Word on the Street    

EPA Gives HVAC Microbial Guidance to NADCA

Pandora's Box: Not So Long Ago, Not So Far Away

Architects Honored for Green Buildings 

The American Institute of Architects selected 10 examples of architectural and "green" design solutions that protect and enhance the environment. The projects address significant environmental challenges with designs that integrate architecture, technology and natural systems.

The top 10 projects make a positive contribution to their community, improve comfort for building occupants and reduce environmental impacts through strategies including reuse of existing structures, connection to transit systems, low-impact site development, energy and water conservation, use of "green" construction materials, and design that improves indoor air quality.

The AIA's Committee on the Environment represents more than 5,300 AIA members committed to making sustainable design integral to the practice of architecture. The sixth annual AIA/COTE Top 10 Green Projects initiative was developed in partnership with the U.S. Department of Energy and Environmental Building News magazine.

A five-member jury selected projects that cover a broad spectrum of project types. Facilities include both new construction and renovation of office, retail, residential, academic and institutional facilities. The jury was impressed by the range of building types and sizes among the applicants.

"The variety we saw was encouraging. The profession is clearly beginning to address sustainability in increasingly sophisticated and effective design solutions. Whether reducing greenhouse gas emissions to mitigate climate change, peak energy loads to lessen demand on the power grid, using stormwater on site to eliminate run-off, conserving building water, or preserving wetlands, these buildings also promise to enhance the level of comfort and amenity for the people who inhabit them. In future years, the jury recommends broadening the competition scope to include an additional open category of submissions such as research, best practices, urban design and land use studies, and educational resources."

The AIA's Top 10 green projects in 2003 and their architects were the Argonne Child Development Center in San Francisco, Calif. (450 Architects); the Center for Green Technology in Chicago (Farr Associates Architecture and Urban Design); Colorado Court in Santa Monica, Calif. (Pugh Scarpa Kodama); the Cusano Environmental Education Center in Philadelphia (Susan Maxman & Partners Ltd.); the Fisher Pavilion, Seattle (Miller/Hull Partnership LLP); the Herman Miller marketplace, Grand Rapids, Mich. (Integrated Architecture); the Hidden Villa hostel and summer camp in Los Altos Hills, Calif. (Arkin Tilt Architects, Albany, Calif.); San Mateo (Calif.) County sheriff's forensic laboratory and coroner's office, San Francisco (Hellmuth, Obata & Kassabaum); the Steinhude Sea recreation facility in Los Angeles (Randall Stout Architects); and the Wine Creek Road residence, Emeryville, Calif. (Siegel & Strain Architects).

The American Institute of Architects honored the top 10 projects twice during May. Hundreds gathered May 1 at the National Building Museum in Washington, D.C. A more warmly attended presentation took place May 9 at the institute's National Convention and Design Expo in San Diego.

Making the Business Case
Another attention-getting presentation having to do with green buildings across the country took place in Senate office on April 30, just one year and six days after Sen. James Jeffords (Ind-Vt.) in the same room challenged the U.S. Green Building Council to "make the business case for high-performance green buildings."

The USGBC followed through on its challenge, and Jeffords was there again to lend his support to the release of the council's 21-page booklet titled, "Building Momentum: National Trends and Prospects for High-Performance Green Buildings."
"The best sustainable designs are not just environmentally responsible; they also produce buildings where employees can thrive and productivity can soar," said USGBC President and CEO Christine Ervin. "We call these high-performance green buildings."

She added, "Thanks to federal programs such as ENERGY Star and the U.S. Green Building Council's voluntary LEED rating system - widely accepted as the national standard for green buildings - common benchmarks, support tools and opportunities are emerging to offer market differentiation for buildings that create higher private and public value."

According to the report, U.S. design, construction and operation of the more than 76 million residential and nearly 5 million commercial buildings accounts for 20 percent of the economy and more than 40 percent of energy consumption, pollution and waste.

"This report underscores the need to provide federal incentives and resources to promote the construction of high-performance green buildings," Jeffords commented at a press conference. "In this Congress, I'll be working to introduce bipartisan legislation to promote buildings that incorporate energy efficiency, waste reduction and other green design features."

Asked specifically about his goals for this legislation, Jeffords responded, "I intend to address legislation taking into account research, coordinating federal efforts and public outreach." He later added that he hopes to "establish a clearinghouse to promote public outreach and provide funding."

One comment from the senator took USGBC Board Chairman Jim Hartzfeld by surprise. Jeffords remarked that he hopes to become an active participant in having his own Vermont farm LEED certified. Hartzfeld recalled this comment a few times throughout the next hour, teasing that the congressman's property would become the first farm to be certified under the LEED program.

The USGBC report is based on an April 2002 roundtable convened by the Senate Public Works and Environment Committee. The roundtable brought together representatives from government, academia, the private sector and the non-profit community.

"Building Momentum" highlights components of green building in four categories:

• environmental - reduced impacts of natural resource consumption;
• economic - competitive first costs, reduced operating costs, optimization of life-cycle performance, increased building value, decreased building vacancy and increased tenant retention and reduced liability;
• health - enhanced occupant comfort and health; and
• productivity - improved occupant performance, reduced absenteeism and turnover and increased retail sales through daylighting.

The report also features a section on school environmental quality and its effect on children's health and learning.

A separate booklet outlines 10 points that make the business case for high-performance green buildings. To summarize, the 10 points are:

1. In the event up-front costs are higher for high-performance green buildings, they can be recovered.
2. Integrated design lowers ongoing operating costs.
3. Better buildings equate to better employee productivity.
4. New technologies enhance health and well being.
5. Healthier buildings can reduce liability.
6. Tenants' costs can be significantly reduced.
7. Property value will increase.
8. Many financial incentive programs are available.
9. Communities will notice your efforts.
10. Using best practices yields more predictable results.

Word on the Street

• Voices: "We gave up a very pleasant table [on an enclosed patio] for the convenience of those who couldn't wait until after dinner to light up cigarettes and blow smoke in our faces."
  -Montgomery County Md. Councilman George L. Leventhal on his family's dining experience at a restaurant in Washington, D.C.
      
• Heeeeeere's More Money: The combined amount of all settlements in Ed McMahon's mold case is about $7.23 million, reportedly the largest recovered sum in an individual's case alleging property damage due to mold. Court documents reveal the biggest chunk was $5.05 million, paid by American Equity Insurance Company and parent company Travelers Property Casualty.
  
  A March 4 hearing transcript listing the other settlements in the case states that Benchmark MPE Ltd. agreed to pay the plaintiffs $750,000; Alliance Environmental Group Inc. agreed to $500,000; Southern California Insurance Adjustors agreed to $250,000; Pacific Health & Safety Consulting Inc. also agreed to $250,000; and California Power Vac agreed to $3,000.
  
  The $230,000 settlement with Controlled Environmental Solutions, as reported last month, was one of the smaller financial agreements accepted on behalf of the former Tonight Show sidekick. In addition, the amount of McMahon's settlement with Monteleone Interiors Inc. was $200,000, according to Brian S. Kabateck in a May 9 article in the Los Angeles Times.
  
  McMahon and his wife filed their lawsuit in April 2002, claiming Stachybotrys chartarum thriving in their 8,000-square-foot mansion made them sick and killed their dog. At first, they sought $20 million from the defendants.
    
• Rethink the Link: Chalk one up for the tobacco industry: "The association between exposure to environmental tobacco smoke and coronary heart disease and lung cancer may be considerably weaker than generally believed," say the authors of a paper published in the British Medical Journal on May 16. The study, partially funded by the Tobacco Institute's Center for Indoor Air Research, came into question not only from the National Cancer Society, which has long endorsed considerable cancer-causing effects of direct secondhand smoke exposure from living in a household with a smoker, but also from the journal's parent company, the British Medical Association.
    
• Hilton Hawaiian Village: The Waikiki beach hotel that closed 453 guestrooms in a 24-story tower last year after mold was found in a guestroom is now taking some construction and design companies to court. The cost of cleanup at Hilton Hawaiian Village is estimated to be $56 million, which would include mold remediation and the removal and replacement of furniture. Hilton claims a number of "substantial factors" aggravated the mold problem, including faulty air conditioning and an inability to control the indoor humidity.
  
  Now, Hilton Hotels wants many of the parties involved in the construction and design of Kalia Tower to foot the bill. A lawsuit filed April 21 in Hawaii Circuit Court names architectural firm Wimberly Allison Tong & Goo, as well as 13 separate companies related to construction and some engineering consultants who all worked on the $95 construction project completed in 2001. Among the eight counts for which Hilton is suing are breach of contract, negligence, and breach of good faith and fair dealing.
  
  Only days after Hilton sued many of its contractors, a class action suit against the hotel reached the Hilton Hawaiian Village. A family from Florida claims the hotel made excuses about excess water in the guestroom where they stayed from July 6-23, 2002. Guestrooms at Kalia Tower were shut down on July 24. Jeff Moffett and his family maintain that during their stay, the hotel did not disclose knowledge about any mold in the guestroom. Their lawsuit points out a contention made by the hotel in its lawsuit against the contractors: that Managing Director Peter Schall became aware of the mold as early as June 7, 2002.
     
• Stinky Marriage: It used to be that perfume and scented candles meant a romantic evening at home. Not so for a chemically sensitive Florida man who claims his wife of three years was using an array of aromas to harm him. The Associated Press reported in May that allergies and exposure to chemicals at work made 46-year-old David Taylor chemically sensitive, but he says at home his wife "went around spraying" perfume, air fresheners, disinfectants and bug killers - even directly in his face. Lynda Taylor, 36, was arrested and charged with aggravated battery but maintains her innocence.
     
• Cleaning Up the Supply Chain: An article at Inside Supply Management's Web site of highlights the recent efforts of several states and municipalities that worked together to agree upon a single set of criteria for purchasing more environmentally preferable cleaning products. The article, written by Scot Case, of the Center for a New American Dream, and a link to the purchasing criteria can be found online at www.ism.ws/Pubs/ISMMag/040306.cfm. For more information, contact Case at (610) 373-7703 or Stephen Ashkin at (812) 332-7950.
    
• Correction: A portion of legal columnist Michael Bowdoin's May 2003 article "Watch Out for Claims on Using UV to Improve IAQ" was mistakenly omitted. The full text appears below:
  
  The Importance of Specific Language
  In making claims regarding the effectiveness of a product, a potentially responsible party must pay close attention to all "terms of art" utilized in the marketing and advertising process. It is extremely tempting to use highly technical "terms of art" to convey greater degrees of expertise, effectiveness or experience to a consumer. However, it seems that the longer and more technologically impressive a term, the more it is utilized either out of context or improperly.
  
  For example, numerous federal regulatory agencies have clearly defined the meaning of certain terms in the IAQ industry. The U.S. Environmental Protection Agency has utilized certain definitions in describing the effectiveness of antimicrobial agents. These biocides have been defined as chemical or physical agents capable of killing or inactivating groups of microorganisms. These specific microorganisms are listed in the EPA guidelines. The EPA guidelines further define such terms as "sanitizer," "disinfectant," "sterilant," "germicide," "bactericide," "fungicide" and "sporicide." Each of these terms takes into consideration the types of organisms destroyed or inactivated, the amount of the organism destroyed or inactivated and the time in which it took the specific antimicrobial agent to destroy or inactivate an organism.
  
  In addition to defining certain "terms of art," the EPA and other federal regulatory agencies have mandated certain requirements regarding directions for use of products, methods of usage, user requirements and labeling. I do not believe that UV lights should be governed by the same regulations that govern the use of biocides as outlined in the definitions above. However, I do insist that the "terms of art" utilized by manufacturers, distributors and installers of UV lights be both scientifically and legally precise. Proper usage of "terms of art" in advertising and marketing will provide a measure of consistency and uniformity in evaluating UV light effectiveness. Once the language is standardized, I believe a great step forward will be taken to insure that manufacturer claims line up with consumer expectations.

The U.S. Environmental Protection Agency has adopted and implemented a new process for labeling pesticide products, following "concerns regarding the possible use of sanitizer and/or disinfectant products to treat HVAC systems" due to confusion over the previous labeling system.

In a two-page letter addressed to the National Air Duct Cleaners Association, the director of the Office of Pesticides' Antimicrobials Division cautions against making "incorrect assumptions and about the status of EPA review and conclusions about [pesticides]."

"Products registered for use on hard, nonporous surfaces … may not specifically be registered for use in HVAC systems," Frank T. Sanders notes. "The agency may not have received and reviewed adequate data to fully evaluate risks to humans" for HVAC uses of sanitizers and disinfectants. He says this applies even to those labels specifically including HVAC systems as a possible use.

In future EPA registration of pesticide products, the agency would "conduct a risk assessment to support the HVAC systems use for all new submissions," while prior registrants with possibly misleading labels would eventually be held accountable, according to Sanders. "We intend to work with pesticide registrants to make certain that these labels clearly communicate the uses which EPA has or has not authorized," he states.

In the letter, Sanders references the following 15 guidelines for the use of antimicrobial products in HVAC systems. Prefacing the list, the Antimicrobials Division states: "The following are elements to consider in using antimicrobial products to treat microbial contamination in HVAC systems."

1. The product must be registered with EPA. Look for an identification statement on the label that says "EPA Registration Number XXXX-XX"
2. Clear description of what microbes the product is intended to control and what level of efficacy will be achieved. Most products will likely claim bacteriostatic/fungistatic (inhibition of bacteria/mold) properties. Efficacy testing methods/performance standards/data are lacking to support public health claims such as sanitization.
3. Distinctly separate set of label directions set apart from any other use directions grouped placed under a heading such as Air Ducts or HVAC Systems or similar designations.
4. Directions to inspect the HVAC system first. Reference/directions as to how you inspect an HVAC system.
5. Label statements and directions limiting use of the product on HVAC systems/duct work or other HVAC system components that are in sound mechanical condition only. References/directions to guidelines and standards for making the determination as to the mechanical condition of the HVAC system/component.
6. Guidance as to conditions that suggest the need for repairs or possible replacement of the system and/or components.
7. Requirement that the HVAC system and associated components be cleaned prior to application of the product.
8. Statement on the label advising that the product be used only in cases where visible microbial growth has been detected in the system and then only after removing that growth and identifying and correcting the conditions that led to that growth.
9. List of the HVAC system components that can be treated. If duct work is included then a list of the types of duct work such as bare metal ducts, flexible ducts, semi porous ducts with a descriptor and any other.
10. Use on lined duct work is likely not to be allowed due to efficacy concerns.
11. List and detailed description of application equipment, devices or other means of applying the product should be on the label.
12. Mixing instructions including dilution chart/table.
13. An application rate for each application method listed on the label that clearly describes how much area a gallon of product will treat.
14. Frequency of application needs to be addressed.
15. Reentry into treated rooms/buildings and drying time need to be addressed on a label.

John Parks Trowbridge
Medical Doctor
Life Celebrating Health
Houston, Texas

The world of Jules Verne, described 130 years ago in Around the World in 80 Days, was one where many died from infectious diseases. Tuberculosis, syphilis, pneumonia and gangrene claimed lives that are now saved by antibiotics and prevention. Railroads and steamships soon made the world small enough for outbreaks of "the Asian flu" to occur with infrequent regularity.

Thirty short years ago, modern transportation and commerce led to a dramatically changed situation. Sick Building Syndrome, legionella, AIDS and HIV infections, and the Ebola and West Nile viruses became sudden and serious topics. Within just the past three years, the "post-9/11" era threats of anthrax and other bioterrorism have joined with hotel and cruise ship "outbreaks" to narrow our perspectives on travel safety.

Now comes SARS, severe acute respiratory syndrome. Outbreaks of this emerging viral "pneumonia" in several countries appear traceable to exposures to fellow travelers with later spread within families, healthcare workers and other close contacts.

Thanks to modern jet travel, 80 hours is enough time for a business traveler to hold meetings on six continents and arrive innocently back home before symptoms appear. All that time, the traveler would have exposed hundreds of contacts, and they would have exposed other contacts.

The "game" most certainly has changed, and the stakes are potentially deadly. The exponential value of such contacts makes the amount of potential exposure immeasurable and challenging to contain. Hundreds of deaths thus far give testament to the seriousness with which we must prepare for unexpected outbreaks.

SARS seems both simple and complicated: simple in the sense of recognizing symptoms - fever (often high), headache, malaise, muscle aches, mild respiratory symptoms, then later development of a dry nonproductive cough, shortness of breath, and even lowered blood oxygen. The picture looks like a mild to severe "common cold" that dramatically worsens into a life-threatening pneumonia. At this writing, the death rate approaches 5 percent. Hundreds have died in a few short weeks, and no effective treatment has been found.

SARS is complicated in the sense of determining a cause, finding a cure and controlling outbreaks. The majority of patients have been adults aged 25-70 years who were previously healthy; few cases have been found in children under 16 years old. Typical incubation appears to be two to seven days, though periods up to 10 days have been suggested. Viral shedding (promoting infection of others) apparently can occur for 10-20 days or perhaps longer.

Where did SARS come from? The answer probably will be simple - but worrisome. SARS appears to be caused by a coronavirus, so named due to the "halo" or "crown-like" appearance around particles viewed by an electron microscope. The SARS agent, as genetically sequenced in April, is a novel coronavirus that has not previously been present in humans. This might be the first example of a coronavirus causing severe disease in humans. Did it arise as a recombination between a human coronavirus - which causes perhaps 50 percent of "common colds" - and an animal virus? Or is this an animal coronavirus now attacking humans? The answer isn't clear.

What is clear, though, is that developing countries have large human populations, often living in close contact with large animal populations used for food and farming. Unlike our "clean" society, many of these people endure marginal sanitation, rampant malnutrition and minimal access to medical care. Such large population reservoirs are fertile breeding grounds for mutation of bacteria and viruses, experienced commonly as "the Asian flu." Coronavirus infection is very common, occurs worldwide, and has a seasonal prevalence in winter.

First isolated from chickens in 1937, the (15 or so?) known coronaviruses infect man but also cattle, pigs, rodents, cats, dogs and birds. Coronaviruses have a single strand of RNA, the longest found in any RNA-type virus. Genetic sequencing has not yet provided any clues to designing a vaccine. Re-infections occur throughout life, so the prospects for effective immunization appear bleak. Opportunistic co-infections by other viruses might contribute to rapid and easy mutation of the coronavirus and to a higher death rate.

The implications for control of the SARS epidemic, to prevent a worldwide pandemic, are ominous. Coronaviruses in humans have been found to cause respiratory infections commonly (including SARS), enteric infections occasionally and even neurological syndromes (rarely). Investigators recently documented SARS viral particles in stool samples. The finding of fecal contamination strongly suggests that poor sanitation, hand-to-hand and hand-to-mouth contact, and even fomite transfer (spread of infection present on inanimate objects which do not support their growth, such as plumbing fixtures, towels, and toilets) must be monitored.

The well accepted vectors of airborne droplets (produced by coughing and sneezing), direct contact with secretions or droplets (nose, mouth, eyes and skin) and personal-environment fomite objects (bedrails and bedside furnishings, personal articles, plumbing fixtures, towels, bed linens and clothing) - as encountered with "the common cold" - have led to recommendations from the U. S. Centers for Disease Control for isolation infection control precautions and potential quarantine. Of special concern for compromised environments is the potential for spread onto surfaces and into airflows through lingering secretion-contaminated skin scales continuously disseminated with ordinary body movement.

A Hong Kong physician who hypothesized raised one novel consideration that street shoes might play a role of "virus-carrying vehicles." Shoe soles could become contaminated by patient secretion droplets (from sneezing or coughing) that have settled onto the floor of a sickroom or apartment. The next victim later innocently walks into his own apartment, unknowingly depositing coronavirus on his carpets or floors. Vacuum cleaners or fans could stir the particles, creating new indoor airborne transmission. Dr. Lee Chi Wei notes that Japan and Korea have been spared from SARS outbreaks. More than 90 percent of residents in Japan and Korea take off their street shoes before entering their apartments; those in Hong Kong, China, and Singapore do not. Detection of coronavirus in the feces of kittens in the quarantined Hong Kong apartments raises the specter that domestic pets (or commercial animals) might serve as non-symptomatic hosts, creating worldwide reservoirs of SARS that might never be eliminated.

The future is here now, and it might be more demanding than we ever anticipated. The old days' method of "splash-and-dash" decontamination of compromised indoor environments very likely will provide marginal protection to later occupants. Current recommendations suggest that a diluted household bleach solution (1:50 or perhaps 1:100) might assist with immediate local disinfection of a sickroom. And commonsense precautions for "common cold" exposures still make sense - adequate rest and nutrition, avoidance of smoking, frequent hand washing, good personal hygiene, covering nose and mouth when sneezing or coughing, separate utensils and towels, good indoor ventilation and avoidance of crowded places with poor ventilation. Wearing "surgical" masks or N95 masks might provide some obvious protection as well.

The questions for the indoor environmental quality professional, though, require a much greater attention to detail. If the primary exposure route is indeed airborne, what implications does this fact have for HVAC systems, not only filtration but also ductwork? Concerns repeatedly expressed by the U.S. Environmental Protection Agency regarding the limitations of, and long-term residual exposures to chemicals required for, HVAC disinfection could become paramount.

If airborne droplets settle onto and can spread from floors, walls, furnishings, light fixtures, and even window drapes, what implications does this fact have for remediation or disposal of furnishings before remediation of the actual room structure?

A foremost consideration in the investigation and remediation processes should be assurance of safety for the personnel involved in the effort. Next should be a review of what guidelines or standards are most appropriate for handling the apparently compromised environment - encompassing industry, medical, and regulatory concerns. Finally, a crisp delineation should be made on how "clearance" will be established and assured.

The challenge with SARS is the increased need for suitable protection from respiratory, fecal and contact (fomite) vectors. Airborne droplet-spread is easy to mentally visualize. Less apparent are the surfaces that become contaminated through contact with secretions (including stool-soiled skin and hands), propelled droplets, and deposited skin cells carrying secretions. Protection of inspection and remediation personnel might involve high-level isolation techniques from the outset. While use of a bio-suit and self-contained breathing apparatus might seem overly dramatic, remember that indoor environmental quality professionals will not be invited into areas that are "simple" to remediate - the risk of exposure to SARS in complex environments might be very real.

Discretion is essential, since the general population might react with hysterical misunderstanding if they witness the precautionary use of bio-protective gear during an investigation. The days of the casual investigation - short-sleeved shirt and a clipboard - are gone; solid safety protocols must be honored. The initial investigation needs to identify and quantify risk levels with confirmed or suspected biologicals, whether SARS or hepatitis or newly emerging infections, and the highest standards for avoiding cross-contamination are required. Non-intrusive custom-designed mobile vehicles can be utilized as portable decontamination units to maximize safety and minimize visibility to the public.

Difficulty in establishing "quarantine" for an area needing investigation and remediation can complicate the investigation when a high suspicion exists for biological contamination. With a timely and thorough investigation, and prompt development and approval of a professional scope of work, the remediation practices should be straightforward, even if they have to be performed behind shielding screens or walls. Normal pedestrian traffic and building operation parameters must be reviewed at the outset, since failure to account for these in the scope of work can create a quagmire with frustrating and unnecessary challenges. While prompt remediation is the goal, "rushing" to completion must never compromise the result.

Adequate containment might involve creation of several levels, much like layers in an onion, with "general" remediation of "outer" areas allowing for safe progressive creation of gradually more intensive levels of containment, resulting in the highest level at the areas of greatest presumed contamination. This multi-dimensional containment - with attention to critical barriers, layered negative-pressure areas, and sterilization of collateral equipment - will be key in any remediation attempt. Monitoring of remediation personnel should include supervisory insistence on "standard operating procedures" and the capability to clear them from containment in compliance with a custom-tailored medical directive prepared by a qualified physician.

Establishing clearance poses special issues with regard to coronavirus decontamination. At present, most recommendations are for adherence to hospital infection control manuals, such as would be used for hepatitis virus. We expect that further experience with the SARS agent will lead to specific standards that will give the highest degree of assurance to the community. Serological testing (detecting antibodies against the virus) and molecular testing (for virus genetic material) involve fluids from an infected patient. As yet, no "swabs" from an environmental object (floor, fixture, duct) or air-sample plates or filters can detect viral presence. Airborne human coronavirus particles appear to survive dramatically longer in lower temperature/higher relative humidity conditions. Demonstration of this fact raises several remediation issues, particularly if decontamination of the HVAC system seems advisable.

Expeditious installation of adequate containment might be mandated in a scenario where SARS (or similar biologicals) arises in a community unexpectedly. HAZMAT or military protocols should be reviewed when considering containment practices sufficient to the task at hand. Multi-dimensional containment, as we have discussed above, could assure minimal opportunity for biological release. A building might, in the worst-case scenario, require total encapsulation similar to tenting used in termite or pest remediation. An appreciation for the limitations and operating parameters of collateral equipment is essential, such as air negative-pressure and scrubber machines. Bag in/bag out filter techniques would be essential for the ongoing maintenance of containment. The scope of work would impose a strict protocol in the dismantling of the multi-dimensional containment and disposal techniques, in order to establish, confirm, and preserve clearance.

The exercise of professional judgment by the investigator and the supervising remediator will depend upon early and continuing input and support from other team professionals, including infectious control and regulatory personnel. One key example is the choice of the best chemical agent to eliminate threats resulting from airborne biologicals (such as SARS). Where the most effective agent might not be formally approved for a specific application, waivers might need to be sought and their approval scientifically justified. The goal, quite simply, is to build a suitable "biological trap" and aggressively eliminate the compromising agent with extreme prejudice. While this might be achievable now in most situations, SARS raises the prospect that regulatory changes might need to be on a fast track to provide the required results in hospitals, office buildings, hotels, even cruise liners.

A well-orchestrated team, relying on experience and professional judgment, might be essential to promptly overcome any regulatory resistance. Those who "set standards" are expected to be cautious, to reduce the likelihood of future unintended consequences. SARS and other infections might spotlight the urgency for an accelerated review/approval process for the tools we need now while at the same time preserving safety for the future. Tools to deal with these diabolical biologicals that challenge our wellbeing and survival are available; needed now are uniform standards to provide for their proper use.

SARS creates a whole new world for all of us, not just indoor environmental quality professionals. But everybody else in the world will be looking to us to assure them of clean and healthy indoor air quality. SARS, in itself, might be a short-lived "event." But the prospect remains that Pandora's box has been opened, and we've seen just the tip of the iceberg - the tip with regard to the spread of SARS or (and more ominously) the tip with regard to a ushering in new era, with ready development and easy spread of "common infections gone wild," bringing severe complications or deadly outcomes. Whatever the scenario, we need to begin the thinking and adopt the perspectives that will enable us to address these challenges squarely and successfully.

John Parks Trowbridge is a specialist in integrative (complementary/alternative) approaches in medicine and healthcare now working as chief medical consultant for AQM Consultants LLC. He earned a bachelor's degree in biological sciences at Stanford University and a master's degree at Case Western Reserve. His private medical practice, Life Celebrating Health, is conveniently located near Bush Intercontinental Airport in Houston, Texas. His most popular book is The Yeast Syndrome, a Bantam bestseller. He can be reached by e-mail at MedicalDirector@AQMconsultants.com and by phone at (281) 540-2329.

J. L. Skiter Kowalski has 20 years of vast multi-faceted experience is derived from handling technical filtration/containment applications with the military, aerospace, computer peripheral, medical and domestic markets. His filtration experience covers areas of particulate, gas phase adsorptive, paint recovery, anti-microbial technologies in air and liquid environments. In addition, he is certified under the Asbestos Hazard Emergency Response Act and is also a certified indoor environmentalist, certified air filter specialist, certified mold remediator and a professional indoor air quality manager. He can be reached by e-mail at skiter@AQMconsultants.com and by phone at (270) 842-1940..