This post was updated on October 21, 2011 to reflect the current state of politics and why and how information continues to be suppressed of the serious illness caused by water damaged buildings.

California Courts Have Been Colluding With “Product Defenders” VeriTox, Inc. For Six Years To Defraud Public Over Mold Issue. Suppressed Evidence In A Strategic Litigation Against Public Participation, Bruce Kelman vs. Sharon Kramer, San Diego, California.

In 2009, the World Health Organization issued a REPORT regarding known illnesses caused by exposure to microbes found in water damaged building. Within the REPORT, they accurately state that exposure to molds and toxins can cause a perturbing of the immune system.

The US Department of Transportation has found that a Federal employee was permanantly disabled from his chronic inflammation caused by exposure to microbes in the water damaged Detroit Metro Air Traffic Controller Tower.

There is an ICD-9 Code for these illnesses of Chronic Inflammatory Response from exposures in Water Damaged Buildings, CIRS-WDB.

US OSHA has issued health advisories in which they, too, recognize the perturbance of the immune system from poor indoor air quality of moldy buildings.

What has precluded this information from coming to greater public light is that members of the California Judicial Council and the California Commission on Judicial Performance have been colluding to defraud the public for six years by suppressing evidence that VeriTox owner, Bruce J. Kelman, used criminal perjury to establish needed reason for malice while Strategically Litigating Against Public Participation.

This, over the first public writing (March 2005) to expose how VeriTox was able to get scientific fraud marketed into public health policy for the purpose of influencing the courts and while generating handsome incomes as expert defense witnesses in mold litigations across the US.

Kelman is the author of the two fraudulent policy papers that have been used throughout the US for the past ten years to suppress information of serious illnesses caused by water damaged buildings. One paper was for a physician trade association. The other, for the US Chamber of Commerce.

He had applied math extrapolations to a single rodent study and professed this proved no one could ever be exposed to enough mold toxins in a water damaged building to cause illness. The conclusion has never been duplicated. Regardless, special interests marketed it as legitimate science into US public health policy.

They sued Sharon Kramer for the first public writing of how they marketed the “garbage science” into policy. Their sole claim of the case was that Sharon’s phrase “altered his under oath statements” was a maliciously false accusation of perjury. In six years time, no one can state how that phrase tranlates into an accusation of perjury. No one can state why Sharon would have malice for Kelman.

For six years, all courts suppressed the evidence that Kelman committed perjury to establish needed reason for malice and suppressed the evidence of Sharon’s explanation of why she used that phrase.

Now, the courts are trying to make Sharon stop writing of what they did to frame a whistleblower for libel while knowing the courts were aiding billions in fraud over the mold issue to continue and keeping the physicians of America in the dark about serious illness. This, for the sake of staving off liability for water damaged buildings. Many lives have been unnecessarily ruined for the lack of awareness over this issue.

Threat of jail for speaking and evidencing the truth in America of how the public has been defrauded with the aid of the California courts suppressing evidence in a SLAPP suit, is looming for Sharon.

If she cannot republish the phrase, “altered his under oath statements”, she cannot write and evidence of what the courts did to frame her while knowing they were aiding fraud in policy to continue.

Kelman along with VeriTox co-owner, Bryan Hardin, are co-authors of the 2003 US Chamber of Commerce’s “A Scientific View of the Health Effects of Mold”.

The US Chamber’s “Scientific View” cites false physician authorship, was paid for by a think-tank and was written with the express direction that it should be something judges can understand. What it says to “educate” judges is “Thus the notion that Toxic Mold is an insidious secret killer as so many trial lawyers and media would claim is ‘Junk Science” unsupported by actual scientific study.”

In 2007, Dr. David Michaels, current Director of OSHA and author of “Doubt is their product. How industries assault on science threatens your health”; submitted a REQUEST to the EPA that Hardin and Veritox not be permitted to sit on an EPA advisory committee over environmental illness. This is because of their close ties to industry making them unfit candidates for influencing US public health policy.

Unfortunately, they have had far too much influence over health policy and in US courts with regard to illnesses caused by water damaged buildings and for far too many years.

This is DIRECTLY BECAUSE the Fourth District Division One Appllate Court in San Diego, California is severely compromised. For six years they suppressed the evidence that Kelman committed criminal perjury to establish needed reason for malice while strategically litigating against the first person, Sharon Kramer, to write of how Vertitox was able to mass market “garbage science” into policy.

The justices of the San Diego Appellate Court, for six years, suppressed the evidence that Hardin was an undisclosed party to the strategic and malicious litigation. The justices framed Kramer to make it look like her March 2005 writing falsely accused Kelman of lying about being paid to author a mold position statement for the American College of Occupational and Environmental Medicine, (ACOEM) “Adverse Human Health Effects of Mold in the Indoor Environment”.

November 2006 anti-SLAPP Appellate Opinion written by Justice Judith McConnell, Chair of the California Commission on Judicial Performance in an unpublished anti-SLAPP Opinion:

“This testimony supports a conclusion Kelman did not deny he had been paid by the Manhattan Institute to write a paper, but only denied being paid by the Manhattan Institute to make revisions in the paper issued by ACOEM. He admitted being paid by the Manhattan Institute to write a lay translation. The fact that Kelman did not clarify that he received payment from the Manhattan Institute until after being confronted with the Kilian deposition testimony could be viewed by a reasonable jury as resulting from the poor phrasing of the question rather from an attempt to deny payment. In sum, Kelman and GlobalTox presented sufficient evidence to satisfy a prima facie showing that the statement in the press release was false.”

Kramer’s writing speaks for itself and is abolutely correct. The exchange of think-tank money between the Manhattan Institute and Veritox’s Kelman and Hardin, was for the US Chamber’s Mold Statement. ACOEM’s was a “version on the Manhattan Institute commissioned piece.” Kelman had to admit this in front of a jury, after being forced to discuss the connection of the US Chamber’s mold statement to that of ACOEM’s by a prior testimony of his from Kilian being permitted into the trial over the defense counsel’s objection.

From Kramer’s March 2005 writing staing the money was for the US Chamber’s Mold Position Statement. ACOEM’s was a version:

He [Bruce J. Kelman] admitted the Manhattan Institute, a national political think-tank, paid GlobalTox $40,000 to write a position paper regarding the potential health risks of toxic mold exposure…..In 2003, with the involvement of the US Chamber of Commerce and ex-developer, US Congressman Gary Miller (R-CA), the GlobalTox paper was disseminated to the real estate, mortgage and building industries’ associations. A version of the Manhattan Institute commissioned piece may also be found as a position statement on the website of a United States medical policy-writing body, the American College of Occupational and Environmental Medicine.”

Now, after six years of basically judicial gang rape by compromised courts of a whistleblower of fraud in policy; the courts are threatening Contempt of Court – jail time – if Sharon, the first person to publicly write of how the fraud in policy came to be, refuses to be forced to collude with Kelman, Hardin, Veritox & the compromised courts of San Diego; and refuses to be a party to defrauding the public by remaining silent of what Kelman, his business partner, Hardin, the US Chamber of Commerce, the American College of Occupational & Environmental Medicine, ACOEM, US Congressman Gary Miller (R-Ca) and the compromised judicial leaders of California have done — that is nothing short of crimes against humanity, defrauding the US and worldwide public for SIX YEARS by criminal means for the purpose of suppressing the fact that science holds moldy buildings indeed cause serious illness.

SHARON KRAMER
STATEMENT TO THE COURT
October 21, 2011
Bruce Kelman v. Sharon Kramer
Case No. 37-2010-00061530 CU DF NC
North San Diego Superior Court
The Honorable Thomas Nugent Presiding

Kelman is President and one of six owners of VeriTox, Inc. He is the co-author of the 2002 ACOEM’s & 2003 US Chamber of Commerce’s position statements on mold that profess to scientifically prove the concept that moldy buildings do not harm.

Kramer is the catalyst of a 2008 Federal GAO audit report that finds serious illnesses from mold and their toxins are indeed plausibly occurring in water damaged buildings through out the US.

Begin statements on the court record:

According to California law, uncontroverted evidence is generally accepted as true, including US Citizen, KRAMER’s and including in this case.. “Uncontradicted and unimpeached evidence is generally accepted as true.” (Garza v. Workmen’s Comp. App. Bd. (1970) 3 Cal.3rd 312 317-318 [90 Cal.Rptr. 355]; Keulen v. Workers’ Comp. Appeals Bd., supra, 66 Cal.App.4th at p. 1099.)

The uncontroverted evidence on record in this case is that in March of 2005, I was the first to publicly write of how it became a fraud mass marketed in US public health policy and before US courts that it was scientifically proven moldy buildings do not harm people, while I named the names of those involved: Bruce Kelman, GlobalTox, Inc (now known as Veritox), the Manhattan Institute think-tank, the US Chamber of Commerce, the American College of Occupational and Environmental Medicine (ACOEM) and US Congressman Gary Miller (R Ca).

To quote the hatred and distrust of the sick inspiring marketing campaign as written by Bruce Kelman and co-owner of VeriTox, Bryan Hardin, and as penned by the two PhD’s for the US Chamber of Commerce and paid for by the Manhattan Institute think-tank, “Thus the notion that toxic mold is an insidious secret killer as so many trial lawyers and media would claim in “Junk Science” unsupported by actual scientific study”

The undisputed evidence on record of this case is that Bryan Hardin has been an undisclosed party to litigation against me, for six years.

The undisputed evidence on record in this case is that the US Chamber Mold Statement cites false physician and industrial hygienist authorship. It was only authored by Bruce Kelman and Bryan Hardin. They were the only two who billed hours and were paid for the US Chamber’s “A Scientific View of the Health Effects of Mold.”

The undisputed evidence on record in this case is that Bruce committed criminal perjury to establish a needed theme for my malice of being a sour grapes litigant while strategically litigating to silence me. His attorney, Keith Scheuer, repeatedly suborned Bruce’s perjury to inflame all courts and portray a false portrait of me. Published California case law evidences that Keith as a no less than thirty year history of litigating by these means in the state of California.

The undisputed evidence on record of this case is that all courts to oversee Kelman and GlobalTox v. Kramer suppressed the evidence of Kelman’s perjury, with the Fourth District Division One Appellate Court being directly evidenced of willfully suppressing this evidence in both 2006 and 2010.

The undisputed evidence on record of this case is that in their 2006 anti-SLAPP Appellate Opinion written by Justice Judith McConnell, Chair of the Ca Commission on Judicial Performance, she framed me to make it appear that I had accused Bruce of getting caught on a witness stand lying about being paid to author ACOEM’s Mold Statement.

Absolutely undeniable evidence on record in this case is that my writing is 100% accurate. The think-tank money is for the US Chamber Mold Statement. ACOEM’s was a version.

The undisputed evidence on record of this case is that in their 2010 Appellate Opinion, concurred with by Justice Richard Huffman, ex-Chair of the Executive Committee of the Judicial Council, they suppressed the evidence of what their peers had done in 2006, to suppress the evidence of Bruce’s perjury, Hardin’s non-disclosure as a party to the litigation, and the framing of me for libel.

The undisputed evidence on record of this case is that I have never republished the phrase “altered his under oath statements”, the only phrase for which I was sued without disclosing it was the subject of a lawsuit.

The undisputed evidence on record of this case is that if I cannot republish that phrase, I can also not write or evidence of what the San Diego courts have done to frame a whistleblower of fraud in policy, me, for libel while suppressing the evidence of some of the most notorious “Product Defenders” in the mold issue, VeriTox’s use of criminal perjury to establish needed reason for malice while strategically litigating so (in the words of Jonathan Borak, overseer of Scientific Affairs for ACOEM) their “garbage science” may continue to be used in US courts so they can make money as expert witnesses while selling doubt of causation of serious illness from moldy buildings.

The evidence on record in this case is that on July 15, 2011, this court made a statement in oral argument that it was frivolous of me to want Bruce and Keith to be made to corroborate their reason given for malice in the prior case. This court threatened to sanction me for my “frivolous” request.

With all respect due to this court, there is nothing frivolous about a bunch of judges suppressing evidence of a plaintiff’s criminal perjury and his attorney’s repeated suborning of it for six years – with the Appellate Court directly evidenced of knowing by doing so, they were aiding with interstate insurer fraud in courts and in policy over the mold issue, adverse to public health.

I have not and will not adhere to any gag order that precludes me from writing of what the compromised justices in the Fourth District Division One Appellate Court have done to collude with VERITOX to defraud the public for six years.

I refuse to be victimized by compromised judiciaries and then victimized again by being forced into silence of the courts’ suppressing evidence of Bruce’s criminal perjury for SIX YEARS, gagged from writing of what they (and now this court) have done; and thereby become a forced accomplice with the compromised San Diego courts and Veritox, Inc. in the defrauding of the American public.

As evidenced for this court, Dr. David Michaels, Director of OSHA has deemed Veritox, Inc, to be product defenders who ties are so close to industry that they have no business influencing US public health policy. This is what the compromised Justices of the Fourth are aiding to conceal while suppressing evidence for now SIX YEARS, that Bruce used criminal perjury to establish reason for my malice, Bryan has been an undisclosed party to this litigation all along and they framed me for libel.

This court’s designated role was obviously to finish the job and scare me with the threat of jail time if I refuse to be silenced of the rampant corruption in the Fourth District Division One Appellate court colluding with VeriTox to defraud the public for now SIX YEARS.

If that is contempt of court that I refuse to be bullied, intimidated, threatened and framed for libel so fraud and collusion may continue, then so be it. I am not going to be forced into silence so money can be made by the compromised, while lives are destroyed directly because of corrupt justices in the San Diego Appellate Court and now, this court aiding to conceal it.

This court does not even have jurisdiction over this case to gag me of anything. As evidenced for this court by the Abstract of Judgment Bruce and Keith obtained on December 31, 2008 and the Lien they placed on my property on January 20, 2009, along with other evidence, the three page judgment document, upon which this entire case is founded, is fraudulent and void.”

First published in July 2009, updated October 21, 2011.

Begin Original Posting, as cited as reference no 15 for an Federal OSHA IAQ Advisory.Abstract

Microbial pollution is a key element of indoor air pollution. It is caused by hundreds of species of bacteria and fungi, in particular filamentous fungi (mould), growing indoors when sufficient moisture is available. This document provides a comprehensive review of the scientific evidence on health problems associated with building moisture and biological agents. The review concludes that the most important effects are increased prevalences of respiratory symptoms, allergies and asthma as well as perturbation of the immunological system. The document also summarizes the available information on the conditions that determine the presence of mould and measures to control their growth indoors. WHO guide-lines for protecting public health are formulated on the basis of the review. The most important means for avoiding adverse health effects is the prevention (or minimization) of persistent dampness and microbial growth on interior surfaces and in building structures.

Keywords 

AIR POLLUTION,
INDOOR – adverse effects – prevention and control
FUNGIHUMIDITY – adverse effects – prevention and control
ENVIRONMENTAL EXPOSURE
RISK ASSESSMENTGUIDELINES

Contents

Contributors
Acknowledgements
Foreword
Executive summary

Introduction

Background
Scope of the review
Preparation of the guidelines
Guidelines and indoor air quality management

Building dampness and its effect on indoor exposure to biological and non-biological pollutants

Frequency of indoor dampness
Effects of dampness on the quality of the indoor environment
Dampness-related indoor pollutants
Exposure assessment
Summary and conclusions  

Moisture control and ventilation

Introduction
Sources of moisture
Mould and mites as indicators of building performance
Ventilation performance
Ventilation systems
Outdoor and other sources of pollution related to ventilation
Ventilation and spread of contaminants
Moisture control in buildings
Measures to protect against damage due to moisture
Conclusions and recommendations

Health effects associated with dampness and mould

Review of epidemiological evidence
Clinical aspects of health effects
Toxicological mechanisms
Synthesis of available evidence on health effects

Evaluation of human health risks and guidelines

Summary
Conditions that contribute to health risks
Guidelines

References

Annex 1. Summary of epidemiological studies
Annex 2. Summary of in vitro and in vivo studies

Foreward

Healthy indoor air is recognized as a basic right. People spend a large part of their time each day indoors: in homes, offices, schools, health care facilities, or other private or public buildings. The quality of the air they breathe in those buildings is an important determinant of their health and well-being. The inadequate control of indoor air quality therefore creates a considerable health burden.

Indoor air pollution – such as from dampness and mould, chemicals and other biological agents – is a major cause of morbidity and mortality worldwide. About 1.5 million deaths each year are associated with the indoor combustion of solid fuels, the majority of which occur among women and children in low-income countries.

Knowledge of indoor air quality, its health significance and the factors that cause poor quality are key to enabling action by relevant stakeholders – including building owners, developers, users and occupants – to maintain clean indoor air. Many of these actions are beyond the power of the individual building user and must be taken by public authorities through the relevant regulatory measures concerning building design, construction and materials, and through adequate housing and occupancy policies. The criteria for what constitutes healthy indoor air quality provided by these guidelines are therefore essential to prevent disease related to indoor air pollution.

These guidelines were developed by the WHO Regional Office for Europe in collaboration with WHO headquarters as part of the WHO programme on indoor air pollution. Further guidelines on indoor air quality in relation to pollution emanating from specific chemicals and combustion products are under development. 

The WHO guidelines on indoor air quality: dampness and mould offer guidance to public health and other authorities planning or formulating regulations, action and policies to increase safety and ensure healthy conditions of buildings. The guidelines were developed and peer reviewed by scientists from all over the world, and the recommendations provided were informed by a rigorous review of all currently available scientific knowledge on this subject. We at WHO thankthese experts for their efforts, and believe that this work will contribute to improvingthe health of people around the world.

Marc Danzon
WHO Regional Director for Europe

 Executive Summary

This document presents World Health Organization (WHO) guidelines for the protection of public health from health risks due to dampness, associated microbial growth and contamination of indoor spaces. The guidelines are based on a comprehensive review and evaluation of the accumulated scientific evidence by a multidisciplinary group of experts studying health effects of indoor air pollutants as well as those specialized in identification of the factors that contribute to microbial growth indoors.

Problems of indoor air quality are recognized as important risk factors for human health in both low-income and middle- and high-income countries. Indoor air is also important because populations spend a substantial fraction of time within buildings. In residences, day-care centres, retirement homes and other special environments, indoor air pollution affects population groups that are particularly vulnerable due to their health status or age. Microbial pollution involves hundreds of species of bacteria and fungi that grow indoors when sufficient moisture is available. Exposure to microbial contaminants is clinically associated with respiratory symptoms, allergies, asthma and immunological reactions.

The microbial indoor air pollutants of relevance to health are widely heterogeneous, ranging from pollen and spores of plants coming mainly from outdoors, to bacteria, fungi, algae and some protozoa emitted outdoors or indoors. They also include a wide variety of microbes and allergens that spread from person to person. There is strong evidence regarding the hazards posed by several biological agents that pollute indoor air; however, the WHO working group convened in October 2006 concluded that the individual species of microbes and other biological agents that are responsible for health effects cannot be identified. This is due to the fact that people are often exposed to multiple agents simultaneously, to complexities in accurately estimating exposure and to the large numbers of symptoms and health outcomes due to exposure. The exceptions include some common allergies, which can be attributed to specific agents, such as house-dust mites and pets.

The presence of many biological agents in the indoor environment is due to dampness and inadequate ventilation. Excess moisture on almost all indoor materials leads to growth of microbes, such as mould, fungi and bacteria, which subsequently emit spores, cells, fragments and volatile organic compounds into indoor air. Moreover, dampness initiates chemical or biological degradation of materials, which also pollutes indoor air. Dampness has therefore been suggested to be a strong, consistent indicator of risk of asthma and respiratory symptoms (e.g. cough and wheeze). The health risks of biological contaminants of indoor air could thus be addressed by considering dampness as the risk indicator.

Health hazards result from a complex chain of events that link penetration of water indoors, excessive moisture to biological growth, physical and chemical degradation, and emission of hazardous biological and chemical agents. The review of scientific evidence that supports these guidelines follows this sequence of events. The issues related to building dampness and its effect on indoor exposure to biological and non-biological pollutants are summarized in Chapter 2, which also addresses approaches to exposure assessment. An important determinant of dampness and biological growth in indoor spaces is ventilation, and this issue is discussed in Chapter 3. The evidence for the health effects of indoor exposure is presented in Chapter 4, based on a review of epidemiological studies and of clinical and toxicological research on the health effects of dampness and mould. The results of the epidemiological and toxicological studies are summarized in the appendices.

The background material for the review was prepared by invited experts and discussed at a WHO working group meeting, convened in Bonn, Germany, 17–18 October 2007. The conclusions of the working group discussion are presented in Chapter 5 and are reproduced in this executive summary, as follows.

Sufficient epidemiological evidence is available from studies conducted in different countries and under different climatic conditions to show that the occupants of damp or mouldy buildings, both houses and public buildings, are at increased risk of respiratory symptoms, respiratory infections and exacerbation of asthma. Some evidence suggests increased risks of allergic rhinitis and asthma. Although few intervention studies were available, their results show that remediation of dampness can reduce adverse health outcomes.

There is clinical evidence that exposure to mould and other dampness-related microbial agents increases the risks of rare conditions, such as hypersensitivity pneumonitis, allergic alveolitis, chronic rhinosinusitis and allergic fungal sinusitis.

Toxicological evidence obtained in vivo and in vitro supports these findings, showing the occurrence of diverse inflammatory and toxic responses after exposure to microorganisms isolated from damp buildings, including their spores, metabolites and components.

While groups such as atopic and allergic people are particularly susceptible to biological and chemical agents in damp indoor environments, adverse health effects have also been found in nonatopic populations.

The increasing prevalences of asthma and allergies in many countries increase the number of people susceptible to the effects of dampness and mould in buildings.

The conditions that contribute to the health risk were summarized as follows

The prevalence of indoor dampness varies widely within and among countries, continents and climate zones. It is estimated to affect 10–50% of indoor environments in Europe, North America, Australia, India and Japan. In certain settings, such as river valleys and coastal areas, the conditions of dampness are substantially more severe than the national averages for such conditions.

The amount of water on or in materials is the most important trigger of the growth of microorganisms, including fungi, actinomycetes and other bacteria. Microorganisms are ubiquitous. Microbes propagate rapidly wherever water is available. The dust and dirt normally present in most indoor spaces provide sufficient nutrients to support extensive microbial growth. While mould can grow on all materials, selection of appropriate materials can prevent dirt accumulation, moisture penetration and mould growth.

Microbial growth may result in greater numbers of spores, cell fragments, allergens, mycotoxins, endotoxins, β-glucans and volatile organic compounds in indoor air. The causative agents of adverse health effects have not been identified conclusively, but an excess level of any of these agents in the indoor environment is a potential health hazard.

Microbial interactions and moisture-related physical and chemical emissions from building materials may also play a role in dampness-related health effects.

Building standards and regulations with regard to comfort and health do not sufficiently emphasize requirements for preventing and controlling excess moisture and dampness.

Apart from its entry during occasional events (such as water leaks, heavy rain and flooding), most moisture enters a building in incoming air, including that infiltrating through the building envelope or that resulting from the occupants’ activities.

Allowing surfaces to become cooler than the surrounding air may result in unwanted condensation. Thermal bridges (such as metal window frames), inadequate insulation and unplanned air pathways, or cold water plumbing and cool parts of air-conditioning units can result in surface temperatures below the dew point of the air and in dampness. 

On the basis of this review, the following guidelines were formulated

Persistent dampness and microbial growth on interior surfaces and in building structures should be avoided or minimized, as they may lead to adverse health effects.

Indicators of dampness and microbial growth include the presence of condensation on surfaces or in structures, visible mould, perceived mouldy odour and a history of water damage, leakage or penetration. Thorough inspection and, if necessary, appropriate measurements can be used to confirm indoor moisture and microbial growth.

As the relations between dampness, microbial exposure and health effects cannot be quantified precisely, no quantitative health-based guideline values or thresholds can be recommended for acceptable levels of contamination with microorganisms. Instead, it is recommended that dampness and mould-related problems be prevented. When they occur, they should be remediated because they increase the risk of hazardous exposure to microbes and chemicals.

Well-designed, well-constructed, well-maintained building envelopes are critical to the prevention and control of excess moisture and microbial growth, as they prevent thermal bridges and the entry of liquid or vapour-phase water.

Management of moisture requires proper control of temperatures and ventilation to avoid excess humidity, condensation on surfaces and excess moisture in materials. Ventilation should be distributed effectively throughout spaces, and stagnant air zones should be avoided.

Building owners are responsible for providing a healthy workplace or living environment free of excess moisture and mould, by ensuring proper building construction and maintenance. The occupants are responsible for managing the use of water, heating, ventilation and appliances in a manner that does not lead to dampness and mould growth. Local recommendations for different climatic regions should be updated to control dampness-mediated microbial growth in buildings and to ensure desirable indoor air quality.

Dampness and mould may be particularly prevalent in poorly maintained housing for low-income people. Remediation of the conditions that lead to adverse exposure should be given priority to prevent an additional contribution to poor health in populations who are already living with an increased burden of disease.

The guidelines are intended for worldwide use, to protect public health under various environmental, social and economic conditions, and to support the achievement of optimal indoor air quality. They focus on building characteristics that prevent the occurrence of adverse health effects associated with dampness or mould. The guidelines pertain to various levels of economic development and different climates, cover all relevant population groups and propose feasible approaches for reducing health risks due to dampness and microbial contamination. Both private and public buildings (e.g. offices and nursing homes) are covered, as dampness and mould are risks everywhere. Settings in which there are particular production processes and hospitals with high-risk patients or sources of exposure to pathogens are not, however, considered.

While the guidelines provide objectives for indoor air quality management, they do not give instructions for achieving those objectives. The necessary action and indicators depend on local technical conditions, the level of development, human capacities and resources. The guidelines recommended by WHO acknowledge this heterogeneity. In formulating policy targets, governments should consider their local circumstances and select actions that will ensure achievement of their health objectives most effectively.

WHO Guidelines for Indoor Air Quality – Dampness and Mold  – PDF

Development of WHO Guidelines for Indoor Air Quality – Dampness and Mold

 

World Health Organization – The Right to Healthy Indoor Air

Abstract

Indoor air quality is an important determinant of health and wellbeing. However, the control of indoor air quality is often inadequate, one reason being the poor articulation, appreciation and understanding of basic principles underlying policies and action related to indoor air quality. As a result, the general public is familiar neither with those principles nor with their associated rights.

A WHO Working Group was convened to agree on a set of statements on “The right to healthy indoor air”, derived fromfundamental principles in the fields of human rights, biomedical ethics and ecological sustainability.

This document presents the conclusions of the Working Group, informs individuals and groups responsible for healthy indoor air about their rights and obligations, and individuals by bringing those rights to their attention.

Keywords

– AIR POLLUTION

– INDOOR ENVIRONMENTAL POLICY

– HOUSING

– HUMAN RIGHTS

– ETHICS

– EUROPE

Background

Indoor air quality (IAQ) is an important determinant of population health and well being. People in modern societies spend most of their time in indoor spaces such as at home, work, school and in vehicles. Exposure to the hazardous airborne agents present in many indoor spaces causes adverse effects such as respiratory disease, allergy and irritation of the respiratory tract.Improperly or poorly ventilated combustion appliances pose a real risk of acute poisoning bycarbon monoxide. Indoor exposure to radon and environmental tobacco smoke increases the risk of lung cancer. Many chemicals encountered indoors cause adverse sensory effects, giving rise to a sense of discomfort and other symptoms.

The control of indoor air quality is often inadequate in spite of its significant role in determining health.

Tensions and conflicts often occur between individuals suffering from indoor air pollution and those whose actions negatively influence indoor air quality. Most exposure to indoor air occurs in private homes, where intervention by public regulation is often considered a violation of personal freedom. Furthermore, commercial interests have often delayed the implementation of indoor air pollution controls in spite of scientific evidence of the harmful impact of such pollution on health.

To a large extent, the inadequate quality of indoor air arises from a poor articulation, appreciation and understanding of the basic principles underlying the policies and actions related to indoor air quality. As a result, the general public is familiar neither with those principles nor with their associated rights.

A WHO Working Group was convened to agree on a set of statements on “The right to healthy indoor air”, derived from fundamental principles in the fields of human rights, biomedical ethics and ecological sustainability.

These statements inform the individuals and groups responsible for healthy indoor air about their rights and obligations, and empower the general public by makingpeople familiar with those rights. The statements were formulated at a meeting of the Working Group convened by the WHO European Centre for Environment and Health (WHO/ECEH), Bilthoven Division, in Bilthoven on 15–17 May 2000. The invited experts, who represented a wide range of specialties and countries, were recommended to WHO by contacts in governmental institutions and through expert groups involved in the assessment and maintenance of indoor air quality, bioethics and environmental ethics (list of participants in Annex 1). The Chairperson of the meeting was Dr Lars Mølhave and Dr Nadia Boschi acted as Rapporteur. Those invited received in advance of the meeting a background paper prepared by a small group convened by WHO/ECEH in November 1999.

The exact text of the principles recommended, and most of the text of the commentary was agreed at the meeting. A smaller editorial group worked on it directly after the meeting, and the entire text of this report was reviewed and accepted by all members of the Working Group within a few weeks following the meeting. The report summarizes the main conclusions and recommendations of the Working Group, and sets out the statements on The Right to Healthy Indoor Air.

Statements on the right to healthy indoor air – Introduction

Everyone has a right to healthy indoor air. It is the dual purpose of this document to:

1. Inform those who have an influence on public health about this right and of their obligations related to this right, and

2. empower the general public by making people familiar with this right.

The right to healthy indoor air applies across the world. While it is an individual responsibility to prevent air pollution indoors, decision-makers both inside and outside the public health sector have important additional tasks in this respect. In particular, the building and energy sectors have pertinent roles to play. Many factors influence indoor air quality, including the design, construction, equipment, operation and maintenance of buildings or other indoor spaces, as well as outdoor air quality and the occupants’ preferences or activities. All individual groups, whether private or public, associated with a building or other indoor space, bear responsibility for healthyindoor air and the protection of the health of its occupants.

Human rights are the rights of individuals that should apply to all people around the world, representing fundamental freedoms or needs that every state ought to recognize and protect. Specific human rights law is listed in several key documents; foremost of these is the Universal Declaration of Human Rights, which was drawn up to give more specific definition to the rights and freedoms referred to in the United Nations Charter. The Charter, the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights constitute what is often called the “International Bill of Human Rights”. These humanrights apply globally, irrespective of gender, age, religion, economic status, national origin, ethnicity and the like.

Dissemination of knowledge of the principles that determine individual rights to healthy indoor air will help people to understand what values are being given priority in any specific context, be it at the home, office or government level of decision-making and/or policy formulation. At the same time, encouraging individual behaviour towards sustainability will also help to ensuresustainable indoor air quality.

The principles below derive from the fundamental principles in the fields of human rights, biomedical ethics and ecological sustainability, and focus on interactions among them.

Principles

Principle 1 – Under the principle of the human right to health, everyone has the right to breathe healthy indoor air.

Principle 2 – Under the principle of respect for autonomy (“self-determination”), everyone has the right to adequate information about potentially harmful exposures, and to be provided with effective means for controlling at least part of their indoor exposures.

Principle 3 – Under the principle of non-maleficence (“doing no harm”), no agent at a concentration that exposes any occupant to an unnecessary health risk should be introduced into indoor air.

Principle 4 – Under the principle of beneficence (“doing good”), all individuals, groups and organizations associated with a building, whether private, public, or governmental, bear responsibility to advocate or work for acceptable air qualityfor the occupants.

Principle 5 – Under the principle of social justice, the socioeconomic status of occupants should have no bearing on their access to healthy indoor air, but health status maydetermine special needs for some groups.

Principle 6 – Under the principle of accountability, all relevant organizations should establish explicit criteria for evaluating and assessing building air quality and its impact on the health of the population and on the environment.

Principle 7 – Under the precautionary principle, where there is a risk of harmful indoor air exposure, the presence of uncertainty shall not be used as a reason for postponing cost-effective measures to prevent such exposure.

Principle 8 – Under the “polluter pays” principle, the polluter is accountable for any harm to health and /or welfare resulting from unhealthy indoor air exposure(s). In addition, the polluter is responsible for mitigation and remediation.

Principle 9 – Under the principle of sustainability, health and environmental concerns cannot be separated, and the provision of healthy indoor air should not compromise global or local ecological integrity, or the rights of future generations.

Commentary

In this part of the document, the application of the above principles is placed into context and explained. The principles and the commentary are mutually supportive. It may happen that any of the principles could be in apparent conflict with others. It is the object of any rights – or ethics-based analysis to be transparent in the rationale as to how a decision to act was reached. Inproviding such a rationale, any principle could take precedence over any other. The articulation of the rationale for invoking any one principle over another establishes transparency.

Principle 1 – The human right to health

The severity of symptoms and the duration of any negative health effects are primary criteria for determining the seriousness and importance of various indoor air pollution health impacts. Shortened life expectancy, diminished quality of life, disability and hospitalization are key indicators. Symptoms of health effects resulting from indoor pollutant exposure can be classified by severity and duration. Short-term acute effects resulting from infectious agents are often affected by building practices.

Examples include –

Respiratory diseases such as legionnaires’ disease and hypersensitivity pneumonitis. Asthma and allergy, or chronic upper respiratory obstructive diseases may have less severe acute symptoms but are important because of their lengthy (often life-long) duration. The quality of indoor air not only has a bearing on health, but also on the quality of life.

This interpretation derives from the 1977 World Health Assembly, which resolved that by the year 2000, all people should attain a level of health permitting them to lead socially and economically productive lives. Exposure to pollutants that qualitatively decrease the health, functioning or comfort of occupants is, therefore, unacceptable. Indoor air pollution from the use of solid fuels in simple unvented stoves is common in developing countries. As their economies develop, populations tend to use cleaner fuels and less polluting stoves. That this occurs, however, does not imply that waiting for economic development is a necessary or desirable approach to achieving better indoor air quality. Indeed, the great triumphs in public health are in identifying ways to help people improve their health even before they participate in the fruits of economic development.

Principle 2 – Respect for autonomy (“self-determination”)

Everyone has the right to expect others to respect their individual judgement in their own evaluation of personal exposure and its effects. For example, if a person finds the air quality uncomfortable or offensive enough to warrant a formal comment or complaint, that person’s assessment needs to be respected.

Those responsible for public health and education have a duty to inform people regarding the relationship of indoor air quality to health. Article 26 of the United Nations Declaration on Human Rights states:

Article 26: (1) Everyone has the right to education…(2) Education shall be directed to the full development of the human personality and the strengthening of respect for human rights and fundamental freedoms. It follows from Article 26(1) that education programmes for the general population should underline the importance of indoor air quality for health and provide insight into the basic mechanisms and sources of pollutants.

It is essential that individuals have some level of personal control over their own indoor environment and air quality. The personal control is necessary because the evaluation of an “optimal indoor environment” differs from person to person. However, public health authorities should recommend minimum standards.

People have the right to adequate, understandable information about the environments that they inhabit. This includes balanced and objective information on the exposures and associated risks.

The right to self-determination requires that full information be available to people making decisions about actions affecting their indoor air exposure. Therefore, those with access to relevant information should make it available to others. The providers are accountable for the adequacy of the information they provide. The population should be protected against factors which may change their sensitivity to indoor air exposures as well as against misinformation causing people to set wrong priorities. All reasonable measures should be taken to inform the general public of national and international laws pertaining to indoor air quality, and their rights in relation to these laws.

Principle 3 – Non-maleficence (“do no harm”)

Indoor air should contain no pollutants without a justifiable reason or purpose for their presence.

It is recognized that a balance must be struck between indoor air requirements and considerations such as the economy and health.

Unwanted or unacceptable exposures are defined as the presence of indoor exposures that cause undesirable effects on the occupant(s).

Those who design, provide, build, maintain and occupy indoor environments have a duty to do no harm to indoor air quality in that environment.

Ignorance about indoor air quality matters is not an excuse for causing harm. The facts on indoor air quality must therefore be readilyavailable to, and used by, all the parties concerned.

Exposures indoors should not occur as the result of mitigation of environmental problems in occupational or outdoor environments (e.g. by discharge, dilution or substitution that migrates to the indoor environment).

Environmental tobacco smoke is a special case of an indoor air pollutant with serious, large-scale negative health consequences. As such, environmental tobacco smoke should be excluded from indoor environments.

Principle 4 – Beneficence (“doing good”)

Those who provide, maintain and occupy indoor environments have a responsibility to promote good indoor air quality. Protection of the health and comfort of the most sensitive occupants is required under the principle of beneficence.

When convincing evidence exists on health risks due to indoor air exposures, the appropriate societal authorities should organize or initiate action to prevent or eliminate these exposures.

Principle 5 – Social justice

Social justice refers to the equitable distribution of burdens and benefits within society.

Unhealthy indoor air is a burden, and healthy indoor air is a benefit. Therefore, there should be social and economic equity in the distribution of healthy indoor air. Those involved in public health should recognize this unequal distribution of healthy air by virtue of social or demographic factors. Special attention may need to be paid to affected groups, as well as to others vulnerable by virtue of their health status, to reduce health inequalities and ensure progress toward more egalitarian societies. Various groups experience different exposures to unhealthy indoor air, e.g. the economically disadvantaged (more exposure to environmental tobacco smoke, more poor quality combustion devices), women and the elderly (more time spent indoors), and ethnic minorities (lack of information in an appropriate language).

The right to quality indoor air is equally essential for people of all nations and at all socio-economic levels. Economically disadvantaged individuals must be given due consideration whenever decisions affecting their indoor air quality are to be made by either public or private organizations. All minorities (including susceptible groups such as children) have the same rights to protection as the general population. In particular, sensitive groups within the population have the right to adequate means for ensuring them an indoor air quality that meets their specific needs. Solidarity with the less privileged urges rectification of the unequal distribution of resources and prevention of and a response to human suffering.

Principle 6 – Accountability

As a minimum, all applicable laws and regulations should be followed. In addition, all relevant standards of practice and guidelines should be followed. Transparency provides the basis for understanding the rationale for decision-making.

Those responsible for and concerned with human and environmental health, both in governments and in nongovernmental organizations, should develop and adopt indicators of healthy indoor air and its achievement for the whole population. These indicators should include exposure and risk assessment related to indoor pollutants with significance for health. They should also include factors that have an impact on indoor air quality as well as determinants of general environmental quality that directly and indirectly affect and are affected by the quality of the built environment.

It is sometimes argued that household air pollution should not be the concern of government public health bodies. After all, it is said, the occupants themselves are responsible for most of the activities that produce the indoor air pollution they experience. Indoor air pollution, by this reasoning, is not an “externality” and thus does not need to be addressed by society at large. However, there are several problems with this argument.

• Governments and other outside agencies clearly do have a role in research and education to inform householders of the risks. Householders alone are not in a position to conduct or interpret such research.

• Through appliance standards, building codes, fuel standards and pricing, consumer product standards and labelling and other measures, governments already exercise a number ofcontrols over indoor air quality and have the responsibility to see that such controls reflect actual risks.

• Households are not democracies with every person having an equal say. Children, in particular, are not in a position to make the kind of judgment needed to protect themselves. In many societies, women have little say in many household economic decisions, such as the purchase of fuel, even though they may experience most of the indoor air pollution exposure.

• Children are a vulnerable group. Therefore, particularly stringent controls should be applied to afford their protection from involuntary exposure to indoor air pollutants. This includes exposure in home, hospitals, kindergartens and schools.

• Lastly, distinguishing hazards as being externalities or not may fit some economic decision-making models but is not congruent with public health practice. From a public health standpoint, the task is to reduce human exposures to harmful substances no matter what their origin or where they occur.

Principle 7 – Precautionary principle

Prevention is better than restitution, mitigation and restoration, not only for reasons related to health, but also because prevention is cost-effective. Prevention is better than cure.

Principle 8 – “Polluter pays”

Regardless of the primary responsibility, no party is exempt from the responsibility to act for the achievement of healthy indoor air. Polluters cannot avoid their responsibility to compensate the affected parties. Economic, operational or administrative arguments are insufficient justification for not acting against the pollution of indoor air.

Principle 9 – Sustainability

The provision of healthy indoor air is a fundamental aspect of the design, construction, operation, maintenance, replacement/demolition or conservation of sustainable buildings. However, in providing healthy indoor air, the minimization of environmental impacts is also essential for sustainability. Considerations of sustainable development, sustainable living and sustainable health are all relevant to the promotion of healthy indoor air. The policies of public health and energy programmes should be coordinated. It is also important that private sector actions consider both indoor air quality and energy. Luxury services that improve the short-term quality of life should not take precedence over longer-term global or local ecological considerations. Global ecological integrity is dependent not only on consumption and the population, but also on technology. The inappropriate uses of technology in conjunction with over-consumption have a negative impact on the sustainability of life-support systems. The latter are based in the services provided to humanity from the natural world. Over-exploitation and pollution are destroying these natural systems. In other words, humans are threatening global ecological integrity by over-consumption, the growth in populations and the inappropriate uses of technology. A dilemma emerges when considerations of human comfort, not essential to human health and wellbeing, place in jeopardy the ability of life-support systems to be self-sustaining because of over-exploitation and pollution.

Thus, where human health needs conflict with the health needs of other species, human health needs should prevail; but where human comfort jeopardizes the sustainability of life-support systems, the protection of the life-support systems should prevail.

WHO – Right to Healthy Indoor Air (2000)