Washington, D.C. to License Mold Remediation 

Mold in Schools: Ready for Network TV

When Disaster Strikes, Just Strike Back

Word on the Street

• Voices: “Someone on the [football] field had a breathing problem. It was hard to see whose son it was, and 15 parents ran to the field with inhalers.”
  
  — Dr. Scott Bautch, past president of the American Chiropractic Association’s Council on Occupational Health, who attended a football game with his 13-year-old son
      
• Still in Review
  At press time, the IICRC S520 Mold Remediation Standard and Reference Guide is currently in public review and will not be available until the beginning of November. Phones were ringing off the hook at the Institute of Inspection, Cleaning and Restoration Certification headquarters in Vancouver, Wash., and many other IAQ trade organizations after the publication of Larry Cooper's article on the standard in the July issue of Indoor Environment Connections. The S520 committee is scheduled to meet at the end of September to review final preparations for the release of the document. You can look for standard updates on the IICRC Web site at www.iicrc.org.
     
• Farmers Kicks Out Mold Manager, Sued
  Isabelle Arnold, the former national mold claims manager for Farmers Insurance, recently sued her former employer, alleging she had been wrongfully terminated after making a concerted effort to change the way Farmers handled mold claims. The suit was filed suit in a Los Angeles district court. According to the Austin Chronicle newspaper, Arnold was reportedly hired to change insurer's mold claim practices and ended up being fired for allegedly farming out investigation work to her husband's claims service company in Texas.
     
• Lawmaker Just One of Little People
  And in other Farmers Insurance news... Texas State Rep. Joseph Nixon is taking a pummeling in the press for cashing in on a $300,000 claim for mold contamination on his house reportedly worth $369,000. Former Farmers employee Isabelle Arnold (see item above) is also reportedly part of this case. Arnold claims that some of Nixon's cleanup costs were not covered by his insurance policy but that other Farmers officials stepped in and approved the costs. According to the Houston Chronicle, Nixon also sponsored the tort reform bills on behalf of Citizens Against Lawsuit Abuse who claimed mold was nothing but frivolous claims and he was placed on the mold task force.
    
• Now Schools Can Communicate
  The U.S. Environmental Protection Agency has just released the Indoor Air Quality Tools for Schools Communications Guide to help a school's IAQ team develop and carry out activities that communicate the benefits of participating in an IAQ management plan. EPA expects the guide to raise awareness of good IAQ practices among administrators, school board members, the community and local media that will build support for a team's efforts to improve trust and collaboration while decreasing liability. The guide is available at www.epa.gov/iaq/schools/images/communication_guide.pdf.
     
• No Chatting about Arvida
  According to the First Coast News TV station in Jacksonville, Fla., a judge recently ruled that homeowners and attorneys for Arvida Homes and for the homeowners must stop using Internet chat sites to discuss problems with the developer. Six homeowners are part of an ongoing lawsuit involving Arvida and allegations that the homes were not built to Florida code. Discussions between owners erupted after residents found mold and structural problems on their properties. Homeowners and attorneys (on both sides) were accused of discussing the lawsuit online in chat rooms. Attorneys have accused each other of doing the same thing. By the way... the same judge who issued the recent ruling will reportedly determine whether the Arvida lawsuit can become a class action.
    
• Smokeless NYC Still Going Strong
  Officials say that New York City's restaurants and bars have seen a slight increase in jobs since the city's smoking ban went into effect March 30, according to the New York Times. Employment figures for the industry show that jobs increased from 155,200 to 164,900 between March 11 and June 11, an increase of 9,700 jobs. It also says the report is a response to the New York Nightlife Association and other critics of the ban, who said the ban would cause restaurants and bars to lose business. According to the Times article, the majority of existing research supports the city's report; studies in New York, California and elsewhere have shown that smoking bans in restaurants and bars do not result in a drop in business.
     
• urine test for mold
  The Journal of Environmental Biology has published a scientific study titled “Clinical Confirmation of Trichothecene Mycotoxicosis in Patient Urine.” In the study, authors found inhalational mycotoxin disease in the apartments and homes of human test subjects and recommended testing the urine of patients suffering from symptoms or diseases related to indoor environments. Various tests, they say, could indicate trichothecene mycotoxins. The authors administered a wide range of tests to patients to identify this mycotoxin exposure; one autopsy even detected these mycotoxins in the body of the deceased. One method of locating these trichothecene mycotoxins is through urine extraction, the authors write. They even extracted some mycotoxins and injected them into rats, who then developed similar symptoms as experienced by humans.
    
• Chiropractic As Asthma Treatment
  A series of journal articles investigate the reasons for a 60 percent increase in asthma since the 1980s. The association sponsoring the journal mentions building design and increased environmental exposure to potential allergens such as formaldehyde in furniture and carpets. The association also refers to non-IAQ related causes such as stress factors and allergen-containing food.
  These conclusions come from the American Chiropractic Association, whose press release stating all of the above leads up to a quote from chiropractic neurologist Dr. Gail Henry: "Doctors of chiropractic can be a great addition to the healthcare team treating the asthma patient."
     
• Corrections
  The photo caption on the front page of the August 2003 issue was incorrect. The photo was of a modular classroom at a school located in California. A caption mentioning two forms of mold found on support beams was unrelated to this building and should not have appeared with this photo. IE Connections regrets any implication this may have caused.
    
  A July 2003 Bulletin Board piece should have stated that Mycotech Biological's laboratory in Jewett, Texas, achieved EMLAP accreditation through the American Industrial Hygiene Association, as announced by Mycotech President Larry D. Robertson.
    
  Contact information for Delmhorst Instrument Co. appearing in the August issue's Product Showcase was incorrect. The company's correct phone number is (800) 222-0638.

Washington, D.C. to License Mold Remediation 

The Department of Health of Washington, D.C., intends to present legislation before the city council that would empower the department to license mold remediators. First drafts of the legislation and a companion regulation were the subject of an industry roundtable hosted by the department on Aug. 12.

The D.C. roundtable was chaired by a lead attorney for the Department of Health, Kimberly Katzenbarger. Also representing the city were two representatives of its Air Quality Division, Keith Keemer, CIE, and Bob Johnson, a microbiologist.

About 25 people attended the meeting, including representatives from the Indoor Air Quality Association and the Environmental Information Association. Others in attendance included industrial hygienists, remediation and construction contractors, public health officials from neighboring Maryland counties and providers of mold remediation training.

At the opening of the meeting, Ed Light, CIH, made an argument that mold is neither toxic nor hazardous, and there is not scientific backing to say mold is harmful to health in general. Therefore, he said, it was premature to be setting any mold-related regulations and that the city should wait until better science is available.

In response, Keemer said mold is such a huge problem in Washington, D.C., - the city is built on marshland and has a very old housing stock - that the city is very concerned about worker health issues, and that regulations for mold remediation will go forward.

Glenn Fellman, commenting on behalf of IAQA, noted that the draft regulations provide that remediators are responsible for investigations and testing, and he stressed that remediators should not be held accountable for this work. Fellman said it is outside the scope of their expertise and training and that it is normally considered a conflict for a remediator to do pre- and post-clearance testing. City officials agreed to consider separate licensing for assessment and remediation activities.

Several people in attendance expressed concern that the D.C. regulations did not address solving moisture and engineering problems that lead to mold contamination. Katzenbarger explained regulations regarding this area are outside the scope of the Department of Health's authority and that its regulations would be limited to training, testing and licensing of mold remediation activities.

Joe Hughes, president of the IAQ Training Institute, suggested that D.C. prepare a brochure to educate consumers about water intrusion and other causes of mold contamination, and that the regulation require that remediators provide this brochure to every client. This suggestion met with wide approval, and D.C. officials said they would consider it.

Discussion took place regarding the sections of the D.C. draft regulation that mirror the New York City Guidelines on defining levels of remediation based on square footage of contamination. Many in attendance pointed out flaws with this system. D.C. officials agreed to wait until the October release of IICRC Standard S-520 for mold remediation, and to consider using S-520 as a basis for their regulations rather than the NYC Guidelines.

One CIH in attendance pushed to have certified indoor hygienists defined as responsible for investigatory work under the regulation. This argument was quickly put down by many people in attendance, including a safety engineer, as unfair, since the CIH skill set does not necessarily include IAQ investigations. The D.C. officials seemed unwilling to give CIHs this role in the regulation.

One of the remediation contractors suggested that D.C. do the testing and training itself. Katzenbarger said that the city has neither the resources nor desire to do this. She said the Department of Health would evaluate existing training and certification programs and accept those deemed worthy. D.C. officials made reference numerous times to IAQA as already having been evaluated and as a model for the types of organizations that might get approved as testing and training authorities. It was also mentioned that D.C. has begun reviewing IICRC and IESO programs.

The D.C. Department of Health is expected to revise its regulations and send out a draft for public comment in the next three months.

Schools have long been a source of controversy when it comes to mold and other indoor contaminants. Our children spend as much time in the classroom as they do at home, often sealed in stale portables or in buildings with huge leaking problems or building with air conditioning systems that do not work at proper efficiencies. School boards lack the funding to build new schools, particularly in growing areas of the country, let alone repair leaks rapidly and spend significant sums in curing past ills.

Recently, a grand jury in Broward County, Fla., reported on conditions in county schools after a lengthy investigation. While exploring the grand jury's report, I could not help but think of my favorite television show. Is mold a crime? It's hard to say, but it may be as interesting as stories of murder in Central Park.

The following story is fictional and does not represent any particular person or event. This is my proposed teleplay for a new pilot television series, Law and Odor.

Voiceover: In the health protection system, there are two separate but equally important groups: the health department officers who investigate sick buildings and the grand jury who nails the offenders. This is their story (ripped from the headlines, of course).

Music: Dunnh, dunnnh.
[A high school in Bonaparte County in south Florida. Two students are walking down a hallway and talking to each other.]

Dante: Hey, man. Wassup?

Josh: Gonna catch a movie with Ricki tonight.

Dante: She's fine. Hey, what's that?
[Dante and Josh walk over to a spot between two banks of lockers.]

Josh: Oh, man! Call someone. Quick!
[The two boys are sitting on the floor of the hallway 45 minutes later. Josh is resting his head on his hands. Two men walk up and flash badges.]

Lenny Borescope: Borescope of County Health. This is Ed. Ed Greenmold. What's the story, boys?

Josh: It's. It's black mold - there on the wall.

Ed Greenmold: We know. We're from County Health. We're from the Fungicide Squad.

Borescope: Tell us what you know. Have you seen any water? How 'bout a roof leak?

Dante: Man, this school leaks like the football team after a keg party. Roof, walls, hey even the lockers leak.

Greenmold: So, anyone ever report this to the proper authorities?

Josh: I told Mr. Spore. He's the principal.

Borescope: That's Albert G. Spore?

Josh: Yeah, that's him.

Dante: And my mom, she called someone at the School District. She even sent off an e mail or two.

Greenmold: And what did they do?

Dante: Nothin'. Absolutely nothin'.

Music: Dunnh, dunnnh.
[The office of Principal Albert G. Spore. Borescope and Greenmold flash their badges.]

Principal Spore: Gentlemen. What brings the Fungicide Squad out to Claude Kirk High School?

Borescope: Fungus. That's why they sent the Fungicide Squad. If you had gambling in the locker room, they would have called Vice.

Greenmold: Yeah, but Lenny would have put a quick five spot on the Gators. So, Al, what's with the leaks. This is a new school.

Principal: I know. I know. The building has leaked since day one. It's the system, low bid, low cost, high tide on the inside. But, I reported it to the Chief of Facilities every time.

Borescope: So that's it. Fill in a reporting form. And you're off the hook.

Principal: Hey, I've got a budget to keep. It's tough enough to buy buckets to catch the leaks.

Greenmold: So instead, kids and teachers get sick?

Principal: There's no proof anyone gets sick from mold!

Borescope: Yeah, and the moon is made from Roquefort.

Music: Dunnh, dunnnh.
[The office of Robert Stank, the superintendent of schools. Borescope and Greenmold enter.]

Superintendent Stank: What can I do for the fine representatives of the Health Department?

Greenmold: You can stop making kids sick, for one.

Superintendent: Now, now. Mold is everywhere.

Borescope: Yeah, but a big chunk of it seems to be at Claude Kirk High School.

Superintendent: Claude Kirk is not unique; we have lots of schools with mold! …Um, let me rephrase...

Borescope: No need, Superintendent. You'll have your chance to explain to the grand jury.

Music: Dunnh, dunnnh.
[The grand jury room at the Bonaparte County Courthouse. The grand jury sits in a wood-paneled area. The district attorney, Jack Microscope, stands in front of the witness box. Superintendent Stank sits in the witness box, nervously loosening his tie.]

Jack Microscope: So, Superintendent Stank. You told agents Borescope and Greenmold that lots of Bonaparte County schools have mold. Is that true?

Superintendent: Er, well I tried to explain.

Microscope: It's a yes or no question, Superintendent.

Superintendent: Well, er, yes, I said that, but -

Microscope: Now, Superintendent Stank, I have provided the grand jury with the punch lists from several county schools. Let's take a look at Everglades Aquifer Middle School. Why, Superintendent, the punch list is 456 pages!

Superintendent: Yes, Mr. Microscope, we had some problems in the mid 1990s. We have dramatically reduced our construction problems since then.

Microscope: Well, let's see if that is the case, Mr. Stank. [He pulls out a stack of documents from his trial case and slaps them down on the D.A.'s table.] The school district now has several prototype designs, is that correct?

Superintendent: Yes, we can reduce costs by repetition, and we learn from each one we build.

Microscope: In other words, you make mistakes in some buildings and hope you figure it out by the time you get to the last one? Withdrawn. I have here the list of remediation costs for each of the new prototypes constructed in 1998 and 1999. Mr. Stank, the average cost to fix leaks and remove mold from each of the Creekside model schools is $2 million! The reports also reveal that many projects were started without final plans and that teachers and students were moved in before they were complete.

Superintendent: Mr. Microscope, the student population in Bonaparte County is increasing by an average of 6,000 students per year. We do not have the money to keep up with adding new schools with the same quality as they build a Ritz.

Microscope: Yet you budgeted $44 million for mold remediation in 1999. Would it not have been less expensive for the already overburdened taxpayers of Bonaparte County to build the schools right in the first place or, at least, to fix the leaks before mold became an issue?

Superintendent: We hired consultants to assay more than 100 schools and determine what we needed to do to remove the mold, fix the leaks and try to do better at solving problems earlier.

Microscope: Thank you, Superintendent. I believe that the grand jury has heard enough from you. I'd like to call School District Commissioner Elaine Lane. [A tall, blonde woman wearing an expensive business suit takes the stand and is sworn in by the bailiff.] Ms. Lane, how long have you served on the school board?

Lane: Almost 10 years since I was first elected by the fine, upstanding citizens of Bonaparte County.

Microscope: So, you've approved many schools to be built.

Lane: Yes, Mr. Microscope, more than 250.

Microscope: And how many of those schools have developed mold problems?

Lane: About 150.

Microscope: So, Commissioner, 60 percent of the schools constructed on your watch have mold problems. If you were a builder, and 60 percent of your houses had mold problems, I dare say that you'd be out of business.

Lane: That's quite unfair; we are not a profit-making enterprise.

Microscope: That's clear, Ms. Lane. Is there not a design review process?

Lane: Yes, but they are lay persons appointed by the commissioners. They are not there to review plans or construction procedures.

Microscope: Thank you, Commissioner. I'd like to call next, Little Sally Sulking, a student at Everglades Aquifer Middle School.
Sally Sulking: Hi, Mr. Microscope. I'm a little nervous.

Microscope: Nothing to be nervous about, Sally. Just tell us what you've experienced at Everglades Aquifer Middle school.

Sally: Well, there were lots of leaks when the school first opened. We used to joke that we did not need to shower after phys ed; we could just walk down the hall.

Microscope: Sally, did you see any mold?

Sally: Well, I'm not a certified indoor environmentalist, but there was black, powdery stuff on the walls and ceiling tiles and on our stuff in our lockers.

Microscope: Did you get sick from the mold?

Sally: Yes, I had allergy problems at first, then sinusitis, and then hives. The allergist said that they were all due to exposure to Aspergillus.
Microscope: Now, Sally, were you an isolated case?

Sally: No, many of my teachers and friends also were sick or had rashes. We all knew it was sick building syndrome because we all felt better when we left school, particularly for the weekend.

Microscope: Thank you, Sally, for telling us your story. [Turns to the grand jury.] Ladies and gentlemen, you have heard the testimony of almost 80 witnesses. You have seen the reports as to the condition of our schools. You have also been provided with all of the latest research regarding the health effects of mold. We call upon you to review all of this information and report to the people of Bonaparte County as to the problems and solutions to this crisis affecting our children.

Conclusion
Ok, so I'm not Dick Wolf, but you get the point. Mold is a problem in schools throughout the country. While attention is focused on insurance for homeowners, claims in apartment complexes and quality of home construction, the real concern may lie where our children and their educators spend up to eight hours every day.

The story you have read is a work of fiction. For a real-world account of mold in schools courtesy of the Broward County grand jury report, please visit www.sao17.state.fl.us/grandjury2002.html.

BMichael S. Greene is a partner in the Boca Raton, Fla., office of Blank Rome LLP. His background in architecture and construction have enabled him to develop a substantial practice in the legal aspects of the indoor environment, both in addressing problems as they have arisen in, and in establishing protective measures for owners, managers and IAQ professionals. He can be reached by e-mail at greene-m@blankrome.com or by phone at (561) 417-8100..

John Parks Trowbridge, M.D.
Chief Medical Consultant
AQM Consultants LLC
Humble, Texas

JL Skiter Kowalski
Executive Administrator
AQM Consultants LLC
Humble, Texas

Hurricane Lili rumbled ashore on Oct. 3, 2002, pounding Intracoastal City, La., with 145-m.p.h. winds being carried in the Category 4 storm. To compound the issue, Tropical Storm Isidore had dealt its ravaging blows here only one week earlier, resulting in a loss of power in 465,000 homes. Hurricane Lili's inland path spawned multiple tornados, wreaking further disaster in other communities.

A three-foot wall of muddy water from Vermilion Bay inundated Intracoastal City. One victim was an oil company heliport. The storm surge overwhelmed 22,000 square feet of office, 80,000 square feet of warehouse, and 200,000 square feet of helipads and drives, depositing four inches of muddy silt. Time to strike back at disaster: The call went out to us at ServiceMaster of Lafayette.

Close your eyes and try to imagine: heavy rains and floods; destructive gusts of wind; deafening sounds of nature crashing on structures both natural and manmade; breaking glass; utilities suddenly absent; power lines snapped and downed; tornadoes suddenly engulfing entire blocks; telecommunications gone or spotty; traffic jammed; crowds first fleeing and then attempting to return in the absence of control signals; food and survival supplies limited, if available at all.

Each of these dramatically impairs the logistics of all emergency responders trying to carry out their missions in the midst of pure mayhem. For some remediators, this would be business as usual, just a starting point seen so many times before. For those without such experience, hazards lurk at every turn, including unsuspected potential medical risks.

After completing the damage survey at the oil company helipad facility, I called ServiceMaster Project Manager Harvey Barton. A hastily assembled crew of 18 swarmed the entire facility 14 hours a day for the next five days - shoveling, vacuuming and pressure-washing the silt and mud from all inundated areas. After physical removal of the mud was completed, the entire area was sanitized by spray application of Anabec Advanced Cleaner™ and X-70 Microbe-Shield™. All contents and areas were cleaned thoroughly and sanitized, with drying equipment utilized to control the humidity. The HVAC systems were damaged and inoperable; their demolition was scheduled to be performed as priority-one after completion of "muck out."

Sometimes a good remediator has to ask just why he commits to fighting back at hurricanes - the customer might pose an even greater disaster, just waiting to happen. Imagine yourself as the CEO of a company facing revenue losses of $3-4 million dollars a day while this heliport is being restored. When a "usable" level of restoration was achieved, the customer unfortunately decided to resume "normal" operations, stopping the remediation effort before recommended intrusion into the walls. The remediator advised the customer that allowing the compromised structure "to dry on its own" was not based on sound science, even though that appeared to be a practical solution to the CEO. The remediator was obliged to honor the customer's insistence on "no demolition." After carefully hearing the consequences of not completing the specified in the work order, the customer chose to sign a release of liability for incomplete remediation, and the work crews were reluctantly withdrawn from striking back at the disaster. The "presentable" work area by no means had been restored to being a "safe" work area.

Rome wasn't built in a day, nor was it destroyed in a day. Every remediation company concerns itself first with the logistics of available personnel, safety equipment, remediation equipment and strategies for controlling health and safety risks. These are the "everyday stock-in-trade" for this business - and the urgency of coordinating these factors increases exponentially when disasters create sudden demands for such assets. When economic pressures induce a customer to forfeit completion of a solid safety protocol in striking back at disaster, the long-term story takes on a completely new look.

Remobilization by the remediator, returning to a site where the customer now fears that unresolved problems have worsened, can present even more critical issues - including serious new health concerns as well. Yes, the inevitable did happen, just weeks later. In early November 2002, ServiceMaster received a call from the heliport facility: Something mysterious was growing on the walls and cabinets. A relatively easy initial disaster cleanup can become much more complicated when a third party needs to be called in to investigate, verify, and issue a definitive scope of work. In addition, just as surely, the remediator will be back to strike at the new disaster, where the economic costs are now amplified despite the customer's original hope of curtailing overall expenses.

A case of 20/20 hindsight clearly showed that the multiple challenges created by nature were dramatically compounded by the customer's myopic view of cost-control. Within a few dozen days, the facility had been compromised by significant growth of Stachybotrys and Chaetomium mold. Walls showed moisture readings over 25 percent - ripe for microbial growth creating further environmental disaster. By resuming "normal" operations before allowing adequate remediation to a "safe" facility, the customer inadvertently exposed staff personnel, visitors, transients and remediators to dangerous molds.

The remediators must acknowledge and, wherever possible, assist the customer's interest in resuming or maintaining satisfactory operations at the facility while safe and thorough remediation is underway. Critical issues include limiting collateral damage to "human assets": remediators, facility personnel and customers they service. The challenge is clearly frustrating to the remediators who now have to work in an occupied environment, one where they earlier requested the opportunity to make the compromised zone safe before rehabitation. The number of exposed people is substantially increased, and health and safety concerns are more complicated.

Out come the guidelines, regulations, specifications and safety and demolition equipment to fulfill the incompleted initial mission of striking back at disaster. As our industry becomes more proficient, remediation procedures are being implemented at an increasingly higher standard of performance. Many of these are specifically intended to provide maximum protection to living and non-living assets, during and after the remediation effort. Containment protocols, safety suits and respirator programs are just a few of the requirements that figure prominently in the logistics of dealing with any compromised area. Paying attention to detail, I addressed each step in this nightmare just as I had done many times before - striking back at disaster - and efficiently returned the helipad facility to full and safe operation.

Four more weeks of enhanced safety, protocols and intensive coordination were required for area-by-area remediation with meticulous attention to comprehensive clearance techniques. A third-party safety consultant hired by the customer was invaluable to assure conformity to priority-based area remediation. Comprehensive cleaning and sanitization led to final clearance, validating the original remediation recommendations for striking back at disaster. The customer's lesson was expensive: deferring the inevitable might increase your economic penalty far beyond that suffered by patiently waiting for the right job to be completed the very first time.

One final area needs specialized attention - the human health and safety factors that might not receive their full due by less experienced (or less thorough) remediators. Disasters, by definition, are sudden unexpected events that overwhelm local capacity and require outside assistance. Cleanup after an overflowing toilet is usually handled by "local" building staff; removing four inches of muddy muck after a hurricane flood requires specialized "outside" assistance. Disastrous events often present extremely unusual situations.

For example, cleanup after a severe flood means comprehensive cleaning in every nook and cranny, something rarely done. Potentially dangerous insects such as spiders or scorpions inhabit dark corners, or they may float in and find a quiet, safe haven. Snakes, rodents and other animal life, faced with nature's horrendous turn of events, are similarly seeking shelter. They bite. Fish, sharks, water snakes, and other "sea creatures" can be deposited in buildings far removed from riverbanks and seacoasts. Furniture and fixtures carelessly tossed about have sharp protruding edges. Unseen cables and wires are waiting to trip the unsuspecting. Falling into or onto unyielding structures can lead to puncture wounds, gashes, blunt trauma, and broken bones. Any breach of the skin carries with it the risk of infection that is more easily contaminated by whatever lurks at the compromised site.

Do these factors really matter? Consider this: Does anyone get unexpectedly injured at the remediation site? If so, is that person … you? This point was brought home to John Parks Trowbridge years ago when reviewing the history of a new patient who was missing his right arm.

The story started innocently enough. While fishing on the Texas Gulf Coast, this person suffered a fish fin puncture to the right middle finger at about 1 p.m. He awakened early the next morning to severe pain, swelling and marked redness of his finger and hand. When seen at the local emergency at 10:20 a.m., his temperature was 101 degrees Fahrenheit. Thought to have a strep or staph tissue infection, he was admitted and started on intravenous antibiotics. By noon, his right arm was swollen and the middle finger had started to die. Surgery to clean up the hand was done (had begun? was performed? was concluded? was over?) by? at? about 3:30 p.m. His entire arm became discolored by 6 p.m., and he was transferred to a university hospital in Houston at 10 p.m. He was confused, disoriented and in severe pain, with marked swelling and red discoloration of the entire right arm. Two hours later, he was in the operating room for removal of his right arm, with extensive cleanup of the area of the right armpit. Life-threatening complications followed from the infection, yet he slowly recovered and returned home after almost 10 weeks.

The cause of his misfortune: apparently devastating toxins produced by Vibrio damsela, a gram-negative bacterium introduced by the casual fish-fin puncture.

This sad story illustrates the potential for disastrous consequences for the personnel involved in any clean up and remediation effort. Conscientious continuing education, comprehensive attention to detail, persistent enforcement of safety protocols and adherence to the highest safety standards are our best defense against the unexpected. Saving buildings is our stated goal, but saving life and limb in the process have to be our watchwords in the process of striking back at disaster.

Huey Miller, Jr. is the general manager and large loss coordinator for ServiceMaster of Lafayette, a full-service fire, water and mold restoration company serving southern Louisiana and the nation since 1958. Miller is also a partner in Air System Remediation, a large loss HVAC remediation firm with offices in Lafayette, La.; Little Rock, Ark.; and St. Louis, Mo. A certified mold remediator and certified mechanical hygienist with over 30 years of experience, Miller has been invited to speak at the American Conference of Industrial Hygienists's "Quest for Uniformity" mold symposium in November. He can be reached by e-mail at hueyjr@smoflafayette.com or by phone at (866) 654-2700.
This article was written with AQM Executive Administrator JL Skiter Kowalski and Chief Medical Consultant John Parks Trowbridge, who have contributed earlier articles to this paper.