- The Washington Times - Thursday, March 22, 2001

Fumes can be deadly, and fumes can be frustrating. Sometimes they are both.

Mary McCaffrey, 60, of Lorton, Va., who worked for 15 years in a basement office at the National Museum of American History at the Smithsonian Institution, at a desk over a long undiscovered and uncapped sewer line, escaped death. But not the fumes or the frustration.

She occasionally found a puddle under her chair. Nearly everyone in her office complained about the stink.

At some point over the 15 years, Mrs. McCaffrey, who worked at the Smithsonian for 23 years, contracted pemphigus vulgaris, a life-threatening skin disease that medical experts know little about. The Smithsonian, after a lengthy investigation, said Mrs. McCaffrey's illness, and the presence of the uncapped sewer line under her desk, were an unhappy coincidence.

Her long and unsuccessful pursuit of damages is a tale of a journey through a maze of federal bureaucracy and the frustration of finding satisfactory answers to a medical mystery.

Mrs. McCaffrey, the manager of an office in the basement of the Office of Imaging, Printing and Photographic Services, sued, and lost the final appeal of her claim last month.

The sewer line has been repaired.

"My office was always so silty and dirty from stuff coming out the air ducts," Mrs. McCaffrey said in an interview. "During this time is when there was a wet spot in my office under the chair."

One of Mrs. McCaffrey's doctors told her the disease might have resulted from exposure to the sewer fumes. But they also told her that little is known about the disease, including the exact cause. She took medical retirement in 1995 and has had illnesses from time to time that she thinks were caused by exposure to the fumes. Her symptoms have diminished since she retired, though she occasionally gets lesions inside her throat.

Her doctor, she said, told her the disease could eventually be fatal.

A spokeswoman for the Smithsonian said the disease could have resulted from exposure to toxins outside the office or from some other physiological problem unique to Mrs. McCaffrey.

The spokeswoman said agency policy forbids discussing litigation. "It's a personnel issue and we just don't discuss it," said Linda St. Thomas.

In rejecting her claim, the Labor Department said a speculative conclusion about what might have caused the disease was inadequate to prove it job-related.

"She fell into one of these odd gaps from which there is no escape," said John Kovin, her attorney, and the Federal Employees Compensation Act, under which she filed the workers' compensation claim, leaves her scant hope for further appeals. Unless her attorney discovers evidence that the judges violated procedural rules, the Labor Department's appellate ruling stands.

Though not much is known about pemphigus vulgaris, it is most commonly found among Jews and persons of Mediterranean descent. Mrs. McCaffrey, whose forebears were Middle European, is neither.

Inspectors from the Smithsonian's environmental management and safety office began an investigation after workers in the basement office complained of a recurring "rotten eggs" odor and of persistent moisture in the carpet. Workmen broke through the floor and found a cracked and improperly sealed sewage pipe, which apparently had been sealed with foam insulation and thin layers of concrete before the building was opened in 1967. They repaired the pipe, plugged the cracks and properly sealed it.

Investigators also found bacteria in the water on the floor and in the air ducts, which are connected to the ventilation system that circulates air throughout the museum building.

Some of the bacteria they found is commonly associated with diseases of the immune system. "Most of these secondary compounds are toxic to animal and human cells," the environmental office report stated. Mrs. McCaffrey cited the report as evidence in her worker's compensation claim.

The bacteria found in her office, the report said, "have health effects that include carcinogenicity, induction of tremors and/or damage to the immune system or organs. These documented symptoms attributed to exposure of high concentrations of trichothecene toxins are consistent with those reported by the complainant. Exposure to trichoderma is believed to have contributed to the complainant's symptoms."

In a letter to the Labor Department, which is part of the record, Dr. Mervyn Elgart, chairman of George Washington University Medical Center's Dermatology Department, said: "Both the disease and the exposure [to toxins] are extraordinary. If they are unrelated, we must postulate that two very unusual happenings occurred to the same individual at the same time, sort of explaining how lightning could strike twice in the same place.

"While there is no direct evidence that toxins have played a role, she was exposed to toxins before the disease occurred, and she is much better now that she is no longer working. This is enough to suggest to me that there might have been a direct relationship in the case of Mrs. McCaffrey."

In an interview, however, he said there was no evidence to prove or disprove that the toxins spread to others in the National American History Museum.

"In other words," Dr. Elgart said, "we don't know what was going on in that building."

The Labor Department decided in 1995 that before she could receive workers' compensation benefits, she must demonstrate "medical evidence establishing that the diagnosed condition is causally related to the employment factors identified by the claimant. [Mrs. McCaffrey], however, fails to establish that the claimed medical condition or disability is causally related to the injury."

In a letter to Mrs. McCaffrey, the Smithsonian's attorneys told her: "While it is regrettable in this instance that the Department of Labor has not ruled in your favor, the Smithsonian cannot compensate you for your injuries."

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