EDITORIAL: Sick ‘Something’ Syndrome, Part One
1. A group of symptoms that consistently occur together or a condition characterized by a set of associated symptoms.
2. A characteristic combination of opinions, emotions, or behavior.
A 23-page medical toxicologist’s report released by the Colorado’s Sixth Judicial District on December 14, 2017 — which you can download here — characterizes the Archuleta County Courthouse as suffering from “sick building syndrome.”
For any of our readers not familiar with “sick building syndrome,” the report’s author — medical toxicologist Michael J. Kosnett, MD — offers this explanation:
A substantial number of employees who work in all sections of the Archuleta County Courthouse Building have complained of a constellation of symptoms, particularly headache, eye irritation, upper respiratory tract irritation, and fatigue, that is highly characteristic of “sick building syndrome.” Sick building syndrome is a well-documented condition that occurs among occupants of buildings with poor indoor air quality due to inadequate fresh air ventilation and/or the presence of a strong source of indoor air pollutants (EPA, 1991; Brightman et al, 2008; Norback 2009; Sternberg B, 2011; LBL, 2017).
Dr. Kosnett notes that the National Institute for Occupational Safety and Health compared 80 buildings they had classified as “sick buildings” to another 100 randomly selected buildings, and categorized a “constellation of symptoms” that seems to occur when air quality inside a building is causing employee complaints. Eye problems, fatigue, and headache constituted the three most prevalent complaints, according to Dr. Kosnett’s 23-page report. Much of the report consists of discussions about “sick building syndrome” as a general concept — as experienced in, say, Portugal?
A recent study in Portugal documented that intrusion of geothermal gases was characterized by marked day-to-day and seasonal variation (Viveiros et al, 2016). Intrusion was greatest during periods of low barometric pressure…
That’s interesting, except that Dr. Kosnett neglects to present any scientific evidence that “geothermal gases” are in fact present in substantial amounts inside the County Courthouse in Pagosa Springs. He merely makes what appears (to me) to be an unsupported assumption — when the evidence in the report seems to suggest such is not the case.
The two “geothermal gases” Dr. Kosnett seems particularly concerned about — hydrogen sulfide and carbon dioxide — have indeed been found in the Courthouse. According to the good doctor’s 23-page report, traces of hydrogen sulfide were detected using an extremely sensitive instrument. To quote Dr. Kosnett:
Twenty indoor measurements of hydrogen sulfide on the west side of the building were made with a sensitive Lumex direct reading instrument. The median hydrogen sulfide concentration was 23.5 ppb (range 2 to 34 ppb).
“34 ppb” means “34 parts per billion.”
The federal Occupational Safety & Health Administration — OSHA — believes that hydrogen sulfide becomes an irritant at around 2,000-5,000 ppb (2-5 parts per million.)
That’s an average of about 3,400 ppb.
In other words, the good doctor seems awkwardly concerned about amounts in the County Courthouse that are about 100 times less than anything OSHA would consider to be an irritant. Dr. Kosnett shows a similarly exaggerated concern when discussing the importance of carbon dioxide readings in the older portion of the Courthouse where the courtrooms are located.
The doctor includes, in his report, the results of interviews with numerous County employees around a “constellation of symptoms,” and shares a chart with us:
The report does not tell us whether any of these employees were Judicial District employees. We know that Sheriff’s Office employees have cited negative health effects while working in the west wing of the Courthouse, but Dr. Kosnett does not provide evidence that any Judicial District employees have experienced unusual symptoms, nor that any employees who work for the County Clerk, the County Assessor or the County Treasurer — who continue to work in the east wing — have shown symptoms. (Only Sheriff employees have had regular working hours in the west wing, where a 9,500-square-foot jail was abandoned almost three years ago.)
Dr. Kosnett explains, in a footnote, the limited value of the research that generated the above chart of symptoms:
A survey of all employees working in the building was not requested or attempted for this assessment. Therefore, although the results identify a constellation of symptoms experienced by many building occupants, these data cannot be quantitatively compared to symptom prevalence in published studies of indoor air quality in office buildings.
The doctor’s report is not terribly enlightening if the reader truly wants to understand whether the building environment was causing “a constellation of symptoms” in some Sheriff’s Office employees who previously worked in the County Courthouse — or if those complaints might have had an unrelated cause, such as, for example, a contagious illness temporarily spreading through the office.
But we do learn about the experiences of some people exposed to pig farming:
For example, in a controlled, cross-over chamber study involving healthy volunteers (n = 48), exposure for one hour to diluted air from a swine confinement facility was 4.1 times more likely to result in the subjective report of headache (p = 0.001) and 6.1 times more likely to result in the subjective report of eye irritation (p = 0.004) compared to control (fresh air) conditions (Schiffman et al, 2005).
One interesting comment illustrates the apparent lack of careful, on-site research that seems to pervade the report:
3.c) Stained ceiling tiles and drip marks in several rooms on the second floor of the building were consistent with prior water leaks and damage. Many areas of the building were carpeted, including those with evidence of past water leaks. The underside of the carpet was not inspected for mold overgrowth.
If I were a scientist concerned with accurate, truthful analysis, would I fail to inspect the “underside of the carpet” in question? Seems like an obvious thing to do.
Dr. Kosnett includes several pages of useful information, of general interest, and at least one chart that might have a vague relationship to the County Courthouse, although I was not able to fully understand the connection. (I’m not a scientist.)
Taken as a whole, the December 14 report makes generous use of suppositions, in place of actual scientific findings — leaving the reader with the impression that Dr. Kosnett was not in fact writing a scientific report, but rather had assembled a politically-motivated document based on a Sixth Judicial District agenda.
Dr. Kosnett’s report was emailed to the Durango Herald and the Pagosa Daily Post on Wednesday, December 20, accompanied by this email message:
I have attached a copy of Dr. Kosnett’s report, which has been shared with the BOCC. We will not be re-occupying the courthouse building. We are continuing our search to find a suitable location in Pagosa Springs to reconvene court operations.
I hope you have a great holiday…
Rob McCallum, Public Information Officer
Colorado Judicial Department
I am not clear what the Colorado Judicial Department might mean by, “We will not be re-occupying the courthouse building.”
Possibly, they mean, “We will never re-occupy the Archuleta County Courthouse, no matter what improvements are made to the building. Period.”
Or they might mean, “We will happily re-occupy the Archuleta County Courthouse when the County invests in improved building ventilation, and also provides expanded courtroom space.”