mold litigation perspectives

Mold Litigation PerspectivesMold Litigation Perspectives

Presented by:Presented by:Ben Kollmeyer, MPH, CIHBen Kollmeyer, MPH, CIHForensic Analytical Consulting ServicesForensic Analytical Consulting Services

CIHC – December 5, 2006CIHC – December 5, 2006

Forensic Analytical

OverviewOverview

The Case of the Phantom MoldThe Case of the Phantom Mold

Common IssuesCommon Issues

PCR: A Better Mousetrap?PCR: A Better Mousetrap?

The Case of the Phantom Mold:The Case of the Phantom Mold:Carpet Microvacuum Results in a Carpet Microvacuum Results in a

Litigated MannerLitigated Manner

BackgroundBackground

Teacher alleges various injuries caused Teacher alleges various injuries caused

by environmental conditions at a school.by environmental conditions at a school.

Suit against school dismissed (worker’s Suit against school dismissed (worker’s

compensation as exclusive remedy).compensation as exclusive remedy).

Focus shifts to school builders and Focus shifts to school builders and

suppliers.suppliers.

Focus shifts to mold and mycotoxins.Focus shifts to mold and mycotoxins.

Environmental SettingEnvironmental SettingSchool set in an arid climate.School set in an arid climate.

Rooms arranged around a central quad with Rooms arranged around a central quad with exterior entrances.exterior entrances.

Teacher predominately spent time in two Teacher predominately spent time in two classrooms, 4 & 7. Predominately 7.classrooms, 4 & 7. Predominately 7.

Room 4: slab on grade, sticks & bricks.Room 4: slab on grade, sticks & bricks.

Room 7: modular at grade w/ crawlspace.Room 7: modular at grade w/ crawlspace.

Focus of claims is on room 7.Focus of claims is on room 7.

Environmental DataEnvironmental DataVisual observation by three different Visual observation by three different

environmental consultants.environmental consultants.

Air sampling by one consultant.Air sampling by one consultant.

Microvacuum sampling by two consultants Microvacuum sampling by two consultants

within 6 months of each other.within 6 months of each other.

Tapelift and swab samples by two Tapelift and swab samples by two

consultants.consultants.

Visual Findings SummaryVisual Findings SummaryRoom 7Room 7– Standing water and biological growth in sub-grade Standing water and biological growth in sub-grade

crawlspace.crawlspace.– Evidence of exterior surface moisture and intrusion Evidence of exterior surface moisture and intrusion

into entry.into entry.– No elevated moisture in carpet.No elevated moisture in carpet.– No visible mold.No visible mold.

Room 4Room 4– Mold at sink separator.Mold at sink separator.– Mold behind baseboard.Mold behind baseboard.

Room 7Room 7

Room 4Room 4

Swab and Tapelift SamplesSwab and Tapelift Samples

Confirm visual observations.Confirm visual observations.

Others do not reveal elevated levels.Others do not reveal elevated levels.

General agreement among consultants.General agreement among consultants.

Air Sampling SummaryAir Sampling Summary2 locations in each room.2 locations in each room.

Viable and non-viable samples.Viable and non-viable samples.

Variety of rooms other than 7 & 4.Variety of rooms other than 7 & 4.

4 outdoor control controls.4 outdoor control controls.

Results do not show elevations in 4 or 7.Results do not show elevations in 4 or 7.– Generally lower than outdoors.Generally lower than outdoors.

– No different than other rooms.No different than other rooms.

General agreement among consultants.General agreement among consultants.

Microvacuum ResultsMicrovacuum Results

Consultant #1Consultant #1– cfu/100cm2cfu/100cm2

– 8 samples from room 7.8 samples from room 7.


Consultant #2Consultant #2– cfu/gcfu/g



Carpet Dust StudiesCarpet Dust Studies

Chao, et al (Harvard Study)Chao, et al (Harvard Study)– Mycopathologia 154:93-106, 2001Mycopathologia 154:93-106, 2001

Randomly selected office buildings.Randomly selected office buildings.

Most strongly correlated w/ age of carpet:Most strongly correlated w/ age of carpet:– YeastYeast

– CoelomycetesCoelomycetes

– AureobasidiumAureobasidium

– Non-sporulatingNon-sporulating


Chew, et alChew, et al– Allergy 58:13-20, 2003Allergy 58:13-20, 2003

Randomly selected homes.Randomly selected homes.

Most common:Most common:– Non-sporulating, Penicillium, YeastNon-sporulating, Penicillium, Yeast

More prevalent in dust than air:More prevalent in dust than air:– Yeast, Eurotium, A. versicolorYeast, Eurotium, A. versicolor


Horner, et al.Horner, et al.– Applied & Environmental Microbiology Applied & Environmental Microbiology

70:6394-6400, 200470:6394-6400, 2004

Non-problem homes.Non-problem homes.

Most common:Most common:– CladosporiumCladosporium

– YeastYeast

– PenicilliumPenicillium


Hicks, et al.Hicks, et al.– JOEH 2:481-492, 2005JOEH 2:481-492, 2005

Non-problem homes.Non-problem homes.

Most common, high traffic:Most common, high traffic:– Cladosporium, Yeast, Penicillium, Cladosporium, Yeast, Penicillium,

AureobasidiumAureobasidium

Most common, low traffic:Most common, low traffic:– Cladosporium, Penicillium, YeastCladosporium, Penicillium, Yeast

Consultant #1 Microvac Sample Results By Room - High Traffic Locations

0

100

200

300

400

500

600

700

800

900

1000

Co

lony F

orm

ing U

nit

s P

er

100 c

m2 (C

FU

/100cm

2)

Room 7 Entry

Room 4 Entry

Series3

Consultant #1 Microvac Sample Results By Room - Medium Traffic Locations

0

100

200

300

400

500

600

700

800

900

1000

Altern

aria

A. syd

owii

A. ver

sicolo

r

Aureo

basid

ium

Clados

poriu

m

Epicoc

cum

Ocelom

yces

Rhodo

toru

la

Uloclad

ium

Yeast

Co

lon

y F

orm

ing

Un

its

Pe

r 1

00

cm

2 (

CF

U/1

00

cm

2)

Room 7 Desks

Room 4 Desks

Series3

Consultant #1 Microvac Sample Results By Room - Low Traffic Locations

0

100

200

300

400

500

600

700

800

900

1000

Altern

aria

A. syd

owii

A. ver

sicolo

r

Aureo

basid

ium

Clados

poriu

m

Epicoc

cum

Ocelom

yces

Rhodo

toru

la

Uloclad

ium

Yeast

Co

lon

y F

orm

ing

Un

its

Pe

r 1

00

cm

2 (

CF

U/1

00

cm

2)

Room 7 Corner

Room 7 E Wall

Room 4 N wall

Series4

Consultant #2 Microvac Sample Results By Room - High Traffic Locations

0

50,000

100,000

150,000

200,000

250,000

300,000

Aureobasidium Cladosporium Fusarium Penicillium Phoma Yeast

Co

lon

y F

orm

ing

Un

its

Pe

r G

ram

(C

FU

/g)

Room 4 N. Entry

Room 4 S. Entry

Room 6 Entry

Room 7 Entry

Series5

Consultant #2 Microvac Sample Results By Room - Medium Traffic Locations

0

50,000

100,000

150,000

200,000

250,000

300,000


Co

lon

y F

orm

ing

Un

its

Pe

r G

ram

(C

FU

/g)

Room 6 Center

Room 7 Center

Room 8 Center A

Room 8 Center B

Series5

Consultant #2 Microvac Sample Results By Room - Low Traffic Locations

0

50,000

100,000

150,000

200,000

250,000

300,000


Co

lon

y F

orm

ing

Un

its

Pe

r G

ram

(C

FU

/g)

Room 4 Rear

Room 6 Rear

Room 7 Rear

Room 8 Rear

Room 8 Corner

Series6

The PositionsThe Positions

Plaintiff focused on the presence of Plaintiff focused on the presence of elevated levels of yeast with moisture elevated levels of yeast with moisture under the building as the cause.under the building as the cause.

Defense found results to be typical of Defense found results to be typical of carpets and foot traffic patterns. Focused carpets and foot traffic patterns. Focused on moist grass outside of classrooms and on moist grass outside of classrooms and lack of differences in sampling results lack of differences in sampling results between the two types of construction.between the two types of construction.

The OutcomeThe Outcome

It settled before trial (of course).It settled before trial (of course).

Both sides equally unhappy (supposedly).Both sides equally unhappy (supposedly).

Interpretation of Mvac ResultsInterpretation of Mvac Results

Quantitative….less valuableQuantitative….less valuable– Extremely variable. Highly dependent upon Extremely variable. Highly dependent upon

how sample is collected.how sample is collected.

– Commonly used numerical values (i.e., 100K Commonly used numerical values (i.e., 100K cfu/g) not very reliable.cfu/g) not very reliable.

– Focus on comparative samples.Focus on comparative samples.

Interpretation of Mvac ResultsInterpretation of Mvac Results

Qualitative….more valuableQualitative….more valuable– Compare to genera/species commonly found Compare to genera/species commonly found

in non-problem buildings.in non-problem buildings.

– Compare to known growth reservoirs.Compare to known growth reservoirs.

Visual….most valuableVisual….most valuable– If there is mold exposure, show me the mold.If there is mold exposure, show me the mold.


Mold is Gold?Mold is Gold?

Investigative Approach:Investigative Approach:

Specificity of Repair Recommendations:Specificity of Repair Recommendations:– ““Remove Remove ???? inches beyond inches beyond affectedaffected materials.” materials.”– Methods…containment, PPE, etc.Methods…containment, PPE, etc.– DT protocols.DT protocols.

X

CONSTRUCTION MOLD SAMPLING


Linkages to Causal FactorsLinkages to Causal Factors

Linkages to Health EffectsLinkages to Health Effects

Reasonable Degree of Scientific CertaintyReasonable Degree of Scientific Certainty

SOURCE PATHWAY EXPOSURE HEALTH EFFECTS

100% = “YES” “MAYBE” 0% = “NO”


What Does the Future Hold?What Does the Future Hold?

– ““Damp Indoor Spaces & Health”Damp Indoor Spaces & Health”

fungal spores? materials? mycotoxins? mVOCs?fungal spores? materials? mycotoxins? mVOCs?

bacteria?bacteria?

dust mites?dust mites?

allergens?allergens?

moisture?moisture?

sick people with lawyers?sick people with lawyers?

PCR:PCR:A Better Mousetrap?A Better Mousetrap?

Mold Sampling MethodsMold Sampling Methods

Total airborne spores – “nonviable”Total airborne spores – “nonviable”

Viable airborne spores – “culturable”Viable airborne spores – “culturable”

Airborne mold spore equivalents – genetic Airborne mold spore equivalents – genetic material – PCR methodmaterial – PCR method

Nonviable Spore CountingNonviable Spore Counting

Limited ID at genus level onlyLimited ID at genus level only– Genera groupings become surrogates for Genera groupings become surrogates for

individual species.individual species.– May be comparing apples to oranges…May be comparing apples to oranges…

missing differences between species.missing differences between species.

Short sampling times.Short sampling times.

Fast TAT (hours to days).Fast TAT (hours to days).

Relatively inexpensive.Relatively inexpensive.

Viable CulturingViable Culturing

Can provide identification to the species level, but is Can provide identification to the species level, but is frequently too expensive and time consuming.frequently too expensive and time consuming.Viable mold spores only, misses non-viable spores. Viable mold spores only, misses non-viable spores. Furthermore, “viable” may not be “culturable”.Furthermore, “viable” may not be “culturable”.Short sampling time.Short sampling time.Long turn-around time.Long turn-around time.Can be quite expensive to get species.Can be quite expensive to get species.

““Viable” may not be “culturable”Viable” may not be “culturable”

Long TATLong TAT

PCR AnalysisPCR Analysis24-hour speciation of viable and non-viable 24-hour speciation of viable and non-viable spores.spores.

Instrument-based method with less subjectivity Instrument-based method with less subjectivity and more conducive to quality assurance and more conducive to quality assurance procedures.procedures.

Sampling time constraints lifted, allowing for Sampling time constraints lifted, allowing for longer duration samples (e.g., 8-hour).longer duration samples (e.g., 8-hour).

Must target a species or panel for analysis.Must target a species or panel for analysis.

Optical microscopy and molecular genetics Optical microscopy and molecular genetics differ taxonomically.differ taxonomically.

Spore Traps CulturesPCR

Mold Analysis MethodsMold Analysis Methods

Putting PCR to UsePutting PCR to Use

Characterize SourcesCharacterize Sources– Non-viable assessment to ID key genera.Non-viable assessment to ID key genera.

– Collect a representative dust/bulk sample.Collect a representative dust/bulk sample.

Non-viable methods to begin focusing panel. Non-viable methods to begin focusing panel. PCR analysis of source sample to see what PCR analysis of source sample to see what responds.responds.

Selection of “indicator” species.Selection of “indicator” species.

Targeted analysis of long-term air samples.Targeted analysis of long-term air samples.

Lessons from the Past: PCMLessons from the Past: PCM

Surrogate MethodSurrogate Method (PCM): counts relatively (PCM): counts relatively large airborne fibers instead of airborne large airborne fibers instead of airborne asbestos fibers, which are often too short and/or asbestos fibers, which are often too short and/or too thin ever to be counted by PCMtoo thin ever to be counted by PCM

Surrogate StandardSurrogate Standard (PCM): Clearance at levels (PCM): Clearance at levels below 0.01 f/cc by PCM. Nearly assured not to below 0.01 f/cc by PCM. Nearly assured not to have actually assessed airborne asbestoshave actually assessed airborne asbestos

Lessons from the Past: TEMLessons from the Past: TEM

““The The TEMTEM method gives the most complete method gives the most complete information on airborne asbestos: it can information on airborne asbestos: it can distinguish asbestos from other fibers and also is distinguish asbestos from other fibers and also is

able to detect very thin fibers. able to detect very thin fibers. However, it However, it is expensive and time-consumingis expensive and time-consuming. .

TEMTEM is not readily available.” is not readily available.” – The EPA Purple Book, – The EPA Purple Book,

19851985

PCR: Looking AheadPCR: Looking AheadBack to IH BasicsBack to IH Basics

8-hour TWA sampling8-hour TWA sampling

reproducibilityreproducibility

personal air samplingpersonal air sampling

Changing the “No TLV for Mold” ParadigmChanging the “No TLV for Mold” Paradigmpersonal air sampling occupational exposurespersonal air sampling occupational exposures

epidemiology and linkage to health outcomesepidemiology and linkage to health outcomes

movement away from I/O comparisonsmovement away from I/O comparisons

Better Defined Standard of PracticeBetter Defined Standard of Practiceseparating the IH from the overnight mold expertseparating the IH from the overnight mold expert

Thank You!Thank You!www.forensica.comwww.forensica.com

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