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American College of Medical Toxicology, Choose Wisely to Sunset Your Mold Statement
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EMSL lab director acknowledges EPA investigation; offers free repeat ERMI
PUBLIC SERVICE ANNOUNCEMENT
I was asked to share this information. Apparently there is a problem with EMSL’s Environmental Relative Moldiness Index (ERMI) and people are being offered a free do-over. Seems that it has been marketed to the mold community though various websites and people need to know how to obtain their free do-overs — so they are not living with a false sense of security as to the safety of their living and working environments.
Two key highlights from Dr. Shoemaker’s message that he asked me to share:
“Just to be clear: I am stating my opinion that anyone, including Dave Asprey and his employee who is selling ERMI from EMSL, as well as any and all others promoting flawed ERMI testing, should stop now and refund all users since 6/22/2015, at least until EMSL and all other labs with quality control problems pass all aspects of EPA quality control. The public trust depends on lots of sunshine being focused regarding this important question about validity.”
“Beginning in late spring 2015, physicians from the Professionals Panel of Surviving Mold noted that something was odd with a variety of Environmental Relative Moldiness Index (ERMI) reports. A number of labs, including EMSL, appeared to not report low levels of Aspergillus penicilloides, A. versicolor and Wallemia sebi. ERMI testing (involves MSQPCR DNA identification and quantification) is a necessary part of a peer reviewed, published protocol used to diagnose and treat chronic inflammatory response syndrome (CIRS) caused by exposure to the interior environment of water-damaged buildings (WDB). Significant health risks are associated with low levels of these fungi when present in WDB, with as few as 10 spore equivalents/mg dust markedly associated with acquisition of illness.”
The message in its entirety:
“EMSL lab director acknowledges EPA investigation; offers free repeat ERMI
Beginning in late spring 2015, physicians from the Professionals Panel of Surviving Mold noted that something was odd with a variety of Environmental Relative Moldiness Index (ERMI) reports. A number of labs, including EMSL, appeared to not report low levels of Aspergillus penicilloides, A. versicolor and Wallemia sebi. ERMI testing (involves MSQPCR DNA identification and quantification) is a necessary part of a peer reviewed, published protocol used to diagnose and treat chronic inflammatory response syndrome (CIRS) caused by exposure to the interior environment of water-damaged buildings (WDB). Significant health risks are associated with low levels of these fungi when present in WDB, with as few as 10 spore equivalents/mg dust markedly associated with acquisition of illness.
Many people think that Stachybotrys is the important fungus in damp buildings (“Black Mold; Toxic Mold”), and it is but to a very small extent, but the Aspergillus species named above are major players in occurrence of adverse health effects caused by exposure to the interior of WDB.
Another under-stated organism, Wallemia sebi, also was under-reported by EMSL in casual physician observations. Far more important, Wallemia likes lower water activity (A(w)) than other fungi (and bacteria!) in wet buildings. Wallemia is perhaps the worst actor of all the molds when it comes to risks for acquisition of human illness from WDB. From its drier locations, especially in ductwork, Wallemia gets no significant publicity on the Internet but it sure does in offices of actual data-driven, CIRS-treating physicians.
Simply stated: EMSL wasn’t finding the DNA of these organisms often. Even worse, other mycology labs found these DNA markers in the same places when EMSL didn’t. Was there a problem with methods used by EMSL? If so, was the problem in primers (ABI but not IDT?), probes or TaqMan enzymes? Or the DNA analyzer?
We reported our concerns to experts at the EPA who promised to initiate an investigation. And they did.
Remember that the patent for QPCR testing for ERMI was granted to the EPA in 5/14/2002, number 6,387,652 B1. EPA began licensing their testing protocols to private labs later, provided that the testing outlined in the EPA Standard Procedures for Fungal DNA QPCR Analysis was followed.
Think about it, here we have EMSL, a reputable lab, having problems detecting low levels of important organisms, but for most of the newbies (they seem to be appearing faster than wire grass in a new garden!) coming to the mold field, who would ever know? Add to the problem of rookies trying to help mold patients is the entry of another entrant into the ERMI field, myERMI. When this outfit, linked to Dave Asprey and his new Bulletproof Internet business, announced they were providing ERMI testing, they asked, any questions?
Even now, you can hear my voice on the (listen to it on the Bulletproof website) trailer for Dave’s movie, Moldy. So, Dave knows me.
I asked who their ERMI lab supplier was. Answer: EMSL. What were the primers EMSL used? I was surprised at the aggressive non-response from Dave’s employee.
“What do you want that information for? What relevance is the primer?” Whoa, bro! Just answer the question.
You know, when someone is not responsive to a simple question, they usually are doing so for some no-good reason. Attorneys really focus on non-responsive answers. Me too. I still have a lot more questions for this non-responder. We expect politicians to be evasive, not salesmen. Moving on.
Actually, all DNA labs obsess over accuracy of MSQPCR testing, the basis of ERMI. All DNA labs must pay attention to much more than primers, but primers are where the analysis is based. They must be exquisitely careful with a series of lab methods. Primers, enzymes and machines all are important in providing people in a life and death situation with accurate information. Imagine if someone with CIRS-WDB were told that a building was assuredly safe because the ERMI was low and then the patient went into the building with a false sense of security. What would happen to the victimized patient? We all know.
There would be a significant relapse, with all its chronic proteomic and genomic abnormalities. Who would be responsible for the ensuing wrongful death or disability? The lab? Or the agent that funneled business to the lab when they must have known, or should have known, the lab was having trouble?
Now imagine being the business outfit that sells ERMI. Do you think that ongoing EPA investigation for failure to meet specifications from patents and lab procedures might fit into your advertising campaign?
Can you understand how people like me would be demanding accuracy from labs? And can you understand why I would be demanding accuracy from outfits like myERMI who seemingly didn’t know what a primer was, yet was selling ERMI tests? Maybe it is just my opinion, but if I am selling a test, I feel I have to know everything a reasonable person would be expected to know about that test.
Just to be clear: I am stating my opinion that anyone, including Dave Asprey and his employee who is selling ERMI from EMSL, as well as any and all others promoting flawed ERMI testing, should stop now and refund all users since 6/22/2015, at least until EMSL and all other labs with quality control problems pass all aspects of EPA quality control. The public trust depends on lots of sunshine being focused regarding this important question about validity.
But how did anyone know that EMSL was having problems with their assay? Quality control is supposed to be performed with every new batch of chemicals used in such a complex assay. No one demands publication of the results of QC, however. The EPA can’t force its ERMI licensees to do anything! But a question still nags at me: if the lab isn’t following dictates of both the patent and lab instructions, can we really say the lab is using the patented test?
By the time myERMI was selling EMSL testing, the investigation of EMSL procedures and results was already initiated. One can only wonder how a lab test that was being doubted by a Federal agency was being sold by a non-medical website without informing the public of the investigation. Didn’t they know that they might be selling a test that could get them in trouble? Sounds to me like old fashioned due diligence was missing.
So I called EMSL, asking about problems with the EPA testing. Dr. Charlie Li was direct with me on the phone on 9/23/2015. He knew there was a problem. He was working with EPA to resolve the difficulty with “non-detects.” He promised me that everyone who had an EMSL ERMI done in the last three months could be repeated at no charge when the methods of EMSL were corrected. Just call the EMSL phone number on your lab result, ask for the lab, give them the lab number on the upper right hand corner and ask the lab to repeat the test at no charge when the lab passes EPA requirements.
I hope that everyone who had an EMSL ERMI done since 6/22/2015 will contact EMSL or their test broker to obtain a repeat of their ERMI when the lab is doing better in QC for the three species of incredible importance. If the ERMI was sold through a broker, I feel a refund is in order.
Are there people harmed by the difficulty EMSL has? I don’t know. But my data set is truncated at best. At www.survivingmold.com we are willing to be a clearing house for information regarding possible adverse health effects from flawed ERMI reporting. Alternatively, if you have concerns, perhaps if your ERMI was bought from and paid to myERMI you could contact myERMI, as all of their ERMI reports done since they started their service in mid-July will likely be flawed. Dave Asprey has written me that he wants to help people get better; so let him make things right. I don’t speak for Dave but since he wants to help people by offering ERMI testing, and I believe that he will stand by his products, let him obtain your refund for you.
When I raised the issue of quality problems with EMSL with Dave on our call 9/9/2015 at 12:30 EDT, he wasn’t receptive, yet promised to look into the matter, which he did. Two weeks later, Dave and his employee apparently didn’t feel that they had to know the science underlying the product they were selling. Hypothetically, when anyone is selling unsubstantiated treatment with some diet or another to mold patients using environmental studies that are being investigated, how can one say diet is the culprit when the environment is falsely being ruled out? Remember, saying one feels “amazing” as a testimonial doesn’t translate to showing data to a journal editor and unbiased reviewers.
If you think you have been injured by a falsely low reported ERMI from EMSL from 6/22/2015-9/22/2015, please don’t go seeking a lawyer. Let us know and we will help you. No charge.
There are so many points to be made with this lab problem. I remember doing cardiac isoenzymes in Clinical Chemistry years ago. If my CPK result showed heart attack, that person was changed forever. Integrity of science and medicine was my mantra then. Still is. Medical care for CIRS is not just a game or a profit-making venture. Integrity counts.
I remember well fifteen years when the outspoken voices of mold world were Jonathan Wright, Erik Johnson, Sharon Kramer and me, with maybe a few others. Internet sales? Nope. Weren’t there. Now 15 years later, mold is selling like crazy. Crazy is a good word for the unsupported claims. If today’s Internet is a “Wild, Wild West,” patients surely can be swayed by slick advertising, just like they might be at a used car lot. In mold venues, if you are selling, sell truth. Sell honesty. For patients, if the claims of Dr. Mike O. Toxin (made up name) aren’t matched by high quality, published peer reviewed data, skip using your credit card that day.
Now, you should see the non-existent data and undisciplined ideas about mold being sold that are dressed up like the Emperor (the one with no clothes). “Yes, I ate this food and I got sick. I know it was the food because I never lie and I don’t need science,” says one. Another says, “Ignore what you eat, your urine shows what is wrong with you.”Another is now selling “special nutrients;” and others are selling “methylation correctors.”The list goes on.
OK, let us see the data. Oops. None are available. Our group has been publishing for 15 years! You want data? So do I. We have published data on over 2500 adults and children in peer reviewed literature, not to mention 1000 controls and two double blinded, placebo controlled clinical trials.
I still am bemused by folks thinking that diet will cause CIRS-WDB illness (Oh, really?), knowing that this attempt at an argument was one we defeated in fierce one-on-one combat in mold litigation. When the CDC says diet is no big deal (MMWR 2/2015), and they do (and the overwhelming scientific community agrees), don’t start buying mold free tea or mold free wheat or mold free blue cheese or mold free mushrooms. Dietary causes of CIRS-WDB illness? Show me some science. Show me objective markers in a prospective study.
The world of CIRS-WDB is now full of tests providing objective fingerprints of brain injury, proteomics and genomics. We are in a Golden Era of peer reviewed, published papers on therapy of CIRS-WDB. We must demand scientific integrity from our new-found Internet sales machines. We cannot giveaway our science for false hopes based on marketing ploys.
Thankfully, EMSL has said they have a problem with their ERMI results. The EPA is working with them and other labs to make sure we won’t have the problem of possibly unreliable ERMI results in the future. Let us all revisit their ERMI products in the future when the bugs are out of their systems. Talk to Dave Asprey; I’m sure he will get your money back if you bought a flawed ERMI from him.”
As we all know by now, the mold issue is complex and mistakes get made by relying upon the words and actions of others — who may also be relying upon the words and actions of others. The true test of character is when one takes action to acknowledge the mistake and moves to correct any problems it may be causing.
Thank goodness that this one looks relatively easy to correct any possible damage done, by people simply being made aware of the problem and being provided an opportunity to accept help to undo it. Glad to see EMSL is offering free do-overs of ERMI. Hopefully, others will follow suit.
Sharon Kramer
PS. Don’t contact me if you have any questions. This is not my area of expertise in the mold issue. I’m simply forwarding a public service announcement.
Contact Dr. Shoemaker with any questions. He says,
“If you think you have been injured by a falsely low reported ERMI from EMSL from 6/22/2015-9/22/2015, please don’t go seeking a lawyer. Let us know and we will help you. No charge.”
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Say WHAT??? Consumer Reports recommends bleach for mold because….
“you’re not so worried about mold anymore, we think a better and cheaper way to gain peace of mind is to drop that coverage and simply take steps to prevent a mold problem from developing in the first place by taking the steps below.”
http://www.consumerreports.org/cro/homeownersinsurance/avoid-a-mold-problem-with-bleach-not-insurance
Seems step #1 for consumers is to let your insurer off the hook for liability when you get sick from inhaling the mold spore and their toxins via their becoming airborne by use of bleach. CR’s advice to drop any mold coverage you may have on your policy, helps no one but your homeowner’s insurer.
The author of this article is a senior editor for Consumer Reports. He infers he has come over from the dark side of money and now advocates for consumers’ protection from “tricks”. According to his bio for this article:
“I learned how corporations operate as a reporter at Forbes, switched sides to Consumer Reports, and now use my business savvy to uncover the tricks and find better deals for you. My passion for investigative reporting about money won two National Magazine Awards and a Loeb Award. I love sharing wine with my wife and pitching batting practice to my MLB-focused son. Follow me on Twitter (@JeffBlyskal); assist my work at Tell-A-Reporter.com.”
Here’s what you need to understand:
Consumer Reports is a non-profit organization that has teamed up with non-profit medical associations of dubious reputation. They have a new campaign to control and “educate” U.S. physicians called “Choosing Wisely” of which, Consumer Reports dissiminates the info to the public.
Here is just one recent example of what Consumer Reports put out for the American College of Medical Toxicology with regard to teaching physicians not to diagnose environmental disabilities/acquired idiopathic environmental sensitivities:
“Don’t order tests to evaluate for or diagnose ‘idiopathic environmental intolerances,’ “electromagnet hypersensitivity’ or ‘mold toxicosis.’ These diagnoses reflect labels to indicate that patients have adverse non-allergic reactions to normal environmental stimuli. These diagnoses are made on the bases of self-reported symptoms or non-validated testing procedures. Although these conditions have been widely promoted, evidence-based assessments fail to support these diagnoses as disease entities. Labeling a patient with these diagnoses may adversely affect the patient’s lifestyle, obscure ascertainment of the etiology of their symptoms and promote unnecessary testing.”[1]
http://www.choosingwisely.org/clinician-lists/acmt-and-aact-tests-for-idiopathic-environmental-intolerances/
This begs the questions:
What motivates medical organizations whose members often serve as toxic tort expert defense witnesses, to teach physicians that environmental injuries should not be diagnosed as reactions to NOT-normal environmental stimuli?
Choosing Wisely for WHOM? The answer seems self-evident.
“How The List Was Created -The American College of Medical Toxicology’s (ACMT’s) Board of Directors established a Choosing Wisely® work group in 2013 to develop a list of items for the Choosing Wisely® campaign. Members of the work group were chosen to represent various practice settings within the field of medical toxicology, including ambulatory, acute and population-based practice. Work group members included the President of the College, the Chair of the Practice Committee, the Chair of the Positions and Guidelines committee and other academic leaders within the medical toxicology community. All work group members also represented the American Academy of Clinical Toxicology (AACT). The first list was released by the work group in 2013 and in 2014, the work group reconvened to develop a second list of items for the campaign. A second preliminary list was disseminated to all members of ACMT and AACT for review, commentary and potential additions. Additional feedback was solicited from leaders within the field of medical toxicology. The work group reviewed all responses, and narrowed the list to the final five items based on a review of scientific evidence, relevance to the specialty and greatest opportunity to improve care, reduce cost and reduce harm to patients. The final list was approved by the ACMT Board of Directors and the AACT Board of Trustees.”
It has been known for at least twenty years that some people acquire environmental intolerances and multiple chemical sensitivities after atypical environmental exposures. Just ask presidential candidate, Bernie Sanders, about it. He spoke before Congress on the matter in 1998.
Those Old Tobacco scientists are Sneaky, Sneaky, Sneaky when it comes to using “non-profit” organizations to mass market “Garbage Science” and sell doubt of causation of environmental injuries in public policies, courts and health care!
Sharon Kramer
Advocate for Integrity in Health Marketing.
Posted in Health - Medical - Science
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DePaul Univ Seeks Participants for ME/CFS Mortality Research
“ADULT CONSENT TO PARTICIPATE IN RESEARCH Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Related Mortality- Phase 1Principal Investigator: Abigail Brown, M.A., Graduate StudentInstitution: DePaul University, Chicago, Illinois, USADepartment (College): Department of Psychology, College of Science and HealthFaculty Advisor: Leonard A. Jason, Ph.D. Department of Psychology, College of Science and HealthWhat is the purpose of this research? We are asking you to be in a research study because we are trying to learn more about myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) related mortality. This study is being conducted by Abigail Brown, a graduate student at DePaul University. This research is being supervised by her faculty advisor, Dr. Leonard A. Jason. We hope to include up to 250 people in Phase 1 of the research.Why are you being asked to be in the research? You are invited to participate in this study because you knew an individual who was diagnosed with ME or CFS and has since passed away. We are looking to document your experiences as well as the deceased individual’s experiences from your perspective. You must be age 18 or older to be in this study. This study is not approved for the enrollment of people under the age of 18.What is involved in being in the research study? If you agree to be in this study, you will be asked to fill out a confidential online survey for Phase 1 of the research. You also have the option of completing this survey by hard copy. If you choose the hard copy option, it will be sent via postal mail to you.The survey will ask questions about the deceased individual’s demographics and health history. The survey will also ask questions about your demographics and relationship with the deceased individual. At the end of the survey, you will be given the chance to identify yourself and volunteer to participate in Phase 2 of the research. Phase 2 will consist of an in-person or over-the-phone interview. You will consent for Phase 2 at a different time. By consenting to Phase 1 right now, you are not consenting to Phase 2. By identifying yourself at the end of Phase 1, you are not consenting to Phase 2.How much time will this take? Phase 1 will take about 1 hour of your time.Are there any risks involved in participating in this study? Being in this study does not involve any risks other than what you would encounter in daily life. You may feel uncomfortable or upset, because some of the questions are sensitive and the topic can provoke strong feelings or emotions. You do not have to answer any question you do not want to. If, at any point in this study you feel that any test question brought up feelings that would compel you to seek counseling outside of this study, you may ask for a referral at any time during the assessment via phone or email. If your need for counseling is urgent, you can also be referred to a Response Hot Line (1-800-273-8255), a confidential crisis counseling service. However, you would still be responsible for payment for any additional treatments and services provided by the referred clinician or for arranging payment through your medical insurance company or another source.Are there any benefits to participating in this study? You will not personally benefit from being in this study. We hope that what we learn will help individuals with ME and CFS and their friends and family.Can you decide not to participate? Your participation is voluntary, which means you can choose not to participate. There will be no negative consequences, penalties, or loss of benefits if you decide not to participate or change your mind later and withdraw from the research after you begin participating.Who will see my study information and how will the confidentiality of the information collected for the research be protected? The research records will be kept and stored securely. Your information will be combined with information from other people taking part in the study. When we write about the study or publish a paper to share the research with other researchers, we will write about the combined information we have gathered. If you choose to identify yourself at the end of Phase 1, we will not include your name or any information that will directly identify you. We will make every effort to prevent anyone who is not on the research team from knowing that you gave us information, or what that information is. However, some people might review or copy our records that may identify you in order to make sure we are following the required rules, laws, and regulations. For example, the DePaul University Institutional Review Board may review your information. If they look at our records, they will keep your information confidential.Who should be contacted for more information about the research? Before you decide whether to accept this invitation to take part in the study, please ask any questions that might come to mind now. Later, if you have questions, suggestions, concerns, or complaints about the study or you want to get additional information or provide input about this research, you can contact the researcher, Abby Brown (773-325-1164, abrown57@depaul.edu) or the faculty sponsor, Dr. Leonard Jason (773-325-2018, ljason@depaul.edu). This research has been reviewed and approved by the DePaul Institutional Review Board (IRB). If you have questions about your rights as a research subject you may contact Susan Loess-Perez, DePaul University’s Director of Research Compliance, in the Office of Research Services at 312-362-7593 or by email at sloesspe@depaul.edu. You may also contact DePaul’s Office of Research Services if:-Your questions, concerns, or complaints are not being answered by the research team.-You cannot reach the research team.-You want to talk to someone besides the research team.You can print this information to keep for your records.” |
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Paradigm Change offers help to those with debilitating intolerance to mold
Dear All,
The Executive Director of Paradigm Change is Lisa Petrison, Ph.D. For years, the organization has been a strong advocate for those who have developed various forms of idiopathic intolerances and debilitating weaknesses after exposure to an excessive amount of mold and other biocontaminants that are often found in water damaged buildings.
Below is a message sent today by Dr. Petrison. It is regarding the many endeavors occurring to provide help to the environmentally injured and disabled.
Begin forwarded message:
“August 29, 2015
Dear Friends,
For those who missed the initial free screening of Dave Asprey’s excellent move “Moldy” (which I am in), or who would like to see it again, there is a free screening this weekend (through Sunday, 8/30/15).
The event honors Jared Dussault, a 17-year-old mold victim who killed himself after expressing discouragement about his illness and who had stated that he wished everyone could see this movie.
*
In order to provide assistance to mold victims working to recover their health, Paradigm Change has launched a new standalone help forum, Mold Avoiders.
It serves as a complement to the Mold Avoiders Facebook group, which now has more than 900 members.
The forum includes an “Ask the Experts” help desk, where people can get their questions answered by experienced mold avoiders, healthcare practitioners and respected remediators. If you fall into one of those categories and would be willing to even occasionally share your knowledge with those in need, please sign up to receive emails of new help desk questions.
More information about the new forum is summarized in a Paradigm Change blog article.
GO TO THE NEW MOLD AVOIDERS FORUM
*
In other Paradigm Change news:
To accompany the launch of the forum, a compilation book of a previous Q&A project – called The Avoiding Mold Archives – has been released.
The basics about Environmental Mold Testing are summarized in a new page on the Paradigm Change website.
A list of Mold Remediators who have received positive reports from mold victims also has been added to the site.
In order to draw attention to the financial devastation that toxic mold illness typically causes, a page of Mold Illness Fundraisers also is now on the website..
On the healing front, I wrote a new article for the Living Clean in a Dirty World blog, called “What I’ve Learned (So Far) About Getting Set Up for Ozone Therapy.”
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Some great new mold-oriented podcast resources:
Functional medicine physician Jill Carnahan did an excellent interview on UndergroundWellness.com.
Dr. Ritchie Shoemaker did an interview with influential biohacker Chris Kresser.
Dave Asprey did an interview on DanielVitalis.com. The Moldy page on the Paradigm Change website summarizes other interviews of Dave done in connection with the film.
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The New Orleans Times-Picayune wrote a remarkable three-part news story focusing on whether the failure to clean up mold after Hurricane Katrina was responsible for the deaths of four professors, all of whom worked on the same floor of a campus building.
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Finally, 261 people have now responded to the Mold Avoidance Survey.
I prepared an in-depth write-up of the first responses to the survey. The final results are going to be really enlightening!
The survey deadline has been extended to September 10, 2015. If you have done any kind of mold avoidance and not taken the survey yet, please participate (and encourage others to participate as well).
TAKE THE MOLD AVOIDANCE SURVEY
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Thanks much to everyone who has taken the survey so far and for all the general support provided to making the dangers of toxic mold more widely known..
Best regards,
Lisa Petrison, Ph.D.
Executive Director
Paradigm Change
Website: www.paradigmchange.me
Email: info@paradigmchange.me “
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