17/4/2014.

Doctors, Nurse Practioners, Allergists, ENTs, and Environmental Physicians:

We Make House Calls! We have over 20 years experience providing Doctors unique monitoring and assessment data, for homes of their patients' that can reveal critical information unknown by the patient. We identify and quantify chronic, acute, and unpredictable, episodic exposures of Chemical, Biological, Radiological, and Physical insults, frequently at very low levels; not uncommonly three to four orders of magnitude Below Regulatory Concern (BRC)-the standards industry usually meets. Physicians know modern laboratory instrumentation is far more sensitive, revealing, and definitive than human perception even before desensitization. Our comprehensive process employs published Scientific and Medical methods from many sources, here and abroad, in medical, environmental, CDC, Industrial Hygiene, Exposure Science, regulatory, and other relevant literature. Physicians can request their own too, or we can together develop/modify one. Our data, findings, and reports are a 'road map' which make complete diagnoses much easier, and sometimes provide easy, low cost remedies for the problems unaddressed by others. We can answer the question: "Can these toxics be 'neutralized' in situ?". Our services are the critical Quality Control missing from American design/build firms. It is rare when our clients do not find our findings shocking - even in 'Green/LEED' built buildings!

Sources of problems and resulting contamination our studies reveal include those from designers; builders; pesticide applicators; the neighborhood environment (what patients are down wind of), including Leaking Underground Storage Tanks (LUSTs), underground solvent plumes, site geology; and toxic building materials. Post remediation follow up monitoring, always included in our flat rate fee, assures permanent solutions, continuous support, and a known degree of clean up. Such a procedure is necessarily 100% free of all 'side effects' and last the life of the unchanged environment. Very sadly, new construction in the U.S. has only a one year warranty. Otto the Orkin Man started spraying our homes, school, and work places in 1901! But hope abounds. A leading manufacturer of state of the art laboratory instrumentation has developed a method of analysis for 402 pesticides in well under 10 minutes! What a great screening tool.

Our patients cannot speak, but they NEVER forget! Pesticides, diluted Diesel exhaust, and so much more make findings from the field of pertinent Exposure Science very compelling to all. This web page defines many obligatory, new and not so new techniques for assisting Physicians' and their patients too. Astute Physicians have used our services for their own abodes, to minimize ill health, lost retirements, lost ambiance, and independent compliance with standards of: American Society of Heating, Refrigerating, and AirConditioning Engineers (ASHRAE), C.D.C, E.P.A., O.S.H.A., N.I.O.S.H., L.E.E.D., Green Building Institute, etc. But: We sell no hardware nor remediation services as this would be conflict-of-interest.

What is Exposure Science? It is a critical arm of Industrial Hygiene that addresses identification, quantification, and control of harmful exposures; frequently ignored by others. We know the presence of a disease linked to environmental exposures is a clear, solvable danger; and we also know many different maladies can result from any one insult regardless of what is the leading indicator disease. Our assessments may reveal patients whose maladies indicate the presence of toxics that require cleanup for their recovery. These include very low level exposure to complex mixtures of chemicals, smoke, biologicals, and radiologicals, that are BRC but well above medical and economic consequences of exposure. This is very doable. For the very young, old, transplant patients, and the most sensitive ten percent of the population, our services are their first & most important line of defense.

We seek and test for 'worst case scenario' with technology that transcends human perceptions by many, many orders of magnitude. We are guided by the 'Precautionary Principle'. Click on 'Definitions' above for our chosen eloquent confirmation of this philosophy and BRC. We frequently identify and report, from nothing more than a low cost visual on site inspection, serious sources of problems or concerns without doing any sampling at all! Our written report of a visual inspection can be shocking, our monitoring and lab data will sometimes blow your socks clean off - even in high end homes! 'Because it is Wright does not mean it cannot be wrong!' Flat roofs are very common and sooner or later they leak. See a partial insult list by clicking on 'Homes...' above, and scroll down to the third list. It could also beg the question: why didn't they teach us this in medical school? Your patients will love you - even more!

Who is Greg Marsh, B.S. Chemistry? Long before huge grade and course inflation, he finished his degree work, punctuated with a five year stint in a biological research toxicology laboratory of the yet to be formed U.S. Environmental Protection Agency. This lab was later named 'Environmental Monitoring and Support Laboratory' in Newtown (Cincinnati) Ohio.

Here, many different aquatic species were exposed to certain toxic metals and pesticides at low part per billion levels under highly controlled conditions for many life cycles, with eye popping results, not just mortality! Chronic studies could easily last several generations while our acute study methods development settled on 96 hour duration of what is now called Whole Effluent Testing (WET) testing. The analytical monitoring data generated by Marsh are the supporting basis for discharge permit levels still present in the Clean Water Act. These were typically the detection limit of state of the art Spectroscopy and Chromatographic methods and instrument systems of those days. These are still, with vast embellishments, in use today. Our parent lab was assigned the task of resolving the Lake St. Claire mercury debacle in 1970, that was discovered by a graduate student. This was the realization of vast problems of mercury in coal and methyl mercury in fish. Ironically, Marsh quit this professional position because of vast unsafe working conditions endemic to the National Water Quality Lab, Duluth, MN, as managed by Dr. Donald I. Mount!

Subsequently, he configured & started up a new fuels, facility, and environmental monitoring lab in a 2.2 giga watt coal and oil fired power plant complex on the Ohio River, that had military significance and many toxic emissions of great concern today. He became an expert in many aspects of pollution from major, common sources that comprise our world - including mercury - which to this day keeps popping its toxic head up in so many places including homes, foods, & fracking emissions. Ask. Information Technology was in its infancy and was part of the job.

Marsh returned to Ohio University to finish 13 years after starting. He stuck with Chemistry, as a new on campus college of Industrial Hygiene wasn't quite ready. Upon completion, he took a E.H. & S. contract with the U.S. Army monitoring poorly controlled environmental contamination from chemical agents and pesticides at Rocky Mountain Arsenal. These were chemicals designed to disable and kill at extremely low concentrations - perfect experience in today's contaminated world. In summary, we ask you consider the following list of our experiences from this field now called 'Exposure Science'.

• Marsh and his associates have long backgrounds in toxicology, chemistry, special sampling, methods development, analyses, and deep working knowledge of epidemiology, so relevant to solving today's problems with environmental exposures of any kind. We all keep up with emerging technologies in a number of ways. We also listen to the Physician. The following are some of the principles we know and practice:
  
• We live in a world made toxic by ourselves. Or as Walt Kelly/Pogo Possum said in the 1950s: "We have met the enemy and he is us!" Dilution is not the solution for pollution. We are all downwind and downstream, 100% of the time.
  
• People breathe 25 kilograms of air a day, most often (ambiguously) stated in liters. Therefore it is 25 times as important as that eaten. Human lungs are perfect traps for toxic gasses, aerosols, particulates, and vapors. In fact, OSHA requires about 5 different kinds of air monitoring strategies to mimic human lungs.
  
• All people, responsible for the creation of all built environments, are uneducated and untrained in Physiology, Exposure Science, and Industrial Hygiene, etc., and know not its most important attribute: its toxicity!
  
• The International Building Code, used throughout this country, does not address monitoring building toxicity nor 'baselining'. As from day one, Government inspectors have no such standards nor authority to require toxicity testing of anything. It follows that our homes, schools, and work places are built by the lowest bidders with materials from the cheapest sources - totalitarian countries using old, obsolete, cheap methods, in societies who swim in pollution and couldn't care less about the health and welfare of their own workers. Those materials are delivered to our stores in the world's biggest ships by the mega ton, in the total absence of any toxicity testing (quality control) whatsoever! Some would label such government efficiency "Socialism"! All quality control is a 'sink' for money and never a source of revenue. In 2008, R. Nader reported the Food and Drug Administration had budget cuts 18 of the last 19 years. How many other regulatory agencies have the same problems and lack of adequate of funding?
  
• Those treating illnesses know the myriad of diseases linked to environmental exposures. We know chronic exposure can be the source of chronic disease(s). We also know identify & quantify harmful levels of toxic chemical, biological, radiological, and physical contaminants - including pesticides, Legionella, respirable mold, estrogen mimicking/disrupting chemicals, animal emissions, etc., to name only a few! We are very concerned for the risks of those returning to a home, school, or workplace with easily identifiable insults. It is far easier and less expensive for the Scientist to identify and quantify insults than it is for the Physician to cure their effects. We evaluate at concentrations below not only economically important criteria , but below that which can cause medical harm (sometimes sub ppb), even if the patient has a propensity of harm to their exposure(s).
  
• Exposure Scientists have very powerful sampling & laboratory analyses tools whose detection limits are far lower than many existing exposure standards. Many standards are set politically and are hence irrelevant. It is very easy to find and quantify very low level, unexpected insults - clandestinely when needed.
  
• We rarely take 'grab' samples but prefer long term collections. We then send them to the lab(s) we know and trust, who supplied the sampling hardware. These are the same labs used by the Harvard School of Public Health, National Jewish Health, etc. Their laboratory analyses reports always accompany our reports. Our motto: "One who tests with poor methods and people knows not".
  
• Our assessments answer questions like: "Does the abode have environmental problems that baffle your patients; illnesses in others; or strange and unique, unmentioned odors? Has Otto the Orkin Man been a visitor (he started in 1901)? Arsenical rodenticides were his first, they persist, and many are now banned. Are previous occupants deceased? At what age, from what? Has that nearby gas station been leaking for decades into the aquifer below your patient's home, school, or workplace? What materials are present that are in, or about to be in litigation from newly realized risks? We are on the 'front lines' of these type issues.
  
• We seek 'worst case scenario' with guidance from the Precautionary Principle, the Doctor, and long experience. We never work from a check sheet! Sensitivities to an insult can cover a range of six orders of magnitude between the most sensitive and least sensitive members of a population. What does 'synergistic effects' from all the others do to this?
  
• All Exposure Science solutions for poor Indoor Environmental Quality (IEQ) are 100% free of all 'side effects', 100% of the time! Such solutions last the life of the unchanged structure and are very well understood.
  
• The best buildings are designed to manage the following three pitfalls: They do not deteriorate over time with regular maintenance and cleaning; they must handle short term, predictable insults, e.g., keeping a friend's cat for a week or two; and they must provide quick management of unpredictable, catastrophic, acute events, such as a spill of something harmful.
  
• Beware of 'Green' buildings and those with high LEED scores. 'Green' is a good idea but nothing more than a selection process conducted by folks not trained in toxicology or anything else that is relevant! Natural wool carpet labeled 'Green' can be saturated with pesticides! A 'Green' label pushes the vendors' profits up, while the building in which it is installed has a one year guarantee. The effects of such toxic exposures frequently take a lot longer to manifest their harm. Our optimization process easily spots such 'tricks'.
  
• Our Scientific methods are consistent with the Hippocratic Oath. We accept the broad implications of Dr. Ignaz Semmelweis's policies; and the motto of the American Lung Association: "When you can't breathe, nothing else matters!", without reservations. We never abandon patients after optimization is completed.
  
• We sell no hardware nor remediation services as this is a clear conflict of interest. Such a 'convenience' would cause costs to skyrocket. Assessment is a profession, remediation is a semi-skilled trade, which real assessors know not. People of substance are very rare.
  
• We submit when discovered, unsolicited, peer reviewed, relevant, scientific articles in our field to those Doctors whose interests we know, to conveniently keep them abreast of new findings in our complementary field. Our profession is as dynamic as theirs.
  
• Scientists, nurses, and teachers are the most loved of all professions and a pleasure to deal with. We have good news, and we accommodate those who 'do it yourself'. Our 'road map' for remediators limits the scope and costs of the clean up drastically, as remediation is far more expensive than assessment.
  

Testing includes monitoring conditions over long time periods (30 days and nights). Our methods employ sophisticated, powerful, published sampling methods recommended by the Physician and/or taken from national and international sources in the profession of Exposure Science, worldwide, for chemical, biological, radiological or physical insults, including those that may be intermittent, unpredictable, or episodic. This is aided with automated data logging, sometimes patient assistance, real time analyses, and analyses from real, independent laboratories we know and trust, whose analysts are on the 'front lines'. Think pollution from fracking that's "Blown in the Wind".

Our assessment of biologicals is entirely consistent with: Storey, E., M.D. M.P.H., "Guidance for Clinicians on the Recognition and Management of Health Effects related to Mold Exposure and Moisture Indoors", University of Connecticut Health Center, Division of Occupational and Environmental Medicine, Center for Indoor Environments and Health, 263 Farmington Avenue, Farmington, CT 06030-6210.

Expect our full, complete, comprehensive optimization assessment to take from twelve to eighteen (12-18) months, including time needed for remediation and follow up assessment. We provide relevant environmental monitoring data interpretations in the form that meets you and your patient's needs.

We work under your direction, professionally, discreetly and promptly. Costs of the services of the Exposure Scientist are far, far less than those of Physicians, Attorneys, Architects, and remediators. For the typical home, they are far less than one fifth the cost of a simple heart attack that has no complications and requires 56 hours in the CICU.

A patient considering a prophylactic 'double mastectomy' but instead implements our services will, of course, protect all others under the same roof from all those insults. Not only has Otto the Orkin Man been adding poisons to our homes, schools, and workplaces, but many, many other sources of carcinogens have been out there for a long time. All those poisons are still there unless it has been discovered, assessed, and cleaned up with monitoring methods that include subsequent clearance (final) monitoring. Ask about the same chemicals used in wall paper as fungicides that will likely cause a deadly 'whole home time bomb' a century after its application.

Important advice to Doctors: Screen those who purport to be Industrial Hygienists, Environmental Chemists or Exposure Scientists, as the field is virtually unregulated and these titles have virtually no protection, in great contrast to that of Doctors and Engineers. Thank the Colorado State Legislature for their refusal to act on our title protection proposals for four years in the middle 1990s. Certification (CIH) from a common I.H. society can be for an Engineer or Geologist! Ask three questions: What did you study in school; what were you doing 5 years ago; and what were you doing 25 years ago? Degrees outside the areas of exposure science, environmental chemistry, Industrial Hygiene, toxicology, microbiology, and some other forms of biology are dubious and rarely relevant. Those who mix remediation and/or hardware sales with assessment are phonies with conflicts of interest. Qualified Scientists have real degrees in relevant areas like Chemistry, Exposure Science, and Industrial Hygiene from real universities. The best have long, environmental experience, the more the better. Marsh started his scientific career in a biological research toxicology laboratory charged with establishing safe discharge levels of toxic metals and pesticides, for the Clean Water Act.

A professional Forensic, Environmental Chemist or Exposure Scientist will ascertain what needs to be done, create a working plan for remediation, provide remediation oversight, report results and monitoring data, interpret laboratory data in terms of exposure standards for the layman, provide follow up assessment to ascertain degree of cleanup which can reveal remaining, undiscovered insults; provide relevant, peer reviewed articles from relevant scientific and medical literature; and consult with the Doctor for the best long term care of his/her patient's environment. We never provide remediation services nor sell hardware as this is a clear conflict of interest.

Words of Wisdom: The Exposure Scientist is not a 'technician', he needs your goals, key concerns, and wishes. Existing conditions, under which a patient lives, can be so bad as to not warrant immediate sampling. Listen when he reports from his first visit to the patient's home that, visually, conditions do not warrant or indicate sampling until suggested remediation is complete, e.g., visible mold is mold far above the level of concern. Many other common observable conditions exist, that preclude immediate sampling unless litigation is eminent. The experienced Scientist, with professional discretion, can save the patient big money when this protocol is followed on day one. He shouldn't loose time and be paid to sample an environment he knows to be highly contaminated during his initial evaluation, unless there is other medical or legal justification. His ideal client says: "Marsh, we have a real difficult situation with our patient who we suspect is from a toxic environment. Please do as thorough job as you can searching for low levels of toxics, including those that are Below Regulatory Concern."

Have the Exposure Scientist oversee remediation in the manner he prescribes. The Physician can establish the level of clean up sought. Degree of clean up is limited only by time and cost. The Scientist may have knowledge of needed sources of additional services - well beyond remediation planning and oversight, e.g., cost savings through application of renewable energy technologies - which can be huge.

The Exposure Scientist must do follow up (post remediation) monitoring to verify degree of clean up and assure no insults, obscured by previous contamination, remain. This process can take from weeks to months.

Consider recommending occasional, routine monitoring, just like drinking water, over the long term.

Our dream is for Doctors to use their influence to pressure the insurance industry to get serious about vast medical claims' losses they are funding because they do not realize the pervasiveness of environmental exposer linked insured losses. Dr. Jill Stein, M.D., quantified these to be about $ 1.75 Trillion per annum in 2012. This is entirely consistent with minor research findings in Marsh's white paper on this subject.

This web page hopes to give America's Physicians another tool that will help this country catch up with all other 'Developed' countries in life span and quality. Our low cost, Flat Rate (Fixed Fee), permanent solutions are conveniently available when the Doctor is assisted by an Exposure Scientist when treating illnesses suspected or known to be linked to environmental exposures. Exposure Science solutions have no 'side effects', and last the life of the unchanged environment! Your abode is no exception, reference your colleague Dr. Nick Nonas, M.D. in Denver.