Rash Conclusions

An unexplained and lingering medical condition can sometimes feel like an unscratched itch. Ignore it, and it only seems to get worse. In an age when environmental horror stories abound, and previously unknown threats seem to come at us from all directions, even an apparently benign ailment can take on much larger proportions. That’s especially true when the perceived danger is in a position to affect children.

For the past couple of weeks, school administrators have been trying to calm concerns about reports of persistent rashes that plague several teachers at Burlington High School [1]. The as-yet-unexplained skin reactions, which the district first learned of two months ago, affect at least three teachers. The rashes appear to get worse when the teachers enter the building and subside when they’re away for significant periods of time, such as over vacations.

Privately, several current and former BHS teachers have voiced their concerns about the indoor air quality in one of the high school buildings. However, nearly all declined to speak to Seven Days on the record, in part because Principal Amy Mellencamp has asked her staff not to go to the press or circulate her internal memos. The teachers say they feel intimidated when it comes to expressing their worries publicly, against the district’s wishes.

Others have suggested that it’s premature, even “alarmist,” for the media to report a few isolated cases of wintertime dermatitis as an “outbreak” — especially when the problem affects only a small number of teachers in a workplace occupied by 1500 people each day. At least, that’s the position of school administrators and a state epidemiologist, even as the district struggles to get to the bottom of those itchy red bumps.

“We don’t have anything conclusive of what’s causing the rashes, and it’s a very, very small number of adults,” notes superintendent Jeanne Collins. Nevertheless, she says the district is working with some of the teachers’ doctors to try to isolate the cause, adding, “There is no evidence in all the testing we’ve done thus far that it’s related to the building.”

To date, the Vermont Department of Health [2]’s involvement has been minimal, and environmental health epidemiologist Dr. Austin Sumner warns against reading too much into the BHS cases. “It’s very important to be careful with indoor air-quality concerns and not jump to conclusions,” Sumner says. “Although it’s possible there’s some relation [to past medical problems in the building], it doesn’t make sense on a biological level.”

Some of the heightened concern can be chalked up to an unfortunate coincidence of location and timing. The “E Building,” where the rashes have occurred, is the same one where teachers complained for years about chronic problems with the heating and ventilation system. It’s also the place where much more serious ailments arose in 2002 [3]. Back then, at least three teachers and a student contracted potentially life-threatening heart conditions, which their doctors all attributed to viral infections. Those illnesses were never definitively linked, though two of the teachers, who still work at the high school, have ongoing medical concerns. Their dispute with the district is scheduled to go to mediation this week.

Those faculty members — Laura Allyn, who teaches family and consumer science, and Arnie Gundersen, who teaches math and physics — declined to comment on their cases for this story. So did the attorney with the Vermont NEA, administrators and school board members. Understandably, all the parties say they’d like to avoid “poisoning the waters” in advance of this week’s closed-door session.

Nonetheless, the recent health complaints associated with Building E highlight the often-difficult task of nailing down the source of an indoor allergen or contaminant. Despite the small number of reported rashes, in November the district hired an outside consultant, ATC Associates, to test the building for elevated levels of carbon dioxide, carbon monoxide, mold, airborne fungi and other possible irritants. Those readings all came back normal. A fumigation was scheduled for earlier this month but had to be canceled for legal and technical reasons.

“I think it’s fair to say that we’re doing everything we can to figure out what’s going on, and to give the teachers whatever assistance we can,” notes Burlington school board member Fred Lane. “Certainly, when you look at what’s happened at the state level with their buildings, people are very conscious of this kind of thing. As a board and as an administration, we want to make sure that people have no qualms whatsoever about their work environment.”

Lane is referring to the health issues that arose in the Bennington State Office Building [4], which was closed last March after six current or former employees were diagnosed with sarcoidosis, an inflammatory disease of unknown origin. Although the state has plans to clean and renovate the building, some Bennington lawmakers are now calling for it to be torn down and rebuilt, at an estimated cost of $18 million.

So far, no one is suggesting that the problems in BHS’s Building E rise to that level of severity. But Wally Elliott, who chairs the school board’s Infrastructure and Technology Committee, admits there are more questions than answers. When asked if he thinks the current rashes are related to the health complaints several years ago, he says, “I don’t know how anyone could rule that out. But I don’t know that anyone can make that connection yet, either.”

Those health problems were significant. Laura Allyn (who agreed to discuss her medical condition provided we didn’t touch on her outstanding complaint against the district) is the youngest of the three teachers — and also the sickest. She recounts how her condition was first misdiagnosed as asthma, as she’s a woman in her early forties with no history of heart disease in her family.

Only later did her doctors discover that she’d contracted viral myocarditis [5], a condition that damages the heart muscle. Allyn eventually underwent valve-replacement surgery in February 2005 and missed half the school year. Her doctors theorized that her virus could have been spread by “inadequate ventilation.”

These days, Allyn is back teaching at three-fifths time, but still suffers from shortness of breath. Since her heart functions at only 25 percent, she now has a Pacemaker, tires easily, and has difficulty with stairs. She’s also had to move in with her brother in Colchester, and says her condition has “changed my whole life.” Though she’s appreciative of the district’s efforts to accommodate her condition, she declined to comment on how she thinks the school is handling the recent health complaints.

Bill McGrath, 64, another teacher who fell seriously ill six years ago, is now retired and uninvolved in this week’s mediation — primarily, he says, because he’s the only one of the three who made a full recovery. In February 2002, McGrath was hospitalized after his heart output dropped to 25 percent. He was diagnosed with congestive heart failure, a condition his doctor also attributed to a viral infection. McGrath, who taught for 36 years, said he had “terrible” problems with the heating and ventilation in his classroom. Like Allyn, he missed half the ’02 school year and didn’t return until the following fall.

When asked if he thinks the current skin rashes at BHS might be tied to the problems he experienced with the ventilation system, McGrath says, “Of course they’re related! They’ve never fixed the ventilation system properly. You ask any teacher from that school what happens when they come back from vacation. That place stinks to high heaven!”

Gundersen, whose illness was first reported in this paper in July 2005, declined to comment for this story. However, an open-records request filed by Seven Days with the Vermont Department of Labor [6] uncovered a February 2007 letter Gundersen sent to Attorney General William Sorrell and Labor Commissioner Patricia Moulton Powden. In it, he requested a formal investigation into the district’s alleged failure to report a “viral outbreak” in the school, and also claimed administrators had made “materially false, misleading and erroneous statements” to state investigators. Gundersen further alleged that four members of the community contracted serious viral heart illnesses due to the school’s practice of shutting off its ventilation system during the winter months in an effort to save on heating costs.

Both the attorney general and the Department of Labor denied Gundersen’s request for an investigation. And, on October 10, 2007, the Department of Labor rejected his workers’ compensation claim, noting that Gundersen had “failed to show the nexus between the air quality at Burlington High School and his work-related illness and symptoms.”

Although Sumner wasn’t working for the health department when those heart ailments arose several years ago, the epidemiologist believes it’s unlikely the ventilation system caused them. Certain diseases, such as tuberculosis, can be dispersed through a ventilation system, he explains. But viruses are more commonly spread physically through direct, person-to-person contact or aerosol droplets, like those released in a sneeze.

For her part, Superintendent Collins says the problems with Building E’s ventilation system have been resolved. Since 2002, a district-wide indoor air quality committee has been established, she explains, and BHS has made progress on a number of related fronts. (For instance, the district’s no-idling policy has reduced absenteeism and the use of medical inhalers.) And, as for tracking potentially related medical issues in the schools, Collins says the district updated its reporting procedures as recently as last year — though, she admits, it probably won’t catch everything.

“We have people out sick all the time,” Collins points out. “There is no reason to assume that my cold today is connected to the building. My cold is because it’s January, there’s a thaw, and I work with a lot of people all the time.”