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American College of Occupational and Environmental Medicine Mold Policy Paper

by | Oct 24, 2016 | Mold Facts

In the world of mold defense and mold research papers, the American College of Occupational and Environmental Medicine (ACOEM) Mold Policy Paper titled, Adverse Human Health Effects Associated with Molds in the Indoor Environment, has been used by more defense attorneys to help deny health claims by people who have been exposed to toxic mold than any other.

It has been successfully used in countless lawsuits and it has been estimated that since it was first published in 2002, that it has saved insurers and workmen’s compensation funds hundreds and hundreds of millions of dollars in claims that were denied based on the ACOEM Mold Policy Paper. This paper has also caused defense lawyers and experts to earn millions of dollars in fees.

However, there is good news to report over a decade later. The American College of Occupational and Environmental Medicine appears to have retired its Mold Policy Paper, Adverse Human Health Effects Associated with Molds in the Indoor Environment as their official position statement on mold in March of 2015.

I will get more into these most recent revelations below, but first, here is a little history of the controversy and lies surrounding this mold policy paper.

A 2007 Wall Stree Journal article titled, “Amid Mold Suits, Experts Wear Two Hats,” had detailed how the American College of Occupational and Environmental Medicine had mold policy paper written by non-physician authors who falsely claimed to prove that humans could not plausibly be exposed to enough mold toxins within a damp indoor environment to cause symptoms of ill health.

The Wall Street Journal reported, “The paper has become a key defense tool wielded by builders, landlords, and insurers in litigation. It has also been used to assuage fears of parents following the discovery of mold in schools. One point that rarely emerges in these cases: The paper was written by people who regularly are paid experts for the defense side in mold litigation.

These paid experts promote the legitimacy of the mold policy paper while billing as much as $700 per hour. The US Chamber of Commerce has promoted the document throughout the industry by trumpeting it as scientific proof that serious mold induced illnesses are merely a result of “trial lawyers”, “media reports” and “Junk Science”.

Another medical association published a policy paper in 2006, the American Academy of Allergy, Asthma and Immunology (AAAAI).  It was titled “The Medical Effects of Mold” and was simply a rehash of the ACOEM Mold Policy Paper.

The problem with this paper is that one of the paper’s authors, Jay Portnoy, chief of allergy, asthma and immunology at the Children’s Mercy Hospital in Kansas City, Mo., had told the Wall Street Journal that he “felt that there was an agenda” and the effort “seemed very biased toward denying the possibility of there being harmful effects from mold on human health.”

Portnoy also stated that parts of his contributions to the paper were rewritten without his knowledge and he even considered trying to get his name off the paper, but it was too late because they already published it.

The Wall Street Journal reports;

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

Dr. Portnoy says a section he contributed was rewritten by Dr. Saxon to be “a lot more negative.” He says the paper wrongly says mold isn’t proven to cause allergic rhinitis, with symptoms like wheezing, sore throat and sneezing.

Long time mold activist, Sharon Kramer was very instrumental in helping to get this article written in the Wall Street Journal and she had a hand in getting the American College of Occupational and Environmental Medicine mold policy paper unpublished. She had said this about the WSJ article;

“As referenced by the WSJ, to make this key finding, the authors borrowed data from one rodent study in which mold was forced into the trachea of rats. They then applied calculations to make the leap that human illness could not plausibly occur if one is exposed indoors. The leaders of ACOEM put their imprimatur on the statement. The insurance industry and its surrogates have since brandished it like the biblical jawbone of an ass. The finding carries much weight within the courts as it is portrayed to be the opinion of thousands of environmental physicians.

But the EPA and the Institute of Medicine, Damp Indoor Spaces Committee, have both identified the technique used by ACOEM to make the key conclusion, as non-acceptable methodology for determining existence or absence of human illness from indoor mold toxin exposure. The finding represents an affront to anyone with rudimentary logic skills. It is a complete non sequitur, where the premise does not support the conclusion.

Since the ACOEM mold paper’s publication in November of 2002, it has saved worker’s compensation insurers, property insurers, general liability insurers and building stakeholders, hundreds and hundreds of millions of dollars. Insurance industry surrogates – the paid witnesses – including some ACOEM members themselves – and the lawyers, have earned millions in fees. Of more importance, the sick receive no medical treatment and no compensation for devastated lives and financial ruin.”

Kramer told WorkCompCentral in an interview in March 2015 that Michael Hodgson, medical director for the U.S. Occupational Safety and Health Administration, received a statement from ACOEM’s publications director [Marianne Dreger] last year that the organization would sunset the position paper in early 2015.

Kramer said the sunsetting that appears to have occurred takes away any weight the paper might hold as a defense against workers’ compensation claims where the claimant is seeking benefits for mold-related illness.

“It’s sort of damning for anybody who tries to use that in court because they basically said, �?Eh, this [is] no longer our understanding,’” Kramer said.

Kramer said the position statement was first published in 2002, then revised in 2011. Neither paper, she said, acknowledged mounting evidence supporting that mold can cause respiratory problems and inflammatory responses in the body.

“It was a litigation defense argument right from the get-go,” she said.

Ritchie Shoemaker, a mold researcher who has testified in more than 200 court cases related to mold illness, said the ACOEM paper was ubiquitous in litigation for many years.

“After 2003, there were no cases that I participated in where defense did not quote ACOEM,” he said.

Mold inhalation causes reactions of varying degrees, depending on the individual, Shoemaker said, and can present itself in an array of symptoms – confusion, memory problems, numbness and tingling, tremors, respiratory problems and even joint problems that look like rheumatoid arthritis at first glance.

“It’s fascinating to see the diversity of inflammatory responses that we have,” Shoemaker said. That position has been supported in literature from the World Health Organization as well as the National Institute of Occupational Safety and Health.

Shoemaker said there are several ways to show that a patient has been exposed to the inhalation of mycotoxins, which mold produces. Blood samples, brain imaging and soon genetic tests can all be used to show a “fingerprint” that only mycotoxin inhalation produces, he said.

He said he has submitted a journal article for publication on genetic testing. That paper shows that a person’s messenger ribonucleic acid can be analyzed to see which genes have been activated and which have been suppressed by mold inhalation.

“If all we look at is just a genomic sample, we can take it as a blind without knowing anything about the patient and tell you with 93% accuracy whether we’re dealing with a mold patient,” he said. Further evaluation can bring the accuracy of diagnosing a person as suffering from mold inhalation up to 99%, he said.

Other workers’ compensation treatment guidelines don’t have much to say about mold. The medical treatment guidelines available on the Washington state Department of Labor and Industries website make no specific mention of mold. Colorado’s guidelines, which were among the first for workers’ compensation adopted in the country, also make no mention of mold.

“We can’t cover everything and what we focus on are really the nine highest frequency and highest cost conditions in Colorado, and (mold) is actually not on the list,” said Daniel Sung, manager of medical policy for Colorado’s Division of Workers’ Compensation.

In mold cases, he said, Colorado stakeholders will have to instead look for the best evidence-based medicine they can find.

The online portal for the Official Disability Guidelines offers no entry in its “UR Advisor” tool and points users to MedLineConnect, a government-run website which simply states that “inhaling or touching mold or mold spores may cause allergic reactions or asthma attacks in sensitive people.”

Shoemaker said that even though the ACOEM paper appears to have been sunset, he expects it to continue cropping up in court because ACOEM was the last organization to hold the position that mold inhalation wasn’t likely to cause medical problems.

“They don’t have anything else,” Shoemaker said. “The British were throwing rocks at Washington as he crossed the Delaware River because the Hessians were too drunk to fire their muskets.”


1. Wall Street Journal – Amid Suits Over Mold, Experts Wear Two Hats

2. Sharon Kramer’s Blog

3. Workers Comp Central

4. The Medical Effects of Mold” and was simply a rehash of the ACOEM Mold Policy Paper


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