The Center for School Mold Help

Q: Why do people ill from dampness and mold in schools and other settings have such monumental problems receiving help, compared to other injuries? 

Q: Why is no one in authority recognizing or addressing the problems of dangerous, damp buildings?

 

 

Read the accusations against ACOEM* by IJOEH**, the ACOEM response and IJOEH's March, 2008 reply

*American College of Occupational and Environmental Medicine

**International Journal of Occupational and Environmental Health (IJOEH)

A new paper, titled "ACOEM in Service to Industry" has been published in the current edition (Oct. 2007) of the International Journal of Occupational and Environmental Health (IJOEH).  I had the privilege to co-author this paper along with several, who are recognized worldwide as the consciences of occupational medicine. The link for the paper and a commentary regarding it are linked below, along with ACOEM's response.
(submitted by Sharon Kramer)

An excerpt:

Central to the perverse relationships of ACOEM to
industry and government is the practice of legislative
advocacy. ACOEM’s government relations activities
maintain a strong presence in Washington, DC, to
ensure that its members’ interests are represented in
key decisions affecting occupational and environmental
medicine, particularly workplace standard setting.79
The ACOEM made direct payments of $175,621 to
Kent and O’Connor in 2004, and $136,550 in 2005.
Relatively few ACOEM members are even aware of the
legislative lobbying activities of the organization.(p.10)

The IJOEH paper:

American College of Occupational and Environmental Medicine (ACOEM): A Professional Association in Service to Industry

Commentary:
 
http://www.ijoeh.com/pfds/IJOEH_1304_Greenberg.pdf
 
ACOEM response, from the ACOEM website:
 
http://www.acoem.org/ResponseToIJOEH.aspx

To read the following articles in their entirety regarding "ACOEM A Professional Organization in Service to Industry" and the ACOEM "Cornerstone Project",  please go to the following link:  http://www.ijoeh.com/index.php/ijoeh
ACOEM                                                                                                                                      

Setting the Record Straight: A Response to IJOEH An Open Letter to ACOEM Members

http://www.acoem.org/ResponseToIJOEH.aspx

Robert K. McLellan, MD, MPH, FACOEM
President

"An article and accompanying guest commentary recently published by the International Journal of Occupational and Environmental Health (Int J Occup Environ Health 2007; 13: 404-426) inaccurately and unfairly characterize ACOEM’s historical role and current activities in occupational and environmental medicine and are based largely on unfounded and irresponsible accusations.

We are profoundly disappointed that the Journal chose to publish this material, which, in addition to being a broad-brush attack on ACOEM and the Journal of Occupational and Environmental Medicine, maligns the integrity of some of the most respected institutions in academic medicine and many other governmental and non-governmental organizations.

ACOEM stands firmly on its record of service to our members, to the broader community of health care professionals and health-related organizations, and to the general public. We welcome critical appraisal of our work. Unfortunately, rather than presenting new evidence to inform a reasoned debate about how we as a society can best advance the health and safety of workers, IJOEH has chosen to renew many outdated, one-sided accusations about historical events. Much of its analysis of problems in the practice of occupational and environmental health has nothing to do with ACOEM or the other organizations it cites. Taken as a whole, the IJOEH article offers what is essentially a giant conspiracy theory involving virtually all sectors of our profession.

The article characterizes ACOEM as exerting a negative and controlling influence over the American political and economic systems that have affected occupational health. But in making its case, IJOEH selectively quotes history, incorporates blatant misstatements of facts, ignores information widely available that refutes its assertions, and uses quotations that do not support its conclusions..."

IJOEH
March 2008
Industry Partisanship of ACOEM
http://www.ijoeh.com/index.php/ijoeh/article/view/94/82
 
LADOU,MD; TEITELBAUM, MD; EGILMAN, MD, MPH; FRANK, MD, PHD;
KRAMER;HUFF, PHD.

"To the Editor:—Two articles published in IJOEH1,2 provoked a response from Robert McLellan,
President of the American College of Occupational and Environmental Medicine (ACOEM). Although
Dr. McLellan’s letter published here does not address any specific points of disagreement with our article, he
has posted an “Open Letter to ACOEM Members” on his organization’s web site <www.acoem.org/
ResponseToIJOEH.aspx> that does raise several points that, in our view, require a response.
 
McLellan’s criticisms of our papers are unjustified. The “Open Letter” takes issue with our assertion
that ACOEM board members prioritize the interests of corporate employers and insurers over
improving occupational and environmental health. McLellan states that only 24% of ACOEM’s members
work in a corporate setting, and that the board reflects that makeup. Our research shows that seven (43%) of the board’s members work for corporations or for consultants that provide services to employers, or the insurance and healthcare industries. Three work for for-profit health providers. The remaining six work in academic settings; we are not sure whether these six receive corporate funding. The board contains no representation from government, worker, or environmental advocacy groups.3 Board member affiliations notwithstanding, ACOEM priorities are evident from the actions the organization has taken over the
years....
 
...Finally, in his “Open Letter,” McLellan mentions the ACOEM’s “Cornerstone Project” as an example of the organization’s positive public health efforts. In response to our request for information on this project, ACOEM’s Executive Director sent us the “Special Report” from a March 2007 “Cornerstone Summit” convened by ACOEM.11 The theme of the summit was “Shaping the Future of Occupational Medicine: Finding Opportunities for Collaboration.” Participants were “representatives from 7 large employers, 8 payer organizations (insurers and third party administrators), and 12 ACOEM members.” The summit deliberations focused around five central questions.12 The last of these questions, “How can ACOEM support employers and insurers in other ways?” says more about the ACOEM’s priorities than we ever could. Given this effort to
“shape the future of occupational medicine” in line with the interests of employers and insurers, ACOEM
leadership can hardly take issue with our characterization of their organization as “a professional association
in service to industry.”

 
JOSEPH LADOU, MD
Division of Occupational and
Environmental Medicine
University of California School of
Medicine
San Francisco, CA 94143
 
DANIEL THAU TEITELBAUM, MD
Adjunct Professor of Environmental
Sciences
Colorado School of Mines
Golden, CO 80401
Associate Clinical Professor of
Preventive Medicine
University of Colorado Health Sciences
at Denver
Denver, CO 80202

 
DAVID S. EGILMAN, MD, MPH
Clinical Associate Professor
Department of Community Health
Brown University
Providence, RI 02912

 
ARTHUR L. FRANK, MD, PHD
Professor and Chair
Department of Environmental and
Occupational Health
Drexel University School of Public
Health
Philadelphia, PA 19102

SHARON N. KRAMER
Environmental Health Writer
Escondido, CA 92029

 
JAMES HUFF, PHD
Associate Director for Chemical
Carcinogenesis
National Institute of Environmental
Health Sciences
Research Triangle Park, NC 27709

The Center for School Mold Help Commentary:

As many with environmental exposures have come to understand, the American College of Occupational and Environmental Medicine (ACOEM) has had a major influence on what doctors and governmental agencies think about environmental illness involving mold. Therefore, ACOEM has influenced medical approaches to dampness and mold-related illnesses and often, related legal cases. This has directly impacted physician associations and thus, the treatment of patients seeking medical help for mold and damp building exposures - and the health of the nation. The Center for School Mold Help has noted that, certainly, ACOEM's position paper on mold exposure and health, Adverse Human Health Effects Associated with Molds in the Indoor Environment, written more than five years ago, does not reflect current research or  the experiences of millions who have become sickened in damp buildings. This is disturbing, considering that ACOEM bills itself on its website, as "... the pre-eminent organization of physicians who champion the health and safety of workers, workplaces, and environments".

The history of this influence, with its alleged deep conflicts of interest, is discussed in this paper, which may well set the stage for an investigation of the appropriateness of ACOEM as a driving force in risk management, occupational and environmental health, government policy, and law (SMH).

You may submit comments about this paper to The Center for School Mold Help, to review for consideration for publication on this site, by emailing them to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .

--------------------------------

Click here to read Court of Opinion: Amid Suits Over Mold, Experts Wear Two Hats. Authors of Science Paper Often Cited by Defense Also Help in Litigation a Washington Post article, published in Jan., 2007, related to the above topics.

---------------------------------

A related story:

Toxic Mold -- Wall Street Journal Uncovers Medical Association's Alleged Conflicts of Interest -- Advocacy Groups Call for Senate Investigation

http://www.imakenews.com/pureaircontrols/e_article000741671.cfm?x=b8V9g0h,bvtvCt3

by PRWeb

Advocacy groups say they applied mathematical calculations to make the leap that human illness could not plausibly occur if one is exposed indoors. The leaders of ACOEM put their imprimatur on the statement. The insurance industry and its surrogates have since brandished it like the biblical jawbone of an ass. Advocacy Groups see this as an abuse of political clout and power that has harmed US Citizens
 
Washington, DC (PRWEB) January 29, 2007 -- After years of working together to enlighten the public of the serious illnesses caused by mold, advocacy groups are thankful to the Wall Street Journal for bringing the matter to greater light. Upon completing a six month investigation, veteran Wall Street Journal reporter, David Armstrong, wrote of the leaders of the American College of Occupational and Environmental Medicine, ACOEM, permitting a litigation defense corporation, Veritox Inc (aka GlobalTox Inc) to author the association's policy paper regarding mold induced illnesses. The two Veritox authors were not prior members of the physician trade association. They are not physicians.
 
The American College of Occupational and Environmental Medicine mold policy paper is at the heart of the contention over the Toxic Mold Issue. The paper claims to prove humans could not plausibly be exposed to enough mold toxins within a damp indoor environment to cause symptoms of ill health. "Highly unlikely at best, even among the most vulnerable of subpopulations" is what the non-physician authors wrote.

As referenced by the WSJ, to make this key finding, the authors borrowed data from one rodent study in which mold was forced into the trachea of rats. They then applied calculations to make the leap that human illness could not plausibly occur if one is exposed indoors. The leaders of ACOEM put their imprimatur on the statement. The insurance industry and its surrogates have since brandished it like the biblical jawbone of an ass. The finding carries much weight within the courts as it is portrayed to be the opinion of thousands of environmental physicians.

But the EPA and the Institute of Medicine, Damp Indoor Spaces Committee, have both identified the technique used by ACOEM to make the key conclusion, as non-acceptable methodology for determining existence or absence of human illness from indoor mold toxin exposure. The finding represents an affront to anyone with rudimentary logic skills. It is a complete non sequitur, where the premise does not support the conclusion.

Since the ACOEM mold paper's publication in November of 2002, it has saved worker's compensation insurers, property insurers, general liability insurers and building stakeholders, hundreds and hundreds of millions of dollars. Insurance industry surrogates - the paid witnesses - including some ACOEM members themselves - and the lawyers, have earned millions in fees. Of more importance, the sick receive no medical treatment and no compensation for devastated lives and financial ruin.

ACOEM is a medical trade association made up of approximately 7000 physicians. The organization writes evidence based protocol for the treatment of injured workers under the platform of Workers Comp Reform. Several of their evidence based conclusions are currently being used to determine what illnesses and injuries will and will not be treated and/or covered under workers compensation insurance guidelines.

In California, under State Senate Bill 889, ACOEM evidence based guidelines are also known as Medical Treatment Utilization Schedules, MTUS, and are the law that physicians must follow when determining treatment for their patients. ACOEM affiliated clinics, American Occupational and Environmental Clinics, are government funded through the Agency for Toxic Substances & Disease Registry and a branch of the Centers for Disease Control and Prevention, the National Institute of Occupational Safety & Health. (NIOSH).

The article points out several members of ACOEM serve as experts for the defense in mold litigation. They promote the legitimacy of the mold policy paper while billing as much as $700 per hour. The US Chamber of Commerce has promoted the document throughout industry by trumpeting it as scientific proof that serious mold induced illnesses are merely a result of "trial lawyers", "media reports" and "Junk Science".

When interviewed for the WSJ article, Dr. Jonathan Borak, overseer of the mold policy peer review process, indicated he was unaware the authors had conflicted interests. Yet, within the subpoenaed documents referenced within the WSJ article, was an email authored by him in Sept, 2002, Dr. Borak acknowledged he was aware the paper would have "currency in other ways and other places" for the authors. The email also referenced concern that the ACOEM mold paper was a "defense argument" that would be turned into "garbage" if rejected by the Board of Directors.

Although reported to exist, the mold policy paper authors' conflict disclosure statements were never made available to the members of ACOEM, even when requested. Within the subpoenaed emails referenced within the WSJ article, was one written in 2003. An ACOEM member wrote, "Related to this topic, some weeks ago many of us on the list were anticipating the conflict of interest statements from the JOEM [Journal of ACOEM in regard to the authors of the 'Mold Statement' adopted by the ACOEM. It seems they got lost in the mail. This question arises if this is just an oversight, or if such a disclosure of conflicts is purposeful, as many of us who are members of ACOEM who actually see patients with mold exposure were excluded from the discussion."

Needless to say, consumer, worker, health and environmental advocacy groups are calling for a senate investigation and will be on the Hill this week requesting the investigation.

 The Wall Street Journal article, Page One, January 9, 2007. "Amid Mold Suits, Experts Wear Two Hats" may be read at:
 
online.wsj.com/article_print/SB116831654647871083.html
www.ciphi.ca/forum/viewtopic.php?p=6500&sid=000cd0970ddb9be8716b84ba3baf8f9c
 
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