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    Post: WSJ, Mold ACOEM & AAAAI Conflicts of Interest!!!!!

    Posted by Sharon on 1/09/07


    Hi All,

    Wish I could post the entire story from today's front page
    of the Wall Street Journal, but that would not be nice
    since they write to sell papers. So....just some key
    highlights:

    Court of Opinion
    Amid Suits Over Mold,
    Experts Wear Two Hats
    Authors of Science Paper
    Often Cited by Defense
    Also Help in Litigation
    By DAVID ARMSTRONG
    January 9, 2007; Page A1

    ...they began to suffer headaches, rashes, respiratory
    infections and fatigue. They attributed it to mold.

    But their lawsuit against the cooperative that owns the
    building hit a roadblock when the court wouldn't let their
    medical expert testify that mold caused their problems.
    This is "unsupported by the scientific literature," the
    state trial judge said.

    She relied in part on a position paper from the American
    College of Occupational and Environmental Medicine, or
    ACOEM...

    ....The paper was written by people who regularly are paid
    experts for the defense side in mold litigation.

    The ACOEM doesn't disclose this, nor did its paper....

    The dual roles show how conflicts of interest can color
    debate on emerging health issues and influence litigation
    related to it.

    ...Building groups and the U.S. Chamber of Commerce have
    cited it to rebut the notion that mold in the home can be
    toxic.

    ....The result, Dr. Craner maintains, is that "a lot people
    with legitimate environmental health problems are losing
    their homes and their jobs because of legal decisions based
    on this so-called 'evidence-based' statement."

    ...Two other medical societies have also published
    statements on mold written, in part, by legal-defense
    experts. The societies didn't disclose this when they
    released the papers, although one later published a
    correction saying two authors served as expert witnesses in
    mold litigation.

    .. Read the full text of Dr. Borak's September 2002 email
    to the leaders of the American College of Occupational and
    Environmental Medicine about his struggles in drafting
    their position paper on mold.

    Read the official position statements of the American
    College of Occupational and Environmental Medicine and of
    the American Academy of Allergy, Asthma and Immunology, as
    posted on their Web sites.

    .... reviewed the research in 2004 and said "studies have
    demonstrated adverse effects -- including immunotoxic,
    neurologic, respiratory and dermal responses -- after
    exposure to specific toxins, bacteria, molds or their
    products."....

    'Highly Unlikely'

    The ACOEM paper goes further. It says not only is there no
    evidence indoor mold causes serious health effects, but
    even if mold produced toxic substances, it's "highly
    unlikely at best" that anyone could inhale enough to cause
    a problem. The paper reaches this conclusion by
    extrapolating from animal studies in which rodents' throats
    were injected with molds.

    The paper's authors say their conclusions are validated by
    the Institute of Medicine's paper. But the author of the
    Institute paper's mold toxicity chapter, Harriett Ammann,
    disagrees, and criticizes the ACOEM paper's
    methodology: "They took hypothetical exposure and
    hypothetical toxicity and jumped to the conclusion there is
    nothing there."


    ....The ACOEM, a society of more than 5,000 specialists who
    investigate indoor health hazards and treat patients with
    related illnesses, first moved to develop a position paper
    on mold in early 2002. Dean Grove, then the medical
    society's president, asked the head of its council on
    scientific affairs, Yale medical professor Jonathan Borak,
    to set the process in motion.

    He turned to a retired deputy director of the National
    Institute for Occupational Safety and Health -- part of the
    CDC -- to spearhead the project. Dr. Borak says he wanted
    someone with "no established background record of
    litigation related to mold."


    ...The person he chose, Bryan Hardin, says he hadn't worked
    on any mold lawsuit at that point, though he was a
    consultant on other matters for GlobalTox Inc., a firm that
    regularly worked for the defense in mold cases. And Dr.
    Hardin says he consulted for the defense in a mold case
    while he was helping write the ACOEM paper.

    In a Feb. 27, 2002, email, Dr. Borak told Dr. Hardin: "That
    position paper would be prepared by you and your GlobalTox
    colleagues." Dr. Borak says he believes he didn't know at
    the time that GlobalTox did mold defense work.

    A GlobalTox colleague who aided Dr. Hardin was Bruce
    Kelman, now president of the firm, which recently changed
    its name to Veritox Inc. Drs. Kelman and Hardin, now
    principals at the firm and entitled to a share of its
    profits, were two of the ACOEM paper's three authors. They
    are paid $375 to $500 an hour for work on mold cases, court
    records say.

    The Situation: Mold defendants rely on medical-society
    position papers that reject a link to serious ills, but
    papers were written by scientists who often work for
    defense side in mold cases.

    ..Outcome of widespread litigation over mold.

    The paper's third author was Andrew Saxon, then chief of
    clinical immunology and allergy at the medical school of
    the University of California, Los Angeles. He, too, has
    served as a defense expert in numerous mold suits. Dr.
    Saxon says he is paid $510 an hour for his help. If called
    to testify in court, his rate rises to $720 an hour,
    according to a deposition he gave.

    ....Dr. Saxon estimates he generates $250,000 to $500,000 a
    year from expert defense work, which includes non-mold
    cases.

    The ACOEM knew about mold defense work by the authors of
    its paper. Dr. Hardin informed the society in a Sept. 23,
    2002, document under his letterhead. Labeled "confidential"
    and "share only with the ACOEM board of directors," it told
    of his work as a defense expert on one mold case.

    The letter said the other two authors, Drs. Saxon and
    Kelman, "have been retained by both the defense and
    plaintiff bar in litigation relating to indoor mold." Both
    say they work mostly for the defense in mold cases.

    Internal ACOEM documents indicate that as the paper was
    being written in August 2002, there was concern within the
    society that the paper was too friendly to defense
    interests. Its authors were asked to modify the first
    draft's tone "because of the concern about possible
    misinterpretation of 'buzz words' and phrases such
    as 'belief system,' 'adherents may claim,' 'supposed
    hypersensitivity,' and 'alleged disorder,'" according to a
    June 2002 email to Dr. Hardin from the society's
    communications director. (The email was obtained by a
    plaintiff's attorney in a mold case, Karen Kahn.)

    Dr. Borak, the head of the society's council on scientific
    affairs, suggested sending a draft for review to one
    particular mold authority, Michael Hodgson, director of the
    occupational safety and health program at the U.S. Veterans
    Health Administration. Dr. Hardin objected. He said it
    would be "inappropriate to add ad hoc reviewers who are
    highly visible advocates for a point of view the draft
    position paper analyzes and finds lacking." The draft
    ultimately wasn't sent.

    In September 2002, Dr. Borak emailed colleagues that "I am
    having quite a challenge in finding an acceptable path for
    the proposed position paper on mold." He said several
    reviewers "find the current version, much revised, to still
    be a defense argument."

    The society released a paper two months later, and its
    authors, as well as ACOEM officials, say it accurately
    reflects the science on indoor mold exposure. The
    authors' "views, if prejudicial, were removed," Dr. Borak
    says. "It went through a dramatic change of top-heavy peer
    reviews." He says objections come mainly from "activist
    litigants" who find it "annoying."

    Drs. Hardin and Kelman say the paper has been controversial
    because it challenged "a belief system" that mold can be
    toxic indoors. "A belief system is built up and there is
    anger when the science doesn't support that belief system,"
    Dr. Kelman says.

    The Manhattan Institute, a conservative think tank, paid
    Veritox $40,000 to prepare a lay version of the paper. That
    version said "the notion that 'toxic mold' is an insidious,
    secret 'killer,' as so many media reports and trial lawyers
    would claim, is 'junk science' unsupported by actual
    scientific study." Its authors were the three writers of
    the longer paper plus a fourth, who also is a principal at
    Veritox.

    Lawyers defending mold suits also cite a position paper
    from the American Academy of Allergy, Asthma and
    Immunology. This paper says it concurs with the ACOEM that
    it is highly unlikely enough mycotoxins could be inhaled to
    lead to toxic health effects.

    Among the academy paper's five authors is Dr. Saxon.
    Another, Abba Terr, a San Francisco immunologist, has
    worked as a defense expert in mold cases. The academy
    published the paper in its Journal of Allergy and Clinical
    Immunology last February, not citing the mold-defense work
    of either man. The publication later ran a correction
    disclosing their litigation work.

    ..."We should have published their [disclosure] statements
    with the paper," says the official, Thomas Platts-Mills.


    A third author of the academy's paper, Jay Portnoy, chief
    of allergy, asthma and immunology at the Children's Mercy
    Hospital in Kansas City, Mo., says he "felt that there was
    an agenda" -- the effort "seemed very biased toward denying
    the possibility of there being harmful effects from mold on
    human health." He says he considered removing his name from
    the paper, but it was published before he could decide.

    Dr. Portnoy says a section he contributed was rewritten by
    Dr. Saxon to be "a lot more negative." He says the paper
    wrongly says mold isn't proven to cause allergic rhinitis,
    with symptoms like wheezing, sore throat and sneezing. Dr.
    Saxon denies the authors had a bias but says they applied a
    high standard for proving mold causes a particular effect.
    He says he didn't skew the content of Dr. Portnoy's section
    but rewrote it because it was "too diffuse." Dr. Terr in
    San Francisco didn't return a call seeking comment.

    In New York, the Frasers are appealing the refusal of the
    trial judge, state Supreme Court Justice Shirley Werner
    Kornreich, to let their expert testify that indoor mold
    caused their health complaints.

    ...Their appeal attacks the credibility of mold position
    papers drafted by scientists who work for defendants. "What
    you have here is defense experts authoring papers under an
    official guise," says their attorney, Elizabeth Eilender.
    Justice Kornreich declined to comment.

    Write to David Armstrong at david.armstrong@wsj.com



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