After I got the washcloths back, I performed a preliminary test—not the official, double-blind one to come—to convince myself that the Berkeley washcloths were indeed detectably contaminated and that the Santa Fe washcloths were okay. Standing next to the shower, naked and ready to quickly rinse off, I held one of the Santa Fe washcloths to my nose first. No problem.
Then I breathed through a Berkeley washcloth. At first I thought, Damn, it didn’t work. This doesn’t bother me at all! But after about 10 seconds, I felt a sensation like someone toying with a dimmer switch on my consciousness. After another five seconds, the contamination slammed through my nervous system, scrambling the wiring inside my body so that the only signal it seemed capable of carrying was pain.
I threw the washcloth away from me and tried to get into the shower, but I couldn’t even get over the rim of the tub. John helped me, and the water, as always, restored order.
The next day, we ran the experiment itself. My friend, Ondrej, a PhD physicist, manned the washcloths. Sitting alone at a table on the patio of my house, he flipped a coin, and if it came up heads, he chose a Berkeley washcloth; if tails, he chose a Santa Fe one. (That was the randomized part.) He then called John out and handed the selected washcloth to him. John carried the washcloth to me in the bathroom. (This was the “double-blind” part—neither I nor John knew whether the washcloth was from Santa Fe or Berkeley.)
Next, I held the washcloth to my nose until I made my determination. If I declared the washcloth contaminated, I showered before the next one. John took the washcloth back to Ondrej, washed his hands, and got the next randomly chosen washcloth.
We performed the same procedure on a friend who wasn’t a moldie, as an extra control. After all, if the Berkeley washcloths simply smelled musty, my detecting them wouldn’t be so impressive.
When John handed me the first washcloth, I had to steel myself. I felt like I was about to punch myself in the face—or worse, completely embarrass myself by showing that I couldn’t distinguish the contaminated washcloths from the uncontaminated ones.
Bam! Within seconds, the strength seemed to pour out of my body into a puddle on the floor. I whimpered and let the washcloth fall. John helped me stagger into the shower, and the strength poured back into me.
John brought me the next washcloth. It was fine. The next one too, and the one after that.
Bam! The fifth one slammed into me. Again, the strength poured out of me, and again, the shower poured it back in.
By the eighth washcloth, a contaminated one, the reaction was notably stronger, my body curling, my nerves screaming. John struggled to get me into the shower because I couldn’t lift my legs over the edge of the tub even with him supporting my torso. After that, I realized I was making this harder on myself than I had to, and I stayed inside the tub for the rest of the experiment.
The violence of my reaction to the 12th washcloth frightened me. How much of this can my body take? I wasn’t recovering fully between the washcloths, and the image came to mind that I might go into convulsions. By then I’d determined that six washcloths were contaminated and six weren’t. Fuck this, I decided. I’ve obviously proven my point, so I don’t need to torture myself further in the name of science. My reactions were so clear that there’s no way could I have made a mistake. I stopped.
Afterward, Ondrej reported the results: I had gotten 10 out of 12 correct, with one false positive and one false negative. My non-moldie friend, on the other hand, had done worse than chance and reported that he had absolutely no idea—the washcloths all seemed identical to him.
How on earth did I get any wrong? Truly assessing what the results meant would require doing some statistics, but immediately, all I could think about was whether a Santa Fe washcloth and a Berkeley washcloth could have gotten switched, or if the Santa Fe washcloth I declared bad somehow got contaminated despite our precautions, or if I had rushed when I called the Berkeley one okay. I started scheming about repeating the experiment to get more data and to see if I could figure out what happened with my mistakes.
But I spent the next day in a miserable miasma, and it took several days before I felt fully myself. The idea of inflicting that on myself again—ugh.
And when I recovered and did the calculations, the results looked pretty good. If I’d just been guessing, with no ability to detect contamination at all, I would have had less than a two percent chance of doing as well as I did. In statistical terms, my experiment had a p-value of 0.019. The threshold for a result to be considered “statistically significant” (and hence publishable) was far looser, a p-value of less than 0.05.
Woohoo! I could publish this! Scientific proof!
Well, not really. I knew that my little experiment couldn’t really prove anything—all it could show was that I was unlikely to do as well as I did if I couldn’t detect the contaminated washcloths at all. That suggested, but didn’t prove, that I had my moldie superpower.
Additionally, this was what a scientist would call an “n of 2” experiment—there were only two subjects, me and my non-moldie friend. At most, its conclusions applied only to the two of us. It couldn’t be generalized to say that other moldies truly detected mold, or that non-moldies couldn’t.
Later, I asked statistician Philip Stark of the University of California, Berkeley to review my experiment. He declared it “pretty convincing” but pointed out that changing my study design by shortening the number of trials was a flaw that weakened the experiment a bit. My mind agreed; my body didn’t care. I decided I’d sacrificed myself for science quite enough, and I left it at that.
My personal washcloth trial made me feel like I was on more scientifically solid ground, but it still left a zillion questions about what the hell was going on in my body. Surely someone has studied this! So over the next few years, I pored through the scientific literature and history about mold.
Even in Biblical times, I learned, people knew mold could be dangerous. The Old Testament gave explicit instructions for decontaminating a house with “defiling mold,” and ordered that if the technique didn’t work, the house “must be torn down—its stones, timbers and all the plaster—and taken out of the town to an unclean place.”
And for centuries, scientists and doctors had also recognized that mold can cause illness. The very first textbook on asthma, in 1698, described how asthma could be triggered by visiting a moldy wine cellar. In the 1930s, mold got some of its first serious scientific attention after horses in the Ukraine started getting swollen lips, massive bruises, fevers, blindness, and tremors. Many of the horses died, and people who handled straw from the horses developed similar symptoms. Scientists traced the problem to a mold called Stachybotrys chartarum that had infested the straw.
This problem turned out to go far beyond the Ukraine: Moldy food was found to frequently make all manner of farm animals vomit, convulse, hemorrhage, become paralyzed, or die. In 2003, mold-related losses in agriculture totaled $1.4 billion per year.
These big losses had generated big money for science to understand the problem. As a result, most studies on health impacts of mold had focused on mold in food, not in the air. Scientists had traced the many ways ingested mold toxins poison the immune and nervous systems, cause inflammation, and damage cells.
The toxins are all part of mold’s arsenal for defeating its microbial enemies: Since mold can’t clunk other microbes on the head or run away from them, it instead engages in chemical warfare, oozing out nasty compounds that will poison bacteria or other fungi. Humans are just collateral damage in this nanoscale war. (And also, sometimes, we are beneficiaries of it. Penicillin, for example, is a mold toxin that doesn’t poison us but whacks bacteria inside us.)
Mycotoxins are such good weapons for chemical warfare that humans may have used them in our own wars. The US Department of State has accused the Soviet Union of using mycotoxins as weapons in the 1970s in Laos, Cambodia, and Afghanistan, resulting in skin blistering, eye irritation, and then death within minute
s. The United States itself studied the possibility of using mycotoxins as weapons. And Iraq stockpiled 2,200 liters of a mycotoxin in the late 1980s.
So there’s no question that some mycotoxins are nasty substances indeed. But that isn’t enough to establish that mycotoxins from moldy buildings can make people sick. A big question remains: Can we absorb enough of them from the air in water-damaged buildings to hurt us?
The possibility didn’t receive serious scientific attention until the mid-1980s, not long after builders started more thoroughly sealing and insulating homes and office buildings in response to the energy crisis. Public health officials began getting reports of office buildings in which large percentages of workers complained they felt sick in their workplaces—and felt better when they left.
Scientists investigated, and they realized that the buildings had dangerous levels of toxins in their indoor air. Chemicals were leaking out of building supplies, outdoor pollution was accumulating in dust, mold was chomping through damp drywall and flinging its spores into the air—and with the buildings sealed up so tightly, all these nasties built up in the indoor air over time. Scientists patiently put together the clues and saw a clear signal that mold could cause or exacerbate serious allergies and asthma.
This was all part of the orderly, calm process of science—until the mid-1990s. Dorr Dearborn, a pediatric pulmonologist in Cleveland, Ohio, treated a string of babies with bleeding lungs in 1993. The condition is ordinarily very rare: Dearborn had seen only three cases in the previous 10 years. But within a year and a half, 10 cases came to his clinic, and three of the babies died. Some recovered in the hospital, only to relapse after they went home. All the babies were from a single, low-income area of Cleveland that had been flooded.
As the cases piled up, Dearborn grew alarmed and contacted the CDC. Ruth Etzel, the branch chief of air pollution and respiratory health, came to investigate. Together, Dearborn and Etzel compared the sick babies with healthy ones to examine possible explanations: Could the babies have been exposed to pesticides intended to treat cockroaches? Perhaps they were breathed fumes from crack cocaine, second hand? Cigarettes? Child abuse? None of these possibilities seemed like plausible explanations, but one thing stood out: All the babies lived in extremely moldy homes. The homes were contaminated with Stachybotrys chartarum, the particularly nasty strain of mold that had killed the Soviet horses long ago. Spore levels of Stachybotrys were 3,000 times higher in the homes of the sick babies than the healthy ones.
The media, naturally, freaked out. One AP headline read “Baby-Killing Fungus.” An article in the Plain Dealer newspaper claimed that health officials were “99 percent certain” that Stachybotrys had killed the babies (though Dearborn and Etzel never made such a claim, only saying there was an association between the illness and the mold).
In 1999, even as Dearborn and Etzel were continuing to investigate the cases that kept appearing in Dearborn’s clinic—close to 30 in seven years—the CDC launched a second investigation by an anonymous panel. It reported that Dearborn and Etzel’s work had “serious shortcomings,” criticized the methods of the CDC’s own statisticians, and concluded that “the postulated associations should be considered, at best, not proven.”
The CDC’s decision to undermine its own ongoing investigation struck many as quite unusual, even bizarre. Nicholas Money, a highly regarded mycologist at Miami University, reviewed the controversy in his book Carpet Monsters and Killer Spores: A Natural History of Toxic Mold. Although Money agreed that Dearborn and Etzel’s study had some shortcomings, he argued that most of the criticisms in the reevaluation were baseless. Money concluded, “I don’t know if Stachybotrys is guilty of killing babies, but I think its presence in the homes of IPH [lung bleeding] patients is more than pure coincidence.”
The Cleveland bleeding lung case alerted the world that mold could pose serious dangers, and lawyers perked up their ears.
In 2001, a court awarded a Texas homeowner, Melinda Ballard, $32 million for the cost of her mold-damaged 12,000-square foot mansion and the belongings inside, including punitive damages, emotional distress, and lawyers’ fees. Ballard was an irresistible subject of news coverage: a Jaguar-driving, photogenic, loud-mouthed New Yorker-turned-Texan who described the deterioration of her house and family in frightening detail. The insurance company perfectly fit the villain’s role with its refusal to pay for repairs, and the images of the mold in her house were viscerally revolting: The New York Times described it as “thick and black and gangrenous, with a dull, powdery sheen that makes it seem waiting and alive. Just looking at it makes you want to throw up.”
On appeal, the judgment was reduced to $4 million, and then the parties settled for an undisclosed sum. The judge rejected arguments that Ballard’s husband had suffered brain damage from the mold exposure on the grounds that science couldn’t prove the link.
Nevertheless, the case marked the beginning of the Mold Wars. According to a buzz phrase at the time, “mold was gold.” Insurance claims skyrocketed. The television celebrity Ed McMahon won $7.2 million from his insurance company, claiming that mold had spread through his Beverly Hills home, sickening both him and his wife and killing their dog, Muffin. Erin Brockovitch, the environmental toxicity activist, sued her contractor for more than $1 million over her moldy home. Mold litigation became a legal specialty, with one lawyer handling 1,000 cases, according to the New York Times. In 1999, before the Ballard verdict, Farmers Insurance handled only 12 cases in Texas. In 2001, it handled 15,000. Expert witnesses could sometimes charge $1,000 an hour, arguing that science did or did not support litigants’ claims.
The insurance industry was reeling from the asbestos disaster, which industry analysts projected could cost $275 billion, and it feared that mold could be a second calamity. So it acted fast to protect itself. Companies added riders to essentially every insurance policy refusing to cover mold. They also lobbied to pass legislation in many areas protecting industry from mold claims.
The insurance companies also gained a huge legal tool from an official statement by the American College of Occupational and Environmental Medicine (ACOEM), a professional organization of nearly 5,000 doctors and other health care professionals. “Molds growing indoors are believed by some to cause building-related symptoms,” the statement said. “Despite voluminous literature on the subject, the causal association remains weak and unproven.” This proved invaluable to insurance companies in subsequent litigation.
The statement acknowledged that mold was involved for some people with allergies or asthma, but granted it only “an important but minor overall role.” It conceded that it was a good idea to remove mold in buildings, but only because it was ugly, smelly, and damaging to building materials, along with being allergenic to those susceptible.
The three authors of the ACOEM statement were all physicians who had earned money as expert witnesses for insurance companies defending themselves in mold cases, none of whom had significant experience in indoor air-quality research. Two of them, Bryan Hardin and Bruce Kelman, worked for GlobalTox, Inc., a firm that regularly testified for the defense in mold cases. Kelman was a seasoned player in the toxin-denialism drama, having participated in the organized effort to sow doubt that cigarettes cause health problems. The third author, Andrew Saxon, went on to earn more than a million dollars over three years as a private expert witness in mold-related trials.
Even before the statement was published, scientists objected. They argued that the statement was at odds with the science of the time, which had found strong links with allergies and asthma and identified the allergens, irritants, and toxins that can inflame our lungs. And asthma was no small matter—it could be deadly, and its rates were dramatically rising without explanation. Several ACOEM members called the statement “a defense argument” to protect insurance companies in mold litigation, rather than a dispassionate scientific evaluation. Some pointed out that the authors’ conflicts of interest weren’t disclosed and needed to be.<
br />
Nevertheless, ACOEM published the statement with few revisions and without a disclosure of conflict of interest.
The statement immediately became a tool for the insurance industry in litigation. Within months of its publication, the US Chamber of Commerce, the largest business advocacy group in the United States, sent an adapted version of the statement to judges around the country. “The notion that ‘toxic mold’ is an insidious, secret ‘killer,’ as so many media reports and trial lawyers would claim,” it argued, “is ‘junk science’ unsupported by actual scientific study.”
One of the authors of the ACOEM statement, Saxon, went on to coauthor a similar report in 2006 for the American Academy of Allergy, Asthma, and Immunology (AAAAI), an association of more than 6,000 allergists and immunologists. He bolstered the credibility of the new report by adding an author with a strong reputation in indoor air-quality research—Jay Portnoy, chief of allergy, asthma and immunology at the Children’s Mercy Hospital in Kansas City. But Portnoy never approved the paper for publication. He discovered only after the paper was in print that his coauthors dramatically weakened his section of the article so that it denied the evidence that mold causes even hay fever. When he read the revision, he was so incensed that he asked to have his name removed.
Other scientists continued to work to get the statements retracted, and in 2007, the Wall Street Journal published an exposé revealing the insurance industry’s influence on these statements. But such rebuttals had little apparent effect. ACOEM reissued its statement with only minor changes in 2011—even though by then, studies had shown that more than 20 percent of asthma cases were attributable to water-damaged buildings.
When I realized that special interests were powerful enough to override science in official statements from professional organizations, I saw the CDC’s reversal on the Cleveland bleeding lung cases in a different light. In an argument I found persuasive, Nicholas Money, the mycologist and book author, speculated on the reasons the CDC might have chosen to take on a second, highly skeptical investigation:
Through the Shadowlands Page 26
