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RutlandHerald.com - We Are Vermont

Tests may have found sarcoidosis triggers



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By PATRICK McARDLE Herald Staff - Published: November 17, 2007

BENNINGTON — The National Institute for Occupational Safety and Health may have found the cause for the unusually high rate of sarcoidosis among employees of the Bennington state office building, according to a report from the Vermont Department of Health.

"Based on the Turner Group report and the information that we've gotten back from NIOSH, a reasonable conclusion can be made that suggests there is a mechanism for both the development and dispersion of both combustion byproducts and microbes which may be related to the development of asthma, asthma-like symptoms and sarcoidosis," said Dr. Cort Lohff.

Lohff, the epidemiologist for the Vermont Department of Health, said doctors could not "definitively state" the microbes caused sarcoidosis. However, he said the findings indicated there were materials in the building that could have had an adverse reaction on its occupants' health.

The report, released by the state Thursday, refers to samples collected last year by NIOSH with the assistance of a Connecticut-based environmental testing company, Turner Building Science and Design.

NIOSH collected almost 100 plastic drainage tubes from the building's condensate drainage system and 120 dust samples from various carpets. After testing, three microbes were found — thermophilic actinomycetes, mycobacteria and paecilomyces — which are "not commonly found in an office-type work environment," according to the report.

"Thermophilic actinomycetes, mycobacteria and paecilomyces have been associated with the formation of noncaseating granulomas. Sarcoidosis is a disease characterized by the formation of noncaseating granulomas and there is a higher than expected rate of sarcoidosis among people who work or worked in the building," the report said.

The building has been empty since April, after Gov. James Douglas and Secretary of Administration Michael Smith toured the building and Douglas subsequently ordered the building cleared.

Employees had been complaining for years about the air quality in the building but in the summer of 2006, those protests took on a new urgency after it came to light that at least six past or present employees of the building had developed sarcoidosis.

While there is no generally accepted cause or cure for sarcoidosis, it is known to be a disease that causes granular growths in the body's organs. Many people with sarcoidosis never show symptoms but the disease caused one state employee to leave with a disability and left another legally blind in one eye, causing her to give up her driver's license.

Sarcoidosis can be fatal in extreme cases when it causes bodily organs to shut down.

In October 2006, the Vermont Department of Health recommended the Bennington state office employees be relocated although at the time, employees were cautioned the cause of sarcoidosis may never be found.

Lohff said the NIOSH test results and the Turner report confirmed the Health Department had made the right decision calling for the employees to be relocated.

Even the recent report does not make any definitive conclusions. The report states that not all the NIOSH test results have been returned.

"However, because the Health Department has received and reviewed the majority of the test results, understands the source of contamination and what remediation is required, we believe the few remaining test results will not change, and will only confirm, the conclusions drawn here," the report said.

Employees also reported unusually high numbers of asthma and asthma-like symptoms.

The Health Department said they may have been caused by "combustion byproducts from the oil-fired boiler on surfaces throughout the building" and a "hidden reservoir of microbial growth" that was found in pipes used to capture condensed moisture.

In August, representatives of the Turner company presented their findings to employees, findings that included the soot from the boiler and the reservoir of microbes. Turner made 13 recommendations for building remediation, including replacing boilers and the heating and air-conditioning system, rebuilding walls built in the late 1970s and cleaning and refinishing the interior.

The Health Department report recommends implementing all 13 Turner suggestions.

Douglas and Buildings and General Services Commissioner Gerry Myers said earlier this year they were inclined to preserve the building but essentially gut it and create a new, "green" workspace within the existing shell.

Employees are now in temporary, modular offices in the parking lot of the state office building but several maintenance issues have already come up. On Thursday, a roof in the Bennington County District Court began leaking during a strong rain.

Lohff said the Health Department would work with NIOSH when the final test results came in to see if they could map the microbial findings with the locations where the employees who developed illnesses worked. Lohff said that would be for analysis only and wouldn't change their conclusions.

The Health Department will also cooperate with Buildings and General Services to develop a new work environment for the employees of the building.

Calls to Myers and Douglas' press secretary were not immediately returned Friday.

Contact Patrick McArdle at patrick.mcardle@rutlandherald.com.







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