or simply misunderstood, and
the realities involved in applying it to mold cases are being blithely
ignored. As a result, some mold victims are being denied evenhanded
justice
Ultimately the issues all come down to this one question: Is mold
harmful? That is a straight-forward question. But the answers have
been anything but straight forward. Turns out they depend on a host of
complex variables, assumptions, and issues. Included among them are
characteristics of the victim, of mold, and of illnesses so far
studied and not yet studied; standards of acceptable proof; how to
treat molds that may only contribute to or aggravate an ailment; the
number of victims it takes before mold is counted as a serious threat;
and how one regards “minor” reactions, such as skin and mucous
irritations, runny nose, congestion, and flu-like symptoms that go
away. Truth is, mold advocates do not rate some ailments as “serious,”
even though 30 to 60 million people may be affected; that they are
making unfounded generalizations long before enormous gaps in the
knowledge base have been plugged; and that they minimize threatening
risks to people only because they do not always materialize. Legal
rules and traditions are obstructing justice for many mold victims.
The courts have been complicit and must now decide which type of error
to live with: the error of treating potentially dangerous mold as
benign, or the error of treating potentially benign mold as
dangerous.
Some resolutions are unfolding through a confluence of
controversial research, pressures from business interests, politics,
and ultimately court decisions. I show in the following pages that a
handful of skeptics who are acting as advocates for mold want us to
believe it is benign and are urging us to remain complacent about its
potentially damaging effects. Their appeals are based on fallacies and
twisted logic designed to prevent victims from substantiating harm
from mold. The following review demonstrates there are actually
abundant reasons for believing that exposure to some types of mold is
positively linked to human disease. Even if the causal chains cannot
be fully explained in terms of the chemical interactions involved, the
data show that exposure to the mycotoxins present in specific types of
mold makes some people sick, and at the very least creates a serious
health threat to most people. Skeptics—among them some prominent
scientists and health officials, as well as steadfast special interests
—continue to question that there is a scientifically proven link
between mold and illness, or at least serious illness, in otherwise
healthy people.
Yet, it is telling that even the staunchest doubters do not
advocate living with mold, and ironically they often prescribe steps
to eradicate it even while denying there is evidence it can be
harmful. Of course, a reasonable person can argue that there is
nothing wrong with “playing it safe” by avoiding mold even though
causal links with adverse effects have not been established. However,
that is precisely the point. If a judge or lawyer will not live with
mold because of fear, why should a plaintiff be penalized because he
or she cannot provide scientific proof of harm? The challenge before
the courts is to adjust standards to allow for the distinct
possibility that it will never be possible to for mold victims to
prove with scientific certainty that they were harmed by mold even
though there is reason to believe they have been harmed.
In the following pages, you will find a story about
scientific uncertainty and contests among researchers for
methodological dominance. You will discern conflicts of interest,
bias, political pressures, and wrangling over the validity of
different kinds of legal proof. Then you will see that the outcomes of
law suits have been random. Yes, you will hear about some bloated
court awards awarded several years ago, but then you will also learn
about a more recent backlash against mold victims who cannot meet
unrealistic standards of proof based on esoteric scientific data not
likely to have been obtained or could not afford to obtain. And
finally, you will discover that the biggest allergic reaction of all
is coming from business interests standing to lose billions of dollars
from mold suits.
After a brief background narrative and an overview, Part I
describes mold characteristics and some studies documenting its
harmful affects, followed by implausible allegations being made by
mold advocates who obstinately deny the evidence. Part II is devoted
to exposing several myths that underlie the faulty science and logic
that mold advocates use to support their skepticism about mold. More
studies are reviewed there as well. Several myths the courts have
adopted are discussed in Part III along with analyses showing how the
courts are penalizing mold victims. A Conclusion and Appendix with
examples of mold litigation follow.
BACKGROUND
In 2002, homeowners in California filed over 100,000 water-related
insurance claims, and the number has risen steadily. It is estimated
that over 10,000 mold-related court cases are pending nationwide, a
300 percent increase over a five-year period. The average mold
insurance claim today costs about $35,000 and many exceed $100,000. In
1999, residents of a federally subsidized housing development filed an
eight billion dollar lawsuit over un-repaired plumbing leaks
responsible for mold infestation and a variety of problems ranging
from skin rashes to memory loss. They settled for much less, but still
over one million dollars. More recently, a high profile $32 million
award for negligence and mental anguish went to Melinda and Ron
Ballard, a Texas couple who charged their insurance firm with
improperly handling a claim for water damage from a broken ice-maker
valve, which allowed toxic mold to form and take over the family's $3
million home.[i][i] Other major cases include an $18.5 million award
to a California homeowner, and an action by a New York employee
seeking $65 million for workplace mold exposure. In Illinois, a county
courthouse opened in 1991 and was closed a year later due to health
claims by hundreds of employees, resulting in a multi-million dollar
settlement. A county courthouse in Florida had to be evacuated for
mold remediation, and the county’s suit for $14 million against the
contractor was upheld on appeal. And there are many more such cases,
some of which are mentioned in the Appendix.
This rash of litigation has prompted some observers to label mold
the “new asbestos”— which is say, a lucrative source of personal
injury tort cases intended to fill a void left by declining asbestos
claims which made many happy lawyers and their victimized claimants
rich. However, mold litigation is not evolving quite that way. The
difficulty in proving causation between mold and illness is one of the
factors that distinguish mold claims from asbestos claims. Also, there
is no one disease exclusively linked to mold, as there is to asbestos,
and many mold injuries are considered to be less severe than those
related to asbestos. Unlike asbestos, symptoms associated with mold
often occur only in its presence and tend to disappear when exposure
ends, although sometimes it does have lasting and even devastating
effects. Also important is the fact that “deep pockets” are hard to
identify. Insurers are now excluding or drastically limiting mold
coverage from insurance policies (although claimants frequently have
sued builders, public agencies, and product manufacturers).
The flood of litigation claiming adverse health effects from
mold, coupled with mounting skepticism about those claims, has ignited
a seismic backlash that is shaking up litigation in this area.
Especially noteworthy are three papers and a legal opinion, which have
inflamed intense controversies over whether toxic mold is harmful.
The Cleveland, Ohio Study
A scientific controversy over a 1994 Cleveland, Ohio study of a rare
disorder characterized by bleeding lungs in eight infants has
emboldened the skeptics.[ii][ii][2] The report claimed to have found
evidence suggesting the malady might have been caused by a potentially
deadly form of mold called Stachybotrys chartarum. The study’s authors
were initially cautious, representing their findings as a preliminary
evaluation of some suspicions. But by 1997, media were
sensationalizing the study with titles like, “The Fungus Did It,”
“Baby-Killing Fungus,” and “A Look at Deadly Mold Found in Homes.” The
study’s lead author became more assertive about the casual role of
toxic mold, even as her co-author continued to speak cautiously. In
1999, the Center for Disease Control (CDC) commissioned a panel of
scientists to evaluate the validity of this research project. Their
report unmercifully attacked the study on the basis of numerous
methodological problems it identified, including inconsistency of case
identification and measurement/assessment techniques, statistical
shortcuts, and survey errors, as well as differences in the way
control and subject cases were treated. The report also called into
question both the small size of the sample and the diagnosis of the
medical condition, which the CDC says is not a disease but a condition
that accompanies a host of ailments. A later study of three infants,
published in 2004, suggested that the infants with this particular
pulmonary disease might have had underlying acquired or genetic
susceptibility that predisposed them to pulmonary bleeding.
The scientist who headed the study, Ruth Etzel, M.D., was at the
time employed by CDC as an epidemiologist. She has since resigned over
the incident and now charges that the CDC has sought to bury the
connection between mold and disease. In retrospect, it seems that the
panel was justified in criticizing the authors for exaggerating the
causal implications of their work. However, the panel itself can be
faulted for using standards more appropriate to a pure experimental
laboratory model than to field research, where often circumstances
cannot be well controlled. Unfortunately, the controversy surrounding
this one stream of research has obscured an emerging consensus among
many scientists that mold and water-damaged housing are threats to
human health, notwithstanding the inconclusive connection between
Stachybotrys and the rare malady that struck the Cleveland infants.
The significance of the CDC report has been grossly exaggerated by a
clique of outspoken mold advocates who are using this one study to
discredit other research on mold.
Two Papers Commissioned by the U.S. Chamber of Commerce
It did not take the U.S. Chamber of Commerce long to exploit the
Cleveland study controversy. In July 2003, in conjunction with the
politically tilted Manhattan Institute, the Chamber’s Institute for
Legal Reform released two decidedly one-sided reports that were both
calculated to crush claims that mold is a health hazard.[iii][iii][3]
The 1st paper. One of the papers is authored by two lawyers who
categorically smear all research on mold as “junk science.” Their
paper, provocatively titled “How Junk Science and Hysteria Built an
Industry,” is an all-out attack on mold claims.[iv][iv][4] The lawyers—
both of whom apparently have built practices representing the
insurance industry and companies that have been targets of toxic tort
cases—argue that the serious health claims that pervade mold
litigation cannot withstand the scrutiny of reliable science.
Citing billions of dollars in claims suffered by the insurance
industry, they casually flip off concern about mold as a fiasco
produced by bad science and worse journalism. They steadfastly hammer
away at mold claims, brushing them off as a symptom of hysteria and
unfounded fears, promulgated by scary stories whipped up by media
frenzy, and exploited by unscrupulous and unregulated remediators. And
they don’t miss opportunistic trial lawyers, who they claim are
exploiting junk science as “the new asbestos.”
Mundane mold is everywhere, they proclaim, but through a
convergence of bad science, environmentalists’ sensationalist alarms,
and entrepreneurship, it has become the basis of a new “toxic cottage
industry” feeding on unfounded paranoia. The “sick building syndrome”—
dry skin, mental fatigue, headaches, and airway infections—is, they
contend, nothing more than a catchy but misleading fiction. The
authors cite several surveys by prominent scientists and health
organizations to bolster their case. For example, in 2003 Cleveland
microbiologists concluded from an analysis of 465 references that
there is no supportive evidence for “serious illness” from toxic mold
in the contemporary environment. The American Industrial Hygiene
Association and the National Institute of Occupational Safety and
Health came to similar conclusions. Texas Medical Association’s
Council on Scientific Affairs concluded that evidence for the
existence of a separate “sick building syndrome” is weak.
The 2nd paper. The other paper that the Chamber of Commerce chose to
sponsor, titled “A Scientific View of the Health Effects of Mold,”
concludes that there is no scientific evidence that mold causes
“toxicity” in doses found in indoor home environments.[v][v][5] The
authors acknowledge that mold can cause allergies for people who are
already susceptible to allergic reactions, and for individuals who are
“immune-compromised.” However, they dismiss these cases, labeling them
“rare” (even though they involve many millions of people).
The lead author, Brian Hardin, though not a physician, is a
former Assistant Surgeon General in the Public Health Service. More to
the point, Hardin went on to consultant with a corporation that
represents insurance companies and profits from testifying against
individuals claiming to have been harmed by mold. Another author of
this paper has been in court over conflict-of-interest charges related
to it.[vi][vi][6] Much of the data cited in the paper appears to have
come primarily from a study of rats that were subjected for a few
minutes to doses of mold.
The Daubert Test
The U.S. Supreme Court eventually entered the fray. Expert witnesses
were being paid to slant their testimony to fit whatever opinion was
needed, sometimes justifying personal opinion with pseudo theories
without scientific basis. The Court reacted by telling judges to act
as gatekeepers and vigilantly guard against fake experts and “science
that is junky.” With the so-called Daubert test, the Supreme Court
recognized that the scientific method used in research is also
required in judicial analysis.[vii][vii][7] Factors making up this
test include: The theory or technique must be falsifiable; its error
rate must be known; it should be subject to peer review and generally
accepted within the relevant scientific community; it should be
measured according to standards used by the particular field of
knowledge at issue, including non-technical fields; and, conclusions
must be based on evidence.
Requiring courts to respect the cannons of science is a good
thing. However, the Daubert test clearly stacks the deck against
plaintiffs in toxic tort cases. Just how much it hurts them may be
debatable, but it clearly sets an extreme standard that some lawyers
can and probably will exploit. At the same time, the test in itself
does not stop scientists who have conflicts of interest and fail to
disclose all sources of income. Nor does it stop scientists who fake
or exaggerate data. And, there has been an unintended consequence: the
Daubert test has erected a host of practical obstacles for mold
victims trying to prove personal injury. Here are the problems.
On the scientific side, unlike allergies, there is no way to test
for Stachybotrys in the body, nor for poisoning after it has left the
body. And, unless the victim has recently had a comprehensive medical
exam, physicians cannot verify that any physical change has occurred—
especially if a victim has been exposed intermittently over a long
period of time. And on the practical side, victims who have become
sick are most likely focused on recovery, and are not at that point
thinking about filing mold claims. Frequently they do not become aware
that mold was the cause until well after the actual exposure and after
the environment has been altered or cleaned. By that time, it is too
late to commission the required tests, and also too late for
scientists and physicians to verify the condition of the environment,
and of the person’s body, at time of exposure.
Then too, it is becoming nearly impossible to find physicians
willing to testify in court, because medical liability insurers
usually prohibit testifying (or sometimes even reviewing cases) on
behalf of a plaintiff. Also, many hospitals require doctors to sign
contracts prohibiting them from testifying on behalf of plaintiffs,
and even some colleges threaten to revoke certification if they
disagree with an expert’s opinion.[viii][viii][8] Testimony from a
victim’s neighbors, acquaintances, friends, contractors, and family
may be more directly relevant to a case than testimony from
scientists. But they do not meet the Daubert test.
PART I: MOLD
It is generally known that many molds can produce allergens that
affect up to 20 to 30 percent of the population. Mayo Clinic
researchers have identified mold as the leading cause of most chronic
sinus infections (a condition that affects over 37 million people in
the U.S.).[ix][ix][9] According to warnings from the CDC, certain
individuals with chronic respiratory disease, such as chronic
obstructive pulmonary disorder or asthma, may experience difficulty
breathing in the presence of molds. In addition to allergies and other
illnesses that target people with pre-existing conditions, some molds
can also produce infectious toxins, which can affect everyone,
depending on the length of exposure and other conditions. According to
the Mayo Clinic researchers, sinus infections do not come from
allergies but from responses to fungus experienced by otherwise
normal, healthy people. Most of the controversy about mold’s affect on
health has focused on whether some molds can harm people who are not
already allergic, and if so, if they can be seriously harmed.
The term “toxic mold” is often used to describe the more
threatening types of molds. However, it should be understood that
molds themselves are not toxic. Instead they can nurture secondary
metabolites that produce mycotoxins, which then can become airborne.
Common ailments, such as many flu-like symptoms, usually can be
treated and reduced after people leave the tainted environment.
However, some symptoms can become permanent in the form of weakened
immune systems, possibly brain damage, and damage to the pulmonary
system, memory, eyesight, and hearing.
Mold can grow between the walls of a home when water leaks in
through windows, roof lines, or from plumbing failures. CDC
information suggests that molds will grow anywhere indoors where there
is moisture. Microscopic mold spores can quickly become airborne and
travel throughout air conditioning and heating systems. A mold-
infested home creates a potentially lethal environment for anyone.
Sometimes the only method to rid a structure of the more extreme toxic
molds is with a bulldozer and trucks to haul off the debris. The most
common indoor molds are Cladosporium, Penicillium, Aspergillus, and
Alternaria. Accurate information about how often Stachybotrys
chartarum (or Stachybotrys atra) is found in buildings and homes is
not available, but it is thought to be a rare occurrence.
Mold Characteristics
There are many types of mold, only a few of which are harmful to
humans.
Aspergillus, Stachybotrys Chartarum, and Chaetomium
Aspergillus is a genus of mold often found within indoor
environments, which can become dangerous to some people. The genus
includes over 150 species, only a few of which can cause an illness in
humans and animals. Most people are naturally immune, but when this
illness occurs, it takes several forms, ranging from "allergy-type”
illnesses to life-threatening generalized infections. Some believe
that Aspergillus molds can cause cancer, although skeptics dispute it.
The severity of the disease inside the human body is determined by
various factors, but one of the most important is the state of a
person’s immune system.
The most dangerous mold strains are: Stachybotrys and Chaetomium,
both of which produce mycotoxins, which can lead to disease in
otherwise healthy individuals. Certain people are especially
vulnerable to minor and temporary allergic reactions from non-toxic
mold, but anyone who has been exposed to either of these toxic molds
can experience myriad symptoms and illnesses, including skin problems,
chronic fatigue, respiratory and heart problems, nose bleeding, and
bronchitis. While disputed, some authors believe it can also lead to
learning disabilities, mental deficiencies, cancer, multiple
sclerosis, lupus, fibromyalgia, rheumatoid arthritis, and more.
Stachybotrys chartarum (atra), which occurs widely in North America,
requires water soaked cellulose (wood, paper, and cotton products) to
grow. While wet it looks black and slimy, perhaps with white edges;
when dry it looks less shiny.[x][x][10] Bob Krell, chief executive of
IAQ Technologies, a Syracuse indoor air quality specialty company,
says that although mold spores from roughly 100,000 strains are
everywhere, finding Stachybotrys indoors is unusual.[xi][xi][11] This
is because it is basically a water-loving mold, and it needs a lot of
water. But once inside, the mycotoxins it releases can be inhaled and
result in the illnesses mentioned.
Adverse Health Effects Commonly Associated With Various Types of Mold
According to a statement issued by the California Department of
Health, toxic effects from Stachybotrys were first reported in Europe,
where horses, sheep and cattle suffered fatal hemorrhagic disorders
following ingestion.[xii][xii][12] Human occupational exposures to
contaminated straw or hay resulted in nasal and tracheal bleeding,
skin irritation and alterations in white blood cell counts.[xiii][xiii]
[13] The first U.S. case of Stachybotrys-associated health effects
from inhalation exposure was reported in a suburban Chicago family.
[xiv][xiv][14] The fungus had contaminated the ventilation system and
ceilings of the house. Health effects reported by the family included
chronic recurring cold and flu-like symptoms, sore throat, diarrhea,
headache, fatigue, dermatitis, intermittent focal alopecia and
generalized malaise. Workers who cleaned and removed contaminated
material from this house also experienced skin irritation and
respiratory symptoms. After Stachybotrys contamination was removed,
the house was reoccupied and residents reported no recurrence of
clinical symptoms.
Stachybotrys was found in a water-damaged office building in New
York City. A small case-control study showed workers exposed to the
fungus were at statistically significant higher risk for nonspecified
disorders of the lower airways, eyes and skin; fevers and flu-like
symptoms; and chronic fatigue.[xv][xv][15] Another recent report
describes identification of 10 likely or possible cases of building-
related asthma in a courthouse contaminated with Stachybotrys and
Aspergillus species.[xvi][xvi][16] Self-reported symptoms among co-
workers included fever, headache, rhinitis, coughing, dyspnea and
chest tightness. Chest radiographs were negative and Stachybotrys-
specific serology was uninformative.
A wide array of symptoms are known to be, or suspected to be,
associated with exposure to various types of fungi. They include the
following:
Respiratory Problems
Respiratory Distress; Flu Symptoms, including Digestive System-
Diarrhea; Nausea and Vomiting; Recurring Colds, Chronic Coughing,
Runny Nose, (From Sinus Cavities), and Nose Bleeds; Choking, Spitting-
Up Mucous, Coughing-up Blood, Rhinitis, and Sinusitis; Difficulty
Swallowing, Asthmatic Signs, and Allergies.
Pulmonary Problems
Breathing Difficulties; Tightness of the Chest; Lung Congestion;
Elevated Blood Pressure; Heart Palpitations; Heart Attack.
Other Problems
HeadachesAnxiety; Chronic Fatigue; Insomnia and Other Sleep Disorders;
Memory Loss/Forgetfulness/Brain Fog; Bladder or Kidney Problems; Joint
Pains, and/or Swelling; Cancer; Death in Severe Cases.
Emotional Distress, Stress, and Heart-Related Problems
Stress and emotional distress can be directly caused by mold, or
indirectly caused by trauma related to coping with it. Skeptics tend
to deny that emotional distress has any connection with mold,
sloughing it off it as “psycho-social” in origin. One article, for
example, maintains that a “sick building syndrome” outbreak in a
manufacturing plant was actually due to “somatic conditions
characterized by anxiety and depression,” the implication being that
they are not relevant to air quality. However, stress can exacerbate
physical conditions and directly or indirectly affect the heart by
releasing fatty acids and glucose into the bloodstream, which in turn
can become deposited on arterial walls and restrict blood flow and
produce hypertension and respiratory problems; it also can contribute
to coronary related symptoms.[xvii][xvii][17] Courts allow emotional
damages under restricted conditions, for example if it can be shown
that stress pushes the plaintiff into the zone of danger for physical
harm. Studies published in the New England Journal of Medicine
indicate that chest pains can be caused by inflammation of the sac
surrounding the heart (pericaditlis) associated with viral infection.
[xviii][xviii][18] Mold, and in particular Stachybotrys, is thought to
be one source of congestive infection. In addition, emotional stress
can independently contribute to chest pain by precipitating severe
reversible left ventricular dysfunction, even in patients without
coronary disease (myocardial stunning). This condition does not
necessarily produce heart failure. Stress cardiomyopathy is a related
condition which, unlike heart attacks, involves no blood clot in a
coronary artery that cuts off circulation. Patients can recover fully
without lasting damage to the heart muscles. John Hopkins University
doctors say exaggerated sympathetic stimulation is probably central to
the cause of this syndrome. Intense grief, fear, anger or shock can
lead to a temporary weakening of the heart which affects the heart’s
ability to pump blood.
Illustrative Studies
Myriad studies from a variety of sources, ranging from respected
universities and research centers to the military and agricultural
environments, have discovered that significant health problems can
readily arise from the inhalation of elevated levels of fungal spores
and toxins. Laboratory studies (both of animals and at the cellular
level) provide supporting evidence for direct toxicity of fungal
spores and mycotoxins in mammalian lungs. A health study by the
Finnish Institute of Occupational Health links 35% of newly acquired
asthma in healthy adults to workplace mold exposure.[xix][xix][19] A
European Community respiratory health survey in 2002 reported that
asthma patients experience more significant asthma symptoms after they
become sensitized to molds such as Alternaria and Cladosporium species.
[xx][xx][20]
A compilation of 18 current, scientific, peer reviewed papers
presented in 2003 summarizes the preliminary conclusions from studies
of several hundred patients. The book, addresses the question, are
illnesses associated with exposures to indoor mold growth real, or the
results of a conspiracy fueled by media hype and greedy lawyers?
Evidence is presented for severe neurobehavioral impairment, nasal
sinus and lung dysfunctions, and immunological disturbance.[xxi][xxi]
[21] The evidence shows that many mold-exposed people are indeed sick,
with significant brain function impairment. The investigations are
based on measurements of single patients and groups, studied
systematically. Physiological functions and brain scans were abnormal.
Mechanisms of mold damage to brain cells resemble those for Gulf War
Syndrome, chemical intolerance, and exposure to chlorine, ammonia, or
hydrogen sulfide gases. The book warns that because exposures are
invariably to mixtures of molds, attempts to define exposure in terms
of specific molds and toxins, or by searching for biomarkers in body
fluids, are necessarily inconclusive.
In May, 2004, The Institute of Medicine (IOM) issued a report
that concludes various types of studies show that microbial toxins
associated with mold can cause both allergic and non-allergic
reactions in otherwise healthy people.[xxii][xxii][22] Well documented
adverse affects mentioned in the report include upper-respiratory
tract symptoms, cough, wheeze, and asthma symptoms. Other possible
affects include lower-respiratory illnesses, shortness of breath, and
asthma development. The report questions associations with
neurological problems, fevers, fatigue, gastrointestinal symptoms,
pulmonary hemorrhage in infants, and cancer. The IOM report cites a
1994 Harvard University School of Public Health study of 10, 000 homes
in the United States and Canada which found that mold was associated
with a 50% to 100% increase in respiratory problems for the residents
of water- and mold-damaged homes. Chronic sinusitis, a condition that
affects about 37 million people in the United States, is apparently
caused by an immune response to mold and other fungus.
Research doctors at the Mayo Clinic conducted a study of 210
patients with chronic sinus infections and found that most had
allergic reaction to mold (fungal sinusitis). Before the Mayo Clinic
study, the prevailing medical opinion had been that mold accounted for
only 6 or 7% of all chronic sinusitis.[xxiii][xxiii][23] The Mayo
Clinic work is the first to provide data for the role of airborne
fungi in chronic rhinosinusitis and to show that several immune system
branches appear to collaborate in response to the fungi -- resulting
in an abnormally enhanced response in otherwise healthy people that
causes troublesome inflammation and congestion. The research team's
data show that specific cells in 90 percent of chronic rhinosinusitis
patients produce an enhanced immune-system response to one fungus in
particular, Alternaria. Another kind of common fungus, Cladosporium,
also provoked an abnormally enhanced immune response.
A Florida study concluded that people’s immune system changed
with regular exposure to toxic mold even at low levels. The study
involved just one square foot of mold on a 100 square foot wall.[xxiv]
[xxiv][24] K. H. Kilburn, University of Southern California, Keck
School of Medicine, evaluated sixty-five consecutive outpatients
exposed to mold in their respective homes and compared them with 202
community subjects who had no known mold or chemical exposures.[xxv]
[xxv][25] The author concluded that indoor mold exposures were
associated with neurobehavioral and pulmonary impairments that likely
resulted from the presence of mycotoxins, such as trichothecenes.
Balance, choice reaction time, color discrimination, blink reflex,
visual fields, grip, hearing, problem-solving, verbal recall,
perceptual motor speed, and memory were measured. Medical histories,
mood states, and symptom frequencies were recorded with checklists,
and spirometry was used to measure various pulmonary volumes and
flows. Neurobehavioral comparisons were made after individual
measurements were adjusted for age, educational attainment, and sex.
Significant differences between groups were assessed by analysis of
variance. The mold-exposed group exhibited decreased function for
balance, reaction time, blink-reflex latency, color discrimination,
visual fields, and grip, compared with referents. The exposed group's
scores were reduced for the following tests: digit-symbol
substitution, peg placement, trail making, verbal recall, and picture
completion. Twenty-one of 26 functions tested were abnormal. Airway
obstructions were found, and vital capacities were reduced. Mood state
scores and symptom frequencies were elevated.
In Germany, research by The World Health Organization finds
prostate cancer, breast cancer, and other cancers increasing due to
mold-related problems. Mold is the number one health problem
identified, with one in every three persons affected; and one in ten
of those so affected reportedly have a severe problem. At the
University of Texas M.D. Anderson Cancer Center, approximately 15-20%
of patients with leukemia die of fungal leukemia caused most
frequently by the species Aspergillus.[xxvi][xxvi][26] Of patients
with leukemia who have undergone allogenic bone marrow or stem cell
transplantation, 15-30% have died because of refractory fungal
infections. In recent years, comparative risk studies performed by EPA
and its Science Advisory Board (SAB) have consistently ranked indoor
air pollution among the top five environmental risks to public
health.
A physician, Dr. Michael Gray, found a range of adverse symptoms
among 70 percent of the 350 patients he studied who had been exposed
to toxigenic molds and other compounds.[xxvii][xxvii][27] It was
concluded that mycotoxins stimulate immune reactions and also can
adversely affect mobility and cognitive functions. At least some
toxins are small enough to enter the respiratory system. Ann Davidoff
found no evidence that reactions to mold can be explained by
psychosomatic factors.[xxviii][xxviii][28]
On September 2, 2004 Richie C. Shoemaker, M.D., testified before
congress about the health effects of mold. He is a medical
practitioner who also conducts research for The Center for Research on
Chronic Biotoxin Associated Illness (CRBAI). He said, in part:
Statements made by authoritative groups such as the Centers for
Disease Control and Prevention (CDC) and Institute of Medicine (IOM)
that “exposure to mold illness has not been shown to cause chronic
health effects beyond respiratory illness.” They are completely wrong…
We have the hard scientific data on causation of illness, showing a
direct connection between exposure to biotoxic mold in buildings and
subsequent acquisition of illness.”[xxix][xxix][29]
The “Mold-Is-Benign” Advocates
These authoritative sources and many other studies from reputable
sources frequently document negative health consequences of mold. Yet,
as already shown, some spokespersons in authoritative scientific-,
public-, and business-related positions flatly deny that mold is a
serious health threat. At most, some mold advocates reluctantly
acknowledge that exposure to mold may sometimes cause runny noses,
itchy eyes, scratchy throats, and other allergic symptoms, but—they
usually hasten to add—only in already highly susceptible people.
One of the most outspoken naysayers is, ironically, a public
agency that oversees the nation’s health, The U.S. Centers for Disease
Control. It has concluded that, “There are very few case reports that
toxic molds… inside homes can cause unique or rare health conditions
such as pulmonary hemorrhage or memory loss. These case reports are
rare, and a causal link between the presence of the toxic mold and
these conditions has not been proven.” While acknowledging that some
individuals can be seriously affected, the agency off-handedly
depreciates such cases to the category, “rare.” Note that only two
ailments are mentioned in the advisory; but they are used to justify
the over blown generalization that there is no proof that mold causes
serious harm. If the CDD has hard evidence about other serious
conditions not affected by mold, it should identify them. If not, it
should clearly limit its conclusions to the two listed.
Jumping on the band wagon, Dallas attorney, Beth Bradley,
dogmatically asserts that there is "not a lot of hard evidence
connecting mold" to illnesses. She adds, "We are just now starting to
see the other side of the story in these cases.”[xxx][xxx][30] What is
the “other side?” According to her, it includes what she calls the
“false positives” for Stachybotrys from improper testing, unscrupulous
remediation contractors, and mainly, inflated repairs that drive up
insurance costs.
Quade R. Stahl, Ph. D., director of the Indoor Air Quality
division at the Texas Department of Health disparages the available
anecdotal evidence, calls for more data to prove a positive
connection, and cautions that the collection of sufficient data will
be a "slow and tedious process that is not going to happen next
year."[xxxi][xxxi][31] According to the Texas Medical Association's
Council on Scientific Affairs, “burgeoning litigation on Stachybotrys
in homes has far outrun the available science." It issued a reassuring
report advising that while mold can cause reactions in people with
allergies and asthma, there's no evidence that it causes other health
problems or aggravates other existing health conditions.
In his Washington Post, article, "It's Everywhere," Christopher
Wanjek quotes sources insisting that mold is common and therefore not
a big deal."[xxxii][xxxii][32] One source is quoted as saying, "For
most, mold is a mostly ignored part of their lives. For some with mold
allergies, the smell can cause nasal allergy or even asthma symptoms.
Yet what is increasingly clear is that their mold related illness has
nothing to do with toxic substances produced by molds." Organizations
that stand to lose from mold claims are among the prominent doubters.
They include especially insurance companies, the National Home
Builders Association, and the U.S. Chamber of Commerce, all of which
have disseminated often unsubstantiated assertions disputing the
effects of mold. Because they reflect self-interested biases of their
constituencies, their statements deserve to be met with intense
skepticism.
The U.S. Chamber of Commerce is a federation of businesses that
include insurance companies and others that are most likely to be sued
for mold-related problems. In 2003 it issued a statement lauding
findings from the two previously mentioned papers it sponsored denying
scientific links between mold and health problems. The Chamber’s
statement mentions billions of dollars in mold claims paid by the
insurance industry.[xxxiii][xxxiii][33] The National Association of
Home Builders and its subsidiaries also downplay the health effects of
mold, even while disseminating information about how to prevent,
detect, and eradicate it. The Dallas chapter’s web site, for example,
maintains that mold is everywhere in our environment, and people are
exposed to it every day.[xxxiv][xxxiv][34] While conceding that people
with weakened immune systems may be more vulnerable, healthy
individuals, it asserts, are usually not vulnerable to infections from
airborne exposure to mold. The website also maintains that:
“Currently, to our knowledge, there are no authoritative studies
establishing a reliable, scientific connection between mold and the
more serious illnesses that are being alleged…According to respected
scientific bodies like the Environmental Protection Agency and Centers
for Disease Control, among others, there is very little scientific
evidence linking mold with serious human illness, particularly
considering the low levels of exposure in most homes.”
Some state health agencies have also been reluctant to take any
position that might upset special interests. The following statement
from the California Department of Health Services is illustrative:
[xxxv][xxxv][35]
“The demonstration of mold-specific antibodies alone is generally
considered insufficient to prove that health effects reported by
individuals in moisture-damaged buildings are caused by mold exposure.
Symptoms associated with mold exposure are nonspecific and vary
greatly with individual susceptibility. There are currently no
validated biomarkers of exposure to specific indoor fungi or their
toxins. S. chartarum serology tests have no clinical application at
this time. They cannot be used to imply the presence of S. chartarum
within a home or workplace environment, nor can they be used to prove
patient exposure to this specific mold or its toxins.
PART II: MOLD, MYTHS, AND SCIENCE
To be sure, research on mold has not yet yielded conclusive answers
about its full effects. Still, the preponderance of findings seems to
suggest, and often demonstrate, that mold is harmful. So, why are some
mold advocates so resolutely convinced that mold has not been proven
harmful? It is tempting to blame their connections with (or pressure
from) groups threatened by the information. However, that is too
simple. Another important part of the answer is misunderstanding of
the scientific method. Both explanations will be considered, along
with a series of commonly held myths about scientific research in this
area.
Read More:
http://www.socialissues.us/17701.html
Ronald G. Corwin obtained his Ph.D. degree in sociology from the
University of Minnesota and is now a Professor Emeritus of Sociology
at Ohio State University
The Mold Wars
A seller failed to disclose water intrusions from a leaking ice maker
and washer shut off valves, and also said he could not explain stains
around the kitchen island. His realtor dismissed an odd odor
throughout the house, saying it was coming from an air purifier. After
the sale, the buyers (age 74) and their physically impaired adult
daughter became sick with headaches, coughing up blood, bleeding
through the nose, and related respiratory and pulmonary illnesses. One
of them was hospitalized for “atypical” chest pains, tightness in the
chest, and breathing problems, all diagnosed as stress related. A
certified mold inspection company found massive amounts of toxic mold
in three places throughout the house. The inspection report stated
that the presence of Stachybotrys and Aspergiallus is indicative of
moisture, and that Stachybotrys emits a mycotoxin that may cause a
sensitive individual to react with the symptoms the buyers had been
experiencing. The sellers refused to take any responsibility for
exposing the buyers to health risks. And they could get away with it
if the mold advocates have their way.
_______________________________________________________________________________
OVERVIEW
Maybe it is because so many lawyers and scientists make money working
for defendants in toxic mold cases. Maybe it is because otherwise
unbiased studies of mold’s effects on human health have been flawed.
Or, maybe it is because science is simply incapable of answering the
tough questions being put before it. For whatever reason, scientific
credibility, and with it justice, have become casualties of the mold
wars. Though not always deliberate, the ultimate victims are
plaintiffs who have been harmed by mold. Influential skeptics are
orchestrating attacks on credible evidence that clearly shows black
mold is harmful. Courts are using fanciful visions of science to erect
unattainable standards of proof. Science is being misused,
misconstrued, or simply misunderstood, and the realities involved in
applying it to mold cases are being blithely ignored. As a result,
some mold victims are being denied evenhanded justice.
There are abundant reasons for believing that exposure to some
types of mold is positively linked to human disease even though the
causal chains cannot be fully explained. Yet mold advocates and other
skeptics—among them some prominent scientists and health officials, as
well as steadfast special interests—continue to question that there is
a scientifically proven link between mold and illness, or at least
serious illness, in otherwise healthy people. Apparently persuaded by
some critics who are labeling research on mold “junk science,” some
courts seem to be inappropriately applying a test that attempts to
separate good from bad science, to the detriment of mold victims.
Science is being misused, misconstrued, or simply misunderstood, and
the realities involved in applying it to mold cases are being blithely
ignored. As a result, some mold victims are being denied evenhanded
justice
Ultimately the issues all come down to this one question: Is mold
harmful? That is a straight-forward question. But the answers have
been anything but straight forward. Turns out they depend on a host of
complex variables, assumptions, and issues. Included among them are
characteristics of the victim, of mold, and of illnesses so far
studied and not yet studied; standards of acceptable proof; how to
treat molds that may only contribute to or aggravate an ailment; the
number of victims it takes before mold is counted as a serious threat;
and how one regards “minor” reactions, such as skin and mucous
irritations, runny nose, congestion, and flu-like symptoms that go
away. Truth is, mold advocates do not rate some ailments as “serious,”
even though 30 to 60 million people may be affected; that they are
making unfounded generalizations long before enormous gaps in the
knowledge base have been plugged; and that they minimize threatening
risks to people only because they do not always materialize. Legal
rules and traditions are obstructing justice for many mold victims.
The courts have been complicit and must now decide which type of error
to live with: the error of treating potentially dangerous mold as
benign, or the error of treating potentially benign mold as
dangerous.
Some resolutions are unfolding through a confluence of
controversial research, pressures from business interests, politics,
and ultimately court decisions. I show in the following pages that a
handful of skeptics who are acting as advocates for mold want us to
believe it is benign and are urging us to remain complacent about its
potentially damaging effects. Their appeals are based on fallacies and
twisted logic designed to prevent victims from substantiating harm
from mold. The following review demonstrates there are actually
abundant reasons for believing that exposure to some types of mold is
positively linked to human disease. Even if the causal chains cannot
be fully explained in terms of the chemical interactions involved, the
data show that exposure to the mycotoxins present in specific types of
mold makes some people sick, and at the very least creates a serious
health threat to most people. Skeptics—among them some prominent
scientists and health officials, as well as steadfast special interests
—continue to question that there is a scientifically proven link
between mold and illness, or at least serious illness, in otherwise
healthy people.
Yet, it is telling that even the staunchest doubters do not
advocate living with mold, and ironically they often prescribe steps
to eradicate it even while denying there is evidence it can be
harmful. Of course, a reasonable person can argue that there is
nothing wrong with “playing it safe” by avoiding mold even though
causal links with adverse effects have not been established. However,
that is precisely the point. If a judge or lawyer will not live with
mold because of fear, why should a plaintiff be penalized because he
or she cannot provide scientific proof of harm? The challenge before
the courts is to adjust standards to allow for the distinct
possibility that it will never be possible to for mold victims to
prove with scientific certainty that they were harmed by mold even
though there is reason to believe they have been harmed.
In the following pages, you will find a story about
scientific uncertainty and contests among researchers for
methodological dominance. You will discern conflicts of interest,
bias, political pressures, and wrangling over the validity of
different kinds of legal proof. Then you will see that the outcomes of
law suits have been random. Yes, you will hear about some bloated
court awards awarded several years ago, but then you will also learn
about a more recent backlash against mold victims who cannot meet
unrealistic standards of proof based on esoteric scientific data not
likely to have been obtained or could not afford to obtain. And
finally, you will discover that the biggest allergic reaction of all
is coming from business interests standing to lose billions of dollars
from mold suits.
After a brief background narrative and an overview, Part I
describes mold characteristics and some studies documenting its
harmful affects, followed by implausible allegations being made by
mold advocates who obstinately deny the evidence. Part II is devoted
to exposing several myths that underlie the faulty science and logic
that mold advocates use to support their skepticism about mold. More
studies are reviewed there as well. Several myths the courts have
adopted are discussed in Part III along with analyses showing how the
courts are penalizing mold victims. A Conclusion and Appendix with
examples of mold litigation follow.
BACKGROUND
In 2002, homeowners in California filed over 100,000 water-related
insurance claims, and the number has risen steadily. It is estimated
that over 10,000 mold-related court cases are pending nationwide, a
300 percent increase over a five-year period. The average mold
insurance claim today costs about $35,000 and many exceed $100,000. In
1999, residents of a federally subsidized housing development filed an
eight billion dollar lawsuit over un-repaired plumbing leaks
responsible for mold infestation and a variety of problems ranging
from skin rashes to memory loss. They settled for much less, but still
over one million dollars. More recently, a high profile $32 million
award for negligence and mental anguish went to Melinda and Ron
Ballard, a Texas couple who charged their insurance firm with
improperly handling a claim for water damage from a broken ice-maker
valve, which allowed toxic mold to form and take over the family's $3
million home.[i][i] Other major cases include an $18.5 million award
to a California homeowner, and an action by a New York employee
seeking $65 million for workplace mold exposure. In Illinois, a county
courthouse opened in 1991 and was closed a year later due to health
claims by hundreds of employees, resulting in a multi-million dollar
settlement. A county courthouse in Florida had to be evacuated for
mold remediation, and the county’s suit for $14 million against the
contractor was upheld on appeal. And there are many more such cases,
some of which are mentioned in the Appendix.
This rash of litigation has prompted some observers to label mold
the “new asbestos”— which is say, a lucrative source of personal
injury tort cases intended to fill a void left by declining asbestos
claims which made many happy lawyers and their victimized claimants
rich. However, mold litigation is not evolving quite that way. The
difficulty in proving causation between mold and illness is one of the
factors that distinguish mold claims from asbestos claims. Also, there
is no one disease exclusively linked to mold, as there is to asbestos,
and many mold injuries are considered to be less severe than those
related to asbestos. Unlike asbestos, symptoms associated with mold
often occur only in its presence and tend to disappear when exposure
ends, although sometimes it does have lasting and even devastating
effects. Also important is the fact that “deep pockets” are hard to
identify. Insurers are now excluding or drastically limiting mold
coverage from insurance policies (although claimants frequently have
sued builders, public agencies, and product manufacturers).
The flood of litigation claiming adverse health effects from
mold, coupled with mounting skepticism about those claims, has ignited
a seismic backlash that is shaking up litigation in this area.
Especially noteworthy are three papers and a legal opinion, which have
inflamed intense controversies over whether toxic mold is harmful.
The Cleveland, Ohio Study
A scientific controversy over a 1994 Cleveland, Ohio study of a rare
disorder characterized by bleeding lungs in eight infants has
emboldened the skeptics.[ii][ii][2] The report claimed to have found
evidence suggesting the malady might have been caused by a potentially
deadly form of mold called Stachybotrys chartarum. The study’s authors
were initially cautious, representing their findings as a preliminary
evaluation of some suspicions. But by 1997, media were
sensationalizing the study with titles like, “The Fungus Did It,”
“Baby-Killing Fungus,” and “A Look at Deadly Mold Found in Homes.” The
study’s lead author became more assertive about the casual role of
toxic mold, even as her co-author continued to speak cautiously. In
1999, the Center for Disease Control (CDC) commissioned a panel of
scientists to evaluate the validity of this research project. Their
report unmercifully attacked the study on the basis of numerous
methodological problems it identified, including inconsistency of case
identification and measurement/assessment techniques, statistical
shortcuts, and survey errors, as well as differences in the way
control and subject cases were treated. The report also called into
question both the small size of the sample and the diagnosis of the
medical condition, which the CDC says is not a disease but a condition
that accompanies a host of ailments. A later study of three infants,
published in 2004, suggested that the infants with this particular
pulmonary disease might have had underlying acquired or genetic
susceptibility that predisposed them to pulmonary bleeding.
The scientist who headed the study, Ruth Etzel, M.D., was at the
time employed by CDC as an epidemiologist. She has since resigned over
the incident and now charges that the CDC has sought to bury the
connection between mold and disease. In retrospect, it seems that the
panel was justified in criticizing the authors for exaggerating the
causal implications of their work. However, the panel itself can be
faulted for using standards more appropriate to a pure experimental
laboratory model than to field research, where often circumstances
cannot be well controlled. Unfortunately, the controversy surrounding
this one stream of research has obscured an emerging consensus among
many scientists that mold and water-damaged housing are threats to
human health, notwithstanding the inconclusive connection between
Stachybotrys and the rare malady that struck the Cleveland infants.
The significance of the CDC report has been grossly exaggerated by a
clique of outspoken mold advocates who are using this one study to
discredit other research on mold.
Two Papers Commissioned by the U.S. Chamber of Commerce
It did not take the U.S. Chamber of Commerce long to exploit the
Cleveland study controversy. In July 2003, in conjunction with the
politically tilted Manhattan Institute, the Chamber’s Institute for
Legal Reform released two decidedly one-sided reports that were both
calculated to crush claims that mold is a health hazard.[iii][iii][3]
The 1st paper. One of the papers is authored by two lawyers who
categorically smear all research on mold as “junk science.” Their
paper, provocatively titled “How Junk Science and Hysteria Built an
Industry,” is an all-out attack on mold claims.[iv][iv][4] The lawyers—
both of whom apparently have built practices representing the
insurance industry and companies that have been targets of toxic tort
cases—argue that the serious health claims that pervade mold
litigation cannot withstand the scrutiny of reliable science.
Citing billions of dollars in claims suffered by the insurance
industry, they casually flip off concern about mold as a fiasco
produced by bad science and worse journalism. They steadfastly hammer
away at mold claims, brushing them off as a symptom of hysteria and
unfounded fears, promulgated by scary stories whipped up by media
frenzy, and exploited by unscrupulous and unregulated remediators. And
they don’t miss opportunistic trial lawyers, who they claim are
exploiting junk science as “the new asbestos.”
Mundane mold is everywhere, they proclaim, but through a
convergence of bad science, environmentalists’ sensationalist alarms,
and entrepreneurship, it has become the basis of a new “toxic cottage
industry” feeding on unfounded paranoia. The “sick building syndrome”—
dry skin, mental fatigue, headaches, and airway infections—is, they
contend, nothing more than a catchy but misleading fiction. The
authors cite several surveys by prominent scientists and health
organizations to bolster their case. For example, in 2003 Cleveland
microbiologists concluded from an analysis of 465 references that
there is no supportive evidence for “serious illness” from toxic mold
in the contemporary environment. The American Industrial Hygiene
Association and the National Institute of Occupational Safety and
Health came to similar conclusions. Texas Medical Association’s
Council on Scientific Affairs concluded that evidence for the
existence of a separate “sick building syndrome” is weak.
The 2nd paper. The other paper that the Chamber of Commerce chose to
sponsor, titled “A Scientific View of the Health Effects of Mold,”
concludes that there is no scientific evidence that mold causes
“toxicity” in doses found in indoor home environments.[v][v][5] The
authors acknowledge that mold can cause allergies for people who are
already susceptible to allergic reactions, and for individuals who are
“immune-compromised.” However, they dismiss these cases, labeling them
“rare” (even though they involve many millions of people).
The lead author, Brian Hardin, though not a physician, is a
former Assistant Surgeon General in the Public Health Service. More to
the point, Hardin went on to consultant with a corporation that
represents insurance companies and profits from testifying against
individuals claiming to have been harmed by mold. Another author of
this paper has been in court over conflict-of-interest charges related
to it.[vi][vi][6] Much of the data cited in the paper appears to have
come primarily from a study of rats that were subjected for a few
minutes to doses of mold.
The Daubert Test
The U.S. Supreme Court eventually entered the fray. Expert witnesses
were being paid to slant their testimony to fit whatever opinion was
needed, sometimes justifying personal opinion with pseudo theories
without scientific basis. The Court reacted by telling judges to act
as gatekeepers and vigilantly guard against fake experts and “science
that is junky.” With the so-called Daubert test, the Supreme Court
recognized that the scientific method used in research is also
required in judicial analysis.[vii][vii][7] Factors making up this
test include: The theory or technique must be falsifiable; its error
rate must be known; it should be subject to peer review and generally
accepted within the relevant scientific community; it should be
measured according to standards used by the particular field of
knowledge at issue, including non-technical fields; and, conclusions
must be based on evidence.
Requiring courts to respect the cannons of science is a good
thing. However, the Daubert test clearly stacks the deck against
plaintiffs in toxic tort cases. Just how much it hurts them may be
debatable, but it clearly sets an extreme standard that some lawyers
can and probably will exploit. At the same time, the test in itself
does not stop scientists who have conflicts of interest and fail to
disclose all sources of income. Nor does it stop scientists who fake
or exaggerate data. And, there has been an unintended consequence: the
Daubert test has erected a host of practical obstacles for mold
victims trying to prove personal injury. Here are the problems.
On the scientific side, unlike allergies, there is no way to test
for Stachybotrys in the body, nor for poisoning after it has left the
body. And, unless the victim has recently had a comprehensive medical
exam, physicians cannot verify that any physical change has occurred—
especially if a victim has been exposed intermittently over a long
period of time. And on the practical side, victims who have become
sick are most likely focused on recovery, and are not at that point
thinking about filing mold claims. Frequently they do not become aware
that mold was the cause until well after the actual exposure and after
the environment has been altered or cleaned. By that time, it is too
late to commission the required tests, and also too late for
scientists and physicians to verify the condition of the environment,
and of the person’s body, at time of exposure.
Then too, it is becoming nearly impossible to find physicians
willing to testify in court, because medical liability insurers
usually prohibit testifying (or sometimes even reviewing cases) on
behalf of a plaintiff. Also, many hospitals require doctors to sign
contracts prohibiting them from testifying on behalf of plaintiffs,
and even some colleges threaten to revoke certification if they
disagree with an expert’s opinion.[viii][viii][8] Testimony from a
victim’s neighbors, acquaintances, friends, contractors, and family
may be more directly relevant to a case than testimony from
scientists. But they do not meet the Daubert test.
PART I: MOLD
It is generally known that many molds can produce allergens that
affect up to 20 to 30 percent of the population. Mayo Clinic
researchers have identified mold as the leading cause of most chronic
sinus infections (a condition that affects over 37 million people in
the U.S.).[ix][ix][9] According to warnings from the CDC, certain
individuals with chronic respiratory disease, such as chronic
obstructive pulmonary disorder or asthma, may experience difficulty
breathing in the presence of molds. In addition to allergies and other
illnesses that target people with pre-existing conditions, some molds
can also produce infectious toxins, which can affect everyone,
depending on the length of exposure and other conditions. According to
the Mayo Clinic researchers, sinus infections do not come from
allergies but from responses to fungus experienced by otherwise
normal, healthy people. Most of the controversy about mold’s affect on
health has focused on whether some molds can harm people who are not
already allergic, and if so, if they can be seriously harmed.
The term “toxic mold” is often used to describe the more
threatening types of molds. However, it should be understood that
molds themselves are not toxic. Instead they can nurture secondary
metabolites that produce mycotoxins, which then can become airborne.
Common ailments, such as many flu-like symptoms, usually can be
treated and reduced after people leave the tainted environment.
However, some symptoms can become permanent in the form of weakened
immune systems, possibly brain damage, and damage to the pulmonary
system, memory, eyesight, and hearing.
Mold can grow between the walls of a home when water leaks in
through windows, roof lines, or from plumbing failures. CDC
information suggests that molds will grow anywhere indoors where there
is moisture. Microscopic mold spores can quickly become airborne and
travel throughout air conditioning and heating systems. A mold-
infested home creates a potentially lethal environment for anyone.
Sometimes the only method to rid a structure of the more extreme toxic
molds is with a bulldozer and trucks to haul off the debris. The most
common indoor molds are Cladosporium, Penicillium, Aspergillus, and
Alternaria. Accurate information about how often Stachybotrys
chartarum (or Stachybotrys atra) is found in buildings and homes is
not available, but it is thought to be a rare occurrence.
Mold Characteristics
There are many types of mold, only a few of which are harmful to
humans.
Aspergillus, Stachybotrys Chartarum, and Chaetomium
Aspergillus is a genus of mold often found within indoor
environments, which can become dangerous to some people. The genus
includes over 150 species, only a few of which can cause an illness in
humans and animals. Most people are naturally immune, but when this
illness occurs, it takes several forms, ranging from "allergy-type”
illnesses to life-threatening generalized infections. Some believe
that Aspergillus molds can cause cancer, although skeptics dispute it.
The severity of the disease inside the human body is determined by
various factors, but one of the most important is the state of a
person’s immune system.
The most dangerous mold strains are: Stachybotrys and Chaetomium,
both of which produce mycotoxins, which can lead to disease in
otherwise healthy individuals. Certain people are especially
vulnerable to minor and temporary allergic reactions from non-toxic
mold, but anyone who has been exposed to either of these toxic molds
can experience myriad symptoms and illnesses, including skin problems,
chronic fatigue, respiratory and heart problems, nose bleeding, and
bronchitis. While disputed, some authors believe it can also lead to
learning disabilities, mental deficiencies, cancer, multiple
sclerosis, lupus, fibromyalgia, rheumatoid arthritis, and more.
Stachybotrys chartarum (atra), which occurs widely in North America,
requires water soaked cellulose (wood, paper, and cotton products) to
grow. While wet it looks black and slimy, perhaps with white edges;
when dry it looks less shiny.[x][x][10] Bob Krell, chief executive of
IAQ Technologies, a Syracuse indoor air quality specialty company,
says that although mold spores from roughly 100,000 strains are
everywhere, finding Stachybotrys indoors is unusual.[xi][xi][11] This
is because it is basically a water-loving mold, and it needs a lot of
water. But once inside, the mycotoxins it releases can be inhaled and
result in the illnesses mentioned.
Adverse Health Effects Commonly Associated With Various Types of Mold
According to a statement issued by the California Department of
Health, toxic effects from Stachybotrys were first reported in Europe,
where horses, sheep and cattle suffered fatal hemorrhagic disorders
following ingestion.[xii][xii][12] Human occupational exposures to
contaminated straw or hay resulted in nasal and tracheal bleeding,
skin irritation and alterations in white blood cell counts.[xiii][xiii]
[13] The first U.S. case of Stachybotrys-associated health effects
from inhalation exposure was reported in a suburban Chicago family.
[xiv][xiv][14] The fungus had contaminated the ventilation system and
ceilings of the house. Health effects reported by the family included
chronic recurring cold and flu-like symptoms, sore throat, diarrhea,
headache, fatigue, dermatitis, intermittent focal alopecia and
generalized malaise. Workers who cleaned and removed contaminated
material from this house also experienced skin irritation and
respiratory symptoms. After Stachybotrys contamination was removed,
the house was reoccupied and residents reported no recurrence of
clinical symptoms.
Stachybotrys was found in a water-damaged office building in New
York City. A small case-control study showed workers exposed to the
fungus were at statistically significant higher risk for nonspecified
disorders of the lower airways, eyes and skin; fevers and flu-like
symptoms; and chronic fatigue.[xv][xv][15] Another recent report
describes identification of 10 likely or possible cases of building-
related asthma in a courthouse contaminated with Stachybotrys and
Aspergillus species.[xvi][xvi][16] Self-reported symptoms among co-
workers included fever, headache, rhinitis, coughing, dyspnea and
chest tightness. Chest radiographs were negative and Stachybotrys-
specific serology was uninformative.
A wide array of symptoms are known to be, or suspected to be,
associated with exposure to various types of fungi. They include the
following:
Respiratory Problems
Respiratory Distress; Flu Symptoms, including Digestive System-
Diarrhea; Nausea and Vomiting; Recurring Colds, Chronic Coughing,
Runny Nose, (From Sinus Cavities), and Nose Bleeds; Choking, Spitting-
Up Mucous, Coughing-up Blood, Rhinitis, and Sinusitis; Difficulty
Swallowing, Asthmatic Signs, and Allergies.
Pulmonary Problems
Breathing Difficulties; Tightness of the Chest; Lung Congestion;
Elevated Blood Pressure; Heart Palpitations; Heart Attack.
Other Problems
HeadachesAnxiety; Chronic Fatigue; Insomnia and Other Sleep Disorders;
Memory Loss/Forgetfulness/Brain Fog; Bladder or Kidney Problems; Joint
Pains, and/or Swelling; Cancer; Death in Severe Cases.
Emotional Distress, Stress, and Heart-Related Problems
Stress and emotional distress can be directly caused by mold, or
indirectly caused by trauma related to coping with it. Skeptics tend
to deny that emotional distress has any connection with mold,
sloughing it off it as “psycho-social” in origin. One article, for
example, maintains that a “sick building syndrome” outbreak in a
manufacturing plant was actually due to “somatic conditions
characterized by anxiety and depression,” the implication being that
they are not relevant to air quality. However, stress can exacerbate
physical conditions and directly or indirectly affect the heart by
releasing fatty acids and glucose into the bloodstream, which in turn
can become deposited on arterial walls and restrict blood flow and
produce hypertension and respiratory problems; it also can contribute
to coronary related symptoms.[xvii][xvii][17] Courts allow emotional
damages under restricted conditions, for example if it can be shown
that stress pushes the plaintiff into the zone of danger for physical
harm. Studies published in the New England Journal of Medicine
indicate that chest pains can be caused by inflammation of the sac
surrounding the heart (pericaditlis) associated with viral infection.
[xviii][xviii][18] Mold, and in particular Stachybotrys, is thought to
be one source of congestive infection. In addition, emotional stress
can independently contribute to chest pain by precipitating severe
reversible left ventricular dysfunction, even in patients without
coronary disease (myocardial stunning). This condition does not
necessarily produce heart failure. Stress cardiomyopathy is a related
condition which, unlike heart attacks, involves no blood clot in a
coronary artery that cuts off circulation. Patients can recover fully
without lasting damage to the heart muscles. John Hopkins University
doctors say exaggerated sympathetic stimulation is probably central to
the cause of this syndrome. Intense grief, fear, anger or shock can
lead to a temporary weakening of the heart which affects the heart’s
ability to pump blood.
Illustrative Studies
Myriad studies from a variety of sources, ranging from respected
universities and research centers to the military and agricultural
environments, have discovered that significant health problems can
readily arise from the inhalation of elevated levels of fungal spores
and toxins. Laboratory studies (both of animals and at the cellular
level) provide supporting evidence for direct toxicity of fungal
spores and mycotoxins in mammalian lungs. A health study by the
Finnish Institute of Occupational Health links 35% of newly acquired
asthma in healthy adults to workplace mold exposure.[xix][xix][19] A
European Community respiratory health survey in 2002 reported that
asthma patients experience more significant asthma symptoms after they
become sensitized to molds such as Alternaria and Cladosporium species.
[xx][xx][20]
A compilation of 18 current, scientific, peer reviewed papers
presented in 2003 summarizes the preliminary conclusions from studies
of several hundred patients. The book, addresses the question, are
illnesses associated with exposures to indoor mold growth real, or the
results of a conspiracy fueled by media hype and greedy lawyers?
Evidence is presented for severe neurobehavioral impairment, nasal
sinus and lung dysfunctions, and immunological disturbance.[xxi][xxi]
[21] The evidence shows that many mold-exposed people are indeed sick,
with significant brain function impairment. The investigations are
based on measurements of single patients and groups, studied
systematically. Physiological functions and brain scans were abnormal.
Mechanisms of mold damage to brain cells resemble those for Gulf War
Syndrome, chemical intolerance, and exposure to chlorine, ammonia, or
hydrogen sulfide gases. The book warns that because exposures are
invariably to mixtures of molds, attempts to define exposure in terms
of specific molds and toxins, or by searching for biomarkers in body
fluids, are necessarily inconclusive.
In May, 2004, The Institute of Medicine (IOM) issued a report
that concludes various types of studies show that microbial toxins
associated with mold can cause both allergic and non-allergic
reactions in otherwise healthy people.[xxii][xxii][22] Well documented
adverse affects mentioned in the report include upper-respiratory
tract symptoms, cough, wheeze, and asthma symptoms. Other possible
affects include lower-respiratory illnesses, shortness of breath, and
asthma development. The report questions associations with
neurological problems, fevers, fatigue, gastrointestinal symptoms,
pulmonary hemorrhage in infants, and cancer. The IOM report cites a
1994 Harvard University School of Public Health study of 10, 000 homes
in the United States and Canada which found that mold was associated
with a 50% to 100% increase in respiratory problems for the residents
of water- and mold-damaged homes. Chronic sinusitis, a condition that
affects about 37 million people in the United States, is apparently
caused by an immune response to mold and other fungus.
Research doctors at the Mayo Clinic conducted a study of 210
patients with chronic sinus infections and found that most had
allergic reaction to mold (fungal sinusitis). Before the Mayo Clinic
study, the prevailing medical opinion had been that mold accounted for
only 6 or 7% of all chronic sinusitis.[xxiii][xxiii][23] The Mayo
Clinic work is the first to provide data for the role of airborne
fungi in chronic rhinosinusitis and to show that several immune system
branches appear to collaborate in response to the fungi -- resulting
in an abnormally enhanced response in otherwise healthy people that
causes troublesome inflammation and congestion. The research team's
data show that specific cells in 90 percent of chronic rhinosinusitis
patients produce an enhanced immune-system response to one fungus in
particular, Alternaria. Another kind of common fungus, Cladosporium,
also provoked an abnormally enhanced immune response.
A Florida study concluded that people’s immune system changed
with regular exposure to toxic mold even at low levels. The study
involved just one square foot of mold on a 100 square foot wall.[xxiv]
[xxiv][24] K. H. Kilburn, University of Southern California, Keck
School of Medicine, evaluated sixty-five consecutive outpatients
exposed to mold in their respective homes and compared them with 202
community subjects who had no known mold or chemical exposures.[xxv]
[xxv][25] The author concluded that indoor mold exposures were
associated with neurobehavioral and pulmonary impairments that likely
resulted from the presence of mycotoxins, such as trichothecenes.
Balance, choice reaction time, color discrimination, blink reflex,
visual fields, grip, hearing, problem-solving, verbal recall,
perceptual motor speed, and memory were measured. Medical histories,
mood states, and symptom frequencies were recorded with checklists,
and spirometry was used to measure various pulmonary volumes and
flows. Neurobehavioral comparisons were made after individual
measurements were adjusted for age, educational attainment, and sex.
Significant differences between groups were assessed by analysis of
variance. The mold-exposed group exhibited decreased function for
balance, reaction time, blink-reflex latency, color discrimination,
visual fields, and grip, compared with referents. The exposed group's
scores were reduced for the following tests: digit-symbol
substitution, peg placement, trail making, verbal recall, and picture
completion. Twenty-one of 26 functions tested were abnormal. Airway
obstructions were found, and vital capacities were reduced. Mood state
scores and symptom frequencies were elevated.
In Germany, research by The World Health Organization finds
prostate cancer, breast cancer, and other cancers increasing due to
mold-related problems. Mold is the number one health problem
identified, with one in every three persons affected; and one in ten
of those so affected reportedly have a severe problem. At the
University of Texas M.D. Anderson Cancer Center, approximately 15-20%
of patients with leukemia die of fungal leukemia caused most
frequently by the species Aspergillus.[xxvi][xxvi][26] Of patients
with leukemia who have undergone allogenic bone marrow or stem cell
transplantation, 15-30% have died because of refractory fungal
infections. In recent years, comparative risk studies performed by EPA
and its Science Advisory Board (SAB) have consistently ranked indoor
air pollution among the top five environmental risks to public
health.
A physician, Dr. Michael Gray, found a range of adverse symptoms
among 70 percent of the 350 patients he studied who had been exposed
to toxigenic molds and other compounds.[xxvii][xxvii][27] It was
concluded that mycotoxins stimulate immune reactions and also can
adversely affect mobility and cognitive functions. At least some
toxins are small enough to enter the respiratory system. Ann Davidoff
found no evidence that reactions to mold can be explained by
psychosomatic factors.[xxviii][xxviii][28]
On September 2, 2004 Richie C. Shoemaker, M.D., testified before
congress about the health effects of mold. He is a medical
practitioner who also conducts research for The Center for Research on
Chronic Biotoxin Associated Illness (CRBAI). He said, in part:
Statements made by authoritative groups such as the Centers for
Disease Control and Prevention (CDC) and Institute of Medicine (IOM)
that “exposure to mold illness has not been shown to cause chronic
health effects beyond respiratory illness.” They are completely wrong…
We have the hard scientific data on causation of illness, showing a
direct connection between exposure to biotoxic mold in buildings and
subsequent acquisition of illness.”[xxix][xxix][29]
The “Mold-Is-Benign” Advocates
These authoritative sources and many other studies from reputable
sources frequently document negative health consequences of mold. Yet,
as already shown, some spokespersons in authoritative scientific-,
public-, and business-related positions flatly deny that mold is a
serious health threat. At most, some mold advocates reluctantly
acknowledge that exposure to mold may sometimes cause runny noses,
itchy eyes, scratchy throats, and other allergic symptoms, but—they
usually hasten to add—only in already highly susceptible people.
One of the most outspoken naysayers is, ironically, a public
agency that oversees the nation’s health, The U.S. Centers for Disease
Control. It has concluded that, “There are very few case reports that
toxic molds… inside homes can cause unique or rare health conditions
such as pulmonary hemorrhage or memory loss. These case reports are
rare, and a causal link between the presence of the toxic mold and
these conditions has not been proven.” While acknowledging that some
individuals can be seriously affected, the agency off-handedly
depreciates such cases to the category, “rare.” Note that only two
ailments are mentioned in the advisory; but they are used to justify
the over blown generalization that there is no proof that mold causes
serious harm. If the CDD has hard evidence about other serious
conditions not affected by mold, it should identify them. If not, it
should clearly limit its conclusions to the two listed.
Jumping on the band wagon, Dallas attorney, Beth Bradley,
dogmatically asserts that there is "not a lot of hard evidence
connecting mold" to illnesses. She adds, "We are just now starting to
see the other side of the story in these cases.”[xxx][xxx][30] What is
the “other side?” According to her, it includes what she calls the
“false positives” for Stachybotrys from improper testing, unscrupulous
remediation contractors, and mainly, inflated repairs that drive up
insurance costs.
Quade R. Stahl, Ph. D., director of the Indoor Air Quality
division at the Texas Department of Health disparages the available
anecdotal evidence, calls for more data to prove a positive
connection, and cautions that the collection of sufficient data will
be a "slow and tedious process that is not going to happen next
year."[xxxi][xxxi][31] According to the Texas Medical Association's
Council on Scientific Affairs, “burgeoning litigation on Stachybotrys
in homes has far outrun the available science." It issued a reassuring
report advising that while mold can cause reactions in people with
allergies and asthma, there's no evidence that it causes other health
problems or aggravates other existing health conditions.
In his Washington Post, article, "It's Everywhere," Christopher
Wanjek quotes sources insisting that mold is common and therefore not
a big deal."[xxxii][xxxii][32] One source is quoted as saying, "For
most, mold is a mostly ignored part of their lives. For some with mold
allergies, the smell can cause nasal allergy or even asthma symptoms.
Yet what is increasingly clear is that their mold related illness has
nothing to do with toxic substances produced by molds." Organizations
that stand to lose from mold claims are among the prominent doubters.
They include especially insurance companies, the National Home
Builders Association, and the U.S. Chamber of Commerce, all of which
have disseminated often unsubstantiated assertions disputing the
effects of mold. Because they reflect self-interested biases of their
constituencies, their statements deserve to be met with intense
skepticism.
The U.S. Chamber of Commerce is a federation of businesses that
include insurance companies and others that are most likely to be sued
for mold-related problems. In 2003 it issued a statement lauding
findings from the two previously mentioned papers it sponsored denying
scientific links between mold and health problems. The Chamber’s
statement mentions billions of dollars in mold claims paid by the
insurance industry.[xxxiii][xxxiii][33] The National Association of
Home Builders and its subsidiaries also downplay the health effects of
mold, even while disseminating information about how to prevent,
detect, and eradicate it. The Dallas chapter’s web site, for example,
maintains that mold is everywhere in our environment, and people are
exposed to it every day.[xxxiv][xxxiv][34] While conceding that people
with weakened immune systems may be more vulnerable, healthy
individuals, it asserts, are usually not vulnerable to infections from
airborne exposure to mold. The website also maintains that:
“Currently, to our knowledge, there are no authoritative studies
establishing a reliable, scientific connection between mold and the
more serious illnesses that are being alleged…According to respected
scientific bodies like the Environmental Protection Agency and Centers
for Disease Control, among others, there is very little scientific
evidence linking mold with serious human illness, particularly
considering the low levels of exposure in most homes.”
Some state health agencies have also been reluctant to take any
position that might upset special interests. The following statement
from the California Department of Health Services is illustrative:
[xxxv][xxxv][35]
“The demonstration of mold-specific antibodies alone is generally
considered insufficient to prove that health effects reported by
individuals in moisture-damaged buildings are caused by mold exposure.
Symptoms associated with mold exposure are nonspecific and vary
greatly with individual susceptibility. There are currently no
validated biomarkers of exposure to specific indoor fungi or their
toxins. S. chartarum serology tests have no clinical application at
this time. They cannot be used to imply the presence of S. chartarum
within a home or workplace environment, nor can they be used to prove
patient exposure to this specific mold or its toxins.
PART II: MOLD, MYTHS, AND SCIENCE
To be sure, research on mold has not yet yielded conclusive answers
about its full effects. Still, the preponderance of findings seems to
suggest, and often demonstrate, that mold is harmful. So, why are some
mold advocates so resolutely convinced that mold has not been proven
harmful? It is tempting to blame their connections with (or pressure
from) groups threatened by the information. However, that is too
simple. Another important part of the answer is misunderstanding of
the scientific method. Both explanations will be considered, along
with a series of commonly held myths about scientific research in this
area.
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