Health Hazard Evaluations (HHEs)

(2011) Evaluating a persistent nuisance odor in an office building - Maryland. (Click to open report)
NIOSH investigators evaluated a federal government office on December 15-16, 2010, after receiving a technical assistance request from the property manager. The office employees believed a chemical odor present since the building opened in 2007 was responsible for their symptoms, which included nausea; headache; and eye, nose, throat, and respiratory irritation. We measured temperature, RH, CO2, and CO in the office. We took air samples for H2S, formaldehyde, and VOCs in the office and in two ne... (Click to show more) NIOSH investigators evaluated a federal government office on December 15-16, 2010, after receiving a technical assistance request from the property manager. The office employees believed a chemical odor present since the building opened in 2007 was responsible for their symptoms, which included nausea; headache; and eye, nose, throat, and respiratory irritation. We measured temperature, RH, CO2, and CO in the office. We took air samples for H2S, formaldehyde, and VOCs in the office and in two nearby businesses for comparison. We took carpet and paint samples from the office and analyzed them for VOCs. We also looked for water damage in the office and checked the HVAC system. We surveyed employees about odors in the office, asking them to describe the odors and health concerns they associated with the odor. The CO2 concentrations inside the office had a range of 750-1160 ppm, while the CO2 concentrations outdoors had a range of 420-440 ppm. Usually, CO2 concentrations are used to determine the adequacy of an HVAC system, but not for sparsely occupied areas such as this office. However, with only two employees working, the fact that indoor CO2 concentrations were nearly triple the outdoor concentration indicated the HVAC system was likely not introducing much outdoor air into the occupied office areas. Temperature in the office had a range of 71-75 degrees F and RH had a range of 21-28 percent, compared to outdoor temperature, which had a range of 18-27 degrees F and RH at 20 percent. These levels are within the recommended thermal comfort guidelines for the winter season. The CO concentrations were low (0-0.1 ppm) and were likely caused by the entrance door to the office being located adjacent to a parking lot. No water damage in the office was identified. No H2S was detected (detection limit was 1 ppm) and formaldehyde was less than 0.02 ppm in the office and ranged up to 0.03 ppm in the adjacent businesses. The formaldehyde concentrations are below some exposure guidelines for office spaces (0.05-0.10 ppm) but above other recommended indoor air levels for offices (0.003 ppm). In area air samples collected from carpeted areas of the office, we identified VOCs (specifically alcohols) that were similar to VOCs from a headspace analysis of carpet taken from the office. These VOCs were not found in air samples taken in non-carpeted areas of the office or from two nearby businesses that were not carpeted. This suggests that either the carpet or incompletely cured carpet adhesive may be the source of the odor. Incomplete curing of the carpet adhesive can happen when the concrete slab onto which the carpet was installed had excessive alkalinity and water vapor. We also surveyed employees about odors in the office, asking them to describe the odors and any health concerns they associated with the odor. All eight office employees returned surveys. Six reported having smelled an odor at the office, and four still smelled the odor. The odor was described as a glue, adhesive, plastic, chemical, or cleaner smell. Two employees mentioned burning of their eyes and one mentioned occasional headaches during work, which are irritation symptoms typically associated with indoor VOC and formaldehyde exposures. The residential-style electric HVAC system serving the office was well maintained and had been modified in 2010 to introduce outdoor air. Under some conditions the bathrooms and locker rooms were under positive pressure in relationship to the office, meaning that odors from the bathrooms and locker rooms could enter into the occupied office spaces. We recommended removing the carpet and adhesive to eliminate the source of the odor. We recommended running the HVAC system continuously to minimize stagnant air, evaluating the HVAC system to determine if enough outdoor air is being introduced into the occupied spaces, and to determine if bathrooms are under negative pressure. We recommended that employees minimize other sources of odor, like air fresheners. We also recommended that employees be informed in advance about any remediation efforts, such as carpet and adhesive removal and the installation of new flooring. (Click to show less)
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(2011) Indoor environmental quality evaluation at a health clinic - Indiana. (Click to open report)
In response to a technical assistance request from the Indiana Occupational Safety and Health Administration we evaluated a university-operated health clinic on December 21, 2010. Employees of the health clinic believed that poor IEQ was responsible for symptoms including headache, dizziness, lethargy, itchy and watery eyes, cough, and a metallic taste. We measured carbon dioxide, temperature, and relative humidity in the health clinic throughout the workday. We looked for evidence of water dama... (Click to show more) In response to a technical assistance request from the Indiana Occupational Safety and Health Administration we evaluated a university-operated health clinic on December 21, 2010. Employees of the health clinic believed that poor IEQ was responsible for symptoms including headache, dizziness, lethargy, itchy and watery eyes, cough, and a metallic taste. We measured carbon dioxide, temperature, and relative humidity in the health clinic throughout the workday. We looked for evidence of water damage and checked the HVAC system. We reviewed previous IEQ evaluations conducted by the university environmental health and safety office. We also held confidential interviews with employees to discuss their health and workplace concerns. Additionally, we reviewed the medical records from employees who saw a doctor because of work-related health concerns. The carbon dioxide concentrations in the health clinic ranged from 475 to 600 ppm; outdoor concentrations were 420 ppm. Indoor carbon dioxide concentrations that are similar to outdoor concentrations suggest that the health clinic was adequately ventilated. Temperature in the health clinic ranged from 69 degrees F-72 degrees F, and relative humidity ranged from 22%-24%; these temperature and relative humidity levels are within recommended thermal comfort guidelines for the winter season. We did not see water damage to the walls, ceiling tiles, or exterior windows, and there was no evidence of water incursion in the space above the suspended ceiling. The constant volume HVAC system for the health clinic was approximately 40 years old but was well maintained. In 2010 the ventilation supply diffusers and return air grilles were cleaned, new thermostats were installed, and more outdoor air was provided to the HVAC system. Sixteen of 22 employees who were interviewed reported having symptoms that began or worsened at work in the 2 months prior to our visit. The most commonly reported symptoms included headache, eye irritation, shortness of breath, chest tightness, fatigue, and dizziness. Most of the employees who reported experiencing symptoms in 2010 reported that they worsened during the second floor renovation, particularly during the cleaning and renovation of the pamphlet room. Most employees with work-related symptoms reported that their symptoms improved after renovation efforts on the second floor were completed. More than one third of the employees interviewed felt that management was not adequately communicating to employees what was being done to evaluate and resolve potential health hazards in the workplace. A review of medical records from six employees found four employees with work-related symptoms that had begun or significantly worsened in April or May 2010. At that time, the building was undergoing renovations. Three of these four were diagnosed with an allergic illness exacerbated by working in the health clinic building. Records showed that the symptoms of these three employees had improved by their last medical visit. We recommended that management maintain acceptable IEQ practices during renovation projects such as sealing off areas of the building that are being renovated. Management should also inform employees in advance about any remediation efforts, and track and promptly investigate any work-related complaints or problems reported by employees. (Click to show less)
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(2010) Comparison of mold exposures, work-related symptoms, and visual contrast sensitivity between employees at a severely water-damaged school and employees at a school without significant water damage. (Click to open report)
On January 18, 2005, NIOSH received a request for an HHE at AFSHS in New Orleans, Louisiana. Employees submitted the request because of concerns about exposure to mold and lead paint in their school building. Employees reported a variety of health effects, including difficulty breathing, chronic sinusitis, immune system problems, nosebleeds, skin rashes, irregular menses, headaches, irritable bowel syndrome, and nausea. We visited AFSHS on April 18-19, 2005. During informal interviews, employees... (Click to show more) On January 18, 2005, NIOSH received a request for an HHE at AFSHS in New Orleans, Louisiana. Employees submitted the request because of concerns about exposure to mold and lead paint in their school building. Employees reported a variety of health effects, including difficulty breathing, chronic sinusitis, immune system problems, nosebleeds, skin rashes, irregular menses, headaches, irritable bowel syndrome, and nausea. We visited AFSHS on April 18-19, 2005. During informal interviews, employees reported possible work-related symptoms, some of which were consistent with symptoms reported by people working in water-damaged buildings. The building had obvious microbial contamination, so we decided that further evaluation was needed. On May 23-24, 2005, we returned to New Orleans for a follow-up evaluation. During this visit we administered a work history and health symptom questionnaire. We also conducted VCS testing using the F.A.C.T. handheld chart. VCS testing measures the subjects' ability to determine changes in alternating light and dark bands of varying intensity. Performance on this test has been adversely associated with exposure to neurotoxins such as solvents and lead among many other conditions and exposures such as aging, certain eye conditions, alcohol and medication use, and depression. We used VCS testing for this evaluation to determine if it could serve as a biomarker of effect for occupants who experience adverse effects from a water-damaged building. We also collected environmental samples for culturable and aerosolized fungal spores and measured IEQ parameters (CO2, temperature, and RH). We performed a similar evaluation at WHHS in Cincinnati, Ohio, on February 27-29, 2006. WHHS had no history of ongoing water intrusion or mold growth. Of 119 employees at AFSHS, 95 (80%) participated in the evaluation. Of 165 employees at WHHS, 110 (67%) participated. Participants at both schools were similar in sex, age, history of psychiatric disease, atopy (the predisposition to allergic disease), smoking history, and having mold or moisture problems in their homes. Employees at AFSHS had higher prevalences of work-related cough, wheezing, or whistling in the chest; chest tightness; unusual shortness of breath; sinus problems; sore or dry throat; frequent sneezing; stuffy nose; runny nose; fever or sweats; aching all over; unusual tiredness or fatigue; headache; difficulty concentrating; confusion or disorientation; trouble remembering things; change in sleep patterns; and rash, dermatitis, or eczema on the face, neck, or arms than employees at WHHS. At each school, 13 employees reported currently having asthma. A significantly higher percent of the asthmatics at AFSHS reported their asthma was worse at work. Monocular and binocular VCS values were significantly lower at all spatial frequencies among AFSHS employees. A significantly higher percentage of employees at AFSHS had scores that fell below the average performance for 90% of the population compared to the results found among employees at WHHS. Actively growing Cladosporium was found on the walls of AFSHS. Mold was found in all three MSQPCR air samples with C. sphaerospermum being the most prevalent. The vacuum dust samples detected 32 of the 35 fungal species tested. The culturable air samples showed that Cladosporium and Pencillium were the most prevalent genera both inside and outside the school. Aspergillus species were detected in inside samples but not in outside air samples. The spore trap samples showed that Cladosporium was the prevalent genera both inside and outside the school with the exception of Room 316. No fungal growth was detected on six of eight sticky tape samples collected at WHHS. One had a trace of hyphae, and the other showed a few Aspergillus/Pencillium-like spores and a trace of hyphae. Both were from the band room. Air samples analyzed with MSQPCR showed low counts for inside samples compared to outside samples. The culturable and spore trap air samples collected inside and outside WHHS were comparable in terms of both counts and genera ranking. CO2 concentrations were elevated in some classrooms. We determined that a health hazard existed at AFSHS. Employees had significantly higher prevalences of rashes and nasal, lower respiratory, and constitutional symptoms than employees at WHHS. The prevalences of several neurobehavioral symptoms were also significantly higher. VCS values across all spatial frequencies were lower in the employees at AFSHS. Further studies are needed to determine what factors could be responsible for the VCS findings and whether they have any clinical significance for affected individuals. The building problems at AFSHS need to be addressed; recommendations to prevent water damage and microbial growth and for remediation in NOPS and WHHS are provided in this report. (Click to show less)
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(2009) Cancer among occupants of two office buildings. (Click to open report)
On October 11, 2007, NIOSH received a request for an HHE from the management of the NASA GRC in Cleveland, Ohio, regarding ongoing employee and union concerns about a possible higher rate of cancer among current and former employees of Buildings 500 and 501. This was the second HHE request NIOSH had received regarding this issue. The first request, received in 2004, was also submitted by management. In response to the first request, NIOSH investigators identified no hazardous exposures and close... (Click to show more) On October 11, 2007, NIOSH received a request for an HHE from the management of the NASA GRC in Cleveland, Ohio, regarding ongoing employee and union concerns about a possible higher rate of cancer among current and former employees of Buildings 500 and 501. This was the second HHE request NIOSH had received regarding this issue. The first request, received in 2004, was also submitted by management. In response to the first request, NIOSH investigators identified no hazardous exposures and closed the HHE with a letter [NIOSH 2004]. In this latest request, NASA GRC management explained that cancer concerns had resurfaced, no cause for these cancers had been identified, and employees were concerned about potential exposure to jet fuel and deicing compounds from the nearby airport, asbestos in the buildings, water damage in the buildings, and general IEQ. This evaluation focused on the employees in Buildings 500 and 501, adjacent three-story brick office buildings constructed in the early 1960s. Building 500 has approximately 110,000 square feet of office space, and Building 501 has about 25,000 square feet; neither building has research labs. Both buildings are on the NASA GRC campus and across the road from the Cleveland Hopkins International Airport. We reviewed reports provided by NASA GRC management concerning asbestos remediation in these buildings, responses to complaints from building occupants, and environmental sampling during the past 14 years. We evaluated surveys about cancer diagnoses from current and former employees in Buildings 500 and 501 that were provided to us by LESA and NASA management. Additionally, a supervisor sent a confidential list of employees with cancer, and the NASA GRC human resources office provided a list of medical and regular retirements from the buildings during the past 5 years. We spoke with representatives from the Ohio Environmental Protection Agency regarding any past or current environmental contamination issues involving Buildings 500 and 501. We also consulted with representatives from the Ohio Department of Health's cancer registry. We visited the site on October 7-8, 2008. On October 7, 2008, we held an opening meeting with representatives of management and LESA, then walked through the buildings, took measurements of IEQ comfort parameters, and looked for evidence of water damage, water incursion, visible mold, and other potential IEQ problems. On October 8, 2008, we gave two presentations to employees regarding the findings of our evaluation of the cancers reported among employees, and then had a closing conference with representatives of management and LESA. Twenty different types of cancer were diagnosed among employees of Buildings 500 and 501 since 1985. The most common types of cancer diagnosed were breast (17 cases), lung (7 cases), and prostate (4 cases), which are the three most common cancers in the United States. The other types of cancer diagnosed were melanoma, nonmelanoma skin cancer, colon, thyroid, bladder, pancreatic, cervical, uterine, head and neck, bile duct, brain, and stomach cancers; Hodgkin lymphoma, non-Hodgkin lymphoma, clear cell sarcoma, leukemia; and one unknown primary. We found that airport runoff of jet fuel and deicing fluid had entered the Rocky River, which runs next to Building 500. However, jet fuel and deicing fluids are not known to cause cancer, and the river was not a source of drinking water for building occupants, who are supplied with city water. Much of the asbestos in Buildings 500 and 501 had been removed over the years, but some was still managed in place and posed no hazard to building occupants. We identified minor IEQ problems, such as water damage to ceiling tiles and walls, and in some cases poor maintenance of fan coil units, but these are not associated with the cancers that were diagnosed among employees of Buildings 500 and 501. We found no evidence that the cancers reported are associated with work in Buildings 500 and 501 because the number and types of cancers do not appear unusual, the different types of cancers do not suggest a common exposure, no significant hazardous exposures were identified, and evidence leads to nonoccupational causes. Although we recommend no further investigation into the cancers reported in these buildings, employees may have concerns about their own risk for cancer. Therefore, management and the union should take this opportunity to encourage employees to learn about known cancer risk factors, measures they can take to reduce their risk for preventable cancers, and availability of cancer screening programs for certain types of cancer. (Click to show less)
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(2009) Health concerns at a printed circuit board manufacturing plant. (Click to open report)
NIOSH received a confidential employee request for an HHE at Sanmina-SCI Corporation (Sanmina-SCI) located in Huntsville, Alabama. Employees were concerned about exposure to solder paste and fumes during the fabrication, assembly, and testing of printed circuit boards, and noise. Other exposure concerns included copy machine toner, asbestos, mold, and dust. Health effects mentioned in the HHE request included cough, burning eyes, nosebleeds, loss of voice, headache, sinus infection, bronchitis, ... (Click to show more) NIOSH received a confidential employee request for an HHE at Sanmina-SCI Corporation (Sanmina-SCI) located in Huntsville, Alabama. Employees were concerned about exposure to solder paste and fumes during the fabrication, assembly, and testing of printed circuit boards, and noise. Other exposure concerns included copy machine toner, asbestos, mold, and dust. Health effects mentioned in the HHE request included cough, burning eyes, nosebleeds, loss of voice, headache, sinus infection, bronchitis, and respiratory problems. On July 9-10, 2007, we conducted our first site visit. We toured the facility to observe work processes and practices, conducted confidential medical interviews with 40 employees, and collected GA air samples for VOCs and surface wipe samples for lead and tin. We reviewed air sampling records, injury and illness records, the respiratory protection program, and MSDSs. We also reviewed the PPE used for the solder dross cleaning operation and the maintenance schedule for the ARUs. We conducted a second site visit on December 12-13, 2007. We collected air samples for lead and specific VOCs. We conducted noise dosimetry at the AI stations, evaluated the room acoustics near ARUs, evaluated the effectiveness of local exhaust hoods for the wave solder and surface mount machines, and collected hand wipe samples to assess lead contamination on skin. We found that a wave solder operator (cleaning wave solder machines) was exposed to an airborne lead concentration of 49 microg/m3, which exceeded the OSHA AL (30 microg/m3) and was close to the OSHA PEL (50 microg/m3). However, during normal wave solder activities, wave solder operators had lead exposures well below the OSHA AL. We found lead on work surfaces and on hands of employees despite hand washing. We also sampled larger surface areas of the break room tables to ensure they were clean but found detectable levels of lead. Air sampling results for specific VOCs indicated that employee exposures were well below all applicable OELs. Full-shift noise exposures for the AI operators in the MS and DAS were well below the NIOSH REL, and the room acoustics were appropriate for the work environment. A consultant's IEQ assessment report from 2007 identified mold in several ARUs, prompting the company to address employee concerns about odors and mold contamination. Our review of air sampling data collected by the company in March 2007 indicated that the airborne carbon black concentrations resulting from Xerox(TM) toner cartridge cleaning were below OELs. We did not evaluate asbestos exposure, another concern listed in the original HHE request, because management informed us that asbestos-containing material was identified and being managed-in-place. Some of the employees we interviewed were concerned about thermal comfort and exposure to dust and solvents. Most interviewed employees did not report work-related symptoms. Furthermore, the upper respiratory symptoms reported by some employees are common in the general population. We recommend following all requirements of the OSHA lead standard (29 CFR 1910.1025). We recommend using engineering controls such as portable exhaust hoods when removing solder dross and cleaning wave solder machines. General housekeeping practices should be improved to keep break rooms and work surfaces clean. We also recommend cleaning and maintaining the ARUs to ensure mold growth does not occur in the future. Additionally, we recommend revising the written respiratory protection program to address inconsistencies between the written program and current employee respirator use. (Click to show less)
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