Health Hazard Evaluations (HHEs)

(2011) Lead exposure at an indoor firing range - California. (Click to open report)
In August 2008, NIOSH received an HHE request from employees at an indoor small arms firing range concerned about lead exposure and indoor environmental quality. We met with employer and employee representatives and observed work processes, practices, and workplace conditions on January 12-13, 2009. We also evaluated the ventilation systems, measured airflow in the firing range, and spoke with employees. On the basis of this initial visit, we recommended installing a new ventilation system capab... (Click to show more) In August 2008, NIOSH received an HHE request from employees at an indoor small arms firing range concerned about lead exposure and indoor environmental quality. We met with employer and employee representatives and observed work processes, practices, and workplace conditions on January 12-13, 2009. We also evaluated the ventilation systems, measured airflow in the firing range, and spoke with employees. On the basis of this initial visit, we recommended installing a new ventilation system capable of delivering the NIOSH-recommended airflow. The follow-up site visit to collect air and surface lead samples was scheduled for March 2009; however, we delayed this site visit until December 2009 because of plans to install a new ventilation system in the firing range. This renovation was still delayed by the time of the December site visit, so we offered instead to collect air and surface samples to assess lead exposure before and after installation of the new ventilation system. This report only describes conditions before installation of the new ventilation system. On December 8-10, 2009, we collected PBZ air samples on firing range instructors (instructors), shooters, and the hazardous materials technician at the facility. General area air samples, floor vacuum samples, and surface wipe samples were collected in areas around the facility. We also repeated the airflow measurements in the firing range. The lead concentrations from PBZ air sampling on instructors ranged from ND- 96 microg/m3 over the sampling period (calculated 8-hour TWAs were ND- 83 microg/m3); one instructor's calculated TWA exposure (83 microg/m3) exceeded applicable OELs for an 8-hour TWA. For shooters, PBZ lead exposures ranged from 42 - 340 microg/m3 over the sampling periods (calculated 8-hour TWAs were 10 - 99 microg/m3). One shooter who repeated a portion of the qualification had an exposure of 99 microg/m3; this exceeded applicable OELs for an 8-hour TWA. The hazardous materials technician's lead exposure was 3,200 microg/m3 over the sampling period (calculated 8-hour TWA was 670 microg/m3), exceeding the applicable OELs for an 8-hour TWA. The PBZ air sample was collected outside the loose-fitting PAPR that the hazardous materials technician wore while sweeping, vacuuming, and changing exhaust air vent filters in the firing range. Floor vacuum and surface wipe sample results showed the presence of lead on work surfaces. This suggests that workplace contamination was being tracked into these areas by employees' footwear, clothing, or hands. Our review of the instructors' medical monitoring results indicated that BLLs were all below 10 microg/dL of lead. While reviewing medical records, we noted that four instructors had slightly more hearing loss in the left ear than the right ear. Two instructors had threshold shifts that met the NIOSH definition of 15 dB or more at any testing frequency. In addition to our previous recommendation for a new ventilation system, we recommended eliminating dry sweeping, removing carpeting, and improving general housekeeping practices. We also recommended that instructors not use firearms on their workdays and that all personnel working in the firing range wash their hands, arms, and face before eating, drinking, or touching others. Periodic air sampling for lead should be performed whenever changes are made that affect instructor, shooter, or hazardous materials technician exposures. Management should also continue medical monitoring for personnel at the facility. (Click to show less)
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(2011) Police officers' exposures to chemicals while working inside a drug vault - Kentucky. (Click to open report)
In November 2009, NIOSH received an HHE request from a police department in Kentucky. The request concerned possible health effects from working inside a vault used to store drug evidence, including marijuana, cocaine, methamphetamine, and oxycodone. We conducted evaluations in December 2009 and July 2010. We held confidential interviews with 14 employees to learn about their health and workplace concerns. We observed work processes, practices and workplace conditions. We took area and PBZ air s... (Click to show more) In November 2009, NIOSH received an HHE request from a police department in Kentucky. The request concerned possible health effects from working inside a vault used to store drug evidence, including marijuana, cocaine, methamphetamine, and oxycodone. We conducted evaluations in December 2009 and July 2010. We held confidential interviews with 14 employees to learn about their health and workplace concerns. We observed work processes, practices and workplace conditions. We took area and PBZ air samples for inorganic acids, VOCs, and drug particles, and work surface samples for drug particle contamination. We also evaluated the supply and exhaust ventilation systems inside the drug vault and adjacent office area and measured the temperature and RH levels in these areas. The air concentrations of inorganic acids inside the drug vault were well below applicable OELs. The primary VOCs we identified in the drug vault were terpenes. Terpenes are chemicals produced by plants, including marijuana, that contribute to their taste and smell. The low levels we measured are unlikely to cause health effects. However, some individuals are particularly sensitive to strong odors. Only methamphetamine particles were detected in the area air samples, while all the drugs (cocaine, methamphetamine, oxycodone, and THC) were measured in some of the PBZ and surface samples. Of the compounds we measured, drug particles probably present the greatest potential health risk because of their physiological and neurological effects. Employees reported a variety of nonspecific health symptoms, with upper respiratory symptoms, headache, eye irritation, and skin rash most commonly reported. Limited evidence exists linking low levels of indirect drug exposures to acute or chronic health effects. Nevertheless, it is possible that the drug exposures we measured could have contributed to some of the reported symptoms. These symptoms can also be caused by a variety of other occupational (e.g., odors, mold, poor indoor environmental quality, and stress) and nonoccupational factors. The general exhaust ventilation in the drug vault was adequate for gases and vapors based on the recommended minimum exhaust rate for chemical storage rooms. However, the ceiling-mounted exhaust air grills were near the supply air diffusers, leading to short-circuiting (a situation where supply air is immediately exhausted) and reduced ventilation effectiveness. Although temperature and RH levels inside the drug vault and office were acceptable for thermal comfort of employees, RH levels above 50 percent measured during our July visit could promote mold growth. We found visible mold contamination on cardboard boxes used for storing plant-based drugs. We recommend that the employer develop written policies and SOPs to ensure health and safety for employees working inside the drug vault. Employees should be trained on these policies and SOPs, and all training should be documented. All drug vault employees should participate in the medical surveillance program and wear recommended personal protective equipment. If the recommendations provided in this report are implemented, the use of respirators is not necessary inside the drug vault. A drying chamber should be used to remove moisture from plant-based drugs; these drugs should be sealed in plastic bags to prevent off-gassing. Simple modification of the existing supply and exhaust ventilation systems will improve the mixing of air and removal and dilution of the odor-causing compounds. Reducing odors may help reduce the incidence of reported symptoms. In addition, surfaces that are contaminated with drug particles should be thoroughly cleaned. Once cleaned, the recommendations we provide should help control further contamination. (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) Exposure to hazardous metals during electronics recycling at four UNICOR facilities. (Click to open report)
Introduction: On November 27, 2007, the National Institute for Occupational Safety and Health (NIOSH) received a request for technical assistance from the United States Department of Justice (USDOJ), Office of the Inspector General (OIG), in their health and safety investigation of the Federal Prison Industries, Inc. (UNICOR) electronics recycling program at Bureau of Prisons (BOP) institutions in Elkton, Ohio; Texarkana, Texas; and Atwater, California. We were asked to assess the current medica... (Click to show more) Introduction: On November 27, 2007, the National Institute for Occupational Safety and Health (NIOSH) received a request for technical assistance from the United States Department of Justice (USDOJ), Office of the Inspector General (OIG), in their health and safety investigation of the Federal Prison Industries, Inc. (UNICOR) electronics recycling program at Bureau of Prisons (BOP) institutions in Elkton, Ohio; Texarkana, Texas; and Atwater, California. We were asked to assess the current medical surveillance program for inmates and staff exposed to lead and cadmium during electronics recycling, and to make recommendations for future surveillance. In addition, we were asked to assess past exposures to lead and cadmium, and to investigate the potential for "take-home" exposure. Later we were asked to perform a similar evaluation for the BOP institution in Marianna, Florida. We reviewed medical surveillance records, individual medical records, and industrial hygiene sampling records from each institution. We visited each institution and toured the current and/or former recycling and glass breaking facilities and met with staff and inmates to hear their concerns and present our findings. We also performed industrial hygiene sampling at Elkton and Texarkana. At the time of our site visits, glass breaking was being performed at Elkton and Texarkana, but not at Marianna or Atwater. Letters containing detailed information about our assessment, findings, and recommendations for each facility were sent to the OIG and the warden and union at each facility after each of these evaluations. In August 2009, the OIG forwarded additional data for inmates at Elkton. This report contains a summary of our findings at each institution, a review of the additional biological monitoring for Elkton, and overall conclusions and recommendations. For a copy of the individual letters for each BOP institution, please call 513-841-4382. Facility Evaluations: Federal Correctional Institution Elkton: Electronics recycling at the Federal Correctional Institution (FCI) Elkton appears to have taken place from 1997 until May 2003 without adequate engineering controls, respiratory protection, medical surveillance, or industrial hygiene monitoring. Because of the lack of biological monitoring and industrial hygiene data, we cannot determine the extent of exposure to lead and cadmium that occurred during that time frame, but descriptions of work tasks from staff and inmates indicate that exposures were not well controlled, causing the potential for exposure above occupational exposure limits (OELs) for lead and cadmium. Based upon available sampling results, we determined that the current glass breaking operation (GBO) controls exposure to lead and cadmium to far below occupational exposure limits. The GBO can be further enhanced to limit exposure to those performing glass breaking as well as limiting the migration of lead and cadmium from the GBO into other areas. Results of biological monitoring of staff and inmates since 2003 were unremarkable. While some take-home contamination was documented in inmate cubicles, surface wipe sampling and biological monitoring suggest that take-home contamination did not pose a health threat. In late August 2009, the USDOJ provided biological monitoring data for 10 inmates, 8 of whom were on the roster of inmates performing glass breaking. The results of this monitoring were unremarkable. One inmate glass breaker was tested in early April 2002, prior to the installation of the glass breaking booth in 2003. This inmate is the only individual for whom we have results prior to that time. His blood lead level (BLL) was 5 micrograms per deciliter (microg/dL), and his blood cadmium level (CdB) was 0.7 micrograms per liter. We cannot determine the extent of exposure to lead that occurred in the chip recovery process because of the lack of data. Descriptions of work tasks from staff and a BLL of 5 microg/dL in an inmate 4 months after the process ended indicate that exposure to lead during this process did occur. We found no evidence that actions were taken to prevent exposure to lead at the outset in the chip recovery process and that no medical surveillance was performed until after the process ended. Medical surveillance has not complied with Occupational Safety and Health Administration (OSHA) standards. No medical exams (including physical examinations) were done on inmates, staff received inconsistent examinations and biological monitoring by their personal physicians, biological monitoring for lead was not done at standard intervals, and results were not communicated to the inmates. Inappropriate biological monitoring tests such as urine lead and arsenic testing have been done. Records of medical surveillance were not maintained by the employer for the appropriate length of time. After careful review of existing records and current operations, we conclude that the only persons with current potential for exposure to either lead or cadmium over the OSHA action level are the inmates who perform glass breaking or monthly filter change-out. We believe that medical surveillance can be discontinued for all other inmates and staff. Some former inmates and/or staff may require surveillance under the OSHA Cadmium Standard. Federal Correctional Institution Texarkana: Electronics recycling at FCI Texarkana appears to have been performed from late 2001 until May 2004 without appropriate engineering controls, respiratory protection, medical surveillance, or industrial hygiene monitoring. Because of the sparse biological monitoring and industrial hygiene data, we cannot determine the extent of exposure to lead and cadmium that occurred during that time. Descriptions of work tasks from staff and inmates indicate that exposures were not well controlled, causing a potential for exposure above OELs for lead and cadmium. Based on information provided to us and our industrial hygiene sampling, we believe that the current GBO is a significant improvement with respect to controlling worker exposures to cadmium and lead. Some lead- and cadmium-containing dust is still being carried out of the glass breaking booth. Although this does not represent a serious health hazard, it shows a need to maintain good housekeeping throughout the glass breaking area. Exposures since May 2004 are sufficiently low that the OSHA-mandated medical surveillance has not been required since that time. In addition, the results of medical surveillance conducted since 2003 on inmates and staff were generally unremarkable. It is not possible to quantify past exposures to determine whether they triggered the OSHA lead and/or cadmium standard prior to that time. Inmates are advised of the results of their monitoring and see the physician's assistant; however, records of medical surveillance are not maintained by the employer for the appropriate length of time. Some staff have refused to participate in medical surveillance paid by UNICOR but conducted by their personal physicians. After careful review of existing records and current operations, we conclude that medical surveillance can be discontinued for inmates and staff who work in electronics recycling and GBO. UNICOR may choose to continue to perform the limited biological monitoring currently in place as an additional safeguard against excessive exposure and to provide reassurance to inmates and staff. United States Penitentiary Atwater: Inmates were exposed to cadmium and lead above OELs during glass breaking from 2002-2003. It appears that inmates worked without adequate respiratory protection from April 2002 until July 2002. Exposures seem to have been better controlled with relocation of the GBO to the spray booth; however, one sample taken after the relocation demonstrated significant airborne cadmium exposure. Results of medical surveillance of inmates and staff were unremarkable. The medical surveillance program was not in compliance with the... (Click to show less)
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