Congratulations, you’ve reached the final day of the Brain Health Challenge! Today, we’re asking you to do a few things that might feel a bit out of left field — like getting your blood pressure checked.
No, it isn’t as fun as playing Pips, but experts say it’s one of the most important things you can do for your brain. That’s because heart health and brain health are intrinsically linked.
High blood pressure, in particular, can damage brain cells, and it’s a significant risk factor for stroke and dementia. When blood pressure is too high, it places stress on the walls of arteries in the brain. Over time, that added stress can cause the blood vessel walls to thicken, obstructing blood flow. In other cases, the increased pressure causes the artery walls to thin and leak blood into the brain.
These changes to the blood vessels can sometimes cause a large stroke to occur. More commonly, the damage leads to micro-strokes and micro-hemorrhages, which cause fewer immediate problems and often go unnoticed. But if someone has hypertension for years or decades, these injuries can build up, and the person may start to experience cognitive impairment.
High blood pressure “is known as a silent killer for lots of reasons,” said Dr. Shyam Prabhakaran, the chair of neurology at the University of Chicago. “It doesn’t cause you any symptoms until it does.”
Because the damage accumulates over many years, experts say that managing blood pressure in midlife matters most for brain health. Hypertension can be addressed with medication or lifestyle changes, as directed by your doctor. But the first thing you need to do is know your numbers. If your blood pressure comes back higher than 120/80, it’s important to take it seriously, Dr. Prabhakaran said.
While you’re at it, there are a few other aspects of your physical health that you should check on.
Your eyes and ears are two of them. Hearing and vision loss have both been shown to increase the risk of dementia. Experts think that with less sensory information coming in to stimulate the brain, the regions that process hearing and vision can start to atrophy. What’s more, people with sensory loss often withdraw or are left out of social interactions, further depriving them of cognitive stimulation.
Oral health can also affect your brain health. Research has found a connection between regular flossing and reduced odds of having a stroke. That may be because good oral health can help to reduce inflammation in the body. The bacteria that cause gum disease have also been tied to an increased risk of Alzheimer’s.
And have you gotten your shingles vaccine? There is mounting evidence that it’s a powerful weapon for protecting against dementia. One study found that it lowered people’s odds of developing the condition by as much as 20 percent.
To wrap up this challenge, we want you to schedule a few medical appointments that benefit your brain, as well as your body.
After five days of feeding, exercising and challenging your brain, you are well on your way to better cognitive health. Thanks for joining me this week, and keep up the good habits!
Experts think this is partly thanks to cognitive reserve: Basically, the more brain power you’ve built up over the years, the more you can stand to lose before you experience impairment. Researchers still don’t agree on how to measure cognitive reserve, but one theory is that better connections between different brain regions corresponds with more cognitive reserve.
To build up these connections, you need to stimulate your brain, said Dr. Joel Salinas, a neurologist at NYU Langone Health and the founder and chief medical officer of the telehealth platform Isaac Health. To do that, try an activity that is “challenging enough that it requires some effort but not so challenging that you don’t want to do it anymore,” he said.
Speaking a second language has been shown to be good for cognition, as has playing a musical instrument, visiting a museum and doing handicrafts like knitting or quilting. Reading is considered a mentally stimulating hobby, and experts say you’ll get an even bigger benefit if you join a book club to make it social. Listen to a podcast to learn something new, or, better yet, attend a lecture in person at a local college or community center, said Dr. Zaldy Tan, the director of the Memory and Healthy Aging Program at Cedars-Sinai. That adds a social component, plus the extra challenge of having to navigate your way there, he said.
A fewstudies have found that playing board games like chess can be good for your brain; the same goes for doing crossword puzzles. It’s possible that other types of puzzles, like those you find in brain teaser books or from New York Times Games, can also offer a cognitive benefit.
But there’s a catch: To get the best brain workout, the activity should not only be challenging but also new. If you do “Wordle every day, it’s like well, then you’re very, very good at Wordle, and the Wordle part of your brain has grown to be fantastic,” said Dr. Linda Selwa, a clinical professor of neurology at the University of Michigan Medical School. “But the rest of your mind might still need work.”
So play a game you’re not used to playing, Dr. Selwa said. “The novelty seems to be what’s driving brain remodeling and growth.”
Today, we want you to push yourself out of your cognitive comfort zone. Check out an online lecture or visit a museum with your challenge partner. Or try your hand at a new game, below. Share what novel thing you did today in the comments, and I’ll see you tomorrow for Day 5.
Today, you’re going to do perhaps the single best thing for your brain.
When I asked neurologists about their top behaviors for brain health, they all stressed the importance of physical activity.
“Exercise is top, No. 1, when we’re thinking about the biggest bang for your buck,” said Dr. Gregg Day, a neurologist at the Mayo Clinic.
Numerous studies have shown that people who exercise regularly tend to perform better on attention, memory and executive functioning tests. There can be a small cognitive boost immediately after a workout, and the effects are sustained if people exercise consistently. And while staying active can’t guarantee you won’t develop dementia, over the long term, it is associated with a lower risk of it.
Researchers think that moving your muscles benefits your brain in part because of special signaling molecules called exerkines. During and after a workout, your muscles, fat and other organs release these molecules into the bloodstream, some of which make their way up to the brain. There, those exerkines go to work, helping to facilitate the growth of new connections between neurons, the repair of brain cells and, possibly, the birth of new neurons.
Exercise also appears to improve blood flow in the brain. That ramps up the delivery of good things to brain cells, like oxygen, glucose and those amazing exerkines. And it helps remove more bad things, namely toxic proteins, like amyloid, that can build up and damage brain cells, increasing the risk for Alzheimer’s.
All of the changes brought on by exercise are “essentially allowing your brain to age more slowly than if you’re physically inactive,” said Kirk Erickson, the chair of neuroscience at the AdventHealth Research Institute.
The benefits are particularly pronounced in the hippocampus, a region critical for learning and memory. In older adults, the hippocampus shrinks 1 to 2 percent a year, and it is one of the main areas affected by Alzheimer’s. Researchers think physical activity helps to offset some of that loss.
The best exercise you can do for your brain is the one you’ll do consistently, so find something that you enjoy and that fits easily into your life.
Walking is one option; two neurologists I spoke to said they got their exercise in by walking at least part of the way to their offices. Recent research suggests that just a few thousand steps a day can reduce the risk of dementia. It’s important to get your heart rate up, though, so “walk as though you’re trying to get somewhere on time,” said Dr. Linda Selwa, a clinical professor of neurology at the University of Michigan Medical School.
Or you could try swimming, cycling, Pilates, weight lifting, yoga, pickleball, dancing, gardening — any type of physical exertion can be beneficial.
If the thought of working out feels like a drag, try pairing it with something else you enjoy doing, like listening to an audiobook. This is a trick that Katherine Milkman, a professor who studies habits at The Wharton School of the University of Pennsylvania, calls “temptation bundling.”
For Day 3, we’re asking you to spend at least 20 minutes exercising for your brain. Go for a walk with your accountability partner if they’re nearby. (If not, call them and do a walk-and-talk.) Or let us find you a new workout to try, using the tool below. As usual, we can all meet in the comments to catch up and check in.
Welcome to Day 2 of the Brain Health Challenge. Today, we’re talking about food.
Your brain is an energy hog. Despite comprising about 2 percent of the average person’s body mass, it consumes roughly 20 percent of the body’s energy. In other words, what you use to fuel yourself matters for brain health.
So what foods are best for your brain?
In a nine-year study of nearly 1,000 older adults, researchers at Rush University in Chicago found that people who ate more of nine particular types of food — berries, leafy greens, other vegetables, whole grains, beans, nuts, fish, poultry and olive oil — and who ate less red meat, butter and margarine, cheese, sweet treats and fried food had slower cognitive decline.
Based on these findings, the researchers developed the MIND diet.
Experts think the foods included in the MIND diet are especially good for the brain because they contain certain macro and micronutrients.
Berries and leafy greens, for example, are rich in polyphenols and other antioxidants, said Jennifer Ventrelle, a dietitian at Rush and a co-author of “The Official Mind Diet.” Many of these compounds can cross the blood-brain barrier and help to fight inflammation and oxidative stress, both of which can damage cells and are linked to dementia.
Nuts and fatty fishes, like salmon and sardines, contain omega-3 fatty acids, which are important for building the insulating sheaths that surround the nerve fibers that carry information from one brain cell to another.
Whole grains and beans both contain a hefty dose of fiber, which feeds the good microbes in the gut. Those microbes produce byproducts called short-chain fatty acids that experts think can influence brain health via the gut-brain axis.
You don’t have to revamp your whole diet to get these nutrients. Instead, think about “MIND-ifying” whatever you already tend to eat, said Dr. Joel Salinas, a neurologist at NYU Langone Health and the founder and chief medical officer of the telehealth platform Isaac Health. For instance, add a handful of nuts or berries to your breakfast.
Today’s activity will help you MIND-ify your own meals. Share your choices with your accountability partner and in the comments, and I’ll discuss the ways I’m adjusting my diet, too. For added inspiration, check out these MIND-approved recipes from New York Times Cooking.
Welcome to the Brain Health Challenge! I’m Dana Smith, a reporter at The New York Times, and I’ll be your guide.
To live a healthy life, it’s crucial to have a healthy brain. In the short term, it keeps you sharp and firing on all cylinders. In the long term, it can reduce your risk of cognitive decline, dementia and stroke.
Practicing basic healthy behaviors, like eating nutritious food and getting regular exercise, is the best way to enhance your brain power and protect the longevity of your neurons. These types of lifestyle habits can benefit the brain at any age. And while they won’t guarantee that you’ll never develop dementia or another brain disease, severalclinicaltrials have shown that they can improve cognition or slow decline.
Every day this week, you’ll do an activity that’s good for your brain, and we’ll dig into the science behind why it works. Some of these activities can provide a small immediate cognitive benefit, but the bigger reward comes from engaging in them consistently over time. So along with the neuroscience lessons, we’ll include a few tips to help you turn these actions into lasting habits.
To keep you accountable, we’re encouraging you to complete this challenge with a friend. If you don’t have a challenge buddy, no problem: We’re also turning the comments section into one big support group.
There are so many fascinating ways your daily behaviors affect your brain. Take sleep, for example.
Lots ofstudies have shown that getting a good night’s rest (seven to eight hours) is associated with better memory and other cognitive abilities. That’s because sleep, especially REM sleep, is when your brain transfers short-term memories — things you learned or experienced during the day — into long-term storage.
Sleep is also when your brain does its daily housekeeping. While you rest, the brain’s glymphatic system kicks into high gear, clearing out abnormal proteins and other molecular garbage, including the protein amyloid, which is a major contributor to Alzheimer’s disease. A buildup of amyloid is one reason experts think that people who routinely get less sleep have a higher risk of dementia.
What other behaviors play a big role in brain health? For today’s activity, we’re going to test your knowledge with a quiz. Share your score with your accountability partner and in the comments below — I’ll be in there too, cheering you on.
Near the refrigerator, the lead level was 27 times the federal limit. And that wasn’t all.
Jeff Van Ness is constantly cleaning.
Every day, he vacuums, mops and wipes every surface in his house, which stands on one of the blocks in Altadena, Calif., that survived the flames of the Los Angeles wildfires, but not the smoke.
He works in deliberate lines across the kitchen tile, then along the baseboards, then into the corners where the smoke pooled nearly a year ago — following a map only he can see.
It’s the only way to quiet his thoughts: Is it safe for his children, 6-year-old Sylvia and 9-year-old Milo, to walk barefoot on the kitchen tiles? Should he wash the toys they drop on the floor with bleach, or with soap and water? The darkest thoughts are about his wife, Cathlene Pineda, 41, a jazz pianist who is on medication for cancer. If the toxins were in the house, he wonders, could they bring the cancer back?
The family reluctantly returned home in August, eight months after the Los Angeles fires and two months after a consultant they hired found lead — a dangerous neurotoxin — inside the house. After their insurer, Farmers Insurance, dismissed those findings and cut off payments for their hotel, the Van Nesses had little choice but to return and do the only thing they could: clean.
“We don’t have the means to pay our mortgage and live somewhere else,” said Mr. Van Ness, 44, a waiter at a five-star hotel. “It’s a feeling of helplessness that is indescribable.”
Lead level in the dining area: 7 times the federal limit
Source: New York Times testing from Sept. 26Gabriela Bhaskar/The New York Times
For nearly every house reduced to ash by the fires that blackened the Los Angeles sky last January, another was left standing but steeped in smoke, according to an analysis by The New York Times.
These homes sit at an uncomfortable juncture: intact but potentially contaminated.
Like most insurance policies in California, the Van Nesses’ contract with Farmers — the second largest home insurer in the state — covers smoke damage, but it doesn’t spell out how the damage should be repaired. That’s because there are no state or federal standards for how an insurer should remediate a smoke-damaged home after a fire. In May, the California Department of Insurance created a task force to establish such standards, but until its recommendations are announced, families like the Van Nesses are caught in a regulatory no man’s land.
A growing body of research shows that smoke from urban wildfires, like the ones that engulfed Altadena and Pacific Palisades, is more dangerous than smoke produced when vegetation alone burns. Ordinary objects become poisons when extreme heat turns them into gases. The button you push to start your car often contains beryllium — harmless when sealed in metal but highly toxic once airborne. A car’s tires can melt into a cloud of benzene, as can the foam in a sofa. The handle of a kitchen faucet can give off chromium.
Microscopic particles carried by the smoke slip into a home’s insulation, lodge in the seams of hardwood floors and pass through the mesh in kitchen tiles, contaminating the space with carcinogens and other toxins. Industrial hygienists and toxicologists insist that removing the contamination requires tearing out nearly every surface the smoke touched — not just the insulation, but the hardwood floors, tiles, plaster and stucco.
By contrast, the insurance industry is relying on what experts interviewed by The Times describe as outdated or incomplete research, endorsing cleanups based only on what can be seen and smelled. If insurers test at all, it is for a small subset of contaminants.
According to more than two dozen scientists, insurance adjusters and consumer advocates interviewed for this article, as well as a review of thousands of pages of internal insurer documents, this approach is supported by a small roster of industry consultants who cite research papers that have not been peer-reviewed, or were funded by the insurance industry.
“We call it the tobacco playbook because it was done for so long and so successfully by an industry that was making a deadly product,” said David Michaels, who served as the assistant secretary of labor directing the Occupational Safety and Health Administration from 2009 to 2017, and who has written two books detailing this strategy. “This is absolutely the latest iteration of ‘science for hire.’”
The Exposure
To understand what happened to the Van Ness home and whether it was safe to return over the summer, The Times asked the family for permission to have a certified professional test for lead and other heavy metals in each room, and to submit strands of hair so scientists could measure family members’ exposure to these metals over time.
Jan. 8: Smoke from the Eaton fire looming over the Van Ness home.Photo by Jeff Van Ness
By then, the house had already been extensively cleaned.
In February, a contractor hired by the family carried out the remediation that Farmers Insurance had recommended: The attic insulation was ripped out, floors were vacuumed and mopped, countertops and other surfaces were wiped, carpets and drapes were laundered and air scrubbers were left roaring in every room.
Feb. 18: Furniture wrapped in plastic during the remediation.Composite image from video taken by Jeff Van Ness
By March, dangerous chemicals were being found inside neighboring homes. But Farmers’ tests concluded that the Van Ness house was safe inside, finding hazardous levels of lead only outdoors.
Those findings were contradicted by an independent test the family paid for in June, which showed lead above the federal threshold in the living room and in the attic — results that Farmers dismissed. That was when Mr. Van Ness repainted the walls and began his obsessive cleaning.
The readings commissioned by The Times were taken in September — a month after the family had moved back in — and allowed reporters to see whether the home remained contaminated, and whether the Van Nesses had been exposed to harmful substances.
Six of the 11 samples collected in the house showed unsafe levels of contaminants, including extremely high levels of lead which is known to metabolize quickly, leaving the blood and entering bones and tissue. No metals were found in the other five samples taken from the bedrooms, the living room, the piano and a wooden toy.
Sept. 26: Where testing by The Times found lead and other metals after the house was remediated.
Source: New York Times testing from Sept. 26
The readings showed 27 times the federal hazard limit of lead on the floor next to the refrigerator, and more than seven times the limit where the kitchen tile meets the dining room floor.
A sample taken from the HVAC in the attic found lead levels close to 8,000 micrograms per square foot. Although the Environmental Protection Agency does not set lead-dust standards for attic surfaces, a rule change passed during the Biden administration holds that any reportable level of lead dust inside a home is considered a hazard. The concentrations found in the attic were “sky high,” said Joe L. Nieusma, a toxicologist who was one of 10 experts who reviewed the results.
“There are multiple carcinogens in the house and extremely high levels of lead,” Dr. Nieusma said. “It’s not safe for humans — or animals — to live in that residence.”
To determine whether the toxins inside the Van Ness home had made their way into their bodies, The Times commissioned Manish Arora, vice chairman of environmental medicine at the Icahn School of Medicine at Mount Sinai in New York and the creator of a technology that uses strands of hair to measure a person’s exposure to chemicals in the environment.
One centimeter of hair represents approximately one month in a person’s life.
“Every other test is like a snapshot,” Dr. Arora told the family, explaining why their blood tests were negative. “Hair has the ability to map back in time. It’s like a molecular movie.”
After reviewing the family’s hair samples, Dr. Arora concluded that the Van Nesses had been exposed to dangerous levels of toxins.
Each family member’s strand of hair showed “measurable spikes in heavy metals after they returned to the home in August, indicating a period of elevated exposure,” he said. The results revealed that Milo had elevated levels of all 11 chemicals that Dr. Arora’s lab tested for, including lead, a potent neurotoxin with no safe level of exposure in children. Sylvia’s hair showed elevated levels of nine chemicals compared with the exposure levels of 1,000 children in California who are participants in an ongoing statewide study funded by the National Institutes of Health.
But he also found that the continued cleaning was working — at least for lead. For both parents and children, the levels of lead in their hair began to decline after they returned home and as they steadily moved bags of contaminated belongings to the curb and Mr. Van Ness continued his compulsive cleaning.
The presence of these metals does not mean the family will necessarily become ill, Dr. Arora, the founder and chief executive of LinusBio, which analyzed the hair, cautioned. “But it does show that their bodies absorbed contaminants during that period, exposure that scientists associate with increased risks of neurological and developmental harm and, in the case of arsenic, cancer,” he said.
All 10 experts who reviewed the testing results from the house expressed concern about the level of contamination and said that the insurance-led remediation effort was not sufficient. Several of them highlighted the risk in the attic, where testing by The Times detected beryllium, chromium and cadmium, all known to cause cancer in humans.
Especially concerning is beryllium, said Dr. Michaels, who issued the standard for beryllium during his tenure as the longest-serving administrator of OSHA. “There is no safe level of beryllium exposure,” he said, describing how, at the Department of Energy, an accountant had developed the debilitating lung condition known as chronic beryllium disease after handling files stored in a building where beryllium had been processed years before.
“The most shocking thing is that this is after the home was remediated,” said Joseph G. Allen, the director of the Healthy Buildings Program at Harvard University’s T.H. Chan School of Public Health and a former scientific adviser to the White House, who reviewed the results.
“Junk Science”
What happened to the Van Ness family is unfolding across the Los Angeles basin, as homeowners navigate a narrow range of options: accept a modest cleanup or shoulder the cost themselves. Or, most fraught of all: move back in and accept their insurers’ assurances that the air is breathable, the walls are clean and the home is safe, according to responses to a Times survey of more than 500 survivors of the recent fire, as well as interviews with three dozen affected families.
For nearly every house destroyed by the fires, another was left standing but steeped in smoke, according to a Times analysis.Philip Cheung for The New York Times
Evidence showing that the remediation approved by insurers is inadequate is mounting: Data from 45 homes tested after professional cleaning showed that 43 of them still tested positive for unsafe levels of lead, according to Eaton Fire Residents United, a coalition of concerned residents.
Farmers ultimately paid for the Van Ness family’s hotel accommodation for seven months and approved a budget of $25,900 to have the home professionally cleaned — a fraction of what it would have cost to follow the advice of experts who insisted that the only way to remove the contaminants was to strip away every surface the smoke touched. That kind of renovation would have cost upward of $500,000, according to data from the real estate tracking firm Cotality.
Scale those numbers across the Los Angeles burn zone, and the math is staggering: Doing only a surface-level cleanup of the nearly 10,000 homes that likely had smoke damage would save insurers over $8.5 billion, according to a Times analysis using Cotality data.
“The first commandment of an insurance company is, ‘Pay as little as possible and as late as possible,’” said John Garamendi, a Democratic congressman who represents Northern California and who was the state’s first insurance commissioner in 1991.
Dylan Schaffer, a lawyer who is representing more than 500 policyholders whose homes were damaged by toxic smoke from the Los Angeles fires, agreed that the insurers are driven by the bottom line. “There is no other explanation. The science is against them.”
It was when the Van Nesses started asking about the science that they ran into problems with Farmers.
Ms. Pineda was diagnosed with cancer five years ago, leaving her immunocompromised.Gabriela Bhaskar/The New York Times
Five years ago, Ms. Pineda was diagnosed with Stage 3B cancer. Concerned that she could be exposed to carcinogens inside her house after the fire, her oncologist wrote a letter to Farmers urging the insurer to replace all the soft goods — including mattresses, bedding and carpets — according to correspondence reviewed by The Times.
The adjuster texted back: “Did the oncologist perform any type of testing of these soft goods to support their recommendation?”
The question landed like a blow — as though her doctor’s warning didn’t count unless it came with results from the very tests the family had asked the insurer to perform.
“It felt like when you have those dreams that something’s happening,” she said, “and you’re screaming at the top of your lungs in your dream to wake someone up or to alert someone, and nothing is coming out.”
In California, insurers began trying to limit payouts for smoke damage more than a decade ago, after a series of devastating wildfires, according to Dave Jones, a former state insurance commissioner who was the top regulator when carriers first started inserting policy language that excluded toxic smoke.
When those exclusions were struck down in court, the carriers turned to something more subtle: They downplayed the science by relying on in-house experts, whose studies are often not peer-reviewed and whose methods are increasingly at odds with the emerging science of urban wildfires, according to interviews with two former insurance commissioners, insurance industry whistleblowers, attorneys and consumer advocates.
The initial settlement letter that Farmers sent to the Van Nesses, which was reviewed by The Times, referred to “scientific studies” that it said showed that household materials exposed to the smoke could be cleaned. According to these studies, it said, soot, char and ash have “no inherent physical or chemical properties that will cause physical damage to common household materials,” and that “routine laundering” and “everyday cleaning methods” were enough to restore the home to its pre-fire state.
In a single footnote, the letter referred to only one source: a three-page paper from 2019. It appeared on the website of a private company specializing in hazardous materials that once employed Richard L. Wade, the paper’s author.
Contacted by The Times, Dr. Wade confirmed that the document was never published nor peer-reviewed and described it not as a study but as “a research summary,” contradicting how Farmers characterized it.
“This report is not objective science,” said Dr. Michaels, currently a professor at George Washington University’s Milken Institute School of Public Health, after reviewing the paper. “It makes unsupported and unverifiable assertions,” he said, adding, “It’s science for hire.”
Dr. Wade did not respond to questions regarding the criticism of his research paper.
In an email, Luis Sahagun, a spokesman for Farmers Insurance, wrote: “Every claim is evaluated and reviewed on an individual basis. Our goal is to pay claims quickly and fairly, taking into account the circumstances of the loss and the terms of the policy.”
The company did not address detailed questions from The Times about the contamination found inside the Van Ness home after the insurer-led remediation, or about the carcinogens detected in the family’s hair, saying that “we cannot comment on individual claims or customers.”
Jeff Van Ness is nervous about turning on the HVAC which sits inside a contaminated attic. So he opens the window.Gabriela Bhaskar/The New York Times
When the family sent their independent results to Farmers in June, the insurer turned to Safeguard EnviroGroup, a company that is advising the leading insurance carriers in California following the fires, and whose principal scientist is Dr. Wade, the expert whose paper was not peer-reviewed but was used as a reference.
In a document labeled “confidential” and obtained by The Times, Safeguard EnviroGroup’s founder, Brad Kovar, sought to discredit the family’s independent report, writing that the hygienist hired by the Van Nesses lacked a particular license, and that the report — which found the highest levels of lead in the attic — had failed to specify whether the samples came from a floor, a shelf or a windowsill, each of which has a different regulatory threshold.
In their denial letter to the family, Farmers, citing the report by Safeguard EnviroGroup, further described the attic as a “non-habitable space” — the only explanation the insurer provided for never having tested the attic for contaminants.
But in response to a detailed list of questions, a spokesman for Mr. Kovar seemed to contradict that guidance, saying that “all non-habitable spaces are relevant if they meet established contamination thresholds and provide pathways of exposure.”
The spokesman added: “Our conclusions are based on fact, data, established methodologies and recognized scientific standards.”
Dr. Nieusma pointed out that the HVAC is in the attic and acts as the “lungs of the house.” If the attic is contaminated, the HVAC is likely redistributing those toxic particles throughout the home.
“What they are doing is junk science,” said Dr. Zahid Hussain, winner of the Department of Energy Secretary’s distinguished service award for his work at the Lawrence Berkeley National Laboratory, adding that references to empty or unvetted studies are rife in the insurance industry when it comes to smoke.
The (Lack of) Standards
The Van Ness home, along with the debate over what the family’s insurer should have done to repair it, is a microcosm of a broader fight now dividing the American Industrial Hygiene Association, which publishes a technical guide for how to remediate smoke damage. In the absence of state or federal standards, insurers have cited this guide, which lists Mr. Kovar and Dr. Wade among its authors.
But a cohort of industrial hygienists say the guide has been hijacked by insurance industry contractors who have introduced language suggesting that toxins can be cleaned using everyday methods. This summer, the hygienists submitted to the A.I.H.A. a list of what they said were errors and distortions in the latest edition of the guide, arguing it should be retracted or significantly revised.
They said that numerous non peer-reviewed research papers had been added as references in the bibliography, while peer-reviewed studies showing that microscopic particles of smoke can penetrate the fibers of a house were removed or omitted.
On Dec. 16, the debate turned tense on a video call during which the A.I.H.A. declined to make changes, according to three participants on the call.
In an emailed statement, Jessie Lewis, an A.I.H.A. spokeswoman, declined to discuss the specifics of the meeting, saying that the technical guide was a “science-based publication” and that the most recent edition was not influenced by the insurance industry. She had no comment after The Times pointed out that the organization’s top donors included the Property Casualty Insurance Association of America, one of the main lobbying groups for the insurance industry.
The same battle is now roiling the newly created California Smoke Claims & Remediation Task Force, where Safeguard EnviroGroup employees including Dr. Wade presented slides claiming that professional cleaning was enough and that testing for anything more than lead, asbestos and soot, char and ash was an unnecessary “rabbit hole,” as first reported in a San Francisco Chronicle investigation. They argued that the A.I.H.A. guide — the same one that scientists are asking to be retracted — should be the accepted standard.
Back in Altadena, the Van Nesses are trying to make their home feel like home again.Gabriela Bhaskar/The New York Times
Since returning to their house in August, the Van Nesses have debated leaving for good. But where would they go?
Mr. Van Ness’s job provides the health insurance needed for his wife’s continuing cancer treatment with the oncologist who saved her life. And on his waiter’s salary, they feel trapped in one of the country’s most strained housing markets.
“It’s free-falling while reaching for branches that you hope will break your fall but don’t,” he said. “And so you flail. You paint, you rack up debt and get rid of the things that you think are dangerous, you keep windows open, you wash your hands more,” he said. “And you worry that your efforts are no match for what really needs to happen.”
For now, the Van Nesses are doing what they can: fighting with their insurer. And cleaning.
Methodology
Sample collection – With the family’s permission, The Times commissioned certified professionals and scientists to collect samples from the house and the family. Eleven wipe samples were taken from the house, including the attic and the family’s converted garage, using the National Institute for Occupational Safety and Health’s 9102 sampling method: seven samples and one blank for lead; four samples and one blank for a broader metals panel. Additionally, air samples were collected using equipment from Access Sensor Technologies and Casella Solutions.
The Times commissioned an independent lab, Eurofins, to analyze the results, and the professional hired by The Times followed strict chain-of-custody procedures, documenting each step in the collection, handling and transfer of the samples to ensure their integrity and prevent contamination or tampering.
Lab analysis – For the wipe samples, the lab used Inductively Coupled Plasma (I.C.P.) Mass Spectrometry (M.S.), modifying the N.I.O.S.H. 9102 protocol to use a more precise analytical method, a step recommended by scientific advisors and senior researchers at the lab. Air samples were analyzed using three common analytical methods: I.C.P.-M.S., I.C.P.-Atomic Emission Spectroscopy (A.E.S.), and X-ray Fluorescence (X.R.F) Spectroscopy. The air samples were analyzed by Thomas Reilly, chief executive officer at Access Sensor Technologies, a company that makes portable technology measuring contaminants in the air; the analysis yielded inconclusive results. Experts agreed that detecting metals in the air would be difficult when collecting samples months after the fires, because the family ventilated the home and used air purifiers.
For the hair analysis, the samples were sent to LinusBio, the lab funded and led by Manish Arora.
Results – Ten experts reviewed the lab results commissioned by The Times and compared them with the tests conducted by the contractor chosen by Farmers Insurance.
Dr. Joseph G. Allen, a certified industrial hygienist and an associate professor of exposure assessment science at Harvard University’s T.H. Chan School of Public Health, where he heads its Healthy Buildings Program.
Dawn Bolstad-Johnson, a certified industrial hygienist who has tested more than 100 homes in the Los Angeles area.
Dr. Jill Johnston, an associate professor at the University of California at Irvine’s Joe C. Wen School of Population & Public Health whose research focuses on the health impacts of environmental contaminants.
Jeanine Humphrey, an industrial hygienist who has tested more than 100 smoke-damaged homes in Los Angeles.
Dr. Zahid Hussain, a former division deputy of the Lawrence Berkeley National Laboratory and the recipient of the Department of Energy Secretary’s Distinguished Service Award.
Dr. Lisa A. Maier, a pulmonologist who leads a clinical team studying and caring for patients with chronic beryllium disease as chief of National Jewish Health’s Division of Environmental and Occupational Sciences.
Peggy Mroz, lead epidemiologist in the Division of Environmental and Occupational Health Sciences at National Jewish Health, who studies chronic beryllium disease.
Dr. Joe L. Nieusma, a toxicologist and author of a recent study showing that particles of smoke saturate every crevice, seam and texture of a home and are recirculated through airflow.
Dr. Michael Weitzman, a professor and former chairman of the department of pediatrics at the New York University School of Medicine, whose research on lead poisoning in children contributed to the decision by the E.P.A. to lower its dust lead clearance levels.
One expert asked not to be named because of fear of retaliation.
The following chemicals were detected in the home via wipe samples: lead, beryllium, cadmium, chromium, lithium and manganese. Some of these elements are naturally occurring in the body, but when found in extremely high concentrations they are harmful to human health and linked to neurological and developmental problems, as well as damage to specific organs, including the kidneys.
For surface wipe samples, the post-abatement federal hazard limit for lead is 5 µg/ft2 for floors, 40 µg/ft2 for window sills and 100 µg/ft2 for window troughs.
The following chemicals were found in the hair analysis at elevated levels when compared with median exposure levels of 1,000 children in California who are participants in an ongoing statewide study funded by the National Institutes of Health: zinc, strontium, phosphorus, manganese, magnesium, lithium, lead, copper, calcium, barium and arsenic.
Estimating damage from smoke – To estimate the number of homes that were likely smoke-damaged, The Times drew a 250-yard buffer around structures identified by Cal Fire as partially burned. This buffer was chosen based on the public health advisory issued by the Los Angeles County Department of Public Health after the fires. It is a conservative measure: A National Academy of Sciences report stated that any property within one to 10 kilometers from a burned structure could be damaged by smoke, depending on the direction of the wind.
To estimate the $8.5 billion in savings for insurers to remediate the homes that have likely experienced smoke damage, The Times counted the homes within 250 yards of a burned structure. When a property had additional structures, like a guesthouse or a garage, the structures were all counted as one. For each property, The Times used a median cost of remodeling, excluding demolition — a metric provided by Cotality, a company that tracks and analyzes real estate.
Why hair sampling and not blood? –To date, 99.5 percent of residents tested by the Los Angeles County Department of Public Health following the recent fires — all but 10 out of more than 2,000 people — had blood lead levels below the Centers for Disease Control’s ceiling of 3.5 micrograms per deciliter, meaning almost no one showed elevated levels despite widespread evidence of lead contamination. The Times turned to the technology created by Dr. Arora which uses hair strands because it maps past exposure over time.