“Does mold make you sick?”

[You might think "well, duh" after reading the title, but keep in mind that this is the popular press. And at least a genetic connection has been made. Quote from a doctor:  "This is almost certainly a genetic issue."]

Does mold make you sick? Doctors seek answers

By Maggie Fox, Health and Science Editor

http://www.reuters.com/article/healthNews/idUSTRE49R7A720081028

Tue Oct 28, 2:40 pm ET

WASHINGTON (Reuters) – Fungus expert Joan Bennett did not believe in so-called toxic mold — the cause of “sick building syndrome” and many lawsuits — until her New Orleans home was flooded during Hurricane Katrina in 2005.

When she got a whiff of the foul air that the black goo had created in her home, she decided to change her research focus and try to find out how and if the fungi that took over most of the flooded homes on the Gulf Coast might make people ill.

“The overwhelming obnoxiousness of the odor and of the enveloping air made me start to believe in something that I had never believed in before — sick building syndrome,” Bennett, of Rutgers University in New Jersey, told a news conference.

But it has been more difficult than she thought.

Bennett believes that molds could potentially cause illness in certain susceptible people via volatile organic compounds — gassy versions of chemicals produced as the organisms metabolize food.

She has been unable to show this in the lab so far. But she told a joint meeting of the American Society for Microbiology and the Infectious Diseases Society of America.

She has tested various molds on the laboratory roundworm C. elegans. “Sometimes the worm swims away and sometimes the worm does nothing and sometimes the worm eats the fungus,” Bennett said.

“I am actually looking for something that has never been discovered by methods that have never been worked out.”

Yet hundreds of lawsuits have been filed — and some won — by people claiming mold in their homes or workplaces has made them ill.

Dr. David Denning of the University of Manchester in Britain said it is plausible that molds and fungi would emit volatile organic compounds.

GENETIC SENSITIVITY

If these can be found, they could form the basis of diagnosing fungal illness as well — perhaps using a breath test. People with fungal infections of the lungs, such as aspergillosis, would release these chemicals when they breathed.

“A certain group of severe asthmatics — about a million people — are sensitive to a number of different fungi,” Denning told the news conference. These include Aspergillis and Candida.

“This is almost certainly a genetic issue,” he added. “If you have (a) predisposition (to asthma), you probably have an additional predisposition to fungal sensitization.”

Dr. David Goldman, a pediatrician in the Bronx, New York, said asthma rates in his borough are disproportionately high, and he blames in part Cryptococcus neoformins, a microbe found in pigeon droppings that causes disease in immune-compromised people.

“We believe this fungus contributes to asthma by modulating the immune response,” Goldman told the news conference.

Both Goldman and Denning said treating patients with antifungal drugs such as itraconozole and fluconazole helped relieve the symptoms of patients with severe asthma. This supports evidence that fungi are contributing to symptoms.

All three experts agreed it would likely take a combination of factors — including a person genetically susceptible to molds and unusual fungal activity — to cause any disease.

“It is probably a relatively temporary disease, not a life-threatening disease,” Denning said.

“As we sit here we are probably breathing in hundreds of spores,” Bennett added. “Usually we only get sick if our immune systems are compromised or if we have this genetic susceptibility to allergy.”

(Reporting by Maggie Fox; Editing by Julie Steenhuysen and Philip Barbara)

‘Reasonable’ accommodations?

Quote: “You don’t become disabled because of your illness. You become disabled because of poverty. You lose everything to this disease.”

‘Reasonable’ accommodations?
Palo Alto woman, housing corporation battle over disability, responsibility

Friday, May 9, 2008
http://www.paloaltoonline.com/news/show_story.php?id=7981

by Sue Dremann
Palo Alto Weekly Staff

A disabled woman is being evicted from her apartment by the Palo Alto Housing Corporation after 15 years of battling over what constitutes “reasonable accommodation” for her disability.

Beth Bradach, 53, has three conditions — chronic fatigue and immune dysfunction (CFIDS) myalgic encephalomyelitis (ME), and combined immune deficiency — that cause her to become ill when exposed to tiny amounts of chemicals.

Everything from molds to pesticides to laundry soap make Bradach’s throat close down and could lead to lung infections, diarrhea and sores, she said. Her caregivers must wash their clothes and themselves in water free of detergents before visiting her.

But years of accommodating her disability have created an unreasonable administrative and financial burden on the Housing Corporation, which provides affordable rental and ownership housing, according to its staff.

They have put in natural-fiber rugs without toxic glues in adjacent apartments and used paints low in volatile organic compounds when refurbishing other units at the Plum Tree Apartments on Emerson Street, they said. When they needed to spray for pesticides, they found a place for Bradach to move to until the work was completed. And they have refrained from renting out units adjacent to Bradach’s for the past two years.

But adjusting to her needs has created an unreasonable accommodation to other tenants, staff now say, and it is time for Bradach to move out.

The controversy illustrates the difficult dilemma individuals with chemical sensitivities, such as Bradach, have in getting housing — and housing providers have in accommodating them without creating significant hardship for themselves and their other tenants.

The dividing line between what is “reasonable” and what is not is not that easy to define, according to experts.

Reasonable accommodation law was created to give people with disabilities equal access to employment and housing. But there are limits, the experts say.

In general, reasonable accommodation is defined as any changes in rules, policies, practices or services that may be necessary to afford a person with a disability an equal opportunity to use and enjoy a dwelling, according to Bill Branch, deputy director of communications for the California Department of Fair Employment and Housing.

“A request for accommodation made by a tenant with a disability is presumptively reasonable unless a housing provider can demonstrate that it would result in an undue administrative or financial burden. In that instance the law requires that the tenant and the landlord engage in an ‘interactive process’ in an attempt to arrive at a mutually acceptable conclusion,” he added.

But reasonable accommodation is decided on a case-by-case basis, according to Stanford Law School Professor Richard Thompson Ford.

“There are limits even when there is no doubt that a plaintiff needs accommodation. It’s not as if a landlord is required to spare no expense,” he said.

Advocates for people with CFIDS say that housing accommodations are among the hardest cases to resolve, according to Gail Kansky, president of the National CFIDS Foundation.

“We’ve encountered this over and over again,” she said.

Bradach alleges the housing corporation has repeatedly violated her legal rights, even though she notified staff of her disability when she moved in in 1992. When the apartments were sprayed for pesticides that year, Bradach developed ocular and rectal sores and her hair fell out two weeks afterward.

“I was in so much pain, I was just looking for a cold, dark place to hide,” she said.

In February 2002, a California Department of Fair Employment & Housing investigator concluded, and another investigator agreed, that housing corporation officials had violated her reasonable accommodation through inconsistent and vague notices or accounts of the substances to be used at the apartments.

Bradach proposed in 2005 that the housing group could dedicate the five units in her building to “green housing” for the chemically sensitive, similar to Ecology House in San Rafael.

But housing corporation officials said they don’t see their role as supporting such housing <0×2014> particularly since there are so many other tenants in need.

The final straw for the housing group involved building repair and termite control.

Staff wanted to spray orange oil and other chemicals they said a pest-control company deemed safe to eradicate the insects. But Bradach’s doctor, Randy S. Baker of Soquel, Calif., said the oil and other chemicals would not be safe alternatives for Bradach.

Bradach pushed for a super-heating method to eradicate the insects, but housing corporation officials said it is not effective and could risk setting the building on fire.

On May 1, the housing corporation sent Bradach a 90-day notice to vacate her apartment.

“We have tenants in need of housing, and we have an obligation to provide it. We’re risking the welfare of other tenants — we can’t let our building fall apart. We’ve exhausted our resources with trying to find her other housing,” Candice Gonzalez, the corporation’s executive director said. “We don’t know what else to do at this point.”

The group, which rents out 600 units, also claims it has lost $75,000 by not renting out the neighboring apartments.

Bradach says she has nowhere to go.

“They’ve always got me between a rock and a hard place,” Bradach said, her voice reedy and rattling on the phone. “I’m supposed to find my own place but most days I’m too sick to even get up off my couch.”

Ann Marquart, executive director of Project Sentinel, a Palo Alto fair-housing agency that has been trying to help Bradach, said the only viable solutions are to find a stand-alone unit that meets Bradach’s needs or to create a building for the chemically sensitive.

Kansky said her organization has a donor who has offered to pay the difference above reasonable costs to use “fully green” alternatives in the building’s renovations. She estimated the costs above the housing corporation’s share to be $5,000 to $8,000.

“The problem is she shouldn’t really have to get out. Yes, it’s difficult, but it isn’t insurmountable,” Kansky said.

The question of reasonable accommodation is almost a question in itself, according to Marquart.

“Do we have a question of reasonable accommodation if this is a person’s life?” she said.

Bradach recalled when she was a vibrant, contributing member of society with a degree in botanical taxonomy and a potential job at the Smithsonian Institution. Then, people didn’t find her annoying. On good days, she is a better advocate for others than she is for herself, she said. She has helped people with bipolar disorder get the treatment and benefits they need.

“It’s easier to get what you need if someone else is an advocate for you. People don’t want to hear it — and they don’t want to hear it from the person who’s asking for help for themselves. We’re shrill. People think you are crazy.

“I got sick with the disease, but the way I got disabled is that I lost all my money to this disease. You don’t become disabled because of your illness. You become disabled because of poverty. You lose everything to this disease,” she said.