GIVEN IN COOPERATION

William J. Rea, M.D., F.A.C.S.

Symposium Chairman,

American Environmental Health Foundation,

Environmental Health Center - Dallas,

Dallas, Texas

Bertie B. Griffiths, Ph.D.,

Environmental Health Center - Dallas

Dallas, Texas

Kaye H. Kilburn, M. D.

University of Southern California Medical Center

Keck School of Medicine

Los Angeles, CA

William J. Meggs, M.D.

Dept. of Emergency Medicine

E. Carolina Univ. School of Medicine

Greenville, NC

Allan D. Lieberman, M.D.

Center for Occupational Environmental Medicine

North Charleston, SC

21st ANNUAL INTERNATIONAL SYMPOSIUM

ON MAN & HIS ENVIRONMENT

SCHEDULE

Thursday, June 19, 2003

7:00 a.m. REGISTRATION

8:50 WELCOME/MODERATOR: William J. Rea, M.D.

9:00 Douglas B. Seba, Ph.D., Independent Marine Scientist, Alexandria, VA: “Environmental Update 2003: Molds, Dust, Global Warming”

9:20 Q&A

9:30 Tapani Tuomi, Laboratory Chief, Finnish Institute of Occupational Health, Helsinki, Finland: “Mycotoxins in Indoor Climates”

9:50 Q & A

10:00 BREAK

10:30 William J. Meggs, M.D., Professor of Toxicology, Dept. of Emergency Medicine, E. Carolina Univ. School of Medicine, Greenville, NC: “Systemic Anaphylactic Reactions to Molds and Other Aeroallergens”

10:50 Q & A

11:00 William J. Rea, M.D., Director, Environmental Health Center B Dallas, Dallas, TX: “Diagnosis of Mold & Mycotoxin Sensitivity”

11:20 Q & A

11:30 Andrew W. Campbell, M.D., Clinical Immunotoxicologist, Center for Immune, Environment and Toxic Disorders, Spring, TX: “Immunological and Neurophysiological Abnormalities in Adults with Exposure to Molds”

11:50 Q & A

12:00 p.m. Lunch in the Primebird Restaurant

MODERATOR: Wallace Rubin, M.D.

1:30 Professor Tang G. Lee, AAA, Professor, Faculty of Environmental Design, University of Calgary, Calgary, Alberta, Canada: “Molds in Native Housing and SIDS Potential”

1:50 Q & A

2:00 William A. Croft, D.V.M., Ph.D., Private Practice, Mycotoxins, Environmental Diagnostic Group Inc., Madison, WI: “Pathology of Trichothecene Mycotoxins in Man”

2:20 Q & A

2:30 Kaye H. Kilburn, M.D., Director of Environmental Sciences Lab, Ralph Edgington Professor of Medicine, University of S. California Medical Center, Keck School of Medicine, Los Angeles, CA: “How Molds and Mycotoxins Affect Human Brains”

2:50 Q & A

3:00 BREAK

3:30 Kalpana D. Patel, M.D., Director of Environmental Health Center Buffalo, Northwest Center for Allergy & Environmental Medicine, Buffalo, NY: “What is New and Different in the Diagnosis and Management of Different Skin Disorders B Itching Eczema and Urticaria”

3:50 Q & A

4:00 Katherine Warsco, Ph.D., Department of Interior Design, East Carolina University, Greenville, NC: “Teaching Design for Good Indoor Air Quality”

4:20 Q & A

4:30 Michael R. Gray, M.D., M.P.H., Internal Occupational Medicine Certified Independent Medical Examiner, Progressive Health Care Group, Benson, AZ: “Molds, Mycotoxins & Public Health: a Clinicians Perspective”

4:50 Q & A

5:00 Panel Discussion: How to evaluate moldy house? Chris Rea, William J. Rea, M.D., Geoffrey Hutton, William Croft, D.V.M., Ph.D., and Larry Foster

6:00 AJOURN

THURSDAY, JUNE 19, 2003

ABSTRACTS

AND

HANDOUTS

Abstract Information & Notes

Douglas Seba, Ph.D. Date of talk: Thursday, June 19, 2003, 9:00am

P.O. Box 1417, #323 Phone: 703/949-1055

Alexandria, VA 22313 Fax: N/A

E-mail: N/A

Major and date of Graduation: Environmental Oceanography - 1970

Current Job Description: Independent Marine Scientist

Other Information: Forty years experience in Ecology and Chemicals

Disclosure Statement: None

SPEECH TITLE: “Environmental Update 2003: Molds, Dust, Global Warming”

The speaker has provided the information below.

1.) Goals and objectives: To review selected environmental phenomena that contributes to patient exposure to biochemicals and molds

2.) Outline of talk/abstract: Molds, xenobiotics, genetics, dust, global warming, fate and transport mechanisms, and wildlife anomalies will all be reviewed for contemporary aspects.

3.) Conclusion of what is to be learned: That adverse health effects can occur at vast distances from their environmental origins and put physicians and patients in a constant state of exposure and challenge.

4.) References: Taken from a broad spectrum of media, websites and scientific publications relevant to the moment.

Environmental Update 2003: Molds, Dust Global Warming

Douglas B. Seba

The world is both a moldy and dusty place. Both may be increasing in the natural environment perhaps aided by global warming. There also appears to be an increase in these moieties in indoor environments as we spend increasing amounts of time in air conditioning. Certainly structural mold insurance claims have increased greatly in states, like Texas and Florida, where climate change has increased warmth. Florida is also first among all large states in both total cancer and increase in pediatric cancers being over double that of California, for example. Dust from Africa, containing numerous molds, has also increased in Florida over the last few decades, as well as throughout the Caribbean and the entire United States as far west as New Mexico and north to Canada. Additionally, relative humidity has increase about 10% over the fifty years in the Caribbean and extending into the southeast U.S. All of these factors combine to make more nutrients and moisture available for mold growth. Asthma cases are also increasing nationally, but the increase in the Southeast is outpacing the rest of the country and there is a connection between molds/dust and asthma.

African dust is a quantitative source of hormonally active environmental agents. Global assessment of endocrine disrupters show pervasive distribution throughout the environment including the human body. Recent work with bisphenyl A at very low levels inducing highly significant increases in chromosomal aberrations in mouse eggs, frog deformities caused by interaction between parasites and atrazine, or degradated fluorinated telomers found in human blood are contemporary examples of these environmental agents.

These agents profoundly affect the state of your health as they trigger genes that would not otherwise be expressed. Thus, the nascent field of toxicogenomics will rapidly expanded as the role of endocrine disruptors as biomarkers is investigated. These continuing and emerging sciences will also change the focus of environmental regulation.

Examples of the items will be personally applied by the author to ongoing research in wildlife anomalies in the Bitterroot Mountains of Montana.

Abstract Information & Notes

Tapani Tuomi Date of talk: Thursday, June 19, 2003, 9:30am

Finnish Institute of Occupational Health (FIOH) Phone: 358-9-47472926

Arinatie 3 A Fax: 358-9-5061087

Helsinki, Finland FIN-00370 E-mail: tapani.tuomi@occuphealth.fi

School Attended: Helsinki University of Technology

Major and date of Graduation: DR, Chemical Engineering (Applied Microbiology), 1995

Current Faculty Appointments: Docent in Environmental Chemistry and Microbiology, Helsinki Univ. of Technology

Current Job Description: Laboratory Chief, Laboratory of Chemistry and Microbiology, Finnish Inst. Of Occupational Health, Helsinki, Finland

Disclosure Statement: None

SPEECH TITLE: “Mycotoxins in Indoor Climates”

The speaker has provided the information below.

1.) Goals and objectives: To present current literature on the presence of mycotoxins in indoor climates and to discuss the possibility for carry-over of mycotoxins from contaminated indoor surfaces to air.

2.) Outline of talk/abstract: It has been recognized that mycotoxin-producing fungi can proliferate and produce mycotoxins in damp building materials in water-damaged building. Mycotoxins are also frequently found in deposited dust from indoor environments. There is very little evidence, however, on the presence of mycotoxins in indoor air. This suggests that the air-concentration of mycotoxins even in buildings hampered by long-standing water-damage and following mold-damage is below the limit of detection of contemporary methods of analysis. The talk will examine the spectra of mycotoxins found on building materials naturally contaminated by fungi, as well as the evidence on the presence of mycotoxins in inhalable air in damp buildings.

3.) Conclusion of what is to be learned: A wide range of mycotoxins are potentially present in indoor climates harboring moldy surfaces. It has proven difficult, however, that mycotoxins may contribute to the variety of symptoms experienced by patients exposed to moldy propagules in indoor climates.

4.) References: Skaug et al., 2001, Mycopathologia, 151:93-8, Page and Trout, 2001, AIHAJ 2001 Sep-Oct; 62(5):644-8, Peltola et al, 2001, Appl Environ Microbiol. 2001, 67:3269-74, Tuomi et al., 2000, appl. Environ. Microbiol, 66:1899-1904

Mycotoxins in Indoor Climates

Tapani Tuomi

As of present, analyzing for mycotoxins in indoor environments is difficult, if the goal is to assess the health consequences of extensive water damage on the occupants of a particular building. There is accumulating evidence on the presence of mycotoxins in crude building materials^1-7 as well as a body of indirect evidence linking the presence of mycotoxins in indoor environments to health problems^{5,
8-15}. It is frequently maintained that mycotoxins present in bulk materials infested with toxigenic fungi are carried to indoor air by fungal propagules. It follows that the route of exposure to mycotoxins in indoor environments is inhaling dust particles containing toxigenic fungal propagules².

Dose-responses of humans to airborne mycotoxins are not known and it seems that mycotoxin concentrations in inhalable dust would have to be some 100-fold higher than what is frequently encountered in indoor environments for air sampling to be feasible on a general level. If air sampling is not attempted, deposited dust constitutes one step closer to the composition of indoor air with respect to mycotoxins. There are numerous studies from agricultural environments establishing that mycotoxins present in bulk material are - given the right circumstances - carried into dust. For instance, trichothecene concentrations of 0,1-1 µg/g dust, aflatoxin concentrations of 0,02-5 µg/g dust, ochratoxin A concentrations of 0,2-70 ng/g dust, and zearalenone concentrations of 20-100 ng/g dust have been reported during grain handling and from other agricultural settings^16-21. In laboratory settings, Sorensen et al.²² found satratoxin concentrations in the 10 µg/g dust-range, whereas Smoragiewicz et al.⁶ detected trichothecenes in deposited dust from a moisture problem building in amounts exceeding 0.4-4 µg/g and Engelhart et al.²³ found sterigmatocystin (2-4 ng/g) in carpet dust from a damp indoor environment. It follows that samples of deposited dust should be considered alongside with bulk samples when assessing the presence of mycotoxins in indoor environments.

In agricultural settings, aflatoxin concentrations of 0,01 - 1000 ng/m³ and eoxynivalenol (DON) concentrations of 3-20 ng/m³ have been reported in air^{17-18,
20-21, 24-25}. In indoor environments, satratoxin in concentrations of 0,1-0,5 ng/m3 and unidentified trichothecenes in concentrations of 1-35 ng/m³ have been found^22-23. It seems therefore, that irrespectively of the environmental setting, whether agricultural or indoor environments, measurement of airborne mycotoxins generally require use of high-volume samplers in combination with sensitive chemical or immunological methods of analysis. Risk-assessment on the inhalation of mycotoxins cannot be made based on the analysis of bulk samples of construction materials. Neither can mycotoxin contents of deposited dust serve as basis of risk-assessment. Therefore, with the development of more efficient methods of sampling and analysis, air sampling will help us better understand the health consequences of exposure to mycotoxins in indoor climates and perhaps will at some point enable estimation of dose-responses of humans to airborne mycotoxins.

In conclusion, a wide range of mycotoxins are potentially present in indoor climates harboring moldy surfaces. It has proven difficult, however, to establish the presence of mycotoxins in indoor air. This does not take away from the fact, however, that mycotoxins may contribute to the variety of symptoms experienced by patients exposed to moldy propagules in indoor climates.

REFERENCES: ¹Andersson et al., Appl Environ Microbiol, 1997, 63: 387-393; ²Croft et al., Mycopathologia, 1986, 151:93-98; ³Flappan et al., Environ Health Perspect, 1999, 107: 927-930; ⁴Gravesen et al., Environ Health Perspect, 1999, 107: 505-508; ⁵Johanning et al., Int Arch Occup Environ Health, 1996, 68: 207-218; ⁶Smoragiewicz et al., Int Arch Occup Environ Health, 1993, 65: 113-7; ⁷Tuomi et al., Appl Environ Microbiol, 2000, 66, 1899-1904; ⁸ Auger et al., Am J Ind Med, 1994, 25: 41-2; ⁹Hodgson et al., J

Occup Environ Med, 1998, 40: 241-9; ¹⁰Miller, Atm Environ, 1992, 26A: 2163-2172; ¹¹Morb Mortal Wkly Rep, 1994, 43: 881-883; ¹²Morb Mortal Wkly Rep, 1995, 44: 67-74; ¹³Morb Mortal Wkly Rep, 1997, 46: 33-35; ¹⁴Rautiala et al., Am Ind Hyg Assoc J, 1996, 57: 279-84; ¹⁵Smith et al., Fems Microbiol Lett, 1992, 79:337-43; ¹⁶ Lappalainen et al., Atmosph Environ, 1996, 30, 3059-3065; ¹⁷Burg et al., Am Ind Hyg Assoc J, 1981, 42:1-11; ¹⁸Burg et al., Am Ind Hyg Assoc J, 1982, 43:580-587; ¹⁹Silas et al., Am Ind Hyg Assoc J, 1987, 48:198-201; ²⁰Selim et al., Am Ind Hyg Assoc J, 1998, 42:252-256; ²¹Palmgren et al., Am Ind Hyg Assoc J, 1983, 44:485-488; ²²Sorenson et al., Appl Environ Microbiol, 1987, 53: 1370-5; ²³Engelhart et al., Appl Environ Microbiol, 2002, 68:3886-3890; ²⁴Ghosh et al., Am Ind Hyg Assoc J, 1997, 58:583-586; ²⁵Kussak, Ph.D. Thesis, Umeå University, Umeå, Sweden, 1995. ²²Johanning et al., Unpublished data pertaining to filter no. 1 in Johanning et al., Proceedings: Indoor air 2002; 23Yike et al., Appl Environ Microbiol, 1999, 65: 88-94.

Abstract Information & Notes

William J. Meggs, M.D., Ph.D. Date of talk: Thursday, June 19, 2003, 10:30am

Brody School of Medicine

East Carolina University Phone: 252/744-2954

600 Moye Blvd., Room 4W54 Fax: 252/744-3589

Greenville, NC 27858 E-mail: meggsw@mail.ecu.edu

Medical School Attended: University of Miami

Major and date of Graduation: M.D., 1979

Residency: University of Rochester

Board Certifications: Medical Toxicology, Allergy & Immunology, Internal Medicine, Emergency Medicine

Current Faculty Appointments: Professor & Chief of Toxicology

Current Job Description: Physician

Other Information: Author of “The Inflammation Cure” to be published in Sept. 2003. Editor of “Health & Safety in Agriculture, Forestry, & Fisheries.” Author of numerous research articles and textbook chapters.

Disclosure Statement: None

SPEECH TITLE: “Systemic Anaphylactic Reactions to Molds and Other Aeroallergens”

The speaker has provided the information below.

1.) Goals and objectives:

$ To present the signs, symptoms, treatment, epidemiology, and prognosis of systemic anaphylaxis

$ To discuss the clinical situations in which systemic anaphylaxis can occur to aeroallergens

$ To discuss the mechanisms of systemic anaphylaxis

2.) Outline of talk/abstract: Aeroallergens are proteins found in the air on mold spores, pollen grains, and from animals. Humans become sensitized by the production of IgE antibodies to these antigens. Most commonly aeroallergen exposures are by inhalation, and the most common symptoms are rhino sinusitis, conjunctivitis, and asthma. Less commonly, reactions such as urticaria, dermatitis, and systemic anaphylaxis can occur from inhalation exposures to aeroallergens. The clinical presentation, diagnosis, treatment, and mechanism of systemic anaphylaxis will be discussed, and situations in which systemic anaphylaxis can occur from aeroallergen exposures will be presented. These include inhalation induced systemic anaphylaxis, dermal exposures, the alpine slide syndrome, and ingestion of honeybee pollen containing aeroallergens.

3.) Conclusion of what is to be learned: Aeroallergens can lead to systemic anaphylaxis from inhalation, ingestion, and dermal exposures.

4.) References:

Chivato T, Juan F, Montoro A, Laguna R. Anaphylaxis induced by ingestion of a pollen compound. J Investig Allergol Clin Immunol 1996 May-Jun; 6(3): 208-9.

Eriksson NE, Formgren H, Svenonius E. Food hypersensitivity in patients with pollen allergy. Allergy 1982 Aug; 37(6): 437-43

Mansfield LE, Goldstein GB. Anaphylactic reaction after ingestion of local bee pollen. Ann Allergy 1981 Sep; 47(3): 154-6

McGrath KG. Anaphylaxis. In Grammar LC, Greenberger PA, eds., Patterson=s Allergic Diseases. 6^th Edition. Lippncott Williams & Wilkins. Philadelphia, 2002. Chapter 20, pp 415-436.

Patterson R, Harris KE. Idiopathic Anaphylaxis. In Grammar LC, Greenberger PA, eds, Patterson=s Allergic Diseases. 6^th Edition. Lippncott Williams & Wilkins. Philadelphia, 2002. Chapter 20, pp 415-436.

Spitalny KC, Farnham JE, Witherell LE, Vogt RL, Fox RC, Kaliner M, Casale TB. Alpine slide anaphylaxis. N Engl J Med 1984 Apr 19;310(16):1034-7

Abstract Information & Notes

William J. Rea, M.D. Date of talk: Thursday, June 19, 2003, 11:00am

Environmental Health Center - Dallas Phone: 214/368-4132

8345 Walnut Hill Lane, Ste. 220 Fax: 214/691-8432

Dallas, TX 75231 E-mail: wjr@ehcd.com

Medical School Attended: Ohio State University College of Medicine

Major and date of Graduation: M.D., 1962

Residency: UTSWS

Board Certifications: American Board of Surgery, American Board of Thoracic Surgery, American Board of Environmental Medicine

Current Faculty Appointments: Professor of Medicine, Capital University of Integrative Medicine, Washington, DC

Current Job Description: President, Environmental Health Center - Dallas

Disclosure Statement: None

SPEECH TITLE: “Diagnosis of Mold and Mycotoxin Sensitivity”

The speaker has provided the information below.

1.) Goals and objectives: 1.) To understand the cause. 2.)Understand the diagnostic tests. 3.) To understand their value in pulmonary function.

2.) Outline of talk/abstract: Mold Tests used in diagnosing - building inspection and mold plates, SPECT-Brain Scan, autonomic nervous system, evaluation through pupillography and HRV, balance test, psychological - neuro-evaluation, blood tests, skin tests, and urine test for mycotoxins.

3.) Conclusion of what is to be learned: How to diagnose and individual with mold exposure

4.) References: Chemical Sensitivity, Volume 2, 3

Abstract Information & Notes

Professor Tang G. Lee, AAA Date of talk: Thursday, June 19, 2003, 1:30pm

Faculty of Environmental Design

The University of Calgary Phone: 403/220-6608

2500 University Dr. NW Fax: 403/284-4399

Calgary, Alberta T2N 1N4 E-mail: lee@ucalgary.ca

Canada

Major and date of Graduation: Site planning and architecture, 1975

Current Faculty Appointments: Professor of Architecture (Building Science and Environmental Health). Also Adjunct Professor at the University of Manitoba, and visiting scholar at the Lyle center for Regenerative Studies, California State Polytechnic University, Pomona

Current Job Description: Conducting research investigations and teaching environmental health, particularly indoor air quality, building science and sustainability.

Other Information: Conducts comprehensive indoor air quality investigations in an interdisciplinary team for those cases that could not be solved by other indoor air quality consultants. Also designs buildings such as medical clinics, institutions and residences that feature low toxicity.

Disclosure Statement: None

SPEECH TITLE: “Molds in Native Housing and SIDS Potential”

The speaker has provided the information below.

1.) Goals and objectives: To understand the environmental conditions of native housing and its impact on occupant health. To develop appropriate housing design, construction and maintenance of native housing to minimize building deterioration and resulting health impacts.

2.) Outline of talk/abstract: Many native houses are built without regards to climate and cultural needs. Premature deterioration of these houses created conditions for microbial amplification. The resulting occupant symptoms reduced their potential for achieving a quality of life and may even aggravate SIDS. Recommendations for proper site planning, design and maintenance is presented.

3.) Conclusion of what is to be learned: Building deterioration will impact occupant health and well-being. Better quality buildings are needed to ensure occupant health.

4.) References:

Wilson, C.E. Sudden infant death syndrome and Canadian Aboriginals: bacteria and infections. FEMS Immunology and Medical Microbiology 25 (1999) 221-226. Federation of European Microbiological Societies, Elsevier Science.

Lee, T.G. and Stooke, T. Mould propagation resulting from air pressure differences across the building envelope. Proceedings of the 9^th International Conference on Indoor Air Quality and Climate (Indoor Air 2002), Monterey, California, June 30 B July 5.

Abstract Information & Notes

William A. Croft, D.V.M., Ph.D. Date of talk: Thursday, June 19, 2003, 2:00pm

Environmental Diagnostic Group Inc. Phone: 715/757-3756

521 Hilltop Dr. Fax: 715/757-9302

Madison, WI 53711 E-mail: doccroft@hotmail.com

Veterinary School Attended: University of Minnesota

Medical School Attended: University of Wisconsin, Madison, Wisconsin

Major and date of Graduation: Ph.D. in Medical Pathology from the University of Wisconsin, Madison, Wisconsin.

Current Job Description: Study Human diseases within the environment from outbreak of human disease as a Medical Pathologist.

Other Information: Was on Faculty of the University of Wisconsin as Medical Pathologist, was accepted by the National Institute of Health as a Medical Pathologist, qualified to research human diseases. Obtain over $900,000 of highly competitive research grants from the national Institute of Health while at the University of Wisconsin.

Disclosure Statement: None

SPEECH TITLE: “Pathology of Trichothecene Mycotoxins in Man”

The speaker has provided the information below.

1.) Goals and objectives: To demonstrate the pathologic changes in the primary target organs after inhalation verses ingestion exposure to Trichothecene Mycotoxins in man.

2.) Outline of talk/abstract: A. History of Mycotoxicosis, B. Detection of "Sick Buildings” ingestion verses inhalation exposure. Signs and Symptoms expressed by over 6,000 patients exposed to Trichothecene Mycotoxins, attempting to establish diagnosis. C. The pathologic changes associated with inhalation exposure to trichothecene mycotoxins. D. The primary organs involved with inhalation Mycotoxicosis.

3.) Conclusion of what is to be learned: The primary target organs of this disease and how this mycotoxin affects every cell in the body.

4.) References:

a. Croft, W.A., Jarvis, B.B., and Yatawara, C.S.,: Airborne Outbreak of Trichothecene Toxicosis, In: Atmospheric Environ, 20(3), 549-552 (1986).

b. Croft, W.A., Jastromski, B.M., Croft, A.L., and Peters, H.A., "Clinical Confirmation of Trichothecene Mycotoxicosis In Patient Urine," In: Journal of Environmental Biology 23(3), 301-320 (2002).

The Pathology of Trichothecene Mycotoxicosis In Humans

1. The Fingerprint of the Agent Causing the Disease is Displayed Within the Cells or Tissue of The Body.

2. Degeneration and Necrosis of The Entire Central Nervous System, Cardiovascular, lung, Digestive Tract, Spleen, Liver, Kidney, Pancreas, Immune, Skin, Reproductive, Eye, Urinary Bladder and Prostate.

3. The Signs and Symptoms Described For Trichothecene Mycotoxicosis Match the Pathology Observed.

4. Every Cell in The Body is Affected or Susceptible to Trichothecene Mycotoxins When Exposed.

5. The Exposed Cells Are Not Allowed to Grow and Make Cellular Products in The Rough Endoplasm Reticulum Represents of First Mechanism of Action on The Cells.

6. The Burning or Denaturation of Tissue From the Epoxide Molecule is Another Mechanism of Action on The Cells of The Body Causing Intense Scarring of Organs. (Like Phenol)

7. The Rapidly Turnover Organs Systems Are Affected The Most Severe, G.I. Tract, Immune System and Reproductive, (like radiation damage)

8. The Central Nervous System is Severely Affected and is A Primary Target Organ. The Neurons in the Cerebral Hemispheres, White and Grey Matter, Brain Stem and even the Ependymal Cells. The Purkinje Cells of The Cerebellum Are Severely Affected That Affect Motion and Balance. The Dorsal and Ventral Motor Neurons Are Destroyed Causing Amyotrophic Lateral Sclerosis. Peroxidation of Peripheral Nerves is Also Observed. The Central Nervous System is The Organ Most Affected as Reported By People Exposed to Toxic Mold.

9. Lack of Cellular Production, Epoxide- Peroxidation of Lipid Membranes, Loss of Vessels, Loss of Oxygen From Severe Lung Scarring, and Loss of Proper Nutrients Due Loss of Functional Absorption of Intestine Affect the Brain and All Organs of The Body.

10. The Trichothecene Mycotoxins are Cumulative in Their Health Effects on Organ Systems.

11. Trichothecene Mycotoxins are “Hit and Run” Poisons and are not Stored in The Body.

12. Inhalation of Trichothecene Mycotoxins Are More Poisonous As Observed by The Intense Scarring of The Alveolar Tissue Than Consumption Due To The Neutralization of Mycotoxin by Bacteria.

13. Depression of the Immune System Allows for Increase Infections by Bacteria, Viral, Fungal and Cancer to Form.

14. Yeasts are allowed to Colonize the Intestine Tract Because They Are Resistant to Trichothecene Mycotoxins.

15. Yeast Can Cause Diabetes Mellitus, Gout and Prevent Proper Liver Function to Detoxify Xenobiotics.

16. Trichothecene Mycotoxins are Released Within the Urine and Feces as Evidenced by The Pathology Observed Within Those Tissues.

17. Children Exposed to Trichothecene Mycotoxins are 100 to 1000 X more susceptible because stems are killed not allowing for additional growth within the individual.

18. There is No Safe Level of Exposure to Trichothecene Mycotoxins.

19. The third Mechanism For Trichothecene Mycotoxicosis is To Develop Anaphylaxis to Mold Allergens When Mycotoxin Leaves The Body.

Dr. William Croft, (Medical Pathologist)

Stages of Mycotoxicosis: For Inhalation of Mycotoxin

The three Stages (1-3) ranging from lower to higher severity of poisoning were modified according to exposure via the air as opposed to ingestion already established (Forgacs et al., 1962; Joffe, 1971). A separate Stage of convalescence occurs when a patient is completely removed from the contaminated premises and the source of mycotoxin or mold spores.

Stage 1: The primary changes are in the brain, respiratory and immune systems, mucus membranes and gastrointestinal tract. Signs and symptoms may include burning sensation in the mouth, tongue, throat, palate, esophagus, and stomach, which is a result of the action of the toxin on the mucous membranes and skin in the exposed areas. Moist areas of the body armpits, under breasts, belt line and groin are more sensitive or first affected. Patients may report burning within the eyes, ears and nose. Patients also reported that their tongues felt swollen and stiff. Mucosa of the oral cavity may be hyperemic. Mild gingivitis, stomatitis, glositis, and esophagitis developed. Inflammation, in addition to gastric and (small and large) intestinal mucosal, resulted in vomiting, diarrhea and abdominal pain. Excessive salivation, headache, dizziness, weakness, fatigue and tachycardia were also present.

There may be fever and sweating. The respiratory system develops burning sensations and congestion. Severe exposure to mycotoxin within the lungs may lead to congestion, edema and failure, due to caustic action. Body temperature remains normal and controllable by the patient. The poisoning appears and disappears relatively quickly in this Stage with the exception of, lungs and central nervous system. Initially (Stage 1), the patient’s symptoms are very uncomfortable or painful. As the poisoning continues and the patient progress toward Stage 2, he or she becomes accustomed to the presence of the mycotoxin and a quiescent period follows due to lack of nerve sensation. Depending on exposure levels, the first Stage may last from 3 - 9 days. In scoring the 50 signs and symptoms listed in Tables-1 and 2, an average score range of 20-45 represents Stage 1.

Stage 2 : This Stage is often called the latent Stage or incubation period because the patient feels apprehensive, but is capable of normal activity in the beginning of this Stage. Every organ of the body is affected by degeneration and necrosis with continued exposure. The primary target organs for an individual become evident over time, due to biological variation. These are disturbances in the central and autonomic nervous systems resulting in headaches, mental depression, loss of short-term memory, loss of problem-solving ability, various neuropsychiatric manifestations, meningism, severe malaise and fatigue, narcolepsy, loss of temperature control, hyperesthesia or numbness of body areas, and cerebellar dysfunction including hypotonia, attitude and gait, dysmetria, asthenia, vertigo, disturbances of speech, and loss of balance (Best, 1961). Spinal cord degeneration may also be observed in gait and reflex abnormalities, such as the ability to drive vehicles, ride bicycles or pass sobriety tests (inability to tolerate ethyl alcohol). Attention deficient disorder may be observed in children. Various systems may include: Eyes: visual disturbances, floating objects, light sensitive, lack of tears, burning and itching. Ears: burning, itching, and loss of hearing. Immune and hematopoietic: progressive loss of white and red cells including a decrease of platelets and hemoglobin, and high susceptibility to bacterial, mycotic and viral infections, debilitating chemical and allergies. Gastrointestinal: metallic taste in mouth, tooth loss, gum problems, stomatitis, sores in gums and throat, nausea, vomiting, diarrhea or constipation, excessive flatulence, abdominal distention, hepatitis, pancreatitis, and diabetes mellitus. Respiratory : burning and bleeding from nasal membranes, respiratory difficulty, asthma, extreme susceptibility to cold, flu and pneumonia. Skin: thinning of hair on head, burning on face, rashes, irritation, and edema. Renal: proteinuria, possible hematuria. Reproductive: irregular ovarian cycles, increased menstrual flow, fibroid growths in uterus, cystic development in mammary glands, and tumors of mammary and prostate glands. Musculoskeletal : somatitis, muscle weakness, spasms, cramps, joint pain, enlargement of joints in hand, and clubbing of fingers. Cardiovascular: chest pain, palpitations, ruptures of atrial walls, myocardial infection and aneurysm of arteries.

The skin and mucous membranes may be icteric, pupils dilated, the pulse soft and labile, and blood pressure may decrease or increase. The body temperature does not exceed 38 degree C and the patient may be afebrile, or chilled. Visible hemorrhagic spots may appear on the skin. Thoughts of suicide may be prominent in the person’s mind at this time or anytime in Stage 2. Human bonding is very important for survival.

Degeneration and hemorrhages of the vessels marks the transition from the second to the third Stage of the disease and may not be consistently observed. The degeneration of the vital organs including serious respiratory insufficiency or asthma and CNS degeneration will take the patient into Stage three along with development of necrotic angina. If exposure continues, depending on exposure levels, Stage 2 may continue from weeks to months or even years until the symptoms of the third Stage develop. Evaluating the 50 signs and symptoms (Table-1 and 2) by assigning a score (0-least intense to 5-most intense or severe) to each symptom, we have determined that an average score range of 45-180 represents Stage 2.

Stage 3: Severe degeneration of the vital organs. The transition from the second to the third Stage is sudden. In this Stage, the patient’s resistance is already low, and violent severe symptoms are present, especially under the influence of stress, or associated with physical exertion and fatigue. The first visible sign of this Stage may be lung, brain or heart failure (heart attack), with or without the appearance of petechial hemorrhage on the skin of the trunk, the axillary and inguinal areas, the lateral surfaces of the arms and thighs, the face and head, and in serious Cases, the chest. The petechial hemorrhages vary from a few millimeters to a few centimeters in diameter. There is increased capillary fragility and any slight trauma may cause the hemorrhages to increase in size.

Aneurysms of the brain or aorta may be observed by angiography. Hemorrhages may also be found on the mucous membranes of the mouth and tongue, and on the soft palate and tonsils. There may be severe interstitial thickening or scarring of the lungs, or respiratory failure. Nasal, gastric and intestinal hemorrhages and hemorrhagic diathesis may occur. Necrotic angina begins in the form of catarrhal symptoms and necrotic changes soon appear in the mouth, throat, and esophagus with difficulty and pain on swallowing. Severe degeneration of the skin on the face, eyelids, and loss of lashes is also often present.

Necrotic lesions may extend to the uvula, gums, buccal mucosa, larynx, vocal cords, lungs, stomach, and intestines and other internal organs such as the liver and kidneys and are usually contaminated with a variety of avirulent bacteria. Bacteria infection causes an unpleasant odor from the mouth due to the enzymatic activity of bacteria on proteins. Areas of necrosis may also appear on the lips and on the skin of the fingers, nose, jaws, and eyes. Regional lymph nodes are frequently enlarged. Esophageal lesions may occur and involvement of the epiglottis may cause laryngeal edema and aphonia (loss of voice). Death may occur by strangulation.

Patients may suffer an acute parenchymatous hepatitis accompanied by jaundice. Bronchopneumonia, pulmonary hemorrhages, and lung abscesses are frequent complications. Tumors may develop of various organs, including skin, urinary bladder, brain, mammary gland, bone, immune, liver, prostate, possibly resulting in death. The most common cause of death is brain failure due to both direct effects of the mycotoxin on the central nervous system and indirect effects due to respiratory failure or lack of oxygen to the brain caused by the severe caustic inflammation (fibrinous exudation) reaction with the lung tissue, rendering it non-functional. Again, using the scoring system represented in Tables-1 and 2, an average score of greater or equal 180 represents Stage 3.

Stage of Convalescence: The course and duration of this Stage 3 depends on the intensity of the poisoning and complete removal of the patient from the premises or source of mycotoxin. Therefore, the duration of the recovery period is variable. There is considerable cellular necrosis and scarring to all major organs of the body in which cells will not regenerate, including the brain, spinal cord, eyes, lung, heart, liver, pancreas, kidney, adrenal, and blood vessels. If the disease is diagnosed during the first Stage, hospitalization is usually unnecessary, but allergies and asthma should be monitored closely. If the disease is diagnosed during the second Stage and even at the transition from the second to third Stages, early hospitalization may preserve the patient’s life. If however, the disease is only detected during the third Stage, death cannot be prevented in most Cases.

1. Croft, W. A., Jastromski, B. M., Croft, A. L., and Peters, H. A., “Clinical

Confirmation of Trichothecene Mycotoxicosis in Patients Urine”, In: Journal of

Environmental Biology 23(3), 301-320 (2002)

2. .Forgacs, J., and W. T. Carll : Mycotoxicoses. In : Advances in Veterinary

Science. Academic Press, New York and London, pp 273-372 (1962).

Abstract Information & Notes

Kalpanna D. Patel, M.D. Date of talk: Thursday, June 19, 2003, 3:30pm

65 Wehrle Dr. Phone: 716/833-2213

Buffalo, NY 14225 Fax: 716/833-2244

E-mail: aehcwhy@wny.com

Medical School Attended: BJ Medical College, India

Residency: University of Texas Health Science Medical School at San Antonio

Board Certifications: American Board of Pediatrics, American Board of Environmental Medicine

Current Faculty Appointments: Associate Professor of Pediatrics, Suny, Buffalo

Current Job Description: President/Director AEHC-Buffalo

Other Information: Elected Appointments: President of American Board of Environmental Medicine, President of International Board of Environmental Medicine

Disclosure Statement: None

SPEECH TITLE: “What Is New And Different in The Diagnosis And Management of Different Skin Disorders - Itching Eczema And Urticaria”

The speaker has provided the information below.

1.) Goals and objectives:

1) To demonstrate importance of good environmental and dietary history of mold and mycotoxin exposure for the diagnosis and management of different skin disorders.

2) To demonstrate importance of Intradermal mold antigen testing and the efficacy of maximum tolerated end point, dose of mold antigen to obtain optimal response to relieve different skin conditions.

2.) Outline of talk/abstract:

$ Presentation of different cases having different symptomatology that failed to respond to traditional management.

$ To demonstrate effectiveness of Environmental Medicine approach in treatment of these cases.

$ Discussion of newer methods for the diagnosis and treatment of mold related skin disorders.

3.) Conclusion of what is to be learned:

1) Exposure to mold has become an enigma in homes as well as newer and older sick buildings.

2) Mold plays a major role in the immune dysfunction and development of inhalant sensitivity.

3) Chronic health problems like intense itching, eczema urticaria fatigue and many others can be effectively treated without drug therapy if the source of the problem is detected and treated effectively.

4.) References:

Abstract Information & Notes

Katherine Warsco, Ph.D. Date of talk: Thursday, June19, 2003, 4:00pm

East Carolina University Phone: 252/328-6929

152 Rivers Building, ECU Fax: 252/328-4276

Greenville, NC 27834 E-mail: warscok@mail.ecu.edu

Medical School Attended: NA (Ph.D. College of Human Ecology, Michigan State University)

Major and date of Graduation: Family and Child Ecology, 1988

Residency: NA (Doctoral Internship B Energy Information Administration, US Department of Energy, Washington D.C.)

Board Certifications: NA

Current Faculty Appointments: Interior Design Program, School of Human Environmental Sciences, East Carolina University, Greenville, NC

Current Job Description: Chair, Department of Apparel Merchandising and Interior Design, School of Human Environmental Sciences, East Carolina University, Greenville, NC

Other Information: Founder of Environmental Quality in Interiors Network, Interior Design Educators Council

Disclosure Statement: None

SPEECH TITLE: “Teaching Design for Good Indoor Air Quality”

The speaker has provided the information below.

1.) Goals and objectives: The purpose of this speech is to report on the development of an environmental education curriculum that bridges fields of medicine, building science, and design to address indoor air pollution, environmental illness, and interior design. As a result of participation in this curriculum, students of interior design will be able to apply design criteria to address the following issues:

a) Application of non-toxic and radon-resistant construction practices;

b) Removal, isolation, and/or dilution of chemicals released into indoor air by appliances, cleaning solvents, pesticides, and the off gassing of synthetic materials, adhesives, and finishes;

c) Selection and layout of HVAC and lighting systems to avoid the buildup of moisture and the collection of dust;

d) Selection of furniture, cabinetry, and surface finishes that provide inhospitable conditions for microbial growth; and

e) Accessible design of living quarters to facilitate movement by a chemically sensitized client suffering from episodes of reduced stamina and mobility.

2.) Outline of talk/abstract: An environmental education curriculum was developed to assist students in exploring linkages between micro-climate, architectural shell, interior space plan, building systems, materials specification, indoor air quality, and environmental illness. In the context of a national design competition, students applied a series of programming exercises to develop solutions for a hypothetical residential design problem. Exercise 1 required students to identify effects of chemical and biological contaminants on building occupants based on patient profiles published in Volume III of William Rea’s series on chemical sensitivity. Exercise 2 required students to identify sources, paths of entry and design solutions for chemical and biological irritants. Exercise 3 required students to identify the effects of Multiple Chemical Sensitivity on physical dexterity as applied to an anthropometric model developed by Ralph Faste. Exercise 4 required students to outline design solutions for controlling indoor air quality. Students applied a series of schematic diagramming exercises to a hypothetical building and residential site located in a hot, humid climate to explore the following:

a) Orienting the building and fenestration for day lighting and ultraviolet light, passive solar and winter heat movement, and passive cooling and prevailing winds;

b) Radon resistant construction practices;

c) Interior spatial arrangement to facilitate movement of building occupants with low stamina and exhaustion of pollutants in a depressurized building;

d) Interior spatial arrangement to isolate sleeping quarters to provide a pollutant-free sanctuary; and

e) Specification of building materials, and interior finishes, fabrics, and equipment to remove contaminants from the interior-breathing zone.

3.) Conclusion of what is to be learned: This environmental education project represents a first attempt to partner with the Environmental Protection Agency to employ student design competitions as a vehicle for disseminating scientific environmental information to post-secondary schools of interior design in the U.S. Fulfilling sponsor expectations for developing a curriculum inclusive of the major threats to human health by indoor air was complicated by conflicting assumptions within the scientific community as to what constitutes environmental disease. Although this curricular tool was successful in providing a thorough overview of indoor air quality design considerations, deliberately retaining the complexity of issues within a multi disciplinary framework challenged the definition of acceptable boundaries for a problem addressed by interior designers. Future efforts to integrate environmental health issues in interior design curricula must balance the need to avoid unidimensional problem solving with limitations to the scope of training for interior design students. Increasing collaboration among schools of design and health sciences to provide opportunities for multi disciplinary problem solving would ensure design solutions are grounded in current knowledge of the effects to health of biological and chemical indoor contaminants.

4.) References: See attached

Teaching Design for Good Indoor Air Quality

Katherine Warsco

East Carolina University

Goals and objectives

The purpose of this speech is to report on the development of an environmental education curriculum that bridges fields of medicine, building science, and design to address indoor air pollution, environmental illness, and interior design. As a result of participation in this curriculum, students of interior design will be able to apply design criteria to address the following issues:

a. Application of non-toxic and radon-resistant construction practices;

b. Removal, isolation, and/or dilution of chemicals released into indoor air by appliances, cleaning solvents, pesticides, and the off gassing of synthetic materials, adhesives, and finishes;

c. Selection and layout of HVAC and lighting systems to avoid the buildup of moisture and the collection of dust;

d. Selection of furniture, cabinetry, and surface finishes that provide inhospitable conditions for microbial growth; and

e. Accessible design of living quarters to facilitate movement by a chemically sensitized client suffering from episodes of reduced stamina and mobility.

Outline

A curriculum was proposed for improving the quality of interior design instruction for addressing indoor air pollution and environmental illness through residential interior design. The purpose of the project was:

a. To develop, disseminate, and implement materials and methods for assisting post-secondary instructors and students of design to increase their knowledge of indoor air quality issues;

b. To promote the application of this knowledge to develop innovative solutions for radon-resistant, non-toxic, and allergy-free interiors; and

c. To provide opportunities for interdisciplinary problem solving, drawing from the fields of medicine, architecture and engineering to address residential design solutions for medically at-risk populations such as the elderly and the infirm.

This project targeted 460 faculty and their students in two- and four-year university interior design programs in the US. The coastal southeast region was the focus of this environmental illness project because the following factors make indoor air quality concerns critical components of the building design process:

a. The population exceeds the national average for age 65 years and older and percent of elderly both in poverty and in poor health;

b. For coastal states such as Florida, housing stock exists with radon levels exceeding EPA limits; and

c. Hot and humid climate conditions increase microbial growth and the release of chemicals that incite toxic and allergic reactions among the hypersensitive.

The vehicle used to improve the quality of interior design instruction was a national student design competition and teacher’s supplement. A competition was developed incorporating requirements for the design of a residential setting for a retired couple who suffered from environmental illness. Included in the competition were the following components linked to principles of environmental design:

a. Site profile. Students were asked to design a retirement residence in Northern Florida in a county where radon gas is prevalent in levels that exceed the EPA limit. The hot, humid micro-climate posed medical problems concerning microbial growth. Lots were selected from a housing development that adheres to tenets of sustainable design in order to integrate principles of enviroscaping (i.e., environmentally safe & energy conscious landscaping practices) and sustainable construction with the residential design problem. Sustainable construction building codes released by the John D. and Catherine T MacArthur Foundation and information from a market survey conducted by the University of Florida Center for Construction and the Environment were made available for use in this competition.

b. Building profile. Students were asked to modify a design given of a Florida Cracker House, a vernacular archetype suitable for hot, humid climates predating mechanized air conditioning and development of synthetic building materials. Focusing on a process of archetypal ideation developed by Ronald Haase, students explored traditional principles of passive cooling to address good indoor air quality.

c. Client profile. Students were given information concerning the needs and characteristics of a hypothetical client family. The medical case histories were based on actual patient case reports from the Environmental Health Center-Dallas, Texas. Students were introduced to medical profiles as a source of information regarding client responses to toxin and allergen exposures within building interiors.

d. Drawings. Site plans, building elevations, foundation plan, roof plan and floorplan were included in hard copy and made available in electronic format. Information was provided to assure compliance with the Southern Building Code regarding foundation design and break-away construction to address the velocity of hurricane-force winds and coastal flooding of the foundation.

e. Resources. Order forms were included for literature and electronic media pertaining to designing for indoor air quality, hot humid climates, and environmental illness.

A supplement to the competition provided a suggested teaching plan for integrating the competition in university instruction. The teaching plan included learning objectives, suggested readings, discussion questions, and examples of student outcomes. In the context of the national design competition, students applied a series of programming exercises to develop solutions for a hypothetical residential problem:

a. Patient Profile. In Table 1, students were required to identify effects of chemical and biological contaminants on building occupants based on patient profiles published in Volume III of William Rea’s Series on chemical sensitivity (Rea, W., 1996). In Table 2, students were required to identify sources, paths of entry and design solutions for chemical and biological irritants based on information provided in the suggested textbook, Your Home, Your Health and Well-Being (Rousseau, Rea, and Enwright, 1990). The purpose of these exercises was to gain understanding of the linkages between pollutant sources in the built environment and medical symptom behaviors of building occupants. Students explored translating medical data into design parameters for use in the process of design ideation for a hypothetical client family.

b. Disability Compensation. In Table 3, students were required to identify the effects of chemical sensitivity on physical dexterity as applied to “The Enabler,” an anthropometric model developed by Ralph Faste (Rashko, B., 1991). The purpose of this exercise was to identify design requirements associated with selective physical disabilities for use in the process of design ideation for a hypothetical client family.

c. IAQ Solutions. In Table 4, students were required to outline design solutions for controlling indoor air quality in the “sanctuary;” the primary sleeping quarters for their hypothetical client couple. In Table 5, students provide a material assessment for client health and well-being. Building materials, finishes and furnishing materials, and building systems (i.e., plumbing, electrical, heating and appliances) were chosen according to a rating-for-safety system developed by Rousseau and Rea (Rousseau, et. al., 1990). Students intertwined issues of materials science with aesthetic considerations in their development of a residential prototype for benign design.

Students applied a series of schematic diagramming exercises to a hypothetical building and residential site located in a hot, humid climate as a means to explore principles from the following areas of design:

a. Micro-Climate Design. Students explored orientation of openings in the architectural shell for daylighting, passive solar and winter heat movement, and passive cooling and prevailing winds to address building occupant thermal comfort, reduce consumption of fossil fuels for heating and cooling, and dilute airborne contaminants in the near environment.

b. Enviroscaping and Sustainable Development. In the manner of case studies of the Kanapaha Botanical Gardens and the Florida House Learning Center, students were required to develop conceptual plot plans. Specification of drought tolerant plants indigenous to the climate minimized irrigation as a habitat for mold and use of chemical fertilizers that were a source of toxins for their chemically sensitive clients.

c. Radon-Resistant Construction Practices. Students explored radon mitigation techniques for homes with above-grade foundations in terrain prone to coastal flooding.

d. Accessible Design. Students considered human activity patterns influenced by loss of stamina, general muscle weakness, and chronic fatigue characteristic of medical conditions of the age and chemical sensitivity of their clients. Structural and nonstructural design solutions were explored to support daily routines of the non-ambulatory and infirm.

e. Non-Toxic, Allergy-Free Design of the “Sanctuary.” Students explored the design of sleeping quarters free of environmental irritants that might interfere with healing and revitalization. Strategies for removing and isolating indoor contaminants were explored with regards to design of mechanical systems, space planning, and specification of furnishings, finishes, equipment, and accessories for residential interiors.

Evaluation of Competition Submissions

Of the 460 competition packets mailed to US members of the Interior Design Educators Council, thirteen universities participated with thirty-nine submissions. Although every region except the Northwest was represented in the competition, three-fourths of the submissions were from universities in hot, humid climates. A three-member jury independently ranked student entries. Criteria used to evaluate submissions included the following:

a. The design solution is appropriate for sustainable development considerations of the climate, terrain, and vernacular archetype (15%)

b. The design solution reflects an accurate and sensitive application of principles of radon-resistant, non-toxic, allergy-free, and accessible design (40%)

c. The solution represents innovative design for the “sanctuary,” addressing specific medical conditions of the clients as explained in the patient profiles of the design program (10%)

These criteria constituted 65% of the overall evaluation score. Winning submissions were selected from top scores, ranging from 81-90/100 points. Jurors provided numerical and open-ended responses to student submissions. Faculty and students participating in the competition received written feedback as to the strengths and weaknesses of each submission according to disciplinary perspectives represented by the jury.

Evaluation of Student Contributions to Teacher’s Supplement

Student outcomes presented as illustration for exercises in the teacher’s supplement received national attention. Conceptual designs prepared by an undergraduate research assistant, Michelle Puckett Jenkins were awarded first place in two national student competitions: a) a call for student design entries sponsored by Affordable Comfort Inc., an interdisciplinary organization that promotes environmentally friendly, energy-efficient, healthy building practices; and b) a national lighting competition sponsored by Cooper/Halo Metalux, Inc. These projects received external validation from juries comprised of educators and practitioners in the fields of building construction, architecture, and mechanical engineering.

Conclusions

This environmental education project demonstrated viable linkages between the arts and sciences in addressing indoor air quality and environmental illness. Employing a student design competition as a vehicle for disseminating scientific environmental information provided a thorough overview of indoor air quality design considerations. Increasing collaboration among schools of design and health sciences to provide opportunities for multidisciplinary problem solving would ensure design solutions would be grounded in current knowledge of the effects to health of biological and chemical indoor contaminants.

References

American Lung Association. (1992). Indoor Air Pollution Fact Sheet: Radon. Atlanta, GA: American Lung Association.

American Lung Association, Environmental Protection Agency, Consumer Products Safety Commission, & American Medical Association. (1994). Indoor Air Pollution: An Introduction for Health Professionals (Government document 1994-523-217/81322). Washington, D.C.: American Lung Association

Environmental Protection Agency, Consumer Product Safety Commission, & American Medical Association. (1998). Trends in Cigarette Smoking. Morbidity & Mortality Weekly Report, 47(43).

Axelrad, B. (1993). Improving IAQ: EPA's program. EPA Journal, 4(October-December), 14-17.

Beecher, M. A., & Davies, B. (2002, March 19-24). Shades of Green: The Philosophical Challenges of Ecological Responsibility in Interior Design Education and Practice. Paper presented at the Mesas and the Mysteries: On the Edge of Imagination/Green Design, Santa Fe, NM.

Bode, M., & Munson, D. (1995). Controlling Mold Growth in the Home, [Guidance Document]. Kansas State University Agricultural Experiment Station and Cooperative Extension Service. Available: http://www.oznet.ksu.edu/library/hous2/mf2141.pdf [2002, November 11].

Browner, C.M. (1993). Environmental Tobacco Smoke: EPA's report. EPA Journal, 4(October-December), 18-22.

Canada Mortgage and Housing Corporation. (1993). The Clean Air Guide: How to Identify and Correct

Indoor Air Problems in Your Home (NHA 6695; NH15-8311993E). Eobicode, ON: Canada Mortgage and Housing Corporation.

Coleman, C. (1999). Life-cycle design: Leaving future generations a legacy. Perspective (Spring/Summer), 27-28, 30.

Danko, S., Eshelman, P., & Hedge, A. (1990). A taxonomy of health, safety, and welfare implications of interior design decisions. Journal of Interior Design Education and Research, 16(2), 19-30.

Fernández-Caldas, E., Trudeau, W. L., & Ledford, D. K. (1994). Environmental control of indoor biologic agents. Journal of Allergy & Clinical Immunology, 94(2), 404-412.

Guerin, D. A. (1992). Issues facing interior design education in the twenty-first century. Journal of Interior Design Education and Research, 17(2), 9-16.

Haase, R. W. (1992). Classic Cracker: Florida's Wood-Frame Vernacular Architecture. Sarasota: Pineapple Press.

Hasell, M. J., & Scott, S. C. (1996). Interior Design Visionaries' Explorations of Emerging Trends. Journal of Interior Design, 22(2), 1-14.

Human Ecology Action League. (1992). Chemicals Can Effect Your Health . Atlanta, GA: Human Ecology Action League.

Inman, M., & Shea, J. (1993, October, 1993). Housing problems for older adult households in the southeast. Paper presented at the Paper presented at the 1993 annual meeting of the American Association of Housing Educators, Columbus, OH.

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Kibert, C. J. E. (1996). Sustainable Construction Code--Residential: For the Abacoa Development (Unpublished Manuscript ). Gainesville: University of Florida Center for Construction and Environment.

Kloeppel, J. E. (1993, April, 1993). Beware the fungus among us: Emissions from mold & fungus may be culprits in indoor air problems. Georgia Tech News, 1-4.

Lechner, N. (1991). Heating, Cooling, Lighting: Design Methods for Architects. New York: John Wiley & Sons.

Marcinowski, F., Lucas, R. M., & Yeager, W. M. (1994). National and regional distributions of airborne radon concentrations in U.S. homes. Health Physics, 66(6), 699-706.

Mendler, S. (2002). LEED: A Roadmap for Added Value. Perspective: Journal of the International Interior Design Association(Winter 2002), 42-49.

Miller, B. R., Miller, P. B., & Bateman, M. S. (2002, March 19-24). Two's Company, Three's a Good Team: Multidisciplinary Teams are a 21st Century Necessity. Paper presented at the Mesas and the Mysteries: On the Edge of Imagination/Green Design, Santa Fe, NM.

Miller, J. W. (2002). Green Home Building. Perspective: Journal of the International Interior Design Association(Fall 2003), 22-27.

Moussatche, H., King, J., & Rogers, T. S. (2002, March 19-24, 2002). Material Selection in Interior Design Practice. Paper presented at the Mesas and the Mysteries: On the Edge of Imagination/Green Design, Santa Fe, NM.

Odom, J. D.,& DuBose, G. (1996). Preventing Indoor Air Quality Problems in Hot, Humid Climates: Design and Construction Guidelines (Unpublished manuscript). Orlando: CH2M Hill, Inc., Disney Development Co.,.

Peart, V. (1993). Indoor air quality in Florida: Formaldehyde (Fact Sheet He 3205). Gainesville: University of Florida Cooperative Extension Service.

Raschko, B. (1991). Housing Interiors for the Disabled & Elderly. New York: Van Nostrand Reinhold.

Rea, W. J. (1996). Chemical Sensitivity (Vol. 3). Boca Raton: CRC Press.

Rousseau, D., Rea, W. J., & Enwright, J. (1990). Your Home, Your Health, & Well-Being. Berkeley: Ten Speed Press.

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Sexton, K. (1993). An inside look at air pollution. EPA Journal, 19(4), 9-12.

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US Environmental Protection Agency. (2001a, May 28, 2002). Healthy Buildings, Healthy People: A Vision for the 21st Century, [Guidance Document]. US Environmental Protection Agency. Available: http://www.epa.gov/iaq/hbhp/index.html [2002, November 11].

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Warsco, K. (1997a). Designing for Good Indoor Air Quality in a Hot, Humid Climate: Student Design Competition . Unpublished competition materials prepared for US EPA Environmental Education Grants Program, Washington, D.C.

Warsco, K. (1997b). Teaching Supplement to the Student Design Competition: Designing for Good Indoor Air Quality in a Hot, Humid Climate: Unpublished supplement to competition materials prepared for US EPA Environmental Education Grants Program, Washington, DC.

Waxman, H. A. (1993). The view from congress. EPA Journal, 19(4), 38-39.

Wilson, K. P. (2002). The Case for Green Design. Perspective: Journal of the International Interior Design Association(Winter 2002), 21-26.

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Abstract Information & Notes

Michael R. Gray, M.D., M.P.H. Date of talk: Thursday, June 19, 2003, 4:30pm

300 S. Ocotillo Phone: 520/586-9111

Benson, AZ 85602 Fax: 520/586-9091

E-mail: DocMike007@aol.com

Medical School Attended: University of Cincinnati, College of Medicine; University of Illinois School of Public Health

Major and date of Graduation: M.D., 1974; M.P.H., 1978

Residency: 1975-77 Internal Medicine, Cook County Hospital, Chicago, IL; 1977-78 Chief Resident, Internal Medicine, Cook County Hospital, Chicago, IL

Current Job Description: Medical Director, Progressive Healthcare Group, Benson, AZ, 1988-present; Medical Director and Board Chairman, Benson Ambulance Service, Benson, AZ, 1990-present

Other Information: Published several articles

Disclosure Statement: Cholestyramine

SPEECH TITLE: “Mold, Mycotoxins & Public Health: a Clinicians Perspective”

The speaker has provided the information below.

1.) Goals and objectives: To help clinical practitioners recognize and treat systemic illnesses associated with mixed molds and mycotoxins

2.) Outline of talk/abstract: A descriptive epidemiologic survey of the results of clinical evaluations of 250 patients exposed to mixed, toxigenic, structural molds and mycotoxins will be presented

3.) Conclusion of what is to be learned: How to evaluate and manage mycotoxicosis

4.) References: Bibliography provided with handouts.

Mold, Mycotoxins, and Public Health

Michael R. Gray, M.D., Robert C. Crago, Ph.D., Kaye Kilburn, M.D.

Clinical evaluations of 250 patients compiled from 1994-2003, are presented in a clinically based descriptive epidemiologic study with results compared to unexposed controls, general reference ranges, and national databases for multiple parameters measured. Abnormalities of immune function, pulmonary function, and neurocognitive function and impairment, are presented confirming that exposure to mixed toxigenic structural filamentous, terrestrial molds (e.g., Stachybotrys sp., asperigillius/Penicillium sps., Fusarium, etc), and their associated mixed mycotoxins (eg., aflatoxin, rubrotoxin, sterigmatocystin, vomitoxin, tremulotoxin, zearalanone, trycothecenes, T-2 toxin, etc.) collectively induce mycotoxicosis, a clinical syndrome resulting from infectious and toxic neuroimmunopathophysiologic effects. Key features include: immune toxicity with hyper activation and simultaneous suppression, small airways obstruction and reactivity, and neurological toxicity involving multiple neurophysiologic processes (e.g., balance, visual perception, peripheral vision, simple and choice reaction time, blink reflex, etc.).

21st ANNUAL INTERNATIONAL SYMPOSIUM

ON MAN & HIS ENVIRONMENT

SCHEDULE

Friday, June 20, 2003

7:00 a.m. Breakfast with Drucker Labs, Michelangelo Room

8:00 a.m. ANNOUNCEMENTS/MODERATOR: Sherry A. Rogers, M.D.

8:05 Eugene A. Shinn, U.S. Research Geologist, Geological Survey, St. Petersburg, FL: “Update: Transoceanic Soil Dust Transport and Medical Implications”

8:25 Q & A

8:35 Lester Friedlander, B.A., D.V.M., Wyalusing, PA: “Molds and Mycotoxins in the Food Chain”

8:55 Q& A

9:05 Katherine Warsco, Ph.D., Department of Interior Design, East Carolina University, Greenville, NC: “Interior Design for a Mold-Free Environment”

9:25 Q & A

9:35 Aristo Vojdani, Ph.D., M.T., Director, Immunosciences Laboratories, Inc., Beverly Hills, CA: “Immunotoxicology of Molds and Mycotoxins”

9:55 Q & A

10:05 BREAK WITH EXHIBITORS

10:30 Bruce Small, Director of Envirodesic Certification Program, Georgetown, Ontario, Canada: “Prescription for Preventing Mold and for Mold Remediation”

10:50 Q & A

11:00 Martha Stark, M.D., Department of Psychiatry, Harvard Medical School, Boston, MA: “Mysterious Mental Illnesses, Pernicious Poisons”

11:20 Q & A

11:30 John H. Boyles, Jr., M.D., Dayton Ear, Nose & Throat Surgeons Inc., Centerville, OH: “Diagnosis & Treatment of Inhalant and Mold Allergy”

11:50 Q & A

12:00n OPEN LUNCH

MODERATOR: Kaye H. Kilburn, M.D.

1:00 p.m. David C. Straus, Ph.D., Department of Microbiology, Texas Tech University Health Science Center, Lubbock, TX: “The Role of Fungi in Sick Building Syndrome”

1:20 Q & A

1:30 Tapani Tuomi, Laboratory Chief, Finnish Institute of Occupational Health, Helsinki, Finland: “Mycotoxins in Cigarettes and in Tobacco Smoke”

1:50 Q & A

2:00 Mohamed B. Abou-Donia, Ph.D., Duke University Medical Center, Durham, NC: “Acute Exposure to Sarin Increases Blood Brain Barrier Permeability & Induces Neuropathological Changes in the Rat Brain: Dose Response Relationship”

2:20 Q & A

2:30 Sherry A. Rogers, M.D., Medical Director, Northeast Center for Environmental Medicine, Author, Syracuse, N.Y.: “Rescuing the Heart as Toxic Target Organ”

2:50 Q & A

3:00 BREAK WITH EXHIBITORS

3:30 Bruce Jarvis, Ph.D., Department of Chemistry & Biochemistry, University of Maryland, College Park, MD: “History and Toxicology of Mycotoxicoses”

3:50 Q & A

4:00 David C. Straus, Ph.D., Department of Microbiology, Texas Tech University Health Science Center, Lubbock, TX: “Recent Research in Sick Building Syndrome”

4:20 Q & A

4:30 William J. Rea, M.D., Director, Environmental Health Center B Dallas, Dallas, TX: “Treatment of Mold & Mycotoxin Exposure”

4:50 Q & A

5:00 Panel Discussion: “How and when to remodel a moldy building” Donald P. Dennis, M.D., Larry Foster, Professor Tang G. Lee, AAA, David C. Straus, Ph.D., Bruce Small, and Tapani Tuomi

6:00 RECEPTION WITH THE EXHIBITORS

FRIDAY, JUNE 20, 2003

ABSTRACTS

AND

HANDOUTS

Abstract Information & Notes

Lester C. Friedlander, B.A., D.V.M. Date of talk: Friday, June 20, 2003, 8:35am

P.O. Box 534 Phone: 570/746-3072

Wyalusing, PA 18853 Fax: 570/746-1386

E-mail: iamlfbadvm@aol.com

Undergraduate School Attended: Northland College, Ashland, WI

Araneta University Foundation, College of Veterinary Medicine, Metro Manila, Philippines

Major and date of Graduation: BA, 1971: DVM,1979

Board Certifications: None

Current Faculty Appointments: None

Current Job Description: Independent Researcher, Consultant

Other Information: Chronic Wasting Disease Workshop – Veterinary Professional C.E. UNIV. of Minnesota, College of Veterinary Medicine. Co-Authored: Accumulation 0f 2.8 Dihydroxyadenine in Bovine Liver, Kidneys, and Lymph Nodes. Journal of Veterinary Pathology 28:99-109(1991)

Disclosure Statement: None

SPEECH TITLE: “Molds and Mycotoxins in the Food Chain”

The speaker has provided the information below.

1.) Goals and objectives: To inform and educate health professionals that there are molds and mycotoxins in the foods we eat. Furthermore to explain and list the symptoms of mycotoxins in both humans and animals

2.) Outline of talk/abstract: Please refer to page 2

3.) Conclusion of what is to be learned: There are many mycotoxins in our environments with similar symptoms in humans

4.) References:

1. Black, Kevin. “Aflatoxins in Corn” (Dec. 1996): 2 pag. Online. Internet. 20, Feb. 1997

2. Cheeke, Peter R., Lee R. Shull. ed. Natural Toxicants in Feeds and Poisonous Plants. Westport: AVI Publishing 1985.

3. Hascheck, Wanda M. “Selected Mycotoxins Affecting Animal and Human Health”: Academic Press 2002

4. GIPSA, Technical Services Division: “ Grain Fungal Diseases & Mycotoxin Reference” USDA 2003

5. http://vm.cfsan.fda.gov/~frf/iupac.html

http://www.btny.purdue.edu/NC129/

http://pasture.ecn.purdue.edu/~grainlab/

http://www.ces.ncsu.edu/drought/dro-29.html

http://www.aces.edu/department/grain/ANR767.htm

http://www.ianr.unl.edu/pubs/pesticides/g790.htm

http://www.ipm.iastate.edu/ipm/icm/1998/1-19-1998/btdiscon.html

http://www.scisoc.org/feature/Btcorn/Top.html

Molds and Mycotoxins in the Food Chain

Lester Friedlander, B.A., D.V.M.

1.) Goals and objectives:

To inform and educate health professionals that there are molds and mycotoxins in the foods we eat. Furthermore, to explain and list the symptoms of mycotoxins in both humans and animals.

2.) Outline of talk/abstract:

I. Introduction

A. Condensed History of Mycotoxicology (Early 1960’s to Present)

II. Classification of Mycotoxins

A. Aflatoxins

B. Trichothecenes

C. Fumonisins

D. Zearalenone

E. Ochratoxin A

F. Ergot Alkaloids

III. How We Consume Mycotoxins

A. How mycotoxins get into your Food

1. Growth

2. Storage

3. Transportation

B. Mycotoxins Carried by Animals

1. General Carriers

2. Species Specific

3. Rarities

IV. Conclusion

A. Current Mycotoxin Standards

B. High risk areas

Abstract Information & Notes

Katherine Warsco, Ph.D. Date of talk: Friday, June 20, 2003, 9:05am

East Carolina University Phone: 252/328-6929

152 Rivers Building, ECU Fax: 252/328-4276

Greenville, NC 27834 E-mail: warscok@mail.ecu.edu

Medical School Attended: NA (Ph.D. College of Human Ecology, Michigan State University)

Major and date of Graduation: Family and Child Ecology, 1988

Residency: NA (Doctoral Internship – Energy Information Administration, US Department of Energy, Washington D.C.)

Current Faculty Appointments: Interior Design Program, School of Human Environmental Sciences, East Carolina University, Greenville, NC

Current Job Description: Chair, Department of Apparel Merchandising and Interior Design, School of Human Environmental Sciences, East Carolina University, Greenville, NC

Other Information: Founder of Environmental Quality in Interiors Network, Interior Design Educators Council

Disclosure Statement: None

SPEECH TITLE: “Interior Design For A Mold-Free Environment”

The speaker has provided the information below.

1.) Goals and objectives: This speech will provide an overview of current thinking within the professional community of interior design with regards to methods of proactive environmental design. Objectives include identifying current >best practices= advice of a general and conceptual nature for the types of mold problems experienced in many homes, schools and office facilities. Current thinking is based on a comparison of philosophical positions of the interior design community evident among practitioners and educators of interior design and agricultural experiment station cooperative extension specialists.

2.) Outline of talk/abstract: Presented here are proactive approaches to achieving mold-free building interiors along with strategies for mold remediation in building interiors resulting from water leakage, condensation, or flooding. Interior design decisions impact prevalence of moisture and nutrient matter through space planning and specification of interior finishes, fabrics, furnishings, and equipment. Also, covered are current efforts in the development of certification programs to rate building materials and interior products. This speech concludes with trade-offs between >best practices= advice and other considerations regarding up-front building costs, building maintenance and operation, and building occupant comfort, health and well-being.

3.) Conclusion of what is to be learned: Interior design practice and education contribute to the prevention and remediation of mold growth in indoor environments. The literature points to a need for interior designers to be educated from a perspective of eco-materialism that links indoor material choices to building occupant health.

4.) References: See attached

Interior Design For A Mold-Free Environment

Katherine Warsco, Ph.D.

East Carolina University

Goals and objectives

This speech will provide an overview of current thinking within the professional community of interior design with regards to methods of proactive environmental design. Objectives include identifying current ‘best practices’ advice of a general and conceptual nature for the types of mold problems experienced in many homes, schools and office facilities. Current thinking is based on a comparison of philosophical positions of the interior design community evident among practitioners and educators of interior design and agricultural experiment station cooperative extension specialists.

Presented here are proactive approaches to achieving mold-free building interiors along with strategies for mold remediation for moisture intrusion due to water leakage, condensation, and flooding. The US Environmental Protection Agency and East Carolina University supported the development of an environmental education curriculum. A design competition and teacher’s supplement were developed to assist educators and students of interior design to explore linkages between microclimate, architectural shell, interior space plan, mechanical systems, materials specification, indoor air quality, and environmental illness. Excerpts from student submissions to this competition, shown in this presentation serve to illustrate interior design for a mold-free environment.

Proactive Approach

Interior design decisions impact prevalence of moisture and nutrient matter that support microbial growth through space planning of the building interior and specification of interior finishes, furnishings, fabrics, and equipment. Strategies for removing, isolating, and diluting moisture and nutrient matter in the building interior follow two schools of thought; they typically either focus on the natural environment (i.e., healthy planet), or they focus on the interaction of the building and the building occupant (i.e., healthy people). Architectural and engineering ventilation strategies illustrate these approaches. A ‘healthy planet’ design approach might use a negative pressurized architectural shell that maximizes airflow through interior breathing zones. Benefits to the planet include reduced fossil fuel consumption for heating, ventilating and air conditioning. A ‘healthy people’ design approach might use a positive pressurized architectural shell that balances and filters airflow within interior breathing zones. Although ventilation strategies are largely within the domains of architecture and engineering, Interior design decisions intertwine with those of allied building fields to impact the ultimate success of these approaches to address mold-free design.

Ventilation (dilution) strategies are addressed through space planning and design of mechanical systems.

a. Arranging fenestration and interior partitions to facilitate natural ventilation will dry moisture-laden areas and exhaust indoor contaminants.

b. Arranging air inlets and air outlets to facilitate cross-ventilation will dry moisture-laden stored items and exhaust indoor contaminants.

c. Specifying fans will exhaust moisture-laden air prevalent in rooms such as kitchens, bathrooms, hobby rooms, and utility rooms.

d. Specifying air-to-air exchanger units can be used to filter incoming air for interior living spaces and to exhaust contaminants at their source.

The arrangement of interior spatial volumes in conjunction with openings in the architectural shell of a building can impact moisture intrusion and dissipation.

Maximizing day lighting and solar gain in the interior will retard microbial growth.
Planning for adequate space to ensure airflow around furnishings will dry moisture-laden areas.
Providing transitional zones such as vestibules, air lock entries, mudrooms, or breezeways to shed contaminants from outer garments and footwear reduces airborne contaminants entering living areas.

The specification of interior products contributes to prevalence of moisture and nutrient matter within the breathing zones of buildings. Specification of products includes interior finishes, fabrics, furnishings & equipment.

Specifying porous wall coverings on perimeter interior walls will allow surfaces with temperature differences to ‘breathe.’
Specifying wall materials so that permeability increases from exterior cladding to interior finish will allow moisture within the wall cavity to dissipate.
Specifying non-porous finishes for interior walls with low temperature difference between rooms can avoid entrapment of moisture and organic materials due to activities of the building occupant.
Specifying nonporous, continuous work surfaces will avoid entrapment of moisture and organic materials.
Specifying non-fleecy interior surfaces and designing built-in furniture reduces surface-to-volume ratio for collection of dust and the sink effect of VOCs.
Specifying non-fleecy fabrics and designing built-in window treatments reduces surface-to-volume ratio for collection of dust and sink effect of VOCs.
Specifying finishes and fabrics that easily can be cleaned (laundered or wiped clean) will prevent build up of contaminants.
Specifying non-cellulose materials such as ceramic, glass, and metal decreases hospitable habitats for microbial growth.
Specifying open storage containers will allow stored items to ‘breathe’.
Specifying upholstery with open construction allows for air movement and dissipation of body heat.

Reactive Approach

Strategies to minimize exposure to contaminants in indoor air as a result of moisture intrusion focus on their removal, isolation, and dilution. These strategies are a response to flooding and damage control for water leakage and condensation.

Drying contaminated materials with daylight and air and exposing contaminated materials to ultraviolet light will kill mold.
Depressurizing the building through exhaust fans and natural ventilation will dry wet materials.
Elevating the building to facilitate airflow in the crawl space will retard microbial growth.
Encapsulating fungi embedded in organic materials will prevent their exposure to interior breathing zones.
Cleaning, drying, sealing, and maintaining the building will prevent damage from water intrusion and microbial growth.
Pressurizing the interior with central air systems can prevent infiltration of ambient pollutants and dormant spores within cavities of the architectural shell.
Drying, cleaning, and disinfecting nonporous interior products will kill mold and remove dormant fungal spores.
Disposing of porous interior products such as bedding, upholstery, thermoplastics draperies, softwoods, and paper products will remove interiors furnishings and accessories with embedded mold.
Seeking restoration specialists to remove mold and dormant fungal spores from porous products can preserve valuable belongings.

Caveats to ‘best practices’ advice

Important trade-offs should be factored into design decisions between ‘best practices’ advice and other considerations regarding upfront building costs, building maintenance and operation, and building occupant comfort, health and well-being. These considerations are relevant to ventilation strategies and specification of interior products.

Procedures for operating mechanical systems, designing passive convection systems, and tightening the architectural shell to address reductions in energy consumption can be counterproductive to occupant health.

Strategies to address energy efficiency can result in high relative humidity for indoor air conducive to growth of molds (e.g., cycling air with no cooling or heating on weekends; bringing in unfiltered ambient air in humid climates via passive convection).
Negative air pressure fans used to exhaust moisture also can draw dormant spores out of crawl spaces and wall cavities into interior breathing zones.
Negative air pressure caused by inadequate ventilation in tightly sealed buildings may cause back drafts from combustion appliances and equipment, releasing pollutants into indoor air.

Decisions regarding the selection of interior products can be counterproductive to occupant health with regards to building occupants with heightened sensitivities to noise pollution, allergens and toxins.

Acoustics - specifying non-fleecy surfaces may increase transmission of unwanted sounds.
Chemical sensitivity - using chemicals for cleaning and in finishes that retard microbial growth (e.g., fungicides, bleach, and desiccants) may trigger allergic or toxic response.
Maintenance - interior finishes specified in office and hotel facilities for their ease of maintenance often have a low permeability rating. Inability of exterior wall cavities to ‘breathe’ can result in condensation and growth of mold.

Certification Programs & Consultancies

Certification programs and consultancies have emerged in the fields of building sciences and industrial hygiene. Current efforts in the development of certification programs to rate building materials and interior products include the following:

a. Leadership in Energy and Environmental Design (LEED) program is a voluntary certification program that analyzes content of building materials in new facilities (US Green Building Council, 2002; Mendler, 2002). Beginning with exterior materials, the program is currently focusing on interior materials for commercial buildings and eventually will develop a materials rating system for remodeling of old buildings. Criteria of this program include recycled content, energy efficiency, and VOC emissions.

b. Air Quality Sciences, Inc. has a Greenguard certification program that rates building materials according to biologicals and toxins (Air Quality Sciences, Inc., 2002).

c. Industrial Hygiene association regulates a mold remediation certification program that has been developed along the lines of asbestos removal and radon mitigation (American Industrial Hygiene Association’s EMLAP Program).

d. McDonough Braungart Design Chemistry (MBDC) and Environmental Protection Encouragement Agency (EPEA) provide consulting services on chemical composition of interior products from the perspective of ‘cradle-to-cradle’ impact on the natural environment and wellness of building occupants (McDonough, 2003).

The Interior Design Community

Interior design practice and education contribute to the prevention and remediation of mold growth in indoor environments. The literature points to three prevailing philosophical perspectives with regards to interior design practice that influences approaches to achieving a mold-free environment.

A traditional materialist philosophy, Indicative of mainstream interior design practice values materials for their appearance, durability, and availability (Nielson & Taylor, 2002). Designers subscribing to this philosophy have focused on client considerations to the exclusion of ecological considerations of protecting and preserving the natural environment. If economy is a consideration, the expectation is that designing with ecologically sensitive products will increase the cost for completion of the project (Beecher and Davies, 2002). Historically, knowledge underlying interior design decisions has been held by an elite group and applied on behalf of an elite clientele.

An eco-materialism philosophy, indicative of a growing interest in the green design movement and sustainable design movement values materials for their environmental sensitivity over availability, convenience, or appearance (Beecher and Davies, 2002). This philosophy embraces an ecology-centered approach that expands traditional measures of building performance (e.g., cost per square feet, minimum standards for air quality) to include issues of building occupant comfort, satisfaction, and overall well-being. Health factors affecting material selections would include VOC emissions and susceptibility to allergens and toxins. Long-term environmental impact would be considered in tandem with upfront building costs (Moussatche, King, and Rogers, 2002). Knowledge based on the science of product quality can effect changes to the way interior products are manufactured, the composition of interior products, and the specification of products by the interior designer (McDonough, 2003).

A Human ecology (Home Economics) philosophy, indicative of a cooperative extension approach to design values materials for their durability and for wise use of natural resources within a tradition of supporting health and wellness in the family. This philosophy embraces a holistic approach to design decisions that includes considerations of the environment and human needs (e.g., University of Florida, University of Minnesota, Kansas State University). Knowledge based on science and best practices developed by federal and state government (e.g., programs addressing disaster relief for flooding) is translated to a layman’s language to empower the consumer.

Conclusions - Toward a Hybrid Model of Benign Design

The professional community of design education and practice could benefit from the development of a design model that reflects a merger of values indicative of an aesthetic tradition (beautiful design), a science of product quality evolving from the environmental movement (contaminant-free design), and the cooperative extension tradition of empowering individuals and families (user-driven design). Needed to support this model is a more comprehensive metrics to evaluate building performance inclusive of measures of improved occupant health and well-being and life-cycle analyses of interior products that provide measures of long-term impact to the natural environment.

References

AERIAS. (2002a). Carpet, a Haven for Unwanted Guests. AERIAS. Available: http://www.aerias.org/sitemap.htm [2002, October 11].

AERIAS. (2002b). Ceiling Materials and Problems Associated with Indoor Air. AERIAS. Available: http://www.aerias.org/sitemap.htm [2002, October 11].

AERIAS. (2002c). Healthy ("Green") Workplaces: The Economical Choice. AERIAS [2002, October 11].

AERIAS. (2002d). Indoor Air Problems Associated with Different Types of Flooring. AERIAS. Available: http://www.aerias.org/sitemap.htm [2002, October 11].

AERIAS. (2002e). Overview of Furniture in the Indoor Environment. AERIAS. Available: http://www.aerias.org/sitemap.htm [2002, October 11].

AERIAS. (2002f). Overview of IAQ Problems in Homes and Apartments. AERIAS. Available: http://www.aerias.org/home_overview.htm [2002, October 11].

AERIAS. (2002g). Prevention of Indoor Air Quality (IAQ) Problems in the Home. AERIAS. Available: http://www.aerias.org/home_prevention.htm [2002, October 11].

Air Quality Sciences, I. (2002). Greenguard Registry: The World's Leading Guide to Healthy Indoor Products and Materials. Air Quality Sciences, Inc. [2002, October 11].

American Red Cross, & Agency, F. E. M. (1992, 2001). Repairing Your Flooded Home, [Guidanc