We appreciate Dr Sudakin's comments regarding our investigation of acute pulmonary hemorrhage among infants in Cleveland, Ohio. Unfortunately, he has erroneously interpreted our findings regarding the relationship between ETS and acute pulmonary hemorrhage. It is not correct to state that exposure to ETS was found to have a much stronger association with pulmonary hemorrhage than did the detection of molds in the environment. Our data indicate that the association between exposure to ETS and pulmonary hemorrhage did not reach statistical significance. When both ETS and S atra were present, however, the risk seemed to be greater than the risk from exposure to S atra or ETS alone. This suggests a synergistic role for exposure to ETS but does not support a primary role.
Etzel RA, Sorenson WG, Miller JD, Jarvis BB, Allan TM, Dearborn DG. Mycotoxins and Pulmonary Hemorrhage—Reply. Arch Pediatr Adolesc Med. 1999;153(2):205. doi: