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HHE Search Results
1060 HHE reports were found based on your search terms. Reports are listed in order of year published with the most recently published reports listed first.
Year Published and Title
(2013) Sensitization and exposure to flour dust, spices, and other ingredients among poultry breading workers. (Click to open report) The HHE Program evaluated employees' exposures to breading dust containing flour, spices, and other ingredients at a poultry breading plant. Reported health symptoms included asthma, bronchitis, and nasal symptoms. Investigators took air samples for inhalable flour dust, wheat, and soy and took samples of employees' blood to see if they were allergic to flour dust, wheat, garlic, onion, soybean, corn, or paprika. They also surveyed employees about their job and health. The air sampling showed th... (Click to show more)The HHE Program evaluated employees' exposures to breading dust containing flour, spices, and other ingredients at a poultry breading plant. Reported health symptoms included asthma, bronchitis, and nasal symptoms. Investigators took air samples for inhalable flour dust, wheat, and soy and took samples of employees' blood to see if they were allergic to flour dust, wheat, garlic, onion, soybean, corn, or paprika. They also surveyed employees about their job and health. The air sampling showed that employees in almost all areas of the plant had the potential for exposure to flour dust levels above the threshold limit value of 0.5 milligrams per cubic meter, set by the American Conference of Governmental Industrial Hygienists. Investigators grouped employees as "lower-exposure" or "higher-exposure" based on their exposure to flour, other ingredients, and uncooked breaded product in their current job. Samples taken for inhalable flour dust from the air in the personal breathing zone of employees in the higher-exposure group had a median value of 8.21milligrams per cubic meter, while samples taken from the breathing zone of employees in the lower-exposure group had a median value of 1.03 milligrams per cubic meter; both median values exceeded the threshold limit value for inhalable flour dust of 0.5 milligrams per cubic meter. Employees in the higher-exposure group were more likely than those in the lower-exposure group to report several work-related symptoms in the last 12 months. These symptoms included wheezing or whistling in the chest, sneezing, running nose or blocked nose without a cold, and running nose or blocked nose without a cold accompanied by itchy, water eyes. Employees in the higher-exposure group were nearly 2.5 times more likely than those in the lower-exposure group to be sensitized to flour dust and wheat. Employees who were allergic to flour dust, wheat, corn, or onion were more likely to report work-related asthma symptoms than those who did not have these allergies. HHE Program investigators recommended that plant managers use an enclosed system to transfer powdered ingredients to the dispensing hoppers and use local exhaust ventilation to lower flour dust levels. Starting a plant medical surveillance program was recommended as well as implementing a respiratory protection program until engineering controls and work practices can reduce exposures below the exposure limit for flour dust set by the American Conference of Governmental Industrial Hygienists.
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(2013) Zoonotic disease and exposures in persons working with marine mammals. (Click to open report) The HHE Program evaluated potential exposure of employees and volunteers to zoonotic diseases at a marine mammal rescue and rehabilitation center. Zoonotic diseases are those that can be transmitted from animals to humans. Investigators with the HHE Program observed work practices and personal protective equipment use and found that some practices may lead to a higher risk of exposure to zoonotic diseases. Employees and volunteers were given a survey and blood tests to look for evidence of past ... (Click to show more)The HHE Program evaluated potential exposure of employees and volunteers to zoonotic diseases at a marine mammal rescue and rehabilitation center. Zoonotic diseases are those that can be transmitted from animals to humans. Investigators with the HHE Program observed work practices and personal protective equipment use and found that some practices may lead to a higher risk of exposure to zoonotic diseases. Employees and volunteers were given a survey and blood tests to look for evidence of past infection. Among the 213 participants, little evidence was found of past infection with the organisms that cause leptospirosis, brucellosis, or Q fever. Air, surface, and bulk dust samples were collected for C. burnetti, the bacterium that causes Q fever; all but one of 130 samples was negative. A ventilation assessment showed that the biological safety cabinet in the laboratory did not have enough airflow so investigators recommended that the employer have this cabinet certified yearly and ensure that it meets minimum flow requirements. Investigators also found that when the harbor seal area ventilation system was turned on air flowed from the intensive care unit to other areas of the building. Investigators recommended that harbor seal pups not be housed in the intensive care unit if they are suspected of having Q fever. Instead they should be housed outside and isolated from other harbor seal pups. Investigators recommended that the carpet in the triage building be removed and replaced with a nonporous surface. Investigators noted that some employees and volunteers were not wearing the correct personal protective equipment and recommended that the employer provide initial training and refresher training for all employees and volunteers on hand washing, proper personal protective equipment use, and the risk of infection. Employees were encouraged to (1) wash their hands after exposure to animals or animal areas even if they were wearing gloves, (2) not wear personal protective equipment in areas where people eat or drink, (3) report signs of possible zoonotic infection to their supervisor, and (4) to tell their healthcare provider about their duties and exposures to marine mammals. The employer was encouraged to post signs about hand washing.
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(2012) Air sampling methods for abrasive blasting - Louisiana. (Click to open report) NIOSH received a request for an HHE from the management at a Louisiana shipyard to evaluate sampling methods for measuring employee PBZ exposures during abrasive blasting. On July 20, 2001, NIOSH investigators collected side-by-side PBZ air samples using three types of commercially available sampling devices: a closed-face 37-mm cassette, an unshielded BAS, and a shielded BAS. For each type of sampling device we collected an "active" PBZ sample that was connected to an air sampling pump and a "p... (Click to show more)NIOSH received a request for an HHE from the management at a Louisiana shipyard to evaluate sampling methods for measuring employee PBZ exposures during abrasive blasting. On July 20, 2001, NIOSH investigators collected side-by-side PBZ air samples using three types of commercially available sampling devices: a closed-face 37-mm cassette, an unshielded BAS, and a shielded BAS. For each type of sampling device we collected an "active" PBZ sample that was connected to an air sampling pump and a "passive" PBZ sample that was not connected to an air sampling pump. These active and passive samples were collected side-by-side for the duration of the abrasive blasting activity (approximately 60 to 80 minutes). Samples were used to evaluate whether inertia-driven abrasive material could enter the sampler during abrasive blasting. All of the air samplers were positioned outside the employees' abrasive blasting helmet following OSHA sampling guidance. Total dust was measured for the 37-mm filter samples. Inhalable dust was measured for the unshielded and shielded BAS samples. The harsh and dusty abrasive blasting environment caused frequent sampling pump failures. Because of the failures, there was insufficient data for a statistical comparison of the air sampling results for the three sampling methods. All 37-mm cassette samples contained inertia-driven (loose) abrasive grit particles that accounted for up to 99% of the total particle weight. All unshielded and shielded BAS samples contained loose particulate. BAS total weights exceeded the recommended maximum sample loading of 2 mg. Some of the passive samples collected a similar amount of particulate as the active samples. We concluded that none of the sampling methods we used performed reliably in an abrasive blasting environment. All were likely to overestimate air concentrations because of the presence of inertia-driven particulate in the samplers. Improving the design of sampling devices or developing alternative sampling methods is needed to accurately and reliably assess PBZ dust exposure concentrations during abrasive blasting operations.
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(2012) Legionnaires' disease at an automobile and scrap metal shredding facility, New York. (Click to open report) On May 11, 2011, the National Institute for Occupational Safety and Health (NIOSH) received a request from the management of an automobile and scrap metal shredding facility regarding cases of Legionnaires' disease that had been identified among their workers. The request listed concerns about dusts, mists, and vapors generated during the process of shredding automobiles and scrap metal. The health concerns were Legionnaires' disease and respiratory disease. During telephone discussions with the... (Click to show more)On May 11, 2011, the National Institute for Occupational Safety and Health (NIOSH) received a request from the management of an automobile and scrap metal shredding facility regarding cases of Legionnaires' disease that had been identified among their workers. The request listed concerns about dusts, mists, and vapors generated during the process of shredding automobiles and scrap metal. The health concerns were Legionnaires' disease and respiratory disease. During telephone discussions with the New York State Department of Health (NYSDH), NIOSH learned that four employees from the shredding facility had been diagnosed with Legionnaires' disease: one in 2009, two in 2010, and one in May 2011. All performed shoveling and/or picking activities; the latter involves manually removing copper and other material passing on a moving conveyor. In December 2010, NYSDH identified Legionella bacteria on a swab sample taken from a conveyor belt that exited the shredder and from water dripping from that same belt. An additional water sample obtained in May 2011 from the same conveyor belt also contained Legionella. Prior to our initial site visit, NIOSH investigators contacted management and recommended that any employee with respiratory, flu-like, or gastrointestinal symptoms (e.g., fever, chills, cough, shortness of breath, muscle aches, nausea, vomiting, diarrhea) be removed from his or her job and seek evaluation for Legionnaires' disease from a healthcare provider. We also recommended that employees who work near any aerosols or mists wear fit-tested N-95 respirators. On June 1-2, 2011, NIOSH investigators visited the facility. We spoke briefly with all available facility employees about Legionnaires' disease and any symptoms they may have or have had; none reported current symptoms consistent with Legionnaires' disease. We observed large quantities of standing water throughout the facility grounds. We also observed workers standing and shoveling in or around the water; vehicles driving through puddles of water; and front-end loaders picking up and setting down materials in and around standing water. We observed no employees wearing respirators. We collected air, water, and swab samples at multiple locations around the facility to be tested for Legionella bacteria. We also collected area air samples to be analyzed for metals, volatile organic compounds (VOCs) and dust. Legionella was identified in water dripping from the exterior of the shredder onto the exit conveyor belt that contained the shredded material and in multiple puddles of water. Metals detected in the air samples were below applicable NIOSH recommended exposure limits (RELs) and the Occupational Safety and Health Administration (OSHA) permissible exposure limits (PELs), where standards existed. Toluene, ethyl benzene and xylene isomers, and some alkyl benzenes were the major VOCs identified. The dust samples were below the OSHA particulates not otherwise regulated standard of 5 milligrams per cubic meter (mg/m3) for respirable particles. At the end of the walk-through visit, we again recommended implementing a formal respiratory protection program that would require employees working around or near aerosols or mists to wear fit-tested N-95 respirators. We also discussed the possibility of Legionella in the standing water which could be aerosolized during shoveling activities and while driving or walking through the puddled water. We reiterated that symptomatic employees should be removed from their jobs until they are evaluated for Legionnaires' disease by a healthcare provider. We recommended that the groundwater drainage system be improved to eliminate the pools of water and that shoveling activities be avoided as much as possible during shredding operations because of the potential for generating aerosols. We recommended the shredder, conveyor systems, and any mobile equipment be cleaned and sanitized. Following our initial site visit, a fifth employee was diagnosed with Legionnaires' disease in June 2011. He had recently been hired at the facility, worked in the picking shed, and had not worn a respirator. On September 23, 2011, we revisited the facility to conduct a follow-up assessment. Facility grounds had been cleared of a build-up of dirt, improving drainage and revealing a previously blocked drain. A new shredder had been installed which required only half the previous water flow. The plant manager reported that the picking room had been cleaned and sanitized but not the rest of the facility. Some puddles of water still existed, and Legionella was detected in water samples taken from multiple puddles. Legionella was not detected in swab samples taken from the conveyor system. We observed workers wearing N-95 respirators; none had been fit-tested, and some were wearing their respirators incorrectly. In each of these cases, we showed the worker how to wear the respirator. We also hung posters in the break room and mechanical room that showed how to put on and take off an N-95 respirator. We recommended that workers wearing respirators be fit-tested. We also recommended that the ground drainage be improved to remove the remaining standing water, and that the rest of the facility be cleaned and sanitized.
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(2011) Contact dermatitis among ink ribbon manufacturing employees - New York. (Click to open report) In May 2007, NIOSH received a management request for an HHE to look at dermatitis in production employees. In August 2007, we toured the plant, interviewed employees, and examined their skin for irritation. We took air samples for volatile organic compounds, reviewed MSDSs and medical records, and tested workplace substances to see if they could cause skin allergy. Our evaluation found that airborne solvent exposures were low; however, production employees had the potential for skin contact with... (Click to show more)In May 2007, NIOSH received a management request for an HHE to look at dermatitis in production employees. In August 2007, we toured the plant, interviewed employees, and examined their skin for irritation. We took air samples for volatile organic compounds, reviewed MSDSs and medical records, and tested workplace substances to see if they could cause skin allergy. Our evaluation found that airborne solvent exposures were low; however, production employees had the potential for skin contact with chemicals. The predominant location of dermatitis in employees was the hands and fingers, suggesting that the most likely cause of dermatitis was direct skin exposure to chemicals. Some ingredients in workplace inks, hand wipes, and hand cleaners were known sensitizers or were found to be sensitizers by our testing. In March 2008, we asked employees to fill out health questionnaires and observed workplace improvements made by the company. The analysis of questionnaire data revealed that reporting work-related dermatitis was related to being exposed to ink production work and having a predisposition to allergic disease (defined as asthma, atopic eczema, or allergic rhinitis/hay fever). Our initial findings suggested that the cause of the employees' dermatitis was skin allergies, so we returned to do skin patch testing in September 2009. We tested 13 employees with a history of dermatitis to newly identified workplace allergens and to common allergens. No skin patch test participants reacted to any of the workplace substances; seven reacted to common allergens. A dermatologist under contract to NIOSH diagnosed eight participants with irritant contact dermatitis. Employees were exposed to several irritants at work including solvents, dusts, and irritating soaps and/or hand wipes. In addition, employees with dermatitis reported worsening of symptoms when exposed to cold, dry weather. Because the company made improvements in ventilation, work practices, and housekeeping; introduced appropriately protective gloves; introduced less irritating hand products; and began healthy skin program training, the dermatitis of most skin patch test study participants improved or resolved. Although no participants reacted to workplace materials, we recommended taking precautions in handling sensitizing substances, because prolonged and/or large exposures to those substances may cause a skin sensitizing reaction in allergy-prone employees.
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(2011) Exposures to pharmaceutical dust at a mail order pharmacy - Illinois. (Click to open report) NIOSH investigators conducted an health hazard evaluation (HHE) at a mail order pharmacy to determine whether employees were exposed to pharmaceutical dust and noise and were experiencing health effects related to these exposures. We observed work processes, practices, and workplace conditions. We collected air samples to characterize employees' exposures. We measured employees' noise exposures and sound levels in the production areas. We held confidential interviews with 45 employees to learn a... (Click to show more)NIOSH investigators conducted an health hazard evaluation (HHE) at a mail order pharmacy to determine whether employees were exposed to pharmaceutical dust and noise and were experiencing health effects related to these exposures. We observed work processes, practices, and workplace conditions. We collected air samples to characterize employees' exposures. We measured employees' noise exposures and sound levels in the production areas. We held confidential interviews with 45 employees to learn about their health and workplace concerns. Using real-time particle meters, we identified releases of dust during the cleaning, repairing, and refilling of cells and canisters. We sampled the air for different sizes of dust particles and analyzed the samples for active pharmaceutical ingredient (APIs) and lactose, a common ingredient of pharmaceuticals. Most of these air samples contained lactose and one or more APIs, suggesting that some of the airborne dust came from pharmaceuticals. We quantified two APIs on these air samples, warfarin and lisinopril; the air concentrations were well below applicable OELs. Most employees wore protective gloves but did not wear protective clothing when handling pharmaceuticals. Consequently, personal clothing could become contaminated with APIs and become a source of secondary exposure to employees or their family members. Many employees washed hands before eating or smoking, which should minimize the ingestion of APIs. Some employees voluntarily wore N95 filtering facepiece respirators. However, these respirators were not always worn or maintained correctly. Shortly before our second visit, pharmacy managers developed standard operating procedures for the handling of hazardous drugs. These procedures required hazardous drug prescriptions to be filled and verified in a separate area by dedicated personnel. Gloves were the only control measure required for this process. The most likely health effects from exposure to APIs are allergic reactions and upper respiratory irritation. Nearly half the employees reported eye and upper respiratory irritation, which could be related to their exposures to APIs. However, these symptoms could also be caused by general dust exposures or non-occupational factors, such as weather conditions and seasonal allergies. We were unable to quantify employees' exposures to all APIs. Given the uncertainty of our exposure assessment, the potential for surface and personal clothing contamination, and the lack of knowledge regarding the toxicity of low-level exposures to multiple APIs, exposures to pharmaceutical dust should be reduced as much as feasible. We recommend installing ventilation booths and movable capture hoods that can be used when hand filling hazardous drug prescriptions and cleaning, repairing, and refilling cells and canisters. All hazardous drugs should be identified and labeled. All employees who handle drugs should wear lab coats or other protective clothing to minimize contamination of their personal clothing. We found that full-shift TWA noise exposures for employees working near the Baker machines could exceed the OSHA AL and NIOSH REL of 85 dBA. Employees' noise exposures in other production areas were below these exposure limits. Some employees wore hearing protection, but the noise reduction rating was more than what was needed. We recommend providing hearing protectors with a noise reduction rating of 15-20 dB. We noted that many employees wore an earphone from a personal music player in one of their ears. Because this can increase the risk of hearing loss if the sound level from the earphone is higher than the background noise in the facility, we recommend that personal music players not be used in the workplace. One-third octave band noise level measurements at several different work areas or around pharmacy equipment indicated that the highest noise levels occurred at high frequencies (greater than 8,000 Hz). To reduce noise levels and noise exposures, we recommend installing mufflers on the exhaust port of solenoid valves and actuators throughout the facility and constructing a better enclosure at the capper machine, located near the Baker machine.
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(2011) Health concerns in a public middle school - Virginia. (Click to open report) On January 12, 2010, NIOSH received an employer request for an HHE at a middle school in Virginia. The request was made because of staff concerns about exposure to mold in the school building. More than a dozen employees had reported health complaints they thought had been caused by mold since the school underwent renovation in 2006-2007. NIOSH investigators made a site visit on January 27-28, 2010. We randomly selected 72 (out of 137) employees for confidential medical interviews; 68 were avail... (Click to show more)On January 12, 2010, NIOSH received an employer request for an HHE at a middle school in Virginia. The request was made because of staff concerns about exposure to mold in the school building. More than a dozen employees had reported health complaints they thought had been caused by mold since the school underwent renovation in 2006-2007. NIOSH investigators made a site visit on January 27-28, 2010. We randomly selected 72 (out of 137) employees for confidential medical interviews; 68 were available. In addition, three employees on medical leave and nine employees not on our list were interviewed. We observed workplace conditions and the crawl space beneath the renovated part of the building. We reviewed the HVAC system balancing reports, current HVAC operations, and consultant reports, and we evaluated the functioning of the HVAC system. We measured air pressure differentials between the classrooms and crawl space to determine which direction air was flowing between the two areas. Sticky-tape samples were collected from surfaces for microscopic fungal analysis, and vacuum dust samples were collected from furniture for cat, dog, dust mite, and cockroach allergens. Surfaces were wiped with a Swiffer sheet and analyzed for the presence of fungal species. A meter was used to measure the interior wall moisture levels. Measurements of CO2, CO, temperature, and RH were made throughout the workday in the new and renovated classrooms. Randomly selected school employees had rates of work-related symptoms similar to or below those reported in a study of buildings not known to have IEQ problems and in the general population. Many of the nonspecific symptoms reported, such as sinus problems and headaches, are common among people working in offices and schools, as well as in the general population. More serious health problems reported by some staff are not related to working in the building. The crawl space under the renovated part of the building has a dirt floor with a partial moisture barrier, and the soil slopes toward the foundation instead of away from it, allowing water to enter the crawl space. At the time of our site visit in January 2010, there was no visible mold growth or standing water in the crawl space but there was moisture under the partial moisture barrier. The RH levels in the crawl space were higher than in the school building, and there was rust on the crawl space metal beams. In addition, the crawl space was under positive pressure, which allowed air from the crawl space to enter the school building, because the fan that generates the negative pressure (relative to the school) was not turned on. Samples taken from the new part of the school had lower fungal concentrations overall than those from the first floor of the renovated part. Significant concentrations of cat allergen were found on chairs in several classrooms and on the couch in the teachers' lounge. Recommendations to prevent water incursion and microbial growth are provided in this report.
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(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.
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(2011) Respiratory health among employees in a water-damaged office building - Connecticut. (Click to open report) In July 2001, NIOSH received a health hazard evaluation request from a local union representing employees at a state office building in Connecticut. There had been reports of asthma, hypersensitivity pneumonitis, and sarcoidosis occurring among occupants in the building. The building, which had a reported history of water incursion and damage, was originally built in 1985 and purchased by the state of Connecticut from a private company in 1994. Two agencies had been in the office building since ... (Click to show more)In July 2001, NIOSH received a health hazard evaluation request from a local union representing employees at a state office building in Connecticut. There had been reports of asthma, hypersensitivity pneumonitis, and sarcoidosis occurring among occupants in the building. The building, which had a reported history of water incursion and damage, was originally built in 1985 and purchased by the state of Connecticut from a private company in 1994. Two agencies had been in the office building since the building was purchased, with Agency A occupying the 5th, 6th, and upper floors (14th-20th) and Agency B on the lower floors (7th-12th floors). In 2005, another state agency, Agency C, relocated to the 6th floor of the building. The first four floors are used for parking. NIOSH conducted an initial health survey in 2001 and medical and environmental surveys in 2002. After these surveys, the building underwent major remediation between 2002 and early 2004, with additional remediation through 2007. After major remediation was completed, NIOSH conducted the first follow-up health questionnaire survey in 2004 and two additional follow-up surveys in 2005 and 2007. NIOSH also performed follow-up medical surveys in 2004 and 2005 on a subset of employees, and conducted follow-up environmental evaluations in 2004, 2005, and 2007. NIOSH invited all occupants to participate in the health questionnaire surveys offered in 2001, 2004, 2005, and 2007. Results of the 2001 health questionnaire survey indicated elevated prevalences of asthma and lower respiratory symptoms in the building compared to national and state data. There was a 7.5 times increased incidence of adult-onset asthma after building occupancy compared to before occupancy. Some occupants reported new-onset sarcoidosis and hypersensitivity pneumonitis. From the initial 2001 health and 2002 environmental surveys, NIOSH found that occupants with relatively higher exposure to fungi or endotoxin (a cell wall component of Gram-negative bacteria) in the building had a greater risk of respiratory symptoms and post-occupancy physician-diagnosed asthma in an exposure-dependent way, and that occupants with exposure to both higher mold and higher endotoxin levels in the building had an even greater risk of respiratory illnesses than the summation of the individual risks of higher mold and higher endotoxin concentrations. Throughout the follow-up surveys conducted after the major remediation was completed, NIOSH continued to find elevated rates of symptoms and disease in the building. Rates of lower respiratory symptoms and asthma remained elevated when compared to national and state data. However, the new onset of diseases such as asthma, hypersensitivity pneumonitis, and sarcoidosis appeared to decline after 2001 or 2002. Respiratory and non-respiratory complaints were higher among occupants who had worked in the building for longer time periods (hired prior to 2004), compared to occupants with shorter occupancy times (hired in 2004 or later). In general, we observed no overall improvement in respiratory health, as reflected in symptom scores, overall medication use, spirometry abnormalities, or sick leave when we compared 97 employees' paired medical data from 2002 and 2005. In addition, occupants who reported building-related nasal or sinus symptoms in the 2001 survey had a higher risk of developing building-related lower respiratory symptoms (wheeze, chest tightness, attacks of shortness of breath, cough, or awakened by an attack of breathing difficulty) in any one of the three follow-up surveys. In this repeated measurement analysis, data suggest that employees with rhinosinusitis symptoms that were not associated with building occupancy did not have an increased risk of building-related asthma symptoms. The levels of total culturable fungi in the building decreased in 2004 and 2005 compared to 2002 levels, but increased in 2007. This increase in 2007 occurred on all 15 occupied floors and was mostly attributable to an increase in hydrophilic fungi (fungal group requiring high moisture content to survive and grow on substrates). Repeated measurement analysis showed a significant effect of remediation in floor dust levels in 2004 and 2005 for total and hydrophilic fungi and for endotoxin in 2004, after major remediation was completed between 2002 and early 2004. However, this remediation effect disappeared in 2007, which suggests inadequate ongoing remediation. In summary, this office building with a long history of water incursion is associated with excess respiratory disease among employees. Extensive remediation of water damage temporarily lowered indices of microbial contamination but the building continued to have recurrent water incursion in 2007 and 2008 as documented in consultant reports. Although new employees occupying the building between 2004 through 2007 had fewer respiratory complaints, previously affected employees, on average, did not regain their respiratory health. Employees should seek medical guidance quickly if they develop symptoms. Ongoing medical surveillance can provide health data to guide management decisions about relocation of affected employees and risk management of continued building occupancy in relation to remediation and productivity costs.
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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.
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