Re: Article from Dr. Harriet Burge titled Can Mold Be Safely Lef...

[Guest guest]

Okay, well of course, I have some questions regarding this article by Dr Burge:______________________________________________________________________THE ENVIRONMENTAL REPORTER Brought to you by: EMLABNovember 2005Volume 3 | Issue 11Can Mold Be Safely Left Inside Walls? By: Dr. Harriet Burge This ends up being a question of relative risk,

Whose relative is it that we are risking?

and a complicated one at that. First, in the ideal situation, all the mold growth would be removed, either by removal of the growth itself, or of the material supporting the growth. So - what is an ideal situation? Here is where the relative risk comes in. The ideal situation for complete removal is when the risk of leaving the mold far outweighs the risk of removal. I know some of you will say - "there is no risk associated with removal". I will say the opposite: there is little risk associated with dried mold in walls,

On what scientific data is the prior statement based?

and significant financial and emotional risk associated with its removal.

Because of the uncertainty of ill health caused by molds behind walls, isn't the longterm potential financial and emotional risk far greater if one becomes ill from leaving the mold?

Here are a few examples. 1. Penicillium chrysogenum is known to have grown extensively inside and on the occupied surfaces of walls in a school room. All the occupied space mold has been removed, the water problem repaired, a sequence of air samples has documented the absence of culturable P. chrysogenum, and concentrations of Pen/Asp spores are low. Thus, there appears to be little if any health risk,

Appears to Whom to be little if any health risk and on what data is one able to make this assumption? Does this little if any health risk apply to all children, no matter what their health? Isn't the word "appears" in itself a disclaimer of an acknowlement of uncertainty as to the known risk?

and any risk to the building would require a water event

Based on what info is it established that a water event is the only thing that would cause risk from mold being left in the building?

which would precipitate new (possibly different) mold regardless of whether or not the existing mold is removed. The parents and teachers don't believe or understand this, and want the mold removed.

How would one assure parents and teachers that it is indeed no health risk to leave mold within the walls?

On the other hand, the school board has facts and figures that indicate that undertaking removal of the mold means that the school will have to be closed for the remainder of the year, causing disruption of the children in this and in whatever school they have to move to.

I am not aware of ANY school being closed for behind walls mold remediation where there were NO reports of ill health. However, I am aware of reports of ill health made, only to find mold hidden behind walls.

What is the financial analysis of the cost for schoold districts that performed comprehensive mold removal in the first place compared against the costs for districts that did not fully remediate and experience the costs of ill health of teachers and students, medical costs, lost work, and resultant litigation, etc? Have studies been done to determine the bottom line costs for districts that have chosen partially remediate - and ended up in litigation against the bottom line costs of districts that have remediated properly in the first place?

It impacts the teachers - no school, no job.

What is the financial cost for a teacher who is not teaching for a limited period of time compared against the financial cost for a teacher who can never teach again -not just for the teacher, but the school district? Shouldn't the actual quote be "It impacts the teachers and the district - no health, no job - much workers' comp"?

The school board, contrary to popular belief, does not have the funds at hand to do the removal job and support all of the other essential school expenses (salaries, supplies, services, etc.).

So do schools then have greater funds available to them at some later date to pay for not only the removal of mold, but also for the charges of negligence they will be facing in court when teachers and children are sick? Given the uncertainty of safety of leaving mold behind walls, isn't an ounce of prevention worth a pound of cure? And can't this old adage easily be translated into dollars?

So, who gets laid off?

Ultimately, wouldn't it be the district employee who opted to try and take the cheap route and ended up costing the district far more in the long run?

To me, these few statements justify leaving the mold, making sure no new water events occur, and monitoring routinely for several months, looking only for P.chrysogenum or for sharp increases in Pen/Asp spores.

To me these few statements made without scientific data to back up the guranteed safety of leaving mold in wall cavaties, justify the necessity of limiting the long term risked expense of not properly remediating a building in the first place. And what kind of Pen/Asp spores? Viable or nonviable? What is the cost to routinely need to test? Who will do the testing? How much will this lab charge for this service? What kind of testing will need to be routinely performed? Could this end up like some of the termite maintenance contracts - where one is continually testing and clearing their own prior testing?

2. Here's an example from a hospital. Contrary to popular belief, hospitals do have mold, especially behind baseboards, and near sinks and other water sources.

How is this statement contrary to popular belief when it is well established that 10% of hospital patients experience secondary infections from hospital settings commonly brought on by aspergillis?

They are there in most hospitals, and present no apparent risk (e.g., no increases in infection rates). In fact, the fungi that grow in these areas are generally not those that cause infections.

On what data is this statement based?

So, remember that we are not dealing with an initially pristine environment. Now, you are called in to evaluate a hospital that has had a flood on the lowest level. The flood water has been removed, all the carpeting dried and cleaned, and the walls thoroughly washed. Air samples reveal very little mold of any kind. However, because of the heightened awareness of mold, hospital staff have discovered some of the mold in other parts of the hospital and are clamoring for its removal.

How did this discovered mold get into other parts of the hospital? Was there enough to become airborne and cause problems throughout the entire hospital?

Because there are small amounts of mold at nearly every nurses station (e.g., in cabinets under the sink) and every baseboard that has been pulled back reveals some signs of water damage and mold, removal becomes a significant problem.

If this is a hospital setting where people are already ill and immunocompromised - and it is known that 10% of patients will acquire a secondary infection in a hospital - and "there are small amounts of mold at nearly every nurses station, and every baseboard that has been pulled back reveals some signs of water damage and mold" Then isn't NON-removal a much more potentially significant long term problem?

Hospital administration has to make the decision whether or not there is funding for such a project, which would entail removal of rooms from service, potential release of mold that at the present poses virtually no danger, and a great deal of expense.

Again, on what scientific data is the statement based "potential release of mold that at the present poses virtually no danger"? Isn't the word "virtually" a disclaimer of uncertainty as to the actual safety of the situation? What would be the potential "great deal of expense" for the patient and the hospital should the term "virtually" not prove to be accurate?

If the hospital happens to be wealthy (few are these days), then the risk lies primarily in the potential for mold release during remediation.

On what statistical data is the analysis made that it is a greater financial risk to the hospital if they remediate completely as opposed the the financial, longterm risk of not remediating competently?

If money is short, the hospital must make the same decisions as for the school. Can they afford to have rooms out of service?

Is Dr. Burge saying financial risk is the only risk to be assessed in these scenarios? Isn't not including the health risk of leaving mold, myopically allowing for greater financial risk in the long run?

Does the financial risk, and the risks associated with remediation outweigh the health risks of leaving the mold in place?

There is no financial "risk" of remediating properly. The amount of money needed to remediate a building is, at this point an easily established number, not a risk analysis.

Doesn't limiting the expendeture of remediation and the potential health risk of leaving the mold in place - with unknown results directly cause risk from a financial aspect? Isn't the potential for litigation, complete with the need for attorneys and experts, a far greater potential cost than just removing the mold in the first place?

Since the mold probably developed within weeks of opening, and it is unlikely that remediation will prevent further development (unless they have all the sinks inspected monthly at least, and stop wet-mopping patient rooms and steam cleaning hallway carpets).

Has the topic switched from a necessary remediation of a water damaged building to typical mold growth in a non-water damaged building?The bottom line is, making decisions about whether or not to remove hidden mold requires an analysis of the risks associated with leaving it there balanced against the risks of removal.

This viewpoint is not logical. If there is an atypical amount of mold growth within a wall cavatiy and it is well established that it could possibly escape into a transplant patient's room or a surgical suite, (or a classroom full of children); then given the fact that the potential for ill health is inderminable from the situation, the long term risk from both a health and financial aspect is far greater to leave it in the wall then it could ever be to remove it.

This is exactly how so many school districts have gotten themselves into trouble and ended up paying far greater in the long run.

Obviously, if Aspergillus fumigatus has colonized the inner walls of a hospital, then it must be removed, because the risk is high, even if only a little escapes into a transplant patient's room or a surgical suite. If the Penicillium chrysogenum in the school example is routinely recovered from the room air, then of course it will have to be removed because of the potential effects on asthmatic children. However, removal based on the mere fact of its presence, or based on nonspecific symptoms that are not related to mold exposure, is often not appropriate.

Isn't this last paragraph simply confusing an already confusing situation? What if testing is not appropriately performed to determine fumigatus? How does one know that only those hospitalized patients at risk are transplant or surgical patients? What about AIDS patients or CF patients rooms? Do people with Lupus or MS qualify? Who will monitor what patient may be in what room? If Penicillium chrysogenum could routinely be recovered from classrooms where mold is in the wall, then does one have to monitor how many asmatic children will be in that room every year? Whose job within the district is it to monitor this? What about children who do not have asthma, but have sinus problems? What are the nonspecific symptoms that are not related to mold exposure that schoold districts would have to be educated to? Who educates the districts to these nonspecific symptoms? Does that mean teachers would be assigned certain children, not based on educational needs, but on environmental needs?

As there are too many uncertainties regarding ill health caused by molds left in wall cavaties, one would be financially prudent to err on the side of safety in order to eliminate any future financial risk what so ever.

When in doubt, rip it out! It is the only logical thing to do.

Sharon

[Guest guest]

Regarding the below text from the post from an anonymous person regarding Dr. Burge's recent article:

"She does claim that dried mold in walls posses little risk. It seems his counterexample is that it might, under certain situations, cause odors. However, if the water problem has been fixed, and the mold is no longer growing (hence "dried mold" and not "active mold"), then it is not going to be making new MVOCs or other substances. It'll be dormant, what it has produced may be blown away, dissipate, etc.; but, it will not be a new source. In many situations, I would then agree that leaving it there is probably the best choice."

This unnamed person is taking the position that it is OK to leave mold in the walls because (a) it will not cause a bunch of unproven symptoms in human occupants, but ( it is OK for it to stay and dissipate in a manner that will cause a bunch of proven symptoms in humans. Are we so focused these days on the unproven MVOC mycotoxin debate that we forget that it is the "dry dissipating inactive mold" that is an actual real and proven problem; one that is well known to be causing tens of thousands of nosocomial infections in American healthcare facilities and millions and millions of allergy and asthmatic episodes in other building occupants in America today?

B. Dotson, CIH, CSP

-----Original Message-----From: iequality [mailto:iequality ] On Behalf Of IECnews@...Sent: Friday, December 09, 2005 12:16 PMTo: iequality Subject: Re: Article from Dr. Harriet Burge titled "Can Mold Be Safely Lef...

Group:

The following response to Jim H. White's post is from a source who asked not to be identified to the IE Quality group:

Without spending a lot of time re-reading Harriet's article and quickly going through the response provided by Mr. White, I'm not sure what his contention is.a) he says the article is 'very' misleading and starts with an example examining the direction of airflows through walls. I don't recall / quickly see any reference to the direction of airflows in the walls in Harriet's article. Also, it seems that it can vary quite a bit depending upon what way the wind is blowing, whether the room is under positive or negative pressure, whether doors and windows are open, design of and cycles of the HVAC system, partial pressures of individual components of the air, etc. he says to use such a limited study to make major conclusions is very bad science. I would agree that using limited studies to make major conclusions is bad science; but, Harriet's article was a commentary that gave 2 examples and urged people to think about their specific situation; which seems to agree with what he is arguing for (she says "The bottom line is, making decisions about whether or not to remove hidden mold requires an analysis of the risks associated with leaving it there balanced against the risks of removal.") What's to disagree with there? Perhaps his comment is in reference to other comments in the discussion group? She does claim that dried mold in walls posses little risk. It seems his counterexample is that it might, under certain situations, cause odors. However, if the water problem has been fixed, and the mold is no longer growing (hence "dried mold" and not "active mold"), then it is not going to be making new MVOCs or other substances. It'll be dormant, what it has produced may be blown away, dissipate, etc.; but, it will not be a new source. In many situations, I would then agree that leaving it there is probably the best choice.c) I don't see how he supports the claim that Harriet's article is misleading, much less "very misleading." What I see in Harriet's article, again, is urging people to consider the risks (many different risks) in making a decision about what to do with mold in walls. How can that be misleading? I agree with her viewpoint.Just my quick thoughts.

Jim and others: Feel free to reply, but please don't shoot the messenger!

Sincerely,

Steve Sauer, EditorIndoor Environment Connections12339 Carroll Ave.Rockville, MD 20852Phone: ext. 17Fax: E-mail: IECnews@...

ArnoldHarriet, as usual, does not really understand the limits of her knowledge (which is immense in some areas). This article is very misleading.If there are no air leaks of significance, the air flow is outwards not inwards, and no significant mold growth occurring so no volatiles being generated, then there may be little indoor pollution due to hidden mold. If the mold is along, or accessible to, an air leakage path that sees a significant air inflow, it can contribute to an indoor air exposure when the inflow direction is working. Also, if the path is of low flow but the indoor materials have very low vapour resistance (high permeability) to the fungal volatiles, some odour problems could occur.To use such a limited study to make major conclusions is very bad science, but medical people are not known for a good understanding of science, or the limits of their knowledge. Although I left the manned space program to go into health and housing science (because I thought it was so challenging), I was told by a doctor that I was working with that he lived in a house so he, being a doctor, knew everything about houses. Wow, was I ever stupid to think that there were many unknowns in how houses made people sick!Jim H. White SSAL Article from Dr. Harriet Burge titled "Can Mold Be Safely Left Inside Walls?">> Thought I'd share this article I receive from an e-mail newsletter.> This is a timely article, in light of the extensive recent hurricane> related water damage.> I think we should make reasonable mold remediation recommendations> based on current best practices, without cutting corners, and let the> client make the decision on whether to follow through.>> Arnold (licensed mold assesment consultant) from Texas> ______________________________________________________________________> THE ENVIRONMENTAL REPORTER Brought to you by: EMLAB>> November 2005> Volume 3 | Issue 11>> Can Mold Be Safely Left Inside Walls?> By: Dr. Harriet Burge>> This ends up being a question of relative risk, and a complicated one> at that. First, in the ideal situation, all the mold growth would be> removed, either by removal of the growth itself, or of the material> supporting the growth. So - what is an ideal situation? Here is where> the relative risk comes in. The ideal situation for complete removal> is when the risk of leaving the mold far outweighs the risk of> removal. I know some of you will say - "there is no risk associated> with removal". I will say the opposite: there is little risk> associated with dried mold in walls, and significant financial and> emotional risk associated with its removal. Here are a few examples.>> 1. Penicillium chrysogenum is known to have grown extensively inside> and on the occupied surfaces of walls in a school room. All the> occupied space mold has been removed, the water problem repaired, a> sequence of air samples has documented the absence of culturable P.> chrysogenum, and concentrations of Pen/Asp spores are low. Thus,> there appears to be little if any health risk, and any risk to the> building would require a water event which would precipitate new> (possibly different) mold regardless of whether or not the existing> mold is removed. The parents and teachers don't believe or understand> this, and want the mold removed. On the other hand, the school board> has facts and figures that indicate that undertaking removal of the> mold means that the school will have to be closed for the remainder> of the year, causing disruption of the children in this and in> whatever school they have to move to. It impacts the teachers - no> school, no job. The school board, contrary to popular belief, does> not have the funds at hand to do the removal job and support all of> the other essential school expenses (salaries, supplies, services,> etc.). So, who gets laid off? To me, these few statements justify> leaving the mold, making sure no new water events occur, and> monitoring routinely for several months, looking only for P.> chrysogenum or for sharp increases in Pen/Asp spores.>> 2. Here's an example from a hospital. Contrary to popular belief,> hospitals do have mold, especially behind baseboards, and near sinks> and other water sources. They are there in most hospitals, and> present no apparent risk (e.g., no increases in infection rates). In> fact, the fungi that grow in these areas are generally not those that> cause infections. So, remember that we are not dealing with an> initially pristine environment. Now, you are called in to evaluate a> hospital that has had a flood on the lowest level. The flood water> has been removed, all the carpeting dried and cleaned, and the walls> thoroughly washed. Air samples reveal very little mold of any kind.> However, because of the heightened awareness of mold, hospital staff> have discovered some of the mold in other parts of the hospital and> are clamoring for its removal. Because there are small amounts of> mold at nearly every nurses station (e.g., in cabinets under the> sink) and every baseboard that has been pulled back reveals some> signs of water damage and mold, removal becomes a significant> problem. Hospital administration has to make the decision whether or> not there is funding for such a project, which would entail removal> of rooms from service, potential release of mold that at the present> poses virtually no danger, and a great deal of expense. If the> hospital happens to be wealthy (few are these days), then the risk> lies primarily in the potential for mold release during remediation.> If money is short, the hospital must make the same decisions as for> the school. Can they afford to have rooms out of service? Does the> financial risk, and the risks associated with remediation outweigh> the health risks of leaving the mold in place? Since the mold> probably developed within weeks of opening, and it is unlikely that> remediation will prevent further development (unless they have all> the sinks inspected monthly at least, and stop wet-mopping patient> rooms and steam cleaning hallway carpets).>> The bottom line is, making decisions about whether or not to remove> hidden mold requires an analysis of the risks associated with leaving> it there balanced against the risks of removal. Obviously, if> Aspergillus fumigatus has colonized the inner walls of a hospital,> then it must be removed, because the risk is high, even if only a> little escapes into a transplant patient's room or a surgical suite.> If the Penicillium chrysogenum in the school example is routinely> recovered from the room air, then of course it will have to be> removed because of the potential effects on asthmatic children.> However, removal based on the mere fact of its presence, or based on> nonspecific symptoms that are not related to mold exposure, is often> not appropriate.

[Guest guest]

Are we so focused these days on the unproven MVOC mycotoxin debate that we forget that it is the "dry dissipating inactive mold" that is an actual real and proven problem; one that is well known to be causing tens of thousands of nosocomial infections in American healthcare facilities and millions and millions of allergy and asthmatic episodes in other building occupants in America today?

B. Dotson, CIH, CSP

Hi ,

Yes, I think that is crux of it. is probably going to yell at me for getting on my podium, but we keep getting courtroom science (something is not responsible for causing illness unless you can prove it) mixed up with public safety science (if there are strong indications of future illness from a scenario, then one must err on the side of safety).

Ironically, not following public safety science is exactly what causing more courtroom science. It furthers the confusion over understood illness.

If we do not get a handle on scientists and physicians who advise on this issue, addressing this from a public safety aspect first, then we are directly causing the confusion and contention that makes the toxic mold issue a vicious, self-perpetuating, never ending circle.

Sharon

[Guest guest]

In Florida, I guess the question is “Do you feel lucky?’.If the

walls stay dry here in Florida, it isn’t a problem, until we get very

humid outdoor conditions, and the ambient humidity in the wall cavities reaches

80% (which it often does) or a tropical weather system skirts the area, or the power

is off for a while, or you have seasonal residents who do not understand the

proper use of humidity control during their periods of absence. As Dr.

Burge referenced, you must evaluate the risk. The risks in hot, humid

climates need to be considered when making the decisions to remove or not to

remove. Also from a real estate resale position, this could be a

liability.

H. Spates III, President

Indoor Environmental Technologies, Inc.

1384 Pierce Street

Clearwater, FL 33756

email: wspates@...

www.inevtec.com

Re: Article

from Dr. Harriet Burge titled " Can Mold Be Safely Lef...

Group:

The

following response to Jim H. White's post is from a source who asked not to be

identified to the IE Quality group:

Without

spending a lot of time re-reading Harriet's article and quickly

going through the response provided by Mr. White, I'm not sure what his

contention is.

a) he says the article is 'very' misleading and starts with an example

examining the direction of airflows through walls. I don't recall /

quickly see any reference to the direction of airflows in the walls in

Harriet's article. Also, it seems that it can vary quite a bit

depending upon what way the wind is blowing, whether the room is under

positive or negative pressure, whether doors and windows are open,

design of and cycles of the HVAC system, partial pressures of

individual components of the air, etc.

he says to use such a limited study to make major conclusions is

very bad science. I would agree that using limited studies to make

major conclusions is bad science; but, Harriet's article was a

commentary that gave 2 examples and urged people to think about their

specific situation; which seems to agree with what he is arguing for

(she says " The bottom line is, making decisions about whether or not

to

remove hidden mold requires an analysis of the risks associated with

leaving it there balanced against the risks of removal. " ) What's

to

disagree with there? Perhaps his comment is in reference to other

comments in the discussion group? She does claim that dried mold in

walls posses little risk. It seems his counterexample is that it

might, under certain situations, cause odors. However, if the water

problem has been fixed, and the mold is no longer growing (hence

" dried

mold " and not " active mold " ), then it is not going to be making

new

MVOCs or other substances. It'll be dormant, what it has produced

may

be blown away, dissipate, etc.; but, it will not be a new source.

In

many situations, I would then agree that leaving it there is probably

the best choice.

c) I don't see how he supports the claim that Harriet's article is

misleading, much less " very misleading. " What I see in

Harriet's

article, again, is urging people to consider the risks (many different

risks) in making a decision about what to do with mold in walls.

How

can that be misleading? I agree with her viewpoint.

Just my quick thoughts.

Jim and

others: Feel free to reply, but please don't shoot the messenger!

Sincerely,

Steve Sauer, Editor

Indoor Environment Connections

12339 Carroll Ave.

Rockville, MD 20852

Phone: ext. 17

Fax:

E-mail: IECnews@...

In a

message dated 12/8/2005 1:34:16 PM Eastern Standard Time, systemsa@...

writes:

Arnold

Harriet, as usual, does not really understand the limits of her knowledge

(which is immense in some areas). This article is very misleading.

If there are no air leaks of significance, the air flow is outwards not

inwards, and no significant mold growth occurring so no volatiles being

generated, then there may be little indoor pollution due to hidden mold. If

the mold is along, or accessible to, an air leakage path that sees a

significant air inflow, it can contribute to an indoor air exposure when the

inflow direction is working. Also, if the path is of low flow but the indoor

materials have very low vapour resistance (high permeability) to the fungal

volatiles, some odour problems could occur.

To use such a limited study to make major conclusions is very bad science,

but medical people are not known for a good understanding of science, or the

limits of their knowledge. Although I left the manned space program to go

into health and housing science (because I thought it was so challenging), I

was told by a doctor that I was working with that he lived in a house so he,

being a doctor, knew everything about houses. Wow, was I ever stupid to

think that there were many unknowns in how houses made people sick!

Jim H. White SSAL

Article from Dr. Harriet Burge titled " Can Mold Be

Safely Left Inside Walls? "

>

> Thought I'd share this article I receive from an e-mail newsletter.

> This is a timely article, in light of the extensive recent hurricane

> related water damage.

> I think we should make reasonable mold remediation recommendations

> based on current best practices, without cutting corners, and let the

> client make the decision on whether to follow through.

>

> Arnold (licensed mold assesment consultant) from Texas

> ______________________________________________________________________

> THE ENVIRONMENTAL REPORTER Brought to you by: EMLAB

>

> November 2005

> Volume 3 | Issue 11

>

> Can Mold Be Safely Left Inside Walls?

> By: Dr. Harriet Burge

>

> This ends up being a question of relative risk, and a complicated one

> at that. First, in the ideal situation, all the mold growth would be

> removed, either by removal of the growth itself, or of the material

> supporting the growth. So - what is an ideal situation? Here is where

> the relative risk comes in. The ideal situation for complete removal

> is when the risk of leaving the mold far outweighs the risk of

> removal. I know some of you will say - " there is no risk associated

> with removal " . I will say the opposite: there is little risk

> associated with dried mold in walls, and significant financial and

> emotional risk associated with its removal. Here are a few examples.

>

> 1. Penicillium chrysogenum is known to have grown extensively inside

> and on the occupied surfaces of walls in a school room. All the

> occupied space mold has been removed, the water problem repaired, a

> sequence of air samples has documented the absence of culturable P.

> chrysogenum, and concentrations of Pen/Asp spores are low. Thus,

> there appears to be little if any health risk, and any risk to the

> building would require a water event which would precipitate new

> (possibly different) mold regardless of whether or not the existing

> mold is removed. The parents and teachers don't believe or understand

> this, and want the mold removed. On the other hand, the school board

> has facts and figures that indicate that undertaking removal of the

> mold means that the school will have to be closed for the remainder

> of the year, causing disruption of the children in this and in

> whatever school they have to move to. It impacts the teachers - no

> school, no job. The school board, contrary to popular belief, does

> not have the funds at hand to do the removal job and support all of

> the other essential school expenses (salaries, supplies, services,

> etc.). So, who gets laid off? To me, these few statements justify

> leaving the mold, making sure no new water events occur, and

> monitoring routinely for several months, looking only for P.

> chrysogenum or for sharp increases in Pen/Asp spores.

>

> 2. Here's an example from a hospital. Contrary to popular belief,

> hospitals do have mold, especially behind baseboards, and near sinks

> and other water sources. They are there in most hospitals, and

> present no apparent risk (e.g., no increases in infection rates). In

> fact, the fungi that grow in these areas are generally not those that

> cause infections. So, remember that we are not dealing with an

> initially pristine environment. Now, you are called in to evaluate a

> hospital that has had a flood on the lowest level. The flood water

> has been removed, all the carpeting dried and cleaned, and the walls

> thoroughly washed. Air samples reveal very little mold of any kind.

> However, because of the heightened awareness of mold, hospital staff

> have discovered some of the mold in other parts of the hospital and

> are clamoring for its removal. Because there are small amounts of

> mold at nearly every nurses station (e.g., in cabinets under the

> sink) and every baseboard that has been pulled back reveals some

> signs of water damage and mold, removal becomes a significant

> problem. Hospital administration has to make the decision whether or

> not there is funding for such a project, which would entail removal

> of rooms from service, potential release of mold that at the present

> poses virtually no danger, and a great deal of expense. If the

> hospital happens to be wealthy (few are these days), then the risk

> lies primarily in the potential for mold release during remediation.

> If money is short, the hospital must make the same decisions as for

> the school. Can they afford to have rooms out of service? Does the

> financial risk, and the risks associated with remediation outweigh

> the health risks of leaving the mold in place? Since the mold

> probably developed within weeks of opening, and it is unlikely that

> remediation will prevent further development (unless they have all

> the sinks inspected monthly at least, and stop wet-mopping patient

> rooms and steam cleaning hallway carpets).

>

> The bottom line is, making decisions about whether or not to remove

> hidden mold requires an analysis of the risks associated with leaving

> it there balanced against the risks of removal. Obviously, if

> Aspergillus fumigatus has colonized the inner walls of a hospital,

> then it must be removed, because the risk is high, even if only a

> little escapes into a transplant patient's room or a surgical suite.

> If the Penicillium chrysogenum in the school example is routinely

> recovered from the room air, then of course it will have to be

> removed because of the potential effects on asthmatic children.

> However, removal based on the mere fact of its presence, or based on

> nonspecific symptoms that are not related to mold exposure, is often

> not appropriate.

[Guest guest]

I think the divergence of opinion between Dr. Burge and many on this

list is the belief in serious health effects.

Everyone agrees molds can cause allergy-like symptoms. If you believe

that this is the only risk, you may support leaving some stuff in the

walls. If you believe symptoms can at least sometimes be greater, you

will want to remove it as EPA recommends.

My greatest concern with leaving mold in place in public buildings (as

she suggests may be possible) is the large numbers of people that may

be exposed. I favor removal because 1) you don't know if any of the

current patients, students, or employees already has a strong reaction

to it (although you may have a clue if you conduct a health survey),

and 2) you cannot know if the next patient, student, or employee coming

in may react. So remove it.

Henry Slack, P.E.

U.S. EPA Region 4

Indoor Air Program

For more assistance, try EPA's Web site, www.epa.gov/iaq

or call EPA's Indoor Air Quality Information Clearinghouse

. Experts are available 9-5 M-F

----- Forwarded by Henry Slack/R4/USEPA/US on 12/13/2005 03:09 PM -----

IECnews@...

12/13/2005 02:02 To

PM Henry Slack/R4/USEPA/US@EPA

cc

Subject

Re: Article from Dr.

Harriet Burge titled " Can Mold Be

Safely Lef...

Henry,

While I'm flattered that you do trust me enough as a journalist not to

reveal my sources, I think that my intervention like this could be

stunting good debate. One of the cool things about the IE Quality group

is that its members stress the importance of people signing their own

posts. Part of this reason is because the message is just as important

as the messenger. My decision to post on behalf of an anonymous source

the other day was probably counterproductive to that goal, so I don't

intend to do that again except in extraordinary circumstances. I will,

however, continue to use anonymous sources in my news articles.

As for your other issue at work here, I've seen you post all the time

under the EPA moniker with and without that disclaimer that your

opinions don't necessarily reflect those of your employer. I think you

should continue doing that. It's for everybody's benefit -- in fact, so

much so that I wanted to implore you to do this rather than not replying

to your message to me!

Sincerely,

Steve Sauer, Editor

Indoor Environment Connections

12339 Carroll Ave.

Rockville, MD 20852

Phone: ext. 17

Fax:

E-mail: IECnews@...

In a message dated 12/11/2005 9:44:25 PM Eastern Standard Time,

Slack.Henry@... writes:

Subject: Re: Article from Dr. Harriet Burge titled " Can Mold Be Safely

Lef...

Steve -

Can you also post the following for me, anonymously? I prefer it not

be

associated with my employer. If you choose not to, you need not reply,

just delete the message, and I'm sorry for taking your time. (I don't

want to assume you're a willing messenger for everyone if you don't

wish

to be.)

Thankx either way.

Henry

A quick comment on Dr. Burge:

I respect Dr. Burge's expertise on fungi, but I do not think she has

had

any experience of nasty effects from molds, and consequently, her sense

of safety is different. If she believes the worst effects from most

fungi are irritation and respiratory symptoms, then indeed, leaving

some

mold in the wall may not be so bad.

If this is a home without anyone sick, I tend to agree that yes, we can

leave some stuff in the walls.

If this is a workplace with a hundred employees, or a church or public

building, or a child care center or school whose population changes

every year, then someone who comes in will be sensitive and affected.

Let's err on the side of caution, and remove all the mold we can in

these buildings.

Henry Slack, P.E.

U.S. EPA Region 4

Indoor Air Program

For more assistance, try EPA's Web site, www.epa.gov/iaq

or call EPA's Indoor Air Quality Information Clearinghouse

. Experts are available 9-5 M-F

[Guest guest]

In my read of the article by Dr. Burge, I can easily see how it has

a place in my practice. Dr. Burge has offered an option, and while

some may see it as a new idea, it is not. Sometimes the most

difficult cases we encounter are those where the lively hood of

numerous people or opertation of an important facility stand in the

balance of our professional advice. Knee-jerk recommendations to

vacate & remediate can have an economic or social impact that, in

certain instances, will far outweigh the human health benefit of

mold removal. When in such a position you are derelict in your

responsibilities as an evaluator if you do not explore ALL the

options, including those Dr. Burge has suggested.

Enough said?

Yet, in my read of the reactions by others on list, as I strive to

see the differing point of view, I believe the divergence of

understanding is in regards to understanding that Dr. Burge's

suggestion affects the point in time when remediation is

conducted. This is a common concept known as deferred

maintenance. And the option she has offered appears to be the

option to monitor and manage the risks until repairs are more

economically or organizationally feasible.

To make my point I'll ask the questions:

1. Why shut the school down today, if the remediation work

can " safely " be deferred until Christmas or Easter break or next

summer?

2. Why close down the Pediatrics ward if air samples show good air

right now and repairs can " safely " be deferred to a more appropriate

time within the next 16 months?

3. Can we get creative and come up with a way to manage the risk to

occupants while we continue to operate the facility until a response

plan can be made that will soften the blow to the organization?

Gerber

>

> I think the divergence of opinion between Dr. Burge and many on

this

> list is the belief in serious health effects.

>

> Everyone agrees molds can cause allergy-like symptoms. If you

believe

> that this is the only risk, you may support leaving some stuff in

the

> walls. If you believe symptoms can at least sometimes be

greater, you

> will want to remove it as EPA recommends.

>

>

[Guest guest]

Good perspective.

I’ve heard it said that Americans

are good at managing known risks but horrible at managing unknown risks.  I think the current political climate is a perfect

example of that. Look how we are managing (or not managing) our fear of

terrorism.  

There is a lot of money to be made selling

fear of the unknown.  It is a lot easier

to fleece someone that is irrational than someone that is rational. 

I’ll try your questions below:

Re: Article

from Dr. Harriet Burge titled " Can Mold Be Safely Lef...

In my read of the article by Dr. Burge, I can easily

see how it has

a place in my practice. Dr. Burge has

offered an option, and while

some may see it as a new idea, it is not.

Sometimes the most

difficult cases we encounter are those where the

lively hood of

numerous people or opertation of an important

facility stand in the

balance of our professional advice.

Knee-jerk recommendations to

vacate & remediate can have an economic or

social impact that, in

certain instances, will far outweigh the human

health benefit of

mold removal. When in such a position you

are derelict in your

responsibilities as an evaluator if you do not

explore ALL the

options, including those Dr. Burge has suggested.

Enough said?

Yet, in my read of the reactions by others on

list, as I strive to

see the differing point of view, I believe the

divergence of

understanding is in regards to understanding that

Dr. Burge's

suggestion affects the point in time when remediation

is

conducted. This is a common concept

known as deferred

maintenance. And the option she has offered

appears to be the

option to monitor and manage the risks until

repairs are more

economically or organizationally feasible.

To make my point I'll ask the questions:

1. Why shut the school down today, if the

remediation work

can " safely " be deferred until Christmas or Easter break or

next

summer?

Fear and ignorance.

2. Why close down the Pediatrics ward if air

samples show good air

right now and repairs can " safely " be deferred to a more

appropriate

time within the next 16 months?

Fear and ignorance.  Also we need to keep the little cherubs alive

until we can tax them or execute them for their adult crimes.

3. Can we get creative and come up with a way to

manage the risk to

occupants while we continue to operate the facility until a response

plan can be made that will soften the blow to the

organization?

Our

society frowns on creativity or thinking out of the box.  It creates fear in our hearts that someone

might not think exactly as we do.  There

must be something wrong with them.

I think it

will take a paradigm shift to accomplish this.  The status quo is

good for business.

md  

Gerber

>

> I think the divergence of opinion between Dr.

Burge and many on

this

> list is the belief in serious health effects.

>

> Everyone agrees molds can cause

allergy-like symptoms. If you

believe

> that this is the only risk, you may

support leaving some stuff in

the

> walls. If you believe symptoms

can at least sometimes be

greater, you

> will want to remove it as EPA

recommends.

>

>

[Guest guest]

Good perspective.

I’ve heard it said that Americans

are good at managing known risks but horrible at managing unknown risks.  I think the current political climate is a perfect

example of that. Look how we are managing (or not managing) our fear of

terrorism.  

There is a lot of money to be made selling

fear of the unknown.  It is a lot easier

to fleece someone that is irrational than someone that is rational. 

I’ll try your questions below:

Re: Article

from Dr. Harriet Burge titled " Can Mold Be Safely Lef...

In my read of the article by Dr. Burge, I can easily

see how it has

a place in my practice. Dr. Burge has

offered an option, and while

some may see it as a new idea, it is not.

Sometimes the most

difficult cases we encounter are those where the

lively hood of

numerous people or opertation of an important

facility stand in the

balance of our professional advice.

Knee-jerk recommendations to

vacate & remediate can have an economic or

social impact that, in

certain instances, will far outweigh the human

health benefit of

mold removal. When in such a position you

are derelict in your

responsibilities as an evaluator if you do not

explore ALL the

options, including those Dr. Burge has suggested.

Enough said?

Yet, in my read of the reactions by others on

list, as I strive to

see the differing point of view, I believe the

divergence of

understanding is in regards to understanding that

Dr. Burge's

suggestion affects the point in time when remediation

is

conducted. This is a common concept

known as deferred

maintenance. And the option she has offered

appears to be the

option to monitor and manage the risks until

repairs are more

economically or organizationally feasible.

To make my point I'll ask the questions:

1. Why shut the school down today, if the

remediation work

can " safely " be deferred until Christmas or Easter break or

next

summer?

Fear and ignorance.

2. Why close down the Pediatrics ward if air

samples show good air

right now and repairs can " safely " be deferred to a more

appropriate

time within the next 16 months?

Fear and ignorance.  Also we need to keep the little cherubs alive

until we can tax them or execute them for their adult crimes.

3. Can we get creative and come up with a way to

manage the risk to

occupants while we continue to operate the facility until a response

plan can be made that will soften the blow to the

organization?

Our

society frowns on creativity or thinking out of the box.  It creates fear in our hearts that someone

might not think exactly as we do.  There

must be something wrong with them.

I think it

will take a paradigm shift to accomplish this.  The status quo is

good for business.

md  

Gerber

>

> I think the divergence of opinion between Dr.

Burge and many on

this

> list is the belief in serious health effects.

>

> Everyone agrees molds can cause

allergy-like symptoms. If you

believe

> that this is the only risk, you may

support leaving some stuff in

the

> walls. If you believe symptoms

can at least sometimes be

greater, you

> will want to remove it as EPA

recommends.

>

>

[Guest guest]

Mark and All,

You make some very good points about assessing individual appropriate mold removal timelines and methods based on the physical science of the matter. But read Dr. Burge's article again. I attached it at the end. That does not appear to me to be the subject of the article. It appears to me that what she is discussing is making the decision based on the limiting of short term financial cost being given precedence over the potential health risk.

They always say those most at risk are not just asthmatics, but the very young and the very old. I can just envision little ny's mother when he gets a really bad flu, or cold, etc right after he starts kindergarten. And she finds out little asthmatic is not in ny's classroom because ny's classroom has mold behind the wall (and the School Board never told her because they did not want to set off a panic)

I just think when you take the whole picture into account, the obvious potential for creating a contentious evironment, whether it is based on probable (but not guaranteed) science or not, it is very risky to put so much emphasis on limiting immediate expenditures - from both a long term health aspect and a long term financial liability aspect. Given all the scientific uncertainties and variables over this issue - it just seems to me that it is much wiser and ultimately financially prudent to get rid of that mold in the first place.

Sharon

My experience suggests that they shouldn’t except in cases that involve them directly. I believe it is important to make this distinction at the onset of a project so that the objectives can be determined before remediation work commences.

Just my thoughts.

Mark Doughty

Web Exclusive: Can mold be safely left inside walls?

The following Web Exclusive comes from Dr. Harriet Burge, courtesy of Environmental Microbiology Laboratory, Inc.The removal of mold--under any or all circumstances--ends up being a question of relative risk, and a complicated one at that. First, in the ideal situation, all the mold growth would be removed, either by removal of the growth itself, or of the material supporting the growth. So - what is an ideal situation? Here is where the relative risk comes in.The ideal situation for complete removal is when the risk of leaving the mold far outweighs the risk of removal. I know some of you will say - "there is no risk associated with removal". I will say the opposite: there is little risk associated with dried mold in walls, and significant financial and emotional risk associated with its removal.Here are a few examples.1. Penicillium chrysogenum is known to have grown extensively inside and on the occupied surfaces of walls in a school room. All the occupied space mold has been removed, the water problem repaired, a sequence of air samples has documented the absence of culturable P. chrysogenum, and concentrations of Pen/Asp spores are low. Thus, there appears to be little if any health risk, and any risk to the building would require a water event which would precipitate new (possibly different) mold regardless of whether or not the existing mold is removed.The parents and teachers don't believe or understand this, and want the mold removed. On the other hand, the school board has facts and figures that indicate that undertaking removal of the mold means that the school will have to be closed for the remainder of the year, causing disruption of the children in this and in whatever school they have to move to. It impacts the teachers - no school, no job. The school board, contrary to popular belief, does not have the funds at hand to do the removal job and support all of the other essential school expenses (salaries, supplies, services, etc.). So, who gets laid off?To me, these few statements justify leaving the mold, making sure no new water events occur, and monitoring routinely for several months, looking only for P. chrysogenum or for sharp increases in Pen/Asp spores.2. Contrary to popular belief, hospitals do have mold, especially behind baseboards and near sinks and other water sources. They are there in most hospitals and present no apparent risk (e.g., no increases in infection rates). In fact, the fungi that grow in these areas are generally not those that cause infections. So, remember that we are not dealing with an initially pristine environment.Now, you are called in to evaluate a hospital that has had a flood on the lowest level. The flood water has been removed, all the carpeting dried and cleaned, and the walls thoroughly washed. Air samples reveal very little mold of any kind. However, because of the heightened awareness of mold, hospital staff have discovered some of the mold in other parts of the hospital and are clamoring for its removal. Because there are small amounts of mold at nearly every nurses station (e.g., in cabinets under the sink) and every baseboard that has been pulled back reveals some signs of water damage and mold, removal becomes a significant problem.Hospital administration has to make the decision whether or not there is funding for such a project, which would entail removal of rooms from service, potential release of mold that at the present poses virtually no danger, and a great deal of expense. If the hospital happens to be wealthy (few are these days), then the risk lies primarily in the potential for mold release during remediation. If money is short, the hospital must make the same decisions as for the school. Can it afford to have rooms out of service? Does the financial risk, and the risks associated with remediation outweigh the health risks of leaving the mold in place?Since the mold probably developed within weeks of opening, and it is unlikely that remediation will prevent further development (unless they have all the sinks inspected monthly at least, and stop wet-mopping patient rooms and steam cleaning hallway carpets).The bottom line is, making decisions about whether or not to remove hidden mold requires an analysis of the risks associated with leaving it there balanced against the risks of removal. Obviously, if Aspergillus fumigatus has colonized the inner walls of a hospital, then it must be removed, because the risk is high, even if only a little escapes into a transplant patient's room or a surgical suite. If the Penicillium chrysogenum in the school example is routinely recovered from the room air, then of course it will have to be removed because of the potential effects on asthmatic children.In the end, removal based on the mere fact of its presence, or based on nonspecific symptoms that are not related to mold exposure, is often not appropriate.

[Guest guest]

Mark and All,

You make some very good points about assessing individual appropriate mold removal timelines and methods based on the physical science of the matter. But read Dr. Burge's article again. I attached it at the end. That does not appear to me to be the subject of the article. It appears to me that what she is discussing is making the decision based on the limiting of short term financial cost being given precedence over the potential health risk.

They always say those most at risk are not just asthmatics, but the very young and the very old. I can just envision little ny's mother when he gets a really bad flu, or cold, etc right after he starts kindergarten. And she finds out little asthmatic is not in ny's classroom because ny's classroom has mold behind the wall (and the School Board never told her because they did not want to set off a panic)

I just think when you take the whole picture into account, the obvious potential for creating a contentious evironment, whether it is based on probable (but not guaranteed) science or not, it is very risky to put so much emphasis on limiting immediate expenditures - from both a long term health aspect and a long term financial liability aspect. Given all the scientific uncertainties and variables over this issue - it just seems to me that it is much wiser and ultimately financially prudent to get rid of that mold in the first place.

Sharon

My experience suggests that they shouldn’t except in cases that involve them directly. I believe it is important to make this distinction at the onset of a project so that the objectives can be determined before remediation work commences.

Just my thoughts.

Mark Doughty

Web Exclusive: Can mold be safely left inside walls?

The following Web Exclusive comes from Dr. Harriet Burge, courtesy of Environmental Microbiology Laboratory, Inc.The removal of mold--under any or all circumstances--ends up being a question of relative risk, and a complicated one at that. First, in the ideal situation, all the mold growth would be removed, either by removal of the growth itself, or of the material supporting the growth. So - what is an ideal situation? Here is where the relative risk comes in.The ideal situation for complete removal is when the risk of leaving the mold far outweighs the risk of removal. I know some of you will say - "there is no risk associated with removal". I will say the opposite: there is little risk associated with dried mold in walls, and significant financial and emotional risk associated with its removal.Here are a few examples.1. Penicillium chrysogenum is known to have grown extensively inside and on the occupied surfaces of walls in a school room. All the occupied space mold has been removed, the water problem repaired, a sequence of air samples has documented the absence of culturable P. chrysogenum, and concentrations of Pen/Asp spores are low. Thus, there appears to be little if any health risk, and any risk to the building would require a water event which would precipitate new (possibly different) mold regardless of whether or not the existing mold is removed.The parents and teachers don't believe or understand this, and want the mold removed. On the other hand, the school board has facts and figures that indicate that undertaking removal of the mold means that the school will have to be closed for the remainder of the year, causing disruption of the children in this and in whatever school they have to move to. It impacts the teachers - no school, no job. The school board, contrary to popular belief, does not have the funds at hand to do the removal job and support all of the other essential school expenses (salaries, supplies, services, etc.). So, who gets laid off?To me, these few statements justify leaving the mold, making sure no new water events occur, and monitoring routinely for several months, looking only for P. chrysogenum or for sharp increases in Pen/Asp spores.2. Contrary to popular belief, hospitals do have mold, especially behind baseboards and near sinks and other water sources. They are there in most hospitals and present no apparent risk (e.g., no increases in infection rates). In fact, the fungi that grow in these areas are generally not those that cause infections. So, remember that we are not dealing with an initially pristine environment.Now, you are called in to evaluate a hospital that has had a flood on the lowest level. The flood water has been removed, all the carpeting dried and cleaned, and the walls thoroughly washed. Air samples reveal very little mold of any kind. However, because of the heightened awareness of mold, hospital staff have discovered some of the mold in other parts of the hospital and are clamoring for its removal. Because there are small amounts of mold at nearly every nurses station (e.g., in cabinets under the sink) and every baseboard that has been pulled back reveals some signs of water damage and mold, removal becomes a significant problem.Hospital administration has to make the decision whether or not there is funding for such a project, which would entail removal of rooms from service, potential release of mold that at the present poses virtually no danger, and a great deal of expense. If the hospital happens to be wealthy (few are these days), then the risk lies primarily in the potential for mold release during remediation. If money is short, the hospital must make the same decisions as for the school. Can it afford to have rooms out of service? Does the financial risk, and the risks associated with remediation outweigh the health risks of leaving the mold in place?Since the mold probably developed within weeks of opening, and it is unlikely that remediation will prevent further development (unless they have all the sinks inspected monthly at least, and stop wet-mopping patient rooms and steam cleaning hallway carpets).The bottom line is, making decisions about whether or not to remove hidden mold requires an analysis of the risks associated with leaving it there balanced against the risks of removal. Obviously, if Aspergillus fumigatus has colonized the inner walls of a hospital, then it must be removed, because the risk is high, even if only a little escapes into a transplant patient's room or a surgical suite. If the Penicillium chrysogenum in the school example is routinely recovered from the room air, then of course it will have to be removed because of the potential effects on asthmatic children.In the end, removal based on the mere fact of its presence, or based on nonspecific symptoms that are not related to mold exposure, is often not appropriate.

[Guest guest]

Hi Mark,

That is interesting. When I was referring to "probable science", I was referring to Dr. Burge's article that it is probably okay to leave the mold behind the wall. So am I to take it to mean that you think it is not?

Sharon

Sharon,

In your third paragraph you mention probable science. I would submit to you that probable science is not science at all, but philosophy. Science isn’t probable: if it can’t be proven it isn’t science. We may not like it, but that is the purpose of science. The role of scientists is to be skeptical. This is why so many of us cringe when we hear about “social scienceâ€, probable or not.

Thanks for your concerns and comments.

Mark Doughty