New reports from the NIOSH health hazard evaluation program With each issue, the International Journal of Occupational and Environmental Health publishes a selected set of abstracts of important Health Hazard Evaluations (HHEs) from the National Institute for Occupational Safety and Health (NIOSH) of the US Centers for Disease Control and Prevention. The full HHE reports are available on the NIOSH website: http://www.cdc.gov/niosh/hhe/.
Evaluation of occupational exposures at drycleaning shops using solvonk4 and DF-2000
Diana Ceballos, Jennifer Roberts, Stephan Whittaker, Emily Lee, Wei Gong Health Hazard Evaluation Program received a request from a government program that provides technical assistance to drycleaning shops. The program manager was concerned about occupational exposures to two new drycleaning solvents: SolvonK4 and DF-2000. We visited one drycleaning shop that used SolvonK4 and two that used DF-2000. SolvonK4 contains primarily butylal and small amounts of n-butanol and formaldehyde. No occupational exposure limits have been established for butylal. DF-2000 is a mixture of C11 to C15 aliphatic-branched hydrocarbons. Occupational exposure limits for petroleum napthas are relevant to this exposure. We observed work practices, collected air samples, and skin patch samples for drycleaning solvents and other chemicals produced or used during drycleaning. Our evaluations measured the highest air concentrations of drycleaning solvents on employees loading and unloading drycleaning machines and pressing fabrics. In the SolvonK4 shop, we documented inhalation and dermal exposures to butylal and found low concentrations of formaldehyde and butanol. It is unknown if the formaldehyde originated from the drycleaning solvent or from other sources such as furnishings and clothing. We observed that employees without personal protective equipment mixed SolvonK4 with a pretreatment product and sprayed the mixture onto fabrics. In the DF-2000 shops, we measured airborne concentrations of DF-2000 well below the naptha OELs. We saw employees without adequate personal protective equipment cleaning the stills in the SolvonK4 and DF-2000 drycleaning machines. We recommended the drycleaning shops (1) brush pretreatments onto fabrics instead of spraying, (2) regularly inspect and maintain the drycleaning machine according to the manufacturers’ recommendations, (3) provide eye protection and chemical
© 2016 Informa UK Limited, trading as Taylor & Francis Group DOI 10.1080/10773525.2016.1242820
resistant gloves to employees, and (4) clean the shop regularly with a high-efficiency particulate air filter vacuum cleaner or wet methods. We recommended the employees wear eye protection and appropriate chemical resistant gloves during certain tasks, wash their hands and exposed skin with soap and water after contact with chemicals, and wash their hands after removing gloves. A full report is available at http://www.cdc.gov/niosh/hhe/reports/ pdfs/2012-0084-3227.pdf.
Metal exposures in an electronic scrap recycling facility
Elena Page, Diana Ceballos, Aalok Oza, Wei Gong, Charles Mueller The Health Hazard Evaluation Program received a request from a manager at an electronic scrap (e-scrap) recycling company. The request concerned potential exposure to metals, including lead and cadmium. The company employed about 80 individuals who processed and recycled computers, monitors, hard drives, televisions, printers, light bulbs, and other e-scrap. We (1) interviewed employees about their work practices, symptoms, and health concerns related to work; (2) tested work s urfaces, skin, and clothing for lead, cadmium, chromium, nickel, and mercury; and (3) tested employees’ urine for cadmium and mercury and their blood for lead and cadmium. No employees reported work-related health problems. Exposure to lead was well controlled in the shred room as indicated by employee blood lead levels. However, two employees in the teardown area had elevated blood lead levels (at or above 10 μg/dL). Blood and urine cadmium levels were not elevated, and no mercury was detected in employees’ urine. We found lead and other metals on the skin of employees at lunch and when leaving to go home. We also found metals on nonproduction work surfaces. Lockers stored personal items and food along with work clothing and personal protective equipment. Showers and laundered uniforms were offered only to the glass shredding employees. Workers unjammed scrap from equipment that was powered on and running. We recommended the employer (1) include all employees exposed to lead in a lead prevention program, (2) install a clean locker room area for employees to store personal items and food, (3) provide scrubs, uniforms, shoe covers, and a contract laundering service for all employees exposed to
International Journal of Occupational and Environmental Health 2016 VOL. 22
NO.
3
265
International Journal of Occupational and Environmental Health
lead, (4) require all employees exposed to lead to shower and change clothing before leaving work, and (5) increase the number of sinks for hand washing. We also recommended the employer follow lockout/tagout procedures to de-energize machinery before conducting troubleshooting, repairs, or maintenance. We recommended employees take a shower at the end of the shift, wash their hands before eating or smoking, and not wear or take work clothing or shoes home. A full report is available at http://www.cdc. gov/niosh/hhe/reports/pdfs/2013-0067-3228.pdf.
Evaluation of indoor environmental quality in a college teaching and administrative building
R. Todd Niemeier, Elena Page, Gregory Burr Health Hazard Evaluation Program received a request from a college to evaluate employees’ concerns about health symptoms that were believed to be related to the indoor environmental quality in a campus building. The building had a history of indoor environmental quality complaints; it was mostly unoccupied at the time of our visit. During our visit, we looked for signs of past or current water damage, water entering the building, and mold. We interviewed current and former faculty, managers, and staff. We reviewed (1) ventilation system drawings and maintenance records, (2) reports from indoor environmental quality consultants, and (3) the college’s summary of symptoms reported by employees and students. We found the ventilation systems to be well-maintained, but airborne contaminants in the dental clinic could spread to other areas of the building. First, the return air from the dental clinic mixed with return air from offices and classrooms before recirculation. Second, the dental clinic was not under a consistent neutral or negative air pressure relative to surrounding areas, meaning that air from the dental clinic could flow to adjacent areas. We saw no evidence of current or past water damage, water entering the building, or mold. Most interviewed employees reported nonspecific symptoms common to workplaces and in the general population. We could not link these symptoms to any specific workplace exposure. One employee may have had a lung condition that could be caused by mold exposure. This employee worked in the building at a time when mold problems were found. Additional findings included: (1) some employees using portable ionizing air cleaners (a source of ozone and possibly associated with employee symptoms), and (2) a sewer pipe vented into a cabinet in the dental laboratory. We recommended the employer work with a ventilation engineer to change how return air is mixed and to improve airflow, check for open sewer vents inside the building, and stop sampling for chemical and biological agents to identify a cause for non-specific employee symptoms. We recommended the employees stop using portable ionizing air cleaners. A full report is available at http://www.cdc. gov/niosh/hhe/reports/pdfs/2013-0074-3229.pdf.
266
Evaluation of aerogel insulation particulate at a union training facility
Karl Feldmann, Kristin Musolin, Mark Methner The Health Hazard Evaluation Program received a request from an insulators union concerned with exposure to particulate released when handling aerogel insulation. Union members reported nosebleeds, upper respiratory tract irritation, and skin dryness. Two union employees provide training for over 200 apprentices and 800 journeymen per year at a training facility. We took personal air samples for components of aerogel insulation (amorphous and crystalline silica, aluminum, iron, and titanium) while an instructor applied aerogel insulation. We looked at the shape, size, and size distribution of the airborne particulate released from handling aerogel insulation. Over two days, we observed the work practices of an instructor who handled aerogel insulation during training. We asked students, journeymen, and an instructor about exposure to aerogel insulation, use of personal protective equipment, medical history, symptoms, and personal hygiene practices while training at this facility and at their job sites. Airborne exposures for amorphous silica approached occupational exposure limits, while crystalline silica, aluminum, iron, and titanium were below the most protective occupational exposure limits. Most of the particulate released during aerogel handling was respirable and can be inhaled deep into the lungs. Many participants reported upper respiratory tract irritation, or very dry or chapped skin. We recommended the instructors (1) educate staff and students about potential upper respiratory tract irritation and drying effects from prolonged exposure to aerogel insulation, (2) encourage staff and students to report work-related health problems to their supervisor, (3) explore alternative cleansers that are more effective than soap and water but will not contribute to skin drying, and (4) provide staff and students with personal protective equipment described in the manufacturer’s safety data sheets. A full report is available at http://www.cdc.gov/niosh/hhe/reports/pdfs/20140026-3230.pdf.
Evaluation of carpal tunnel syndrome and other musculoskeletal disorders among employees at a poultry processing plant
Jessica Ramsey, Kristin Musolin, Charles Mueller The Health Hazard Evaluation Program received a request from a poultry processing plant to evaluate risk factors for musculoskeletal disorders. During two visits, we interviewed employees, reviewed medical and personnel records, assessed jobs for repetition and force, surveyed employees and used nerve conduction tests to determine the prevalence of carpal tunnel syndrome and other musculoskeletal disorders, and calculated recordable injury rates. In follow-up telephone calls, we obtained information about changes in the plant, including increases in the evisceration line speed. Of the 32 jobs we evaluated,
International Journal of Occupational and Environmental Health 2016 VOL. 22
NO.
3
81% had average levels of hand activity and force above the American Conference of Governmental Industrial Hygienists’ (ACGIH) action limit, and 59% had average levels of hand activity and force above the ACGIH threshold limit value. Thirty-four percent (64/191) of participants had evidence of carpal tunnel syndrome. Seventy-six percent (145/191) of participants had an abnormal nerve conduction test result in at least one hand. Sprain, strain, pain, soreness, inflammation, or repetitive motion entries were the most common recordable injuries on the illness and injury logs. To address the potential for musculoskeletal disorders and traumatic injuries among employees, we recommended the employer (1) implement the 2013 OSHA Guidelines for Poultry Processing and recommendations from poultry industry groups, (2) design job tasks
International Journal of Occupational and Environmental Health
so that levels of hand activity and force are below the action limit, (3) use a job rotation schedule to reduce stress to specific sets of muscles and tendons, (4) ensure that the knife change out schedule is strictly followed, (5) provide more breaks during the work shift, and (6) implement a standard process to evaluate employee symptoms and provide appropriate treatment, work restrictions, and medical referrals. We recommended the employees (1) report symptoms and injuries as soon as they occur to supervisors and onsite medical staff, (2) use only sharp knives and change knives regularly, (3) adjust standing platforms to the correct height, and (4) promptly report potential fall/ slip/trip hazards to supervisors. A full report is available at http://www.cdc.gov/niosh/hhe/reports/pdfs/2014-00403232.pdf.
International Journal of Occupational and Environmental Health 2016 VOL. 22
NO.
3
267
Evaluation of occupational exposures at drycleaning shops using solvonk4 and DF-2000
Diana Ceballos, Jennifer Roberts, Stephan Whittaker, Emily Lee, Wei Gong Health Hazard Evaluation Program received a request from a government program that provides technical assistance to drycleaning shops. The program manager was concerned about occupational exposures to two new drycleaning solvents: SolvonK4 and DF-2000. We visited one drycleaning shop that used SolvonK4 and two that used DF-2000. SolvonK4 contains primarily butylal and small amounts of n-butanol and formaldehyde. No occupational exposure limits have been established for butylal. DF-2000 is a mixture of C11 to C15 aliphatic-branched hydrocarbons. Occupational exposure limits for petroleum napthas are relevant to this exposure. We observed work practices, collected air samples, and skin patch samples for drycleaning solvents and other chemicals produced or used during drycleaning. Our evaluations measured the highest air concentrations of drycleaning solvents on employees loading and unloading drycleaning machines and pressing fabrics. In the SolvonK4 shop, we documented inhalation and dermal exposures to butylal and found low concentrations of formaldehyde and butanol. It is unknown if the formaldehyde originated from the drycleaning solvent or from other sources such as furnishings and clothing. We observed that employees without personal protective equipment mixed SolvonK4 with a pretreatment product and sprayed the mixture onto fabrics. In the DF-2000 shops, we measured airborne concentrations of DF-2000 well below the naptha OELs. We saw employees without adequate personal protective equipment cleaning the stills in the SolvonK4 and DF-2000 drycleaning machines. We recommended the drycleaning shops (1) brush pretreatments onto fabrics instead of spraying, (2) regularly inspect and maintain the drycleaning machine according to the manufacturers’ recommendations, (3) provide eye protection and chemical
© 2016 Informa UK Limited, trading as Taylor & Francis Group DOI 10.1080/10773525.2016.1242820
resistant gloves to employees, and (4) clean the shop regularly with a high-efficiency particulate air filter vacuum cleaner or wet methods. We recommended the employees wear eye protection and appropriate chemical resistant gloves during certain tasks, wash their hands and exposed skin with soap and water after contact with chemicals, and wash their hands after removing gloves. A full report is available at http://www.cdc.gov/niosh/hhe/reports/ pdfs/2012-0084-3227.pdf.
Metal exposures in an electronic scrap recycling facility
Elena Page, Diana Ceballos, Aalok Oza, Wei Gong, Charles Mueller The Health Hazard Evaluation Program received a request from a manager at an electronic scrap (e-scrap) recycling company. The request concerned potential exposure to metals, including lead and cadmium. The company employed about 80 individuals who processed and recycled computers, monitors, hard drives, televisions, printers, light bulbs, and other e-scrap. We (1) interviewed employees about their work practices, symptoms, and health concerns related to work; (2) tested work s urfaces, skin, and clothing for lead, cadmium, chromium, nickel, and mercury; and (3) tested employees’ urine for cadmium and mercury and their blood for lead and cadmium. No employees reported work-related health problems. Exposure to lead was well controlled in the shred room as indicated by employee blood lead levels. However, two employees in the teardown area had elevated blood lead levels (at or above 10 μg/dL). Blood and urine cadmium levels were not elevated, and no mercury was detected in employees’ urine. We found lead and other metals on the skin of employees at lunch and when leaving to go home. We also found metals on nonproduction work surfaces. Lockers stored personal items and food along with work clothing and personal protective equipment. Showers and laundered uniforms were offered only to the glass shredding employees. Workers unjammed scrap from equipment that was powered on and running. We recommended the employer (1) include all employees exposed to lead in a lead prevention program, (2) install a clean locker room area for employees to store personal items and food, (3) provide scrubs, uniforms, shoe covers, and a contract laundering service for all employees exposed to
International Journal of Occupational and Environmental Health 2016 VOL. 22
NO.
3
265
International Journal of Occupational and Environmental Health
lead, (4) require all employees exposed to lead to shower and change clothing before leaving work, and (5) increase the number of sinks for hand washing. We also recommended the employer follow lockout/tagout procedures to de-energize machinery before conducting troubleshooting, repairs, or maintenance. We recommended employees take a shower at the end of the shift, wash their hands before eating or smoking, and not wear or take work clothing or shoes home. A full report is available at http://www.cdc. gov/niosh/hhe/reports/pdfs/2013-0067-3228.pdf.
Evaluation of indoor environmental quality in a college teaching and administrative building
R. Todd Niemeier, Elena Page, Gregory Burr Health Hazard Evaluation Program received a request from a college to evaluate employees’ concerns about health symptoms that were believed to be related to the indoor environmental quality in a campus building. The building had a history of indoor environmental quality complaints; it was mostly unoccupied at the time of our visit. During our visit, we looked for signs of past or current water damage, water entering the building, and mold. We interviewed current and former faculty, managers, and staff. We reviewed (1) ventilation system drawings and maintenance records, (2) reports from indoor environmental quality consultants, and (3) the college’s summary of symptoms reported by employees and students. We found the ventilation systems to be well-maintained, but airborne contaminants in the dental clinic could spread to other areas of the building. First, the return air from the dental clinic mixed with return air from offices and classrooms before recirculation. Second, the dental clinic was not under a consistent neutral or negative air pressure relative to surrounding areas, meaning that air from the dental clinic could flow to adjacent areas. We saw no evidence of current or past water damage, water entering the building, or mold. Most interviewed employees reported nonspecific symptoms common to workplaces and in the general population. We could not link these symptoms to any specific workplace exposure. One employee may have had a lung condition that could be caused by mold exposure. This employee worked in the building at a time when mold problems were found. Additional findings included: (1) some employees using portable ionizing air cleaners (a source of ozone and possibly associated with employee symptoms), and (2) a sewer pipe vented into a cabinet in the dental laboratory. We recommended the employer work with a ventilation engineer to change how return air is mixed and to improve airflow, check for open sewer vents inside the building, and stop sampling for chemical and biological agents to identify a cause for non-specific employee symptoms. We recommended the employees stop using portable ionizing air cleaners. A full report is available at http://www.cdc. gov/niosh/hhe/reports/pdfs/2013-0074-3229.pdf.
266
Evaluation of aerogel insulation particulate at a union training facility
Karl Feldmann, Kristin Musolin, Mark Methner The Health Hazard Evaluation Program received a request from an insulators union concerned with exposure to particulate released when handling aerogel insulation. Union members reported nosebleeds, upper respiratory tract irritation, and skin dryness. Two union employees provide training for over 200 apprentices and 800 journeymen per year at a training facility. We took personal air samples for components of aerogel insulation (amorphous and crystalline silica, aluminum, iron, and titanium) while an instructor applied aerogel insulation. We looked at the shape, size, and size distribution of the airborne particulate released from handling aerogel insulation. Over two days, we observed the work practices of an instructor who handled aerogel insulation during training. We asked students, journeymen, and an instructor about exposure to aerogel insulation, use of personal protective equipment, medical history, symptoms, and personal hygiene practices while training at this facility and at their job sites. Airborne exposures for amorphous silica approached occupational exposure limits, while crystalline silica, aluminum, iron, and titanium were below the most protective occupational exposure limits. Most of the particulate released during aerogel handling was respirable and can be inhaled deep into the lungs. Many participants reported upper respiratory tract irritation, or very dry or chapped skin. We recommended the instructors (1) educate staff and students about potential upper respiratory tract irritation and drying effects from prolonged exposure to aerogel insulation, (2) encourage staff and students to report work-related health problems to their supervisor, (3) explore alternative cleansers that are more effective than soap and water but will not contribute to skin drying, and (4) provide staff and students with personal protective equipment described in the manufacturer’s safety data sheets. A full report is available at http://www.cdc.gov/niosh/hhe/reports/pdfs/20140026-3230.pdf.
Evaluation of carpal tunnel syndrome and other musculoskeletal disorders among employees at a poultry processing plant
Jessica Ramsey, Kristin Musolin, Charles Mueller The Health Hazard Evaluation Program received a request from a poultry processing plant to evaluate risk factors for musculoskeletal disorders. During two visits, we interviewed employees, reviewed medical and personnel records, assessed jobs for repetition and force, surveyed employees and used nerve conduction tests to determine the prevalence of carpal tunnel syndrome and other musculoskeletal disorders, and calculated recordable injury rates. In follow-up telephone calls, we obtained information about changes in the plant, including increases in the evisceration line speed. Of the 32 jobs we evaluated,
International Journal of Occupational and Environmental Health 2016 VOL. 22
NO.
3
81% had average levels of hand activity and force above the American Conference of Governmental Industrial Hygienists’ (ACGIH) action limit, and 59% had average levels of hand activity and force above the ACGIH threshold limit value. Thirty-four percent (64/191) of participants had evidence of carpal tunnel syndrome. Seventy-six percent (145/191) of participants had an abnormal nerve conduction test result in at least one hand. Sprain, strain, pain, soreness, inflammation, or repetitive motion entries were the most common recordable injuries on the illness and injury logs. To address the potential for musculoskeletal disorders and traumatic injuries among employees, we recommended the employer (1) implement the 2013 OSHA Guidelines for Poultry Processing and recommendations from poultry industry groups, (2) design job tasks
International Journal of Occupational and Environmental Health
so that levels of hand activity and force are below the action limit, (3) use a job rotation schedule to reduce stress to specific sets of muscles and tendons, (4) ensure that the knife change out schedule is strictly followed, (5) provide more breaks during the work shift, and (6) implement a standard process to evaluate employee symptoms and provide appropriate treatment, work restrictions, and medical referrals. We recommended the employees (1) report symptoms and injuries as soon as they occur to supervisors and onsite medical staff, (2) use only sharp knives and change knives regularly, (3) adjust standing platforms to the correct height, and (4) promptly report potential fall/ slip/trip hazards to supervisors. A full report is available at http://www.cdc.gov/niosh/hhe/reports/pdfs/2014-00403232.pdf.
International Journal of Occupational and Environmental Health 2016 VOL. 22
NO.
3
267
