Thank you Myrl Jeffcoat!!! The Never-board-certified Stephen Barrett, MD (Part 1)
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From: Ilena Rose on 29 May 2008 19:36 Thanks to Myrl Jeffcoat for her usual confusion ... she attributes this article to me, but I didn't write it. I will post it here thanks to Myrl! www.BreastImplantAwareness.org/myrl.html www.BreastImplantAwareness.org/QuackWatchWatch.htm http://www.stephenbarrettmd.blogspot.com/ The Never-board-certified Stephen Barrett, MD (Part 1) Never board certified in anything, his experience as a physician ended with his 1958 internship. Yet, he proclaimed himself an expert in medicine, nutrition, & law, as well as having declared himself the media. He has belonged to private interest groups whose names deceptively sound like government agencies, and he has been neither a medical technologist, nor a cytopathologist, nor a biochemist, nor a vaccinologist, nor a researcher, nor a forensic scientist, nor a ... January 16, 2007 The Clone of a Salem Witch Hunter In the Year 2001, a retired psychiatrist stated: "Today, I am the media." He repeat- edly presented himself as an expert in medicine, nutrition, and law, while having zero experience as a practicing physician, zero training in nutrition, and zero bar as- sociation membership. At the principle website that he operates, he is described as a "medical communications expert" of national renown. He even presented himself as a master in spiritual direction, in book form. Representations of Stephen Barrett insinuate that he alone can suffice as the voice of medicine. In fact, representations of him make it sound as if, during any given election, he should run for God. However, the factual score- card on Barrett differs drastically from the representations made of him. Stephen Barrett's Extensive Lack of Credentials, Lack of Experience, and Lack of Board Certification [1] Stephen Barrett, M.D. was never board-certified in anything, at any time in his life. He has never been able to speak with the authority of a board-certified medical expert. [2] Nor has he been able to speak from the vantage point of a practitioner in any type of internal or dermatolog- ical medicine. In fact, Stephen Barrett has not served in the capacity of a physician since the end of his rotat- ing internship days. Those days ended over 48 years ago, in 1958. The "MD" affixed to his name simply means that he graduated from a medical school. He did do that. But, he did it over forty-nine years ago, in 1957. [3] Moreover, Stephen Barrett has never been a research- er in any capacity; neither at the clinical level nor at the murine test level. He has been neither a toxicologist, nor a vaccinologist, nor a neurologist, nor a biochemist, nor an immunologist, nor any type of medical technolo- gist, nor a pharmacologist. This means that he has never been able to speak from the vantage point of a research colleague. That is to say, if Stephen Barrett had been seen in a lab coat after 1958, it was during Halloween. [4] And Stephen Barrett has zero inventions/patents to his name. Therefore, he has never been able to speak from the vantage point of a medical innovator, either. [5] Furthermore, there is no evidence that Stephen Barrett is a firsthand witness to illness on either side of the coin; neither as a practicing physician nor as a patient. That is to say, he has no known history of severe med- ical impairment. By all appearances, he is not able to offer any insight on what it is to intimately know intense physical suffering in the first person singular. And his callousness indicates this. [6] And as far as concerns Stephen Barrett being advertised as a "medical communications expert," his curriculum vitae indicates that he: - never managed disaster relief efforts, - never developed medical software programs, - never oversaw ambulance dispatch operations, - never managed the allocation of medical supplies, - never networked hospital communication systems, - never transmitted emergency medical instructions to sea, - never networked pharmaceutical communication systems, - never translated medical literature into foreign languages. So where is the medical communicating that Stephen Barrett is supposed to do so expertly ? Stephen Barrett's Allegation of Being a Legal Expert It was in a 21st Century California court where Barrett presented himself as an expert in FDA regulatory law. It concerned a case that he himself instigated, under the name of a 501c non-profit organization of which he was/is a mem- ber and even an officer. Barrett saw to the filing of the lawsuit (under the corporate name), and then he hired himself as an expert witness, de- spite the blatant conflict of interest. He then expected money to be transferred from the 501c non-profit group's bank account to his own personal account, in the form of a fee payment. Needless to say, Stephen Barrett never worked for, with, over, under, or besides the FDA. And the presiding judge stated: "the Court finds that Dr. Barrett lacks sufficient qualifications in this area." "He has never testified before any governmental panel or agency on issues relating to FDA regulation of drugs." "Moreover, there was no real focus to his testimony with respect to any of the issues associated with Defendant's products." Furthermore, the judge stated that Stephen Barrett's testimony should be "accorded little, if any, credibility." In the end, the 501c private corporation of which Barrett is a member lost the case. It was ordered to pay the de- fendant's attorney fees. And as an added note, he claimed himself to be a 21st Century legal expert in FDA regula- tory matters, because he completed one and a half years of correspondence law school in 1963; and because he had several conversations with FDA personnel, as well as some sort of continuing education classes that he had not attended in eight years prior to the judgment. Stephen Barrett has filed many lawsuits. Each one is an article of its own. He usually sues for libel, malice, and/or conspiracy. One report attached Barrett to a multiplicity of lawsuits filed against forty defendants. And his most re- cent courtroom loss is dated October 2005, in the Court of Common Pleas of Lehigh County for the State of Penn- sylvania. In that court case, Barrett once again claimed that he was a legal expert. Barrett lost a court case filed in California, under his own name. And he also lost cases in Oregon and Illinois, as well as in Pennsylvania -- also filed under his own name. In summary, Stephen Barrett was never the member of any bar association. He never represented himself as his own attorney in any of his many lawsuits. He was never a dis- trict magistrate, and he was not a clerk of court. Yet, he has formally claimed that he is a legal expert. Barrett did have court appearances as an expert witness in criminal and parole cases, but only in the capacity of a psychiatrist who was never board certified. One such venue was the juve- nile court system in San Francisco during the 1960s. Barrett's Claim of Being a Nutritional Expert As far as concerns his allegations of being a nutritional expert, it was during the 1990s when he once testified against a nutri- tionist who carried a number of credentials, including that of a certification. This was at a hearing of the American Dietetic Association. Barrett was only a non-trained and honorary member of that association, yet he was presented as one of its two expert witnesses. As a result of that hear- ing, the lady against whom Barrett testified lost her registered dietician credentials. Her reputation suffered harm, and her future earnings potential was compromised. The woman then sued the association who presented Barrett as a nutritional expert. And it was during a cross-examination when Barrett finally conceded that he was not a nutritional expert, being that had no training in the subject. He said that he was an expert in "consumer strategy," instead. As a result, the woman against whom Barrett testified had her credentials restored in full. Notification of this was published in the cou- rier & journal of the American Dietetic Association. The woman also received an undisclosed settlement. A Sample of Stephen Barrett's Mode of Communication Stephen Barrett co-authored a book with a publicly known de- frauder whose now-defunct paper review company, in providing health reports to State Farm Insurance adjustors, was de- clared "a completely bogus operation" by an Oregon judge. Concerning Barrett's fraudulent co-author, it was the NBC television network who reported him as the ratifier of fraud- ulent health reports. He is a Dr. Ronald Gots, founder of a company named Medical Claims Review Services. That company went out of business in 1995. The NBC television network obtained 79 of the reports that Gots' paper review company provided for State Farm's ad- justors. And ever-so-coincidentally, 100% of those 79 reports favored State Farm over every auto accident claim- ant profiled in those reports. The irony to this is that Stephen Barrett heralds himself as an exposer of health fraud, as well as a defender of mankind from persons committing health fraud. Yet, he elected to have his name placed in print next to a notorious defrauder. For further information on this matter, see: The Paper Chase: A 15 month NBC Dateline Investigation The Barrett/Gots Book, itself The Barrett/Gots book is titled, "Chemical Sensitivity: The Truth About Environmental Illness." Needless to say, the book is a vehement denial of the valid existence of Chem- ical Sensitivity. However, Chemical Sensitivity comes in many case-specific and medically acknowledged forms; in forms such as: > Red Cedar Asthma (Plicatic Acid Sensitivity), > IgE-mediated Triethanolamine Sensitivity, > Pine Allergy (Abietic Acid Sensitivity), > Formaldehyde-induced Anaphylaxis, > Phthalic Anhydride Hypersensitivity, > Ammonium Persulfate Sensitivity, > Glutaraldehyde-induced Asthma, > Phenyl Isocyanate Sensitivity, > Halothane-induced Hepatitis, > Sulfite-induced Anaphylaxis, > Chemical Worker's Lung, > TDI-induced Asthma, > NSAID Intolerance, . . . .. . . and numerous other forms. Similarly, the Barrett/Gots book is a denial of the existence of the Environmental Illness which also comes in a number of medically acknowledged case-specific forms; in forms such as: > Vasomotor Rhinitis, > Occupational Urticaria, > Irritant-induced Asthma, > Occupational Rhinosinusitis, > Hypersensitivity Pneumonitis, > Photoallergic Contact Dermatitis, > Airborne-irritant Contact Dermatitis, > Reactive Airways Dysfunction Syndrome, > Irritant-associated Vocal Cord Dysfunction, > Sick Building Syndrome (Building-related Illness), . . . .. . . and a few other forms. In fact, the Barrett/Gots book calls Sick Building Syndrome "a fad diagnosis." However, Sick Building Syndrome is listed as one of the "Most Common Diagnoses" at the Occupational & Environmental Health centers of: > Iowa University, > Johns Hopkins University, > The University of Pittsburgh, > The University of Stony Brook, > Detroit's Wayne State University, > The University of Illinois-Chicago, > The University of California-Davis, > Boston Medical Center, as Building-related Illness, > Washington University's Harborview Medical Center, > The University of Maryland, as Building Related Disease, > Nat. Jewish Med. Research Ctr, as Building Related Illness. Needless to say, the Barrett/Gots book also denies the physi- ological existence of the Multiple Chemical Sensitivity which is listed as one of the "Most Common Diagnoses" at the Occu- pational & Environmental Health centers of: > the world renowned Yale University, > the world renowned Mount Sinai Hospital, > hospitals affilated with Harvard University, > four other American medical institutions which are licensed and certified centers of practice. The listing thereof is done by the Association of Occupational & Environmental Clinics. For more information, see: http://www.aoec.org/content/directory_MA.htm http://www.aoec.org/content/directory_NY.htm http://www.aoec.org/content/directory_CT.htm The Objective Medical Findings of Chemically Sensitive Patients which Stephen Barrett Ever-so-coincidentally Neglected to Disclose For the record, there do exist objective medical findings in the world of Chemical Sensitivity. The following findings have been documented in the records of chemically sensitive patients: > dermatitis, > anaphylaxis, > angioedema, > turbinate swelling, > glandular hyperplasia, > excessive nasal pallor, > edema of the adenoids, > edema of the true vocal cords, > nasal and/or laryngeal erythema, > protuberant/distended abdomen, > permeability of epithelial cell junctions, > hepatotoxicity in the absense of viral hepatitis, > paradoxical adduction of the true vocal cords, > marked cobblestoning of the posterior pharynx, > inflammation of the alveoli (air sacs of the lungs), > a 20%+ drop in FEV1 during inhalation challenge testing, .... and a few other things, such as visible and measurable wheals produced during placebo-controlled skin testing, Barrett's Contradiction Barrett also wrote a 64 page booklet on Multiple Chemical Sensitivity. Furthermore, Barrett wrote a text of much short- er length, titled: "Multiple Chemical Sensitivity: A Spurious Diagnosis." In that article, Barrett states: "Legitimate cases exist where exposure to large or cumulative amounts of toxic chemicals has injured people." Well, such exposure scenarios are the causes of Chemical Sensitivity. That is why lay persons regard it as "Chemical Injury." In as much, Barrett first denies the existence of Multiple Chemical Sensitivity in name. Yet, he describes Chemical Sensitivity in function. But, he does so in such a way that he leaves the reader uncertain as to what his state- ment is intended to mean. After all, a novice might assume that Barrett is referring to resovable acute toxicity cases, instead of long-term chemical sensitization illnesses. A Duly Noted Hypocrisy Stephen Barrett markets fear. For example, he has marketed fear of the formerly overrated echinacea flower which is only harmful to persons severely allergic to the inulin that it contains; to the inulin which is also present in Jerusalem artichokes, leeks, bananas, garlic, and onions. Yet, has Stephen Barrett ever warned people about bananas, onions, and Jerusalem artichokes, as he did echinacea? Has he ever warned people about VIOXX, BEXTRA, ZYPREXA and the other pharma- ceuticals that caused harm to mankind? All in all, when you attack as many persons and entities as does Stephen Barrett, the statistical probability is that you are going to be correct some of the time. However, the same statistical probability is that you are going to be wrong some of the time, especially when you are unqualified to comment. Being that Stephen Barrett neither scored a 100% nor a passing grade on his board exams, he cannot be reasonably expected to be 100% correct in his vol- umes of writings. Moreover, people have brain cells. They can recognize "quackery" by ill effect or lack of effect. They don't have need of a "Stephen Barrett" to tell them. And not only can reasonable people detect a "quack" when they see one, they can just as easily detect a disingenuous political operative when they read one. Stephen Barrett's Cookie Cutter Techniques It is not an incident of unheard proportions for Stephen Barrett to have cited an obselete reference, as well as an outdated and isolated instance, in order to have mankind adhere to an assertion of his. For example, in order to convince mankind that Chemical Sensitivity is nothing more than a mental illness, Barrett cited an incident which was put into writing 120 years ago, in 1886, concerning one woman and one woman only. And that incident was not about chemicals. It was about roses. Now, concerning the medical practices and medical doctrines that Stephen Barrett opposes, he is repeatedly found stating, "inconclusive and not yet proven." And if he cannot discredit something on technical merits, he cites an isolated case here and an isolated case there, concerning an unauthorized billing or a marketing violation committed by a person engaged in something that Barrett wants deleted from the face of the Earth. Yet, Barrett never mentions the dozens of frauds that were committed under the supervision of his co-author, Dr. Ronald Gots. And Barrett never mentions the vast num- ber of lawsuits filed against pharmaceutical companies. Barrett often mentions what treatments and tests the Aetna Insurance Company will not cover, as if Aetna is a charity organization founded by Mother Theresa; as if Aetna is not a profit minded corporation which benefits from the denial of claims. In as much, an insurance company will not pay for redundant treatment or redundant testing, and therefore a similar test or treatment will not be covered. Furthermore, an insurance company will not pay for anything that is regard- ed as being in the experimental & investigational stage. And as a side note, everything in established medicine today was at the experimental & investigational stage yesterday. The Ironies about Dr. Stephen Barrett, in Light of the Fact that He is a Retired Psychiatrist The great irony about Barrett is that a psychiatrist is expected to be a master at procuring peace in the minds and hearts of men. A tree is known by its fruits. Stephen Barrett's fruits have been made known. Another great irony is that a psychiatrist is expected by the reasonably minded person to be a master in neurology. Bar- rett failed the Neurology section of his board exams. And yet another irony is that a psychiatrist is expected to have a reflex action for keeping confidentiality, being that patients confide intimate details to a psychiatrist. However, Barrett has placed person after person in an unfavorable spotlight. He is even known to have revealed the tax problems of one of his opponents; not to make notice that the man can use someone's help, but rather, to provoke ill regards for the man. Yet, when has Stephen Barrett ever placed the spotlight on the exorbitant price mark-ups of pharmaceuticals in America? After all, Barrett claims that he is a consumer advocate. So, where is the consumer advocating in one of the most taxing impositions on the American economy and consumer? posted by Atlantic America | Tuesday, January 16, 2007 Dr. Jekyll & Mr. Formaldehyde The Most Deadly & Irresponsible Thing that the Never-board-certified Stephen Barrett Has Thus Far Asserted The AMA, the American Academy of Allergy Asthma and Immunology (the AAAAI), and the American Lung Associ- ation (the ALA) all acknowledge the following: They acknowledge the existence of Chemical Sensitivity as it applies to Asthma. That is to say, all three associations acknowledge that chemical-bearing agents can trigger as- thma attacks in susceptible persons. Each organization advocates the practice of Avoidance; of avoiding the airborne agents which trigger one's asthma. In fact, the AMA formally refers to Avoidance as "Control of Factors Contributing to Asthma Severity." And in French medical Literature, avoidance is known as "Strict Eviction." Examples of recognized asthma triggers in the chemical category include: [A] "NO2" from gas stoves and fireplaces, fumes from kerosene heaters, and volatile organic compounds from carpeting, cabinetry, plywood, particle board, and fumes from household cleaning products." See: http://www.ama-assn.org/ama/pub/category/13603.html [B] "Air pollutants such as tobacco smoke, wood smoke, chemicals in the air and ozone" "Occupational exposure to vapors, dusts, gases or fumes" "Strong Odors or sprays such as perfumes, household cleansers, cooking fumes (especially from frying), paints or vanishes" See: http://www.aaaai.org/patients/publicedmat/tips/asthmatriggersandmgmt.stm [C] "Perfume, paint, hair spray, or any strong odors or fumes." See: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=22916 In fact, the above-cited American Lung Association text furthermore states: "Perfume, room deodorizers, cleaning chemicals, paints, and talcum powder are examples of triggers that must be avoided or kept at very low levels." The same American Lung Association furthermore states: "These 'triggers' can set off a reaction in your lungs and other parts of your body." Now, place an emphasis on "other parts of your body," and keep in mind that: Avoidance furthermore applies to Urticaria (rashes), Ana- phylaxis, Chemically-induced Hepatitis, Irritant Rhinitis, Dermatitis, Irritant-associated Vocal Cord Dysfunction, Reactive Upper-airways Dysfunction Syndrome, etc. The remedy for any chemically sensitive person is Avoidance. Stephen Barrett has called Avoidance "detrimental" in those writings of his which condemn the Multiple Chemical Sensi- tivity diagnosis. He stated that "Multiple Chemical Sensitivity is a label, and not a disease." He advises all to forbid the suf- ferers of MCS to avoid the chemical-bearing agents that harm them, because the Stephen Barrett who has zero experi- ence in every form of internal and dermatological medicine claims that chemical-bearings agents do not harm them. Firstly, this assertion contradicts the diagnostic histories of the Occupational & Environmental Health centers of Johns Hopkins, Yale, Mt. Sinai, and the Harvard-affiliated hospitals, as well as certain Ear Nose Throat and Allergy Specialists. And more importantly, Irritant-induced Asthma is certainly a disease and not a label; not visa-versa. Irritant Rhinitis is not a label, either. It is a medically accepted condition that has been known to co-exist with Irritant-induced Asthma. In as much, the chemical-bearing agents which are sought to be avoided by persons diagnosed with Multi- ple Chemical Sensitivity are the same ones which the AMA, the AAAAI, and the ALA instruct susceptible asthmatics to avoid. The bottom line is this: Stephen Barrett has caused confusion in having created the illusion that Multiple Chemical Sensitivity is the only type of chemical sensitivity in existence. The AMA's Admitting to the Converse Relationship Between Pollution Levels and Hospital Admissions Due to Asthma Five thousand to six thousand people die each year from asthma, in the United States alone. And, one of the highest asthma-related death rates has been in Harlem, NY. Ever so coincidentally, the environs of Harlem are venues for New York City waste sites. Concerning this, the AMA has expressly stated that: "fluctuations in the levels of air pollution correlate with asthma symptoms and hospital admissions." [Report 4 of the AMA's Council on Scientific Affairs (A-98)] Stephen Barrett's Hit & Run Narration of Ecology House's First Two and Half Years of Operation In his effort to convince mankind that Avoidance is a "detri- mental" practice for Chemical Sensitivity sufferers, Barrett cited the 1989 account of a house constructed in California for the benefit of chemically sensitive people. It was a newly built dwelling that could only house eight chemically sensitive persons at a time. Barrett gave an exceptionally short narration of the account, and then he concluded, by stating, "Although the building was intended to be free of synthetic chemicals, most of the initial tenants said it still made them sick." A Lesson in Stephen Barrett's Slight-of-hand Deception Techniques Firstly, Stephen Barrett stated that, "the building was intended to be free of synthetic chemicals." He did not say that the de- signers succeeded in acheiving their intentions. After all, it was the 1980s. How easy was it to locate additive-free building materials in every phase of the project's construction? In fact, the report is that the builders of the safe house used cer- tain building materials that the environmental experts advised against using. Secondly, Barrett did not say that the designers intended to make that house free of naturally occurring chemicals. After all, chemicals exist in unprocessed nature, too. And those chemicals can trigger adverse reactions in suceptible people as much as can synthetic ones. For example, the most untreated and organically grown pine can trigger severe respiratory reactions in persons sensitive to pine. Thirdly, "most of the initial residents" constituted five to seven people. That is not large enough a number to justifiably write off the entire population of chemically sensitive patients. And most importantly, Barrett did not say that any subsequent tenant of Ecology House experienced illness while in that house. This is because no subsequent tenant reported illness while in that same house. That account ever-so-coincidentally concurs with the present understanding of chemical sensitivity, as it applies to new build- ing materials. A new house must first outgas its volatile organic compounds for an extended period of time, before it can be in- habitable for any chemically sensitive person. In fact, it was reported that the California safe house became tolerable two and a half years after its construction. Therefore, the event of 1989, which was resolved by the elapsing of time, is in ac- cordance with the 21st Century understanding of Chemical Sensitivity. That account does not debunk it. In as much, chemically sensitive persons should not be housed in newly built structures. They should be housed in older ones; in ones with well-aged cementitious plaster walls, etc. Further- more, Barrett did not explain that the drapery, furniture, cooking odors, plants, shampoos, lotions, spices, laundry detergent, and the smell of new appliances within any dwelling can cause chem- ically sensitive persons to get ill whenever in that dwelling. Bar- rett never admitted that a strong odor of itself, be it chemical or nonchemical, can trigger an adverse reaction in a sufferer of Environmental Illness. This can happen no matter how "toxin- reduced" the dwelling's building material is. Fair Warning About Stephen Barrett's Assertion If you elect to fanatically act upon Stephen Barrett's assertion that the chemically sensitive have no medical need to practice Avoidance, you might one day find yourself on the defendant's end of either a Toxic Battery criminal case or a "Deliberate Intent" civil action. And Stephen Barrett, having never been the member of any bar assocation, will not be there to defend you. And Stephen Barrett, possessing zero experience in every type of physical medicine, as well as zero board certi- fication even in psychiatry, will not be there to testify for you. posted by Atlantic America | Tuesday, January 16, 2007 Visible & Measurable Wheals Have Been Repeatedly Documented Dr. Stephen Barrett "M.D." is an outspoken individual who retired from psychiatry in 1993 and then proclaimed himself "the media" in 2001. He was never board-certified in psy- chiatry, and he was never board-certified in anything else. He has zero experience as a practitioner in every form of internal, dermatological, & dental medicine. And he was not a researcher in any capacity, either. That is to say, he was neither a biochemist, nor a vaccinologist, nor a med- ical technologist, nor anything similar. An Allegation of Stephen Barrett that Calls for a Response: Stephen Barrett alleged, throughout his anti-MCS literature, that a primary test for chemical sensitivities consists in ... (I) a very subjective and non-quantitative form of testing ... (II) by which a diluted chemical solution is placed under the tongue of a patient (or injected through his skin), ... (III) followed by nothing more than the patient reporting if whether or not he experiences any symptom from the administered chemical solution. This allegation, in combination with numerous omissions of fact, can easily deceive a beginner into assuming that there has never been a test to prove the existence of chemical sensitivities. This allegation, therefore, calls for a response. The Response: (1) The testing for chemical sensitivities has included, but has not been limited to, ... (I) ... the traditional skin prick test, otherwise known as the SPT. (II) In skin prick testing, a test-subject is regarded as having tested positive when a visible and measurable wheal, equal to or larger than a designated size, appears as a result of the skin test. (III) The size of the wheal is then recorded in numerical form, and numerical measurement constitutes objectivity. IgE-mediated Chemicals, via the Process of Haptenation (2) The purpose for the SPT is to test for immediate onset Type I hyperreactivity. Such a reaction occurs within one hour of exposure. (I) IgE stands for Immunoglobulin E, and an immunoglobu- lin is a protein produced by plasma cells & lymphocytes, serving the function of an antibody. (II) A number of chemicals have been found to trigger im- mediate onset reactions, and a subset of those have been discovered to be IgE-mediated, via a process known as "haptenation." (III) Haptein is a greek word which means "to fasten," and a hapten is a low weighted molecular agent that reacts with an antibody, but cannot induce the formation of an antibody until it is fastened to either a carrier protein or to a large antigenic molecule. Chemicals happen to be agents of low molecular weight. Type IV Hypersensitivity Reactions (3) In addition, there are a significant number of chemicals which have been found to induce Type IV, cell-mediated hyperreactivity. This is known as "delayed allergic reac- tivity," and this type hypersensitivity results in dermatitis. (I) Concerning Type I and Type IV hyperreactivity, the Practice Parameter for Allergy Diagnostic Testing, as is issued by the Joint Council of Allergy Asthma and Immunology, states: "Many chemicals (e.g., sulfonechloramides, azo dyes, parabens, fragrances) used as additives in foods, drugs, and cosmetics may induce either IgE-mediated reactions or contact dermatitis, or both." [Ann Al- lergy 1995; 75:543-625] Non-immunological Chemical Sensitivity Reactions, Including Anaphylaxis (4) In addition, a number of chemicals have been identified as irritants, being that they trigger very real "nonimmuno- logical" responses. There is even a nonimmunolgical form of anaphylaxis, called an "anaphylactoid reaction." Such a reaction produces the same final result as does an immunologic anaphylactic reaction, and the only difference between the two types of reactions is in the triggering mechanism of them. That is to say: "An anaphylactoid reaction is another type of immediate reaction that mimics anaphylaxis. While symptoms and treatments are the same the reason for the reaction is not. An ana- phylactoid reaction does not involve the IgE antibodies' immune system and is not consid- ered a true allergic reaction. Even so, the reaction can be just as serious." [American College of Allergy, Asthma & Immunology] See: http://www.acaai.org/public/advice/anaph.htm (I) Thus, there is Allergic Asthma, and then there is Irritant- induced Asthma. One type of asthma is immunologic, while the other type is not. You are not inclined to run a 26 mile marathon in either case, whenever you are exposed to your asthma triggers. Allergic Sensitization, Direct Irritation, and Pharmacological Reactions (5) Hypersensitivity reactions can be triggered via: (a) Allergic Sensitization. This is induced by repeated exposure to a sensitizing agent such as formaldehyde, glutaraldehyde, or phenyl isocyanate. And then, upon becoming sensitized, further exposure to the agent re- sults in an antibody release and/or an inflammatory chemical release. (b) Direct Irritation. This is induced in those who are "atopic;" (in those who possess chronic vulnerabilites or pre-existent conditions). Such persons develop "symptoms immediately after exposure to substances such as chlorine, ammonia, sulfur dioxide, and envi- ronmental smoke." (c) Pharmacological Reaction. This comes as a result of the fact that some chemicals and nonchemical agents elevate the production of chemicals that naturally exist in the body. An example of a naturally existent chemical in the body, able to have its level elevated by nontoxic chemical exposure, is acetylcholine. A case in point is the organophosphate/carbamate class of pesticide. Even at nontoxic levels, it can elevate the level of acetylcholine in the lungs, because that class of pesticide inhibits the enzyme acetylcholinesterase. For further understanding on this, see the Mayo Clinic's teaching on Occupational Asthma. It is found at: http://www.mayoclinic.com/health/occupational-asthma /DS00591/DSECTION=3& A Sample of IgE-mediated Chemicals (6) For confirmation purposes, examples of IgE-mediated chemicals which can be involved in skin testing, include the following: (a) The disinfectant Ortho-phthalaldehyde. It has even resulted in anaphylaxis, concerning the product "Cidex OPA." See: <> Nine episodes of anaphylaxis following cystoscopy caused by Cidex OPA (ortho-phthalaldehyde) high- level disinfectant in 4 patients after cystoscopy. {J Allergy Clin Immunol. 2004 Aug;114(2):392-7} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd= Retrieve&db=PubMed&list_uids=15316522&dopt=Citation (b) Formaldehyde. It is masked behind a number of aliases, and it outgases from the shampoo and liquid soap ingredients, DMDM hydantoin, imidazolidinyl urea, diazolidinyl urea, and quaternium-15. See: <> IgE-mediated urticaria from formaldehyde in a dental root canal compound. (The full text describes 28 cases of Formaldehyde Sensitivity. {J Investig Allergol Clin Immunol., 2002;12(2):130-3} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=12371530&dopt=Abstract <> Exposure to gaseous formaldehyde induces IgE- mediated sensitization to formaldehyde in school children. {Clin Exp Allergy, 1996 Mar;26(3): 276-80} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=8729664&dopt=Abstract <> IgE allergy due to formaldehyde paste during endodontic treatment. Apropos of 4 cases: 2 with anaphylactic shock & 2 with generalized urticaria. {Rev Stomatol Chir Maxillofac. 2000 Oct;101(4):169-74} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=11103423&dopt=Abstract (c) Vinyl Sulphone Reactive Dyes. They are also known as fiber-reactive dyes, as well as azo dyes. They include Remazol Black B. See: <> Roll of skin prick test and serological measure- ment of specific IgE diagnosis of occupational asthma resulting from exposure to vinyl sulphone reactive dyes. {Occup Environ Med. 2001 Jun;58 (6):411-6} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=11351058&dopt=Citation <> Asthma, rhinitis, and dermatitis in workers exposed to reactive dyes. {Br J Ind Med. 1993 Jan;50(1):65- 70} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=8431393&dopt=Abstract (d) Cyanuric Chloride. It is used in the production of plastics, herbicides, pharma- ceuticals, and fiber-reactive dyes. It is also a structural component of monochlorotriazine and dichlorotriazine dyes. See: <> Immunologic cross-reactivity between respiratory chemical sensitizers: reactive dyes and cyanuric chloride. {J Allergy Clin Immunol. 1998 Nov;102(5): 835-40} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=pubmed&dopt=Abstract&list_uids=9819302&query_hl=9 (e) The disinfectant Chlorhexidine. It has even triggered anaphylaxis. See: <> FDA Public Health Notice: Potential Hypersensitivity Reactions to Chlorhexidine-Impregnated Medical Devices http://www.fda.gov/cdrh/chlorhex.html <> Immediate hypersensitivity to chlorhexidine: literaure review. {Allerg Immunol (Paris) 2004. Apr;36(4):123-6} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=pubmed&dopt=Abstract&list_uids=15180352&query_hl=16 (f) Phthalic Anhydride. Nail polish ingredient, ingredient in specific spray paints, and an agent used in the making of unsaturated polyester resins, alkyd resins, polyester polyols, and insect repellents. <> Detection of specific IgE in isocyanate and phthalic anhydride exposed workers: comparison of RAST RIA, Immuno CAP System FEIA, Magic Lite SQ. {Allergy. 1993 Nov;48(8);627-30} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=8116862&dopt=Abstract <> In vitro demonstration of specific IgE in phthalic anhydride hypersensitivity. {Am Rev Respir Dis., 1976 May;113(5):701-4} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=1267268&dopt=Abstract (7) The test that Barrett condemns in his anti-MCS literature is the provocation-neutralization test. And the only type of practitioner that he mentions in the same literature is so-called clinical ecologist. Barrett inaccurately explain- ed the provocation-neutralization test, in his omitting of pivotal fact, and he additionally gave the illusion that the only person on earth who tests for chemical sensitivity is the so-called clinical ecologist. (I) Firstly, the diagnosing of the various forms of chemical sensitivity has been occurring in the worlds of the Occu- pational and Environmental Health Specialist, the Ear Nose Throat & Allergy Specialist, the Dermatologist, and even the Chest Physician. In fact, from the world of the chest physician came the golden rule for diagnos- ing Irritant-associated Vocal Cord Dysfunction. And, two pivotal papers on chemical sensitivity were pro- duced by the head of the department of emergency medicine of an american university. Yes, emergency medicine. (II) And secondly, Barrett failed to mention that the provo- cation-neutralization test has included the measuring of objective skin wheals. Barrett Failed to Mention that it is an Offshoot of the Serial Endpoint Titration Skin Testing Procedure, Covered by Aetna Insurance (8) The provocation-neutralization test is actually an offshoot of the serial endpoint titration skin testing procedure, covered by Aetna Insurance. And this is pertinent to note in light of the observation that Stephen Barrett has repeatedly stated what Aetna covers, as if Aetna alone is the ultimate benchmark in diagnostic testing. (I) Now, the Skin Endpoint Titration seeks to first identify a patient's allergens or hymenoptera venom hypersen- sitivities (such as to that of hornets, bees, wasps, fire ants, and/or yellow jackets.) That is to say, the Skin Endpoint Titration first seeks to find the triggering dose of a hypersensitivity reaction. (II) The same testing then seeks to find the neutralizing dose of the same allergen or venom. Now, this is done for immunotherapy purposes, and the neutraliz- ing dose is found in a series of skin tests. The dose at which the patient no longer experiences a hyper- sensitivity reaction is the "endpoint." It constitutes the neutralizing dose. It then becomes the "safe starting dose" for immunotherapy. Thus originates the name "neutralization" in the provocation-neutrali- zation test. The goal of the provocation-neutralization test is to identify the "neutral dose." (III) In summary, the provocation-neutralization test looks for objective skin wheals, while simultane- ously asking the patient how he/she feels when, of course, such testing involves skin testing. And the appearance of wheals have been documented in such testing. (IV) The diagnostic parameters become exceeded when the testing is considered positive on an either/or basis; on the basis of either the appearance of an objective skin wheal or the subjective reporting of a symptom. However, this is a test that concerns itself with prog- nostic parameters, also. (V) Nonetheless, to consider a test positive exclusively on the merits of an objective skin wheal is to keep the diagnostic part of any type of skin test within accept- able parameters. It's the sublingual drops version of such testing which raises eyebrows. Wheal Reactions Showed a Distinct Pattern (9) Objective skin whealing was consistently documented during a research undertaking that tested the reliability of the provocation-neutralization test. The result of the research goes as follows: "Reaction by symptoms to foods, chemicals, and normal saline solution showed a random pattern, although wheal reactions showed a distinct pattern." (I) Let it be repeated. In the skin test version of the provocation-neutralization test: "wheal reactions showed a distinct pattern." (II) The conclusion of that research undertaking goes as follows: "Skin response alone may be a more reliable indicator and require cross- validation with other tests, such as oral and inhalation challenges and comparison with a control popula- tion." See: <> Intradermal skin testing for food and chemical sensitivities: a double-blind controlled study. {J Allergy Clin Immunol. 1999 May;103(5 Pt 1): 907-11} http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd= Retrieve&db=PubMed&list_uids=10329827&dopt=Abstract (III) Concerning the prognostic aspect of the provocation- neutralization test, Aetna states: "Since provocation-neutralization requires the provoking and neutralizing of symptoms to a single item at a time, the patient could be required to undergo hundreds of indi- vidual tests requiring weeks or months of full-day testing." (Well, this is what Aetna states.) (IV) The bottomline is that skin testing has been used to identify individual chemical sensitivities to chemicals such as formaldehyde, phenyl isocyanate, azo dyes, & phthalic anhydride. Tested patients produced the objective medical finding of visible and measurable wheals. This has included forms of testing other than that of the neutralization-provocation test, and it has included the neutralization-provocation test, itself. (V) Chemically sensitive patients have tested positive in inhalation challenge testing, as well as in patch testing (the testing that seeks to detect delayed hypersensitivity reponses.) And chemically sensitive patients were also documented as having objective medical findings via the fiberoptic rhinolaryngoscopy and even the biopsy. Some patients were found to have inflamed air sacs of the lungs, while other ones were found to have hepatic injury in the absence of viral infection. And yet other ones were found to have upper-respiratory erythema & swelling. Chemical Sensitivity exists in a number of forms. It is very real, and it can be quite brutal. In as much, it has been repeatedly documented that chemicals, at ambient (nontoxic) levels, are not universally harmless. posted by Atlantic America | Tuesday, January 16, 2007 Johns Hopkins, Mt. Sinai, Harvard, Yale & the MCS Diagnosis Keep in mind that Dr. Stephen Barrett "MD" has zero exper- ience in every field of internal and dermatological medicine, (outside of the internship that he completed in 1958.) Also keep in mind that there are a number of forms of chemical sensitivity which have already been identified and defined by mainstream medical science. This means that entire popula- tions of the chemically sensitive are not dependent upon the universal recognition of MCS, in order to have their medical conditions validated. Brief Outline Stephen Barrett has repeatedly asserted that the Multiple Chem- ical Sensitivity diagnosis is an act of malpractice, given to those who are merely mentally ill. He furthermore called Sick Building Syndrome (SBS) a "fad diagnosis," stating that it is intertwined with MCS. He additionally stated that Multiple Chemical Sensi- tivity is supported by "a small cadre of physicians" who identify themselves as "clinical ecologists." The Induced Deceptions Barrett's literature can easily deceive a novice into assuming that the MCS diagnosis has never been given at any occupa- tional & environmental health clinic, as well as at any world renown medical institution. And being that Barrett associated SBS with MCS, it leaves a novice to assume the same things about Sick Building Syndrome. Therefore, Stephen Barrett's assertions call for a response. The Response The Association of Occupational & Environmental Clinics has posted profiles of its members, in State-by-State direc- tory form. In each AOEC profile, mention is made of the profiled member's Most Common Occupational Diagnoses and Most Common Environmental Diagnoses. Placed into focus at this point are the AOEC members listed directly be- low. The profile of each one is dated 03/05. {1} the world renowned John Hopkins, {2} the world renowned Yale University, {3} the world renowned Mount Sinai, {4} Harvard affiliated Cambridge Hospital, {5} Harvard affiliated Northeast Specialty Hospital. {1} We begin with the directory for the State of Maryland. The first member profiled in the Maryland directory is the Johns Hopkins University Center for Occupational and Environmental Health. At the section of the Johns Hopkins profile titled, "Most Common Environmental Diagnoses," Multiple Chemical Sensitivity and Sick Building Syndrome are both listed. See: http://www.aoec.org/content/directory_MD.htm This can be additionally confirmed at the Johns Hop- kins web address posted below. Toward the bottom of that web page, under the subheading Specialty Programs, one can see that Johns Hopkins provides: "Clinical evaluation of occupational and environmentally related condi- tions/disease (i.e. multiple chemical sensitivities, chemical exposures, indoor air quality)" See: http://www.hopkinsmedicine.org/hse/coeh/services.htm {2} In the AOEC directory for the State of Connecticut, the second member profiled is the Yale University Occupa- tional and Environmental Health Clinic. Among its Most Common Environmental Diagnoses is Multiple Chemi- cal Sensitivity. See: http://www.aoec.org/content/directory_CT.htm This can be additionally confirmed at the following Yale University web address, under the heading, Chemical Exposures/Disease: See:http://info.med.yale.edu/intmed/occmed/clinical_services.html {3} We next go to the State of New York. The fourth clinic profiled in the New York directory is The Mount Sinai Irving J. Selikoff Center. Among its three Most Com- mon Environmental Diagnoses is Multiple Chemical Sensitivity. See: http://www.aoec.org/content/directory_NY.htm {4} We now come to the AOEC directory for the State of {5} Massachusetts. The third and fourth listed clinics are the Harvard affiliates, Cambridge Hospital and North- east Specialty Hospital. Multiple Chemical Sensitivity is listed as one of Cambridge Hospital's Most Common Environmental Diagnoses, while the exact same Mul- tiple Chemical Sensitivity is listed as one of Northeast Specialty's Most Common Occupational Diagnoses. See: http://www.aoec.org/content/directory_MA.htm Furthermore, a notable number of AOEC members have Sick Building Syndrome listed among their most common diagnoses. This includes: [] Presbyterian Occupational Medicine Clinic (Albuquerque), [] The University of Washington Harborview Medical Ctr, [] The University of Iowa Department of Internal Medicine, [] Georgia Occup. & Environ. Toxicology Clinic (Atlanta), [] The University of Stony Brook School of Medicine, [] The University of Illinois - Chicago, [] Wayne State University (Detroit), [] The University of Pittsburgh, [] Johns Hopkins, as was previously mentioned. In addition, a number of AOEC members have Indoor Air Quality listed among their most common diagnoses. For example, the world renown Duke Medical Center has Indoor Air Quality Assessment listed among its most com- mon diagnoses, while Yale University has Indoor Air Quality Problems listed. The 21st Century proposed mechanism for MCS does not come from the world of the "clinical ecologist." It comes from the school of molecular biosciences of an american university. The expanded diagram of that proposed mech- anism mentions, in a favorable light, the conclusions about chemical sensitivity which come from the school of emer- gency medicine of yet another american university. In fact, findings in chemical sensitivity also come from the techno- logically advanced nations of Germany, Sweden, Austria, France, Spain, Italy, South Korea, the Netherlands, and Japan. An outline of the 2002/2004 proposed mechanism for MCS can be accessed by clicking on the link provided directly below. The 2002/2004 Proposed Mechanism for MCS. (Clicking here will take you there.) posted by Atlantic America | Tuesday, January 16, 2007 The Invalidating Feature of the Staudenmayer Test The Research Undertaking that Barrett waved Like a National Flag In his attempt to convince mankind that Chemical Sensitivity is merely a mental illness, the never-board-certified Stephen Barrett repeatedly cited a "research undertaking" conducted in Denver during the 1980s. That test is formally titled: "Double-blind provocation chamber challenges in 20 patients presenting with "multiple chemical sensitivity." The article detailing that research undertaking was published on August 18, 1993. The research team who conducted that test consisted of psychologist Herman Staudenmayer (Ph.d), allergist John Selner (MD), and chemist Martin P. Buhr (Ph.d). The title of that test is misleading, being that it was not based on standard challenge testing, such as the methacholine chal- lenge test which measures FEV1 and the such. In fact, it was subjective testing; the type of testing that Barrett condemns as invalid. Thus, we see another instance of contradiction, and even hypocrisy, in Stephen Barrett's anti-MCS literature. Background in Brevity 1) The test consisted in 145 occasions where a test subject received into his/her chamber an injection of air. The test subject was then instructed to discern if whether or not the injected air was accompanied by a chemical agent. Each of the twenty test subjects participated in at least one "provocation challenge." 2) The challenges were divided into two types: a) active challenges, b) sham challenges. Eighty-eight of the provocation challenges were defined as "sham" challenges, and they were recorded as injections of chemical-free air. The other fifty-seven were defined as "active" challenges, and they were recorded as injections of chemical-bearing air. 3) The sham challenges came in two forms: a) clean air injected alone, b) clean air accompanied by an aromatic agent. 4) The active challenges also came in two forms: a) the injection of an airborne chemical alone, b) an airborne chemical accompanied by an aromatic agent. 5) The aromatic agents were called "maskers." Maskers used in the "Staudenmayer Test" included: a) anise oil, b) cinnamon oil, c) lemon oil, d) peppermint spirit (10% oil and 1% leaves.) 4) The overall result of the test, as recorded by the research team, goes as follows: "Individually, none of these patients demonstrated a reliable response pattern across a series of challenges." The conclusion was that persons diagnosed with Multiple Chemical Sensitivity are merely psychologically ill. The Invalidating Feature of that Test The maskers that Stephen Barrett cited as having been used in the "Herman Staudenmayer Test" are known triggers of adverse reactions in susceptible persons. And they are chemical-bearing agents. Now, concerning anything aromatic, keep in mind that the AMA, the world-renown Mayo Clinic, the American Lung Association, and the American Academy of Allergy, Asthma, & Immunology each recognize, in publicly accessible print, that "strong odors" can be triggers of adverse upper and/or lower respiratory reactions in susceptible people, simply be- cause they are strong odors. And this includes anise oil, cinnamon oil, lemon oil, and peppermint spirit. The Chemical Ingredients in the Sample List of Maskers Used in 'the Staudenmayer Test' that were Alleged to be Chemical-free Concerning the sample list of maskers used in the "Stauden- mayer Test," observe the following: Anise Oil: - An active ingredient in it is anethole. - Anethole's chemical composition is C10H12O. - Its CAS No. is 104-46-1. - It is a known trigger to those adversely reactive to it. - In fact, Anethole is known as p-1-propenylanisode. - It is also known as 1-methoxy-4-(1-propenyl)benzene. - Thus, anise oil is a chemical-bearing agent. In all occasions where anise was used as a masker in a clean air injection, a chemical-bearing agent was being injected into the test subject's chamber. Therefore, to have recorded such an injection as one of chemical-free air was to have recorded a falsehood. Cinnamon Oil: Along with being a "strong odor," cinnamon oil is an aldehyde bearer. In fact, the naturally occurring trans-cinnamaldehyde unassistedly becomes benzaldehyde in the presence of heat. In as much, to have recorded a cinnamon oil air injection as a chemical-free one was to have recorded yet another falsehood. Cinnamon oil is a chemical-bearing agent. Lemon Oil: The most prevalent constituent in lemon oil is the monoterpene, limonene, aka 4-isopropenyl-1-methyl-cyclohexene. Limo- nene develops a potent sensitizing capacity when it is oxidized, and it is a reputed skin sensitizer. In addition, a Swedish re- search undertaking recorded the following about limonene: "Bronchial hyperresponsiveness was related to indoor concen- trations of limonene, the most prevalent terpene." Lemon oil also includes the same alpha-pinene that was implicated in oil of turpentine allergy. Peppermint: This aromatic agent is the bearer of Methyl Salicylate, and as is shown below, it is among the salicylate allergy triggers. It is also the bearer of the sensitizing agents (a) limonene, (b) phellandrene, and (c) alpha-pinene. It is additionally the bearer of (d) methyl acetate, (e) menthofurane, and (f) methone. Now, as far as concerns methyl salicylate, Supplement 5 of the Journal of the American Society of Consultant Pharmacists, 1999 / Vol. 14, states: "Of note, methyl salicylate carries the same warnings as oral salicylates and has the potential to cause Reye's Syndrome in children with flu-like symptoms, as well as adverse reactions in those with aspirin allergy, asthma, or nasal polyps." In as much, to record an airborne injection of peppermint spirit as a chemical-free one, is to record yet another falsehood. Dephosphorylation The research team gave no consideration to the "the masking of sensitivity responses;" a phenomenon attributed to the in- volvement of Ca2+ calmodulin phosphatase calcineurin and the ensuing dephosphorylation that it induces. Barrett's Predictable Response to the Test As is to be expected, in an article written by him, Stephen Barrett recommended that clinical researchers conduct more tests likened to the one conducted by Staudenmayer and his colleagues; anise oil, cinnamon oil, and all. You should be able to conjecture why he recommended this. posted by Atlantic America | Tuesday, January 16, 2007 The Bridge to Part 2 Part 2 can be accessed by clicking on the web address posted directly below. http://www.stephenbarrettmd2.blogspot.com posted by Atlantic America | Tuesday, January 16, 2007 |