NIOSH HEALTH HAZARD EVALUATION REPORT 

HETA #2004-0344-2954 

West Virginia University 

Robert C. Byrd Health Sciences Center 

Morgantown, West Virginia 

February 2005 

Jennifer Mosser, M.S. 

Terri A. Pearce, Ph.D. 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health

 

This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally

applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.

Additional HHE reports are available at http://www.cdc.gov/niosh/hhe/reports

This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally

applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.

Additional HHE reports are available at http://www.cdc.gov/niosh/hhe/reports

Additional HHE reports are available at http://www.cdc.gov/niosh/hhe/reports
ii 

PREFACE

The Respiratory Disease Hazard Evaluations and Technical Assistance Program (RDHETAP) of the 

National Institute for Occupational Safety and Health (NIOSH) conducts field investigations of possible 

health hazards in the workplace. These investigations are conducted under the authority of Section 

20(a)(6) of the Occupational Safety and Health (OSHA) Act of 1970, 29 U.S.C. 669(a)(6), or Section 

501(a)(11) of the Federal Mine Safety and Health Act of 1977, 30 U.S.C. 951(a)(11), which authorize the 

Secretary of Health and Human Services, following a written request from any employers or authorized 

representative of employees, to determine whether any substance normally found in the place of 

employment has potentially toxic effects in such concentrations as used or found. 

RDHETAP also provides, upon request, technical and consultative assistance to federal, state, and local 

agencies; labor; industry; and other groups or individuals to control occupational health hazards and to 

prevent related trauma and disease. Mention of company names or products does not constitute 

endorsement by NIOSH. 

ACKNOWLEDGMENTS AND AVAILABILITY OF REPORT

This report was prepared by Jennifer Mosser and Terri Pearce of RDHETAP, Division of Respiratory 

Disease Studies (DRDS). Field assistance was provided by Michael Beaty. Desktop publishing was 

performed by Terry Rooney. Review and preparation for printing were performed by Penny Arthur. 

Copies of this report have been sent to the requesters and the building management. This report is not 

copyrighted and may be freely reproduced. The report may be viewed and printed from the following 

internet address: http://www.cdc.gov/niosh/hhe. Single copies of this report will be available for a period 

of three years from the date of this report. To expedite your request, include a self-addressed mailing 

label along with your written request to: 

NIOSH Publications Office 

4676 Columbia Parkway 

Cincinnati, Ohio 45226 

800-356-4674 

After this time, copies may be purchased from the National Technical Information Service (NTIS) at 5825 

Port Royal Road, Springfield, Virginia 22161. Information regarding the NTIS stock number may be 

obtained from the NIOSH Publications Office at the Cincinnati address. 
iii 

Highlights of the NIOSH Health Hazard Evaluation

Evaluation of Indoor Air Quality

NIOSH received a health hazard evaluation request to conduct an indoor air quality evaluation at the West 

Virginia University, Robert C. Byrd Health Sciences Center, Student Health Services area in 

Morgantown, West Virginia. Employees reported asthma and respiratory symptoms. 

What NIOSH Did

• Conducted visual inspection of the facility 

on two separate occasions 

• Monitored the workplace for indoor air 

quality parameters (temperature, relative 

humidity, carbon dioxide, and carbon 

monoxide) 

• Provided feedback to management about 

conditions and activities within the space 

that could potentially have adverse impacts 

on indoor air quality 

What NIOSH Found

• Evidence of previous water incursion in 

several offices and one clinical exam room 

• Elevated carbon dioxide concentrations in 

the employee office area of Student Health 

Services 

• Photographic chemical leaks through the 

ceiling of one office from an x-ray 

developer located on the floor above Student 

Health Services 

• Unevenness of the floors in hallways and 

two occupied offices caused by water 

incursion beneath the building 

What WVU Health Sciences Center 

Managers Can Do

• Ensure that adequate fresh air is supplied to 

the occupied spaces and that the HVAC is 

operating according to the design 

specifications 

• Respond to water incursion events as they 

occur and provide for thorough methods of 

discovery for identifying and correcting 

water damage or mold 

• Relocate the x-ray developer to another area 

or re-plumb the drain to avoid future leaks 

• Re-purpose the offices that have 

experienced subsurface lifting of the floor 

What Workers Can Do 

• Report indoor air quality concerns and 

health symptoms to management 

• Promptly report leaks or other factors that 

might impact air quality 

• Comply with policies that are designed to 

protect air quality 

What To Do For More Information:

We encourage you to read the full report. If you 

would like a copy, either ask your health and 

safety representative to make you a copy or call 

1-513-841-4252 and ask for 

HETA Report #2004-0344-2954
iv 

Health Hazard Evaluation Report 2004-0344-2954 

West Virginia University 

Robert C. Byrd Health Sciences Center 

February 2005 

Jennifer Mosser, M.S. 

Terri A. Pearce, Ph.D.

SUMMARY

The National Institute for Occupational Safety and Health (NIOSH) received a request 

from the Health and Safety Manager at West Virginia University, Robert C. Byrd Health 

Sciences Center in Morgantown, West Virginia, to conduct an indoor air quality 

investigation in the Student Health Services employee office area. Employees had 

expressed concerns about the air quality including the possibility that exposure to 

photographic chemicals leaking into the office space from the area above might have 

caused health effects experienced by employees. Primary health concerns were asthma 

and other respiratory health problems. 

The NIOSH response consisted of numerous phone interviews with the requester to 

gather information, two site visits, and review of material safety data sheets and other 

information. During the first site visit on September 22, 2004, the industrial hygienist 

visually inspected the premises and interviewed the Health and Safety Manager. 

Evidence of previous water incursion in several offices and in one of the clinical exam 

rooms was observed. Prior to the NIOSH site visit the facilities management staff had 

investigated the drainage system and identified a downspout that directed storm water to 

the basement wall. The drainage was corrected and no further water incursion was 

reported. Other evidence of water incursion was subsurface lifting of the floors which 

had lead to substantial unevenness of the floors in the hallway and two offices. This was 

attributed to water incursion below the building that had caused swelling of the natural 

shale deposits. The second site visit was conducted on November 18, 2004, and included 

a similar visual inspection of the interior spaces along with the heating and ventilation 

(HVAC) systems. The second visit also included real-time monitoring of temperature, 

relative humidity, and concentrations of carbon monoxide and carbon dioxide in the 

Student Health Service employee office area where respiratory problems have been 

reported and in the clinic area where there have been no complaints. 

Investigation of the two HVAC systems that service the Student Health Service revealed 

that no outside air was being introduced into the ventilation system. There was indication 

of continued leaks from the mammography film developer located on the floor above one 

of the offices. Results of the real-time monitoring found that carbon dioxide 

concentrations exceeded recommended levels in the employee office area when the 

building was occupied. 
v 

NIOSH conducted two site visits to the West Virginia University, Robert C. Byrd Health 

Sciences Center, Student Health Services area in Morgantown, West Virginia, to address 

management concerns about the quality of the indoor air and health effects the employees 

were experiencing. Areas of previous or ongoing water incursion were found although 

no mold was observed. Measurements indicated that the office area had elevated levels 

of carbon dioxide and that changes to the ventilation system were necessary to ensure that 

adequate fresh air was provided to the occupants. 

Keywords: SIC: 8221 (College, Universities & Professional Schools) indoor air quality, IAQ, carbon 

dioxide, water incursion 
Table of Contents 

Preface..........................................................................................................................................................ii

Acknowledgments and Availability of Report..........................................................................................ii

Highlights of the NIOSH Health Hazard Evaluation .............................................................................iii

Summary.....................................................................................................................................................iv

Introduction.................................................................................................................................................1

Background .................................................................................................................................................1

Methods........................................................................................................................................................1

Results ..........................................................................................................................................................2

Discussion and Conclusions .......................................................................................................................3

Recommendations.......................................................................................................................................4

References....................................................................................................................................................4
Health Hazard Evaluation Report No. 2004-0344-2954 Page 1 

INTRODUCTION

The National Institute for Occupational Safety 

and Health (NIOSH) received a Health Hazard 

Evaluation (HHE) request from the Health and 

Safety Manager at West Virginia University, 

Robert C. Byrd Health Sciences Center 

(WVUHSC) in Morgantown, West Virginia. 

Management was concerned about the air 

quality in the Student Health Service employee 

office area and the possibility that exposure to 

photographic chemicals might have caused 

health effects experienced by some employees. 

BACKGROUND

Employees of WVU Student Health Services are 

housed in the basement of the Health Sciences 

building. The space is entirely below ground 

and has no windows. The area does not appear 

to have been originally designed for use as 

office or clinic space but has been modified for 

that use. The Health and Safety Manager of the 

WVUHSC, the requester of the HHE, listed the 

primary health concerns as respiratory problems 

and asthma-like reactions. Listed exposures 

included water infiltration during heavy rains, 

photographic chemicals leaking from the floor 

above, and poor indoor air quality. 

Several offices and one clinical exam room had 

a history of water incursion during heavy rains. 

The Health and Safety Manager described the 

history of water incursion in the clinical 

examination area. Maintenance personnel had 

discovered an improperly connected water 

downspout that had allowed water to be 

transmitted from the roof to the soil in that 

corner of the building. Corrective actions to 

reconnect the downspout to the storm water 

drain had been completed prior to the site visit. 

No further water incursion had been reported in 

that area since the repairs were made. An 

additional instance of water incursion had been 

reported in another area of the offices along the 

north exterior wall. The cause was under 

investigation. 

Another item of concern was a previously 

occupied office that had experienced leaks of 

photographic chemicals from the drain of a 

mammography x-ray developer located in the 

clinical area directly above that office. The 

occupant had developed asthma-like symptoms 

and was moved from the space. The leaks had 

been attributed to biomass accumulation 

plugging the drain and causing the waste 

chemicals to overflow. Prior to the first NIOSH 

site visit, WVUHSC maintenance began adding 

antimicrobials to the drainage system and 

physically cleaning the drain to remove 

microbial buildup. The office furnishings and 

carpeting had been cleaned and the damaged 

ceiling tiles and other materials had been 

replaced. 

METHODS

Walk-through Observations 

A site visit was conducted on September 22, 

2004, to observe the conditions in the Student 

Health Service area and to familiarize NIOSH 

personnel with the building layout. The 

WVUHSC Health and Safety Manager 

accompanied a NIOSH industrial hygienist on a 

walk-through during which the Student Health 

Services offices and clinical examination areas 

were inspected. During the walk-through, spotchecks were performed using a TSI Q-trak to 

conduct real-time measurements for indoor air 

quality parameters (temperature, relative 

humidity, carbon monoxide, and carbon 

dioxide). 

The office that had experienced leaks from the 

photographic developer was unoccupied during 

the site visit. Visual inspection found the office 

to be clean and to have no visible evidence of 

additional leaks such as stains on ceiling tiles, 

furnishings, or carpeting. 

Occupants were informally interviewed 

regarding their perceptions of the indoor air 

quality and their health symptoms. 

A walk-through was also conducted in the 

mammography center on the floor above Student 
Page 2 Health Hazard Evaluation Report No. 2004-0344-2954 

Health Services. The location of the 

mammography film developer was examined 

including the exhaust ventilation and waste 

chemical drain system. 

Indoor Air Quality Measurements 

A return visit was conducted on November 18, 

2004, to further investigate the conditions in 

Student Health Services. Visual inspection for 

signs of mold and moisture was conducted in the 

offices and clinical rooms, the heating and air 

conditioning (HVAC) units, and the area above 

the drop ceiling directly below the 

mammography film developer drain. 

Measurements of temperature, relative humidity, 

carbon dioxide, and carbon monoxide levels 

were made in several areas using a TSI Q-trakTM 

Plus Indoor Air Quality Monitor. Two QtraksTM were left in the Student Health Service 

area for a five-day period to monitor these 

parameters with changes in occupancy. One 

instrument was placed in the employee 

conference room in the area where employees 

have reported respiratory problems, and the 

other was placed in the hallway on the clinical 

side. 

RESULTS

Air quality measurement results collected in the 

conference room and the clinic hallway are 

provided in Figures 1 and 2, respectively. 

Temperature at both monitoring locations was in 

the range of 70 to 75 degrees Fahrenheit over the 

five day sampling period and relative humidity 

ranged from 30 to 60 percent. Carbon 

monoxide concentrations were very low to nondetectable, i.e., 0-1 parts per million (ppm). 

Carbon dioxide concentrations ranged from 300 

to 1800 ppm in the employee conference room 

and from 400 to 1000 ppm in the hallway on the 

clinic side. Neither of the HVAC units that 

service the Student Health Service draws air 

from the outdoors. The HVAC unit that services 

the employee office area appeared to be 

approximately 10 years older than the unit that 

services the clinic side. 

The offices and exam room that experienced 

water infiltration during heavy rains showed no 

signs of recent incursions. Floor surfaces 

affected by swelling of the subsurface continued 

to be uneven although no additional lifting of the 

floors was observed. 

Visual inspection of the office that had 

previously experienced leaks from the x-ray 

developer showed a new stain on the recentlyreplaced ceiling tiles indicating that new leaks 

had occurred. Piping above the ceiling was 

found to show signs of rust and was encrusted 

with dried material. A chemical odor was 

noticeable in the area above the drop ceiling. 

The Health and Safety Manager provided copies 

of material safety data sheets (MSDSs) for the 

mammography film development chemicals for 

NIOSH review. A number of employees 

reported respiratory symptoms that they 

attributed to being in the offices. Several noted 

that air quality was worse on the office side of 

the Student Health Services area than on the 

clinic side. Copy machine odors were reported 

by the occupant of an office down the hall from 

the copier room. Two employees reported that 

their symptoms began after being exposed to the 

photographic chemicals leaking from the floor 

above. The previous occupant of the office that 

had experienced the leaks reported a physician 

diagnosis of asthma that the employee attributed 

to exposure to the glutaraldehyde component of 

the photographic chemicals. 

Some floor surfaces in Student Health Services 

are uneven and two offices in particular have 

floors that have noticeable slope. In one office 

the floor had lifted an interior wall to the point 

that it caused the ceiling to buckle in one corner. 

The Health and Safety Manager stated that the 

floor lifting was an ongoing phenomenon caused 

by water-induced swelling of the subsurface 

shale deposits underlying the building. At the 

time of the visit, the two offices with the most 

pronounced unevenness of the floors were 

occupied. In one office, the workstation and 

chair location was noticeably higher on one side 

than the other and did not allow proper 

ergonomic alignment of the worker with the 

work surface. In the other office, the work 
Health Hazard Evaluation Report No. 2004-0344-2954 Page 3 

surface was not as noticeably unlevel but the 

floor in the center of the room was lower than 

around the walls. The unevenness of the floor in 

the hallways could provide a trip and fall hazard 

for persons unfamiliar with the space. 

DISCUSSION AND 

CONCLUSIONS

Measurement values for indoor air quality 

parameters that were spot-checked during the 

first site visit and monitored over time during 

the second site visit were within the 

recommended ranges except carbon dioxide 

concentrations in the area where employees have 

reported respiratory health complaints. 

Measured values for temperature and relative 

humidity at both sampling locations were within 

the acceptable range specified in the American 

National Standards Institute/American Society 

for Heating, Refrigeration, and Air-Conditioning 

Engineers (ANSI/ASHRAE) Standard 55-1992.1

 

No regulatory limit has been set for carbon 

monoxide concentrations in indoor 

environments however, the levels measured in 

Student Health Services were well below the 

Occupational Safety and Health Administration 

permissible exposure limit of 50 ppm for 1 

hour.2

 This value is also lower than the 

Environmental Protection Agency National 

Ambient Air Quality Standard of 9 ppm for 8 

hours.3

The elevated levels of carbon dioxide on the 

office side of Student Health Services exceeded 

the ANSI/ASHRAE recommendation that 

indoor carbon dioxide levels be no more than 

700 ppm greater than the outdoor concentration.4

 

In most areas of the country, outdoor 

concentrations are generally in the range of 300 

to 350 ppm. Therefore, the usual interpretation 

of the ANSI/ASHRAE recommendation is a 

concentration no greater than 1000 to 1050 ppm. 

The elevated carbon dioxide levels can be 

attributed to a lack of adequate fresh air in 

relation to the number of occupants in the space. 

The QtrakTM was placed in the conference room 

as it was a central location on the office side of 

Student Health Services. Occupants were 

interviewed regarding the use of the conference 

room for meetings. No meetings were reported 

during the sampling period so increases in 

carbon dioxide over the course of the workday 

were interpreted as being representative of the 

total space. The higher levels on November 18, 

2004 were attributed to larger numbers of 

patients on that day as that was the week before 

the Thanksgiving Holiday and fewer students 

were reported to use the clinic after that day. 

The QtrakTM data (Figures 1 and 2) 

demonstrates the increases in carbon dioxide 

concentration over the course of the workday 

and during times of greater occupancy. Levels 

were lower on the Friday and Monday workdays 

when fewer patients were in the space as well as 

on the weekend when the space was unoccupied. 

These findings point to the need for increased 

fresh air in relation to the number of occupants, 

both employees and patients. 

The finding that carbon dioxide levels exceeded 

the ANSI/ASHRAE recommendations 

documents the inadequacy of the ventilation 

system. The current ventilation system does not 

provide for any outdoor dilution or make-up air 

to be delivered to the space. The inadequate 

amount of fresh air supplied to the employee 

offices appears to be a factor in the employee 

health symptoms and complaints. The area has 

no windows so all dilution air must come 

through the doorways. During business hours, 

the main door to the office area is kept closed 

and the main door to the clinic area is open. The 

open door on the clinic side appears to allow for 

increased air exchange and consequently helps 

to maintain lower carbon dioxide levels in that 

area. While keeping doors open does allow for 

some air exchange, it is not sufficient as a long 

term solution and is especially problematic as 

the use of the space for clinical services means 

that occupancy fluctuates based upon the 

number of patients receiving care. If the space 

continues to be used for these purposes, the 

ventilation system should be redesigned to 

provide sufficient amounts of fresh air based 

upon occupant density. 

The history of water incursion into the space and 

the subsurface lifting of the floors are evidence 

that this area of the building may be more prone 
Page 4 Health Hazard Evaluation Report No. 2004-0344-2954 

to dampness and further water incursion. While 

no visible mold was observed during either site 

visit, a recent Institute of Medicine report states 

that the scientific evidence suggests that persons 

who live or work in damp buildings have more 

respiratory health symptoms than persons in 

non-damp buildings.5

 Therefore, it is important 

to ensure that the Student Health Services area is 

repaired and maintained in way that prevents 

water incursion. The offices that have 

experienced lifting of the floors to the extent that 

desk areas are not level should be re-purposed 

for use other than as occupied offices to prevent 

discomfort for the person using that work space. 

Review of the MSDSs for the chemicals used in 

the mammography film developer (Kodak 

MiniloaderTM 2000P) found that Part B of the 

developer solution contained glutaraldehyde 

bis(sodium bisulphite) at a weight concentration 

of 20-25 percent and glutaraldehyde 

bis(potassium bisulfite) by weight concentration 

of 1-5 percent. The MSDS for the combined 

components (working solution) obtained from 

the manufacturer’s website lists the components 

of the working solution and their percentages by 

weight as: water (85-90), potassium sulphite (5-

10), hydroquinone (1-5), diethylene glycol (1-5), 

glutaraldehyde bis(sodium bisulphite) (1-5), and 

4-hydroxymethyl-4-methyl-1-phenyl-3-

pyrazoloidinone (<1).6

 The leak of the 

mammography developer that lead to exposure 

for the office occupant pre-dated the NIOSH site 

visit so it was not possible to sample the liquids 

to which the occupant was exposed. However, 

the MSDS obtained from the manufacturer states 

that the mixture may liberate sulfur dioxide 

which can act as a respiratory tract irritant. The 

glutaraldehyde component of the working 

solution is also a consideration as glutaraldehyde 

has been implicated in both acute and chronic 

effects in health care workers exposed during 

equipment sterilization or x-ray development.7

 

The manufacturer does not specify respiratory 

protection for employees using the working 

solution although the stipulation is made that 

adequate ventilation be provided. The specific 

chemicals and concentrations that leaked from 

the mammography developer drain at the time of 

the occupant’s exposure are unknown. 

However, the types of chemicals found in the 

working solution are known to be irritating to 

the respiratory tract even at low concentrations. 

Knowing that the ventilation system is 

inadequate in providing dilution ventilation to 

the office space increases the likelihood that any 

irritant effects may have been exacerbated. 

RECOMMENDATIONS

• If the current HVAC units can be retrofitted 

to allow for adequate amounts of outside air 

to be provided to the Student Health 

Services area, those changes should be made 

to the system. If the current units are not 

capable of allowing for outdoor air supply, 

they should be replaced with units having 

that capability. 

• Relocate the x-ray developer located on the 

floor above the employee offices or 

reconfigure the mammography film 

developer drain system to ensure that 

additional leakage does not occur. 

• Respond to water leaks immediately and 

provide for thorough methods of discovery 

for identifying and correcting water damage 

or mold. 

• Re-purpose the two office areas that have 

experienced substantial lifting of the floor 

due to subsurface water incursion. 

REFERENCES

1. ASHRAE [1992]. Thermal Environmental 

Conditions for Human Occupancy 55-1992 

(ANSI-Approved). Atlanta, GA: American 

Society of Heating, Refrigerating, and Airconditioning Engineers, Inc. 

2. Code of Federal Regulations [1997]. 29 

CFR 1910.1000 Table Z-1. Washington, 

DC. U.S. Government Printing Office, 

3. Code of Federal Regulations [1985]. 40 

CFR 50.8. Washington DC. U.S. 

Government Printing Office. 
Health Hazard Evaluation Report No. 2004-0344-2954 Page 5 

4. ANSI/ASHRAE [2001]. Ventilation for 

acceptable indoor air quality, standard 62-

2001. Atlanta, GA: American Society of 

Heating, Refrigerating, and Air-conditioning 

Engineers, Inc. 

5. Damp Indoor Spaces and Health [2004]. 

Committee on Damp Indoor Spaces and 

Health. Institute of Medicine of the National 

Academies. Washington, DC. The National 

Academies Press. 

6. Material Safety Data Sheet; KODAK XOMAT EXII Developer, Working Solution; 

Product code: 1135433 - Working Solution. 

Revision Date: 10/14/2004 

http://msds.kodak.com/ehswww/external/ind

ex.jsp

7. Glutaraldehyde Occupational Hazards in 

Hospitals. DHHS (NIOSH) Publication 

No. 2001-115, May 2001. 
FIGURES 

Figure 1. Indoor Air Quality Values in the Student Health Service employee conference room. 
Figure 2. Indoor Air Quality Values in the Student Health Service clinic hallway. 
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