sustain
Health issue 2013 - Fall

Forbo Flooring Systems is the global market
leader in commercial floor covering solutions.
Marmoleum, our flagship brand is the global
leader in the linoleum market, while Flotex
is the industry leader in the rapidly growing
flocked textile market. In addition tolinoleum-based products, Forbo develops,
manufactures and markets a diversity of highquality vinyl and textile floor coverings, as well
as Coral & Nuway entrance system solutions.

healthcare;
Cure for a Crisis
The coming challenge to
our nation’s health,starting at the hospitaldoorstep

1. The Biocidal Products Regulation (EU 528/2012). For more information: http://echa.europa.eu/regulations/biocidal-products-regulation
2. “Chemicals and Our Health: Why Recent Science is a Call to Action”, a report published by the Safer Chemicals Healthy Families coalition,
		 for the full report go to www.SaferChemicals.org
3. “The Future of Fabric – Health Care”, published by the Healthy Building Network, October 2007 in conjunction with Health Care Without
		 Harm’s Research Collaborative.
4. http://www.chicagotribune.com/chi-infectiousdiseases-specialpackage,0,2681727.special		http://www.chicagotribune.com/news/chi-0207210272jul21,0,2177158.story.
5. Sathyanarayana, S. (2008) Phthalates and children’s health. Current Problems In Adolescent Health Care, 38, 34-39. doi:10.1016/j.cppeds.2007.11.001
6. “Toxic Chemicals in Building Materials; An Overview for Health Care Organizations” Kaiser Permanent and the Healthy Building Network /		 Healthcare Without Harm, May, 2008
7. Pharos Product Category Descriptions – Resilient Flooring http://www.pharosproject.net/product_category/show/id/3
8. America’s Children and the Environment, U.S. Environmental Protection Agency, 2008. http://www.saferchemicals.org/resources/health.html
9. Holly L. Howe, et al., “Annual Report to the Nation on the Status of Cancer (1973 through 1998), Featuring Cancers with Recent Increasing Trends,”
		 Journal of the National Cancer Institute, 93, no. 11 (June 2001): 824–42. http://www.saferchemicals.org/resources/health.html
10. Janet Gray, ed, State of the Evidence: The Connection Between Breast Cancer and the Environment, (San Francisco: Breast Cancer Fund, 2008).
11. Tracey J. Woodruff , et al., “Trends in Environmentally Related Childhood Illnesses,” Pediatrics, 113, no. 4 (April 2004): 1133-1140.
12. Jeanne E. Moorman, et al., “National Surveillance for Asthma, United States 1980–2004,”Centers for Disease Control and Prevention,
		 www.cdc.gov/mmwr/preview/mmwrhtml/ss5608a1.htm (November 1, 2009).
13. Anjani Chandra and Elizabeth Hervey Stephen, “Impaired Fecundity in the United States:1982-1995,” Family Planning Perspectives, 30, no 1,
		 (1998): 34-42.
14. Anjani Chandra, et al., “Fertility, Family Planning and Reproductive Health of US Women: Data from the 2002 National Survey of Family Growth,”		 Vital and Health Statistics, 23, no. 25 (2005).
15. Kate Brett, “Fecundity in 2002 National Survey of Family Growth Women 15–24 Years of Age” (personal communication), Hyattsville, MD,
		 National Center for Health Statistics (2008) http://www.womensvoices.org/issues/reports/the-health-case-executive-summary/.
16. Leonard J. Paulozzi, “International Trends in Rates of Hypospadias and Cryptorchidism,” Environmental Health Perspectives, 107, no. 4,		 (1999): 297-302.
17. National Institute of Mental Health, “NIMH’s Response to New Autism Prevalence Estimate,”
		http://www.nimh.nih.gov/about/updates/2009/nimhs-response-to-new-autism-prevalence-estimate.shtml
18. Scientific American “The Baffling Link Between Autism and Vinyl Flooring”, Marla Cone, Environmental Health News 2009

More Information on this subject?
If you would like to quickly access the sources cited in this issue of
SUSTAIN as well as nearly 50 other closely related resources, simply
go to www.forboflooringna.com/resources or scan the QR code.
You will find a complete library of studies and papers on the subject.

North American Headquarters
Forbo Flooring Systems
8 Maplewood Drive
Humboldt Industrial Park
Hazleton, PA 18202
T: 1-800-842-7839
570-459-0771
F: 570-450-0258
email: info.na@forbo.com
www.forboflooringNA.com
www.floorcostcomparison.com
CanadaForbo Flooring Systems
111 Westmore Drive
Toronto, ON M9V 3Y6
phone: 1-800-268-8108 (English)
1-800-567-9268 (Francais)
fax: 1-877-893-4680
email: info.na@forbo.com
www.forboflooringNA.com
www.floorcostcomparison.com

Dying for a cureThe Superbug’s
second sting
The Chemical Society
A Tsunami of Consequences
The Way Out: one industry
viewpoint

11/18/20K/MDW© 2013 Forbo Flooring Systems

creating better environments

creating better environments

Looming toxins that affect healthcare now,and threaten its future
Patients think of a health care facility as the first step on the road backto wellness. Health professionals are becoming increasingly aware of adarker truth: toxic threats within the healthcare environment are becoming
a short cut to more serious illness, permanent harm and even death. The samerisks apply to all types of care facilities, including acute care and specialty
hospitals, clinics, ambulatory surgical centers and long term care facilities.

Hospital acquired
infections (HAI’s) areamong the mostcommon causes ofaccidental death in
the United States.

2

Today: deadly infections.
Hospital acquired infections (HAI’s) areamong the most common causes ofaccidental death in the United States.
One in twenty patients will contract a
HAI sometime during a hospital stay.
Four in every hundred will die...more
than the number of Americans killedin car accidents, fires and drowningcombined.

Dying for a Cure

Tomorrow: toxic workplaces.
In addition to enduring the use ofaggressive disinfectants that arecommonly used to fight HAIs, healthcare professionals are forced tofunction in an indoor environment
filled with toxic chemicals that arebound to impact patients andcaregivers alike. The danger isimminent...so much so that theEuropean Union put a set of restrictive
new rules on the use of biocides inplace in 2012.1

Coming soon: a chronic
epidemic. A growing wave ofchronic diseases are already hitting
hospitals, clinics and care centers
nationwide, caused by known
chemical contaminants in indoor
environments that largely gounidentified by designers, building
owners and maintenanceprofessionals.2,3

In response to these
serious concerns, healthcare professionals
worldwide are
becoming increasingly
focused on creating
environments that
fulfill the fundamental
tenet at the heart ofevery physician’s
Hippocratic Oath:
Primum Non Nocere –first, do no harm.

3creating better environments

New hazards,
plus perennial perils

The SuperBug
Stings Twice
Healthcare infections, and thecure that creates new diseases

Powerful new
antibacterial
compounds aredeveloped tofight bacteria,
which mutate
to resist them.

The Second Sting:Pesticides/Biocides
While it’s tempting to turn toproducts, fabrics and flooring treatedwith antimicrobial agents that prevent
bacterial growth, this solution creates
more problems than it solves. Unfortunately
the chemicals used to make these products
anti-microbial are commonly classified as
pesticides/biocides.

SuperBug

Healthcare professionals alreadyknow about SuperBugs. They are
painfully aware of new strains ofSuperBug bacteria that are free
to run wild in hospitals and longterm care settings, thanks to theirimmunity to standard
disinfectants.

4

The Superbugs won’t be crawlingaway anytime soon, due to asituation akin to a microscopic
nuclear arms race. Powerful new
antibacterial compounds aredeveloped to fight bacteria, which
mutate to resist them. Still newer

First, the good news. Healthcare
workers are beginning to makeprogress against MRSA and
C. difficile, the two best known
resistant bacteria. Government
data from Public Health Englandreported that better control of MRSA
and C. difficile led to a nationwide
decrease in the prevalence of HAIs
from 8.2% in 2006 to 6.4% in 2011.

Breeding grounddisinfectants are then created,causing the bacteria to mutate
again and escalate the warfare
further. In addition to the toxicity
this adds to the healthcare
environment, the skyrocketing costof infection control is an escalating
burden on already overtaxed healthcare budgets. Research recently
released by JAMA Internal Medicine
reported that HAIs cost $9.8 billion
every year. This report has received
an enormous amount of attention inan era where health care costsavings are constantly in the news.

The bad news comes on two
fronts. The most threatening is a
new wave of resistant bacteria
now emerging, including
Carbapenem-ResistantEnterobacteriaceae (CRE) andmultidrug resistant Acinetobacter.
The new bacteria combine a highmortality rate with resistance tonearly all contemporary antibiotics.
Paradoxically, infection control
professionals are also seeing a rise in
the incidence of hospital-based
infection from more common
bacteria, from coliforms likesalmonella and E. coli to treatmentresistant strains of tuberculosis.

A half century of experience with theenvironmental impact of pesticides teaches
us that indiscriminate and/or excessive
pesticide use can threaten more than justpests. Because of the bio-accumulative
nature of pesticides, scientists areinvestigating the causal links between
pesticides and the increased incidenceof several types of diseases, including:• Rapid growth in the incidence ofasthma and other respiratory diseases• A sudden increase in allergies andchemical sensitivities• The proliferation of other chronic
health consequences, including
cancer, birth defects, neurologicaland reproductive disorders

5

creating better environments

IPM kills SuperBugs deadThe federal Environmental Protection Agency (EPA)
recommends Integrated Pest Management (IPM) to fightthe SuperBug scourge. The IPM approach balances theneed for effective control of hazards with a more global
concern for the healthiness of everyone impacted, frompatients and caregivers to beneficial microbes and bacteria.

Many products that tout themselves as antimicrobial
are actual impregnated with chemical pesticides.

Antimicrobial
Chemically or Naturally?

Three key steps are commonly part of an IPM program:
1. Prevention rather than poisoning

2. A focus on natural alternatives

3. Setting an action threshold

The EPA’s approach focuses oninvesting time and effort to minimize
risk, rather than reacting topreventable threats after they arise.
The goal is to avoid surfaces that
promote bacterial growth, todisinfect surfaces more frequently
with milder cleaners, and toencourage activities (like handwashing and cough etiquette)that reduce the likelihood oftransmitting infection.

Many products that tout themselves
as antimicrobial are actually
impregnated with chemical
pesticides or biocides that canjeopardize the health of a vulnerable
healthcare population. The use ofnatural materials (like Marmoleum
flooring, which naturally inhibits
bacterial growth without additives)
can achieve the same result without
exposing patients and healthcaregivers to the risks of pesticides andtheir bio-accumulative toxicity.

It is virtually impossible tototally eliminate bio-based risks,
so the wiser strategy is to set an
acceptable level of sanitation andmaintain it consistently. This allows
facility managers to sustain ahealthful environment without
expending vast resources toachieve a marginally negligible
improvement.

A Chicago Tribune undercover investigation42 found that nearly
three-quarters of deadly hospital acquired infections werepreventable. Statistics like these naturally spur us to action.
We have learned, however, that we need to make sure our
natural impulse to act doesn’t lead to an unnaturally harsh
response as a result.

6*

Indoor air is contaminatedwith a complex mixtureof chemicals from manysources, including
emissions from building
materials.
Disease risks related to thispolluted environment can
include asthma, bronchitis,
cancer, and reproductive,
developmental, andneurological disorders.

If you are familiar
with the smell ofa new car interior,
you havepersonallyexperienced thebodily intake ofphthalates.

Caregivers
in aThe long-term hazards
in healthcare interiors
are becoming a curse
to caregivers.

Chemical Society

While patients may be the focus of a healthcare environment, doctors, nurses,
and other medical professionals are equally essential. Surprisingly, very little has
been done to protect U.S. health professionals from exposure to hazardous
chemicals in their indoor environment.
The creation of a “chemical society” has been a long term concern ofgovernments worldwide. In 1995, the United Nations called for global
action to remove persistent organic pollutants (POPs) from ourenvironment. The worldwide Stockholm Convention created aninternational treaty aiming to eliminate POPs from production anduse. Unfortunately, due to the strength of the chemical industry
lobbying of U.S. lawmakers, the United States is one of only sevennations worldwide that has failed to ratify the treaty.

n State parties to the Stockholm
Convention as of May 20128

Professionals in the U.S. healthcare industry are becoming increasingly
concerned about the lack of control over chemical exposure. In the viewof Healthcare Without Harm, a global coalition of hospitals and healthcare systems (www.noharm.org), “by using excess energy, polluting theenvironment with phthalates, mercury and other toxic chemicals, and producing
waste which is burned rather than recycled, healthcare is ultimately compromisingpublic health and damaging the ability of future generations to meet their needs.”

Fortunately, many organizations like Healthcare Without Harm arecooperating with healthcare providers on improvements to hospital,
clinic, specialty care and long term care interior environments.
One bright spot is the elimination of PBT phthalates, a class ofchemicals used to make polyvinyl (PVC) plastics flexible. Phthalatespose two threats to occupants of healthcare environments:• Hospital patients, especially• Health care workers, often
newborn infants, can be harmed
experience heightened phthalateby phthalate exposure in the
exposure over many years,
hospital setting. Studies point toleading to the potential forthe possibility of retarded sexual
allergies, cancers (especiallydevelopment among babies with breast cancer) and endocrine
high blood phthalate levels.5
disruption, plus a host of otherrisks from obesity and diabetes
to liver disease and infertility.6

creating better environments

Rubber: compounding the problem
Many well-meaning design professionals consider
substituting rubber alternatives for PVC-based
products, believing rubber to be a more natural
product. In truth, the vast majority of rubber
products are synthetic products with little to nonatural rubber content. While they do not emit
phthalates, they contain other Chemicals ofConcern in significant amounts. For example,
studies done by the European Resilient Flooring
Manufacturer’s Institute (ERFMI) indicate theoverall environmental impact of rubber flooring issubstantially worse than that of PVC. If you wantto avoid toxic chemicals, combat global warming,ans save scarce resources, PVC is a poor choice.
Rubber can be an absolutely disastrous one.7

Chemicals of Concern: the EPA hit list
In 2009, the United States Environmental
Protection Agency identified four categoriesof chemicals that pose the greatest threat
to human health and environmental harm:• Phthalates found as plasticizers invinyl floor tile and other PVC plastic
products• Short-chain chlorinated paraffinspresent in paints, coatings, adhesives
and caulks• Polybrominated diphenyl ethers(PBDE) used as flame retardants inbuilding materials• Perfouorinated chemicals releasedby food packaging, pesticides, carpets
and personal care products
All four are routinely present in materials
common to healthcare interior environments.

The good news about phthalates is that they are no longer an
essential part of the health care environment. Some products,
including Marmoleum floor coverings, have never contained them.
The products to solve the problem are already in the marketplace.
All we need is the willingness of building designers, facility owners
and maintenance professionals to put them to use.

9

creating better environments

A Tsunami of Consequences300%

The hazardous fallout of our
Chemical Society
100%

Results

We are now
seeing theconsequences interms ofrapidly risingrates of chronic40%
BreastCancerdisease triggeredby our Chemical
Society.
20%
Leukemia

20%

Reproduction
Problems

20%

Childhood
Cancer40%
Brain
Cancer

The need is becoming
more profound as
we create indoor
environments that are
more airtight in thename of energy
efficiency.

• Childhood leukemia, brain cancer, and other childhood cancers
have increased by more than 20% since 1975.8• Breast cancer rates increased by 40% between 1973 and 1998.9,10• Asthma was twice as common in 1995 as it was in 1980.11,12• 40% more women had difficulty conceiving a child in 2002
than in 1982, with a particularly sharp increase in reproductive
difficulty among younger women ages 18–25.13,14,15• The birth of males with undescended testicles has increased
200% between 1970 and 1993.16• Autism spectrum disorders have become ten times more
frequent today than in the 1990s.17,18

200%
Birth Defects

Dangerous

Diseases Skyrocketing

AsthmaIn the last half of the twentieth century, according to the United
Nations’ Millennium Ecosystem Assessment, humans havechanged their ecosystem more rapidly and extensively than in
any comparable time in human history. We are now beginningto see the consequences in skyrocketing rates of chronic disease
triggered by this ecological change. The jump is particularly
pronounced in diseases that have suspected links to hazardous
chemicals present in vinyl flooring, wallpaper and other
PVC-based building materials:

Autism

A wave of chronic disease coming to inundate
tomorrow’s caregivers

The facts are becoming increasingly difficult to ignore. Levels of
bio-accumulative phthalates, dioxins, mercury, lead and cadmiumfrom our built environment must be addressed. The need is
becoming more profound as we create indoor environments thatare more airtight in the name of energy efficiency. This trend is
especially significant in healthcare environments, which are filledwith patients whose diseases could be aggravated byenvironmental toxins
Why wait for these problems to become overwhelming, when
today is the best possible day to search for workable and healthysolutions?

10

For further information and references on disease trends, see page 16 of this issue

11creating better environments

One big steps forward:
Marmoleum
While the larger problems of bacterial infestation and indoor
environmental health may not lend themselves to quick, easysolutions, some steps can create an immediate improvement.
A good first move is to replace products that add to the problem
with ones that reduce the risk naturally, without the need for
toxic chemical additives or expensive installation or
maintenance procedures.

Marmoleum has a significantly longer service life than vinyl or rubber alternatives.
The overall superior performance is good for the health of patients and workers,
and even better for the health of overburdened facility budgets.

Naturally

HealthyMarmoleum sheet and tile
floor coverings are naturally
antimicrobial, and contain no
pesticides whatsoever:• Fights SuperBugs. The
dreaded CRE bacterium
won’t spread effectively
on a Marmoleum surface.
Nor will MRSA, C. dif and theother new SuperBugs. The
garden variety bacteria thatcause stains and odors won’t
grow on Marmoleum either.
• Healthier for occupants.
Thanks to a formulation that is
free of the environmental
toxins emitted by vinyl andrubber flooring, Marmoleum
minimizes threats to current
human health and thegenetic wellbeing of future
generations.
• Biocide free. Marmoleum
is made of naturalingredients that resist
microbial growth by theirvery nature. There’s no needfor added biocides, so
Marmoleum doesn’t requirea BPR biocide label for use in
the European Union.
12• Seam welding not
required. By eliminating
the cracks between seams
that serve as bacterial
breeding grounds in vinyl
floors. Marmoleum fights
infections while saving timeand cost in installation.
Marmoleum also outperforms
vinyl and rubber indimensional stability, hygienic
protection (when properly
installed with net fit seams)
and resistance to topicalmoisture.
• 100% BioBased andbiodegradable.
Independent life-cycle
assessments (LCA) provethat Marmoleum is far lessharmful to the environment
than vinyl and rubber.
• Cost savings. Marmoleum
is occupancy-ready at
installation and half as
expensive to maintain,
freeing maintenance staff
to create a cleaner, more
hospitable hospital. The
30-year system service life of
Marmoleum far outperforms
the durability of vinyl or rubber.

Go beyond the floor.
Marmoleum can be used very
effectively beyond flooring
applications:• Furniture Surfaces.
Marmoleum is commonlyused as a furniture surface
material on nurse’s stations,desks, carts, and otherpermanent surfaces where
naturally anti-microbial,
anti-static, and easy to clean
properties are desired.
• Wall Protection.
Marmoleum can be used
as a cost-effective, highly
durable and repairable wallcovering or wainscoting for
corridors and other areas
needing protection.
• Bulletin Boards.
Forbo Bulletin Board
surfacing material has amultitude of applications.
Made from the same naturalingredients as Marmoleum,
it is ideally suited for use
as a notice board or as afunctional finish to walls,
furniture, door panels andcupboards.

A good firstmove is toreplace productsthat add to the
problem withones that
reduce the risk
naturally.

13

creating better environments

What to do: an industry perspective:
One manufacturer’s viewpoint on the health of future generations
As a company that has served healthcare customers for over a century, we at Forbo can understandand sympathize with the challenges that hospitals, clinics, specialty healthcare providers and longterm care facilities face. On one hand, it is perfectly natural to strive to create the healthiest possible
environment for both patients and caregivers. At the same time, creating a provision system withexcessive costs runs the risk of placing care beyond the reach of deserving people who need it.
There are no simple answers, but there are solutions that work. The challenge is finding them, thengathering the organizational, political and philosophical will power to put them into practice. As acompany with an extensive track record for working at the forefront of environmental sustainability
and human health, we’ve had the privilege of working with many organizations who have made it
happen. We’ve watched healthcare providers who have taken the risk and reaped the rewards.

We arecommitted tocreating
innovative new
products that
help insure
the well-beingof generations
to come.

Industry

Perspective
Where will the solutions come from? It’s difficult to tell the answer, but it’s relatively easy to determine the directions
that are most likely to be fruitful.
1. Examine the alternatives witha critical eye. Don’t be too quick
to embrace a new technology asa magic bullet until the long term
environmental effects are known.
The same caveat applies to somewell-established solutions like rubber
floor tile, that masquerade asenvironmentally sustainable when
they are actually synthetic productsthat release lead, mercury anda host of other carcinogens into
the environment.

2. Look for the natural payoff.
It is important to look at boththe short term cost of installationand the long term cost ofownership when considering anenvironmentally friendly solution.
The best option is a material like
Marmoleum, which provides boththe lowest occupancy-ready cost
today, while also delivering theadded benefit of low-toxicity,
bio-based and biodegradable
performance in the future.

3. Don’t miss the easy
opportunities. Some of the best
ideas for improving infection control
are also among the simplest. Wash
your hands. Make sure staff members
wear personal protective equipment
and are trained in infection control.
Eliminate areas where harmful
bacteria are likely to breed, like thecracks that develop between tiles ina vinyl floor.

The people of Forbo certainly have a professional interest in issues of indoor toxicity and infection control. More
importantly, our interest as parents, personal caregivers and concerned members of our community is also a deeply
personal one. This means we are doubly dedicated to using our industry expertise to keep healthcare decision makers
aware of the issues that affect their industry and our nation’s health. We are equally committed
to creating innovative new products that help insure the well-being of our children andgrandchildren for generations to come.

15

sustain
Health issue 2013 - Fall

Forbo Flooring Systems is the global market
leader in commercial floor covering solutions.
Marmoleum, our flagship brand is the global
leader in the linoleum market, while Flotex
is the industry leader in the rapidly growing
flocked textile market. In addition tolinoleum-based products, Forbo develops,
manufactures and markets a diversity of highquality vinyl and textile floor coverings, as well
as Coral & Nuway entrance system solutions.

healthcare;
Cure for a Crisis
The coming challenge to
our nation’s health,starting at the hospitaldoorstep

1. The Biocidal Products Regulation (EU 528/2012). For more information: http://echa.europa.eu/regulations/biocidal-products-regulation
2. “Chemicals and Our Health: Why Recent Science is a Call to Action”, a report published by the Safer Chemicals Healthy Families coalition,
		 for the full report go to www.SaferChemicals.org
3. “The Future of Fabric – Health Care”, published by the Healthy Building Network, October 2007 in conjunction with Health Care Without
		 Harm’s Research Collaborative.
4. http://www.chicagotribune.com/chi-infectiousdiseases-specialpackage,0,2681727.special		http://www.chicagotribune.com/news/chi-0207210272jul21,0,2177158.story.
5. Sathyanarayana, S. (2008) Phthalates and children’s health. Current Problems In Adolescent Health Care, 38, 34-39. doi:10.1016/j.cppeds.2007.11.001
6. “Toxic Chemicals in Building Materials; An Overview for Health Care Organizations” Kaiser Permanent and the Healthy Building Network /		 Healthcare Without Harm, May, 2008
7. Pharos Product Category Descriptions – Resilient Flooring http://www.pharosproject.net/product_category/show/id/3
8. America’s Children and the Environment, U.S. Environmental Protection Agency, 2008. http://www.saferchemicals.org/resources/health.html
9. Holly L. Howe, et al., “Annual Report to the Nation on the Status of Cancer (1973 through 1998), Featuring Cancers with Recent Increasing Trends,”
		 Journal of the National Cancer Institute, 93, no. 11 (June 2001): 824–42. http://www.saferchemicals.org/resources/health.html
10. Janet Gray, ed, State of the Evidence: The Connection Between Breast Cancer and the Environment, (San Francisco: Breast Cancer Fund, 2008).
11. Tracey J. Woodruff , et al., “Trends in Environmentally Related Childhood Illnesses,” Pediatrics, 113, no. 4 (April 2004): 1133-1140.
12. Jeanne E. Moorman, et al., “National Surveillance for Asthma, United States 1980–2004,”Centers for Disease Control and Prevention,
		 www.cdc.gov/mmwr/preview/mmwrhtml/ss5608a1.htm (November 1, 2009).
13. Anjani Chandra and Elizabeth Hervey Stephen, “Impaired Fecundity in the United States:1982-1995,” Family Planning Perspectives, 30, no 1,
		 (1998): 34-42.
14. Anjani Chandra, et al., “Fertility, Family Planning and Reproductive Health of US Women: Data from the 2002 National Survey of Family Growth,”		 Vital and Health Statistics, 23, no. 25 (2005).
15. Kate Brett, “Fecundity in 2002 National Survey of Family Growth Women 15–24 Years of Age” (personal communication), Hyattsville, MD,
		 National Center for Health Statistics (2008) http://www.womensvoices.org/issues/reports/the-health-case-executive-summary/.
16. Leonard J. Paulozzi, “International Trends in Rates of Hypospadias and Cryptorchidism,” Environmental Health Perspectives, 107, no. 4,		 (1999): 297-302.
17. National Institute of Mental Health, “NIMH’s Response to New Autism Prevalence Estimate,”
		http://www.nimh.nih.gov/about/updates/2009/nimhs-response-to-new-autism-prevalence-estimate.shtml
18. Scientific American “The Baffling Link Between Autism and Vinyl Flooring”, Marla Cone, Environmental Health News 2009

More Information on this subject?
If you would like to quickly access the sources cited in this issue of
SUSTAIN as well as nearly 50 other closely related resources, simply
go to www.forboflooringna.com/resources or scan the QR code.
You will find a complete library of studies and papers on the subject.

North American Headquarters
Forbo Flooring Systems
8 Maplewood Drive
Humboldt Industrial Park
Hazleton, PA 18202
T: 1-800-842-7839
570-459-0771
F: 570-450-0258
email: info.na@forbo.com
www.forboflooringNA.com
www.floorcostcomparison.com
CanadaForbo Flooring Systems
111 Westmore Drive
Toronto, ON M9V 3Y6
phone: 1-800-268-8108 (English)
1-800-567-9268 (Francais)
fax: 1-877-893-4680
email: info.na@forbo.com
www.forboflooringNA.com
www.floorcostcomparison.com

Dying for a cureThe Superbug’s
second sting
The Chemical Society
A Tsunami of Consequences
The Way Out: one industry
viewpoint

11/18/20K/MDW© 2013 Forbo Flooring Systems

creating better environments