Easley et al.
[1982b}

Pesticide
(water solubility)

Methyl parathion

‘Table 16. (Continued) Studies on Laundering Pesticides from Contaminated Clothing

Emulsifiable
concentrate
1.25% solution

100% Cotton and 50/50 cotton-
polyester

Laundry or Decontamination Variables

30°C, 49°C, and 60°C washes
detergents: 8.7% phosphate; carbonate;
non-phosphate heavy duty liquid; 12%
phosphate.

50% removal at 30°C; 70% or
greater removal at 49°C and 60°C.

Heavy duty liquid detergent slightly
better than others at 49°C and 60°C.

Easley et al. [1983] | 2,4 Denim, 80/20 cotton-polyester 60°C wash/49°C rinse; 30°C wash/30°C 24D ester, 26-45% removed, 1-2%
dichiorophenoxyacetic contaminated; 50/50 cotton- rinse; pre-rinse/no pre-rinse; heavy duty transferred; pre-rinse had no effect;
acid (2,4-D) ester and polyester transfer fabric liquid non-phosphate detergent; 12% ammonia had no effect; 30°C wash,
2,4-D amine phosphate detergent; ammonia/no 26% removed; 60°C wash 48%
(ester, insoluble) ; Tepeated washing. removed; non-phosphate detergent
(amine 4-18 g/L at removed 31%; one wash removed
wc) about 30%; two washes removed

about 41%. 2,4-D amine, more
than 99% removed by all
treatments; transfer 0.02-0.26%.

Baster [1983] Captan (3 mg/L at ‘Aqueous suspension Denim 38°C, 49°C, 60°C washes, 2 rinses. Capten-cotton, 73%, 98%, and 99%

Bester and mm Emulsifiable 100% Cotton twill Heavy duty liquid detergent with both removal at 38°C, 49°C, and 60°C;

DeJonge {1985} Guthion® (29 mg/L at | concentrate Nylon anionic and non-ionic surfactants. nylon, 98% removal at 38°C, greater
25°C) Microporous film fabric, 3 layers than 99% removal at 49°C and

orc.

Guthion®-cotton, 94%, 96%, and
98% removal at 38°C, 49°C, and
60°C; nylon 86%, 91%, and 92%
removal at 38°C, 49°C, and 60°C,

Fintey and DDT (insoluble) Fabrics wom in cotton | 100/0, 35/65, $0/50, 65/35 Laundered in automatic washer and DDT averaged 81.8 ppm in clothing

Rogillio {1969} methyl parathion fields for 8 hours on cotton-polyester shirting type electric dryer. before laundering, 24.9 ppm after,

the day after spraying fabric with durable press h 100/0 and 65/35 cotton-polyester

or soil release or soil release
finish (65/35 only)

collected and retained more DDT
than other fabrics. Methy!
parathion averaged 7.7 ppm in
clothing before laundering and 0.2
ppm after laundering. 100/0 and
65/35 cotton-potyester collected
more parathion than other fabrics
and also retained more, but not as
much as with DDT.

207



Lead

Overview. The 18 studies reviewed in this section provide both direct and
indirect evidence that lead-contaminated clothing is a source of home
contamination.

Lead contamination for both clothing and homes was included in three
Teports reviewed in this section: one on ore smelter workers; one on a lead
products trucker; and one on a radiator repairman. In addition there are two
Teports on electric cable splicers, one of which reported on clothing
contamination and the other of which reported on home contamination. The
studies on smelter workers and electric cable splicers, which are the only ones
that had comparable data, indicate that contamination of both the smelter
workers’ homes and clothing was much greater than that of the cable splicers.
However the studies are inadequate for establishing a quantitative relationship
between levels of contamination in clothes and in homes.

Other evidence presented in this section that clothing is a source of lead
contamination in homes includes: (1) additional measurements of clothing
contamination; (2) the findings of the highest lead loadings in areas of homes
where contaminated clothing was stored and laundered; (3) elevated BLLs in
children of parents who wore their contaminated clothing home; and (4)
elevated BLLs in home launderers.

Reports of clothing and home contamination. Measurements of lead
contamination include: concentrations in collected dust, expressed as weight of
lead/weight of total dust (e.g., ug/g or ppm); or lead loading which is the
weight of lead within a square area of surface (e.g., ug/cm’).

Homes of secondary lead smelter workers were found by Winegar et al.
[1977] to contain lead in house dust at 120-26,000 ppm. In this study, lead
concentration in dust of pants cuffs worn under coveralls of two workers were
60,000 and 600,000 ppm and the lead loading of the trouser bottoms of six
workers was 280-7,600 xg/cm’. There was no correlation between
measurements of lead in housedust and the lead loading of trouser bottoms of
the six workers. Only 1 of 33 workers showered at work, 8 took work clothes
home for cleaning and 21 took home street clothes that were worn under
coveralls. There was also no correlation between house dust levels and the type
of clothing brought home.

Pollock [1994] found lead at 240 yg/ft? (2.2 ug/cm’) on the shoes of a worker

who was engaged in trucking lead and lead products; lead up to 0.2 zg/cm* was
found on surfaces of the worker’s home.

Lead carried home from a radiator repair shop was reported by Pitts [1986]
and Garrettson [1988]. Wipe samples were collected at various locations in the

37


CERCLA & SARA

Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

Ln Pemar Nemo | rite Law |S. code | Sens Reet Worn Faniy Proton |

[42 U.S.C. § 9601 et
eq)

priority of such release or threatened release.

$9611 Use of Fund

(3) Subject to such amounts as are provided in appropriate Acte, the costs of a program.
to identify, investigate, and take enforcement and abatement action against releases of
hazardous substances.

(4) Any costs incurred in accordance with subsection (m) of this section (relating to
ATSDR) and section 9604(|) of this title including the costs of epidemiologic and
laboratory studies, health assessments, preparation of toxicologic profiles, development
and maintenance of a registry of persons exposed to hazardous substances to allow long-
term health effect studies, and diagnostic services not otherwise avallable to determine
whether persons in populations exposed to hazardous substances in connection with a
releate or a suspected release are suffering from long-latency diseases,

(6) Subject to such amounts as are provided in appropriation Acta, the costs of a
program to protect the health and safety of employees involved in response to hazardous
substance releases, Such program shall be developed jointly by the Environmental
Protection Agency, the Occupational Safety and Health Administration, and the National
Inatitute for Occupational Safety and Health and shalt include, but not be limited to,
measures for identifying and assessing hazards to which persons engaged in removal,
remedy, or other response to hazardous substances may be exposed, methods to protect
workers from such hazards, and neccesary regulatory and enforcement measures to assure.
adequate protection of such employee.

236


Services, Public Health Service, Centers for Disease Control and Prevention, Agency for
Toxic Substances and Disease Registry, CERCLIS No. MID002931228. 7 pages.

ATSDR [1991a]. Final Report. Philadelphia neighborhood lead study. Atlanta, GA:
US. Department of Health and Human Services, Public Health Service, Centers for
Disease Control, Agency for Toxic Substances and Disease Registry, Report No.
ATSDR/HS-92/14, NTIS No. PB92-123777. 276 pages.

ATSDR [1991b]. Health assessment. Bofors-Nobel, Inc., Muskegon County, Michigan.
Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service,
Centers for Disease Control, Agency for Toxic Substances and Disease Registry,
CERCLIS No. MID006030373. 33 pages.

ATSDR [1990a]. Final report. Technical assistance to the Tennessee Department of
Health and Environment. Mercury exposure study Charleston, Tennessee. Atlanta, GA:
U.S. Department of Health and Human Services, Public Health Service, Centers for
Disease Control, Agency for Toxic Substances and Disease Registry.

ATSDR [1990b]. Health assessment addendum. Anderson Development Company,
Adrian, Michigan. Atlanta, GA: U.S. Department of Health and Human Services, Public
Health Service, Centers for Disease Control, Agency for Toxic Substances and Disease
Registry, CERCLIS No. MID002931228. 10 pages.

ATSDR [1989a]. Health assessment. Anderson Development Company, Adrian,
Michigan. Atlanta, GA: U.S. Department of Health and Human Services, Public Health
Service, Centers for Disease Control, Agency for Toxic Substances and Disease Registry,
CERCLIS No. MID002931228. 12 pages.

ATSDR [1989b]. Preliminary Health Assessment. Roto-Finish Company, Kalamazoo,
Michigan. Atlanta, GA: U.S. Department of Health and Human Services, Public Health
Service, Centers for Disease Control, Agency for Toxic Substances and Disease Registry,
CERCLIS No. MID005340088. 5 pages.

ATSDR [1988]. The nature and extent of lead poisoning in children in the United
States: A report to Congress. Atlanta, GA: U.S. Department of Health and Human
Services, Public Health Service, Centers for Disease Control, Agency for Toxic
Substances and Disease Registry. pages IV-1 to IV-5.

Auslander M [1994]. Letter of January 25, 1994 re: workers’ home contamination in
Kentucky to Mr. Bob Mason, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 1 page.

Aw T-C, Stephenson RL, Smith AB, Glueck CJ [1985]. Health Hazard Evaluation
Report: Manufacturing Chemists, Inc., Indianapolis, Indiana. Cincinnati, OH: U.S.

101


BERYLLIUM
Overview
The reports discussed in this section and summarized in Table 1 document
approximately 40 cases (sometimes called household or contact cases) of chronic
beryllium disease which occurred among family members of beryllium workers
prior to 1967. The report of another case of chronic beryllium disease in 1992
[Newman and Kreiss 1992] indicates that cases may still be occurring among
workers’ family members but are not being diagnosed accurately.

Background

Beryllium, the second lightest metal, was discovered in 1798. Currently it has
many uses. It is added to copper, glass, plastics, and ceramics to be used in
connectors in electronic equipment, semiconductor packages, satellites, rockets,
springs, gyroscopes, aircraft brakes and engines, submarine cable housings, dental
prostheses, nuclear reactors, missile guidance systems, and military vehicle armor
[Lang 1994]. It has also been used in rocket fuels, fluorescent lamps and neon
signs, radio tubes, incandescent lamps and fluorescent powders, and cathode ray
tubes.

Chronic beryllium disease is a potentially fatal granulomatous lung disorder
characterized by a beryllium-specific cell-mediated immunity [Kreiss et al. 1989;
Newman et al. 1989; Kreibel et al. 1988].

Only one-third of those dying from chronic beryllium disease were found to have
mention of berylliosis on the death certificate [Lieben and Williams 1969].
Therefore complete case ascertainment for beryllium disease cannot be assured.
Chest X-rays do not make the distinction between sarcoidosis and beryllium
disease. This is of special concern for non-occupational cases, where a history of
beryllium exposure may be difficult to obtain. In addition, chronic beryllium
disease can be confused with sarcoidosis [Sprince et al. 1976]; therefore a
misdiagnosis of sarcoidosis in a person with chronic beryllium disease is possible,
as happened at first with the patient reported on by Newman and Kreiss [1992].

Several diagnostic testing methods are available. Lung biopsy specimens can be
tested for beryllium. Bronchoalveolar lavage fluid can be tested for specific
lymphoblastic response to beryllium salts. Kreiss et al. [1989] reported the use of
a peripheral blood beryllium-reactive lymphocyte transformation test along with
confirmation methods (more sensitive than those used in the past) such as
bronchoalveolar lavage and transbronchial biopsy. Blood tests for beryllium
sensitization may be positive when chest radiographs and pulmonary function tests
are normal, thus presenting the possibility of an early clinical or subclinical case.
The authors cautioned that issues relating to the use of the peripheral blood
beryllium-reactive lymphocyte transformation test as a screening test still need to
be worked out.


Prevention, Public Health Service, U.S. Department of Health and Human Services. 1
page.

Pasanen AL, Kalliokoski P, Pasanen P, Salmi T, Tossavainen A [1989]. Fungi carried
from farmers’ work into farm houses. Am Ind Hyg Assoc J 50(12):631-633.

Peachey RDG [1967]. Glass-fibre itch: A modern washday hazard. Br Med J 2:221-222.

Pedersen DH, Sieber WK [1988]. National occupational exposure survey (1981-1983):
Analysis of management interview responses. In: National Occupational Exposure
Survey: Analysis of Management Interview Response eds. Cincinnati, OH: U.S.
Department of Health and Human Services, Public Health Service, Centers for Disease
Control, National Institute for Occupational Safety and Health, Division of Surveillance
and Hazard Evaluations and Field Studies, DHHS (NIOSH) Publication No. 89-103
T1I:317-367.

Pelegrin K [1995]. Personal telephone communication of January 24, 1995 re: cases of
childhood poisoning to David Hard. Available in Cincinnati, OH: Docket Office,
Education and Information Division, National Institute for Occupational Safety and
Health, Centers for Disease Control and Prevention, Public Health Service, U.S.
Department of Health and Human Services.

Perkins JL, Johnson JS, Swearengen PM, Sackett CP, Weaver SC [1987]. Residual
spilled solvents in butyl protective clothing and usefulness of decontamination
procedures. Appl Ind Hyg 2(5):179-182.

Piacitelli GM, Whelan EA [1995]. Lead contamination in homes of lead-exposed
construction workers. In: American Industrial Hygiene Conference and Exposition
Abstracts. Fairfax, VA, AIHCE. Page 63

Piacitelli GM, Whelan EA, Ewers LM, Sieber WK [in press]. Lead contamination in
automobiles of lead-exposed bridgeworkers. Appl Occup Environ Hyg.

Piacitelli GM, Rice CH [1993]. Lead contamination in radiator repair shops. Appl
Occup Environ Hyg 8(5):434-438.

Piccinini R, Candela S, Messori M, Viappiani F [1986]. Blood and hair levels in 6-year
old children according to their parents’ occupation. G. Ital Med Lav 8(2):65-68.

Pichette J, Schulz LC, Brender JD [1989]. Parental occupational exposure and childhood
blood lead levels: Texas. Texas Department of Health, Environmental Epidemiology

Program. 26 pages.

Pinnell WP [1994]. Letter of January 27, 1994 re: Code of West Virginia 16 - 32
Asbestos Licensure Law to Ms. Diane Manning, Education and Information Division,

132


Centers for Disease Control, National Institute for Occupational Safety and Health,
NIOSH Report No. HETA 91-290-2131. 32 pages.

McConnell R [1994]. Pesticides and related compounds. In: Rosenstock L, Cullen MR,
eds. Textbook of Clinical Occupational and Environmental Medicine. Philadelphia, PA:
W.B. Saunders Company. pages 847-865.

McDiarmid MA, Weaver V [1993]. Fouling one’s own nest revisited. Am J Indust Med
24:1-9.

McDonald AD, Harper A, El Attar OA, McDonald JC [1970]. Epidemiology of primary
malignant mesothelial tumors in Canada. Cancer 26(4):914-919.

McDonald AD, McDonald JC [1973]. Epidemiologic surveillance of mesothelioma in
Canada. Can Med Assoc J 109:359-362.

McDonald AD, McDonald JC [1980]. Malignant mesothelioma in North America.
Cancer 46(7):1650-1656.

McEwen J, Finlayson A, Mair A, Gibson AAM [1971]. Asbestos and mesothelioma in
Scotland. An epidemiological study. Int Arch Arbeitsmed 28:301-311.

McGee LC, Reed HL, Fleming JP [1952]. Accidental poisoning by toxaphene—Review of
toxicology and case reports. JAMA 149(12):1124-1126.

McKay-Ferguson E, Mortimer PP [1977]. The permeability of soluble laundry-bag
material to bacteria and viruses. J Appl Bacteriol 42:151-155.

Menrath WG, Bornschein RL, Clark CS [1993]. An investigation of the potential for
workers at a lead mine to carry home lead dust. In: American Industrial Hygiene
Conference and Exposition ’93, Abstracts. Fairfax, VA, ATHCE. Page 10.

Metzner EN, Lieben J [1961]. Respiratory disease associated with beryllium refining and
alloy fabrication. J Occup Med 3:341-345.

Miesen A [1991]. [Results of blood examinations in Braubach 1990] (in German). Off
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Milar CR, Mushak P [1982]. Lead contaminated housedust: hazard, measurement and
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32:111-116.


DISCLAIMER

Mention of any company or product does not constitute endorsement by the National
Institute for Occupational Safety and Health.


A study published in 1978 by researchers with the New York Department of Health
showed a correlation between mesothelioma in women and asbestos related
employment of husbands and fathers [Vianna and Polan 1978].

Investigators from the Vermont State Department of Health studied home
contamination and health effects in children of thermometer plant workers exposed
to mercury [Hudson et al. 1985].

In California, the State Department of Public Health investigated mercury exposure
and poisoning of cinnabar miners and mill workers [West and Lim 1968] and
developed a document on how to prevent mercury poisoning [Anonymous 1968].
Although the investigators [West and Lim 1968] noted that home contamination with
mercury brought home on workers’ boots and clothes could increase workers’
exposure to mercury, no mention was made of potential exposure of family members.

RESPONSES OF INDUSTRY

NIOSH has attained little information on how industry has responded to incidents of
workers’ home contamination. This section describes information from NIOSH studies
(primarily those that were requested by employers) and from other reports, articles,
and submissions by industry in response to the Federal Register Announcement
requesting information (Appendix 2). They are tabulated in Table 23.

In a study requested by the owner of a stained glass studio attached to her home,
NIOSH investigators determined that the exemplary industrial hygiene and
housekeeping practices in use were adequate, since no lead was detected in the home
[Donovan 1994a,b]. The owner requested the study because of concerns about
exposures both in the home and the workplace.

In the case of a mercury thermometer plant where children of the workers were found
to have been exposed to mercury, the plant voluntarily closed [Hudson et al. 1987].
Part of the plant re-opened when appropriate controls had been implemented.
Another example of industry response occurred when an employee of a wood treating
company brought home and spilled chloropicrin from a company truck, which made
neighbors ill, and the company instituted a policy forbidding bringing company vehicles
home [Barnett 1994].

Examples of educational material produced by industry (or their associations or trade
magazines) involve lead. The Lead Industries Association, Inc. has produced
brochures, flyers, and videotapes that warn of the dangers of lead exposure and
provide advice on how to reduce these exposures and prevent workers’ home
contamination [LIA 1989; 1991; 1993a,b; 1994a,b]. Several of the videotapes are
specific to particular hobbies or industries that involve the use of lead containing
material. Battery Man, a trade magazine, published an article on protecting the
families of workers involved in battery production [Lundquist 1980].

97


Asbestos

Asbestos sheets brought home from work were used in a cottage industry to repair
burned out mufflers [Epler et al. 1980]. The asbestos sheets were stored in the
basement where the children played and were also used to construct a tree house
in which the children played. Both children developed asbestos related lung
disease at about age 30. Asbestos cement was produced in the basement of
another home for about 20 years {Otte et al. 1990]. The mother, father and one
son died of mesothelioma some 40 years after the beginning of the exposures to
asbestos.

Lead

In addition to the early report by Oliver [1914] of lead poisoning in family
members of home pottery manufacture, 14 recent reports on cottage-industry
home contamination and poisoning of family members by lead were found, 6 of
them involved pottery.

In the report by Oliver [1914], lead at up to 10,000 ppm was found in dust of
potters’ homes where the pottery was dipped in lead glaze in the same room in
which the family lived and slept; lead was also found in the clothes of a young boy
and a baby. Koplan et al. [1977] reported on six home potters and their families
in Barbados and found BLLs up to 71 zg/mL, and average concentrations of lead
in dust for the six households of 2,333-88,159 ppm with a maximum value of
325,892 ppm. The State of Alabama [1992] reported finding lead at up to 177,000
»g/ft in a home pottery workshop where children with elevated BLLs spent some
time; elevated lead levels were also found on the kitchen floor of the family’s
dwelling.

Other studies of home pottery manufacture did not report levels of contamination,
but did report elevated BLLs. BLLs up to 74 4g/100 mL were found for children
of workers engaged in ceramics (plates, cups, vases, etc.) production at home in
Italy [Abbritti et al. 1979]. Molina-Ballesteros et al. [1983] found BLLs up to 98
ug/dL. in children of potters working in their homes in Mexico; and in Japan,
Katagiri et al. [1983] reported lead in urine of children of home pottery workers
up to 79.3 ug/L compared to 59.9 ug/L in control children; 11.2% of children of
home potters had lead in urine greater than 30 ug/L vs. 2.7% of control children.
More recently in the United States, Fischbein et al. [1992] reported finding a BLL
of 48 g/dL in a child of a home potter in New York.

Manufacture, repair and recycling of lead batteries by cottage industries have also
resulted in contamination of living areas and exposure of family members. Lead
loadings up to 53,140 »g/m* were found in households of cottage industry battery
repair shops in Jamaica [Matte and Burr 1989; Matte et al 1989]. Matte and Burr
[1989] also found that playing in the area of the battery repair shops was an
independent predictor of elevated BLLs in children. Other reports did not
measure home contamination but reported lead poisoning or elevated BLLs.

46


Pesticide

(water solubility)

Table 16. (Continued) Studies on Laundering Pesticides from Contaminated Clothing

Laughlin et al.
{1985}

Methyl parathion

Emulsifiable
concentrate 0,25- 54%
Wettable powder

100% cotton and 50/50 cotton:
polyester denim fabrics, All
cotton batiste was used for
transfer studies,

60°C wash, 49°C pre-rinse/no pre-rinse,
phosphate detergent, two rinses at 49°C,
ammonia/no ammonia, bleach/no bleach.
Clean fabric laundered immediately after
contaminated fabric. Four detergents
each at 30°C, 49°C, and 60°C, Multiple
launderings (up to 10),

80-99% of parathion removed, no
differences between fabrics.
Emulsifiable concentrate, 80-89%
removal, other forms more than
90%. Pre-rinse resulted in greater
removal. Laundry equipment was
sufficiently contaminated that the
transfer fabrics (laundered
immediately after contaminated
fabrics) contained 0.0061-0,00181%
of the original contamination. The
four detergents tested gave elmilar
results, Hot water (49°C and 60°C)
was better than cold. With 1.25%
methyl parathion, 18% remained
after first wash and 4% after second
wash and 0.37% after the tenth
wath. With 54% methyl parathion,
84% remained after the first wash
and 33% remained after the tenth
wash. Ammonia and bleach had no
effect.

‘Lillie et al, [1982]

Diazinon
Chlorpyrifos

Emulsifiadte
concentrate

100% Cotton

One-speed washing machine, 30°C, 40°C,
GO°C, detergent, detergent plus bleach,
plain water, 2 rinses, 30 minute gas dryer.

78-96% of diazinon removed; $2-
71% of chlorpyrifos removed; 30-
84% of chlordane removed.
Removal increased with hotter
water and detergent in all cases,

212


Welfare, Health Services and Mental Health Administration, Center for Disease Control,
National Institute for Occupational Safety and Health. 127 pages.

NIOSH [1972a]. Criteria for a recommended standard: Occupational exposure to
asbestos. Cincinnati, OH: U.S. Department of Health, Education, and Welfare, Health
Services and Mental Health Administration, Center for Disease Control, National
Institute for Occupational Safety and Health, NIOSH Publication No. HSM 72-10267.

NIOSH [1972b]. Criteria for a recommended standard: Occupational exposure to
beryllium. Cincinnati, OH: U.S. Department of Health, Education, and Welfare, Health
Services and Mental Health Administration, Center for Disease Control, National
Institute for Occupational Safety and Health, NIOSH Publication No. HSM 72-10268.

NIOSH [1971]. Determination of magnitude of exposure to asbestos fibers associated
with a woman’s coat containing 8 percent asbestos. Cincinnati, OH: U.S. Department of
Health, Education, and Welfare, Health Services and Mental Health Administration,
Center for Disease Control, National Institute for Occupational Safety and Health,
Division of Field Studies and Clinical Investigation. 27 pages.

Novotny T, Cook M, Hughes J, Lee SA [1987]. Lead exposure in a firing range. Am J
Pub Health 77(9):1225-1226.

NIP [1982]. NTP report on the carcinogenesis bioassay of zearalenone (CAS No. 17924-
92-4) in F344/N rats and B6C3F mice (feed study). Research Triangle Park, NC: U.S.
Department of Health and Human Services, Public Health Service, National Institutes of
Health, National Toxicology Program, NIH Publication No. 83-1791.

Nunez CM, Klitzman S, Goodman A [1993]. Lead exposure among automobile radiator
repair workers and their children in New York City. Am J Ind Med 23:763-777.

Oakland BG, Milikin C, Hurwitz MD [1989]. Determination of pesticide levels as the
result of cross-contamination during laundering. Unpublished manuscript. Greensboro,
NC: The University of North Carolina, Department of Clothing and Textiles. 36 pages.

Oakland BG, Schabacker DJ, Dodd RB, Ross RH [1992]. The evaluation of protective
clothing as chemical barriers for mixers/loaders and applicators in agricultural field tests
designed to meet FIFRA GLP testing standards. In: McBriarty JP, Henry NW, eds.
Performance of protective clothing, vol. 4, ASTM STP 1133. Philadelphia, American
Society for Testing and Materials. pages 481-495.

Oakwood J [1994]. Letter of February 10, 1994 re: environmental response law in
Michigan to Richard W. Niemeier, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 1

page.

1B0


Baker et al. [1977] reported on an investigation of a secondary lead smelter. The
authors state that "Since this investigation, remedial action has taken place at the
smelter and in the workers’ homes to reduce lead exposure: work clothes are no
longer worn home, workers shower before leaving work, plant processes have been
redesigned to reduce lead exposure, and homes have been thoroughly cleaned.”
Although it is not clearly stated, the article implies that the remedial action was
taken in response to the results of the investigation. The effectiveness of preventive
measures was not determined.

The Lead Industry Association [LIA 1989; 1991; 1993a,b; 1994a,b] has produced
brochures, flyers, and videotapes that provide information for a wider audience that
is relevant to preventing workers’ home contamination.

CAUSTIC FARM PRODUCTS

After incidents in which children were poisoned by caustic farm products, farm
journals published preventive measures [Morris and Morris 1992, 1993; Devries and
Devries 1993; Jorgenson 1990]. Morris and Morris [1992, 1993] designed a storage
box with a child-proof lid and this design was published in Hoard’s Dairyman in 1992
and in the Farm Journal in 1993. Another design for storing hazardous chemicals in
dairy barns was also published in Hoard’s Dairyman in 1993 [Devries and Devries
1993]. Several precautions that farmers need to take with caustic dairy cleaners were
enumerated by Jorgenson [1990]. These include:

e rinsing the measuring containers immediately;

e mounting the original container and attachments out of children’s reach;
e leaving labels on containers;

© never storing chemicals in food containers, soda bottles, or cups;

¢ storing chemicals in a locked storage area out of a child’s reach; and

© properly disposing of empty containers. “Don’t leave them—even rinsed ones—
around for children to find.”

PESTICIDES

Barnett [1994] reported on a pesticide spill (chloropicrin) that occurred at the house
of an employee who was preparing a work vehicle for a 12-day trip to treat utility
poles. Next door residents, two adults and three children, became ill and the local
fire department was called to clean up the spill. As a result of this incident, the
employer instituted workplace changes which included a policy that company vehicles
were not to be taken home, and that appropriate storage and means to secure
containers while transporting chloropicrin be used.

S7


FEDERAL AGENCY

‘Table 19, (Continued) Pederal Agency Involvement in Incidents of Workers’ Home Contamination and Related Activities

RESPONSE

Other CDC Centers
Baker et al. [1977]

Baker et al. [1980]

Cannon et al. {1978}

Dotcourt et al. (1981)

Dolcourt et al, [1978]

Falk et al, (1981)

Kaye et al, [1987]

Landrigan [1976]
Landrigan and Baker (1981)
Matte et al, [1991]

Matte et al, [1989]
Novotny et al. [1987]

‘Watson et al, [1978]

Wolfe et al. (1961)

A joint study by CDC, the Tennessee Department of Public Health, and the Memphis-Shelby County Health Department of a lead smelter in Memphis,
Tennessee found workers’ houses had significantly higher concentrations of lead dust than controls. Children’s BLLs were significantly higher than control
children's and correlated with the concentrations of lead in dust,

PCBs in sewage sludge. Serum PCB levels were higher in worker's familics than in other community residents.

Joint study by CDC and EPA, Virginia State Department of Health and NIOSH of Kepone poisoning in wives of kepone workers. It is stated that the kepone
episode has stimulated the development of an active, OSHA-approved occupational safety and health plan and has stimulated the passage through the State
Legislature of the Virginia Toxic Substances Information Act,

Joint study by CDC, North Carolina Department of Human Resources, and Cabarrus County Health Department of auto battery recycling. Two families in
cottage industries had high BLLs.

Joint study by CDC and the Wake County Health Department of lead poisoning in children of battery workers. Dust samples were collected in homes and BLLs
of children were determined. Carpeting, clothes, and closets showed especially large amounts of contamination, Took measurements to reduce workers’ exposure
‘and home contamination and to decontaminate homes. Molar and Mushak [1982] studied decontamination of these homes of in a study supported by NIEHS.
Grants.

Girl with angiosarcoma was exposed to arsenic in soll, water, and dust on father’s work clothes and boots. NCI and NIEHS were also involved in this study,

Study of family members of workers exposed to lead, Children and family members had elevated BLLs compared to @ non-exposed group. Lead levels from dust
samples were significantly higher in workers’ homes,

In this review of lead exposure in children, workers’ home contamination is cited as a source of exposure.
In a study of children exposed to heavy metals from smelters, a relation between house dust levels and BLLs of children was found in El Paso, Texas.

Several Centers and NIOSH studied household dust and soil around houses and BLL contamination in households near both conventional and cottage lead

, smelters. Significant increase in BLLs in children and residents near cottage smelters were found.

Study of battery repair shops in Jamaica, Also reported in [CDC 1989a),
Joint study by CDC and the Colorado Department of Health of employees of a firing range and their wives.

‘This joint study by CDC, EPA, and the Vermont State Health Department found elevated BLLs of children of workers manufacturing lead storage batteries,
Even though workers showered and changed clothes at work, clothes were washed at home.

Recommended that if discarded pesticide drums can’t be destroyed, they should be rinsed with water at least twice, so as to be less likely to have toxic residues
that can affect children. Also made recommendations for decontamination of pesticide applicators’ clothing.

246



TABLE OF CONTENTS

Agency for Toxic Substances and Disease Registry (ATSDR) ............ 88
Occupational Safety and Health Administration (OSHA) ..............-. 88

Mine Safety and Health Administration (MSHA) .............-.-.-.-- 89
Environmental Protection Agency (EPA) .........-....2-.2 50000 cues 89
Department of Energy (DOE) ........... 0-0 ec cece cece cece eee 89
Nuclear Regulatory Commission (NRC) ..........-. 22.2 eee eee eee 91
RESPONSES OF STATE AGENCIES ......... 2. cece cee eee eens 93
Lead 2... ccc cece eet eet nee nent eee eennee 93
Pesticides 2.0.2... cece cect e eet ee eee ee eens 96

Other 2... eee eee tee tee eet ee teens 96
RESPONSES OF INDUSTRY .. 2... 20... cece cee cee eee eens 97
CHAPTER 8 - RECOMMENDATIONS AND CONCLUSIONS ...........-... 98
Recommendations for Research and Education ...............-0 0000s eee 98
Conclusions 2... 6... cee eee tee ene e eect eee e ee teees 98
REFERENCES ...... 2... cece ee cece ee eee eee neta ete nneee 99


Finley et al. [1974]

Pesticide
(water solubility)

Methyl parathion
Toxaphene-methy!
parathion-DDT
{toxaphene 3 mg/L)

Table 16. (Continued) Studies on Laundering Pesticitea from Contaminated Clothing

Formulation
|

Bmulsifiable
concentrate

Fabrics

polyester

Laundry or Decontamination Variables

100% Cotton. $0/$0 Cotton: COC, 2 rinses, standard detergent, small

(19.85 L) electric portable washer.
Contaminated and clean fabrics washed 1,
2, or 3 times.

Toxaphene and DDT were difficult
to remove from fabric after first
wash. Transfer of all three
pesticides when applied as a
mixture was much greater for the
$0/S0 cotton-polyester than for
100% cotton. When methyl
parathion was applied by itself,
there was no difference in transfer
by fabric type. All Drosophila
confined on washed fabrics that had
deen contaminated with the mixture
died.

Goodman et al.
[1988]

Methyl parathion

$ days contamination
with and without dally
laundering

Emulsifiable
concentrate 1.25%

100% Cotton poplin, 50/30
cotton-polyester poplin finished
and unfinished with a fluoro-
carbon renewable soilrepelient
finish

49°C water, 2 rinses, pre-wath, non-ionic

heavy-duty liquid detergent, agitation by
2 stainiess steel balls.

Residue after washing daily was less
for sojl-repellent fabrics. Residue
Increased dally when washing was
not done daily. Both contamination
levels and residuals were tess with
soil-repelient finish when laundering
was not done daily. Methyl
parathion concentrations in water
were much less with daily
laundering.

Graves et al.
(1980)

Permethrin
(0.2 mg/L at 20°C)

Pabrics wom in cotton
fields on days 1, 2, or
4 after spraying

Heavy all cotton fabric, 2 layers

Single laundering in hot water, heavy-duty
detergent, dry bleach, perborate additive,

Contamination: Outer layer day 1,
25.8 ppm; day 2, 14.4 ppm; day 4,
3.8 ppm; under layer day 1, 19.9
ppm; day 2, 14.4 ppm; day 4, 1.2
ppm.

After laundering: Outer layer day
1, 18.3 ppm; day 2, 9.2 ppm; day 4,
1.6 ppm; under layer day 1, 9.4
ppm; day 2, 5.8 ppm; day 4, 0.6

ppm.

208


STATE

‘Table 21. (Continued) How State Agencies Respond to Incidents of Workers’ Home

AGENCY

‘Contamination — States that Do Not Have Their Own OSHA Program

INPORMATION PROVIDED TO NIOSH

Oklahoma Department of Health and ‘These Departments reported that they have no data or regulations on home contamination [Coleman 1994].
Department of Environmental Quality
Pennsylvania Department of Labor and Industry ‘The Department of Labor reported that it collects information on hazardous chemicals in the workplace from
employers. It provided NIOSH with copies of the State's:
Employer/Worker Community Right to Know Act;
List of chemicats subject to reporting (EPA);
Menuat for employer compliance with Hazardous Materials Act {Tinney 1994].
South Dakota Department of Health ‘The Department of Health reported that it has been conducting residential indoor air quality studies since 1990,
and has initiated a simple data collection system for surveillance of hazards in the home; however, it has no
reports of take-home cases (Forsch 1994}.
‘West Virginia Department of Health and Human ‘The Department of Health reported that it has no reports or data on workers’ home contamination and submitted
Resources. the State’s Asbestos Licensure Law {Wallace 1994; Pinnell 1994].
Wisconsin Department of Natural Resources ‘The Department of Natural Resources reported that it has no evidence of wastewater staff taking home

(DNR)

contaminants. There is a possibility of home contamination by forest firefighters, since the firefighters wash their
clothing at home. DNR does not systematically collect information on home contamination; it focuses on
environmental protection, rather than public or environmental health [Kavanaugh 1994}.

251



60204

Federal Register / Vol. 58. No. 218 / Monday, November 15. 1993 / Notices

Finley EL. Bellon JM. Graves JB. Koonce KL

[1977]. Pesticide contamination of
‘ing in cotton fields. Louisiana
Agricul 20(3):8-9.
Fulton WB, Matthews JL (19361. A
Proliminary report of the dermatological
and systemic effects of exposure to
bexachloro-naphthalene and chloro-
diphenyl, Special Bulletin No 43
Harcisburg. PA: Bureau of Industrial
Standards.
Ganelin RS, Mail GA, Custo C fr 11964}.
‘equipa-ent contaminated
with parathion. Arch Environ Health
8:826-828.

Garrettson LK [1988]. Childhood lead
poisoning in rediator mechanics’
children. Vet Human Toxicol 30(2):112.

Good CK, Pensky N [1943]. Halowax acne
(cable rash”). Arch Dermatol Syphilo!
48:251-257.

Hardy HL [1946]. Delayed chemical
Poeumonitis in workers exposed to
beryllium compounds. } Ind Hyg Toxicol
28:547-5S6.

Hardy HL. Rabe EW. Lorch S$ {1967}. U.S.
beryllium ces* registry (1952-1956). J
‘Occup Med 9:271-276.

Hild 1DN. Laughlin JM. Gold RE 11989].

‘Laundry parameters as factors in
lowering methyl parsthion residues in
cotton/polyester fabrics. Arch Environ
Contam Toxicol 18:908-914.

Hudson PJ. Vogt RL. Broodum J. Witherell L.
Myers G, Paschal DC [19871 Elemental
mercury exposure emong children of
thannometer plant workers. Pediatrics
7K6):035-038.

Jensen NE. Sneddon IB. Walker AE [1972].
Chloracne: three cases. Proc Royal Soc
Mod 65(8)-687-688.

Kelly B [19771 Ailied chemicsi kept that
kepone flowing. Business end Society
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Kim Cj [3989]. Effects of convection-oven
and microwave-oven drying on removal
of alachlor-residues in a fabric structure.
Bull Eaviron Contam Toxicol 43:904—

909.

Kim Gj. Stone JF. Costs JR. Kadolph S}
11986]. Removal of atachlor residues
from contaminated clothing fabrics. Bul!
Environ Contam Toxicol 36:234-241.

Kim CJ, Stone JF, Sizer CE 1982}. Removal
of pesticide residues es sifected by
laundering variables. Bull Environ
Contam Toxicol 29:95-100.

Krouse! T. Garcas N. Rothschild H 11986).
Femilial clustering of mesothelioma: «

on three affected persons in one
family. Am | Prevent Med 2(4):186-188.

Laughlin J. Gold RE {1989}. Evaporative
‘dissipation of methy! parathion from
laundered protective epperel fabrics.
Bull Environ Cootam Toxicol 42:556-
$73.

Laughlin J. Gold RE [1889]. Methyl parathion

during laundering of

redisposition

functionally finished protective appare!
fabrics. Bull Environ Contam Toxicol
42691-6598.

‘Laughlin JM. Easley CB, Gold RE. Tupy DR
{1981]. Methyl parsthion transfer from
contaminated fabrics to subsequent
laundry and to laundry equipment. Bull
Environ Contam Toxicol 29:518-S23.

Li FP, Lokich J. Lapey J, Neptune WB,
Wilkins EW Jr 1978]. Familial
mesothelioma after intense asbestos
exposure at home. JAMA 240(51:467.

Lieben J. Pistawka H [1947]. Mesothelioma
and asbestos exposure. Arch Environ
Health 14:559-563.

Lisben J Williams RR [1969]. Respiratory

disease associated with beryllium
refining and allay fabrication. J Occup
Med 11:480~-485.

Lillie TH, Hampson RE, Nishioka YA,
Hamilton MA [1932]. Effectiveness of
detergents and detergent plus bleach for
Cecontaminating pesticide applicstor
dothing. Bull Environ Contam Toxicol
29:89-94,

Lowengart RA. Peters JM. Gcioni C Buckley
J. Bernstein L, Preston-Martin
Rappeport E 119871. Childhood Pievkemi ia
and parents’ occupational and home
exposures. INCI 7%(1}:39-46.

Lundquist M {1980]. Surviving the lead
standard 19. Proteczing workers’ families.
Battery Man 22(11:27-28.

Masek V, Jack Z, Kandus J [1972]. Content of
3,4-benzola)pyrene in the working
clothing and underwear of workers ate
Pitch coking plant. J Occup Med
14(7}548-551.

Milar CR, Mushak P {1982}. Lead
contaminated house dust: hazard.
messurement and decoctamination. In:
Chisolm J} Jr, OHara DM. eds. Lead
absorption in children. Baltimore: Urban
and Schwarzenberg. pp 143-152.

MMWR (19771. Increased lead absorption in
children of led workers-Vermont.
Morbidity and Mortality Weekly Report
1977(26}61-62.

MMWR 11976}. Lead poisoning-Tennessee.
Morbidity and Mortality Weekly Report
2s(11kBs.

Newhouse ML, Thompson H [1965].
Mesothelioma of pleura end peritoneum
following exposure to asbestos in the
London area. Brit J Ind Med 22:261-269.

Peters JM, Preston-Martin S [1984].
Childhood tumors and parent!
exposures. Teretogen Carcinogen
Mutagen 4:137-148.

Price HA, Welch RL 19721. Occurrence of
polychlorinated biphenyls in humans.
Environ Health Perspect 1:73-78.

Rice C. Fischbein A. Lilis R, Sarkozi L, Kin
S. Selikoff 1, 11978). Lead contamination
in the homes of employees of secondary
lead smelters. Environ Research 15:375-

Stone JF, Stahr HM [1989]. Pesticide residues
in clothing. Case study of a midwestern
farmer's coverail contamination. J
Environ Health $1(5):273-276.

Taylor JR. Selhorst JB. Houff SA, Martinez JA
11978}. Chlordecane intoxication in man
1. Clinical observations. Neurology
28626-630.

Trost C 11985]. Mercury exposure of workers

jites Vermont cont r. Des
Moines, Sowa: Wall Street } 65(240
September 24).

Versen RA, Bunn WB I! 11989}. Evaluating
the exposure levels incurred while
laundering crystalline silice-containing
work clothing. Am Ind Hyg Assoc J
S0(4}.A241-A242.

Vianna J). Polan Ak (1978). Non-occupational
‘exposure to asbestos and malignant
mesothelioms in women. Lancet
1(8073}:1061-1063.

‘Warren MC, Conrad jP Jr, Bocian Jj, Hayes M
{1963}. Clothing bome epidemic: organic
phosphate poisoning in children. JAMA
184:266-268.

Watson WN. Witherell LE. Giguere GC
11978]. Increased leed absorption in
children of workers in a lead storage
bettery plant. | Occup Med 20:759-761.

Winegar DA. Levy BS, Andrews |S Ir.
Landrigan PJ. Scruton WS, Krause MJ
11977]. Chronic occupational exposure to
lead: an evaluation of tka health of
smelter workers. J Occup Med 19(9):603-

606.

Wolfe HR, Durham WT, Walker KC (1961).
Health hazards of discarded pesticide
containers. Arch Environ Health 3:531-

537.

Zirschky J. Witherell LE [1986]. Cleanup of
mercury contamination of thermometer
workers’ homes. Am Ind Hyg Assoc J
48:81-84.

Zirschky J. Witherell L [1987]. Geanup of
mercury contamiuation of the-mometer
workers’ homes. Am Ind Hyg Assoc |
48(1k81-84.

IFR Doc. 93-2794? Filed 11-12-93: 8:45 am]

Health Care Financing Administration

Public Information Collection
Requirements Submitted to the Office
of Management and Budget (OMB) for
Clearance

AGENCY: Health Care Financing
Administration, HHS.

‘The Health Care Financing
Administration (HCFA). Department of
Health and Human Services, has
submitted to OMB the following
proposals for the collection of
information in compliance with the
Paperwork Reduction Act (Pub. L. 96—
511).

1. Type of Request: Extension; Title
Infooraon Collection: Establishing ¢

lures for Transmitting Information
Betwoen Medicare Carriers and
Medicare Supplemental Insurers; Form
No.: HCFA-R-140; Use: These
procedures provide for the transfer of
claims information from a Medicare
carrier to a Medicare supplemental
(Medigap) insurer when a beneficiary
has assigned his/her right of payment
under the Medigap policy to a
participating physician or supplier in
order to payment of Medigap
benefits to participating physicians and
suppliers. Modigap insurers are required
to issue, to beneficiaries, insurance
enrollment cards and notification of
claims payment determinations. They

3518 Mow 2, 19S VerDate OO-NOV-8D 2d 150757 PO.O0000 Frm 00040 Fat 4703 Sint 4703 EAFPAFANPISNODPTI pind

264


‘Table 11, (Continued) Health Esfects of Take-Home Pesticide Exposure

INDUSTRY HEALTH EFFECT #/RELATIONSHIP COMMENTS AND ISSUES

a
Davies and Enos Farming Pesticide poisoning. 1 Child 3-yearold boy ingested chlorpyrifos, shown by the excretion of alkyl phosphate
[1980] Chlorpyrifoe Symptoms not specified. and phenolic metabolites, The authors note that agricultural workers’ wives and
children may be heavily exposed. These exposures occur in the field and also
from materials brought back to the home.

Griffin and O'Malley | Farming Acetyicholinesterase 1 Daughter S-year-old girl was hospitalized with symptoms of poisoning typical of those
[1992] Aldicard inhibition (lethargia, resulting from exposure to a carbamate anticholinesterase insecticide. ‘The girl,
California respiratory distress). who recovered, fived in a mobile home on a dairy farm where her father worked.
Recovered. {t was determined that a tractor parked near the house contained a box of
Aldicarb, and the soil 15 feet from the house showed 1.84 percent Aldicarb.
Barnett Wood treatment Bye irritation, nausea, Neighbors (2 adults, 3 children) Employee of wood treating company brought home his company vehicle which
{1994) Chioropicrin vomiting, coughing contained 6 containers of chloropicrin. The containers fell and split open,
Oregon spilling 1 gallon on the driveway and it affected the neighbors.
Anderson et al. Salvage Acetylcholinesterase 2 Sons, 1 neighbor child Father operated a salvage business at home. Flannelette sheets purchased from
[1965] Cottage industry inhibition: mild symptoms an insurance adjustor were contaminated with parathion. The children were
California Parathion (nausea, vomiting) to exposed to parathion when they slept on the sheets which were used in the
respiratory distress, coma. home.
All recovered.

Cannon et al. Chemical Kepone poisoning Wives of 2 workers had objective 19% of the 214 community residents had detectable levels of kepone in their
(1978) Manufacture (subjective nervousness, tremor blood (0.005-0.0325 ppm). 94% of family members had detectable levels of
Taylor et al. Kepone objective tremor) kepone in their blood (ranging from 0.003-0.39 ppm). Wives of 2 workers had
[1978] demonstrable tremor. Both gave # history of having washed their husband's
Kelly work clothing.

1977)
Hopewell,
Virginia

175


CDC (Centers for Disease Control) [1989b]. Occupational and paraoccupational
exposure to lead—Colorado. MMWR 38(19):338-340, 345.

CDC (Centers for Disease Control) [1987]. Recommendations for prevention of HIV
transmission in health-care setting. MMWR 36(2S):11S-12S.

CDC (Centers for Disease Control) [1985]. Lead poisoning in a capacitor and resistor
plant—Colorado. MMWR 34(25):384-385.

CDC (Center for Disease Control) [1978]. Polychlorinated biphenyl exposure—Indiana.
MMWR 27(12):99-100.

CDC (Center for Disease Control) [1977a]. Increased lead absorption in children of lead
workers-Vermont. MMWR 1977(26):61-62.

CDC (Center for Disease Control) [1977b]. Lead poisoning in children of battery plant
employees—North Carolina. MMWR 26(39):321.

CDC (Center for Disease Control) [1976]. Lead poisoning—Tennessee. MMWR
25(11):85.

CFR. Code of Federal regulations. Washington, DC: U.S. Government Printing Office,
Office of the Federal Register.

Chamberlin GW, Jennings WP, Lieben J [1957]. Chronic pulmonary disease associated
with beryllium dust. PA Med J 60:497-503.

Champion P [1971]. Two cases of malignant mesothelioma after exposure to asbestos.
Am Rev Resp Dis 103(6):821-826.

Chenard L, Turcotte F, Cordier S [1987]. Lead absorption by children living near a
primary copper smelter. Can J Pub Health 78(5):295-298.

Chesner C [1950]. Chronic pulmonary granulomatosis in residents of a community near
a beryllium plant: Three autopsy cases. Ann Int Med 32:1028-1048.

Chiao-Cheng JH, Reagan BM, Bresee RR, Meloan CE, Kadoum AM [1988]. Carbamate
insecticide removal in laundering from cotton and polyester fabrics. Arch Environ
Contam Toxicol 17:87-94.

Chisolm JJ Jr. [1978]. Fouling one’s own nest. Pediatrics 62(4):614-617.

CH,M Hill [1991]. Final house dust remediation report for the bunker hill CERCLA

site populated areas R1/FS. Document No. BHPA-HDR-F-RO-052091. Boise, Idaho:
CH.M. Project No. B0I24632.G2.01/RI18A, Prepared for the Idaho Department of

106


ACKNOWLEDGEMENTS

The following individuals from other Federal agencies contributed to the study of home
contamination.

Robert W. Aldridge, Esq.
General Attorney

Office of the Solicitor
U.S. Department of Labor
4015 Wilson Boulevard
Arlington, Virginia 22203

Charles Auer, B.S.

Director

Chemical Control Division (7405)
Office of Pollution Prevention & Toxics
US. Environmental Protection Agency
401 M Street, S.W.

Washington, D.C. 20460

Robert J. Biersner, J.D., Ph.D.
Staff Attorney

Associate Solicitor for Occupational
Safety and Health

U.S. Department of Labor

Office of the Solicitor, Room $4004
200 Constitution Avenue, N.W.

Washington, D.C. 20210

Eugenia L. Boyle

ORPS Program Manager
Department of Energy
Washington, D.C. 20585

Ken E. Brockman

Chief, Incident Response Branch

Division of Operational Assessment

Office for Analysis and Evaluation
of Operational Data

USS. Nuclear Regulatory Commission
Washington, D.C. 20555

Caroline S. Freeman, M.P.H.

Director, Office of Standards Analysis
and Promulgation

Occupational Safety and Health Admin.
200 Constitution Avenue, N.W.

Room N3718

Washington, D.C. 20210

Steven K. Galson, M.D., M.P.H.
Chief Medical Officer

U.S. Department of Energy

1000 Independence Avenue, S.W.
Mailstop EH-1

Washington, D.C. 20585

Barry L. Johnson, Ph.D.
Assistant Administrator

Agency for Toxic Substances and
Disease Registry

1600 Clifton Road, N.E.

Atlanta, Georgia 30333

Wendy E. Kaye, Ph.D.

Chief, Epidemiology and Surveillance
Branch

Division of Health Studies

Agency for Toxic Substances and
Disease Registry

1600 Clifton Road, N.E.

Atlanta, Georgia 30333

Melissa A. McDiarmid, M.D., M.P.H.
Director, Office of Occupational
Medicine

Occupational Safety and Health
Administration

200 Constitution Avenue, N.W.
Room N3683

Washington, D.C. 20210

Lori E. Saltzman, M.S.
Directorate for Health Sciences
U.S. Consumer Product Safety
Commission

4330 East West Highway
Bethesda, Maryland 20814


57 Fed. Reg. 42102 [1992]. Occupational Safety and Health Administration: occupational
exposure to cadmium.

59 Fed. Reg. 40964 [1994]. Occupational Safety and Health Administration: occupational
exposure to asbestos.

Finkelstein JS, McCully WF, MacLaughlin DT, Godine JE, Crowley WF Jr. [1988].
Medical intelligence the morticians mystery: Gynecomastia and reversible
hypogonadotropic hypogonadism in an embalmer. N Eng J Med 318(15):961-965.

Finklea JT [1976]. Statement before the Subcommittee on Manpower, Compensation,
and Health and Safety, House Committee on Education and Labor February 9, 1976. 27
pages.

Finley EL, Bellon JM, Graves JB, Koonce KL [1977]. Pesticide contamination of
clothing in cotton fields. Louisiana Agricul 20(3):8-9.

Finley EL, Graves JB, Hewitt FW, Morris HF, Harmon CW, Iddings FA, Schilling PE,
Koonce KL [1979]. Reduction of methyl parathion residues on clothing by delayed field
re-entry and laundering. Bull Environ Contam Toxicol 22:598-602. [See Satoh 1979].

Finley EL, Graves JB, Summers TA, Schilling PE, Morris HF [no date]. Some facts
about methyl parathion contamination of clothing in cotton fields and its removal by
home laundering. Baton Rouge, Louisiana, Louisiana State University. Agricultural
Experimental Station Circular No. 104. 7 pages.

Finley EL, Metcalfe GI, McDermott FG, Graves JB, Schilling PE, Bonner FL [1974].
Efficacy of home laundering in removal of DDT, methyl parathion and toxaphene
residues from contaminated fabrics. Bull Environ Contam Toxicol 12(3):268-274.

Finley EL, Rogillio JRB [1969]. DDT and methyl! parathion residues found in cotton
and cotton-polyester fabrics worn in cotton fields. Bull Environ Contam Toxicol

4(6)343:351.

Fire Administration Authorization Act of 1992. Public Law 102-522, 102nd Congress,
2nd session, §209 October 1992.

Fischbein A, Sassa S, Butts G, Kaul B [1991]. Increased lead absorption in a potter and
her family members. NY State J Med 91(7):317-319.

Fischbein A, Wallace J, Sassa S. Kappas A, Butts G, Rohl A, Kaul B [1992]. Lead

poisoning from art restoration and pottery work: Unusual exposure source and household
risk. J Environ Pathol Toxicol Oncol 11(1):7-11.

112


‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

[42 US.C, § 9601 et
seq.)

(©) In cooperation with the States, and other agencies of the Federal Government,
establish and maintain a complete listing of areas closed to the publie or otherwise
restricted in use because of toxic substances contamination;

(D) in cases of public health emergencies caused or believed to be caused by exposure
to toxle substances, provide medical care and testing to exposed individuals, including but
Hot limited to tissue sampling, chromosomal testing where appropriate, epidemiological
studies, or any other assistance appropriate under the circumstances; and

(E) either independently or as part of other health status survey, conduct periodic
survey and screening programs to determine relationships between exposure to toxic
substances and illness, In cases of public health emergencies, exposed persons shall be
eligible for admission to hospitals and other facilities and services operated or provided
by the Public Health Service,

(2)(A) Within 6 months after October 17, 1986, the Administrator of the Agency for
Toxic Substances and Disease Registry (ATSDR) and the Administrator of the
Environmental Protection Agency (EPA) shal! prepare a list, in order of priority, of at
least 100 hazardous substances which are most commonly found at facilities on the
National Priorities List and which, in thelr sole discretion, they determine are posing the
most significant potential threat to human health due to their known or suspected toxicity

to humans and the potential for human exposure to such substances at facilities on the
National Priorities List or at facilities to which a response to a release or a threatened
release under this section 's under consideration.

(B) Within 24 months after October 17, 1986, the Administrator of ATSDR and the
Administrator of EPA shall revise the list prepared under subparagraph (A). Such
revision shall include, in order of priority, the addition of 100 or more such hazardous
substances, In each of the 3 consecutive 12-months periods that follow, the Administrator
of ATSDR and the Administrator of EPA shall revise, in the same manner as provided in
the 2 preceding sentences, such list to include not fewer than 25 additional hazardous
substances per revision. The Administrator of ATSDR and the Administrator of EPA
shalt not less often than once every year thereafter revise such list to Include additional
hazardous substances in accordance with the criteria In subparagraph (A).

(OA) The Administrator of ATSDR shall perform a health assessment for each facility
‘on the National Priorities List established under section 9605 of this title, Such health
assessment shall be completed not later than December 10, 1988, for each facility
Proposed for inclusion on such list prior to the date of the enactment of the Superfund
Amendments and Reauthorization Act of 1986 of not later than one year after the date of
Proposal for inclusion on such list for each facility proposed for inclusion on such list
after October 17, 1986.

230


Table 9. Health Fifects of Take-Home Lead Exposure (Case Reports/Case Series)

Location Industry Study Design
a EE ooo
Anonymous {1952] Philippines Storage battery Case reports Workers made storage
factories Case 1: 1 Lead-exposed worker, 1 Case 1; Symptomatic child was batteries in or near where the
child age 3 misdiagnosed as a case of poliomyetitis families lived. No BLLs
and later died. reported,
Case 2: 1 Lead-exposed worker, 1 Case 2; Symptomatic child died after
child age 2.5 3 days of treatment
Case 3: 1 Lead-exposed worker, 1 Case 3; Symptomatic child was chelated
child age 2 and recovered.
Joshua et al, (1971] India Gold and silver Case report BLL levels ranged from $2 to 72 ug/dL House and work areas were
recovery 1 Family (9 adults, 9 children); 3 in children and 37 to 61 g/dL in adults, adjacent, Severe fead
generations poisoning including
convulsions and death,
Winegar et al. (1977) Minnesota, Lead smetting Case series Median BLL of workers was 72.5 ug/4L Few family members had
USA 38 Workers (87 family members) (range 21-112 ug/L) and median BLL of symptoms of lead poisonings.
family membere was 17 ug/dL (range 8 Headache and fatigue 20%
44 ug/AL). $ children under age 10 had each. 4 family members with
BLLs & 30 yg/dL. Pree erythrocyte the highest BLLs were
protoporphyrin of family members ranged asymptomatic.
from 10-94 4g/100 mL.
Dolcourt et al. [1978] North Battery factory Case series 40 (69%) of children had BLLs = ‘Used capillary sampling. All
CDC [1977] Carolina, 58 Childsen of unknown number of 30 ug/dL. Levels highest in children age children were asymptomatic
USA workers 3. and statistically significant decline with and all had normal findings on
age. Maximum 90 g/dL. physical and neurological
exams. No anemia. 6
children showed metaphyseal
fead lines. 6 children with BLL
44-90 required chelation on at
feast one occasion.
Hong [1980) Taiwan Battery processing, Case series 4 children had BLLs of at least 80 ug/dL Male heads of household
stabilizer 2 Families - S children (age 16 (2 had lead encephalopathy, 2 had severe worked inside the residence;
manufacturing months - 6 years), 8 adults abdominal symptoms); 1 child had a BLL living areas in both homes

of 50-29 g/dL (no symptoms), 2 adults
had BLLs of at least 80 ug/dL (both were
symptomatic), 4 had BLLs of 50-79 g/dL
(1 symptomatic), and 2 had BLLs of 30-
49 ug /aL.

were contaminated with lead
dust.

167


‘Table 6. (Continued) Health Effects of Take-Home Asbestos Exposure (Case Serics)

AGE AT DEATH

Bianchi et al.
[1982]
Tealy

Asbestos
(shipyard work)

Pleural mesothelioma

1 woman whose husband was a
shipyard worker,

Of 70 cases (64 men; 6 women) seen at
Institute of Pathological Anatomy of Trieste
1967-1980 1 was duc to probable domestic
exposure. Necropsy findings available in 63
cases. Remaining 7 cases were diagnosed at
thoracotomy, Of the cases, 43 employed in
shipyards, most prior to 1940. Intervals
between first exposure and death ranged from
2B to 61 years. Asbestos bodies found in 48 of
61 cases.

Bianchi et al.
(1987)
Italy

Asbestos (shipyard, sodium
carbonate factory)

Hyaline pleural
plaques

59 cases were attributed to domestic
exposure (laundering asbestos-
contaminated work clothes of family
members). 9 cases with occupational
and domestic exposure.

Not stated

74 women with hyaline pleural plaques found
at necropsy. 2 cases with occupational
exposure, Sufficient exposure data could not
be obtained on 4 cases. Pleural malignant
mesothelioma was noted in 2 cases with a
history of household exposure.

Bianchi et al.
[1990}
Italy

Shipyard, sodium carbonate
factory, textile, artisans,
domestic maids)

Hyaline pleura!
plaques

Pleural plaques at necropsy were
found in 55% of 121 women with
history of domestic exposure.

1,620 necropsies (1,040 men, 580 women)
were performed from Oct 1979 to Dec. 1987
in Monfalcone, Italy, 121 women with history
of domestic exposure were compared to 57
women with no history of domestic exposure.
Pleural plaques were significantly more
prevalent in those women with domestic
exposure (p<0,001). The prevalence of
hyaline ptaques was higher in every
occupational category for women with
domestic exposure than for women without
domestic exposure.

Bianchi et al.
1991)
Italy

Shipbuilding, sodium carbonate
factory

Asbestos bodies
Hyaline pleural
plaques

1,765 necropsies (1,127 men; 638
women), In women, cleaning of
work clothes polluted with asbestos
was the main source of exposure.
Domestic exposure resulted in
pleural plaques in about half the
necropsies on female patients.

Prevalence of pleural plaques and asbestos
bodies varied by occupation in men; the
highest prevalence was in those who had
worked in the sodium carbonate factory.

Only 21 of the 638 necropsies on females had
a history of occupational exposure.

156



Lead loading of carpets and furniture was reported by CH,M Hill [1991]. In this
study, lead loadings in carpets and furniture of homes in a lead smelter area were
138,000-2,054,000 g/m? and 613,000-11,118,000 g/m’, respectively.

Lead loadings in automobiles of workers engaged in: removing lead-based paint
from a bridge; radiator repair; electric cable splicing; lead welding and soldering; and
battery recycling have been reported. Floors of the bridge workers’ cars had lead
loadings ranging from 340ug/m’ to 2,000 1g/m? (mean 630 g/m”); other surfaces
had lead loadings less than 500 »g/m* [Ewers et al. 1995; Piacitelli et al. (in press)].
Lead loadings in cars of radiator repair workers were up to 96,000 wg/m’ [Piacitelli
and Rice 1993]. Cars of electric cable splicers had lead up to 133,000 »g/m*
[Venable et al. 1993]. The floor of a car of a worker who soldered and welded with
lead had lead at 40,000 #g/m* [CDC 1992a]. Cars of workers engaged in battery
recycling had lead loadings of 190,000 g/m’ on the floor, 300,000 g/m? on the
drivers’ seat, and 170,000 g/m’ on the dashboard [Gittleman et al. 1991, 1994].

MERCURY

Measurements of mercury contamination in workers’ homes and cars were reported
by ATSDR [1990a], Hudson et al. [1985, 1987], and Zalesak [1994]. Following a
single day of exposure to mercury in a maintenance operation, workers contaminated
their homes and cars from clothing and tools worn and used at work [ATSDR 1990a].
Mercury concentrations in 25 workers’ homes ranged between 1 pg/m’ and 5 pg/m’,
and in cars between 8 pg/m’ and 10 yg/m’*. When workers in a thermometer plant
contaminated their homes, Hudson et al. [1985, 1987] reported mercury
concentrations in air of living areas at 0.02-10 ng/m’ (median 0.24 g/m’) compared
to control homes which had mercury at levels of 0.01-1 zg/m’ (median 0.05 yg/m’).
Zalesak [1994] reported that contaminated homes of gold mine workers had
concentrations of mercury near washers and dryers at 5- 50 zg/m’ and their cars had
mercury concentrations at 30-60 u4g/m*. The MSHA permissible occupational
exposure limit for inorganic mercury vapor [30 CFR 57.5001] is 50 4g/m’ as an 8-hr.
time-weighted average.

CHLORINATED HYDROCARBONS

Concentrations of 3,3’-dichlorobenzidine (DCB) in vacuum cleaner dust from homes
of workers engaged in its manufacture were at 10.5 ppm [ATSDR 1991b]. House
dust in homes of workers exposed to PCBs contained PCBs at concentrations up to
180 ppm [Price and Welch 1972]. No guidelines exist for judging the significance of
these contaminant concentrations. No other measurements of home contamination
levels for this class of compounds were found.

PESTICIDES

Concentrations of diazinon, chlorpyrifos, and propoxur were found at much higher
concentrations in floor dust collected in farmworkers’ homes than in non-
farmworkers’ homes {Osorio 1994]. Diazinon was found at averages of 56 4g/m* and
39 ppm in four of five (not detected in the fifth home) farmworkers’ homes

52


‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

Scetions Relevant to Workers’ Famity Protection

CERCLA & SARA [42 U.S.C. § 9601 et (1) methods of discovering and investigating facilities at which hazardous substances have
seq.) been disposed of or otherwise come to be located;

(2) methods of evaluating, including analyses of relative cost, and remedying any releases
Or threats of releases from facilities which pose substantial danger to the public health or
the environment;

(3) methods and criteria for determining the appropriate extent of removal, remedy, and
other measures authorized by this chapter;

(4) appropriate roles and responsibilities for the Federal, State, and local governments
and for interstate and nongovernmental entities in effectuating the plan;

(S) provision for identification, procurement, maintenance, and storage of response
‘equipment and supplies;

(6) & method for and assignment of responsibility for reporting the existence of such
facilities which may be located on federally owned or controlled properties and any
releases of hazardous substances from such facilities;

(7) means of assuring that remedial action measures are cost-effective over the period of
potential exposure to the hazardous substances or contaminated materials;

(8)(A) criteria for determining priorities among releases or threatened releases.
throughout the United States for the purpose of taking remedial action and, to the extent
practicable taking into account the potential urgency of such action, for the purpose of
taking removal action. Criteria and priorities under this paragraph shall be based upon
relative risk or danger to public health or welfare or the environment, in the judgment of
the President, taking into account to the extent possible the population at risk, the hazard
potential of the hazardous substances at such facilities, the potential for contamination of
drinking water supplies, the potential for direct human contact, the potential for
destruction of sensitive ecosystem, the damage to natural resources which may affect the
human food chain and which is associated with any release or threatened release, the
contamination or potential contamination of the air which is associated with the release or
threatened release. State preparedness to assume State costs and responsibilities, and
other appropriate factors;

(B) based upon the criteria set forth in subparagraph (A) of this paragraph, the
President shall list as part of the plan national priorities among the known releases or
threatened releases throughout the United States and shall revise the list no less often
than annually. Within one year after December 11, 1980, and annually thereafter, each
State shall establish and submit for consideration by the President priorities for remedial
action among known releases and potential releases in that State based upon the criteria
set forth in subparagraph (A) of this paragraph, In assembling or revising the national
list, the President shall consider any priorities established by the States. To the extent
practicable, the highest priority facilities shall be designated individually and shall be
teferred to as the "top priority among known response targets", and, to the extent

234


A matched case-control study of histologically confirmed mesothelioma
among New York State women was reported by Vianna and Polan [1978]. They
reported a relative risk of 10 (95% Cl=1.4-37.4) for domestic exposures, including
hand-laundering of work clothes. Results remained significant after elimination of
occupationally exposed women from the analysis (p=0.02).

Several analyses on a population-based series of North American autopsies
were conducted by McDonald and co-workers [McDonald et al. 1970; McDonald
and McDonald 1973, 1980]. They studied 557 pleural and peritoneal
mesothelioma cases from the U.S. and Canada matched on hospital, gender, age,
and year of death to controls with pulmonary metastases from non-pulmonary
primary cancers. Occupational, residential, smoking, and non-occupational
exposure histories were obtained from relatives. Women with mesothelioma were
more likely to have laundered work clothes of household contacts (p=0.08).

Rubino et al. [1972] reported on 102 cases of mesothelioma that occurred
from 1960 to 1970 in two clinical settings in Turin, Italy. Of these, the diagnosis
was confirmed in 54 cases, and an occupational history was obtained for 50 of
these. Fifty matched controls from the same institution were selected, matched
on age and gender. Of mesotheliomas reported in this case series, 12% resulted
from home contamination, including one man whose wife worked in the asbestos
industry, and a woman whose brother worked in an asbestos cement factory.

A case-control study of British shipbuilders was reported by Ashcroft and
Heppleston [1970}. Patients with mesothelioma (23) were matched on gender and
age with 46 hospital controls who were free of malignant disease. Of the cases,
91% had a history of asbestos exposure, compared with 41% of the controls
(p<0.001). This study was designed to demonstrate a link between asbestos
exposure (primarily occupational) and mesothelioma. Pertinent to workers’ home
contamination, one patient with mesothelioma was the widow of an asbestos
worker. She was exposed for 3 years to asbestos dust brought home on her
husband’s hair and shoes.

One case-control study reported no significant differences in mesothelioma

cases and controls with respect to non-occupational exposure [McEwen et al.
1971).

Case Reports. In Table 5, 16 case reports describing 1 or more cases of an
asbestos-related health effect in family members of asbestos workers are
summarized [Rusby 1968; Teyssier and Lesobre 1968; Champion 1971; Lillington
et al. 1974; Li et al. 1978; Epler et al. 1980; Risberg et al. 1980; Jorgensen 1981;
Martensson et al. 1984b; Krousel et al. 1986; Magee et al. 1986; Huncharek et al.
1989; Li et al. 1989; Otte et al. 1990; Oern et al. 1991; Anonymous 1993b]. Of
these reports, 13 are of mesothelioma, 2 of pleural plaques, and 1 of asbestosis.
Nine of the studies report on effects in multiple family members.

10


‘Table 15. (Continued) Workers’ Home Contamination Industrial Hygiene Aspects

Author [year] Contaminant
Location Basis for Study Process Industrial Hygiene Methodology
| nA
ERM Southeast. | Mercury Protocol for mercury Jerome $11 mercury vapor 05 g/m? were used as clean/non-
Inc, [1989] decontamination of analyzer & dosimeter. clean threshold.
See also workers’ contaminated Jerome 431 instantaneous mercury
ATSDR (19908) homes. vapor monitor,
Tennessee ‘Use of Nilfisk® mercury vacuum
system and mercury binding
solution.
Hudson et al. Mercury Thermometer Air campting in workers’ homes. Mercury-in-alr of living area: Workers All workers brought work clothes
(1985, 1987] manufacture homes 0.02-10 g/m? (median and shoes home, Some elevations
Vermont 0.24 yg/m~); Control homes 0.01- of mercury in places where work
1 g/m” (median 0.05 xg/m’ clothes and shoes were found and
in some washing machines.
NIOSH Mercury Various NIOSH Criterla Document Reviewed reports of workers' home Recommended showering, and
[1973] contamination. changing and washing clothes at
work,
Trost [1985] Mercury ‘Thermometer plant State inspectors found mercury New York times story of mercury
Vermont contamination in over half of SO transport via workers’
workers’ homes. One home had over clothing/shoes to homes.
4 times the levels allowed at work.
West and Lim Mercury Milling cinnabar ore Authors stated that miners had
(1968) contaminated their homes from their
California boots and work clothes,
Zalesak Mercury Gold mining Air sampling in workers’ homes, Mercury at 0.005-0.5 mg/m? near Employees wearing work clothing
[1994] cars, and inside plastic bags washer and dryer, 0.03-0.06 mg/m> in home contaminated their cars and
California containing work clothing. cars, documented contamination of homes.
work clothing.
Aw et al. [1985] Zeranol (an animat Pharmaceutical Air, surface wipes, dermal patches, Employee's work clothing Recommended showering and
Indiana growth hormone) formulator clothing pleces analysis of above 1d with 32 mg of zeranol, changing clothes before leaving
via high pressure liquid kin also contaminated. work.
chromatography. Workers often wore work clothes and
shoes home, and laundered clothes at
home.

202



of pesticide containers, a serious problem in the agriculture sector, would be substantially
teduced.

Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA)
and Superfund Amendments and Reauthorization Act (SARA)

CERCLA was enacted in 1980 in response to concerns by Congress regarding hazardous-
waste disposal problems [Ways and Means Committee 1980]. These concerns involved
sites that contained large quantities of hazardous wastes, unsafe hazardous-waste disposal
practices, and the substantial dangers to health and the environment resulting from
improper hazardous-waste disposal. A primary purpose of SARA, the 1986 Superfund
Amendments, was to decontaminate abandoned hazardous-waste sites and leaking,
underground-storage tanks that present the most serious public health and/or
environmental hazards [Energy and Commerce Committee 1986].

The primary purpose of CERCLA is to address major hazardous-waste issues and to
protect the public from emergency releases of hazardous substances; however, as
discussed by Zirschky et al. [1987] and Zirschky [1990], several sections of CERCLA and
SARA provide, at least indirectly, protections against workers’ home contamination
(Table 17). These protections are inferred from the: broad definitions of "facility,"
“hazardous substance,” "release," and “pollutant or contaminant”; and the authority
assigned to EPA and to the Agency for Toxic Substances and Disease Registry (ATSDR)
to designate hazardous substances, respond to releases of hazardous substances, and
perform health assessments near hazardous-waste sites.

Under the CERCLA provisions, two occupational groups have been identified that are at
enhanced risk of workers’ home contamination. The first occupational group consists of
workers who remediate (i.e., "clean up") hazardous-waste sites; this workforce is both
large and highly mobile. Remediation work involves exposure of workers’ protective
clothing to chemical contaminants, and these contaminants can be carried to workers’
homes unless adequate workplace safeguards are in place. The second occupational
group is composed of chemical-emergency responders. ATSDR data indicate that
chemical emergencies are frequent, and often result from industrial-plant mishaps,
transportation accidents, and improper disposal of chemicals. Emergency responders can
transport chemical contaminants into the home unless clothing changes and other
safeguards are effected.

The worker protection standards [29 CFR 1910.120 and 40 CFR 311] required under §
126 of SARA have provisions for changing and decontaminating work clothing, providing
change rooms, and showering before leaving a hazardous-waste site. Adherence to these
requirements should prevent home contamination by hazardous-waste workers.

Constraints incorporated into CERCLA reduce the likelihood that incidents of workers’

home contamination will be addressed extensively by either EPA or ATSDR. These
constraints include: in responding to hazard-waste releases, the highest priorities must be

81


examination; 3 of the solid ingestions and 5 of the liquid caustic ingestions
resulted in second degree esophageal injury.

A farm-injury study by the Marshfield Medical Research Center in Wisconsin
identified nine cases of children being admitted/treated by one hospital for
injuries associated with caustic farm products during February 1990 through
October 1992. Four cases were from ingestion of caustic dairy pipe line cleaner
by children, four were eye injuries from caustic cleaners, and one was a skin burn
from liquid dairy pipe line cleaner [Young 1994].

Edmonson [1987] provided reports on 10 cases which occurred over a period of 10
years presenting to 4 Wisconsin hospitals. All 10 cases for farm children involved
liquid dairy pipe line cleaner (sodium hydroxide or potassium hydroxide). The 10
cases were equally distributed among sexes (5/5), ages 1-3 years. The 10 cases
occurred in the milkhouse or barn and parents were present in 6 of 9 cases. In 8
of the 10 cases the type of container from which the liquid caustic was ingested
was a beverage container (soda bottles and glasses). Of the 10 cases, 2 resulted in
esophageal stricture and perforation, some of the most serious complications of
caustic ingestions.

Within a 6-month period (December 1990-May 1991) one hospital in rural mid-
state Pennsylvania reported four incidents of dairy pipe line cleaner poisonings
[Geisinger Medical Center 1991]. One incident resulted in the death of a 17-
month-old child and esophageal stricture and perforation in a 2%-year-old child.

Four cases of caustic dairy pipe line cleaner ingestion by children were identified
from the Milwaukee Childrens Hospital (Wisconsin) Trauma Registry from March
1993 until January 1995 [Pelegrin 1995}.

Finally, agricultural trade magazines periodically report incidents which have
involved dairy pipe line cleaner poisonings [Leach and Leach 1992; Jorgenson
1990].

PESTICIDES
Overview
Reports of several fatal cases of pesticide poisoning as well as several serious non-
fatal cases in workers’ children and a few cases of poisonings in adult contacts are
reviewed in this section and summarized in Table 11.

Five reports of pesticide poisoning by workers’ family members relate to
contamination introduced into their houses from the workplace. Other reports
are of incidents of poisoning resulting from farm children playing with improperly
stored or discarded containers or equipment. Two other reports are of incidents
resulting from workers transporting items from the workplace to the residential
area. Although most of the reports are dated 1980 or before, the three reports

17


‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

[42 U.S.C. § 9601 et
seq]

(©) Investigations, monitoring, etc., by President

(1) Information; studies and investigations

‘Whenever the President is authorized to act pursuant to subsection (2) of thi section or
whenever the President has reason to believe that a release has occurred or is about to
occur, or that illness, disease, or complaints thereof may be attributable to exposure to a
hazardous substance, pollutant, or contaminant and that a release may have occurred or
be occurring, he may undertake such investigations, monitoring, surveys, testing, and other
information gathering as he may deem necessary or appropriate to identify the existence
and extent of the release or threat thereof, the source and nature of the hazardous
substances, pollutants or contaminants invotved, and the extent of danger to the public
health or welfare or to the environment, In addition, the President may undertake such
Planning, legal, fiscal, economic, engineering, architectural, and other studies or
investigations as he may deem necessary or appropriate to plan and direct response
actions, to recover the costs thereof, and to enforce the provisions of this chapter.

(€) Information gathering and access; action authorized, access to information, entry,
inspection and samples; authority and samples, compliance orders; issuance and
compliance, other authority, confidentiality of information; basis for withholding

(1) Action authorized

Any officer, employee, or representative of the President, duly designated by the
President, is authorized to take action under paragraph (2), (3), or (4) (or any
combination thereof) at a vessel, facility, establishment, place, property, or location or, in
the case of paragraph (3) or (4), at any vessel, facility, establishment, place, property, or
location which is adjacent to the vessel, facility, establishment, place, property, or location
referred to in such paragraph (3) or (4). Any duly designated officer, employee, or
Tepresentative of a State or political subdivision under a contract or cooperative
agreement under subsection (4){1) of thia section is also authorized to take such action.
The authority of paregraphs (3) and (4) may be exercised only if there is a reasonable
basis to believe there may be a release or threat of release of a hazardous substance or
pollutant or contaminant, The authority of this subsection may be exercised only for the
Purposes of determining the need for response, or choosing of taking any response action
under this subchapter, or otherwise enforcing the provisions of this subchapter.

(2) Access to information
Any officer, employee, or representative described in paragraph (1) may require any
person who has or may have information relevant to any of the following to furnish, upon
reasonable notice, Information or documents relating to such matter:

(A) The identification, nature, and quantity of materials which have been or are
generated, treated, stored, or disposed of at a vessel or facility or transported to a vessel
of facility.

(B) The nature or extent of a release or threatened release of a hazardous substance or
pollutant or contaminant at or from a vessel or facility.

(C) Information relating to the abitity of a person to pay for or to perform a cleanup.
Tn addition, upon reasonable notice, such person either (i) shall grant any such officer,
employee, or representative access at all reasonable times to any vessel, facility,

establishment, place, property, or location to inspect and copy all documents or records

228



Federal Insecticide
Fungicide, Rodenticide Act

Public Law

Public Law 92-516

Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

[7USC. $136]

‘Sections Relevant to Workers’ Family Protection

(3) Solld Waste Dispoeal Act
Nothing in the subsection shall affect the authorities or requirements concerning pesticide
containers under the Solid Waste Disposal Act (42 U.S.C. § 6901).

(g) Pesticide container study
(1) Study

(A) The Administrator shall conduct a study of options to encourage or require-

(i) the return, refill, and reuse of pesticides containers;

(ii) the development and use of pesticide formulations that facilitate the removal of
pesticide residues from containers; and

(iit) the use of bulk storage facilities to reduce the number of pesticide containers
requiring disposal,

(B) In conducting the study, the Administrator shall-

(i) consult with the heads of other interested Federal agencies, State agencies, Industry
groupe, and environmental organizations; and

(il) assess the feasibility, costs, and environmental benefits of encouraging or requiring

various measures of actions.

224


Zirschky J, Witherell L [1987]. Cleanup of mercury contamination of thermometer
workers’ homes. Am Ind Hyg Assoc J 48(1):81-84.

142


Appendix 5.
Glossary


et al. 1985, 1987]. Mercury concentrations in the air of living areas in the
workers’ homes were 0.02-10 ug/m’ compared to 0.01-1 »g/m’ in control homes.
While measurements of clothing contamination were not made, the authors
noted that elevated mercury concentrations were found in places where work
clothes and shoes were located and in some washing machines.

Workers exposed to high concentrations of mercury during a maintenance
operation in a chlor-alkali plant did not shower at the end of the day, and took
their work clothing and tools, which were visibly contaminated with mercury,
home in their private cars [ATSDR 1990a]. The clothing was washed at home,
and the highest concentrations of mercury in the homes were found in the air
over washing machines (54 yg/m’) and sinks (7 ug/m*). The mean
concentration of mercury in living room air of the 45 contaminated homes was
0.92 g/m? (range 0.1-5.0 xg/m’).

While these studies [Zalesak 1994; Hudson et al. 1985, 1987; ATSDR 1990(a)]
did not quantitatively measure mercury contamination of clothing, the findings
of high levels of contamination in areas where work clothes were located and in
washing machines provide evidence that clothing was a source of the home
contamination.

Estrogens

Measurements of home contamination by estrogenic substances were not found.
However, the reports reviewed in this section on documentation of clothing
contamination and the effectiveness of measures to prevent home
contamination by soiled clothing, support the assumption of clothing as a source
of the contamination.

While investigating a pharmaceutical manufacturing plant where children had
developed gynecomastia, Aw et al. [1985] found that clothing wom by one of
the mothers contained 32 mg of zeranol, a compound with estrogenic
properties. The mother washed her clothing at home. Other workers from the
plant whose children were similarly effected had also washed their work clothes
at home. Specificity of the toxic response together with the documentation of
clothing contamination provides evidence of clothing as a source of the
children’s toxic responses.

Workers engaged in manufacturing diethylstilbestrol wore their soiled clothes
home and their children developed signs of estrogen poisoning
[Katzenellenbogan 1956]. When controls (special shoes and clothing, showers
and laundry) were instituted to prevent home contamination, the health effects
were alleviated, providing a basis for the assumption that taking contaminated
clothing home was the source of the problem.

42


FEDERAL AGENCY

Table 19. (Continued) Federal Agency Involvement in Incidents of Workers’ Home Contamination and Related Activities

RESPONSE

Bridbord [1980]

Book Chapter - Lead exposure, The author points out that lead adversely affects sperm, and the fetus; that lead can be brought home as dust on shoes, clothing,
and body; and that elevated blood levels have been found in children of workers exposed to lead (e.g. battery manufacturing).

Clapp et al, (1985)

Aw et al. [1985]

Seixas and Ordin [1986]

Blsenbud and Lisson (1983]
Piacitell! and Rice (1993)
CDC [19928]

Knishkowy and Baker [1986]

Hartle et al. [1987]

Ehrenberg et al, [1986]

Godbey et al. [1987]

Gunter et al. (1987]

Steinmetz & Sons, Moscow, Pennsylvania, Workers in this factory were exposed to MOCA. It was recommended that workers get clothing from company that is
laundered daily and not worn home, use shoe covers, and shower before leaving work,

Manufacturing Chemists, Inc., Indiana, An animal growth promoter (estrogenic) was found in worker's clothing which were laundered at home. Extensive
recommendations were made to prevent home contamination,

Friction Division Products, Trenton, New Jersey. In this plant in which auto and truck break shoes were manufactured, samples from workers’ clothing as they
left the plant showed asbestos, raising potential for home contamination,

Update of Beryllium cases - Up to 1983 no new cases of berytliosis had been reported since 1950,
Measured lead levels in radiator repair shop workers’ clothes, and vehicles.

CDC's MMWR report on lead exposures among lead burners, Wipe samples were taken from changing room, toe of workboot, and floor under auto gat pedal.
BLLs of family members of 2 workers were measured. The company implemented additional hygiene practices,

Journal article. Contamination routes between work and home, types of illnesses that resulted, and preventive measures are discussed,

Aluminum Company of America, Lafayette, Indiana, Investigation of exposure to PCBs. It was recommended that exposed personnel be provided with protective
equipment, including company-laundered coveralls, change rooms, and showers.

Staco, Inc., Poultney, Vermont. Thermometer manufacturing plant. NIOSH trailer where tests were given became contaminated with mercury, suggesting possible
home contamination.

Evaluation of brakedrum service controls at Postal Service in Nashville, Tennessee. Some workers took asbestos-soiled clothes home to wash. Only 1/4 of
workers used shower facilities regularly, and 2/8 did not change out of work clothes before going home. Recommended education about personal hygiene.

Bondar-Clegg, Lakewood, Colorado & Spark's, Nevada, Lead exposure in five-assay labs, Recommended showering and changing clothes and shoes before
leaving work.

244



Carvatho et al.
1986}
Brazil

Cadmium

Table 14. (Continued) Health Effects of Take-Home Exposure to Other Substances:

Lead smelter

Cohort of 396
children ages 1-9
years tiving less than
900 m from primary
lead smelter,

Geometric mean and standard deviation
of CdB were 0.087 and 2.5 g/L resp.,
range 0,004-0.511

380 children (96%) had CdB > than
0.0089 g/L

‘The relationship between parental
‘employment in the smelter and
children's C4B levels was not significant,
but the CAB level was significantly
(0.0001) higher among children living in
households in which "smelter dross" (an
industrial residue obtained from lead
ore containing variable content of Cd
and used for paving) was present, than
in children in whose households smelter
dross was not found, Higher C4B was
significantly (0.00001) associated with
shorter distance from home to smelter.

Brockhous et al.

(1988)
Stolberg

Cadmium

Lead and zinc smelters

Cohort of 9 children
from families of lead
workers and 195
children from other
families, ages 4-17
years,

Children from families of lead workers
(n= 5) had significantly higher GM
CdU of 0.34 (GSD 2.6) than children
from other families whose GM CU was
0.13 (GSD 2.2), p< 0.01.

CAB among children from families of
lead worker were higher than in children
from other families but the difference
was not statistically significant.

Carvalho et al.
(1989)
Brazil

Cadmium

Lead smelter

Cohort of 263
children 1-9 years old,
living less than 900 m
from lead smelter.
Measured cadmium in
hair.

The mean cadmium in hair was
significantly (P<0.0001) higher at 6.0
ppm for children whose fathers worked
in the lead smelter than for children
whose fathers had other jobs (3.7 ppm).

181



GLOSSARY

mucous membranes - membranes that line the passages and cavities of the body which
communicate directly or indirectly with the exterior.

mycoplasma - small organisms that grow within host cells. They are similar to bacteria but their

cell walls are less complex. Mycoplasma are often associated with a relatively mild type of
pneumonia.

necropsy - autopsy; an examination of the organs of a dead body for the purpose of determining the
cause of death or of studying the pathologic changes present.

nephropathy - any disease of the kidney.

paralysis - loss of power of voluntary movement in a muscle through injury or disease of its nerve
supply.

parasites - an organism that lives on a different organism without contributing anything to the
survival of the host. Human parasites may be classified as protozoa, helminths (worms), mites, and
lice.

parenchymal - relating to the specific tissue of a gland or organ, contained in and supported by the
connective tissue framework, or stroma.

parturition - the act of giving birth.
pathogen - any virus, microorganism, or other substance causing a disease.
pericardial - surrounding the heart; relating to the membrane surrounding the heart (pericardium).

peritoneal - the membrane lining the abdominal cavity and covering most of the organs contained in
the abdominal cavity.

pharyngitis - inflammation of the throat (i.e. the area of the gastrointestinal track between the
mouth and the esophagus).

pleura - the membrane surrounding the lungs and lining the walls of the thoracic (chest) cavity.
pleural plaques - a patch or small differentiated area on the pleura.

protozoa - normally found as a microscopic single celled organism. Also, grows in colonies and
exhibits some features of lower level animals. Malaria and amebiasis are examples of parasitic
diseases in humans caused by protozoa.

Q fever - a febrile disease due to infection with the rickettsiae Coxiella burnetii.

radiographic - pertaining to X-ray imaging.

rhinitis - inflammation of the nasal mucous membrane.

280


Marriott D [1994]. Letter of March 4, 1994 re: hazardous waste workers’ home
contamination in Maine to CDC/NIOSH. Available in Cincinnati, OH: Docket Office,
Education and Information Division, National Institute for Occupational Safety and
Health, Centers for Disease Control and Prevention, Public Health Service, U.S.
Department of Health and Human Services. 2 pages.

Martensson G, Hagmar B, Zettergren L [1984a}. Diagnosis and prognosis in malignant
pleural mesothelioma: A prospective study. Eur J Resp Dis 65:169-178.

Martensson G, Larsson S, Zettergren L [1984b]. Malignant mesothelioma in two pairs
of siblings: Is there a hereditary predisposing factor? Eur J Resp Dis 65:179-184.

Martin AE [1974]. Epidemilogical surveys in the vicinity of lead works. Proc R Soc
Med 67(2):165-167.

Martin AE, Fairweather FA, Buxton RStJ, Roots LM [1974]. Recent epidemiological
studies of environmental lead of industrial origin. In: Proceedings of the International
Symposium—Recent Advances in the Assessment of the Health Effects of Environmental
Pollution. Vol H. Luxembourg, Commission of the European Communities. pages
1113-1122.

Masek V, Jach Z, Kandus J [1972]. Content of 3,4-benzo(a)pyrene in the
working clothes and underwear of workers at a pitch coking plant. J Occup Med
15(7):548-551.

Matte TD, Burr GA [1989]. Health Hazard Evaluation Report: Technical assistance to
the Jamaican Ministry of Health, Kingston, Jamaica. Cincinnati, OH: U.S. Department
of Health and Human Services, Public Health Service, Centers for Disease Control,
National Institute for Occupational Safety and Health, NIOSH Report No. HETA 87-
371-1989. 30 pages.

Matte TD, Figueroa JP, Ostrowski S, Burr G. Jackson-Hunt L, Baker EL [1991]. Lead
e from conventional and cottage lead smelting in Jamaica. Arch Environ Contam
Toxical 21(1):65-71.

Matte TD, Figueroa JP, Ostrowski S, Burr G, Jackson-Hunt L, Keenlyside RA, Baker EL
[1989]. Lead poisoning among household members exposed to lead-acid battery repair
shops in Kingston, Jamaica. Int J Epidemiol 18(4):874-881.

May G, [1973]. Chloracne from the accidental production of tetrachlorodibenzodioxin.
Br J Ind Med 30(3):276-283.

McCammon C, Daniels W, Hales T, Lee S [1991]. Health Hazard Evaluation Report:

New England Lead Burning Co. (NELCO) Eaton Metals, Salt Lake City, Utah.
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service,

126


bone lead levels will eventually provide a more accurate method for determining
cumulative lead exposure and the total body burden of lead. However, the best
available method for evaluation of the current biological exposure to lead is
measurement of the BLL.

The toxic responses to lead at various BLLs differ somewhat for children and
adults [ATSDR 1988; EPA 1986]. In children, BLLs greater than 80 zg/dL may
result in coma, convulsions, profound irreversible mental retardation, seizures, and
death. At BLLs greater than 40 ug/dL, the effects include reduced hemoglobin
synthesis and peripheral nerve dysfunction. At BLLs greater than 25 yg/dL,
lower IQS and slower reaction times occur; and BLLs as low as 10 ug/dL may
result in deficits in neurobehavioral development and enzyme inhibition.
Evidence also indicates that children exposed in utero are at increased risk for
adverse neurobehavioral and growth effects if their mothers’ BLL is as low as 8
ug/dL and the umbilical cord BLL-at birth is greater than about 6 ug/dL. The
Centers for Disease Control and Prevention (CDC) defines pediatric lead
poisoning as a BLL of 10 wg/dL or higher [CDC 1991].

In adults, BLLs at or above 100-120 xg/dL may result in encephalopathic signs
and symptoms and chronic nephropathy. At BLLs greater than 80 wg/dL, frank
anemia may occur. At BLLs greater than 40 zg/dL, adults may experience
interference with hemoglobin metabolism, peripheral nerve dysfunction, and male
and female reproductive system effects, and at BLLs as low as 10 ug/dL, enzyme
inhibition and elevated blood pressure may develop.

Review of Studies of Blood Lead Levels

Exposure of lead workers’ families was identified in nearly thirty different
industries/occupations. The industries in which exposure of family members has
been reported most often include: lead smelting, battery manufacturing/recycling,
radiator repair, electrical components manufacturing, pottery/ceramics, and
stained glass making. Family members exposure to lead has rarely been reported
in construction (two case reports, one published). In part, this may be due to the
fact that prior to June of 1993, the construction industry was exempt from the
Occupational Safety and Health Administration (OSHA) lead standard and was
therefore relatively unregulated and understudied. A NIOSH study of lead
exposure among families of construction workers in New Jersey is currently
underway; preliminary findings suggest that children of construction workers are
at increased risk of BLLs greater than 10 ug/dL [Whelan and Piacitelli 1995].

The cohort studies (Table 7) selected households on the basis of exposure (e.g., a
lead worker lived in the household) and BLLs in the exposed group were
compared to households where no one worked with lead. The community studies
(Table 8) were designed to screen for elevated BLLs among residents near a lead
industry, usually a lead smelter. Community studies were included in this review
if investigators also compared BLLs in families of workers to those of other

13


Asbestos

Asbestos-contaminated cotton cloth bags that had been used to transport molded
asbestos insulation were taken home by a worker and used as diapers [Li et al.
1989]; three family members died of mesothelioma at an early age. It should be
noted that dirty clothes were also brought home.

Lead

Lead-contaminated cloths from discarded pollution control filters at a lead
smelter were taken home by workers for use at home [Carvalho et al. 1984]. The
children of these lead workers had a mean BLL of 67.5 ug/dL. In another case,
discarded lead battery casings were taken home for fuel by a worker engaged in
recovering lead from used batteries [Dolcourt et al. 1981]. The battery casings
were burned in the family’s wood-burning stove. House dust contained up to
43,281 ppm of lead; one child had a BLL of 220 4g/100 mL and developed
encephalopathy with seizures. Osorio [1994] reported that when lead
contaminated telephone poles were taken home for fire wood by a worker, the
soil in the yard of the worker’s home where the poles were located contained lead
at 1,500-1,600 ng/dL.

Pesticides

Toxaphene-contaminated metal brought home from a processing plant resulted in
the death of 2-year-old boy [McGee et al. 1952]. The metal, which consisted of
flattened strips made from drums that had contained toxaphene, was used to
cover the walls of a tool shed on the day the child, who played in the area, was
poisoned. In another case, a loaded company truck was parked in an employees
driveway overnight [Barnett 1994]. Part of the load was chloropicrin which leaked
from the vehicle, poisoning the next-door neighbors.

Estrogens

Diethylstilbestrol poisoning of family members was considered by Pacynski et al.
[1971] to be due in part to women bringing home contaminated factory-supplied
milk which was consumed by the children.

Radioactive Substances

Radioactive waste lumber was used to construct a garage at home by a worker
engaged in the manufacture of catalysts containing depleted uranium. About 20
years later the garage was found to be contaminated in excess of NRC release
criteria [Brockman 1993].

COTTAGE INDUSTRIES

Cottage industries, those where work is undertaken in the same building or on the
property where the family resides have been recognized as a hazard since at least
1914 [Oliver 1914]. Poisonings by asbestos, lead, parathion, and mercury have
occurred in cottage industries.

45


Table 9. (Continued) Health Effects of Take-Home Lead Exposure (Case Reports/Case Serics)

Study Design

a

tempering and 27.6 va, 11.7 ug/dL for
type-printing households).

Richter et al. [1980] Polyvinyl chloride Case series Workers’ mean BLL was 27.6 yg/dL.
(PVC) factory 13 Workers (6 spouses, 12 children) Mean BLL was elevated among children

(12.3 g/dL) but not among spouses
(Bug/dL). Mean BLL In 4 children
whose fathers showered and changed
before leaviig work was significantly
lower at 10.3 ug/dL (9.2-12.0 ug/4L) than
in children whose fathers did not (14,7
range 100-200 wg/dL), Child with BLL
of 20 yg/dL had hemoglobin of 11.2
3/41, One wife had BLL of 6 ug/dL,
free erythrocyte protoporphyrin in red
blood cells of 124 yg/4L and hemaglobin
9.4 g/dL.

Dolcourt et al. {1981} North Battery factory Case report All children had BLLs over 30 g/dL. Discarded battery casings were
Carolina, (Family 1) The highest observed levels were in a 3- burned as fuel in home. Used
USA 1 Worker year-old male (256 ug/dL) and a 3-year capillary sampling. Basophille

22 Exposed family members old female (220 ng/4L). Erythrocyte stripping of red blood celis in
protoporphyrin of 400 hemoglobin 6 and 7 family members 15 months-9
9.9, Erythrocyte protoporphyrin was > years old, Metaphyseal
100 in 10 children. 20-year-old woman encephalopathy and lead lines
had BLL of 52 ug/dL. in 15-month-old. Erythrocyte
protoporphyrin 313 and 404,
(Family 2) 2 children age 7 and 16 months had BLLs hemoglobin 9.6 and 10.4,
1 Worker of 64 and 63 wg/dL, respectively.
6 Exposed family members Worker was operating illicit
4 women had BLLs of 24-46 ug/dL. battery recycling in home.
16-month-old had erythrocyte Used capillary sampling.
protoporphyrin of 252.
16month-old hed hematocrit
of 38.
Kawai et al, [1983] Japan Cutlery tempering Case series Children < age 12 had higher mean BLL 2 children had excessive
and type printing 62 Family members from 15 expoted levels than family members not doing 8-aminolevulinic acid in urine;
(at home) households lead work (21.8 ve. 13.7 1g/dL for cutlery 2 children had excessive

coprotoporphyrin In urine.

168


Anne Sergeant, MES.

Environmental Scientist

Exposure Assessment Group (8603)
Office of Health and Environmental
Assessment

Office of Research and Development
US. Environmental Protection Agency
401 M Street, S.W.

Washington, D.C. 20460

Gary Timm, M.S.

Environmental Scientist

Chemical Control Division (7405)
Office of Pollution Prevention & Toxics
US. Environmental Protection Agency
401 M Street, S.W.

Washington, D.C. 20460

Raji Tripathi

Division of Safety Programs

Office for Analysis and Evaluation
of Operational Data

US. Nuclear Regulatory Commission
Washington, D.C. 20555

Andrea Yang, B.S.

Environmental Protection Specialist
Program Development Branch
Chemical Management Division (7404)
Office of Pollution Prevention & Toxics
US. Environmental Protection Agency
401 M Street, S.W.

Washington, D.C. 20460

Margie E. Zalesak, CLH.

Chief of Health Division

Mine Safety and Health Administration
US. Department of Labor

Arlington, Virginia 22203

276


‘Table 11. Health Effects of Take-Home Pesticide Exposure

#/RELATIONSHIP

COMMENTS AND ISSUES

2yearold son died after playing in yard where storage barn had been built from

McGee et al, Chemical Processing. Toxaphene poisoning 1Son

[1952] Plant (convulsions or death) strips of metal taken from drume that had contained toxaphene. The metal was

USA Toxaphene taken home from a processing plant,

Parming 1 Son 17-month-old son died after drinking from tin cup containing toxaphene while his
father was mixing a spray for tobacco,

1 Son 2-year-old ton recovered from convulsions after drinking toxaphene while his
mother was working in a cotton field,

Johnston Farming Acetylcholinesterase 1 Daughter 9-month-old daughter died after playing with a can containing parathion which

(1953) Parathion inhibition (nausea to her father had discarded in the yard,

Washington death) 1 Son, 1 daughter 2Y-yearold son and his S-year-old sister played with sacks containing powdered
parathion, Boy became ill, was hospitalized, and recovered. Girl had no
symptoms.

2 Sons 23-month-old son and his 3-year-old brothers played with a can of parathion that
they found in thelr basement, Only the younger boy had an acetyicholinesterase
test indicating serious poisoning. The younger boy was hospitalized and
recovered. The older boy showed no symptoms,

Simon Farming Acetylcholinesterase 1 Son 4-year-old son was poisoned after playing with a bag of parathion in the bam on

{1963} Parathion inhibition (Coma and his family's farm.

Washington convulsions). Recovered,

MacMillan Farming Acetyicholinesterase 1Child 2-year-old boy was poisoned after he smeared the remaining contents of "an

[1964] Parathion inhibition (respiratory empty jar* of parathion that he found in the barn over his face and lips.

Canada distress, semi-coma).

Recovered.

Ororio Farming Risk of 3. Children < $ years of age Diazinon, chlorpyrofos, and propoxur were found at elevated levels in homes of

(1994) Diazinon acetyicholinesterase farmworkers, Of the farm workers’ children, 3 had diazinon at $2-220 ng and 2

California Chlorpyrofos inhibition by diazinon Of these had chlorpyrifos at 20-100 ng on their hands. No pesticides were found

Propoxur on hands of children of non-farmworkers,

West Crop spraying by Acetylcholinesterase 1Yeyearold daughter Father came home after spraying a crop and cleaned his boots with paper towels,

1959] airplane. Demeton inhibition He threw the towels in the waste basket and placed his boots in the bathroom,
His daughter either contacted the boots or the paper towels,

Eitzman and Wolfton | Farming Acetyicholinesterase Deaths of 30 children between 1959 and 1964 were reported due to parathion

[1967] Parathion inhibition: Death exposure mainly because of adult misuse, or improper storage or disposal

Florida practices included in the report were:

$ Children Children ages 1-5 years ingested parathion stored in Improper containers, such as
soft drink bottles.

6 Children Children aged 9 months-10 years ate parathion that they found on the floor or
window sill where it had been placed to kill roaches.

7 Children Children aged 1-9 years inhaled or had skin contact with parathion powder, 3 of

these children were siblings who died after playing on a swing that they made
from a burlap sack heavily contaminated with parathion,

174


assigned to releases that present the largest public health threat [42 U.S.C. 9604]; and
specification of strict criteria for determining these priorities [42 U.S.C. 9605]. Criteria
to be considered in determining these priorities are the: population at risk; harmful
effects of toxic substances located at hazardous-waste sites; likelihood that these
substances have contaminated, or will contaminate, drinking water; and the potential for
direct human contact with these substances.

Under these provisions, the following rules have been promulgated: 40 CFR 300, which
resulted in the National Priorities List consisting of high-priority, hazardous-waste sites;
and 40 CFR 302, which specifies hazardous substances and the reportable-release
quantities of these substances (i.e., quantities of hazardous substances that, if released,
may be harmful to public health and/or the environment and must, therefore, be
reported to the National Response Center). While these constraints may limit EPA and
ATSDR in prevention and control of workers’ home contamination, recent case law
indicates that State and Federal courts may provide an alternate vehicle for addressing
this issue under CERCLA and SARA”

Although decontamination of workers’ homes is not addressed directly under any of the
above-mentioned rules, some hazardous-waste sites (Alaska Battery Enterprises,
Anderson Development Company, and Borfos Nobel, Inc.) designated on the National
Priorities List have been identified as sources of workers’ home contamination. As EPA
and ATSDR conduct studies at other sites on the National Priorities List, additional
cases of workers’ home contamination may be found. Many of the chemicals noted in
previous chapters as being involved in workers’ home contamination are on the priority
list of hazardous substances [40 CFR 302], and these chemicals typically have low
reportable-release quantities (ie., 1-10 pounds).

REVIEW OF STATE LAWS

NIOSH requested information (Appendices 2 and 3) on State and local laws that were
relevant to preventing workers’ home contamination. The responses from State agencies
to these requests are summarized in Tables 20 and 21. Agencies from 30 States and
Puerto Rico responded to this request; these responses also are summarized in Tables 20
and 21. Eleven States and Puerto Rico replied that no statutes or mules related to
workers’ home contamination currently are in force. Arizona, California, and Idaho
reported that laws existed for reporting elevated blood-lead levels and/or pesticide
poisonings. Michigan, Maine, and Pennsylvania reported on laws, similar to CERCLA,
that regulated hazardous-waste sites and the emergency response to hazardous-chemical
releases. Oregon wrote that, while no laws or regulations dealing directly with workers’

"In Vermont v. Staco, Inc, [1988], the court awarded the plaintiffs (the state of Vermont and the village
of Poultney) nearly $74,000 in damages for decontamination costs incurred by the plaintiffs in responding to
a release of mercury from the defendants’ thermometer-manufacturing facility into Poultney’s sewer system.
In finding the defendants liable, the court stated that “the defendants released mercury to the environment
through the movement of workers to and from the._facility in [the village of} Poultney.”

82


‘Author (year)

Table 2 Health Effects of Take-Iome Asbestos Exposure (Cohort Studies)

Anderson
11983}
Anderson et al.
[1976, 19798,
19790)

Patterson, New Jersey

Amosite workers employed
1941-1945 in thermal
insulation materials factory

Cohort study.

Morbidity and mortality among
2,218 household contacts of amosite
workers identified. 679 of 1,545
alive through 1980 were examined,
Occupational, residential, smoking,
medicat history questionnaire
administered to the exposed cohort.
Vitat status follow-up is through
1980.

Radiographs were taken 20+ years
after first exposure. For
radiographic analysis, a frequency
matched (age, gender) control group
was assembled of 326 unexposed
people from the same urban New
Jersey community who presented for
chest radiograph 1975-1976.

3/663 observed deaths were due to mesothelioma.

Lung cancer overall SMR«= 152 (25 observed/16.4 expected)
after 20 years latency SMR=185. Among females, there were 8
respiratory cancers observed vs. 6.4 expected. Excess risk was
confined to those with 20+ years latency (8 observed vs, 4.7
expected, SMR=170. Among males with 20+ years latency,
there were 12 lung cancer deaths observed vs. 6.1 expected
(SMR#=197).

Increased frequency of asbestos-associated radiographic
abnormalities among household contacts. Prevalence of
radiographic abnormality associated with secondary exposure
was 35% vs. 5% expected based on the comparison population
(p<0.001). Prevalence of abnormalities increased with duration
since first exposure; 40% prevalence among those with longest
latency (p<0.01). ‘Those with 10+ years of household exposure
had « prevalence of abnormal radiographs of 53%. For 1971
ILO classification 1/1 and greater, a prevalence of 10.3
observed vs. 0.6% in controls,

Prevalence of parenchymal or pleural abnormality 20+ years
after first household exposure (1979b): 48% among wives, 21%
among daughters, 42% among sons, and 37% among siblings.

Mesothelioma deaths
occurred 20+ years after
childhood domestic exposure
(2 female; 1 mate). There
were 2 additional
mesotheliomas among
children of workers that
were excluded from analysis.

Dust from work clothes,
shoes, hair assumed causal.
No changing facilities at
factory.

Magnani et al.
[1993]

Italy

Asbestos cement workers

Retrospective cohort mortality study
of 1,964 wives of asbestos cement
workers; cohort had no history of
occupational exposure. Husbands
employed 1950-1985; deaths
occurred 1965-1988,

Between 1965-1988, there were 4 pleural tumors (1
mesothelioma) observed vs. 0.5 expected; 6 lung cancer vs. 4.0
expected. Expected based on local rates. Among women with
domestic exposure, cancer of the pleura was significantly
elevated SMR= 792.3 (95% CI 215.9 - 2,028.8).

145

This plant had no laundering
facilities, and work clothes
were laundered at home,

All 6 cases reported more
than 10 years of exposure.
‘There were 2 additional
mesotheliomas observed.
after 1988,



Blaser MJ, Smith PF, Cody HJ, Wang WL, LaForce FM [1984]. Killing of fabric-
associated bacteria in hospital laundry by low-temperature washing. J Infect Dis
149(1):48-57.

Bohne J Jr., Cohen BS [1985]. Aerosol resuspension from fabric: Implications for
personal monitoring in the beryllium industry. Am Ind Hyg Assoc J 46(2):73-79.

Boyle J [1994]. Reports of February 1994 re: ORPS database submitted to Diana Ordin,
Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services.

Boyles S, Boggan WE [1994a]. SOEH Meeting: Nurse with MDR-Tb now. TBWeekly
December 12:2-4.

Branson D, Henry M [1982]. Take cover! East Lansing, Michigan, Michigan State
University Cooperative Extension Service, Department of Human Environment and
Design, Extension Bulletin E-1546. 1 page.

Braun HE, Frank R, Ritcey G [1989]. Removal of pyrazophos from treated fabric using
household laundering. Bull Environ Contam Toxicol 42:687-690.

Bridbord K [1980]. Low-level exposure to lead in the workplace. In: Needleman HL,
ed. Low level lead exposure: The clinical implications of current research. New York,
Raven Press. pages 267-278.

Briss P [1994]. Memo of October 14, 1994 re: take-home toxins to Denise Hill,
Education and Information Division, National Institute for Occupational Safety and
Health, Centers for Disease Control and Prevention, Public Health Service, U.S.
Department of Health and Human Services.

Brockhaus A, Collet W, Dolgner R, Engelke R, Ewers U, Freier I, Jermann E, Kramer
U, Manojlovic N, Turfeld M, Winneke G [1988]. Exposure to lead and cadmium of
children living in different areas of North-West Germany: Results of biological
monitoring studies 1982-1986. Int Arch Occup Environ Health 60:211-222.

Brockman K [1993]. Reports of November 1993 re: NRC databases submitted to Diana
Ordin, Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute
for Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services.

Budzynska A, Wasikowa R, Zajec J [1967]. Hyperestrogenism in children of workers

employed by the Polfa Pharmaceutical Wroks in Jelenia Gora] (in Polish). Pediatria Pol
42:411-417.

104


‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

[42 US.C. § 9601 et
tq]

‘Sections Refevant to Workers’ Family Protection

(B) Any vessel, facility, establishment, or other place or property from which or to which
a hazardous substance or pollutant or contaminant has been or may have been released.

(C) Any vessel, facitity, establishment, or other place or property where such release is
of may be threatened.

(D) Any vessel, facility, establishment, or other place or property where entry is needed
to determine the need for response or the appropriate response or to effectuate a
response action under this subchapter.

(4) Inspection and samples

(A) Authority
Any officer, employee or representative described in paragraph (1) is authorized to
inspect and obtain samples from any vessel, facility, establishment, or other place or
property referred to in paragraph (3) or from any location of any suspected hazardous
substance or pollutant or contaminant. Any such officer, employee, or representative is
authorized to inspect and obtain samples of any containers or labeling for suspected
hazardous substances or pollutants or contaminants. Each such inspection shall be
completed with reasonable promptness,

(B) Samples
If the officer, employee, or representative obtains any samples, before leaving the
premises he shall give to the owner, operator, tenant, or other person in charge of the
place from which the samples were obtained a receipt describing the sample obtained and,
if requested, a portion of each such sample. A copy of the results of any analysis made of
such samples shall be furnish promptly to the owner, operator, tenant, or other person in
charge, if such person can be located.

(i) Agency for Toxic Substances and Disease Registry; establishment, functions, ete.
(1) There is hereby established within the Public Health Service an agency, to be known
as the Agency for Toxic Substances and Disease Registry, which shall report directly to
the Surgeon General of the United States, The Administrator of said Agency shall, with
the cooperation of the Administrator of the Environmental Protection Agency, the
Commissioner of the Food and Drug Administration, the Directors of the National
Institute of Medicine, National Institute of Environmental Health Sciences, National
Institute for Occupational Safety and Health, Centers for Disease Contro! and Prevention,
the Administrator of the Occupational Safety and Health Administration, the
Administrator of the Sociat Security Administration, the Secretary of Transportation, and
appropriate State and local health officials, effectuate and implement the health related
authorities of this chapter. In addition, said Administrator shall~

(A) in cooperation with the States, establish and maintain a national registry of serious
diseases and illnesses and a national registry of persons exposed to toxic substances:

(B) establish and maintain inventory of literature, research, and studies on the health
effects of toxic substances;

229


fittings, some of which contained mercury, using oxyacetylene torches. The heated
mercury volatilized and condensed on the ceiling, walls, and floor, as well as on
the clothing of the workers. Although protective clothing was used, work gloves,
clothes, and boots which were soaked with mercury were taken home, exposing
family members. As a result of notification of EPA by a worker concerned about
his family, EPA and ATSDR evaluated the extent of exposure to mercury. They
found high levels of mercury in various areas of the workers’ homes but they did
not find elevated urine mercury levels among the family members.

Cases of mine workers’ homes being contaminated have been reported [West and
Lim 1968; Zalesak 1994]. However the reports do not address the impact of this
contamination on the health of the family members.

Severe cases of acute mercury poisoning of family members exposed during home
use of mercury to extract gold from’soil have been reported. These cases are
included because of their similarities to situations that may occur in cottage
industries.

e A husband and wife were exposed to mercury when the husband attempted
to extract gold from sand samples in the home [Haddad and Stenberg
1963). The husband’s symptoms included fever, chills, nausea, and
bronchitis; his urine contained mercury at 540 ug/L. The wife, who was in
an adjacent room during the extraction process, had mercury in urine at 80
ug/L.

. An amateur prospector was exposed to mercury when he heated gold sand
with mercury in a clay dish over the kitchen stove [King 1954]. The
prospector developed severe coughing, vomiting, and became cyanotic.

° A case of family mercury poisoning that occurred when the father
attempted to extract gold from sand was reported by Hallee [1969].
Approximately 30 mL of mercury accidentally spilled into a red-hot pan on
the stove. The father’s urinary excretion of mercury ranged from 200
ug/24 hr. to 560 yg/24 hr. over four days following exposure. The
symptoms of the children (who were asleep in another room) included
frequent coughing, fever, and nausea; their urine excretion of mercury
ranged from 33 4g/24 hr. to 94 4g/24 hr. on the day following exposure.
The mother who was in an adjacent room was also symptomatic, but urine
levels apparently were not checked.

e A woman was poisoned when she used mercury to extract gold ore in a
cast-iron ladle over her kitchen stove [Hatch 1990]. The woman indicated
that she had been told to perform the operation outside, but thought she
would be safe having a window open and a house fan over the kitchen
stove. After 3 weeks of chelation therapy, her blood mercury level was 193

23


chemical and physical properties including: 14 acetylcholinesterase inhibiting
insecticides (9 organophosphates and 5 carbamates); 5 organochlorine insecticides; 4
pyrethroid insecticides; 9 herbicides; and 1 fungicide. The studies were conducted
with various formulations including liquids, emulsifiable concentrates, encapsulated,
wettable powders, and water dispersible granules. Various fabrics were
contaminated, usually by laboratory procedures, to determine the effectiveness of
different laundry procedures. Fabrics of different weights and weaves (e.g., twill
denim, poplin) were chosen to represent clothing worn by exposed workers; they
included 100% cotton, various cotton polyester blends, and fabrics treated with soil
repellents. Most of the studies were conducted using an accelerated laundering
apparatus (Atlas Launder-Ometer), usually using 150 mL water. Laundry variables
studied included water temperature, detergent, and pre-wash treatment.

The various laundry procedures applied to pesticides removed from about 20% to
over 99% of the contaminant from the cloth, depending on pesticide characteristics,
clothing characteristics, and laundry variables.

Pesticide characteristics that make cleaning difficult include: (1) formulation as an
emulsifiable concentrate [Easley et al. 1981b; Kim et al. 1993; Laughlin and Gold
[1989a,b; Nelson et al. 1992; Laughlin et al. 1985; Easter 1983]; (2) high
concentration of pesticide [Easley et al. 1982a; Laughlin and Gold 1989a; Laughlin et
al. 1985]; and (3) low solubility in water (e.g., 1 mg/L) [Easley et al. 1983].
Repeated contamination without laundering after each use also makes it more
difficult to remove pesticides from clothing [Goodman et al. 1988].

Clothing characteristics that may influence the effectiveness of laundering include:
weight of the fabric, chemical composition of the fiber (e.g, cotton, wool, nylon,
polyester), and functional finishes (durable press, soil-release, and soil repellent).
Heavier fabrics, such as denim pants, may be more difficult to clean than lighter
ones, such as shirts [Kim et al. 1982}.

Most studies on the effect of chemical composition of the fibers have been with
various blends of cotton and polyester, ranging from 100% cotton to 65%/35%
polyester-cotton. The results of these studies are variable, and most of them have
found no effect with methyl parathion [Easley et al. 1981b; Easley et al. 1982b; Finley
et al. 1974; Goodman et al. 1988; Laughlin et al. 1985; Laughlin and Gold 1989a].
Finley and Rogillo [1969] studied fabrics worn in cotton fields the day after spraying
with a mixture of DDT and methyl parathion. They found that after-washing
residues of DDT were greater for 100% cotton and 65%/35% cotton-polyester
fabrics than for 50%/50% and 35%/65% cotton-polyester fabrics. The same was
found for methyl parathion but to a lesser extent. By contrast, Nelson et al. [1992]
found greater after-washing residues on 50%/50% cotton-polyester fabrics than on
100% cotton fabrics when organophosphates (methyl parathion, fonofos, and
terbufos) were the contaminants. In the same study, Nelson et al. [1992] found
residues greater on the 100% cotton fabric when carbaryl and atrazine were the

65


State agencies have investigated incidents of workers’ home contamination, made
referrals to Federal agencies for follow-up actions, and recommended workplace
improvements to prevent further contamination of workers’ homes.

Responses to incidents of workers’ home contamination include educational materials
such as those of the Lead Industries Association, Inc. on preventing workers’ home
contamination as well as responses of various employers to specific incidents of home
contamination.

Limitations of the Report

The health information available for the report, which includes incidents of illness and
home contamination obtained from public agencies and published literature, does not
provide a basis for estimating the prevalence of this public health problem.

The Workers’ Family Protection Act requires NIOSH to evaluate relevant information
about indoor air quality as it relates to workers’ home contamination and to study the
special circumstances of firefighters as they relate to contamination of their homes.

e The only report found on indoor air quality applicable to workers’ family protection
involved tetrachloroethylene exposures in living quarters located in the same building
as dry-cleaning establishments. Indoor air quality studies would be useful to protect
family members in cottage industries.

e Incidents of contamination of firefighters’ homes were not identified. However,
NIOSH has conducted several studies of contamination and decontamination of
protective clothing used by firefighters. These studies are reviewed in this report and
NIOSH will continue to pursue the issues related to potential contamination of
firefighters’ homes.

Other limitations of the report include:

e Little research has documented the frequency and distribution of health effects among
the families of workers in various industries and occupations. NIOSH is undertaking
one study addressing lead exposure among families of bridge repair workers.

e Lead and pesticides are the only contaminants for which monitoring or reporting
programs help to identify and prevent cases of poisoning from workers’ home
contamination.

e Despite various case reports, the prevalence of health effects from workers’ home
contamination is not known because there are no surveillance systems in place for
tracking or monitoring such health conditions.

e@ Many diseases have long latency periods between exposure and manifestation of the
disease, making identification and intervention difficult.

xii


PREFACE

The legislative directive (Public Law 102-522, Section 209, the Workers’ Family Protection
Act, [29 U.S.C. § 671a]) to conduct this study of contamination of workers’ homes by
substances carried home on workers’ clothing or bodies was enacted on October 26, 1992.
However, this is not a new problem. Holt [1923] cited two early studies of lead-workers'
families that were published in 1860 and 1896. Oliver [1914] reported on lead poisoning in
wives of house painters who washed their husbands' overalls, observations that resulted in a
series of laws in Great Britain to protect the workers' families from lead poisoning. Lead
poisoning continues to be a problem; this report cites about 65 incidents of lead poisoning
among workers' families. Of these, 35 are from the United States, 24 of which were reported
in the last 10 years.

Lehmann [1905] reported that the mother and child of a worker exposed to chlorinated
hydrocarbons developed chloracne (a condition similar to acne caused by certain chlorinated
chemicals) ascribed to the worker's contaminated clothing. Lehmann also wrote of a laundress
who developed chloracne as a result of washing the contaminated clothing of workers. Thirty
years after Lehmann's report was published in Germany, a similar case was reported by
Fulton and Matthews [1936] from the Pennsylvania Department of Labor and Industry. In this
case a child's father who was exposed to hexachloronaphthalene and chlorodiphenyl wore his
soiled clothing home from work. Additional cases of workers’ homes being contaminated with
chlorinated hydrocarbons have been reported in the last 10 years.

Prior to 1960, beryllium, toxaphene, mercury vapors, and diethylstilbestrol were also
identified as hazards to the families of workers. In the last 10 years, 10 additional chemical
substances have been identified in incidents of workers’ home contamination, as well as
allergens, radioactive materials, and infectious agents.

This report to Congress and the Workers’ Family Protection Task Force summarizes the
incidents of home contamination this study has discovered, including the health consequences,
the sources, and the levels of contamination. The report contains information on the
effectiveness of preventive measures and of decontamination procedures that have been used or
studied. The report summarizes the relevant laws and regulations and responses of Federal
and State agencies and industry to incidents of workers’ home contamination.

The report should be useful not only to Congress and the Workers’ Family Protection Task
Force in deciding future actions, but also to all who have responsibilities and concern for
protecting workers and their families from preventable illnesses.

Linda Rosenstock, M.D., M.P.H.
Director, National Institute for Occupational
Safety and Health

v


‘Table 19, (Continued) Federal Agency Involvement in Incidents of Workers’ Home Contamination and Related Activities

FEDERAL AGENCY RESPONSB
Environmental Protection
‘Agency (EPA)
ERM-Southeatt, Ine. This report contains @ protocol developed by an EPA contractor for monitoring and cleaning homes contaminated with mercury.
[1989]

Beegle and Forslund [1990]

Fisher [1991]

Ramsey [1987]

Hess (1988)

MacDonald [1988)

Price and Welch (1972]

Doherty [1984]

This report contains a protocol for cleaning homes contaminated with lead and asbestos.

In this text of EPA answers to follow-up questions from the Senate hearing on Lead in the Environment, EPA's recognition of home contamination with lead
from the workplace as a serious problem is stated. EPA is working cooperatively with OSHA and Labor groups to develop a research agenda for this tissue,
Although EPA's role is to identify research to minimize home exposure, EPA does not generally respond to specific home contamination incidents,

Tn this report of a Superfund site in Missouri, complete removal of dioxin contaminated soil and materials around homes and clean-up of home interiors is
described,

In this report of a Missouri Superfund site, removal and replacement of dioxin contaminated roads and decontamination of houses and businesses is described,
See Hess (1988) in Table 15,

In this report of a Missouri Superfund site, cleanup of mobile home park, including decontamination of mobile homes, contaminated with dioxin is described.

In this report on EPA supported testing of human adipose tissue samples for PCBs, the authors also reported on PCBs in the house dust of workers homes. See
Table 15,

In this report of a Missouri Superfund site, removal and replacement of a dioxin-contaminated roadway and decontamination of houses is described. See Table
15. :

242


Milne JEH, [1976]. Thirty-two cases of mesothelioma in Victoria, Australia: A
retrospective survey related to occupational asbestos exposure. Br J Ind Med 33:115-122.

Mobrman JH [1994]. Letter of March 9, 1994 re: workers’ home contamination in
Delaware to Ms. Diane Manning, Education and Information Division, National Institute
for Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 1 page.

Molina-Ballesteros G, Zuniga-Charles MA, Garcia-deAlba JE, Cardenas-Ortega A, Solis-
Camara P [1980]. Lead exposure in two pottery handicraft populations. Arch Invest
Med (Mex) 11(1):147-154.

Molina-Ballesteros G, Zuniga-Charles MA, Ortega AC, Solis-Camara RP, Solis-Camara
VP [1983]. Lead concentrations in the blood of children from pottery-making families
exposed to lead salts in a Mexican village. Bull Pan Am Health Organ 17(1):35-41.

Molovich JR [1991]. Letter of September 3, 1991 re: lead poisoning from contaminated
clothing to The Honorable James M. Jeffords (Vermont) from Deputy Commissioner,
Department of Labor, State of Indiana. Available in Cincinnati, OH: Docket Office,
Education and Information Division, National Institute for Occupational Safety and
Health, Centers for Disease Control, Public Health Service, U.S. Department of Health
and Human Services. 4 pages.

Morris D, Morris R [1992]. Childproof storage for dangerous chemicals. Hoard’s
Dairyman July 1992:508.

Morris D, Morris R [1993]. (No title). Farm Journal/Mid-March 1993:17.

Morton DE, Saah AJ, Silberg SL. Owens WL, Roberts MA, Saah MD [1982]. Lead
absorption in children of employees in a lead-related industry. Am J Epidemiol
115(4):549-555.

Murphy TD [1978]. Handling and decontamination guide for elemental mercury.
United States Army Environmental Hygiene Agency. Aberdeen Proving Ground,
Maryland. 19 pages.

Natarajan J [1994]. Lead exposure in radiator shops. Appl Occup Environ Hyg (4):237-
238.

Navratil M, Trippe F [1972]. Prevalence of pleural calcification in persons exposed to
asbestos dust, and in the general population in the same district. Environ Research
5:210-216.

Neidich G [1993]. Ingestion of caustic alkali farm products. J Peditr Gastroenterol Nutr
16(1):75-77.

128


Federal Register / Vol. 58, No. 218 / Monday, November 15, 1993 / Notices

60203

home on equipment, clothing, or the
worker's person. The specific objectives
of the Act are the following:

(1} To increase understanding and
awareness of the extent and impact on
health of hazardous chemicals and
substances transported from the
workplace to the home:

{2) To prevent or mitigate future
incidents of home contamination that
could adversely atiect the health and
safety of workers and their families:

(3) To clarify regulato: y authority for
Preventing and responding to incidents
of home contamination: and

(4) To assist workers in redressing and
tesponding to incidents.

Under the Act, NIOSH is mandated to
conduct a study to evaluate the problem
of contamination of workers’ homes by
hazardous chemicals and substances
transported from the workplace. The
study is to include review of past
incidents of home contamination,
actions taken by governmental agencies
in response to such incidents, the roles
and practices of governmental agencies
and NIOSH study, and an analysis of
relevant statutes, regulations, and
voluntary measures. In addition to
requesting existing information on these
matters, NIOSH is also requesting
existing information on incidents of
home contamination and family illness
or poisoning in situations where the
workplace and home located together,
such as farms and certain small
businesses. NIOSH is requesting both
published reports. including studies,
case histories, voluntary guidance,
statutes, and regulations, and
unpublished reports including accounts
from physicians, poison control centers.
industry management, labor unions, and
other parties. Existing information is
specifically requested on the following:

1, Measurements of home
contamination or incidents of fami
poisoning or illness due to
contamination of the home by
hazardous chemicals or substances
transported to the home from: the
workplace on the equipment (including
vehicles), clothing, or a worker's person.

2. Any measurements of home
contamination or incidents of familial
poisoning or illness resulting from
hazardous chemicals or substances due
ta the proximity of the workplace and
ns home, such as farms or other
businesses with attached living quarters.

3. Reports of Federal, state or local
government actions to either enforce
statutes or regulations or provide
assistance in incidents of familial
poisoning or illness due to hazardous
chemicals or substances transported
home from the workplace, or due to the

1518 Mow 12, 1983 VerDate G3-NOV-S3 Aa 150257 PO.00000 Frm o00G9 Fme4703 Simt4703 EXFRAFMAPISNOQPTI pimo3

proximate nature of the home and
workplace.

4. Measures used by employers to
prevent or remedy home contamination,
including statutory, regulatory, or
voluntary industrial hygiene measures.
(Please specify the approximate number
of workers employed by the business
esiablishment.)

5. Effectiveness of industrial hygiene
practices in the workplace, such as
housekeeping practices and the use of
personal protective equipment. in
preventing home cont:mination.

6. Effective: t rormal house
cleaning and Ia procedures in
removing hazardous materials and
agents from workers’ homes, personal
clothing and equipment (including
vehicles).

7. Information on indoor air quality
research that pertains to the fate of
chemicals transported from a workplace
into the home environment.

8. Information on any of the above
items that pertains specifically to
firefighters.

NIOSH presently has copies of the
references listed at the end of this
request for existing information.

Information received in response to
this notice (except that designated trade
secret and protected under Section 15 of
the Occupational Safety and Health Act
of 1970 (29 U.S.C. 664], or that exempt
from disclosure under the Freedom of
Information Act (5 U.S.C. 552) or the
Privacy Act (5 U.S.C. 552a) will be
available for public examination and
copying at the above address.

Dated: November 5, 1993.
Diane D. Porter,
Acting Director, Notional Institute for
Occupational Safety and Health. Centers for
Disease Control and Prevention (CDC).

References

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Eisenbud M, Wanta RC, Dustan C, Steadman
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Eitzman DV, Wolfson SL {1967}. Acute
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Epler GR, FitzGerald MX. Gaensler EA,
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Falk H. Herbert JT, Edmonds L, Heath CW Jr,
‘Thomas LB, Popper H (1981). Review of
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arsenic exposure in one Case. Cancer
47:382-391.


brought home a loaded company truck containing chloropicrin, about one gallon
was spilled on his driveway, causing eye irritation, nausea, vomiting, and coughing
among two adults and three children living next door.

CHLORINATED HYDROCARBONS
Overview
Seven reports reviewed in this section and summarized in Table 12 document five
instances in which health effects occurred in family members of workers who were
exposed to chlorinated hydrocarbons. Other reports describe cases in which
chlorinated hydrocarbons were found in the urine or blood of family members,
but no adverse health effects were reported.

Background

Among the chemicals discussed in this section are a number of substances that
cause chloracne, including: polychlorinated biphenyls (PCBs); chlorinated
naphthalenes; chlorinated tars including hexachlorobenzene; and the 2,3,7,8- and
2,3,6,7-tetrachlorodibenzodioxins (TCDD). Other chemicals discussed in this
section are the potential carcinogens 4,4’-methylene-bis(2-chloroaniline) (MOCA),
3,3’-dichlorobenzidine, 2,4,5-trichlorophenol, and tetrachloroethylene. In addition
to chloracne, the first group of compounds may cause numerous other health
effects, including cancer. Because of their toxicity and environmental persistence
the uses of all these compounds except tetrachloroethylene and 2,4,5-
trichlorophenol have been greatly curtailed or banned. However, workers may
still be exposed to PCBs remaining in electrical transformers and at hazardous
waste sites, to the dioxins which may be contaminants in certain pesticides, and to
MOCA in production of certain plastics.

Review of Studies

The earliest report found on home contamination by any substance, was by
Lehmann [1905] in Germany on family members who developed chloracne when
the father wore his work clothing at home. The clothing was contaminated with
chlorinated tars which included hexachlorobenzene and pentachlorobenzoic acid.

The earliest report from the U.S. of exposure of family members to a chlorinated
hydrocarbon in a worker’s home was in 1936 [Fulton and Matthews 1936]. The
wife, 11-month-old daughter, and 2¥%-year-old son of a worker in Pennsylvania
who was exposed to hexachloronaphthalene and chlorodiphenyl (also known as
polychlorinated biphenyl [PCB]) in an electrical insulation plant developed the
same type of acne-like dermatitis (chloracne) seen in workers in the plant. The
worker wore dirty work clothes home and played with his children before
changing into clean clothes.

Polychlorinated biphenyls with a pattern resembling Aroclor 1254 (a mixture of

PCBs containing 54% chlorine) were found in the blood of two railway
maintenance workers who repaired transformers (77 and 101 ng/mL) [Fischbein

20


Vermont v. Staco, Inc. [1988]. 684 F. Supp. 822 (D.Vt.).

Versen RA, Bunn WB III [1989]. Evaluating the exposure levels incurred while
laundering crystalline silica-contaminated work clothing. Am Ind Hyg Assoc J
50(4):A241-A242.

Vianna NJ, Maslowsky J, Roberts S, Spellman G, Patton RB [1981]. Malignant
mesothelioma—Epidemiologic patterns in New York State. NY State of Med
(April):735-738.

Vianna NJ, Polan AK [1978]. Non-occupational exposure to asbestos and malignant
mesothelioma in women. Lancet 1(8073):1061-1063.

Votaw AL, Zey J [1991]. Vacuuming a mercury-contaminated dental office may be
hazardous to your health. The Dental Assistant January/Febmuary:27-29.

Wagoner JK [1976]. Statement Before the Subcommittee on Oversight and
Investigations, House Committee on Interstate and Foreign Commerce, May 28, 1976. 6
pages.

Wallace WT Jr. [1994]. Letter of February 17, 1994 re: workers’ home contamination in
West Virginia to Richard D. Niemeier (sic), Education and Information Division,
National Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 1
page.

Walter WG, Schillinger JE [1975]. Bacterial survival in laundered fabrics. Appl
Microbiol 29(3):368-373.

Wang J-D, Shy W-Y, Chen J-S, Yang K-H, Hwang Y-H [1989]. Parental occupational
lead exposure and lead concentration of newborn cord blood. Am J Ind Med 15(1):111-
115.

Ware GW, Morgan DP, Estesen BJ, Cahill WP, Whitacre DM [1973]. Establishment of
reentry intervals for organophosphate-treated cotton fields based on human data: I.
Ethyl-and methyl parathion. Arch Environ Contam Toxical 1(1):48-59.

Wasti K [1994]. Letter of February 9, 1994 re: workers’ home contamination in Virginia
to Ms. Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 7 pages.

Watson WN, Witherell LE, Giguere GC [1978]. Increased lead absorption in children of
workers in a lead storage battery plant. J Occup Med 20(11):759-761.

139


homes in Minnesota were found by Winegar et al. [1977] to be contaminated to
about the same extent (median lead concentration 2,400 ppm; range 120-26,000 ppm)
as the homes of smelter workers reported by Baker et al. [1977]. Homes of workers
cutting down lead cable contained lead in dust at 1,700 ppm [Osorio 1994]. Homes
of battery factory workers in North Carolina had lead concentrations in house dust
ranging from 1,695 ppm to 84,074 ppm {Dolcourt et al. 1978; CDC 1977b].

Lead in house dust of cottage pottery industries in Barbados contained lead at an
average concentration of 5,000 ppm [Koplan et al. 1977]. Homes of workers
manufacturing pewter products in Ohio contained lead in window sill dust at 1,700 to
25,000 ppm [Kelly 1994].

Kawai et al. [1983] found 100-5,000 ppm of lead in dust from carpets of cottage-
industry homes where work with lead took place. Carpets in homes of workers
engaged in manufacture of pewter products contained 675-7,200 ppm of lead in dust
[Kelly 1994]. Dust from carpets in homes of foundry workers contained lead at 105-
1,535 ppm {Nelson and Clift 1992]. Furniture in a home where lead-battery casings
were burned as fuel had lead in dust at 13,283 ppm [Dolcourt 1981].

Concentrations of lead in dust of workers’ cars have also been reported. Cars of
miners had lead in dust at 3,900 ppm compared to control cars at 917 ppm [Menrath
et al. 1993]. Dust in cars of workers manufacturing pewter products contained lead
at 700 ppm [Kelly 1994].

Lead Loading. For lead loading, that is the total amount of lead per unit surface
area, the U.S. Department of Housing and Urban Development (HUD) recommends
as feasible levels for samples collected by wipe methods after lead-paint abatement:
for hard floors, 200 ug/ft? (2,152 4g/m*); and for window sills 500 ug/ft? (5,380
g/m’) [Jacobs 1994]. Only three studies of lead loadings in control homes were
found. Abbritti et al. [1989] reported an average of 800 ug/m’ in homes used for
controls in a study of ceramics workers in Italy. Menrath et al. [1993] reported 602
g/m? in control homes for a study of lead miners in the United States, and Matte et
al. [1991] reported 690 »g/m* in control homes for a study of lead smelter workers’
homes in Jamaica.

Lead loadings on floors in homes of backyard lead smelter workers in Jamaica
were found by Matte et al. [1991] up to 109,000 g/m? (geometric mean 2,790
g/m’). About half the homes had peeling paint with 1%-6% lead. In cottage
industry battery repair shops in Jamaica, Matte and Burr [1989] found 190-53,140
g/m’ in wipe samples from the floors of the workers’ homes. Paint samples
contained less than 1% lead. Homes of ceramics workers in Italy had lead loadings
of 2,700-4,700 j.g/m’ [Abbritti et al. 1989], and in a cottage pottery industry in
Alabama, lead loadings of 172 ug/m’ on a bedroom carpet to 4,196 ug/m’ on the
kitchen floor were found [State of Alabama 1992].

51


measures included use of gloves, special shoes and clothing, and laundering of work
clothes by the company.

ASTHMATOGENS/ALLERGENS

Two case studies of workers’ spouses who had allergic reactions to antigens brought
home by their spouse indicate that the practices of showering and changing clothes
before leaving work were effective at preventing the allergic reactions. In the first
case, the antigen was of animal origin which the wife brought home on her clothing
and body from the research laboratory where she worked. The symptoms of the
worker’s husband resolved after the worker began wearing different clothes at work
and at home, and showering and washing her hair before leaving work. In the
second case, the antigen was platinum salts which the husband brought home on his
clothing and body from his work at a precious metals refining company. The
symptoms of the worker's wife resolved after her husband’s company instituted a
policy that employees should shower and change clothes before leaving work.


Report to Congress
on
Workers’ Home Contamination Study
Conducted Under
The Workers’ Family Protection Act
(29 U.S.C. 671a)

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
PUBLIC HEALTH SERVICE
CENTERS FOR DISEASE CONTROL AND PREVENTION
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
CINCINNATI, OHIO 45226

SEPTEMBER 1995

DHHS(NIOSH) Publication No. 95-123


Kaye et al. [1987] found elevated BLLs among children of workers exposed to

lead in a plant manufacturing electrical components and made recommendations
for taking preventive measures in the workplace.

Novotny et al. [1987] studied the BLLs of firing range workers and their spouses,
finding elevated levels in the workers but not in the spouses.

In an ongoing study of workers exposed on the firing range of the FBI Academy,
the workers’ vehicles have been found to be contaminated with lead; however, lead
dust levels in the workers’ homes and BLLs among the workers’ children were low,
suggesting that the children were not being exposed to significant amounts of lead
[Briss 1994).

In March, 1993 NCEH and NIOSH collaborated on an exposure assessment for
heavy metals associated with a smelter in Oruro, Bolivia. The investigators
evaluated biological and environmental samples for lead, arsenic, antimony, and
tin. Both environmental testing and biological monitoring suggested that workers’
homes were contaminated by tin. However, the biological results were not
elevated to levels documented to cause adverse health effects [Briss 1994].

Other. In a study of a community that had used sludge contaminated with PCBs,
Baker et al. [1980] found higher levels of PCBs in the blood of family members of
sewage treatment workers than in other members of the community.

Falk et al. [1981] reported on a case of angiosarcoma in a young girl whose
father worked with arsenic and wore contaminated clothing home.

Wolfe et al. [1961] studied cases of pesticide poisoning in children and made
recommendations for pesticide applicators that included decontamination of empty
drums and clothing.

A joint study by CDC and EPA [Canon et al. 1978], found that wives of workers’
exposed to kepone had signs of kepone poisoning. These women had washed their
husbands’ clothes.

National Institute for Occupational Safety and Health (NIOSH)

NIOSH conducts evaluations of health hazards in the workplace. About 40
NIOSH studies have addressed potential or actual incidents of workers’ home
contamination.

Asbestos. Five investigations of potential workers’ home contamination by
asbestos were reported by NIOSH. These investigations were made at: a
construction site [Lemen 1972}; a plant manufacturing flooring material [Belanger
et al. 1979}; a plant manufacturing friction products [Seixas and Ordin 1986]; a
chemical plant [Driscoll and Elliott 1990] and a brake-service facility [Godby et al.

86


Table 7. Health Effects of Take-Home Lead Exposure (Cohort Studies)

work at home
89 Unexposed children in community

Author (year) Location Industry Study Design Results ‘Comments
Baker et al. [1977] | Tennessee, USA Lead amelting Cohort Mean BLL significantly higher in Matched on neighborhood and
CDC {1976} 20 Exposed children exposed children; some of whom had | measured lead content in paint by
17 Neighborhood controls BLL > 80 4g/dL. Higher dust lead X-ray fluorescence. 7 children had
levels in exposed houses (2,687 vs. erythrocyte protoporphyrin
404 ppm); children's BLLs correlated | > 190 4g/100 mL which
with dust levels, necessitated immediate medical
attention,
Elwood et al. England Battery plant Cohort Workers’ children had significantly | Used capillary eampling; year-olds
(1977) 192 Exposed children higher BLLs than registry children had highest BLLs. No health effects
273 Children from birth registry (mean 33 va. 27 g/dL), reported,
Koptan et al, (1977] | Barbados Pottery Cohort Mean BLL of potters’ family Homes were adjacent to potteries.
12 Potters members (35 g/dL) was significantly | An adult female member of potter’
19 Family members higher than that of controls (17-19 family had decreased deep tendon
2% Controls g/dL). reflexes in ankles bilaterally, BLL of
54 and erythrocyte protoporphyrin
of 209 mg/100 mL.
Watson et al. Vermont, USA Battery plant Cohort 56% of exposed vs. 12.5% of controls | Used capillary sampling,
(1978) 27 Exposed children, had BLL > 30 pg/OL; highor mean Significantly elevated erythrocyte
CDC [1977a} 32 Neighborhood controls dust lead levels in exposed houses protoporphyrin,
(2,239 ppm) vs. controls (718 ppm).
‘Millar [1978] England Lead Cohort Difference in BLLs between workers’ | No deviation from normal health
smelting/refining 71 Children of workers children (21.1 4g/dL) and community | were found by careful study.
191 Community children children (18.2 g/dL) was statistically
(living near plant) significant for children age < 10,
Rice et al. [1978] USA (city Secondary lead Cohort ‘7 exposed children had zine No BLLs were measured, Other
unspecified) smelter 33 Exposed homes Protoporphyrins over 50 g/dL health effects not reported,
19 Neighborhood homes compared to 1 control child.
Significantly higher lead levels were
found in wipe and dust samples from
exposed homes compared to control
homes.
Abbritti et al. Tealy Ceramics Cohort Mean BLLs for the three groups: Many of the pottery factories were
[1979] 40 Children of ceramic workers 25.1, 27.5, 23.0 (p-value for difference | home-operated. No significant
47 Children of ceramic workers who. between the latter two < 0.001). difference in hematocrit,

160


County, Missouri: U.S. Environmental Protection Agency, Region VII, Environmental
Services Division. Contract No. 68-97-0006.

Dolcourt JL, Finch C, Coleman GD, Klimas AJ, Milar CR [1981]. Hazard of lead
exposure in the home from recycled automobile storage batteries. Pediatrics 68(2):225-
230.

Dolcourt JL, Hamrick HJ, O’Tuama LA, Wooten J, Baker EL Jr. [1978]. Increased lead
burden in children of battery workers: Asymptomatic exposure resulting from
contaminated clothing. Pediatrics 62(4):563-566.

Donaldson HM, Johnson WM [1972]. Field survey of Diamond Shamrock Chemical
Company, Nopca Chemical Division, Redwood City, California. Cincinnati, OH:
Department of Health, Education and Welfare, Public Health Service, Center for
Disease Control, NIOSH Report No. IWS 33.10. 7 pages.

Donovan B [1994a]. A characterization of occupational and residential lead exposure at
a stained glass studio. In: American Industrial Hygiene Conference and Exposition
Abstracts. Fairfax, VA, AIHCE. Page 80.

Donovan BA, [1994b]. Health Hazard Evaluation Report: Kessler Studios, Loveland,
Ohio. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health
Service, Centers for Disease Control and Prevention, National Institute for Occupational
Safety and Health, NIOSH Report No. HETA 92-0029-2392. 17 pages.

Driscoll RJ, Elliott LJ [1990]. Health Hazard Evaluation Report: Chrysler Chemical
Division, Trenton, Michigan. Cincinnati, OH: U.S. Department of Health and Human
Services, Public Health Service, Centers for Disease Control, National Institute for
Occupational Safety and Health, NIOSH Report No. HETA 87-126-2019. 40 pages.

Easley CB, Laughlin J, Gold R [1981a]. Laundering pesticide contaminated clothing.
Lincoln, Nebraska, University of Nebraska Cooperative Extension Service, Home
Economics Neb Guide HEG81-152. 2 pages.

Easley CB, Laughlin JM, Gold RE, Hill RM [1982a]. Laundry factors influencing methyl
parathion removal from contaminated denim fabric. Bull Environ Contam Toxicol
29:461-468.

Easley CB, Laughlin JM, Gold RE, Schmidt K [1982b]. Detergents and water
temperature as factors in methyl parathion removal from denim fabrics. Bull Environ
Contam Toxicol 28:239-244.

Easley CB, Laughlin JM, Gold RE, Tupy DR [1981b}. Methyl parathion removal from
denim fabrics by selected laundry procedures. Bull Environ Contam Toxicol 27:101-108.

109


Sterner JH, Eisenbud M [1951]. Epidemiology of beryllium intoxication. Arch Ind Hyg
Occup Med 4:123-151.

Stewart K [1967]. The resuspension of particulate material from surfaces. In: Fish BR
ed. Surface contamination. Proceedings of a symposium held at Gatlinburg Tennessee,
June 1964. New York, Pergamon Press. pages 63-74.

Stokes L [1994]. Letter of July 20, 1994 re: childhood blood lead registry in Idaho to
Dr. Robert Mason, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 6 pages.

Stone J, Wintersteen W [1988]. What to do when clothes are soiled with pesticide.
Ames, Iowa, Iowa State University Extension, Publication No. Pm-1087-2. 4 pages.

Stone JF, Koehler KJ, Kim CJ, Kadolph SJ [1986]. Laundering pesticide-soiled clothing:
A survey of Iowa farm families. J Environ Health 48(5):259.264.

Stone JF, Stahr HM [1989]. Pesticide residues in clothing. Case study of a midwestern
farmer’s coverall contamination. J Environ Health 51(5):273-276.

Study DG [1994]. Letter of March 14, 1994 re: workers’ home contamination in Alaska
to Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 2 pages.

Sullivan PA, Bang KM, Hearl FJ, Wagner GR [1995]. Respiratory disease risks in the
construction industry. Occup Med: State of the Art Reviews 10(2)313-334.

Sussman VH, Lieben J, Cleland JG [1959]. An air pollution study of a community
surrounding a beryllium plant. Am Ind Hyg Assoc J 20:504-508.

Taylor JR, Selhorst JB, Houff SA, Martinez JA [1978]. Chlordecone intoxication in man.
I. Clinical observations. Neurology 28:626-630.

Tepper LB, Hardy HL, Chamberlin RI [1961]. Toxicity of beryllium compounds. New
York, Elsevier Publishing Co. pages 25-29, 170, 173, 174.

Teyssier L, Lesobre R [1968]. [Non-professional pleural plaques of asbestos] (in
French). J Fr Med Chir Thora 22:797-808.

Tinney JH [1994]. Letter of February 10, 1994 re: workers’ family protection in
Pennsylvania to Richard Niemeier, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services.

237




Table 9. (Continued) Health Effects of Take-Home Lead Exposure (Case Reports/Case Serics)

Pitts [1986] Virginia, USA Radiator repair Case report Radiator worker with BLL of 78 g/dL 2-yearold child with BLL of
Garrettson [1988] 1 Worker had children under age 7 with BLLs of 79 and erythrocyte
3 Children 79, 48, and 27 g/dL. Lead dust found in | protoporphyrin of 100 was
1 Spouse worker's van, and in house where dirty asymptomatic but underwent
clothes stored. Wife had BLL of 12 chelation therapy,
ue/dL.
Novotny et al. [1987] Colorado, Firing range Case series BLLs tevels in workers ranged from 41 to No heatth effects reported in
USA 4 Workers 77 ug/dL. Spouse BLLs ranged from 6 wives.
3 Spouses to 11 pg/dL.
CDC [1989] Colorado, Plaque production Case report Children's BLLs ranged from 13 to 4-year-old daughter's X-ray
USA 1 Worker 37 ug/AL; wife's BLL 15 wg/4L. showed dense metaphyseal
4 Exposed family members Children's free erythrocyte density in tong bones,
(3 children) protoporphyrin 92-196 yg/dL.
Pichette et al. [1989] Texas, USA Battery manu- Case series 12% of children had BLLs of 25-49 No health effects reported.
facturing and ‘71 Lead-exposed workers #g/4L. Mean BLLs for children by age
recycling 101 Children (50% under age 6) were 19 g/dL for 0-3; 13 g/dL for 4-6,
and 10 y.g/4L for children age 7 and over.
‘Children of battery recycling workers had
significantly higher BLLs than children of
other battery workers (p=.001). Mean
BLL level of spouses who laundered
workers clothes was 13 ug/dL compared
to 8.4 ug/dL when clothes were
laundered by the company.
Lussenhop et al. [1989] Minnesota, Radiator repair Case series All but 1 child had BLLs below 15 g/dL. No health effects in children
USA 12 Workers Mean BLL was 9.3 g/dL. reported.
16 Children < age 6
Motovich [1991] Indiana, USA Welding Case report Child was reported to have consecutive Family car was contaminated
1 Worker lead levels of 0.3 and 0.47 (units and with lead, Child had seizures;
1 Child age 4 media not reported) and was neurological measurements

symptomatic.

normal,

169



‘Table 15, (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Industrial Hygiene Met Industrial Hygiene Observation
Ewers et al, Lead Decontamination of Carpets-repeated HEPA. Lead concentration in dust remained Lead loading on carpet surface may
[19946] carpets and floors vacuuming. about the same from first to tenth increase if vacuuming is not done
Ohio Wooden floors-dry HEPA carpet cleaning. Over 95% of total for sufficient time. It may be more
vacuuming, dust was removed from bare wooden | practical to replace rather than
Linoleum floors - dry HEPA floors after dry HEPA vacuuming clean contaminated carpets.
vacuuming followed by wet only. Dry HEPA vacuuming removed
washing. over 75% of total dust from linoleum
Collected dust was analyzed for floors. Wet washing removed an
lead contamination, additional 20%,
Fischbein et al. Lead Home pottery work Blood lead BLL: worker 48 g/dL, daughter 54 ‘The family was asked to
{1992} ug/4L, spouse normal. Art studio discontinue potential exposure to
USA was separated from the family home fead in the studio; 2 years later
by a curtained-off studio. Daughter blood lead concentrations were
(S-years-old) spent significant time in normal,
studio with artist mother.
Gittleman et al. Lead (Pb) Battery recycling Wipe samples in employee autos, Workers did not consistently shower
(1991, 1994] Work practices observations. and change clothes before leaving
Alabama work.
3.mg Pb/100 cm? on drivers seat
1.9 mg Pb/100 cm? on driver's floor
area. 1.7 mg Pb/100 cm? on
dashboard,
Grandjean and Lead Secondary Airborne lead in socks When air lead < 0.1 mg/m3, socks Indicates that all clothes worn at
Bach lead contained 0.13-1.62 g lead/pair. work should not be taken home,
(1986) smelter When air lead > 0.1 mg/m®, socks
Denmark contained 0,06-2.19 g lead/pair.
Gunter et al. Lead Fire assay procedures Air sampling for lead dust & fume. General room air contained lead up The report recommends that the
(1987) to 600 g/m, workers should shower and change
Colorado, Nevada clothes before leaving the

workplace to prevent exposure of
family members to lead
contaminated work clothes.

189



1987]. In each case it was determined that the potential existed for workers to
bring asbestos home on their clothing as a result of inadequate or inconsistently
applied industrial hygiene practices. In two cases [Seixas and Ordin 1986; Driscoll
and Elliott 1990], asbestos was detected on the workers’ clothes as they left the
worksite. In an evaluation of a construction site [Lemen 1972] and a brake-service
facility [Godby et al. 1987], NIOSH found that most workers did not change
clothes before leaving work and that their work clothes were laundered at home.
In all of these studies, recommendations were made that would prevent workers’
home contaminations such as reducing exposures at work and leaving contaminated
clothing at work.

Lead. Five investigations of exposure of workers to lead and potential home
contamination were reported by NIOSH: stained glass manufacturing [Landrigan et
al. 1980]; battery manufacturing and recycling facilities [Apol and Singal 1980;
Matte and Burr 1989; Gittleman et al. 1991]; tank lining [McCammon et al. 1991;
CDC 1992a]; gold assaying [Gunter et al. 1987]; and building renovation [Kiefer
1994}. In a study by Matte and Burr [1989] of back-yard battery repair shops,
contamination of the homes and elevated BLLs of family members were found.
Elevated BLLs of stained-glass workers’ families were related to occupational
exposures of the worker [Landrigan et al. 1980]. Lead was detected in workers’
cars by McCammon et al. [1991], indicating a potential for transfer to the home.
In these reports, improved hygiene practices were recommended to prevent
contamination of homes.

Pesticides. Kominsky {1984c] studied the contamination of firefighters protective
clothing by malathion and diazinon following a fire and made recommendations for
laundering the contaminated clothing.

Chlorinated Hydrocarbons. Investigations of two cases involving PCBs, one a
manufacturing plant and one a railroad yard, resulted in industrial hygiene
recommendations to prevent transportation of the contaminant from the workplace
[Hartle et al. 1987; Hartle 1987]. Several studies addressed instances in which
firefighters’ clothing was contaminated with PCBs [Kominsky 1984a, 1984b, 1987a,
1987b; Kominsky and Singal 1987; Orris and Kominsky 1984; Seligman 1984]. The
reports provided recommendations for laundering clothing and using protective
clothing.

Mercury. During the health hazard evaluation of a thermometer plant in
Vermont, the NIOSH trailer where workers received medical tests became
contaminated with mercury, suggesting that contamination of the workers’ homes
with mercury was possible [Ehrenberg 1986]. Since the plant was closed soon after
the study, industrial hygiene recommendations were not included in the report.

Estrogenic Substances. Children of chemical-plant workers who contaminated
their homes had enlarged breasts due to zeranol, an estrogenic animal growth

87


be at increased risk when compared with female children [Anderson et al. 1979b;
Kilburn et al. 1985, 1986; Grundy and Miller 1972].

Three review articles discuss the adverse effects in family members of asbestos
workers and the bases for inferring that these adverse health effects result from
transporting contaminated clothing and other articles into the home. Grandjean
and Bach [1986] reviewed the literature on effects of asbestos exposure on
workplace bystanders and family members and Rom and Lockey [1982] and Berry
{1986] reviewed the association between asbestos exposure and mesothelioma.

Based on the health effects studies reviewed in this section, contamination of
workers’ homes by asbestos dust appears to be an international problem. Of the
50 reports summarized in Tables 2-6, 16 are from the United States, 10 from
Great Britain, 9 from Italy, 7 from Scandinavia, 3 from Germany, 2 from Canada,
and 1 each from Australia, France, and Czechoslovakia.

Cohort Studies. Investigators from Mount Sinai School of Medicine
[Anderson 1983; Anderson et al. 1976, 1979a, 1979b; Joubert et al. 1991;
Nicholson 1983; Nicholson et al. 1980] studied household contacts of 1,664
amosite asbestos workers who manufactured thermal insulation (Table 2). The
prevalence of parenchymal and pleural abnormality 20 or more years after first
household exposure was 48% among wives, 21% among daughters, 42% among
sons, and 37% among siblings [Anderson 1979b).

The Mount Sinai investigators [Anderson 1983; Anderson et al. 1976,
1979a, 1979b; Joubert et al. 1991; Nicholson 1983; Nicholson et al. 1980) studied
morbidity and mortality among a cohort of household contacts of amosite asbestos
workers employed in a New Jersey asbestos insulation materials factory between
1941 and 1945. Occupational, residential, smoking, and medical histories were
obtained from the exposed cohort. Radiographs were taken 20 or more years
after first exposure. Results for radiographic analysis were compared with a
control group of similar age and gender from the same urban community. A
Statistically significant increased frequency of asbestos-associated radiographic
abnormalities was observed among household contacts of asbestos workers. The
prevalence of radiographic abnormality associated with secondary exposure was
35% vs. 5% expected, based on the comparison population (p<0.001). The
prevalence of abnormalities increased with duration since first exposure (p<0.01).
Those with 10 or more years of household exposure had a prevalence of abnormal
radiographs of 53%. Household contacts of former asbestos workers who entered
the home only after cessation of employment also were at significantly increased
risk of pleural abnormality (12% observed vs. 2% expected; p<0.02) [Anderson et
al. 1979a}.

The Mt. Sinai investigators also examined mesothelioma and lung cancer
mortality for vital status follow-up through 1980. There were 3 mesothelioma

8


‘Table 15. (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Industrial Hygiene Observation

Comments or Recommendations

Martin [1974], Lead ‘Smelters, lead and Lead in clothing and automobiles. Lead was found in underclothing, Factory managers were asked to

Martin et al. other mines, socks, boots and cars of workers, data assure that workers used the

[1974] were not reported. cleaning facilities available so that

United Kingdom they did not take tead dust home
‘on their bodies, clothing, and
footwear,

Matte and Burr Lead Cottage industry: Air, dust, and soil Lead in air, geometric mean = 21 Changing work clothes was not

[1989]; “backyard battery ¢/m? in workshops, Lead in associated with lower house dust

Matte et al. repair shops" household dust, range = 190 to 53,140 | ead levels. None of the facilities

(1989) ‘mg/m. Lead in soil, $1 to 400,000 surveyed had adequate shower and

Jamaica ppm. changing facilities. Threshold for
soil lead = 500 ppm; for house
dust 1,500 ug/m*. Playing in shop
area was associated with higher
BLLs in children.

Matte et al. Lead Conventional & House dust and soil samples from ‘Lead in house dust, 100 to

(1991) cottage lead smelters cottage smelters. 109,000 g/m; in soil, 9 to 320,000

Jamaica Dust samples collected from floor | ppm.

‘of room in which children spent
most of their time.

McCammon et al. | Lead Lining of 2 large tanks | Wipe samples for surface lead Lead on boots and shoes 1-20 The authors state: "The

(1991) with lead sheets. including employees’ street shoes ug/em2; on shirt collars 0.3-2 wg/cm?; | opportunity for lead exposure was

Utah and in employees’ cars. ‘on floor of cars 0.3-4 ug/em*. likely increased by the lack of
shower facilities & the practice of
wearing work clothes at home.”
Recommendation: install clean &
dirty change rooms, and provide
laundry facilities at work.

Menrath et al. Lead Mining Dust samples collected from the Mean lead concentrations in dust =

[1993]
USA

L

cars & homes of both miners &
non-miners in the same
community.

3,909 ppm in miners cars vs. 917 ppm.
in non-miners cars. Lead loadings on
car floors = 3,539 g/t? for miners
va. 565 pg/ft? for non-miners. Lead
loadings in homes were similar for
both groups, approx. 56 zg/ft".
Concentra: tion of lead in house dust
was higher for miners,

191



[1986] found perchloroethylene to be a more effective pre-wash treatment than ethyl
alcohol for removing alachlor from fabrics.

Water level was shown by Hild et al. [1989] to result in lower levels of methyl
parathion in laundered fabrics.

Kim et al. [1986] found that machine drying of fabrics that had been contaminated
with alachlor resulted in lower residual contaminant than air drying. On the other
hand, Kim and Wang [1992] found no difference in residual atrazine between
machine and air drying.

Repeated washing has been studied with parathion, 2,4-D ester, pyrazophos, triallate,
trifluralin, and deltamethrin. Satoh [1979] found that a single washing removed 75%-
95% of parathion from clothing contaminated from one day of work in a cotton field;
the second washing removed a smaller percentage of the remaining contaminant. It
was noted that the more contaminated the clothing the harder it was to clean.

The effect of concentration of methyl parathion on laundry effectiveness was reported
by Easley et al. [1982a] and Laughlin et al. [1985]. When an emulsifiable concentrate
was applied to fabrics at a concentration of 1.25%, 18% of that applied remained
after the first wash, 4% after the second wash, and 0.37% after the tenth wash.

When the emulsifiable concentrate was applied at a concentration of 54%, 84% of
that applied remained after the first wash, 65% after the second wash, and 33%
remained after the tenth wash.

Pyrazophos was applied to fabrics to simulate contamination in greenhouses by
spraying or spilling [Braun et al. 1989]. When applied by spraying, the first wash
removed 78% of the contaminant and the second wash removed an additional 14%.
When applied by spilling, the first wash removed 92% of the contaminant but the
second wash removed only an additional 2%.

Easley et al. [1983] found that a single washing of fabrics contaminated with 2,4-D
ester removed about 30% of that applied and that two washings removed about 41%.

Fifty-two percent of triallate was removed by the first washing and an additional 30%
by the second washing in a study by Rigakis et al. [1987]. In this same report, the
first washing removed 77% of trifluralin and 84% deltamethrin; the second washings
removed an additional 14% of trifluralin, and 15% of deltamethrin.

Other laundry additives such as bleach and ammonia have been found to have little
effect on the effectiveness of laundering fabrics contaminated with methyl parathion
{Easley et al. 1981b; Laughlin et al. 1985], or with chlorpyrifos, diazinon, and
chlordane [Lillie et al. 1982].

67


[19892, 19900]
Hesse (1991]
Adrian,
Michigan

Chemical manufacture

Table 12. (Continued) Health Effects of Take-Home Chlorinated Hydrocarbons Exposure

HEALTH EFFECT

Exposure to 4,4’-methylene
bis(2-chloroanitine)
(MOCA)

Spouses and children

COMMENTS AND ISSUES

MOCA was produced by the Anderson Development Company. The Michigan
Department of Public Health conducted urine analyses on the workers’ spouses
and their children. MOCA was found at concentrations up to 15 ppb.

ATSDR [19916]
Muskegon County,
Michigan

Chemical manufacture
(pesticides, herbicides,
3,3’dichlorobenzidine
(DCB)

ure to
3,3'-dichlorobenzidine

Unspecified number of family
members of workers

Chemical production, including 3,3'-dichlorobenzidine (DCB), began at a site
near Muskegon, Michigan in 1960. In 1980-1981, the Michigan Department of
Public Health conducted a study of DCB in homes of employees. Samples
collected from vacuum cleaner bags from homes of some of the employees had
up to 10.5 ppm DCB, and dryer lint contained up to 0.74 ppm. From 0.006 to
0.281 ppm DCB was found in the urine of employees and family members.

Townsend et al.
[1982]

Midland,
Michigan

Chlorophenol
production

Survey for adverse
Pregnancy outcomes
(stillbirths, spontaneous
abortions, congenital
malformations)

370 Wives

Pregnancy outcome in 370 wives of workers potentially exposed to dioxin formed
as a byproduct in the production of 2,4,5-trichlorophenol were compared to
outcomes in wives of workers with no exposure to dioxin. Results indicated that
there was no statistically significant association between potential for exposure to
dioxin and pregnancy outcome. Exposure potential was categorized on the basis
of job classification and wipe teste of plant surfaces.

‘Smith et al.
(1982)
New Zealand

Herbicide applicators

Surveyed for miscarriages,
congenital defects

989 Applicators and wives

Applicators who sprayed 2,4,5-trichlorophenol products, reported to contain the
contaminant, an animal teratogen, were surveyed to determine pregnancy
outcomes. The wives of New Zealand sprayers reported helping their husbands
spray and handle the herbicide. No detectable reproductive effects were
reported,

Bagnell and
Ellenberger
1977)

Halifax, Canada

Dry-Cleaning

Obstructive jaundice and
hepatomegaly

Daughter

177

The breast-fed daughter of a woman who regularly visited the father during
lunch at a dry-cleaning establishment developed jaundice. The mother's blood
contained 0.3 mg/dL tetrachloroethylene (TCE) and the breast milk, 1.0 mg/dL.
No TCE was present in the blood of the infant when examined 1-week after
breast feeding was stopped. Liver function returned to normal.



For lead loading, the Department of Housing and Urban Development (HUD) has
guidelines for floors of 200 ug/ft’ (2,152 ug/m’) and for window sills of 500 ug/ft,
(5,380 g/m”) [Jacobs 1994]. The HUD guidelines are not based on health
considerations, they are based on levels that can be practically achieved following
lead-paint abatement. These values were used by the State of Alabama [1992] and
Pollock [1994]. Matte and Burr [1989] cited 1,500 ug/m’ as a level of concern for
children’s health. CH,M Hill [1991] used a concentration of lead in dust of 500 ppm
as an action level for cleaning residences.

Mercury concentrations in air of workers’ homes of 0.5 »g/m’ and 1.0 pg/m’ were
used as decontamination goals in the reports by ATSDR [1990a] and Zirschky and
Witherell [1987] respectively. In a recent report on decontamination of homes in
Florida, 0.3 4g/m’ was the level at which families were allowed to return to their
homes following decontamination [CDC 1995].

For PCBs, EPA guidelines for indoor solid surfaces and high contact outdoor solid
surfaces state that post clean-up levels should not exceed 10 »g/100 cm? (40 CFR
761.125). Based on PCB levels found in non-manufacturing buildings, 0.11 #g/100
cm’ was used as a guideline for decontaminating a school building [Orris and
Kominsky 1984]. Other guidelines cited by Hartle et al. [1987] were 0.5 42/100 cm?
for office buildings; for an aircraft plant, 2.50 4g/100 cm? was cited for low contact
surfaces, and 1 ug/100 cm’ for high contact surfaces.

REVIEW OF DECONTAMINATION PROCEDURES

BERYLLIUM

Shirts worn for one day in a beryllium plant were studied by Cohen and Positano
[1986]. Three shirts were classified as “nearly new” and three were classified as “old.”
One “nearly new” and one "old" shirt was laundered at the workplace. Beryllium was
present at 22 mg/m’ and 30 mg/m’ in the “old” washed shirt. Beryllium was present
at 12 mg/m’ and 20 mg/m’ in the “nearly new” unwashed shirts and at 0.2 mg/m’ in
the "nearly new” washed shirt. Although this was a pilot study, it is the only study
found that provides information on laundering clothing contaminated with beryllium
or similar particulate material. The study indicates that the beryllium was laundered
from the “nearly new” shirts, but that beryllium had accumulated and was well
entrenched in the “old” shirts. Substantial levels of beryllium dust in air were
generated during laundry procedures. The concentrations were up to 1.2 mg/m’
[Eisenbud et al. 1949] compared to the occupational exposure limit of 2 ug/m’ as an
8-hr. time-weighted average [29 CFR 1910.1000].

ASBESTOS

There were no studies on the effectiveness of any methods for removal of asbestos
from clothing contaminated in the workplace. One study conducted on dry cleaning
a coat which contained 8% asbestos in its fabric, indicated that some of the loose
fibers were removed [NIOSH 1971]. Concentrations in the air of asbestos fibers

62


TABLE OF CONTENTS

Background ........ 0... cee eee eee eee ccc e ee eee e eet eeeeeeneees 16
Review of Studies ....... 20... cece cece ec cece cence eee e eee 16
PESTICIDES .. 00... ccc ccc cece eee ec ete e eee eeeneeee 17
CO a (Cc 17
Background ........... 0... e eee eee cece nen eeeenee 18
Review of Studies .... 0.0.0... eee eee eee ee eee eee eaee 18
CHLORINATED HYDROCARBONS ...........-:0e ce eeeeee cece eens 20
Overview 2.0... cee eee erent cent eneeneee 20
Background ........... 0... cee eee eee nett eenaee 20
Review of Studies .. 2.0.0.0... cece eect eee eee etre eneee 20
MERCURY .... 0... ccc ccc eect cece ete e eee eeeenees 22
Overview 2.6... eee eee cece eteeeaee 22
Background ........... 0... eee c eee eee tence eneeees 22
Review of Studies .... 2... 0... c eee cece eee eee n eee eeees 22
ESTROGENIC SUBSTANCES ............. eee e eee eee eee eeeee 24
Overview 2.0... eee eee ee eee teen etter eeeeee 24
Background ......... 0... cece cee eect eee cece ete ence neeeees 24
Review of Studies 22.0.0... 0... cece cece cere eee e een eee 24
ASTHMATOGENS/ALLERGENS .............-00 222s eee cece ee eeees 25
ARSENIC... 1. ccc ee eee eee cette tence eee eeee 26
CADMIUM .... 1. ccc ccc cece ce ee cece cette eect eee eeeeee 26
FIBROUS GLASS ... 00.0... cece cee cee een n eet enneee 27
OTHER SUBSTANCES ......... 00... cece cece cece cece eee eens 27
INFECTIOUS AGENTS ........... 0. ccc eee e eee eee ee eter eens 27
CO a (Cc 27
Background ....... 0... cece eee eee cee eee eee reece neneees 28
Review of Studies ......... 2.0... c cece eee eee enter eens 32
RADIOACTIVE SUBSTANCES ...........0 0000 e eee eee eee eee eee 33
CHAPTER 2. SOURCES OF WORKERS’ HOME CONTAMINATION ........ 34
CHAPTER SUMMARY .......... ccc cece cece reer ete e reece eens 34
CONTAMINATED CLOTHING ...... 2.00... cece cece eee eee ences 35
Overview 2... cee ee ee eee eee eee tenes 35
Beryllium ©... 2... cc cece eee etter e tenes 35
ASDESOS 2... cece cnet t ee ee eee eee e eens 36

Lead 2... eee cee tenet ence eens 37
Overview 2.0... cece ete eet eee e eens 37

Reports of clothing and home contamination ................... 37
Supporting studies ..... 2.0.0.2... cece eccrine 38

Pesticides 2.0... ccc ccc cee eee eee eee eee tence eens 39
Chlorinated Hydrocarbons ........... 2. eee eee eee eee eee 41
Mercury .. 2... ee ence eect ee tenet enees 41


‘Table 14. (Continued) Health Effects of Take-Home Exposure to Other Substances

*YEAR).
USCATION STUDY DESIGN

‘Woody et al. [1986] Explosives manufacture Case report Child developed episodes of status Mother worked in explosives
Kaattmetiyiete epilepticus. manufacturing plant and transported
nitramine) clumps of RDX home on clothing and

shoes which the child ate,

183


involve the mediastinum or intestinal tract. It rarely occurs in developed nations.
It is primarily a disease of workers who process hides and veterinarians who come
in contact with infected animals. It may remain viable as a spore in soil
associated with infected animals for years. Inhalation anthrax may result if the
spores are inhaled while intestinal anthrax may arise if the spores are ingested
[Benenson 1985}.

Review of Studies

In this section, a number of examples from the literature that are indicative of the
circumstances where infectious agents have been transmitted to the homes of
workers are discussed.

e An HIV infected 28-year-old male with a disseminated Mycobacterium avium
infection was admitted to an Italian hospital in 1991. He was also diagnosed as
being infected with the mite Sarcoptes scabiei. The hospital staff were aware of
this infection and used protective clothing, gloves, and booties. However, within
one month, 29 staff members were infected with the mite. Six relatives of the
staff were infected at home [Scalzini et al. 1992].

e In 1991, an immunocompromised patient (non-HIV related) was admitted to a
hospital in Kansas. He was later found to be infected with scabies.
Subsequently, 49 hospital staff members were infected with scabies including:
those with frequent direct care responsibilities such as nurses and respiratory
therapists; ancillary staff including those from social services and housekeeping;
and 14 family members of the staff. [Clark et al. 1992]

e In 1984 an outbreak of Q fever in Idaho was associated with a sheep research
station. Of the 18 cases of Q fever 2 were family members of workers
employed at the station. One was a 14-month-old child while the second was
the wife of a worker. It is assumed that these family members were infected
with Q fever rickettsiae contained on dust brought home on the clothes of the
workers. It is also worth noting that a farmer who had no direct contact with
the research station also contracted Q fever. It is thought that he was infected
from a Q fever infected guard dog he had received from the research station
[Rauch et al. 1987].

e A case was reported in England where 10 people became ill with Q fever who
were performers in an Easter play at their village church. The source of the
infection was a shepherd who came to rehearsals in his work clothes. C.
burnetti was subsequently isolated from dust collected from shepherds’ clothing,
demonstrating contaminated clothing to be a potential source for exposure of
family members on farms [Marmon and Stoker 1956].

e Giardiasis is a protozoan (Giardia lamblia) infection that primarily attacks the
small intestine and is associated with symptoms that include diarrhea, cramps,

32


and
McDonald [1980]

Canada and USA

Table 4. (Continued) Health Effects of Take-Home Asbestos Exposure (Case-Control Studies)

Population-based
autopsy series
(Canada 1960-
1972: USA 1972)

Study Design

Matched case-control. $57 pleural and peritoneal
mesotheliomas with autopsy; matched on hospital,
gender, age, and year of death to controls with
pulmonary metastases from non-pulmonary primary
who were autopsied; occupational, residential, smoking,
and non-occupational exposure histories from interview
(blind) with relatives for 490 matched pairs.
Occupational exposures coded blind and cumulated to
10 years before death of case.

8/557 cases vs. 2/557 controls reported
domestic exposure to asbestos dust on
work clothes of household contact
(p=0.08 for matched pairs analysis).

5/8 non-occupational cases
and 2 controls were exposed
to contaminated clothing in
childhood. 3/8 cases and 1
control were exposed to
clothing of a chrysotile
Production worker; 5 cases
and 1 control were exposed
to contaminated clothing of
insulation factory workers.

Whitwell et al, [197]

England

Hospital-based

Case-control, Asbestos fiber content in lungs of 100
consecutive pleural mesothelioma autopsies compared
with 100 lung cancer cases and 100 lungs of people who
died from causes other than industrial lung disease or
Jung cancer for whom occupational histories were
available. Occupational and residential history
obtained from patients or relatives.

149

1 mesothelioma reported in asbestos
worker's family. Although not
explicitly stated in published report,
apparently no cases were observed in
either control series in asbestos
workers’ families.

Father worked in gas mask
production and brought work
home. Lungs of his son had
50,000-100,000 asbestos
fibers/gram dried lung tissue.



Appendix 3.
Letters Requesting Information


workers with clean work clothes (that employees were mandated to wear), rooms for
donning and removing work clothes, and facilities for storing work clothes; employers
also had to communicate and enforce prohibitions against removing work clothes from
the workplace.

In the United States, a variety of statutes and rules currently provide some protection
against workers’ home contamination. This review found only two statutes that
specifically addressed protection of workers’ families. These two statutes are the:

° Asbestos Hazard Emergency Response Act of 1986, Public Law 99-519, [15 U.S.C.
2641 et seq.]; and

© Residential Lead-Based Paint Hazard Reduction Act of 1992, Public Law 102-550,
Title X, Subtitle B [15 U.S.C. 2681 et seq].

Details of these statutes are discussed below under the appropriate statute headings.

The remaining federal statutes that permit agencies to promulgate requirements
addressing prevention of workers’ home contamination, as well as remedial actions to be
taken should such contamination occur, include the:

e Occupational Safety and Health Act of 1970, Public Law 91- 596 [29 U.S.C. 651 et
seq.];

° Federal Mine Safety and Health Act of 1977, Public Law 95-164 [30 U.S.C. 801 et
seq];
e Toxic Substances Control Act, Public Law 94-469 [15 U.S.C. 2601 et seq.];

e Federal Insecticide, Fungicide, and Rodenticide Act, Public Law 92-516 [7 U.S.C.
136 et seq.];

e Comprehensive Environmental Response, Compensation, and Liability Act of
1980, Public Law 96-510, [42 U.S.C. 9601 et seq.]; and

e Superfund Amendments and Reauthorization Act of 1986, Public Law 99-499 [42
US.C. 9601 et seq.].

The sections of these statutes related to workers’ home contamination are presented in
Table 17; this table also lists citations to the case law associated with these sections.’
The following discussion provides a summary of the manner in which each statute has
been used to promulgate rules that address workers’ home contamination.

?Note that this case law will not be discussed extensively in this review.
14


Natalie White

Co-op Student

Office of the Director

National Institute for Occupational
Safety and Health

1600 Clifton Road

Atlanta, Georgia 30333

John N. Zey, B.S.

Industrial Hygienist

Training and Educational Systems
Branch

Education and Information Division
National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

274


Table 7, (Continued) Health Effects of Take-Home Lead Exposure (Cobort Series)

Author (year) Location Industry Study Design Results Comments
Matte et al. {1989} | Jamaica Battery repair Cohort Geometric mean BLLs were ‘These were “backyard® battery
Matte and Burr %A Exposed households (112 workers | significantly higher among exposed repair shops. No health effects
(1989) and family members) households compared to controls. feported,
18 Neighborhood control households | 43% of exposed children aged < 12
(74 family members) years had BLL greater than 70
ug/AL.
CDC [19898] Jamaica Battery repair Cohort All exposed children aged 0-5 had No health effects reported.
17 Bxposed households BLLs > 25 g/dL.
18 Neighborhood controls
Gittleman et al. Alabama, USA Battery reclamation | Cohort Exposed children had higher mean No health effects reported.
[1994] 16 Children and 11 adults of 11 BLLs (mean 22.4 g/dL, max
Gittleman et al. workers 42 g/4L) compared to controls
[1991] 7 Neighborhood contro! families (98 ug/4L). 75% of workers’
CDC [1992b} (S children age 6-17, 11 adults) children had BLLs > 10 g/dL
compared with 40% of control

children, Adult family members of
workers BLLs (mean 8.9 g/dL, max

21 wg/SL).

163


Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

Sections Relevant to Workers’ Family Protection

[42 U.S.C. § 9601 et
sq]

(9) Where the Administrator of ATSDR has determined that there is a significant
increased risk of adverse health effects in humans from exposure to hazardous substances
based on the results of a health assessment conducted under paragraph (6), an
epidemiologic study conducted under paragraph (7), or an exposure registry that has been
established under paragraph (8), and the Administrator of ATSDR has determined that
such exposure is the result of a release from a facility, the Administrator of ATSDR shall
initiate a health surveillance program for such population. ‘This program shall include but
not be limited to-

(A) periodic medical testing where appropriate of population subgroups to screen for
diseases for which the population or subgroup is at significant increased risk; and

(B) a mechanism to refer for treatment those individuals within such population who are
screened positive for such diseases.

(11) If a health assessment or other study carried out under this subsection contains a
finding that the exposure concerned presents a significant risk to human health, the
President chall take such steps as may be necessary to reduce such exposure and eliminate
or substantially mitigate the significant risk to human health. Such steps may include the
use of any authority under this chapter, including, but not limited to-

(A) provision of alternative water supplics, and

(B) permanent or temporary relocation of individuals.
In any case in which information is insufficient, in the judgment of the Administrator of
ATSDR or the President to determine a significant human exposure level with respect to
a hazardous substance, the President may take such steps as may be necessary to reduce
the exposure of any person to such hazardous substance to such level as the President
deems necessary to protect human health.

(12) In any case which is the subject of a petition, a health assessment or study, or &
research program under this subsection, nothing in this subsection shall be construed to
delay or otherwise affect or impair the authority of the President, the Administrator of
ATSDR, or the Administrator of EPA to exercise any authority vested in the President,
the Administrator of ATSDR or the Administrator of EPA under any other provision of
law (including, but not limited to, the imminent hazard authority of section 7003 of the
Solid Waste Disposal Act [42 U.S.C.A. § 6973]) or the response and abatement authorities
of this chapter,

(18) If the Administrator of ATSDR determines that it is appropriate for purposes of this
section to treat a pollutant or contaminant as a hazardous substance, such pollutant shall
be treated as a hazardous substance for such purpose.

$ 9605 National contingency plan; preparation, contents, etc,

(a) Revision and republication

Within one hundred and eighty days after December 11, 1980, the President shall, after
notice and opportunity for public comments, revise and republish the national contingency
plan for the removal of oil and hazardous Title 33, to reflect and effectuate the
Fesponsibilities and powers created by this chapter, in addition to those matters specified
in section 1321(c)(2) of Title 33. Such revision shall include # section of the plan to be

233



Table 19, Federal Agency

ment in Incidents of Workers’ Iome Contamination and Related Activities

Occupational Safety and
Health Administration
(OSHA)

Austin, Texas

(Nicholas 1994; Natarajan
1994]

OSHA
Wichita, Kansas
[Goldberg 1994]

OSHA
Hawaii
[Goo 1994]

OSHA
Chicago, Ilinols
(regional office)
[Wiehrdt 1994]

‘The OSHA office in Austin, Texas investigated a referral from the Texas State Health Department concerning a child with a high BLL. The father’s BLL was
also high and his workplace had high lead levels. OSHA did not inspect the home but made recommendations to prevent further contamination. The State has a
hazard training standard where employers must inform employees of hazardous substances, See Natarajan (1994) in Table 9 for details,

‘The OSHA office of Wichita, Kansas had no data on home contamination and stated that its jurisdiction is the workplace only. However, based on feedback from
chemical workers, home contamination wax a common occurrence. Where applicable, the OSHA standards requiring showers, protective clothing, and employee
training are used to prevent home contamination.

The author pointed out that there are no provisions to ensure that contamination is removed from a worker's clothing if an over exposure cannot be proven,

‘The health department in Kankakee, Illinois referred a case of home contamination to OSHA. Resulting in an OSHA inspection of the father's workplace. In
another case the Indiana OSHA referred a case of home contamination to a Marion County health agency which then found an elevated BLL in a child. Yet in
another case the Cleveland area OSHA office discovered during a workplace inspection some of the employees’ children had elevated BLLs, OSHA made
measurements of home contamination and referred the case to the Ohlo Department of Health. See Wiehrdt [1994] in Tables 9 and 15,

Mine Safety and Health
Administration (MSHA)

Zalesak [1994]

MSHA submitted two reports of workers’ home contamination by mercury.

Department of the Interior
[Heine 1994]

Reported that home contamination has not been a problem at the National Fisheries Contamination Research Center, Personal protective equipment is used and
‘Center has hygiene plan.

Department of Energy
[Boyle 1994]

Sixteen reports of cases including 3 incidents of home contamination were extracted from DOE's Occurrence Reporting and Processing System (ORPS)
reporting system for review by NIOSH, The Department takes follow-up action such as major revisions in facility decontamination procedures,

Nuclear Regulatory
Commission
[Brockman 1993)

NRC has two databases, one for reactor related events and the other for non-reactor related events, A NRC search of these two databases found 34 incidents of
off-site contamination in the reactor related file of which several had potential for worker home contamination. In the non-reactor events databace they found 80
off-site contamination events of which 6 had potential for worker home contamination,

240



London, England

‘Table 4, Health Effects of Take-Home Asbestos Exposure (Case-Controt Studies)

Hospital-based

Matched case-control, Cases (n=83) were autopsy
series who died of mesothelioma (pleural and
peritoneal) 1917-1964; matched on gender and birth
date (+/- $ years) to in-patient controls from same.
hospital who were hospitalized 1964. ‘Two other
comparison groups were used to verify results, but not
reported in paper: 1. matched on gender, birth date,
and date of admission, and 2. 17 patients from same
hospital pathology series who were misdiagnosed as
mesothelioma.

Results

9/76 cases (7 female; 2 male) reported
domestic exposure compared with 1/76
controls from the inpatient series,

(Comment

Most femate exposures from
laundering work clothes; 2
mates exposed in childhood
to family members who
worked in asbestos factory;
latency ranged from 16-5S

years,

Vianna and Polan
(1978)

New York State

Population-based

Matched case-control. Cases were 52 (30 pleural/20
peritoneal) histologically confirmed female
mesothelioma (pleural and peritoneal) deaths (1967+
1977); one-to-one matching on gender, race, county of
residence, marital status, age and year at death;
controls died from causes other than cancer;
‘occupational history by questionnaire, medical and
industrial records.

148

Relative Risk from matched pairs
analysis for domestic exposure
(included 2 with occupational
exposure) reported as 10 (95%
Cl=14-374).

Analysis on subset of 46 non-
occupationally exposed cases: 8/46
Teported domestic exposure va, 1/46
controls (p= 0.02).

All 10 domestic cases

exposed during hand-
laundering of work clothes,



‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

Tos Roan Wort Puy Pom 7

Toxic Substances Control Public Law 94-499 [15 U.S.C. § 2601 & § 2602 Definitions H
Act Seq] (2)(A) Except as provided in subparagraph (B), the term "chemical substance" means any
organic or inorganic substance of a particular molecular identity, including —

@ any combination of such substances occurring in whole or in part as a result of a
chemical reaction or occurring in nature and

i) any element or uncombined radical.

(B) Such term does not include—
(i) any mixture,
any pesticide (aa defined in the Federal Insecticide, Pungicide and Rodenticide Act)
when manufactured, processed, or distributed in commerce for use as a pesticide,

(iii) tobacco or any tobacco product,

(iv) any source material, special nuclear material, or byproduct material (as such terms
are defined in the Atomic Energy Act of 1954 and regulations Issued under such Act),

(&) any article the sale of which is subject to the tax Imposed by section 4181 of Title 26
(determined without regard to any exemptions from such tax provided by section 4182 or
4221 or any other provision of Title 26), and

(vi) any food, food additive, drug, cosmetic, or device (as such terms are defined in
section 321 of Title 21) when manufactured, processed or distributed in commerce for use
as a food, food additive, drug, cosmetic, or device.

(5) The term “environment® includes water, air, and land and the interrelationship which
exists among and between water, air, and land and all living things.

(7) The term "manufacture" means to import into the customs territory of the United
States (as defined in general headnote 2 of the Tariff Schedules of the United States),
produce, or manufacture.

(8) The term *mixture” means any combination of two or more chemical substances if the
combination does not occur In nature and is not, in whole or in part, the result of a
chemical reaction; except that such term does include any combination which occurs, in
whole or in part, as a result of a chemical reaction if none of the chemical substances
comprising the combination is a new chemical substance and if the combination could
have been manufactured for commercial purposes without a chemical reaction at the time
the chemical substances comprising the combination were combined.

(10) The term *process* means the preparation of a chemical substance or mixture, after
its manufacture, for distribution in commerce-
(A) in the same form or physical state as, or in a different form or physical state from,
that in which it was received by the person co preparing such substance or mixture, or
(B) as part of an article containing the chemical substance or mixture.

(11) The term “processor” means any person who processes a chemical substance or
mixture.

219


compared to 0.29 ng/m’ and 0.19 ppm in the one non-farmworkers’ homes where it
was found. Chlorpyrifos was found in three of the five farmworkers’ homes at
averages 6.9 ug/m’ and 11.1 ppm compared to 1.1 ug/m* and 0.71 ppm in the one
non-farmworker’s home in which it was found. Propoxur was found in one
farmworker’s home at 16.9 g/m’ and 0.52 ppm compared to 0.15 ug/m?* and 0.10
ppm in the one non-farmworker’s home in which it was found. Twelve other
pesticides were found at low levels in some homes of both farmworkers and non-
farmworkers.

Since pesticides have many applications and some, such as DDT, are very stable
compounds, it is important to determine sources of pesticides when evaluating
workers’ home contamination. Lewis et al. [1994] found a total of 23 pesticides in 9
homes in North Carolina. From 8 to 18 different pesticides were found in individual
homes. No guidelines for levels of concern for contamination of workers’ homes by
pesticides were found.

ARSENIC

Dust in homes of workers exposed to arsenic in Hawaii contained arsenic at 5.2 to
1,080 ppm, compared to 1.1-31 ppm in dust of control homes [Klemmer et al. 1975].
Guidelines by which to judge the significance of these contamination levels were not
found.

INFECTIOUS AGENTS

Concentrations of fungal spores in farm homes in Finland were 10*-10°/m’, which was
10-1,000 times the concentrations found in urban homes [Pasanen et al. 1989].
Reports of contamination levels for other infectious agents in workers’ homes were
not found.

53


‘Table 16. (Continued) Studies on Laundering Pesticides from Contaminated Clothing

215

Formulation Fabrics Laundry or Decontamination Variables Results

Oakland et al. Atrazine (30 mg/L) Not stated 100% Cotton knit 27-C and 60°C wash, detergent (not ‘The only atrazine cross-

[1989] Diazinon (40 mg/L) 65/35 Cotton-polyester described), contaminated and non- contamination was from denim to
Metolachor (S30 chambray, 100% Cotton denim, contaminated fabrics washed together. denim in cold water, Diazinon
mg/L) 65/35 polyester-cotton with cross-contamination was greater

fluorocarbon finish than metotachlor except transfer to
denim. Cross-contamination was
significantly greater in hot water for
{ diazinon and metolachlor. Atrazine
did not cross-contaminate in hot
water, Both denim and knit fabrics
accepted cross-contamination.

Obendorf and Malathion Not stated $0/S0 Cotton-polyester with and | 200 mL water (temperature not reported, | Washing removed 30-40% of both

Solbrig [1986] Methyl parathion without durable-press finish 10 steel balls (agitation), anionic pesticides, but did not reduce the
(tagged with osmium surfactant with carbonate and reolite amounts in the Jumen of the cotton
tetroxide) builders, 2 rinses, air dried. X-ray fibers,

analysis for fabric distribution of
pesticides,

Rigakis et al. ‘Trifturalin (1 mg/L) Emulsifiable 100% Cotton fabric SO*C wash, 2 rinses at 40°C, pre-wash/no | Trifluratin removal was 77% after

{1987} Triatlate (4 mg/L) concentrate pre-wash each with one or two washes, air | one wash and 91% after two washes
Deltamethrin (0.002 dried. with pre-wash. Triallate removal
mg/L) was 52% after one wash and 82%

after two washes with pre-wash,
Deltamethein removal was 84%
after one wash and 99% after two
washes with pre-wash.

Satoh [1979] Methyt parathion Contamination by 50/50 Cotton-polyester twill 140°F wash, rinse, heavy duty carbonate Contamination levels ranged from

Note this article wearing clothes in pants and shirts laundry detergent, machine dry at 190°F 0.07 to 28.97 ppm. One washing

and the next cotton field for one for 30 minutes. Repeat procedure. reduced residues by 75-95%.

article in the day Washing seemed to be less effective

journal had the as contamination level increased.

authors and titles ‘The second wash removed a smaller
switched, See percentage of the remaining

Finley et al. [1979] residue,

for correct title

hor.



‘Table 15. (Continued) Workers’ Home Contamination-Indvstrial Hygiene Aspects

Industrial Hygiene Obecrvation

‘Winegar et al. Lead Secondary lead smelter Lead in household dust and Lead in household dust from 25 One of 33 workers showered at
[1977] clothing. households ranged from 120 to work, 8 took work clothes home for
Minnesota 26,000 ppm (2,400 ppm median), cleaning, 21 took home clothes
Lead in dust and cloth from cuffs of wom under coveralls,
pants worn under coveralls was
£0,000-600,000 ‘pm, and 700-19,000
8/25 cm* respectively,
Devrles and ‘Caustic farm products Farming Developed a cover for drums of Published design In "Hoard's
Devries acid, soap, and chlorine cleaner Dairyman" for wide distribution to
[1993] used on farm. dairy farmers.
Ontario, Canada
Jorgenson Caustic farm products Farming Precautions needed to prevent Preventive measures include Information published in
(1990) poisoning of children guidelines of storage and use. "Wisconsin Dairies" for distribution
‘Wisconsin to Wisconsin Dairles Cooperative
members,
Morris and Caustic farm products Dairy farms Developed secure storage box for Published description of box in
Morris (1992, caustic substances, “Hoard’s Dairyman" and “Farm
1993] Journal" for ditsemination to a
New Hampshire wide audience.
Anderton et al. Parathion Salvage Operation Strips of material analyzed for Plannelette sheets contaminated with Owner operated salvage business
[1968] Sheets contaminated in parathion parathion, from home and used sheets
Canada hold of ship during purchased from Insurance company
transport for home use,
Barnett [1994] Chloropicrin ‘Wood treating Not applicable. Containers of pesticide dropped on As result of accident, employer no
Oregon employee's driveway. Wind carried longer allowed employees to take
vapors next door. company cars home.
Branson and Pesticides Pesticide application ‘This is an extension bulletin Recommends cleaning clothes after
Henry [1982] alerting pesticide users of potential ‘every use, keeping contaminated
Michigan hazard and precautions for clothing separate from other

workers and familics,

clothing, and using an extra rinse.

196



community members. The group of case reports and case series (Table 9) are
reports of take-home lead incidents or assembled series of exposed family
members without a comparison group.

Of the cohort (Table 7) and community studies (Table 8), 11 were conducted in
the United States, and 25 were conducted in other parts of the world including
England, Italy, Mexico, Greece, and the Caribbean. All but four of the case
series/case reports (Table 9) came from the U.S. and many of these were
reported by State and Federal agencies as a result of the 1993 Federal Register
notice soliciting information on incidents of take-home lead exposure for this
Teview.

Cohort Studies. The cohort studies (Table 7) date back to the late 1970's,
beginning with the widely-cited report by Baker et al. [1977] published in the New
England Journal of Medicine. Over 40% of smelter workers’ children had BLLs in
excess 30 ug/dL. The work clothing was implicated as the vehicle of
contamination. This was one of the first studies to note the differences in
exposure by age; highest BLLs were found in children less than 6 years of age.
The investigators used a comparison group matched on neighborhood and
measured lead content in household paint. Both are ways to account for
background sources of lead exposure in the child’s environment.

In a study of lead storage battery workers, Morton et al. [1982] found
statistically significant differences in BLLs between children of workers with good
hygiene practices (e.g., showering and changing clothes before leaving work) and
those with poor hygiene practices.

The most recent cohort investigation of secondary lead exposure was
conducted as part of a NIOSH health hazard evaluation of a battery reclamation
site in Alabama. The small take-home component of the investigation found that
12 of 16 (75%) workers’ children had BLLs of 10 ug/dL or higher compared with
2 of 5 (40%) control children.

The cohort studies also raise the issue of home-operated shops and cottage
industries where work is conducted in or adjacent to the home. These include
"back-yard" radiator shops in Jamaica [Matte and Burr 1989], home-operated
pottery factories in Barbados [Koplan et al. 1977], and ceramic tile shops in Italy
[Abbritti et al. 1979; Abbritti et al. 1988]. Exposures in these settings pose a
special problem since employees and families are often unaware of the hazards of
working with lead. In the U.S. smaller businesses such as radiator shops are not
likely to have the services of an industrial hygienist and therefore may be unaware
of measures that could be used to prevent take-home contamination (e.g.,
protective clothing, showers) [Pedersen and Sieber 1988].

14


Giarelli et al.
[1992]
Italy

Asbestos (shipyard)

‘Table 6. (Continued) Health Effects of Take-Home Asbestos Exposure (Case Scrics)

Mesothelioma

#/RELATIONSIHIP

5 women with a history of domestic
exposure to asbestos (laundering the
asbestos-contaminated clothing of
family members).

159

AGE AT DEATH

Age at death of all
cases 33 to 92 years
(median 70 years).

170 pleural mesotheliomas examined at
necropsy between 1968-1987 (Trieste
University). Occupational histories consistent
with asbestos exposure in 150 cases, 5 had no
asbestos exposure history but lung sections
showed asbestos bodies. 5 women had a
history of domestic exposure to asbestos
(laundering the asbestos-contaminated
clothing of famity members).



Table 15. (Continued) Workers! Home Contamination-Industrial Hygiene Aspects

Author [year] Contaminant
Location
Lavy [1988] Herbicides Informing applicators of hazards Included in this advisory are
Arkansas ‘and protective measures, recommendations for preventing
contamination of the home.
Lewis et al. [1994] Pesticides Home Contamination Sampling for 30 pesticides in A total of 23 pesticides were found. Demonstrates need to consider
North Carolina carpets in 9 residences. From 8 to 18 pesticides were found in many sources when evaluating
each home, workers’ homes.
‘Oakiand et al. Atrazine Crop-spraying. Atrazine contamination of Atrazine at up to Tugfem?,
[1992] sprayer's clothing after 4 hours of
North Carolina work.
Osorio Pesticides Farming Sampled for pesticides in $ farm Tn all, 15 pesticides were found in the Sources of pesticides (alr, clothing,
[1994] workers’ homes and 6 non- study. Diazinon, chlorpyrifos and shoes) was not determined,
California farmworkers’ homes, Ppropoxur were found at much higher
concentrations in farm workers’
homes.
Stone and Stahr Pesticides Farming Analysis of applicator’s coveralls Measurable levels of 5 pesticides Demonstrates the difficulty of
[1989] for pesticides, found even though the coveralls had removing pesticides from fabrics by
Towa been washed after each use. laundering.
Ware et al. Ethyl and methy! Farming Measured contamination of Blue jeans contained methyl parathion
[1973] parathion clothing from working in treated at 6-16 mg/pair and ethyl parathion at
Arizona cotton fields for 30 minutes. about 8 mg/pair, T-shirts contained
< img.
Wolfe et al. Parathion Agriculture Analysis of parathion in empty After first rinse water contained
[1961] metal drums and effect of rinsing. parathion from 3 to 33 g/gal; after 4
Washington rinses, < 0.15 g/gal.
Fischbein (1987] Polychlorinated bipheny! Transformer ‘Serum PCBs in 2 workers and One worker's serum PCB level, 69-101 | The author recommended
USA (PCB) maintenance their wives. ng/mL, wife's 11-15 ng/mL. Other “appropriate industrial hygiene
Home laundry worker's serum PCB level, 77 ng/mL; measures" to prevent home

wife's 6 ng/mL. In both cases PCB
pattern was same as husbands,

contamination from occupational
sources,

198



Symptoms may include wheezing, chest tightness, cough and shortness of breath,
or recurrent episodic attacks of cough, sputum production, and rhinitis.

Exposures to asthmatogens occur in a number of industries including but not
limited to, agriculture; manufacture of wood products, food, and chemicals;
automobile body shops; and laboratories where animals are kept.

ARSENIC
Two references are included in Table 14. Falk et al. [1981] reported a case of
hepatic angiosarcoma in a child associated with arsenic contamination of parental
clothing, the water supply, and the environment. The father worked in a copper
mine and smelter area where his clothing became contaminated with dust
containing arsenic. His daughter, who exhibited a striking degree of pica (craving
for unnatural food such as dirt), ate dirt from the yard and licked dirt off of her
father’s shoes. Klemmer et al. [1975] studied arsenic levels in homes in Hawaii
and found higher values in homes of employees of firms using arsenic for
pesticides or wood preservation, compared to homes where the residents did other
work not involving arsenic. This lends credence to the observation by Falk et al.
[1981] that arsenic was brought to the home by the worker on clothing and
inanimate objects.

Arsenic (As), discovered in 1250 A.D., is a semimetallic solid which rapidly
oxidizes to arsenuous oxide (As,O,) with the odor of garlic. It is used in bronzing,
pyrotechnics, for hardening and improving the sphericity of shot, and as a doping
agent in solid-state devices such as transistors. Gallium arsenide is used as a laser
material to convert electricity directly into coherent light. Arsenic compounds
have also been used as pesticides. Arsenic exposure has been found near copper,
lead, and zinc smelters [Falk 1981}.

CADMIUM
Four studies reported home contamination with cadmium which originated from
parental occupation in a lead smelter (Table 14). In three of these reports,
investigators found a significant association between parental employment in the
smelter and the concentration of cadmium in the blood (CdB) or in hair (CdH) of
children. In one report no significant relationship was found between parental
occupation in the smelter and CdB in children, but a significant relationship was
reported between presence of smelter dross in the household and elevated CdB
concentration in children. Although, they did not identify women who had lived
in homes of workers exposed to cadmium, Lauwerys et al. [1980] found that
elderly women who lived in a cadmium polluted area in Belgium had a higher
cadmium body burden and a higher prevalence of signs of renal dysfunction than
women from a control area.

Cadmium induces cancers in laboratory animals and is associated with lung and
prostate cancer in humans. Other chronic effects of cadmium include renal

26


local county health department measured the BLLs of the children of these
workers, mean BLLs were 22.4 pg/dL [CDC 1992b].

These investigations resulted in chelation therapy for some victims, recommendations
for improved hygiene practices, improved engineering controls, and, in one case, a
court order to remove all workers from the workplace.

Reports of elevated BLLs in children of radiator repair workers include:

The New York City Department of Health found that three of seven radiator
repair workers’ children had BLLs at or above 10 ug/dL; recommendations for
industrial hygiene consultation were made and on-site educational programs were
undertaken [Nunez et al. 1993];

The Minnesota Department of Health investigated BLLs in radiator repair
workers and their children and identified the need for worker education, safer
work practices, better shop design, and better ventilation in the industry
[Lussenhop et al. 1989];

Other cases investigated by States where elevated BLLs in children were attributed
to the parents’ occupation include:

A Mississippi Department of Health investigation into lead contamination of a
workers’ home and made recommendations for changing shoes and clothes
before entering the home, washing clothing separately, and cleaning the home
[Pollock 1994];

A capacitor and resistor plant in Colorado was investigated by a local health
department and OSHA, finding workers and children with elevated BLLs
resulted in enforcement of the OSHA lead standard to reduce exposures of the
workers and their families [CDC 1985];

A local health department in Colorado investigated a belt buckle, plaques, and

awards manufacturer and assisted the company in reducing exposure of workers
and their families to lead [CDC 1989b];

The Iowa Bureau of Labor investigated a soil nutrient manufacturer whose raw
material contained lead [Hooper 1991]. The employees were not required to
shower or change clothes before leaving work. One workers’ child was "tested
for lead poisoning, the probable cause was washing work clothes with the child’s
clothes. Actions were taken to remedy the problem; and

A welder in Indiana whose family car was contaminated with lead and whose
child had seizures was reported by the State's Department of Labor [Molovich

95


disease with pneumonitis occurring in many cases. The organisms are highly
infectious and are often spread in dusts associated with parturition. Person-

to-person transmission is uncommon, although the disease may be contracted
by direct contact with the laundry of exposed workers.

b. There are several fungi that can be transmitted via the clothes of workers
that are capable of causing disease. These include coccidiomycosis, a
systemic fungal disease which begins as a respiratory infection that may
become disseminated and cause death. The infectious agent (Coccidioides
immitis) is common in the arid and semiarid areas of the United States and
is commonly transmitted on dust particles when the dry soil is disturbed but
may also be transmitted on sheep wool. Also, Aspergillosis (caused primarily
by Aspergillus fumigatus, A. niger, and A. flavus) is a fungal disease that may
be transmitted on workers. Several clinical conditions can be produced by
these fungi including the formation of masses of hyphae within ectatic
bronchi and pneumonic and disseminated infection. The organisms are often
found in compost piles undergoing decay and fermentation, hay that has been
stored damp, in decaying vegetation, and in cereal grains. Although not an
infectious disease, Aspergillus species as well as many other fungi may cause
allergic reactions such as asthma in sensitive individuals.

The occupation or job elements of workers should also be considered when "take-
home infectious diseases" are considered. For example, in occupations such as
farming the worksite and home are often located virtually together and infectious
agents that are at the worksite may easily be transported directly or indirectly
(e.g., via vectors) into the home and infect household members.

Based on the potential proximity to large reservoirs (e.g., grain storage, compost
Piles) of fungus on farms, there is perhaps a greater potential for fungal exposures
in farm households. A study in Finland of airborne fungal spore concentrations in
farm houses during the winter months indicated that some fungal genera not
normally found in the urban environment (e.g., Alternaria, Botrytis) were found in
the farmhouses as well as the cow barns [Pasanen et al. 1989]. The results of the
study indicated that airborne fungal spores may be carried from the cow barn into
the farmers’ homes.

Other diseases that may be directly associated with specific occupations include
animal diseases such as brucellosis and anthrax. Brucellosis is primarily an
occupational disease of farm workers, slaughterhouse workers, veterinarians, and
meat plant workers who are exposed to infected animals or tissues.
Approximately 150-250 cases per year are reported in the United States
[Benenson 1985]. Transmission is primarily by direct contact with infected
animals (e.g., cattle and swine) but the bacteria can survive in dust and airborne
transmission is possible [Anonymous 1978]. Anthrax (Bacillus anthracis) is an
acute bacterial disease that usually initially affects the skin but may occasionally

31


‘Table 14. (Continued) Health Effects of Take-Home Exposure to Other Substances

STUDY DESIGN

Cohort of 514

Average cadmium in blood of these

Maravelias Cadmium Lead smelter On average boys had significantly higher
etal. children age $-12 children was 0.36 ug/L, range 0,1-3.2 COB than girls, CAB increases with age
[1989] from 4 schools ng/L; it was higher in children from (# = 0.1917, p<0.001).
Greece located within various | school closest to the smelter (500 m) as
distances from the compared to the other schools but no
smelter: relationship was found with parental
a. 500m employment in the smelter.
b, 900 m
¢. 1500 m
@, 1500 m
Hofstetter et al. Cadmium Lead smelter Cohort 229 children Mean concentration of CdB 0.14 g/dL,
[1990] ages 6-7 years, range <0.1 -0.5 g/dL. Significantly
Germany Measured cadmium in | higher C4B are observed among
blood (C4B). children from 2 echools (p< 0.01 and
P< 0.001) located in the vicinity of the
smelter as compared to school located
the farthest distance from the smelter,
C4B among children whose fathers were
employed at the smelter was higher than
those of fathers who hed other jobs not
statistically significant.
Madoff Fibrous glass Home Case report Deep excoriations of the skin were ‘The cause was traced to clothes washed in
[1962] found on a S-year-old boy's trunk and a contaminated washing machine where
Unknown thoulders. The boy's 2 younger sisters several pairs of fibrous glass curtains had
also developed the same symptom later. been washed,
Abel Fibrous glass Home Case report A mother and her 3 children developed ‘The mother had washed a fibergtass
[1966] severe pruritus, curtain with the family laundry in the
New York washing machine.
Peachey Fibrous glass Home Case reports A woman and her 6 children, and Both cases were traced to mixing glass-
[1967] another family of 3, developed pruritus. fibre curtains with the family clothes in
‘Unknown The man of the former family did not the same washing machines. The clothes

have the symptom.

of the man who was not affected were
handwashed eeparately,

182


Hardy HL [1948]. Delayed chemical pneumonitis in workers exposed to beryllium
compounds. Am Rev Tuberc 89:547-556.

Hardy HL, Rabe EW, Lorch S [1967]. United States beryllium case registry (1952-1956).
Review of its methods and utility. J Occup Med 9(6):271-276.

Hartle RW [1987]. Hazard Evaluation Report: Letter of February 13, 1987 re:
Southeastern Pennsylvania Transit Authority, Paoli, PA to William D. Steuteville, Region
Ill, U.S. Environmental Protection Agency, Philadelphia, PA. Cincinnati, OH: US.
Department of Health and Human Services, Public Health Service, Centers for Disease
Control, National Institute for Occupational Safety and Health, NIOSH Report No.
HETA 86-241. 18 pages.

Hartle RW, Richardson FD, Crandall MS [1987]. Health Hazard Evaluation Report:
Aluminum Company of America, Lafayette, Indiana. Cincinnati, OH: U.S. Department
of Health and Human Services, Public Health Service, Centers for Disease Control,
National Institute for Occupational Safety and Health, NIOSH Report No. HETA 86-
445-1831. 27 pages.

Hasan FM, Kazemi H [1974]. Chronic beryllium disease: A continuing epidemiologic
hazard. Chest 65(3):289-293.

Hatch M [1990]. Memo of December 11, 1990 re: Yuma - mercury poisoning to the file
of the Arizona Department of Health Services. 5 pages. Available in Cincinnati, OH:
Docket Office, Education and Information Division, National Institute for Occupational
Safety and Health, Centers for Disease Control and Prevention, Public Health Service,
U.S. Department of Health and Human Services.

Heine PR [1994]. Letter of February 1, 1994 re: workers’ home contamination at the
National Fisheries Contamination Research Center to Diane Manning, Education and
Information Division, National Institute for Occupational Safety and Health, Centers for
Disease Control and Prevention, Public Health Service, Department of Health and
Human Services. 1 page.

Heller RM, Janower ML, Weber AL [1970]. The radiological manifestations of
malignant pleural mesothelioma. Am J Roetgenol 108(1):53-59.

Hess GK [1988]. Castlewood removal action, Ballwin, Missouri. OSC Final Report,
FIRE/EP&R/ENSV. May 18, 1988.

Hesse JL [1991]. Letter from State of Michigan to John Zirschky, January 24, 1991 re:
chemicals taken from workplace into the home. Available in Cincinnati, OH: Docket
Office, Education and Information Division, National Institute for Occupational Safety
and Health, Centers for Disease Control and Prevention, Public Health Service, U.S.
Department of Health and Human Services.

116


disease, impaired lung function, and interference with calcium metabolism.
Cadmium has a very long half-life in the body (up to 30 years in muscle);
consequently, toxic levels may eventually be attained from very low levels of
exposures.

Cadmium (Cd) was discovered in 1817 as an impurity in zinc carbonate. Almost
all cadmium is obtained as a by-product in the treatment of zinc, copper, and lead
ores. It is a soft, bluish-white metal, similar in many respects to zinc. Cadmium
is used extensively in electroplating, many types of solder, for Ni-Cd batteries, in
plastics stablizers, and in paint pigments. Cadmium compounds are used in black
and white television phosphors and in blue and green phosphors for color
television tubes. The sulfide is used as a yellow pigment.

FIBROUS GLASS
Three case reports included in Table 14 [Abe] 1966; Madoff 1962; Peachey 1967]
describe a dermatitis caused by wearing clothes contaminated with fibrous glass.
In these cases, the sources of the contamination were family or laundromat
washing machines where fibrous glass curtains had been washed. NIOSH has
been made aware (personal communication) of a current potential case in which
the wife and child suffered dermatitis as a result of washing an insulation worker’s
clothes with the family laundry.

Fibrous glass is a synthetic vitreous fiber manufactured by the blowing, spinning,
or drawing of molten materials comprising silica and selected inorganic oxides. It
has many uses including household and aircraft insulation, filter media, production
of certain types of face masks, and the manufacture of fiberglass boats.

OTHER SUBSTANCES
Another chemical substance found to have been studied as a take-home
contaminant is tin [Rinehart and Yanagisawa 1993; Briss 1994]. Health effects of
tin were not detected in these studies.

Woody et al. [1986] reported a case of a child who developed an episode of status
epilepticus from eating cyclotrimethylenetrinitramine (RDX). The child’s mother
worked in an explosives manufacturing plant and transported RDX home as
clumps on clothing and shoes.

INFECTIOUS AGENTS
Overview
Reviewed in this section are infectious agents that could be transmitted from the
workplace to the home on the body or clothing of the worker. Infectious agents
that normally do not cause life threatening disease in healthy individuals, such as
the common cold, are not considered to be under the perview of the Worker’s
Family Protection Act. Infectious diseases “within” a worker that are not
physically on the body or the clothes are not considered in this review. For

27


ponent eS

‘Author [year]
Location

Contaminant

Table 15. (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Industrial Hygiene Methodology

Industrial Hygiene Observation

Workers Shoes, 11,030

Placiteili and Lead Bridge repair Wipe and vacuum samples for dust Lead loading (ug/m?): Data from homes with lead in paint
Whelan in automobiles and homes of in entry floor, 2,031 > 0.5% excluded.
(1995) workers. Samples of loose paint Change area floor, 2,278
Ohio and water supply analyzed for lead. | Washing machine tid, 801

Sofa/chair, 639

Driver's seat, 5,647

Floor of car, 10,653

Steering wheel, 790

Worker's hands, 3,131

Family member's hands, 140
Piacitelli and Rice | Lead Radiator repair shops Surface wipe sampling of workers’ | Lead in cars up to 96,000 pug/m’; on
[2993] cars, hands and foreheads, foreheads of workers, 6,000 ug/m?;
Ohio Evaluation of hand washing. on unwashed hands, 78,050 ug/m?;

average ‘on unwashed hands, 678

wales after washing hands, 593

wale’,
Piacitelti et al. Lead Bridge work: lead- ‘Wipe and vacuum samples were Lead contamination was found in all Abrasive blasters regularly changed
{in press) based paint abatement | collected in 27 automobiles of automobiles. The mean lead loading | out of work clothing and showered
See also abrasive blasters and other lead- was lower in abrasive blasters’ cars before entering their cars, whereas
Ewers et al, exposed workers, than in other worker cai the other workers did not. Half
{1994a, 1995] g/m? vs. 2,000 g/m. Lead the workers regularly had child
Connecticut loadings on floors and seats of cars passengers.

were 340-2,000 wg/m? and on other

surfaces < $00-1,900 ug/m2.
Pichette et al. Lead Battery manufacture BLL of spouse and other adult When laundered by: company BLLs
{1989} Battery household members by laundry were 8.4 ug/100 mL; spouse,
Texas manufacture/Battery practice. 13.0 g/dL; other household member,

recycling 15.6 g/dL.
Battery recycling

Pitts Lead Radiator repair ‘Wipe samples of lead in dust at Lend (ug/filter) in: Living room paint had lead at
(1986) home and in car; area sampled not | Bathroom closet, 183 0.03%; yard soil had tead at 39
Garrettson reported, Kitchen floor, 284 ppm.
[1988] Floor board of car, 7,580 ‘The father did not change clothes
Virginia Driver's seat, 1,295 or shower at his work site, The

highest lead level in the house was
near the washing machine,
Children frequently played in the
car,

193



GLOSSARY
cyanotic - relating to the dark bluish or purplish coloration of the skin and mucous membranes due
to deficient oxygenation of the blood in the lungs or to an abnormally great reduction of the blood
in its passage through the capillaries.
droplet nuclei - droplets that contain infectious particles and are made by the evaporation of fluid
from the droplets formed during the production of aerosols. Droplet nuclei may remain suspended
in the air for long periods of time and are associated with respiratory diseases.
dysphagia - difficulty swallowing.
encephalitis - inflammation of the brain.

encephalopathic - relating to any disease of the brain.

esophageal perforation - a hole in the portion of the digestive tract between the throat and the
stomach.

febrile disease - a disease with a fever component.
fibrosis - formation of fibrous tissue, as a reactive or reparative process in the body.

fomites - inanimate objects that may be contaminated with infectious organisms and serve in their
transmission.

fungi - molds and yeasts - they have characteristics of both plants and animals and may cause
diseases (i.e., mycoses, mycotoxicoses, and allergies).

gynecomastia - excessive development of the breast in a male.
giardiasis - an intestinal infection with the protozoan Giardia lamblia.
hepatomegaly - enlargement of the liver.

imbecile - mentally deficient.

lymphoblastic - relating to a young, immature cell that is destined to mature into a lymphocyte
white blood cell.

mental retardation - an intellectual deficit that causes incompetence in the performance of social
roles.

metastasis - in cancer, the appearance of neoplasms (tumors) in parts of the body remote from the
seat of the primary tumor.

mesothelioma - a tumor derived from the cells of the pleural or peritoneal membranes.

moribund - dying, at the point of death.

279


‘Table 15. (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Industrial Hygiene Methodology

Apot and Singat Lead Lead acid storage Air sampling in plant Personal breathing zone samples (5) Owner & family lived above plant.
[1980] battery manufacturing ranged from 111 to 1,053 ug/m>, Recommended: Installing change
Alaska room, closing up hallway between
plant and home, clean home, and
monitor family for lead exposure.
Baker et al. Lead Secondary lead smelter Sampled homes for lead content in Dust in workers’ homes contained Asa result of study, workers
11977} house dust. lead at 2,687 ppm (<1,000-80,000) vs. | homes were cleaned, Workers
Tennessee Analyzed wipe samples by anodic 404 ppm for controls. started showering and changing
stripping voltametry. clothes before going home.
Bamett [1994] Lead Tile manufacturing Not applicable 1 worker had a biood lead leve! of Investigators think at least one
Oregon T3 ug/L. child (of a worker) has high blood
lead,
Bamett [1994] Lead Bronze foundry Not applicable. 2 children of foundry workers had Oregon OSHA documented that
Oregon high BBLs (14 & 23 g/dL). employees were taking lead dust
home on clothes.
Carvalho et al. Lead Lead smelter Blood lead samples analyzed via Children of lead workers had higher
{1984] atomic absorption blood lead values (67.5 g/dL) than
Brazil spectrophotometry with heated other children (56.6 g/dL). Lead
graphite furnace atomizer. workers took used “filters” home from
the plant, for re-use in their home.
CH2M Hitt [1991] | Lead Lead smelter Vacuuming and shampooing; Lead loading in carpets ranged from $00 ug/g (lead/total dust) action
Idaho analyses for lead and other metals. 12 to 283 m/f? and in furniture level for cleanup advisory.
from 57 to 1,100 mg/ft4, only 14-30%
of lead was removed from carpets; 5-
40% from furniture.
Cook et al. [1993] Lead Lead mining and Work practices questionnaire. Lead in window sill dust 30-27,900 Positive association between miner
Colorado smelting Samples of floor dust, window sill PPM, floor dust 8-11,000 ppm. wearing work clothes home and
(Leadville) dust, paint and tap water were BLLs in children.
analyzed for lead.
Crachur et al. Lead Various lead industries Telephone interviewers asked The data indicate that elevated blood Data collected after June 1992.
{1998} about showering at work, washing | lead levels in children are associated
New Jersey ctothes at home, etc. with parents washing dirty work

clothing at home.

187



‘Tabte 15. (Continued) Workers’ Home Contamination-lndustrial Hygiene Aspects

Pollock Lead Trucking lead and lead Lead in dust at home. Lead found on surfaces in home up to 200 g/t? is mit for dust on.
[1994] products 20 pe/tt’; on worker's thoes at floors, Change clothes & shoes
Mississippi AO ug/f*. before entering home, wash work
clothes separately, clean or wash
floors, carpets, furniture and toys.
Que Hee et al. Lead Not applicable Method development for sampling Recovery of lead dusts from surfaces
(1985] & analysis of house dust and hand | by single vacuuming was 74%, by five
Ohio contamination. vacuumings, 100%. Recovery of lead
from hands by single wipe was $2%,
by five wipes, 100%.
Rice et al, [1978] Lead Secondary lead ‘Wipe samples of dust collected in Lead content of wipe cloths in More stringent work practices &
USA smelters workers’ homes and control workers’ homes, 79-112 ug; control personat hygiene are required,
homes, homes, 10-29 ug. Lead concentration
In settled dust, 3.31 g/m? In workers’
homes; 1.24, in control homes.
Rinehart and Lead, tin Blectric cable splicing House dust samples collected with Laundry areas of workers’ homes, Since workers’ exposures to lead
‘Yanagiswa [1993] Workers’ homes a hand-held vacuum, anatyzed by 621-1,606 ppm of lead in dust; control were below the OSHA PEL,
See also contamination X-ray Muorescence. homes, 91,212 ppm. Other arcas of workers washed their soiled clothes
Venable et al. measurements workers’ homes, 227-909 ppm of tead at home,
(1993) compared to control in dust; contro! homes, 121-879 ppm.
Massachusetts homes ‘Tin in workers’ homes: laundry areas,
73-242 ppm; other areas, 45-115 ppm.
Tin in control homes: laundry areas
up to 73 ppm; other areas not
detected,
Sherlock et al. Lead Lead levels in BLLs and hand washing practices. Children who washed hands before Children should be encouraged to
(1985) Caucasian and Asian eating had lower BLL levels than wash hands before eating.
‘United Kingdom children children who did not. |
Simonson and Lead Smelter Evaluation of airshowers and Air shower removed $ to 72% of lead Some penetration of lead to
Mecham [1983] automatic shoe cleaners for lead from clothing. No quantitative data underclothes,

removal from clothing,

reported for shoe cleaners,

|

194


Industries Association, Inc. has produced a video tape entitled “Control of Lead
Exposure in the Ceramics Industry” [LIA 1993b].

Piacitelli et al. {in press] studied contamination in cars of workers engaged in
removing lead-based paint from a bridge. They found that lead contamination was
lower in cars of abrasive blasters (379 »g/m’) than in those of other workers (1,100
ug/m’). Abrasive blasters had the highest air-borne exposures at the worksite, but
regularly changed clothes and showered before entering their vehicles whereas the
other workers (industrial hygiene/safety and security personnel) did not. This study
provides evidence of the effectiveness of the preventive measures, but also indicates
that the measures should be extended to the lesser exposed workers. The OSHA
lead standard for construction workers (29 CFR 1926.62) does not require showering
and changing clothes unless exposures exceed 50 g/m’ as an 8-hr. time-weighted
average.

Rinehart and Yanagiswa [1993] found that even though electric cable splicers shower
and change clothes at work, they contaminate their homes by taking their
contaminated clothing home to wash. Since these workers’ exposures are less than
the OSHA standard of 50 zg/m’ (29 CFR 1910.1025), employers are not required to
launder the employees’ clothes.

Excessive lead exposure was identified for workers at a battery factory and for some
of the workers’ children [CDC 1977b]. The factory initiated a program designed to
reduce worker and family exposures. Plant processes, including exhaust ventilation
systems, were improved and coveralls and improved shower facilities were provided.
Under the direction of the local health department, the homes of the affected
children were thoroughly cleaned.

Morton et al. [1982], in a study of BLLs in children of workers engaged in battery
manufacture, found that only changing clothes at work did not reduce the risk of
elevated BLLs in the workers’ children. They recommended showering before
leaving work in addition to changing clothes. Similar findings were reported for
backyard battery repair shops [Matte and Burr 1989; Matte et al. 1989] where
changing from work clothes before entering the home did not result in lower
concentrations of lead in housedust.

An article specifically directed at protecting lead battery workers’ families was
published in Battery News in 1980 (Lundquist, 1980]. This article informs the readers
that levels of contamination that may be considered innocuous in the workplace may
be of concern in the home where children are exposed and daily exposures are for 24
hours. The article also informs the readers of several sources of home and
automobile contamination. In addition to the workers body and clothing, the reader
is advised of the hazard of children visiting the workplace and taking home
contaminated items such as scrap or surplus material.

56




contaminants. Lillie et al. [1981] found no differences in after-washing residues
between 100% cotton and 100% polyester fabrics when diazinon, propoxur, carbaryl
and prometon were the contaminants.

Functional finishes generally make laundering less effective [Laughlin and Gold
1988]. Keaschall et al. [1986] found that fluorocarbon finishes reduced absorption of
pesticides, but did not facilitate removal by laundering. Laughlin and Gold [1989a,b}
found that while contamination of 100% cotton and 50%/50% cotton-polyester
fabrics was decreased by finishing the fabrics with a fluoroaliphatic soil repellent,
residual methyl parathion after washing was greater in the finished fabrics. Similar
results were reported by Hild et al. [1989] for 50%/50% cotton-polyester fabric.

Laundry variables that have been studied include: water temperature, detergents, pre-
wash treatment, water level, drying method (air/machine), repeated washing, and
other laundry additives (bleach, ammonia).

Hot water (60°C), in general, removes more pesticides than warm (49°C) or cold
(30°C) water [Lillie et al. 1981; Kim et al. 1982; Kim et al. 1986; Lillie et al. 1982;
Kim and Wang 1992; Easter 1983; Easter and DeJange 1985; Laughlin et al. 1985].
With 2,4-D ester which is classified as insoluble, Easter et al. [1983] found 26%
removal from contaminated fabrics washed at 30°C and 45% removal when washed
at 60°C. With the 2,4-D amine (solubility 4,400-18,000 mg/L at 30°C), more than
99% was removed when washed either at 30°C or 60°C. Similarly, Chiao-Cheng et al.
[1988] found that more than 99% of carbofuran (solubility 700 mg/L) and methomyl
(solubility 60,000 mg/L) were removed by washing at either 49°C or 60°C.

Detergents that have been studied include heavy-duty liquid detergents without
phosphates, detergents with phosphates, and those with carbonates. Easley et al.
[1982b} and Laughlin et al. [1985] found that a heavy duty liquid detergent resulted
in lower residual methyl parathion in fabrics after washing than when commercially
available detergents containing phosphates or carbonates were used. A heavy-duty
liquid detergent without phosphate was also found to be superior to a 12% phosphate
detergent for laundering clothes contaminated with 2,4-D ester. By contrast, Kim et
al. [1986] found that detergents containing phosphate were superior to a heavy-duty
liquid detergent for removing alachlor from contaminated fabrics. Hild et al. [1989]
found that a heavy-duty nonionic liquid detergent and an anionic phosphate detergent
were equally effective in removing parathion from contaminated fabrics.

Pre-wash treatments have generally been found to contribute substantially to removal
of pesticides from fabrics. Nelson et al. [1992] found that a commercial pre-wash
product lowered the amount of contaminants remaining in fabrics after washing for
11 pesticides, and Keaschall et al. [1986] found that a pre-wash spray and a degreaser
were both beneficial for removing another group of 11 pesticides from contaminated
fabrics. Rigakis et al. [1987] confirmed the effectiveness of a pre-wash treatment to
enhance removal of three of the pesticides studied by Nelson et al. [1992]. Kim et al.

66


and Wolff 1987]. The PCB levels for the wives who laundered their husbands
clothes were not elevated but their PCB pattern resembled the Aroclor 1254
pattern of their husbands, suggesting that the PCBs found in the women’s blood
were derived from contact with their husbands.

After PCBs were released into the municipal sewage treatment plant by an
electrical manufacturing firm in Bloomington, Indiana, PCBs were found in the
blood serum of sewage treatment workers (75.1 ppb), their family members (33.6
ppb), community residents (24.4 ppb) and people who applied sludge from the
plant on their yards (17.4 ppb) [Baker et al. 1980]. Thus, the workers’ family
members had higher concentrations of PCBs in their blood serum than the other
non-occupational groups.

Good and Pensky [1943] reported that 52 electricians exposed to Halowax in
shipbuilding developed chloracne as did some of their wives. Halowax was a
mixture of chlorinated naphthalenes and other chlorinated hydrocarbons. Other
details about the wives were not reported.

After an explosion at a factory producing 2,4,5-trichlorophenol in Derbyshire,
Britain, two pipefitters developed chloracne [Jensen et al. 1972a,b; May 1973].
The son of one of the pipefitters developed chloracne similar to that of his father.
His father wore his dirty work clothes at home after working around equipment
contaminated with dioxin which had formed at the time of the explosion. The
wife of the other pipefitter also developed chloracne.

In Midland, Michigan, Townsend et al. [1982] and in New Zealand, Smith et al.
[1982] measured the reproductive effects in wives of workers exposed to 2,4,5-
trichlorophenol and 2,3,7,8-TCDD (dioxin) respectively. In both cases, no adverse
reproductive effects were found.

A suspected bladder carcinogen, 4,4’-methylene-bis(2-chloroaniline) (MOCA), was
found in excess of 12.0 ppb in urine of family members of workers from two
different specialty plastics manufacturing plants [ATSDR 1989a,b; ATSDR 1990b;
Hesse 1991]. Another potential human carcinogen, 3,3’-dichlorobenzidine was
present at 0.006-0.281 ppm in urine of family members and employees of another
chemical production facility in Michigan [ATSDR 1991b].

A 6-week old girl developed jaundice and hepatomegaly due to exposure to
tetrachloroethylene (TCE) in breast milk [Bagnell and Ellenberger 1977]. TCE in
the mother’s blood was 0.3 mg/dL and in the breast milk it was 1.0 mg/dL. The
mother frequently visited the father during lunch at the dry-cleaning establishment
where he worked. One week after breast feeding was stopped, no TCE was
present in the blood of the infant and liver function returned to normal.

21


Health and Welfare. Available in Cincinnati, OH: Docket Office, Education and
Information Division, National Institute for Occupational Safety and Health, Centers for
Disease Control and Prevention, Public Health Service, U.S. Department of Health and
Human Services.

Christesen HBT [1994]. Epidemiology and prevention of caustic ingestion in children.
Acta Paediatr 82:212-215.

Christian RR, Manchester JT, Mellor MT [1983]. Bacteriological quality of fabrics
washed at lower-than-standard temperature in a hospital laundry facility. Appl Env
Microbiol 45(2):591-597.

Clapp DE, Boeniger M, Heitbrink W, Tolos W [1985]. Health Hazard Evaluation
Report: Steinmetz & Sons, Moscow, Pennsylvania. Cincinnati, OH: U.S. Department of
Health and Human Services, Public Health Service, Centers for Disease Control,
National Institute for Occupational Safety and Health, NIOSH Report No. HETA 84-
508-1626. 20 pages.

Clark J, Frissen DL, Williams WA [1992]. Management of an outbreak of Norwegian
scabies. Am J Infect Control 20:217-220.

Cleverly SD [1994]. Letter of March 7, 1994 re: workers’ home contamination in
Montana to Diane Manning, Education and Information Division, National Institute for
Occupational! Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 1 page.

Clifford NJ, Nies AS [1989]. Organophosphate poisoning from wearing a laundered
uniform previously contaminated with parathion. JAMA 262(21):3035-3036.

Cloud RM, Hrantizky MS, Day MO, Keith NK [1983]. Clothing as a barrier against
insecticides. Louisiana Agriculture 26(4):20-21.

Colavito M [1994]. Letter of February 11, 1994 re: workers’ home contamination in New
York State to Ms. Diane Manning, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 1

page.

Coleman NP [1994]. Letter of February 7, 1994 re: workers’ family protection in
Oklahoma to Ms. Diane Manning, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 1

page.

107


recommended more careful handling of and administrative controls for
americium sources.

Nuclear Regulatory Commission (NRC)

NRC did not report cases of Agency responses to incidents of workers’ home
contamination. However, it has established reporting requirements that identified
cases of potential home contamination and responses of employers involved. The
U.S. Nuclear Regulatory Commission has regulatory jurisdiction over byproduct
material of reactors plus "special nuclear material" used as reactor fuels or bomb
material. Users of radioactive materials falling under NRC jurisdiction include
commercial nuclear power plants, university and hospital laboratories using
radioactive materials, and industrial users of radiation sources. Twenty-nine States
have agreements with NRC delegating to the States regulation of nuclear materials
within their borders; NRC directly administers regulatory activities in the remaining
21 States.

Reporting regulations contained in 10 CFR 20 are intended to cover all significant
incidents of off-site contamination, including contamination by radioactive material
accidentally or intentionally brought home by workers.

NRC maintains two databases potentially containing reports of off-site contamination
of workers’ homes: the database of events called in to the NRC Operations Center
(dealing mostly with reactor-related events) and the Non-Reactors Event Reporting
(NRER) database, which is a compilation of significant Non-Reactor licensee reports
that were originally sent to the NRC regions [Brockman 1993].

At the request of NIOSH, NRC personnel searched these two databases to identify
events involving radioactive contamination brought home from the workplace. A
search of NRC Operations Center data from 1985 to mid-September 1993 identified
34 incidents of off-site contamination; in seven of these, the brief reports directly
address the possibility for take-home radioactive material.

e Contaminated hand tools were found in the home of a nuclear power reactor
contractor’s home. One tool was radioactive, but no personnel or items in the
contractor’s. home were contaminated.

© A deliberate ingestion of uranium acetate was associated with contamination of
the ingester’s home.

e Four nuclear power plant contract workers contaminated their socks and shoes,
which went initially undetected by monitor with potential contamination of a
home and a hotel.

e Low-level contamination, initially undetected at a portal monitor, was discovered
on clothing brought home by a power reactor worker.

91


Table 20, (Continued) How State Agencies Respoad to Incidents of Workers’ Home

‘Contamination — States that Have Their Own OSHA Program

INFORMATION PROVIDED TO NIOSH

STATE AGENCY

Michigan Department of Natural Resources The Department reported that the Michigan Environmental Response Act has a section dealing with identification,
priority evaluations, and remediation of environmental sites of contamination. The Department has no
information about workers transporting chemicals to homes (Oskwood 1994],

New York Department of Environmental The Department reported that it follows OSHA regulations and provides protective equipment for workers. It was

Conservation not aware of any take-home exposure cases [Edouard 1994].

Department of Health The Department of health reported that it has studied exposures resulting from dry cleaning - occupationally
exposed nursing mothers and other populations (London 1994; Schreiber et al. 1993; Stasiuk 1993}.

Department of Labor The Department of Labor reported that it has not conducted any investigations involving contamination in
workers’ homes [Colavito 1994).

Oregon Department of Health The Department of Health reported that it maintains surveillance programs for blood lead and pesticide exposure.
Information on workers’ contamination of homes, such as two case histories submitted to NIOSH can be obtained
from these sources. There are no Oregon rules or laws dealing specifically with home contamination [Barnett
1994),

Department of Labor The Department reported that Oregon OSHA has many regulations that help to prevent home contamination via
work practice controls and work hygiene {Schuster 1994].
Puerto Rico Department of Labor and Human Puerto Rico reported that it has no reports or regulations on home contamination [Valdes 1994].
Resources

Utah Department of Health The Department of Health submitted a report of a study to NIOSH about a take-home Incident among lead
burners conducted by the Utah Department of Health and NIOSH [Beaudoin 1994; CDC 1992a].

Virginia Department of Labor and Industry ‘The Virginia OSHA identified 3 cases of workers’ home contamination by lead and submitted summaries of the
inspection reports to NIOSH [Amato 1994].

Department of Health The Department of Health reported that it had investigated two cases of lead poisoning of children whose parents
were exposed in the workplace [Wasti 1994; Anonymous 1992; Pitts 1986}.

Wyoming Department of Health The Department of Health reported that it has no program in place to measure hazardous chemicals and

substances carried home by workers (Sabes 1994].

249


Anderson LS, Warner DL, Parker JE, Bluman N, Page BD [1965]. Parathion poisoning
from flannelette sheets. Can Med Assoc J 92:809-813.

Anonymous [1994]. Protect yours from pesticides. Talahassee, Florida, Florida
Department of Agriculture and Consumer Services. 4 pages.

Anonymous [1993b]. Pleural plaques due to high exposure in the daughters of a
pipelagger. Case of the month-September 1993. In: McDonald JC. Surveillance of
work-related and occupational respiratory disease (SWORD) report for September 1993.
London, National Heart and Lung Institute.

Anonymous [1992]. Summary of investigation of lead exposure of the employees of the
... Dinwiddie County [Virginia]. Available in Cincinnati, OH: Docket Office, Education
and Information Division, National Institute for Occupational Safety and Health, Centers
for Disease Control and Prevention, Public Health Service, U.S. Department of Health
and Human Services. 6 pages.

Anonymous [1978]. Occupational hazards from animal diseases. Protection. July
1978:19-20.

Anonymous [{1968]. How to prevent mercury poisoning in the quicksilver mining
industry. Los Angeles, CA and Berkley, CA. Department of Industrial Relations and
Department of Public Health. 4 pages.

Anonymous [1952]. Children of storage battery makers in Philippines contract lead
poisoning. Occup Health 12(5):71.

Apol AG, Singal MA [1980]. Health Hazard Determination Report: Alaskan Battery
Enterprises, Fairbanks, Alaska. Cincinnati, OH: U.S. Department of Health and Human
Services, Public Health Service, Centers for Disease Control, National Institute for
Occupational Safety and Health, NIOSH Report No. HE 80-44-731. 11 pages.

Ashcroft T, Heppleston AG [1970]. Mesothelioma and asbestos on Tyneside~a
pathological and social study. In: Shapiro HA, ed. Pneumconios. Proc Int Conf
Johannesburg, So. Africa. Capetown, So. Africa, Oxford University Press. pages 177-
179.

ATSDR [1993a]. Final Report. Studying of symptom and disease prevalence. Caldwell
Systems, Inc. Hazardous Waste Incinerator. Caldwell County, Lenoia, North Carolina.
Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service,
Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease
Registry, NTIS No. PB93-231041. 132 pages.

ATSDR [1993b]. Site review and update. Anderson Development Company. Adrian,
Lenawee County, Michigan. Atlanta, GA: U.S. Department of Health and Human

100


Dolcourt et al.
(1978)

See also

CDC [1977]
North Carolina

‘Table 15. (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Battery factory

Carpet vacuum samples

Industrial Hygiene Observation

Average concentrations of lead in
house dust were 1,700 to 47,534 ppm
in 6 homes, Clothes closets
demonstrated particularty large
degrees of contamination, up to
84,000 ppm. Cars contained lead in
dust at an average of 2,770 ppm.

TV

Contaminated work clothing was
the probable home lead
contamination source; paint, water
supply and air were ruled out as
sources of lead,

Dolcourt et at.
(1981)
North Carolina

Battery recycling.
Battery castings were
burned as fuel in one
family’s wood burning
stove.

Dust samples collected by vacuum.

Decontamination with Calgon®,

Dust from kitchen floor contained
lead at 41,283 ppm (13.6 mg/m“);
from bedroom floor 6,800 ppm (3.3
mg/m?); from living room floor 5,862
ppm (5.9 mg/m"); from sofa 13,283
ppm. About 5.5% was removed by &
single decontamination procedure,

Battery recycting out of the home
kitchen,

Stained glass studio.

Air samples at work and home.
‘Wipe samples at home and studio.
Vacuum carpet at home.

Home-air, home-wipe and carpet-
vacuum samples all were below the
detection limit.

Studio wipe samples = 1.2 to

1,600 mg/m*.

Breathing-zone alg samples in studio
= 0.1 to 80 ug/m”,

General-area air samples in studio
S.2 g/m? home and outside
< 0.1 ug/m>,

‘The studio adjoin the home.
Engineering controls & hygiene
practices account for low blood
lead and low lead in the home.
The simple, fow-cost control
techniques used at the studio could
benefit others in the (rade,

Dog and child not permitted in
studio,

Ewers et al.
[19%4a, 1995)
See also
Piacitelli et al.
{in press)
Connecticut

Abrasive blasting of
lead-based-paint from
bridge

‘Wipe samples for lead taken from
hands and faces of workers’ and
smooth surfaces of personal
vehicles, vacuum samples of car
floor carpets and seats, and gauze
patches were attached to workers
clothing.

Lead on: unwashed faces 4-1,800
ug/wipe, washed 4-260 ug/wipe;
unwashed hands 4-5,600 zg/wipe,
washed hands 1-920 ng/wipe; clothing
17,700 ug/gaune pad (<1-1,200
ug/em“); care up to 2,000 gfe? on
floor, 1,100 g/em? on driver's arm
reat,

188


Calcaterra C [1994]. Letter of January 27, 1994 re: workers’ home contamination in
Nebraska to Richard W. Niemeier, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 1

page.

Cannel RJ, ApSimon HM, Goddard AJH [1987a]. The tracking and measurement of the
ingress of particulate matter into urban dwellings. In: Proceedings Aerosol Society
Conference, March 1987; Loughborough University of Technology, UK. pages 157-160.

Cannell RJ, Goddard AJH, ApSimon HM [1987b]. Contamination of dwellings by
particulate matter: Ingress and distribution within the dwelling. Radiat Prot Dosim, Vol
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Cannon SB, Veazey JM Jr., Jackson RS, Burse VW, Hayes C, Straub WE, Landrigan PJ,
Liddle JA [1978]. Epidemic kepone poisoning in chemical workers. Am J Epidemiol
107(6):529-537.

Carvalho FM, Barreto ML, Silvany-Neto AM, Waldron HA, Tavares M [1984]. Multiple
causes of anemia amongst children living near a lead smelter in Brazil. Sci Total
Environ 35(1):71-84.

Carvalho FM, Silvany-Neto AM, Melo AM, Chaves ME, Brandao AM, Tavares TM
[1989]. Cadmium in hair of children living near a lead smelter in Brazil. Sci Total
Environ 84:119-128.

Carvalho FM, Tavares TM, Silvany-Neto AM, Lima MEC, Alt F [1986]. Cadmium
concentrations in blood of children living near a lead smelter in Bahia, Brazil. Environ
Res 40:437-449.

CDC (Centers for Disease Control and Prevention) [1995]. Mercury Exposure in a
Residential Community-Florida, 1994. MMWR 44(23):436-437.

CDC (Centers for Disease Control and Prevention) [1992a]. Lead exposures among lead
burners—Utah, 1991. MMWR 41(17):307-310.

CDC (Centers for Disease Control and Prevention) [1992b]. Lead poisoning among
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6 pages.

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105


Pesticide
(water solubility)

Table 16. (Continued) Studics on Laundering Pesticides from Contaminated Clothing

Laundry or Decontamination Variables

Kim [1989]

Alachior

Emulsifiable
concentrate

100% Cotton twill

Convection oven 60°C, 100°C, 150°C,
200°C, 15, 30, 60 min drying time.
Microwave 2450 MHz, 50, 250, 500 1st,
50, 100, 150, 200 seconds,

Alachlor degraded rapidly at 200°C
in the convection oven and after 30
minutes at 150°C. At 60 minutes
and 150°C, the residue was 0.004%
of the contamination level. The
microwave was not very effective.

Laughlin and Gold
[19898]

Methyt parathion

Emulsifiable
concentrate
1.28% and $4%

100% Cotton. 50/50 cotton:
polyester. Unfinished or with
fluoroatiphatic soit repetient.

60°C, 2 rinses at 49°C, non-ionic liquid
detergent, 12 minute wash, storage at 0*C,
20°C, and 20°C with airflow, and 20° with
relative humidity at 65, $4% formulation
stored only at 20° with airflow.

Initial contamination with 1.25%
formulation was 50 g/cm? for,
unfinished fabric and 22 ug/cm? for
finished, The finished material had
greater residues (3.63 uslem?) than
unfinished (0.35-1.33 wg/em?),
Residues decreased with storage
time in moving air at 20°C.

Laughlin and Gold
[19890]

Methy! parathion

Emulsifiable
concentrate

Wettable powder
encapsulated

50/50 cotton polyester
Unfinished durable press
Fluorocarbon soil repellent

69°C wash of 49°C wash, 49°C rinse,
heavy duty tiquid non-ionic detergent or
standard detergent, accelerated
laundering apparatus, Also 1 m? fabrics
laundered in automatic home washing
machines at 49°C,

Laundering significantly reduced
contamination of all fabrics, but the
fluorocarbon soil repeliant fabric
‘was more resistant to cleaning.
Residues were lesa with the
encapsulated formulation. Study
demonstrated spread of
contaminant from point of contact
during laundering as well as
contamination of laundry
equipment.

211



Contaminant

Basis for Study

‘Table 15, (Continued) Workers’ Home Contamination-Industrial Hygicne Aspects

Hess [1988] Dioxin Decontamination of Residence and one commercial Residences were satisfactorily cleaned Additional decontamination of
Missouri 2,3,7,8- structures building were cleaned with HEPA (<40 pg/em*) commercial building commercial building included
tetrachlorodibenzodioxin contaminated with equipped high-efficiency vacuum contamination reduced from 36.6 ppb removal of attic insulation and
dioxin from waste oil and every inside surface wiped to 13 ppb. floor replacement.
used in dust with a damp cloth and detergent
‘suppression. wash.
Jensen et al. 2,3,6,7- Trichlorophenol plant ‘Two employees, one employee's son ‘The equipment had been
[1972b] Tetrachlorodibenzodioxin refitting a previously & other employee's wife developed contaminated 3 years earlier, and
United Kingdom cleaned tank chloracne. repeatedly steam cleaned.
Employees must have contacted a
pocket of residual material,
ATSDR [1991b] 3,3'-Dichlorobenzidine DCB production Sampled workers’ home for DCB DCB up to 10.5 ppm was found in
Michigen (OCB) in vacuum cleaner bags and dryer vacuum cleaner bags & up to 0.74
lint. ppm in dryer tint, DCB was found in
urine of same workers & family
members,
ATSDR [19890) 4,4'-methylene-bis(2- Plastics manufacture Vacuum cleaner dust and clothes MOCA up to 2.6 ppm in vacuum dust | MOCA in urine of family members
Michigan chloroaniline) (MOCA) dryer lint in workers’ homes and 0,65 ppm in dryer lint, up to 12.1 ppb,
analyzed for MOCA.
Bagnell and Tetrachloroethylene Suede and leather dry Gas chromatography headspace Mother often ate funch with husband Evidence suggests that the baby
Ellenberger (perchloroethylene) cleaning procedure of breast milk & venous | (30-60 min) in dry cleaning plant. was exposed vie breast milk,
(1977) blood samples.
North Carolina
Clapp et al. 4 A’-methylene-bic(2- ‘Urethane casting Air samples Except for 2 surface wipes which had Company should issue and launder
1985) choroaniline) (MOCA) Surface wipes MOCA > 5.3 ug/wipe, measurements | clothing daily, including underwear,
Pennsylvania Hand contact monitors were below detection level. However require showering before going
Urine samples urine samples for 6 workers ranged home. Shoes and disposable shoe
from 2 to 36 ug MOCA/L. covers should be provided.
Schreiber et al, Tetrachloroethylene Dry cleaning Alt sampling in apartments above Tetrachloroethytene at 100-440 g/m? Although workers’ families were
(1993] dry cleaning catabiishments, In apartments above dry-to-dry units, not identified as living In the
New York 1,350-17,000. wef? above transfer apartments, such a “cottage

industry" situation could exist.

200


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for Occupational Safety and Health, Division of Physical Sciences and Engineering,
NIOSH Contract No. 210-81-7107. 135 pages.

Rice C, Fischbein A, Lilis R, Sarkozi L, Kon S, Selikoff IJ [1978]. Lead contamination in
the homes of employees of secondary lead smelters. Environ Research 15:375-380.

Richter ED, Baras M, Berant M, Tulchinsky T [1985]. Blood zinc protoporphyrin levels

in the children and wives of lead battery workers: A preliminary report. Isr J Med Sci
21(9):761-764.

133


FOREWORD

In 1992, the U.S. Congress passed the Workers’ Family Protection Act (Public Law 102-522, 29
U.S.C. 671), which requested that the CDC’s National Institute for Occupational Safety and
Health (NIOSH) conduct a study to “evaluate the potential for, prevalence of, and issues related
to the contamination of workers’ homes with hazardous chemicals and substances...transported
from the workplaces of such workers.” With this request, Congress identified a compelling
public health issue, bridging health concerns in the workplace and the home. NIOSH found that
contamination of workers’ homes is a worldwide problem, with incidents reported from 28
countries and from 36 States in the United States. Such incidents have resulted in a wide range
of diseases and, in some cases, death among workers’ families.

This report represents an important step in addressing the concerns outlined in the Act. It puts us
on the road to preventing the exposure of families to potentially harmful substances unknowingly
brought home from the job. It also serves as a reminder of the importance of occupational safety
and health research to CDC’s overall mission of promoting health and quality of life by
preventing and controlling disease, injury, and disability.

David Satcher, M.D., Ph.D.
Director, Centers for Disease Control and
Prevention

ili


CERCLA & SARA

‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

[42 USC. § 9601 et
eq]

Note 3b, Hazardous substances criteria-Generally
Amount of hazardous substance released is irrelevant for purposes of CERCLA. U.S. v.
United Nuclear Corp., D.N.M.1992, 814 F.Supp. 1552.

Note 3c. Concentration, quantity, volume

‘Waste material that is not specifically listed as hazardous substance in Environmental
Protection Agency’s (EPA's) designation of CERCLA hazardous substances is hazardous
if it contains hazardous substances, regardless of volume or concentration. State of Ariz.
v. Motorola, Inc., D.Ariz.1991, 774 F.Supp. 566.

§ 9602. Designation of additional hazardous substances and establishment of reportable
released quantities; regulations

(a) The Administrator shall promulgate and revise as may be appropriate, regulations
designating as hazardous substances, in addition to those referred to in section 9601(14)
of this title, such elements, compounds, mixtures, solutions, and substances which, when
released into the environment may present substantial danger to the public health or
welfare or the environment, and shall promulgate regulations establishing that quantity of
any hazardous substance the release of which shall be reported pursuant to section 9603
of this title. The Administrator may determine that one single quantity shall be the
reportable quantity for any hazardous substance, regardless of the medium into which the
hazardous substance is released. For all hazardous substances for which proposed
regulations establishing reportable quantities were published in the Federal Register
under this subsection on or before March 1, 1986, the Administrator shall promulgate
under the subsection final regulations establishing reportable quantities not later then
December 31, 1986, For alt hazardous substances for which proposed regulations
establishing reportable quantities were not published in the Federal Register under this
subsection on or before March 1, 1986, the Administrator shall publish under this
subsection proposed regulations establishing reportable quantities not later than
December 31, 1986, and promulgate final regulations under this subsection establishing
reportable quantities not later than Aprit 30, 1988.

§ 9604. Response authorities

(a) Removal and other remedial action by President; applicability of national contingency
plan; response by potentially responsible parties; public health threats; limitations on
response: exception

(1) Whenever (A) any hazardous substance is released or there is a substantial threat of
such a release into the environment, or (B) there is a release or substantial threat of
release into the environment of any pollutant or contaminant which may present an
imminent and substantial danger to the public health or welfare, the President is
authorized to act, consistent with the national contingency plan, to remove or arrange for
the removal of, and provide for remedial action relating to such hazardous substance,
pollutant, or contaminant at any time (including its removal from any contaminated
natural resource), or take any other response measure consistent with the national
contingency plan which the President deems necessary to protect the public health or
welfare or the environment. When the President determines that such action will be done

227


CERCLA & SARA

‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

[42 U.S.C, § 9601 et
or)

(B) The Administrator of ATSDR may perform health assessments for releases or
facilities where individual persons of licensed physicians provide information that
individuals have been exposed to a hazardous substance, for which the probable source of
such exposure is a release. In addition to other methods (formal or informal) of
providing such information, such individual persons or licensed physicians may submit a
petition to the Administrator of ATSDR providing such information and requesting a
health assessment. If such a petition is submitted and the Administrator of ATSDR does
Not initiate a health assessment, the Administrator of ATSDR shall provide a written
explanation of why a health assessment is not appropriate.

(C) In determining the priority in which to conduct health assessments under this
bubsection, the Administrator of ATSDR, in consultation with the Administrator of EPA,
shall give priority to those fs at which there is documented evidence of the release
of hazardous substances, at which the potential risk to human health appears highest, and
for which in the judgment of the Administrator of ATSDR existing health assessment
data are inadequate to assess the potential risk to human health as provided in
subparagraph (F). In determining the priorities for conducting health assessments under
this subsection, the Administrator of ATSDR shall consider the National Priorities List
Schedules and the needs of the Environmental Protection Agency and other Federal
agencies pursuant to schedules for remedial investigation and feasibility studies,

(D) Where a health assessment is done at a site on the National Priorities List, the
Administrator of ATSDR shai! complete such assessment promptly and, to the maximum
extent practicable, before the completion of the remedial investigation and feasibility
study at the facility concerned.

(B) Any State or political subdivision carrying out a health assessment for a facility thal
Teport the results of the assessment to the Administrator of ATSDR and the
Administrator of EPA and shall include recommendations with respect to further
activities which need to be carried out under this section. The Administrator of ATSDR
shall state such recommendation in any report on the results of any assessment carried
out directly by the Administrator of ATSDR for such facility and shall issue periodic
reports which include the results of all the assessments carried out under this subsection.

(F) For the purposes of this subsection and section 9611(c)(4) of this title the term
“health assessments* shall include preliminary assessments of the potential risk to human
health posed by individual sites and facilities, based on such factors as the nature and

extent of contamination, the existence of potential pathways of human exposure (including |{

ground or surface water contamination, air emissions, and food chain contamination), the
size and potential susceptibility of the community within the likely pathways of exposure,
the comparison of expected human exposure levels to the short-term and long-term health
effects associated with identified hazardous substances and any available recommended
exposure or tolerance limits for such hazardous substances, and the comparison of
existing morbidity and mortality data on diseases that may be associated with the
observed levels of exposure. The Administrator of ATSDR shall use appropriate data,
risk assessments, risk evaluations and studies available from the Administrator of EPA.

231


PUBLIC LAW 102-522 [HLR. 2042 October 26, 1992

FIRE ADMINISTRATION AUTHORIZATION
ACT OF 1992
For Legislative History of Act, see p. 2910.

Aa Bcd to extherine appropriations fer activities ender the Federsi Fie Prevention and Contre!
Bat of 1974, end for ether pespeces.

Be it
the United States of America in
SECTION 1. SHORT TITLE.

This Act may be cited as the “Fire Administration Authorization
Act of 1992".

it enacted Senate and Hc of of
by the louse of Representatives

TITLE I—UNITED STATES FIRE ADMINISTRATION

SEC. 101. AUTHORIZATION OF APPROPRIATIONS.
Section 17(gX1) of the Federal Fire Prevention and Control
Act of 1974 15 king “an at the od of oubpar
and {apecing in hea thefeata senicnions pi aoe
Sb) $25,5505000 for the focal your Saving Sep 30,

155), $28,521,000 for the fiscal year ending September
vopitP) 827,525,000 fr the Bacal year ending September 20

SEC. 102 PRIORITY ACTIVITIES OF THE UNITED STATES FIRE
ADMINISTRATION.

(a) Puonrry Activings.—in m0) a is Ac,
pursuant to the amendments made eres 101 this Act,
i Administration

fire services;
sahancing the residential sprinkler
ae sad tocknsial antineance te

we) echncng es = naan

106 STAT. 3410

256


Lauwerys R, Roels H, Bernard A, Bucket JP [1980]. Renal response to cadmium in a
population living in a non-ferrous smelter area in Belgium. Int Arch Occup Environ
Health 45:271-274.

Lavy TL [1988]. Minimizing applicator exposure. In: Miller JH, Mitchell RJ eds. A
manual on ground applications of forestry herbicides. Atlanta, GA: U.S. Department of
Agriculture, Forest Service, Southern Region. Management Bulletin R8-MB21. pages 8-
1 to 8-6.

Lavy TL [1994]. Memorandum of April 15, 1994 re: pesticide exposure and its
prevention in Arkansas to Diane Manning, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services.

54 pages.

Leach D, Leach A [1992]. Son drank cleaner. Hoard’s Dairyman: The National Farm
Magazine. 1 page.

Lehmann P [1977]. Beyond the factory gates. Chapter 7. In: Lehamnn P. Cancer and
the Worker. The New York Academy of Sciences, New York, NY. pages 45-47.
pages 45-47.

Lehmann W [1905]. On chloracne. Arch Dermatol Syph 77:265-288.

Lemen RA [1972]. Spray application of fireproof insulation at the construction site of the
Proctor and Gamble Technical Center, Blue Ash, Ohio. Cincinnati, OH: U.S.
Department of Health, Education and Welfare, Health Service and Mental Health
Administration, Center for Disease Control, National Institute for Occupational Safety
and Health. 4 pages.

Lewis RG, Fortman RC, Camann DE [1994]. Evaluation of methods for monitoring the
potential exposure of small children to pesticides in the residential environment. Arch
Environ Contam Toxicol 26(1):37-46.

Li FP, Dreyfus MG, Antman KH [1989]. Asbestos-contaminated nappies and familial
mesothelioma. Lancet. pages 909-910.

Li FP, Lokich J, Lapey J, Neptune WB, Wilkins EW Jr. [1978]. Familial mesothelioma
after intense asbestos exposure at home. JAMA 240(5):467.

LIA [1994a]. Controlling lead exposure for stained glass professionals and hobbyists.
12:37 minutes. New York, NY: Lead Industries Association, Inc. Videocassette.

LIA [1994b]. Controlling lead exposures in the workplace. New York, NY: Lead
Industries Association, Inc. Brochure, 16 pages.

123


CHAPTER 7. RESPONSES TO INCIDENTS OF HOME CONTAMINATION

CHAPTER SUMMARY

In this Chapter, responses of Federal and State agencies and industry to incidents of
workers’ home contamination are reviewed. NIOSH found that several Federal
agencies have responded to incidents of workers’ home contamination, often working
together or working with State or local governmental agencies. These responses by
Federal agencies have resulted in identification of workers’ home contamination that
otherwise would have not have been known, decontamination of workers’ homes and
recommendations for instituting workplace changes that would prevent further
contamination. In several cases, Federal agencies have referred incidents to State or
local health departments for follow-up actions.

A number of State agencies have also investigated incidents of workers’ home
contamination, made referrals to Federal agencies for follow-up actions and made
recommendations for workplace improvements to prevent further contamination of
workers’ homes.

In some instances where States reported they had no information on home
contamination investigations or incidents, such reports were found in the literature.
Likewise, for some States that did not respond to inquiries, reports were found in the
literature of investigations that took place in the State. Often, in these instances, the
investigations were conducted by local health departments collaborating with Federal
agencies and reported in journal articles or CDC's Morbidity and Mortality Weekly

Report (MMWR).

Only a few responses of industry to incidents of workers’ home contamination were
found. However, these reports indicate how industry can contribute to prevention by
informing workers of hazards, as well as by taking specific actions to correct situations
where workers’ families are at risk or by use of preventive measures.

RESPONSES OF FEDERAL AGENCIES

In this section, responses of Federal agencies to incidents of workers’ home
contamination are reviewed. The information for this section, compiled in Table 19,
was derived from published reports and responses to requests for information by
NIOSH.

OVERVIEW

Agencies that have responded to incidents of workers’ home contamination include: (1)
the Centers for Disease Control and Prevention (especially the National Center for
Environmental Health and the National Institute for Occupational Safety and Health);
(2) the Occupational Safety and Health Administration; (3) the Mine Safety and
Health Administration; (4) the Department of Energy; (5) the Environmental
Protection Agency; (6) and the Agency for Toxic Substances and Disease Registry. In
many cases, Federal, State, and local agencies collaborated on the investigations. In all

84


Appendix 4.
Acknowledgements

270


Vol. 42 / No. 48 MMWR 43
Fiood-Relatea Mortauty — Continued

or swiftly moving flood waters. In this report, 75% (27,36) of the arownings tnat oc-
curred during tne summer and fall floods in Missour: were motor-venicie-reiated.

The findings in this report underscore the importance of two strategies for prevent-
ing floog-reiated injuries and aeath. First, information about flood ana post-flood
hazards must be disseminated rapidiy and widely to groups at increased risk for in-
jury. For example, motorists snould be warned not to anve through areas inundated
by flash fioods, not to enter swiftly moving water. and that only 2 feet of water can
carry away most automobiles (7). In addition, recreational activities. such as wading
or bicyciing, in flooded areas should be discourageg. Second. hydrologic studies and
hazard anaiyses should address potentially flood-prone tnbutanes. The hazard poten-
tuat of sucn areas during flash floods snauid be icentifieo, and appropnate warning
signs should be posted. MOH is continuing surveiilance of flood-related mortality to
monitor circumstances of death.

References

1. CDC. Public heatth consequences of a flood disaster—iowa. 1993. MMWR 1993:42:653-6.

2.COC. Morbidity surveiilance following the Midwest flood—Missoun, 1993. MMWR 1993;
42:797-8.

3.Frencn JG. Floods. in: Gregg MB. ed. The public heaith consequences of disasters. Atlanta:
US Department of Health and Human Services. Public Health Service. CDC. 1989:39-49,

4.French JG. ing R, Von Allman S. Wood R. Mortality from flash floods: » review of National
Weather Service reports, 1969-81. Public Health Rep 1983,98:584-8.

5. Ducios P. Vidonne O. Beuf P Perray P. Stoebner A. Flash flood disaster—Nimes. France. 1988.
Eur J Epidermol 1991:7:365-71.

6. Wintemute GJ. Kraus JF. Teret SP. Wright MA. Death resuiting from motor vehicie immersions:
the nature of the injuries. personal and environmental contnbutng factors. and potenual in-
terventions. Am J Public Heaith 1990:80:1068-70.

7. National Weather Service/Amencan Red Cross/Federai Emergency Management Agency. Flesh
floods and floods...the swesome power!: a preparedness guide. Washington. OC: US Depart-
ment of Commerce, National Oceanic and Atmospnenc Administration, National Weather
Servicw/Amencan Red Cross, 1992: report no. NOAA/PA 92050. ARC 4493.

Notice to Readers

Workers’ Family Protection Act

On November 15, 1993. CDC's National Institute for Occupational Safety and Health
(NIOSH) published in the Federa/ Register * a request for existing information relevant
to implementing the Workers’ Family Protection Act'. NIOSH is requesting informa-
tion on incidents of family poisonings or home contaminations by substances
inadvertentty carried home by workers on their clothing, equipment, or person and on
regulations and methods for dealing with such incidents. Copies of the Feaera! Regis-
ter announcement are available from the Oocket Office Manager, Division of
Standards Development and Technology Transfer (OSDTT), NIOSH: telephone (513)
533-8304. Additional information is available from the Deputy Director. OSOTT,
NIOSH; tetephone (513) 533-8302.

FR 60202-60204.
"29 U.S.C. $6714.

265


Hands of bridge workers engaged in abrasive blasting of lead-based paint were found
by Ewers et al. [1994a, 1995] to be contaminated with lead up to 5 mg/pair. Hands
of radiator repair shop workers were found by Piacitelli and Rice [1993] to be
contaminated with lead at up to 78 mg/m’ (since the combined surface area of both
hands is about 1,000 cm’, this equates to about 8 mg of lead on two hands). Hands
of utility workers engaged in cable splicing were contaminated with lead at up to 5
mg/ft’ [Venable et al. 1993] (this equates to about 5 mg of lead on two hands). In
an experimental study of fiber contamination on fingers, Schneider et al. [1986] found
up to 82 fibers/cm’ on fingers after contact with dusty surfaces.

TOOLS AND EQUIPMENT

Workers may take their tools and equipment home with them [Hartle et al. 1987] or
transport them in company or private vehicles, as in the case of the workers at the
chlor-alkali plant in Tennessee who transported mercury contaminated tools in their
private cars [ATSDR 1990a]. Although mercury on tools was not measured, the tools
were described as visibly contaminated and air in workers’ cars contained mercury at
8-10 4g/m’. Barnett [1994] described an incident where a pesticide applicator took
the company truck home, ready for the next day’s work. During the night,
chloropicrin leaked from its container and contaminated the worker’s driveway and
the neighbor's premises.

The NRC files contain a record of finding a radioactive hand tool in a nuclear power
reactor contractor’s home; in this case, the radioactivity was confined to the tool
[Brockman 1993}. The only quantitative measurements of tool contamination found
were of PCB contamination of tools used in an aluminum extrusion process [Hartle
et al. 1987]. A hand wrench had PCB contamination at 308 g/m’ and the external
surface of a lunch pail had 14 g/m’; the authors cited contamination limits of 50-250
“g/m? for low contact surfaces.

TAKING ITEMS HOME FROM WORK

There are 10 reports that document home contamination by workers taking home
contaminated items from work for their own use. This practice resulted in serious
Poisonings or exposures of family members from beryllium [Chesner 1950], asbestos
[Li et al. 1989}, lead [Carvalho et al. 1984; Dolcourt et al. 1981; Osorio 1994],
pesticides [McGee et al. 1952], hormones [Pacynski et al. 1971}, and radioactive
lumber [Brockman 1993].

Beryllium

Beryllium-ore bags were taken home by a worker at a beryllium plant and given
to a neighbor woman who used them for dish cloths and who later died from
chronic bilateral granulomatous pneumonitis; beryllium at 0.07 ug/100g of lung
tissue was found [Chesner 1950].


{adapted from Benenson 1985]:

1, Parasitic Diseases
a. Scabies is a parasitic disease of the skin caused by a mite (Sarcoptes scabiei)
that causes severe itching and is highly contagious. It is normally spread via
skin-to-skin contact but in some cases may be spread through contact with
mite-infected undergarments or bedclothes.

b. Roundworm infection (Ascaris lumbricoides) from contaminated soil may be
brought into houses and automobiles on the shoes of workers. The infection
may than be transmitted to members of the household in dusts or via
ingestion. Infection is usually highest in children aged 3-8 years.

c. Pinworm disease (Enterobius vermicularis) is an intestinal infection that is
usually spread through direct contact from anus to mouth of infective eggs
but may be spread via clothing or bedding.

2. Vector-borne Diseases
a. Arthropod-borne diseases that occur in the United States include lyme
disease, caused by a spirochete Borrelia burgorferi. Lyme disease was first
recognized as a clinical disease in 1977 when a group of children in Lyme,
Connecticut was infected. It is considered to be the most common vector-
borne disease in the United States and is characterized by distinctive skin
lesions, polyarthritis, and neurological and cardiac involvement.

b. Additional vector-borne diseases that may be brought home by workers in
the United States include rickettsial diseases where ticks are also the vector
such as Rocky Mountain spotted fever. In addition, approximately 90
arthropod-borne viral diseases have been identified. These include Colorado
tick fever and encephalitis viruses that are tick-borne. The mosquito is the
vector for many arboviruses that infect humans; however, mosquitos are
unlikely to be brought home on workers. Plague (Yersinia pestis) is a disease
of domestic and wild rodents transmitted to humans by flea bite. Tularemia
(Francisella tularensis) may be spread via ticks but also may be transmitted
via inhalation of contaminated dust particles.

3. Air-borne Diseases
a. Respiratory diseases that may be spread via the air should be considered

when infectious diseases that may be taken home are considered. For
example, rickettsiae are small (300-600nm) obligatory parasitic bacteria that
are often transmitted to man through the bite of arthropod vectors such as
ticks. However, the rickettsia that causes Q fever (Coxiella burnetti) is found
in animals as well as ticks and may be transmitted to humans by inhalation of
infected dust, indirectly via the drinking of infected milk, or by direct contact
with animals, particularly cattle, sheep, and goats. It is an acute febrile

30


Appendix 1.
The Workers’ Family Protection Act
29 U.S.C. 671a
Section 209
of the
Fire Administration Authorization Act of 1992
Public Law 102-522

255


Table 5. Health Effects of Take-Home Asbestos Exposure (Case Reports)
———————————

AUTHOR(S) INDUSTRY HEALTH # CASES/RELATIONSHIP AGE(S) AT DEATH COMMENTS,
(YEAR) EFFECT OR DIAGNOSIS
COUNTRY
Rusby Asbestos Mesothelioma 1 Female n ‘Woman laundered clothing of 3 daughters who had worked in an
{1968} asbestos factory for 1-2 years. 26 year latency,
England
Teyssier and Lesobre Asbestos Asbestosis Case report of asbestosis in a man May also have had environmental exposure since he lived near an
[1968] Pleural plaques | exposed as a teen to his father’s asbestos plant for 2 years.
work clothes worn home from an
asbestos plant.
Champion Asbestos Mesothelioma 1 Male zy| Father was a pipe lagger and had asbestosis. Son never had
{1971} occupational exposure.
Canada
Knappmann Asbestos Mesothelioma Man lived for several years with 6 42 years from beginning of exposure to onset of tumor.
[1972] sister who was an asbestos worker
West Germany who came home with dusty clothes
and hair.
Lillington et al. Asbestos Familial 1 Wife 52 Domestic case resulting from residence in the same house as an
{1974} mesothelioma asbestos worker who died of mesothelioma,
USA
Lictal. Asbestos Familial 1 Mother, and 1 daughter 51,34 Father was shipyard insulation worker who had asbestosis and
(1978] mesothelioma died of lung cancer. His wife and eldest daughter died of
USA mesothelioma, Wife laundered dusty work clothes.
Epler et al. Asbestos Pleural changes | 2 Wives of asbestos workers 60,56, Wives were involved with cleaning husbands’ clothes resulting in
{1980} Mesothelioma 2 Brothers 33 and 27 mesothelioma in one and pleural changes in the other. Brothers
USA played as children in room used as muffler shop. Both developed
pleural changes in young adulthood, although changes in one
could have been related to subsequent occupational exposure.
Risberg et al. Construction Familial pleural Father, 2 brothers and 1 sister 61,71, All cases smoked. Father died of peritoneal mesothelioma. The
(1980] and peritoneal 60, and 52 2 sons and their sister died of tubulo-papillary mesothelioma. No
USA mesothelioma asbestos industry employment; father and sons worked in
construction industry.
Jorgensen Asbestos Pleurat plaques | 3 Wives of insulation workers ‘71,54 and 58. Exposure was limited to laundering of clothes, dusty shoes, etc.
(1981) (insulation Of the 3 women, 2 smoked and 2 had other relatives who were
Denmark work) insulation workers.

151


immediately information that a substance or mixture for which they are responsible
presents substantial risk of injury to health).

Under 15 U.S.C. 2605(a) (ie., the provision of the TSCA granting EPA authority to
regulate hazardous-chemical substances and mixtures), EPA promulgated a standard [40
CFR 763.121] that prescribes full-scale decontamination procedures following asbestos-
abatement actions performed by state and local government workers; these asbestos-
decontamination procedures are somewhat abbreviated for workers involved in small-
scale, short-duration asbestos-abatement actions. Among the asbestos-decontamination
procedures specified under this standard is a requirement that workers wear protective
clothing, and that this protective clothing be handled appropriately to avoid release of
asbestos fibers; this standard, therefore, indirectly prevents asbestos contamination of
workers’ homes.

Asbestos Hazard Emergency Response Act of 1986

This act contains a provision [15 U.S.C. 2646(b)(1)(B)(xi)] that addresses, explicitly,
workers’ home contamination. This provision requires implementation of
"[hJousekeeping and personal hygiene practices, including the necessity of showers, and
procedures to prevent asbestos exposure to the employee’s family." Additionally, this act
specifically requires that state plans for accrediting asbestos-removal contractors contain
procedures to prevent asbestos contamination, including contamination of an employee’s
family. This requirement was implemented by EPA under Appendix C to 40 CFR part
763, subpart E.

Residential Lead-Based Paint Hazard Reduction Act of 1992

This Act has several provisions that indirectly protect workers’ families from lead-
contaminated dust in their homes. These provisions include the development of a
health-based standard for lead-contaminated household dust, development of a
comprehensive, lead-exposure abatement program, and studies of the sources of lead
exposure among children, including the occupational contribution to this exposure. In
addition to the sections of this act presented in Table 17, the following sections may be
considered relevant to preventing workers’ home contamination: 15 U.S.C. 2682(a); 15
U.S.C. 2682(c)(2); and 15 U.S.C. 2682(c)(3).

Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA)

Under 7 U.S.C. 136(w), EPA has broad regulatory authority to establish standards that
prevent, indirectly, contamination of workers’ homes. This section authorizes the
promulgation of standards "with respect to the package, container, or wrapping in which
a pesticide or device is enclosed for use or consumption, in order to protect children and
adults from serious injury or illness resulting from accidental ingestion or contact with
pesticides or devices regulated by this subchapter, as well as to accomplish the other
purposes of this subchapter.” Using this authority, EPA has promulgated a number of

719


a

‘Table 18. Regulations of Federal Agencies Relevant to Workers’ Family Protection

Response
{29 CFR 1910.120] (general industry)
[29 CFR 1926.65] (construction)

RULE/CFR NO. AGENCY DESCRIPTION OF RELEVANT ELEMENTS
ic arsenic OSHA ‘The PEL is 10 g/m? as an B-hr. average. Where employees work in areas where exposure concentrations exceed 10 ug/m? or
[29 CFR 1910,1000] (general industry) where the possibilty of skin or eye irritation from inorganic arsenic exists, the employer must provide clean protective work clothing
{29 CFR 1915.1018) (shipyards) weekly (daily if exposure levels exceed 100 ug/m*). Protective clothing must be removed in change rooms and placed in a closed
{29 CFR 1926.1118} (construction) container prior to removal for cleaning, laundering or disposal. ‘The container must be labeled and the launderer informed of the
hazards, When exposures exceed 10 yg/m?, the employer must provide showers and separate storage facilities for street and work
clothes,
Asbestos OSHA PEL is 0.1 fiber/cc as an 8-hr. average. Excursion Limit (EL) is 1 fiber/cc as a 30-min, average. Where employees are exposed
[29 CFR 1910.1001] (general industry) above these limits, or where the possibility of eye irritation exists, the employer must provide, and ensure: that the employee wears
appropriate protective work clothing; that contaminated clothing is remaved only in change rooms; that no employee takes
ted work clothing out of the change room (except those authorized to do so for purposes of laundry, maintenance and
that containers for contaminated clothing are labeled; that laundering is done in a way that will minimize release of fibers
to the air; that the launderer be informed of the hazards; and that contaminated clothing be transported in sealed containers. The
employer must provide facilities to assure that street clothes do not become contaminated if the employees’ exposures exceed the
PEL, that such employees shower at the end of the work shift and that they do not leave the workplace with any clothing or
equipment worn during the work shift.
{29 CFR 1915,1001] (shipyards) In addition to the requirements for general industry, clothes of workers who work in certain regulated areas where the
{29 CFR 1926.1101] (construction) decontamination area and the shower cannot be located next to the regulated area, must be vacuumed with a HEPA vacuum cleaner
before proceeding to the shower, or the employee must remove contaminated clothing in the equipment room and don clean work
suits before proceeding to the shower. For other regulated areas, work clothing must be vacuumed before it is removed, but
showering is not required.
Cadmium OSHA ‘The PEL is $ ug/m? as an 8-hr. average. If an employee is exposed above the PEL or where skin or eye irritation is associated with
[29 CFR 1920.1027} (general industry) cadmium at any level, the employer must provide clothing and equipment that prevents contamination of the employee and the
[29 CFR 1915.1027] (shipyards) employee's garments. Contaminated clothing must be removed at the end of the work shift in change rooms which have separate
[29 CFR 1926.1127) (construction) storage facilities for street clothes and work clothes. The facilities must be designed to prevent contamination of the street clothes.
The employer must assure that employees exposed above the PEL shower during the end of the work shift. The employer must
assure that no employce takes contaminated protective clothing from the workplace, except when authorized to do so for laundry,
cleaning, maintenance or disposal at an appropriate location or facility. Contaminated clothing must be stored in a closed container,
and labeled. Launderers and cleaners must be informed of hazards.
Hazard Communication OSHA ‘These standards have elements that could be used for preventing workers’ home contamination. These elements include: the
(29 CFR 1910.1200] (general industry) written hazard communication which employers must prepare; the requirements that all containers of hazardous chemicals be
{29 CFR 1915.1200) (shipyards) labeled; the requirement for preparation of material safety data sheets containing information on applicable precautions for safe
[29 CFR 1926.59] (construction) handling and use, including appropriate hygiene practices, work practices, or personal protective equipment; the requirement for
‘employee information and training.
Hazardous Waste Operations and Emergency OSHA ‘These standards require a written safety and health program for employees involved in hazardous waste operations, Among the

requirements are: use of appropriate protective equipment for each hazardous waste site; appropriate decontamination of all
employees and contaminated clothing and equipment before leaving the area; location of the decontamination procedures to
minimize cross-contamination; removal of protective clothing or equipment from the site only by authorized employecs; advising
laundries and cleaning establishments of the hazards of contaminated clothing; and provision of showers and change rooms outside
of the contaminated area, when the need is indicated.

237



Review of Studies

Prior to World War I, there was little use of beryllium and few workers were
exposed. During World War I, production of beryllium compounds from the ore
increased and took place in two plants in Ohio and one in Pennsylvania. In this
same period, beryllium was used in the production of fluorescent lights in a
number of manufacturing plants in New England. In connection with these
activities during the 1940’s, disease from beryllium exposure first appeared in the
United States [Van Ordstrand et al. 1943; Kress and Crispell 1944].

Subsequent to the report by Hardy [1948] of chronic beryllium disease in residents
living near facilities manufacturing fluorescent lights, a number of reports
identified neighborhood cases among residents living near the beryllium
production facilities in Ohio [Eisenbud et al. 1949; DeNardi et al. 1949; Chesner
1950; Sterner and Eisenbud 1951] and Pennsylvania [Chamberlin et al. 1957].
Some of these reports [Hardy 1948; Eisenbud 1949; Chesner 1950; Chamberlin
1957] also identified beryllium workers’ family members with beryllium disease
ascribed to exposure to beryllium-contaminated clothing or other contaminated
material. Additional reports continued to identify cases of beryllium disease in
family members of workers which were ascribed to exposure to beryllium-
contaminated clothing [Lieben and Metzner 1959; Tepper et al. 1961; Lieben and
Williams 1969].

A registry of beryllium disease cases was initiated in 1951 [Hardy et al. 1967].
Additional reports on this registry have been published [Hardy 1965; Hasan and
Kazemi 1974; Sprince and Kazemi 1980; Eisenbud and Lisson 1983]. In a review
by Tepper et al. [1961], 32 cases of beryllium disease in beryllium workers’ family
members are cited. In 24 cases, the patients lived with workers who brought
home beryllium-contaminated clothing and in 8 cases the patients had been
exposed to beryllium plant discharges as well as contaminated clothing. Hardy et
al. [1967] identified a total of 40 cases of chronic beryllium disease from the
Beryllium Case Registry where the chief exposure was believed to be
contaminated clothing.

The first case of beryllium disease in workers’ family members was reported by
Hardy [1948]. A woman developed and died of chronic beryllium disease after
caring for her daughter, who also died of the disease. The daughter, who worked
in a fluorescent lamp plant, would come home with beryllium powder on her
clothes and shoes. Eisenbud et al. [1949] reported on a case of a worker’s wife
who developed beryllium disease after she routinely washed his beryllium-
contaminated clothing.

Chesner [1950] discussed a 26-year-old woman whose neighbor brought sacks from
the beryllium plant to her home. She used the sack material for dishcloths. She
died after two years of progressive cough and weight loss. Chamberlin et al.


Braun et al. (1989)

Pyrazophos
(4 mg/L at 20°C)
Spray on three layers
of cloth; spill on three
layers of cloth

‘Table 16. Studies on Laundering Pesticides from Contaminated Clothing

‘Water solution

(450 mg/L)

Fabrics

Cotton polyester coverall fabric,
contaminated and
uncontaminated clothes washed
together

Laundry or Decontamination Variables

Automatic washing machine, heavy-duty
detergent, single wash, 2 rinses; double
wash; pre-toak plus double wash.

Single wash removed 78% of
Pyrarophos from spray-on and 83%
from spill-on; double wash removed
92% and 94%, respectively. Pre-
soak did not improve on double
wash. Transfer fabrics had 68% of
the residual contamination of the
contaminated fabrics. Second and
third layers had traces of

hos when sprayed on and
slightly more when spilled on.

Chiao-Cheng et al.
[1988]

Carbofuran
(700 mg/L)
methomy!

(60,000 mg/L)

Water suspension
Water soluble liquid

100% cotton and 100% polyester

60°C and 49°C washes. Anionic and non-
tonic washes.

More than 99% of the pesticides
were removed from both fabrics by
all laundering methods

Easley et al.
[19810]

Methyl parathion
(50-60 mg/L at 20°C)

Emulsifiable
concentrate
encapsulated wettable
powder

Denim, 100% cotton and 50/30
cotton-polyester

Pre-rinse, detergent, ammonia and
chlorine bleach.

Fabric was not a factor in removal.
For encapsulated and wettable
powder forms, 93-99% of methyt
parathion was removed; for
‘emulsifiable concentrate, 80-88%
was removed by the different
laundry procedures. Pre-rinse was
the most effective variable;
ammonia the least effective,

Easley et al.
[19824]

Methyl parathion

Emulsifiable
concentrate solutions
0.25-54%

Denim, 100% cotton twill

Heavy duty liquid detergent, 1 wash cycle,
2 rinse cycles, Repeated up to 10 times.

More than 9$% methyl parathion
was removed when applied as 0.25
and 0.50% solutions, Only 19.5%
was removed by first wash when
applied as a 54% solution, and only
67% had been removed after 10
washes.

206


Teble 16. (Continued) Studies on Laundering Pesticides from Contaminated Clothing

Nelson et al.
(1992)

Carbamates:
carbaryl (Insecticide)
(120 mg/L at 30°C)

trlailate (herbicide)
(4 mg/L at 20°C)
Organophosphates;
methyl parathion
(insecticide)
(SO mg/L at 20°C)

fonofos (insecticide)
(13 mg/L at 20°C)

terbufos (insecticide)
(10-15 mg/L at
28°C)

Pyrethroids:
deltamethrin
(insecticide)

(0.002 mg/L at
20°C)

oyfluthrin
(insecticide)

(2 mg/L at 20°C)
cypermethrin

(Insecticide)
(0.01-0.02 mg/L at
20°C)

Alachlor (herbicide)
(242 mg/L at 25°C)

Atrazine (herbicide)
(30 mg/L at 20°C)

Trifluralin (herbicide)

Wettable powder and
flowable liquid

Emulsifiable
concentrate

Liquid

Emulsifiable
concentrate

Liquid

Emulsifiable
concentrate

Wettable powder and
emulsifiable
concentrate

Wettable powder and

emulsifiable
concentrate

Emulsifiable
concentrate

Wettable powder and
flowable liquid

Emulsifiable

100% Cotton and 50/S0 cotton-
polyester twill.

49°C, 2 rinses, pre-wash/no pre-wash,
heavy duty liquid detergent, alr drying

Prewash product lowered residue
for all pesticides. The residue
remaining ranged from zero for
carbaryl wettable powder to 48%
for deltamethrin emulsifiable
concentrate without prewash,
Residues were greater on the
cottonpolyester for
organophosphates and lower for
atrazine,

214




home contamination had been enacted, many occupational safety and health regulations
had been promulgated that help, indirectly, to prevent this problem.

About half of the respondents have occupational safety and health programs approved by
OSHA. To be approved, a State’s occupational safety and health laws have to be at
least as protective of workers as the Federal laws. To determine whether any of these
laws had requirements that are more stringent than the commensurate Federal OSHA
regulations, the occupational safety and health laws of States with OSHA-approved
programs were obtained and evaluated. Most of the State laws were identical to the
Federal OSHA regulations with regard to workers’ family protection; unlike the Federal
OSHA regulations, however, the State laws apply to State and local government
employees. Thus, in States that have OSHA-approved programs, the families of
government employees have benefitted indirectly from provisions of the arsenic, asbestos,
cadmium, and lead standards requiring that workers shower and change clothes before
leaving the workplace; in contrast, the families of State and local government employees
in the remaining States may not have benefitted from these requirements because
compliance by these State and local governments is voluntary.


Ways and Means Committee [1980]. House Report No. 96-1016, Part I, 96th Congress,
2nd Session. In: Environmental Responses Act (P.L. 96-510): Legislative History. U.S.
Code Cong & Admin News 5:6119-6123.

Weeks RW Jr., Dean BJ, Yasuda SK [1976]. Detection limits of chemical spot tests

toward certain carcinogens on metal, painted, and concrete surfaces. Analyt Chem
48(14):2227-2233.

Weller C [1994]. Letter of July 7, 1994 re: garment contaminations to Tom Hodous,
Division of Safety Research, National Institute for Occupational Safety and Health,
Centers for Disease Control and Prevention, Public Health Service, U.S. Department of
Health and Human Services.

West I [1959]. Health hazards of the agricultural aircraft industry in the applications of
toxic pesticides. California Vector News 6(3):13-19.

West I, Lim J [1968]. Mercury poisoning among workers in California’s mercury mills. J
Occup Med 10(12):697-701.

Whelan EA, Piacitelli GM [1995]. “Take-home” lead exposure among construction
workers [Abstract]. Epidemiol 6(4):139.

Whitwell F, Scott J, Grimshaw M [1977]. Relationship between occupations and asbestos
fibre content of the lungs in patients with pleural mesothelioma, lung cancer and other
diseases. Thorax 32:377-386.

Widera v. Ettco Wire & Cable Corp. [1994]. 204 A.D.2d 306.

Wiehrdt WQ [1994]. Letter of February 10, 1994 re: home contamination with lead -
Mlinois, Indiana, and Ohio to Diane Manning, Education and Information Division,
National Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 8

pages.

Wilken-Jensen K [1983}. [What is known about occupational respiratory allergies?] (in
Danish). Ugeskr Laeg 145:2529-2530.

Williamson DE [1994]. Letter of February 3, 1994 re: workers’ home contamination in
Alabama to Ms. Diane Manning, Education and Information Division, National Institute
for Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 16 pages.

Winegar DA, Levy BS, Andrews JS Jr., Landrigan PJ, Scruton WS, Krause MJ [1977].

Chronic occupational exposure to lead: an evaluation of the health of smelter workers. J
Occup Med 19(9):603-606.

140


Table 1. Health Fifects of Take-Home Berytlium Fxposure (Case Reports/Case Series)

Hardy [1948] Massachusetts Fluorescent bulb (Case report Woman with chronic beryllium disease from Exposed for 2 years caring for a fatally ill
manufacture household contact. daughter in home (daughter was a beryllium
worker who died of beryllium disease).
Bisenbud et al. Ohio Beryllium plant Case report Woman with chronic beryllium disease from Woman laundered husband's work clothes for
{1949} household contact. 3 months. Estimated that a single laundering
resulted in inhalation of 17 yg of beryllium.
Chesner {1950} Ohio Beryllium plant Case reports Chronic beryllium disea Woman used bags in which beryllium had been
DeNardi et al. U-year-old woman whose neighbor worked shipped as dish clothes; 10 year latency; infant
[1949] at the plant. child may also be a case.
8-year-old girl. Girl's father worked at plant for 1 year before
her birth; her uncle had chronic pneumonitis
and lived in home for a few months the year
before the girl became ill, He had worked at
the plant for a few weeks about 7 years earlier.
26-year-old woman. Husband worked in beryllium plant for 8 weeks;
she denied cleaning his clothes.
Newman and Ohio Beryttium plant Case report Sé-yearold woman whose husband worked Woman had only incidental exposure; plant
Kreiss [1992] in plant for 26 years before initiation of required change of clothes and shower before
symptoms of chronic beryllium disease, going home.
Chamberlin et al. Pennsyivania Beryllium plant Case series $5 women ages 24-56, with chronic Exposed to contaminated work clothes.
(1987) pulmonary fibrosis all deceased. Beryllium in lungs 0.02-0.20 ug/100g of dried
lung.
Lieben and Pennsytvania Beryllium plant Case series 19 cases of beryllium disease ages 10-60 yrs, Alt had contact with contaminated clothing for
Metzner [1959] 9 deceased, 21 neighborhood cases, 2 months to 13 years; beryllium was found in
exposures ages 10-80 yrs. the lungs.
Metzner and Pennsylvania Berytlium plant Case series Added 3 contact cases and 5 neighborhood ‘Two of the cases were a brother and sister who
Lieben [1961] cases to those reported by Lieben and were often present when the mother washed
Metzner [1959], their father's clothes.
Dattoli et al. Pennsyivania Beryllium plant Case series Added 1 contact case and 3 neighborhood Beryllium found in tungs of contact case who
[1964] cases to those reported by Metzner and handled contaminated clothes for $ years and
Lieben [1961]. also had neighborhood exposure.
Lieben and Pennsytvania Beryllium plant Case series Added 3 cases of beryllium disease to those Exposed to clothing or home environment of
Witliams [1969] reported by Dattoll et al. (1964}. Total of 26 | beryllium workers before 1959.

cases ages 17-59 among household contacts
of workers; 22 were female, 18 deceased,

143


Kilburn et al.
(1985, 1986]

Los Angeles County

Shipyard workers

‘Table 3. Health Effects of Take-Home Asbestos Exposure (Community Studies)

Community-based cohort. Prevalence of
radiographic evidence of asbestos among
shipyard workers and their household
contacts with at least 20 years latency
(n= 1017) was compared with that of 2
previously studied comparison groups
(Long Beach census tract and Michigan
adults). Medical and occupational history
obtained by examination and interview.

147

Prevalence among household contacts without
occupational exposure was reported. Among 274
wives of shipyard workers, 11.3% had
radiographic evidence of asbestosis (profusion 1/0

or greater), compared with prevalence of 0.6% in
the California and 0.0% in the Michigan
comparison groups. Prevalence increased with
time since first exposure; the prevalence rate
among those with longest latency was 32%.
Among 140 femate children, the prevalence rate
was 2.1%; a prevalence of 7.6% was observed
among 79 sons of shipyard workers.

Possible selection bias resulting from
volunteer study participants. No
difference in prevalence observed by
smoking status. Most shipyard workers
had indirect (bystander) exposure.
Families of insulators appear to be at
increased risk of asbestosis compared
with other shipyard workers, (1% of
shipyard workers were insulators; about
25% of asbestosis in workers’ families
occurred in families of insulators.)



Nearly 80 reported incidents of workers’ family exposure to lead were identified in
22 published retrospective cohort studies (Table 7), 14 published community
studies (Table 8), and 30 case series or case reports, of which 10 are unpublished
reports or letters (Table 9). Of the 34 reports of workers’ children’s blood lead
levels (BLLs), 19, including 5 which identified children with BLLs in excess of 40
ug/dL, were reported since 1990, indicating that workers’ home contamination by
lead continues to be a current health problem in the United States.

In five reports (six cases) BLLs in adult family members of U.S. lead workers
were reported. In all six cases, BLLs exceeded 10 ng/dL. In two of these, BLLs
exceeded 40 g/dL, one of which reported a BLL greater than 50 ug/dL. Thus,
indicating a need for concern for the health of workers’ adult family members and
concern for prenatal exposure.

This series of reports may represent only a small portion of the documented cases
of take-home lead exposure. Many of the case reports were solicited from State
health departments as part of the NIOSH effort to summarize existing accounts of
such exposures. Of the 28 case reports, 10 (36%) are unpublished.

Background

Lead is a bluish gray metal that has been used since ancient times because of its
useful properties, such as low melting point, pliability, and resistance to corrosion.
The ancient Romans and Greeks first discovered the toxic effects of lead. Lead is
ubiquitous in U.S. urban environments due to the widespread use of lead
compounds in industry, gasoline, and paints during the past century. Exposure to
lead occurs via inhalation of dust and fume, and ingestion through contact with
lead-contaminated hands, food, water, cigarettes, and clothing.

Lead poisoning of workers’ family members has been known since Oliver [1914]
reported cases in Great Britain of "double wrist drop” (peripheral neuropathy) in
women who laundered the clothes of their husbands who were painters. Oliver
also reported severe cases of lead poisoning (infant mortality, paralysis, blindness,
and severe mental retardation) among children of home pottery makers in

Hungary.

Lead deposited in the respiratory and digestive systems is released to the blood,
which distributes the lead throughout the body. More than 90% of total body
lead content is accumulated in the bones, where it is stored for decades. Lead
from bones may be released into the body long after the initial external exposure.
There are several biological indices of exposure to lead. Measurement of
protoporphyrin (free or zinc protoporphyrin [ZPP]) concentration in red blood
cells (erythrocytes) can be a good indicator of inhibition of heme synthesis by
lead; however there are other causes (i.e., anemia) of elevated protoporphyrin
levels. Lead concentrations in urine, skeletal bones, teeth and hair can be used as
biological indicators of exposure to lead. Recent advances in the measurement of

12


Oem et al.
(1991)
Norway

mesothelioma

(Continued) Health Hsfects of Take-Iome Asbestos Hxposure (Case Reports)

# CASES/RELATIONSHIP

AGES) AT DEATH
OR DIAGNOSIS

Family made up of 2 brothers, a sister and her husband. All
males were asbestosis insulators and 2 were smokers. Oldest
brother (alive) has asbestosis, Other brother and sister died
from mesothelioma. Brother-in-law died from cancer bronchiale.
Woman cleaned asbestos-contaminated work clothes.

Asbestos

Pleurat plaques

3 Daughters

Daughters of pipe lager. Exposure was laundering of work
clothes; 2 younger daughters were asymptomatic but all 3 had
varying degrees of pleural plaques. Father died of peritoneal
mesothelioma.



Table 23. Responses of Industry to Incidents of Workers’ Home Contamination

Industry Problem Industry Action
Barnett [1994] Wood treating Chioropicrin brought home in company truck, The ‘Company changed policy - no company vehicles
pesticide spilled in worker's driveway, neighbors can be taken home, better storage procedures
became ill. for pesticides in transport.
Barnett (1994) Bronze foundry Lead determined to be brought into workers homes | Employee homes and workplace were cleaned,

‘on their clothing. Two children identified with
elevated BLLs.

Lower lead content stock was substituted,
OSHA Lead Standard was complied with,

Gunter et al. [1987]

‘Assay laboratory

Workers were exposed to high lead levels and some
had elevated BLLs,

Company requested NIOSH Health Hazard
Evaluation.

Donovan [1994a,b; 1994b]

Stained glass

Work involves use of lead, residence attached to
workplace,

Operator of studio requested a NIOSH Health
Hazard Evaluation. NIOSH found that
exemplary industrial hygiene practices being
used effectively prevented home contamination.

Versen & Bunn (1989)

Mining, processing, and packaging of
diatamacios carth

Possible exposure to silica when laundering worker’
clothes.

‘Company-conducted study indicated that
laundering did not produce silica dust levels
higher than ambient.

Hudson et al. (1985, 1987]

‘Thermometer manufacture

Workers and children of workers had high levels of
mercury in thelr blood

Plant voluntarily closed. Part of plant re-opened
when controls were put into effect.

de Sitva (1994) Sandblasting In a routine annual check-up, a pediatrician found “Preventive actions at the worksite were

an elevated BLL in a 2-year-old. The pediatrician implemented,"
determined that the child's father was working in a

lead related occupation. The father's BLL was

35 g/dL.

Lundquist [1980] Battery manufacturing Take-home lead contamination ‘The reference is an informational/educational
article in a trade magazine, Covers mechanisms
of home contamination and ways to prevent it.

Lead Industries Association Multiple industries and hobbies, Potential take-home contamination Industry association has produced a series of

[1989, 1991, 1993a,b; 1994a,b]

users of lead

254

filers, brochures, and industry/hobby specific
it make reference to preventing



Pesticide
(water solubility)

Table 16. (Continued) Studies on Laundering Pesticides from Contaminated Clothing

Laundry or Decontamination Variables

Hild et al. (1989) Methy! parathion Emulsifiable 50/50 Cotton-polyester with and | 40°C wash, nonionic heavy-duty liquid No effect of detergent type.
concentrate without soil repeltent detergent; phosphate-based powdered Increasing detergent decreased
anionic detergent: Prewash product, air residue, increasing water level
dried, 50, 100, 150, and 225 mL water, 0, decreased residue, agitation (steel
10, 25, 50 steel balls. balls) had no effect. Residues
always greater with soil repellent.
All treatments removed more than
98% of contaminant.
Keaschall et al. Organophosphates: All emulsifiable 50/50 Cotton-polyester, 49°C wash, 2 rinses, detergent, pre-wash Dichlorvos, dimethoate, malathion,
[1986] chlopyrifos (2 mg/L) concentrates except unfinished and fluorocarbon spray or degreaser. carbofuran and propoxur were
dichlorvos (5 g/L) carbofuran which was | finishes consumer applied and effectively removed from all fabrics
diazinon (40 mg/L) a flowable formulation | commercially applied by washing; chlorpyrifos, aldrin, and
dimethoate (25 g/L) lindane were least effectively
malathion (200 g/L) removed. Fluorocarbon finishes
methyl parathion reduced absorption of pesticides by
Carbamates: the fabrics, but did not facilitate
carbofuran (700 removal by laundering. The
mg/L) laundry additives significantly aided
propoxur (2 g/L) residue removal.
‘Organochlorines:
aldrin (30 mg/L)
chlordane (1 mg/L)
lindane (10 mg/L)
Kim and Wang Atrazine Water-dispersible Heavy weight cotton twill 60°C and 49°C, heavy duty liquid Over 99% of the initial
(1992) 30 mg/L at 20°C granules, unground detergent with anionic and non-ionic contamination was removed by the
and ground (dust) surfactants, 10 and 30 steel balls washing and drying process. The
1 gram sewed into (agitation), machine and air drying, amounts in the transfer cloths were
pockets accelerated laundering apparatus, 300 mL | 0,05-0.25% of the initial

water, clean clothe laundered with
contaminated ones.

contamination, The 60°C water
removed more atrazine and resulted
in lower transfer to clean cloths,
Drying methods had no effect.

209



RESPONSES OF STATE AGENCIES

Information on State agency investigations into incidents of home contamination was
obtained in two ways. The first was by direct solicitation of various State agencies,
including State agriculture and State and local health departments, State departments
of labor, and State environmental departments. Responses received from these State
agencies are compiled in Tables 20 and 21. The second way documentation of State
investigations was obtained was through literature searches in the open literature.
Studies by State agencies identified in this way are compiled in Table 22.

The reports of the State agency responses to, or investigations of, home contamination
incidents are discussed by groups: Lead; Pesticides; and Other.

Lead

Because of its wide use in a number of common industries, and particularly because
of its serious neurological impact on children, the most commonly cited incidents of
home contamination from the States involve lead. Many States maintain active
surveillance of lead poisoning through local health departments and physician
reporting and as a result can identify incidents for investigation.

In California, laboratories that analyze blood for lead content are required to report
BLLs of 25 g/dL or above to the California Department of Health Services and to
the local county health department [Osorio 1994]. Programs in the California
Department of Health Services, the Occupational Lead Poisoning Prevention
Program and the Childhood Lead Poisoning Prevention Branch, coordinate
investigations of elevated BLLs with local health departments. Take-home exposure
cases are typically identified during the investigation of workers with high BLLs or
follow-up of childhood cases where lead exposure is identified in the job of a parent
or other household member. In terms of prevention activities, the Occupational
Lead Poisoning Prevention Program includes information on take-home lead
exposure in their outreach and educational efforts. Data from the Childhood Lead
Poisoning Prevention Branch show that of the 1,232 cases of elevated BLLs in
children under age 16 with follow-up information, 106 had a potential exposure in a
worker’s contaminated home. Of those with information reported about the lead
workers in the household, 33% changed clothes before leaving work, 13% took
showers before going home, and only 18% ever had a blood lead test for work.

The California Department of Health Services provided five case studies of take-
home lead exposure in response to the NIOSH Federal Register request for
information [Osorio 1994]. Industries involved in these cases include: lead
recycler/bullet manufacturing; radiator repair; and cable cutting operations.

In the cable cutting operations case, the county health department conducted a
follow up investigation of a 3-year-old child with a BLL of 28 ug/dL whose uncle, a
lead cable cutter, for 4-5 years lived with the family. The father was also employed
in this trade for 3 months prior to the investigation. Their employer did not provide

93


[ FEDERAL AGENCY

‘Table 19. (Continued) Federal Agency Involvement in Incidents of Workers’ Home Contamination and Related Activities

Centers for Disease Control
and Prevention (CDC)
NIOSH [1971]
Donaldson and Johnson
fis72)

Lemen {1972]
Marceleno et al,{1974]
Finklea (1976)

‘Wagoner (1976)
Bierbaum (1993]

Todd and Timbie

[1979]

Belanger et al. (1979]

Landrigan et al. (1980)

Apol and Singal (1980)

A teries of tests were conducted on a woman's coat containing asbestos (8%) to determine magnitude of exposure associated with wearing, brushing, or cleaning
the coat, Found transfer to companion clothing during laundry.

Survey of Diamond Shamrock Company in Redwood City, Califomia, to determine exposure of workers to bis (chlordimethy!) ether. The employees paid half the
cost of the work clothes and although the company paid for laundering, they could take their work clothes home,

Proctor and Gamble in Blue Ash, Ohio. This was a study of asbestos exposure in workers involved in spraying fireproof insulation at new building site, Workers
were covered with insulation material, did not have respirators, and took clothing home at end of day. Recommended supply of respirators and clothing and
laundry by contractor.

Grace Bleachery, Lancaster, North Carolina (textile facility). This was a study to determine the presence and extent of exposure to bis-chloromethyl ether.
Workers did not shower or change work clothes before leaving for home and were seen eating in production areas at work,

‘Testimony of John F. Finklea to Congress, RE: exposure to kepone at Life Science Products plant in Virginia. Found that Kepone contaminated work clothes
were often worn home.

Joseph K. Wagoner’s testimony to the subcommittee of House committee on Interstate and Foreign Commerce pointed out that wives, children, and retatives of
asbestos workers have died from disease related to asbestos exposure from worker's clothing brought home,

NIOSH participated in an incident of diethylstilbestrot poisoning in farm children.

Survey of wood preservative treatment facility (Creosote) at Koppers Company, Inc., Florence, South Carolina. Some employees had work uniforms, but others
brought work clothing from home. Most employees changed clothes before leaving work, but not all employees showered, although shower facilities were
provided,

Kentile Floors, Inc. in Chicago, Illinois, Investigation of worker exposure to asbestos and other chemicals. Manufacturer of vinyl floors and
and asbestos floor covering. Workers required to wear coveralls, respirators, and safety shoes, and can shower, but not required to do so.

Published paper of stained glass workers - hobbyist, professionals and families, BLLs were related to lead in workplaces and workers’ homes. Recommended that
contaminated work clothes not be worn home and be laundered separately.

Alaskan Battery Enterprises, Fairbanks, Alaska, Evaluated lead exposure among workers manufacturing lead-acid storage batteries. Looked at worker BLLs.
Owner and family lived above the plant and 4 employees were children, Home entered through hallway that opened into plant. Recommended shower and
change room, good housekeeping and redesign of entry to house.

243



Ovorio [1994]

California,
USA

‘Table 9. (Continued) Health Effects of Take-Home Lead Exposure (Case Reports/Case Series)

Lead recycling/
bullet manus
facturing
Radiator repair

Cable cutting

Cable salvage

Battery repair

Case reports
1 Worker (2 children)

1 Worker (2 children)

2 Workers (3 children)

1 Worker (1 child)

1 Worker (1 child)

Z-yearold with BLL of 44 g/dL and
Teyear with BLL of 36 g/dL.

Children age 4 and 1.5 had BLLs in 20's.

BLL of children ages 3 and S years, and
9 mos were 28, 27, and 21 ug/dL
respectively.

Child (age 10 mos) had a BLL of
26 pg/dL.

Child (age 6) had BLL of 36 g/dL.
Father had BLL of 121 g/dL.

Environmental sources ruled
out.

Home was constructed post-
1978; no lead paint identified.

Child had learning and
behavioral problems.

Poltock [1994]

Micsicsippi,
USA

Case report
1 Worker
2 Children

Children (age 1 and 3) had BLLS of 24
and 28 ug/L, respectively.

No environmental sources of
lead identified, No health
effects reported.

‘Wiehrdt (1994)

Minois, USA

Indiana, USA

Ohio, USA

Battery plant

Not given

Case report
2 Children of 2 worker

‘Case report
At least 1 child of 5 related workers

(Case report
Unknown number of children

"Gross contamination" of home.

At least 1 child had a BLL of 50 ug/L.

Children of 3 workers had elevated BLLs
(levels not provided)

2 children were hospitalized
and underwent chelation
therapy. 1 child underwent
chelation therapy.

O'Tuama et al, [1979]

North
Carolina,
USA

Burning leed
battery terminals

Cate report
1 Worker
3 Children
Children of coworkers

172

20-month-old son had high blood lead,
2 siblings plus children of $ coworkers
showed evidence of increased lead
absorption.

No health effects reported.



‘Table 19. (Continued) Federal Agency Involvement in Incidents of Workers’ Home Contamination and Related Activitics

FEDERAL AGENCY

RESPONSE

Agency for Toxic Substances
and Disease Registry
(ATSDR)

[Alabama Department of
Public Heatth 1991)
ATSDR [1989]
ATSDR (1990a]

ATSDR [19938]
ATSDR [19918]
ATSDR [1989a; 19900;

19936]

ATSDR (19916]

The Alabama Department of Health conducted an exposure study of children tiving near @ lead reclamation factory in Alabama. Although the investigators
recognized the potential for workers’ home contamination, households of employees of the factory did not participate. Possible reasons for non-participation are
discussed in the report,

A study in Michigan to determine the extent of trackout from the workplace was reported of the homes of workers exposed to MOCA while manufacturing
plastics, See ATSDR [1989] in Tables 12 and 15.

ATSDR and EPA acting under CERCLA provided technical assistance to the Tennessee Department of Health investigating contamination of workers’ homes
with mercury and subsequent decontamination. See ATSDR [199%a] in Tables 13 and 15.

In this study of a North Carolina hazardous waste incinerator, EPA conducted site evaluations, NIOSH conducted neurotoxicity studies on workers, and ATSDR.
Studied the health of area residents. ATSDR was to do study of workers’ families and homes, but was unable to get sufficient volunteers.

In this Phitadelphia neighborhood lead study, exposure of children was evaluated; children of lead workers were included. See ATSDR [19914] in Table 8.
Anderson Development Company, Adrian, Michigan manufactured MOCA. Detectable levels of MOCA were found in urine of workers’ families. Professional
cleaning of homes was reported (carpets, baseboards, hard covered floors) after lab tests (dryer lint, furnace fitters, vacuum bags, urine of family members)
showed home contamination, Currently conducting a study for bladder cancer of workers and workers’ families. See also ATSDR [1989a, 1990b] in Table 12.

At the Bofors - Nobel, Inc. chemical manufacturing site in Michigan. 3,3'-Dichlorobenzidene was found in homes of some workers (vacuum cleaner bags) and in
the urine of some workers and family members. See ATSDR (1991b] in Tables 12 and 15.

241



CERCLA & SARA

‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home ‘Contamination

[42 U.S.C. § 9601 et
sq.)

Sections Relevant to Workers’ Famity Protection

priority facility only once, Other priority facilities or incidents may be listed singly or
grouped for response priority purposes;

(9) specified roles for private organizations and entities in preparation for response and
in responding to releases of hazardous substances, including identification of appropriate
qualifications and capacity therefor and including consideration of minority firms in
accordance with subsection (f) of this section.

‘The plan shall specify procedures, techniques, materials, equipment, and methods to be
employed in identifying, removing, or remedying releases of hazardous substances
comparable to those required under section 1321(c)(2) (F) and (G) and ({)(1) of Title 33.
Following publication of the revised national contingency plan, the response to and
actions to minimize damage from hazardous substances releases shall, to the greatest
extent possible, be in accordance with the provisions of the plan. The President may,
from time to time, revise and republish the national contingency plan.

(b) Revision of plan

Not later than 18 months after October 17, 1986, the President shall revise the National
Contingency Plan to reflect the requirements of such amendments, The portion of such
Plan known as "the National Hazardous Substance Response Plan" shall be revised to
provide procedures and standards for remedial actions undertaken pursuant to this
chapter which are consistent with amendments made by the Superfund Amendments and
Reauthorization Act of 1986 relating to the selection of remediat action,

(©) Hazard ranking system

(1)Revision

Not fater than 18 months after October 17, 1986, and after publication of notice and
opportunity for submission of comments in accordance with section $53 of Title 5, the
President shall by rule promulgate amendments to the hazard ranking system in effect on
September 1, 1984, Such amendments shall assure, to the maximum extent feasible, that
the hazard ranking system accurately assesses the relative degree of risk to human health
and the environment posed by sites and facilities subject to review. The President shall
establish an effective date for the amended hazard ranking system which is not later than
24 months after October 17, 1986. Such amended hazard ranking system shall be applied
to any site or facility to be newly listed on the Nationat Priorities List after the effective
date established by the President. Until such effective date of the regulations, the hazard
ranking system in effect on September 1, 1984, shall continue in full force and effect.

(8) Petition for assessment of release

Any person who is, or may be, affected by a release or threatened release of a hazardous
substance or pollutant or contaminant, may petition the President to conduct a
preliminary assessment of the hazards to public health and the environment which are
associated with such release or threatened release. If the President has not previously
conducted a preliminary assessment of such release, the President shall, within 12 months
after the receipt of any such petition, complete such assessment or provide an explanation
of why the assessment is not appropriate. If the preliminary assessment indicates that the
release or threatened release concerned may pose a threat to human health or the

235



Table 21. How State Agencies Respond to Incidents of Workers’ Home
Contamination ~ States that Do Not Have Their Own OSHA Program

J stars | scency ___] ronnamion rnovinen 10 niost

Alabama Department of Health ‘The Department of Health submitted two case histories where site visita found increaced BLLs, a final report to
ATSDR on lead exposure of children, and a report on tire and battery plants conducted by the regional OSHA
office [Williamson 1994; State of Alabama 1992; Mangum 1994; Alabama Department of Health 1991}.

Arkansas University of Arkansas College of ‘The College reported that it has no reports of take-home toxins, and that the States worker protection standard
Agriculture and Home Economics and applies to agriculture. The Department submitted reports to NIOSH on educational literature with segments
Cooperative extension Service addressing home contamination from workers [Huitink 1994; Lavy 1994}.

Delaware Department of Naturat Resources and ‘The Department reported that it had no information on any take-home cases [Mohrman 1994].
Environmental Control

Florida Department of Labor and Employment | The Department of Labor reported that it has no mechanism in place to monitor worker transportation of
Security chemicals, etc. [Koehler 1994].
Department of Agriculture ‘The Department of Agriculture has published # brochure in English and Spanish on washing clothing

contaminated by pesticides which was provided to NIOSH [Anonymous 1994].

Idaho Department of Health ‘The Department of Health reported that {t has no jurisdiction over private sector or other agencles. It does have
@ health and safety program for its own employees with specific procedures invotving contamination and written
Procedures to comply with OSHA for lab safety and hazardous waste, It has practices and procedures in place to
make sure decontamination occurs at the workplace. It has an elevated blood lead registry and conducts fottow-up.
studies on children that are reported. Employers of adults reported to the registry are identified to sce if there is
an occupationally related cause of exposure [Schultz 1994; Stokes 1994].

Louisiana No responses to requests for information were received; however, the Agriculture Experiment Station provided
reports on pesticide workers’ clothing contamination and laundering when contacted by telephone {Finley et al.
1977; no date).
Maine Department of Environmental ‘The Department of Environment reported that it has an emergency response group that responds to oil and
Protection hazardous chemical incidents, ‘The group follows decontamination procedures and has decontamination areas for
workers, All the workers are in a health monitoring program (Marriott 1994].
Mississippi State Department of Health ‘The Department reported on an investigation of two cases of lead poisoning [Pollock 1994],
Montana Department of Health and ‘The Department reported that it has no system of tracking home-contamination cases, any complaints of
Environmental Sciences hazardous sites are referred to county health officials [Cleverly 1994].
Nebraska Department of Labor ‘The Department of Labor reported that it has no statutes or regulations about home contamination, It uses

applicable OSHA standards (Calcaterra 1994]. The Agricutture Experiment has been active in studying laundering
of pesticide workers’ clothing and informing farm families of appropriate laundering procedures (Laughlin and

Gold 1988, 1989c}.
New Jersey Department of Labor Federal Occupational Safety and Health Standards are applied to public sector employees {Katz 1994]
Department of Health The Department of Health submitted a report on a pilot project on exposure of children to take-home lead

[Stanbury 1994; Czachur et al, 1995}.

250


‘Table 15. (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

a a a |

Process Industrial Hygiene Methodology Industrial Hygiene Observation Comments or Recommendations
Katzenellenbogen Diethyistilbestrol Production of diethyl Established control procedures Health effects reduced by control
(1956) Signs of estrogen stilbestrol in including sufficient ventilation, procedures.
Israel poisoning in workers and pharmaceutical factory. gloves, respirators, special shoes
families Wearing dirty clothes and clothing, showers, and laundry

home procedures.
Pacynski et al. Diethyistilbestrol Manufacturing Observation of work practices Hyperestrogenism in workers and
[1971] including taking potentially children disappeared after installation
Poland contaminated food home. of controls,

Institution of improved industrial
hygiene.

Venables and Rat allergen Animal handling in In both cases, one spouse was allergic Symptoms resolved after workers
Newman-Taylor Platinum salts laboratory to the allergen brought home on the changed clothes and showered
(1989) Use of platinum salts clothing of the other spouse. before feaving work.
United Kingdom in industrial laboratory
Klemmer et al. Arsenic Homes treated with Concentration of arsenic in Arsenic content (ug/g dust) in Arsenic may have been brought
[1975] pesticides against household dust from vacuums after untreated homes without exposed home on clothing of some exposed
Hawaii termite infestations, filtering through a 0.246 mm size worker 1.1 to 31.0; with exposed workers.

and homes with sieve. Analyzed via worker 5.2 to 1,080,

pretreated lumber, spectrophotometry. Arsenic content of treated homes

homes with workers without exposed worker 3.0 to 6.4;

exposed to arsenic, with exposed worker 8 to 380.
Schneider (1986] Man made mineral fibers | Surveys in office Surface and finger sampling for Fiber counts on fingers before

Schneider et al. (MMMFP) and non- buildings and schools fibers. A method was developed exposure to dusty surfaces were 0-1

[1989) MMMP to measure settled fibers from f/em?, after exposure, 1.5-82 f/em”.
hard surfaces,

Litzistorf et al, Fibers Not applicable Study of human activities affecting Demonstrated a large increase in

[1985] airbome fiber concentrations In fiber concentration in air during

fnon-occupational environments in
a classroom.

vacuuming.

203


Garrettson LK [1988]. Childhood lead poisoning in radiator mechanics’ children. Vet
Hum Toxicol 30(2):112.

Garrettson LK [1984]. Direct and indirect chemical exposure in children. Clin Lab Med
4(3):469-473.

Geisinger Medical Center [1991]. Caustic chemicals: An increasing threat to farm
children. Danville, PA, Public Affairs (19-00). Information release May 31, 1991.

Giarelli L, Bianchi C, Grandi G [1992]. Malignant mesothelioma of the pleura in
Trieste, Italy. Am J Ind Med 22(4):521-530.

Gibbs AR, Griffiths DM, Pooley FD, Jones JSP [1990]. Comparison of fibre types and
size distributions in lung tissues of paraoccupational and occupational cases of malignant
mesothelioma. Br J Ind Med 47(9):621-626.

Gibbs AR, Jones JSP, Pooley FD, Griffiths DM, Wagner JC [1989]. Non-occupational
malignant mesotheliomas. In: Bignon J, Peto J, Saracci R, eds. Non-occupational
exposure to mineral fibers. Lyon: International Agency for Research on Cancer. IARC
Publication No. 90. pages 219-228.

Gittleman JL, Engelgau MM, Shaw J, Wille KK, Seligman PJ [1994]. Lead poisoning
among battery reclamation workers in Alabama. J Occup Med 36(5):526-532.

Gittleman J, Estacio P, O’Brien D, Montopoli M [1991]. Health Hazard Evaluation
Report: G.T. Jones Tire & Battery Distributing, Inc. in Birmingham, Alabama.
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service,
Centers for Disease Control, National Institute for Occupational Safety and Health,
NIOSH Report No. HETA 91-213-2123. 30 pages.

Godby FW, Cooper TC, Sheehy JW, O’Brien DM, Van Wagenen HD, McGlothlin JD,
Todd WF [1987]. In-depth survey report: Evaluation of brake drum service controls at
United States Postal Service vehicle maintenance facility Nashville, Tennessee.
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service,
Centers for Disease Control, National Institute for Occupational Safety and Health,
NIOSH Report No. ECTB 152-20b. 27 pages.

Goldberg L [1994]. Letter of January 31, 1994 re: Workers’ Family Protection Act -
Wichita, Kansas to Diane Manning, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 2

Pages.

Goldman RH, Peters JM [1981]. The occupational and environmental health history.
JAMA 246(24):2831-2836.

114


Vianna et al. (1981)
USA

INDUSTRY

Six New York counties

‘Table 6. (Continued) Health Effects of Take-Home Asbestos Pxposure (Case Series)

Mesothelioma

#/RELATIONSHIP

Of 7 cases of indirect exposure, 6
were females,

AGE AT DEATH
EXPOSURE

Population-based incidence study (case
series). Descriptive survey of 31 (22 male; 9
female) histologically confirmed
mesothelioma cases diagnosed 1973-1978;
occupational histories from cases or relative.
No control group.

Grundy and Miller U.S, population-based Childhood 13 cases of childhood mesothelioma | Age range: USS, population-based death certificate search.
[1972] mesothelioma in US children, 4 through 17. No exposure history, although occupational
USA history of some fathers consistent with
asbestos exposure. Apparent short latency in
children compared to adults.
Greenberg and Asbestos Mesothelioma 2 women with mesotheliomas 1967-1968 mesothelioma cate series (n= 413;
Davies [1974] astociated with household exposure 365 pleural; 48 peritoneal) from population-
England/Wales of 2 and 3 years duration; 1 woman's based registry. Asbestos exposure history
husband worked in an asbestos obtained by interview from cases, relatives,
factory, and 1 was exposed to her employers and workmates. For 246 of the
brother's work clothes, 413 cases, the diagnosis was histologically
confirmed,
Milne Asbestos Mesothelioma 1 case in a woman whose father No exposure in the Retrospective survey of 32 cases of
(1976) (asbestos/cement) worked in the asbestos cement series began after mesothelioma in Victoria, Australia, These
Avatralia Industry. 1943; length of authors found occupational history equally
‘exposure ranged from | effective as an asbestos body count to indicate
6 months to 30 years. past exposure. In 16% of cases, there was no
evidence of exposure to asbestos, and 2 cases
of peritoneal cancer were in siblings without
asbestos exposure.
Edge and Choudhury | Asbestos Pleural mesothelioma 1 woman married to shipyard 47 men and 3 women diagnosed with pleural
{1978] (shipyard workers) plumber who may have brought dust mesothelioma 1966-1976 among 64,000
England home on clothes. residents, 7,000 of whom worked in ship

construction. All 50 cases of pleural
mesothelioma histologically proven and
accepted by Pneumoconiosis Panel. All men
plus 1 woman occupationally exposed; 1
woman exposed at home, another had no
known exposure. Asbestos content of last 20
cases was measured; 18 cases substantially
exceeded that of the general population,
Metastases, frequent at necropsy, occurred in
25 of 47 cates autopsied.

155


anaes DEPARTMENT OF HEALTH & HUMAN SERVICES Puolic Health Senice

Centers tor O:sease Control
National institute for
Occupational Safety & Mealtn
Robert A. Taft Laboratories
4676 Columora Parkway
Cincinnats OH 45226-1998

January 10, 1994

Dear Sir/Madam:

The National Institute for Occupational Safety and Health (NIOSH) has recently
published a Federal Register (FR) Netice (Enclosure 1) that requests
information relevant to implementation of the Workers’ Family Protection Act
(29 USC 671la). The Act charges NIOSH with conducting a study of hazardous
chemicals and substances, including infectious agents, that are carried home
by the worker. The FR Notice describes the NIOSH responsibilities under the
Act, including the development of a report that will describe the extent of
the home contamination problem, the efficacy of actions taken to prevent home
contamination, and the role of government agencies in responding to incidences
of home contamination.

A previous FR Notice (Enclosure 2) was published on Septeaber 22, 1993, by
NIOSH that solicits nominations for meabership on the Workers’ Family
Protection Task Force. This task force, vhich is mandated by the Act, will
review the report prepared by NIOSH and determine if additional research data
are needed to fully address the problem of home contamination. If additional
data are needed, the task force will develop a strategy to obtain this
information.

To help prepare this report, please respond to the appropriate questions in
Enclosure 1 and provide to NIOSH information (including laws or regulations),
reports, or data on the contamination of workers’ homes that are relevant to
your agency or office. Please send these coments by February 14, 1994 to
Ms. Diane Manning (NIOSH Mail Stop C-15). If you have any questions on this
request, please call Mr. John Whalen at 513/533-8306.

Sincerely yours,

MLS A Lone

ichard W. Niemefer, Ph.D.

Director

Division of Standards Development
and Technology Transfer

Enclosures

267


were shaken and estimated an inhalation dose of 17 yg during a single home
laundry. The OSHA permissible exposure limit (PEL) for beryllium is 2 ng/m°
as an 8-hr. time-weighted average (TWA) with permissible excursions up to 25
»g/m’ for up to 30 minutes (29 CFR? 1910.1000).

Asbestos

Several studies of asbestos workers’ families inferred that asbestos-related
diseases were due to home contamination emanating from clothes contaminated
at work, especially due to laundering the clothes [Anderson et al. 1979a,b;
Bianchi et al. 1987; Giarelli et al. 1992; Gibbs et al. 1990; Huncharek et al.
1989]. However, no studies evaluated the relationships between home
contamination by asbestos, contamination of clothing brought home from work,
and exposures during home laundering. The few studies reported and reviewed
in this section indicate that clothing probably was a source of home
contamination by asbestos and support the hypothesis that home laundering of
asbestos contaminated clothing could be especially hazardous.

One study reported measurements of asbestos contamination in workers’
homes; however no measurements of clothing as a source of the contamination
were made [Nicholson et al. 1980].

Two studies of workplace clothing contamination by asbestos have been
reported [Seixas and Ordin 1986; Driscoll and Elliott 1990]. Chrysotile asbestos
was found in all clothing vacuumed as employees left work at a brake shoe
manufacturing facility, but neither report provided quantitative data on asbestos
recovered from the workers’ clothing.

No studies of exposure during home laundering were found. However, a study
on laundering clothing contaminated by an asbestos removal operation
produced an average of 0.4 fibers/cm’ while picking up clothing and loading the
washer. A maximum of 1.2 fibers/cm’ was found during the total laundry
operation [Sawyer 1977]. Although the study was not conducted in a home
laundry and measurements of the level of clothing contamination that generated
these concentrations were not made, the study is consistent with the hypothesis
that home laundering of asbestos-contaminated clothing is hazardous. Another
important aspect of laundering asbestos contaminated clothing is that the fibers
can transfer to uncontaminated clothing washed with the contaminated clothing,
as was found by NIOSH [1971] in a study of dry cleaning a coat made with 8%
asbestos fiber.

Code of Federal Regulations. See CFR in references.

36


incidents are summarized weekly in a publication prepared by the Nuclear Safety
Office of DOE.

There are approximately 19,000 reports from 1990-present in the database. Since
off-site contamination of a home is not uniquely coded; the use of word searches
with ORPS can lead to under-counting of relevant cases of potential take-home
contamination. In addition, there may be reports of workers’ home contamination in
the pre-1990 files which were not searched.

The ORPS Program Manager provided 16 reports related to contamination of
workers’ homes with hazardous substances transported from the workplace [Boyle
1994]. These reports primarily describe breaks in procedure or poor work practices
with potential rather than actual take-home contamination, or with take-home
activity that did not result in contamination of the workers’ homes or family
members. The three incidents involving possible contamination of workers’ homes
or family members include:

e Workers contaminated with thorium and protactinium while changing valves on
cylinders, apparently ignored positive readings on contamination monitors,
resulting in contamination of one employee’ 's pillow case and shirt and another
employee’s shoe. The incident led to major revisions in the facility's monitoring
program and contamination control procedures. Based on survey information
and monitoring data, which indicated no internal contamination of the workers
and “minute” external (skin) contamination, the incident was anticipated to have
“negligible effect on the health of the workers or the public.”

e An employee was found to have contaminated hands when monitored upon
entering the facility, the employee had not gone through the monitoring process
when exiting from work the previous night. Survey of the employee’s home
found that two items of personal clothing worn the previous day were
contaminated. Levels of contamination were "extremely low” and there was felt
to be no exposure to the employee’s family. The employee and his clothes were
decontaminated and the employee was terminated for "willful and flagrant
disregard of health and safety procedures."

© Initially-undetected damage to an americium source resulted in contamination of
a worker’s hat, which was found on a routine survey several days after the event.
A follow-up investigation identified americium on the diaper of a worker’s infant
child. A panel of independent experts from the national radiation dosimetry
community, the radiological medicine community, and a local pediatrician guided
the follow-up evaluation. The panel concluded, the most likely explanation was
that this was a false positive because of poor laboratory performance. The poor
laboratory performance was well-documented by the evaluators and no
subsequent samples were sent to this laboratory. The team reviewing the incident

90


CHAPTER 4, PREVENTIVE MEASURES

CHAPTER SUMMARY

Several measures that have been taken to prevent contamination of workers’ homes
and to protect workers’ families are identified in the reports reviewed in this Chapter.
The measures include:

e reducing exposures in the workplace;

e changing clothes before going home and leaving the soiled clothing at work to be
laundered by the employer;

e storing street clothes in separate areas of the workplace to prevent their
contamination;

e showering before leaving work;
e prohibiting taking toxic substances or contaminated items home;
© separating work areas from living areas of cottage industries;

© storing and disposing of toxic substances on farms and in cottage industries
properly;

e preventing family members from visiting the workplace;

e laundering separately from family laundry when it is necessary to launder
contaminated clothing at home; and

e informing workers of the risk to family members from home contamination and
ways to prevent it.

The few studies evaluating these measures indicate that they can be effective in
reducing or eliminating home contamination. There have also been instances in
which home contamination has occurred when one or more of these measures has
been omitted.

BERYLLIUM

Following reports of occupational and non-occupational (community and workers’
families) cases of berylliosis, the beryllium industry instituted a number of preventive
measures, including: engineering controls to reduce air-borne exposures of workers’;
community air pollution controls; and measures to prevent exposure of family
members to contaminated clothing [Eisenbud et al. 1949; Metzner and Lieben 1961].
In one plant, a double locker system was installed in 1955 which prevented removal
of work clothes, underwear, socks and shoes from the facility [Lieben and Metzner

54


This case illustrates the need for vigilant application of industrial hygiene controls
for beryllium even when exposures do not seem high or consistent. Moreover, it
is possible that household and community cases of beryllium disease may still be
occurring but are unrecognized or misdiagnosed as in this case.

ASBESTOS
Overview
Based on the studies reviewed in this section, families of asbestos-exposed workers
have been at increased risk of pleural, pericardial, or peritoneal mesothelioma,
lung cancer, cancer of the gastrointestinal tract, and non-malignant pleural and
parenchymal abnormalities as well as asbestosis. Four cohort studies (Table 2),
one community study (Table 3), seven case-control studies (Table 4), numerous
case reports (Table 5) and case series (Table 6) provide evidence of these adverse
effects in family members of asbestos workers.

The occupations associated with asbestos-related disease in family members are
those where workers were exposed to asbestos dust during: construction and
renovation; prospecting and mining; manufacturing textiles, tiles, boilers, and
ovens; shipbuilding and associated trades; certain railroad shop trades; welding;
insulation; use and manufacture of asbestos products such as cords, seals, and
plates; and renovation and demolition projects within the construction industry.

Although many past uses of asbestos have been abandoned, and asbestos uses and
occupational exposures are now subjected to regulation, potential exposures of
family members in the United States may still exist, especially in the construction
industry [Sullivan et al. 1995).

Background

Asbestos is a generic term for a number of silicate minerals with a fibrous
crystalline structure. The asbestiform varieties of silicate minerals can be found in
both the amphibole and serpentine mineral groups, in veins or small veinlets
within rock containing or composed of the common (non-asbestiform) variety of
the same mineral. The major asbestiform varieties of minerals used commercially
are chrysotile, tremolite-actinolite asbestos, cummingtonite-grunerite asbestos,
anthophyllite asbestos, and crocidolite. Asbestos is marketed by its mineral name
(e.g., anthophyllite asbestos), its variety name (e.g., chrysotile, crocidolite), or its
trade name (e.g., Amosite).

Mesothelioma is a tumor arising from the pleural, pericardial, and peritoneal
membranes, When it occurs in asbestos workers’ household contacts, it is a
sentinel event for exposure to asbestos from home contamination [Gardner and
Saracci 1989]. Lung cancer is a malignant tumor of the lung. Cancer of the
gastrointestinal tract is a malignant tumor of any part of the gastrointestinal tract
including the mouth, pharynx, esophagus, stomach, small intestine, pancreas,
colon, rectum, and anus. Asbestosis is a fibrotic disease of the lungs caused by

6


CHAPTER 6. REVIEW OF EXISTING FEDERAL AND STATES LAWS
CHAPTER SUMMARY
FEDERAL LAWS

Statutes and rules are reviewed that provide Federal agencies with relatively limited
authority to prevent or remediate workers’ home contamination. Table-17 displays, in
summary form, the text of those statutes most relevant to this topic, while Table 18
provides a brief explanation of the relevant regulations. Examples of workers’ home
contamination in which Federal agencies exercised their statutory and regulatory
authority are presented in the following chapter, as well as Table 19. Seven statutes
were identified in the United States Code (U.S.C.), and 20 regulations were found in the
Code of Federal Regulations (CFR), that addressed workers’ home contamination.
Below are summaries of Federal and State laws that are relevant to the issue of workers’
home contamination.

Under the Occupational Safety and Health Act of 1970 (OSH Act), the Occupational
Safety and Health Administration (OSHA) has limited authority to develop and
promulgate standards for protecting workers’ families directly; under this authority,
OSHA can protect workers’ families from workplace contaminants if workers are
required to reside in employer-provided housing as a condition of employment. OSHA
has extensive authority, however, to require that workers not carry home workplace
contaminants on their clothing, in their automobiles, or by other means (i.e., by
promulgating standards that require workers to remove contaminants from their skin and
clothing prior to leaving the workplace). OSHA consultations conducted pursuant to 29
U.S.C. 670 also may promote, indirectly, prevention of take-home contamination.

The OSH Act does not provide specific authority to the National Institute for
Occupational Safety and Health (NIOSH) to conduct studies on family protection from
workers’ home contamination. To the same extent that OSHA regulations and actions
intended to protect workers also help assure that families are protected, however,
NIOSH research assessing work hazards enables the agency to identify the potential for
home contamination and make preventive recommendations. While NIOSH has no
specific legal authority to evaluate conditions in workers’ homes, the agency can conduct
such studies with the cooperation of workers and their families.

The Federal Mine Safety and Health Act of 1977 (Mine Act) provides the Mine Safety
and Health Administration (MSHA) with authority comparable to OSHA's. The Mine
Act also authorizes MSHA to regulate home contamination if the mine is solely owned
and operated by the miner.

72


© The workplace origin of many common diseases that occur in workers’ families (such
as asthma, dermatitis, and infectious diseases) is probably unrecognized because
physicians and other health professionals fail to inquire about the occupation of family
members and to consider whether these diseases are work-related.

© The literature reviewed in this report contained only nominal information about
contamination levels in workers’ homes. Most measurements were of surface dust, for
which there are no guidelines for acceptable levels of contamination.

Recommendations for Research and Education

© The prevalence of health effects of contaminants transported from the workplace
should be determined. One possible approach would be to conduct surveys among
occupational and environmental medicine health care providers and clinics.

e The employment practices and controls that work best in preventing the transport of
contaminants from the workplace to the home should be identified.

e Educational programs to prevent home contamination should be developed for
employers, workers, children, teachers, and parents, physicians, and other health
professionals.

e The special needs and problems of individuals who work in home or cottage industries
need to be identified.

Conclusions

e Workers’ home contamination may pose a serious public health problem. Health
effects and deaths from contaminants brought home from the workplace have been
reported in 28 countries and 36 States.

© The extent to which these health effects occur is not known because there are no
information systems to track them, and physicians do not always recognize the
occupational contribution to various common diseases.

e About half of the reports of health effects from home contamination are less than 10
years old. The literature on the health effects involved approximately 30 different
substances or agents. The potential exists for many of the thousands of other
chemicals used in commerce to be transported to workers’ homes or to be used in
home-centered businesses.

e Health effects and deaths from contaminants brought home from the workplace are

preventable using known effective measures. Educational programs are needed to
promote their use.


1959]. Until Newman and Kreiss [1992] reported on a case, there were no new cases
of berylliosis in beryllium workers’ families reported for more than 30 years. This
recent case report demonstrates the dangers of any relaxation of preventive measures
as the uses of beryllium, the number of workplaces where it exists, and the number of
workers exposed expand.

ASBESTOS

Although poisoning of asbestos workers’ families has been known since the report by

Newhouse and Thompson [1965], and has been repeatedly associated with laundering
contaminated clothing, no information exists on effectiveness of preventive measures.
Belanger et al. [1979] recognized the hazard in evaluation of a factory where asbestos
was used in the manufacture of floor coverings. They specifically recommended that

work clothes not be taken home because this could expose others at home.

Seixas and Ordin [1986] and Driscoll and Elliott [1990] investigated plants
manufacturing brake linings and made recommendations for providing protective
clothing, keeping street clothes separate from work clothes, company laundering and
showering before leaving work. The OSHA asbestos standards [29 CFR 1910.1001,
29 CFR 1915.1001, and 29 CFR 1926.1101] require these actions when employee
exposures exceed 0.1 fiber/cm’ averaged over 8 hrs. or 1.0 fiber/cm’ averaged over
30 minutes. In the absence of information on clothing and personal contamination
levels when workers are exposed to asbestos at concentrations below these limits, the
adequacy of the OSHA standards for protecting workers’ families cannot be judged.

LEAD

The report of an investigation of a stained glass window-making studio [Donovan
1994a,b], documented that the use of controls by the studio effectively prevented lead
contamination of the worker’s home that was adjacent to the studio. Preventive
measures used at the studio included local exhaust ventilation during soldering,
general dilution ventilation equipped with an electrostatic filter, adhesive mats at
doorways to decrease the migration of lead dust on shoes, a laundry room located
between the studio and the house that was also used as a changing room, designated
work clothing that was only worn in the studio, washing work clothes separately from
other clothes, prohibiting work shoes from leaving the studio, and prohibiting the
child from entering the studio. Based on the results of surface-wipe sampling, which
demonstrated elevated lead levels in the studio (1.2 mg/m’ to 1,600 mg/m’) but not
in the home (non-detected or trace), the author concluded that the measures used
prevented contamination of the home. The Lead Industries Association, Inc. has
produced a video tape entitled “Controlling Lead Exposure for Stained Glass
Professionals and Hobbyists” [LIA 1994a].

In another cottage industry, a home-pottery operation, the concerned potter and her
family were asked to discontinue being exposed in the facility because of their
elevated BLLs [Fischbein et al. 1992]. Two years later, the BLLs were normal,
indicating that corrective measures, though not described, were effective. The Lead

55


CHAPTER 5. DECONTAMINATION PROCEDURES

CHAPTER SUMMARY

In this Chapter studies relevant to decontamination of clothing, homes and
equipment are reviewed. Decontamination procedures include: air showers;
laundering; dry cleaning; dispersal into the air; vacuuming; shampooing; washing; and
chemical or physical destruction of contaminated items. The effectiveness of
decontamination procedures depends upon the physical and chemical characteristics
of the contaminant, the level of contamination, and the physical characteristics of the
contaminated material or item.

Clothing and carpets are perhaps the most difficult items to decontaminate. Most
studies on decontamination of clothing have been on laundry procedures for
pesticides, although some clothing decontamination information exists for: fibrous
materials, including asbestos; beryllium; PCBs; lead; 3,4-benzo(a)pyrene; and
infectious agents.

Reports on decontamination of homes that were contaminated by workers’ take-
home activities are limited to lead, mercury, and 4,4’-methylene-bis-(2-chloroaniline)
(MOCA). Information on decontamination of buildings contaminated by dioxin and
polychlorinated biphenyl (PCB) from sources other than workers’ take-home activities
provides additional information on the effectiveness of decontamination procedures.
For asbestos, only laboratory studies are available.

Decontamination is the last resort in protecting workers’ family members, a step that
must be taken when preventive measures have not been used or were inadequate.
The decontamination process can be hazardous to persons involved in the process.
Hazardous concentrations of contaminants can be generated when handling
contaminated clothing, vacuuming and mopping floors. Contaminants can be
transferred to other clothing during laundry and dry cleaning. Laundry and dry
cleaning equipment can become contaminated with subsequent contamination of
other clothing.

Normal house cleaning and laundry practices are usually not effective. To achieve
acceptable levels of decontamination, special procedures are required. These
procedures include specially designed vacuum cleaners, special cleaning compounds,
and use of appropriate laundry procedures, including decontamination of laundry
equipment after each use. Destroying highly contaminated items such as carpets,
furniture, and clothing may be the most effective and practical decontamination
procedure.

DECONTAMINATION GUIDELINES

While the studies cited in this section provide information on decontamination
procedures and effectiveness for several contaminants, guidelines on levels of
contamination that are acceptable were found only for lead, mercury, and PCBs.

61


Garrettson [1984]

Environmental toxicity

Table 15, (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Pesticides, lead and
other toxins

Literature review

Workers need to be informed
about toxicity of compounds and
the potential dangers of taking
them home in one way or another.
Lead regulations intended to
protect workers’ families need to
be enforced,

Cannell et al.
(19872, 19870]

Measurement of home
contamination

Research: Shoe types,
floor types, and traffic

Tracers: Polydisperse stilbene for
carpets; mondisperse silicia
particles for tile.

Ground contact with shoes is
dominant factor in transport capacity;
carpet removes soil from shoes more
rapidly than tile; at most 50% of
contaminant in carpet can be removed
by intense vacuuming.

Beegle and
Porslund (1990]

Asbestos and lead

Not applicable

Protocols for cleaning homes
contaminated with asbestos and

Not applicable.

lead are provided,

Goldman and Occupational and Recommends that clinical physicians Article provides sequence of steps

Peters [1981] environmental health include occupation of family members | to facilitate physician recognition of
history. to identify potential sources of occupationally and environmentally

exposure, including chemicals brought related diseases.
into the home from contaminated
work clothes.

Fish et al. [1967] Particulate ‘Experimental re- Light-scattering particle size Re-dispersion of settled particulates Demonstrated potential for body
dispersion of settled analyzer. was dependent upon room activity, and clothing contamination from
particulates. With light air movement, transfer resuspension of settled dust on

from floor to clothing was 22%/hr. workroom surfaces,

Schneider et al. Non-specific dust. Research Surface sampling method using Practical applications include

[1989] sticky gelatin foil. assessment of the effectiveness of

205

cleaning programs and
characterization of surface
contamination patterns,



Abnormal development from estrogenic substances

Enlarged breasts have occurred in boys and girls and premature menstruation has
occurred in girls from estrogenic substances brought home on contaminated clothing
of pharmaceutical and farm workers.

Asthmatic and allergic reactions from dusts
Farm families and others have suffered asthmatic and other allergic effects from
animal allergens, mushrooms, grain dust, and platinum salts.

Liver angiosarcoma from arsenic

Families of workers engaged in mining, smelting, and wood treatment have been
exposed to arsenic from contaminated skin and clothing; one child developed liver
angiosarcoma.

Dermatitis from fibrous glass
Family members have developed dermatitis when their clothing was contaminated
with fibrous glass during laundering of insulation workers’ clothing.

Status epilepticus from chemical exposure
A child experienced epileptic seizures following ingestion of an explosive compound
brought home on the clothing of a worker engaged in the manufacture of explosives.

Diseases from infectious agents

Family members have contracted infectious diseases such as scabies and Q fever from
agents brought home on contaminated clothing and skin of workers engaged in
agriculture, hospital, and laboratory work. As intended by Congress, infectious agents
are included as hazardous substances to the extent that pathogens can be transported
on a worker's person or clothing.

Measures for Preventing Home Contamination

Preventive measures that were found to be effective when used in the workplace include:

Reducing exposures in the workplace;

Changing clothes before going home and leaving the soiled clothing at work to be
laundered by the employer;

Storing street clothes in separate areas of the workplace to prevent their
contamination;

Showering before leaving work; and

Prohibiting removal of toxic substances or contaminated items from the workplace.

Preventive measures that have been used successfully at home include:

Separating work areas of cottage industries from living areas;
Properly storing and disposing of toxic substances on farms and in cottage industries;

ix


county health department [Wiehrdt 1994]. Subsequent investigation by the county
health department determined that at least one of the children had a BLL of 50
ue/dL.

In 1990, the Cleveland area OSHA office investigated a company where it was
determined that employees were being exposed to lead [Wiehrdt 1994]. Learning of
three employees whose children had elevated BLLs, OSHA conducted sampling in
the employees’ homes. Later, the case was reported to the Ohio Department of
Health and the Cleveland Lead Hazard Abatement Center.

Mine Safety and Health Administration (MSHA)

MSHA has investigated two instances where workers inadvertently brought mercury
into their homes and cars [Zalesek 1994]. In one case, the workers’ washers and
dryers were the most heavily contaminated part of the homes. The company cleaned
the homes.

Environmental Protection Agency (EPA)

The Environmental Protection Agency investigated, and decontaminated homes of
workers contaminated by mercury in Tennessee [ERM-Southeast, Inc. 1989]. In
another study supported by EPA, PCB contamination of workers’ homes was
documented [Price and Welch 1972]. EPA has also conducted various investigations
and remedial activities on homes contaminated by: dioxin [Ramsey 1987; MacDonald
1988; Doherty 1984; Hess 1988]; lead [Beegle and Forslund 1990; CH,M Hill 1991];
and asbestos [Beegle and Forslund 1990]. Although these latter reports are not
about homes contaminated by workers’ activities, they do provide protocols and
information relevant to cleaning contaminated homes of workers.

Department of Energy (DOE)

Beginning in October 1990, the Department of Energy (DOE), under DOE order
5000.3A, required the reporting of any event which could “affect the health and
safety of the public, seriously impact the intended purpose of DOE facilities, have a
noticeable adverse effect on the environment, or endanger the health and safety of
workers." In February 1992, this order was superseded by DOE order 5000.3B, with
some modifications in reporting criteria. The requirements cover "events" related to
radioactive as well as other hazardous materials and replaced a previous "unusual
occurrence reporting system” instituted in 1984. The central DOE operational
database containing all post-1989 occurrence reports is called ORPS (Occurrence
Reporting and Processing System) and is maintained by the DOE Office of Nuclear
Safety. There is no central repository of pre-1989 records or reports [Boyle 1994].

Both chemical and radiologic contamination incidents are covered by the DOE
reporting policy. The database is not classified; if any of the reports involve
classified information, a computer entry notes that there is a classified report, with
the detailed description maintained in a classified hard copy file. The reported

89


Grain growers in Alberta, Canada who did their own pesticide application were
asked to respond to a laundry practices questionnaire in 1984 [Rigakis et al. 1987].
The persons who did the laundry (97% were wives) were the responders. In 34% of
the families, other family members assisted with the laundry. Pesticide contaminated
clothing was stored apart from other clothing prior to laundering by 62% of the
responders, 59% washed contaminated clothing separately from other clothing, and
60% used pre-wash treatment of the clothing. However, only 18% of the responders
reported washing the contaminated clothing on the day it was used, only 25% used
water heated to the usually recommended temperature, 73% used less detergent than
recommended on the container, 76% used a clothes dryer, and only 6% used rubber
gloves for handling contaminated clothes. Based on these results, information on
handling and laundering contaminated clothing was developed and distributed to
farmers.

In 1983, a pamphlet entitled “What to Do when Clothes Are Soiled With Pesticides”
was published by the Iowa Cooperative Extension Service [Stone and Wintersteen
1988]. A survey of laundering practices among farm families was conducted in 1984
[Stone et al. 1986}. The recommendations made in 1983 appear to have influenced
laundry practices in Iowa. The findings of this survey of 368 registered pesticide
applicators indicated much better laundry practices in Iowa, than were found by
Cloud et al. [1983] in Louisiana. Nearly all (98%) of the applicators’ clothing was
washed at home and most families (greater than or equal to 90%) stored and washed
the soiled clothing separately from other clothing. Full water levels were used by
three-fourths of the launderers and about half used hot water. However, 68% of the
launderers did not clean the washing machine after washing the contaminated
clothing and 73% did not destroy clothing on which concentrated liquid pesticides
had been spilled. The recommendations made in 1983 appear to have influenced
laundry practices in Iowa.

Pesticide applicators (23) and farmers (15) in California responded to a questionnaire
that solicited information on their attitudes about some factors relevant to family
protection [Rucker et al. 1986]. The applicators all considered that it wasn’t safe for
children to be around when they were working with pesticides; the growers were less
certain on this item. When asked where they stored their contaminated clothing,
most of them responded that they never stored their clothes with the family laundry
or in closets with other clothes. Also, most of them reported that the contaminated
clothing was always washed in separate loads from other clothing; however, most of
them did not pre-rinse the clothing before washing and most of them used a single
wash.

HORMONES

Effectiveness of controls in the manufacture of diethylstilbestro) in eliminating the
hyperestrogenic signs in the children of workers who manufacture the compound was
documented by Katzenellenbogen [1956] and Pacynski et al. [1971]. The preventive

59


Schuhmacher et
al, [1991]

Table 8. (Continued) Health Effects of Take-Home Lead Exposure (Community Studies)

Multipte lead
industries

Community survey
478 Exposed children

Mean hair lead for children whose fathers worked
in lead-related occupations was 12.7 ug/g compared
to 8.4 ug/g among children of workers not in lead
occupations.

No data on blood lead levels.
No health effects reported.

Cook et al. (1993)

Smelting and
mining

Community screening
150 Children < age 6

166

Mean BLL 10.1 g/dL (range 0.5-30.1 g/dL).
Parental occupation as a miner was an independent
predictor of BLL,

No health effects reported.



of the incidents in which OSHA was involved, State or local health departments were
also involved by either notifying OSHA of probable home-contamination cases or by
being informed by OSHA of such cases. Several of the investigations conducted by
CDC and ATSDR have also been in collaboration with agencies of State or local
governments. These Federal agency investigations and responses to incidents of
workers’ home contamination have resulted in:

Recommendations for instituting changes in industrial hygiene practices to prevent
further home contamination.

Decontamination of workers’ homes.

Identification of workers’ family members who have been exposed to or poisoned
by toxic substances introduced into the home from the workplace.

Centers for Disease Control and Prevention (CDC)

The Centers for Disease Control and Prevention has conducted about 20 studies on
incidents of workers’ home contamination; about half of these have been conducted
by NIOSH, and the rest by other Centers, especially the National Center for
Environmental Health. NIOSH has further identified potential for workers’ home
contamination in a number of its evaluations of individual workplaces and made
recommendations for improved industrial hygiene measures for its prevention. CDC
has also presented information to Congress on issues of home contamination and
published reviews to assist professionals that may be confronted by cases of workers’
home contamination and resulting family poisonings.

National Center for Environmental Health (NCEH)

The mission of NCEH is to prevent and control disease and disability related to
the interactions between people and their environment outside of the workplace.
The Center’s applied research has evaluated incidents of workers’ home
contamination by lead, pesticides, arsenic, tin, and PCBs.

Lead. Three studies [Baker et al. 1977; Landrigan and Baker 1981; Matte et al.
1991] were conducted by NCEH on families of lead smelters workers. These
studies found that homes of exposed workers had higher concentrations of lead
than controls and that family members BLLs were elevated. Following the study
by Baker et al. [1977] the homes were cleaned and workers showered and changed
clothes before going home.

Families living in contaminated homes of battery plant workers were found to
have elevated BLLs in four studies [Watson et al. 1978; Dolcourt et al. 1978;
Dolcourt et al. 1981; Matte et al. 1989]. Following the studies by Dolcourt et al.
[1984], home decontamination was undertaken.

85


abandoned mercury, the homes were decontaminated by a combination of techniques
including destruction of contaminated items, vacuuming, and ventilation [CDC 1995].

OTHER SUBSTANCES

Commercial laundering of clothing contaminated in the workplace with ceramic
fibers at 50 to 500 fibers/mm’ reduced the contamination by 86%-100%, resulting in
levels that ranged up to 7 fibers/mm? [Weller 1994].

One article discusses the effectiveness of removing 3,4 Benzo(a)pyrene by washing
work clothes worn by workers at a pitch coking plant [Masek et al. 1972]. The
author states that "the present procedure of washing working underwear and clothes
by no means ensures an efficient removal of the carcinogenic 3,4-benzo(a)pyrene
from the fabric... ." It is assumed that the “present procedure” was normal
detergent and rinse.

Perkins et al. [1987] found that Freon® decontamination reduced toluene to 0.8% of
the original exposure on a butyl rubber test material. A soap and water
decontamination reduced the level to 1.1 percent. However, air drying the test
material at 50°C for 24 hours reduced the level to 0.25%. This research also showed
that air drying at 50°C reduced seven other solvent contaminants to limits of
detection. Finding no evidence of damage to the material with this process, the
authors recommended it as the preferred means of decontaminating chemical
protective clothing against solvents. They noted that with small amounts of
contamination from solvents with "substantially different solubility properties from
the protective clothing,” air drying at room temperature for 24 hours should be
adequate to remove the solvent.

INFECTIOUS AGENTS

Several articles, and general recommendations [Joint Committee on Health Care
Laundry Guidelines 1983] exist regarding laundering to remove biologic agents, such
as anthrax, which can be transmitted to laundry personnel via work clothes [Hardy
1965}, or fungal spores which can be brought into farmers’ homes on work clothes
[Pasanen et al. 1989}.

In the medical facility setting, laundering is universally recommended, and is believed
to be effective in killing or markedly reducing biological contamination of clothing
and linens [Garner and Favero 1987]. Although a major emphasis of laundering in
this setting is to prevent contagion spread in the medical facility, effective laundering
and other decontamination practices also help to protect employees from bringing
infectious diseases into their homes. A number of mechanisms are probably active in
this process, including dilution and inactivation or the microbicidal properties of heat,
detergents, pH changes, chlorine, and drying. Studies of bacterial survival after
various types of hospital laundering have shown marked reduction of viable bacteria
[Walter and Schillinger 1975], [Christian et al. 1983], [Blaser et al. 1984]. Careful
procedures and appropriate equipment are needed to ensure that the laundry staff

70


Table 6, (Continued) Health Effects of Take-Home Asbestos Exposure (Case Scrics)

#/RELATIONSHIP AGE AT DEATH
EXPOSURE
EE ee
Gibbs et al. Asbestos (shipyard work, Malignant pleural 10 cases in family members, 9 of Age range: ‘This was a comparison of types of lung fibers
[1990} lagging, building, ordnance) mesothelioma whom were spouses of asbestos 47 10 72. and size distribution in a series of non-
Wales workers and 1 was daughter of a man occupational cases of mesothelioma with
who died of asbestosis. series of known occupational exposure in
female gas mask workers.
‘The non-occupational group fiber exposure
was variable; 6 showed high crocidolite; 7
showed high amosite; 1 high chrysotile; and 2
showed norma! for all fiber (several showed
more than 1 high fiber group).
Konetzke et al. Asbestos Asbestosis 48 non-occupational registry cases of Confirmed reports that even in the non-
[1990] Mesothelioma mesothelioma and 19 cases of occupational area, asbestos represents @ non-
Germany asbestosis (11 male; 56 female), 10 negligible risk for diseases of the lung, Non-
of these lived near an asbestos plant. occupational risk factors identified in this
study included: laundering (46%); use of
asbestos containing materials in the house
(21%); and leisure activities (15%).
Kiviluoto Asbestos Pleural plaques, 4 cases of asbestoses in 4 sisters The father 50 years earlier had been
{1965) Pleural adhesions, whose father had been occupationally occupationally exposed to mixed dusts and
Fintand Pulmonary fibrosis, exposed to mixed dusts, presumably brought them home on his
Mesothelioma, clothes,
Martensson et al. Asbestos work Mesothelioma Woman who had been exposed to Analysis of 32 cases of malignant
[19842] asbestos during childhood via her mesothelioma, All but one case was
father’s work clothes. occupational.
Sider et al. Insulation work Radiographic pleural 18 (19.4%) wives of asbestos-exposed 117 wives of asbestos-exposed insulation
[1987] changes (plaques, insulation workers screened had workers were screened with X-rays and
USA. calcification, radiographic abnormalities. pulmonary function tests, None of the 24
thickening) women under age 40 had any X-ray
abnormalities. Exposure for atl of them was
less than 8 years. These 24 were excluded. 18
(19.4%) of the remaining 93 had radiographic
abnormalities,

158


Table 7. (Continued) Health Effects of Take-Home Lead Exposure (Cohort Series)

[1982}

17 Exposed children (age < 5)
30 Control children (age < 5)

was 44 wg/dL and of control
children, 18 wg/dL.

Author (year) Location Industry Study Design Results Comments
Landrigen et al. Georgia, USA Stained glass Cohort Mean BLLs were 20.7 g/dL for No health effects reported.
(1980) 12 Workers workers, 11.6 g/dL for hobbyists
5 Hobbyists and 11.3 ug/4L for family members
4 Workers’ family members. of workers. BLL was associated with
duration of work and percentage of
work involving lead.
Molina-Ballesteros | Mexico Pottery Cohort Children aged < 9 years of exposed | No association between clinical
et al. (1980) 198 Workers and their famili workers had a mean BLL of 81 symptomology and lead poisoning
187 Controls and their families 4/100 compared to control could be established because of
children of same age who had a socioeconomic conditions.
mean BLL of 19.5 4g/100g.
Morton et al. Oklahoma, USA Battery factory Cohort Significantly different BLLs were Used capillary sampling. No health
(1982) 34 Exposed children (age < 7) found between groups p<0.001). effects reported,
34 Age-matched neighborhood BLL > 30 ug/dL (maximum 72
control #8/SL) in 53% of exposed children
children versus 0% in controls. Statistically
significant differences found in
children’s BLL between good and
poor worker hygiene practices.
Milar and Mushak | North Carolina, USA | Battery factory Cohort Average BLL of exposed children No health effects reported.

Ramakrishna et al, | Sri Lanka Gold and sitver Cohort Mean BLL in exposed families was | ‘The youngest child tested was 9
[1982] recovery 33 Members of exposed families 33 ug/L versus 12 yg/4L in control | years old, No health effects
21 Neighborhood controls families. Very high BLLs were reported,
found in two children aged 12 years
(42 and 56 yg/AL).
Molina-Ballesteros | Mexico Pottery Cohort Exposed children had significantly No cases of acute lead poisoning
et al, [1983] manufacturing 153 Children (age 5-15) from higher mean BLL (39.5 g/dL) than | were found. Hemoglobin and

pottery-making families
80 Control children from toca!
schools

controts (24.8 g/dL). Over 40% of
exposed children had BLLs over

40 g/dL compared to none of
control children.

hematocrits were within the lower
limits of normal.

161



home and automobile and from the workers’ shoes; data were reported in
ug/filter but the areas sampled were not reported. Lead in house dust was 183-
284 y«g/filter in the bathroom closet where dirty linen was kept and 284
ug/filter in the kitchen near the washing machine. Other areas of the home
were less contaminated. Higher levels were found in the worker’s car (1,295
ug/filter on the driver’s seat and 7,580 yg/filter on the floor of the car). The
highest level was found on the worker's shoes (11,030 g/filter). Lead in house
paint and in soil outside the house were eliminated as sources of home
contamination.

In a study of electric cable splicers, lead concentrations in house dust in the
homes were measured by Rinehart and Yanagiswa [1993]. As with the study of
battery factory workers’ homes [CDC 1977b], the highest concentrations of lead
in dust were found in the laundry areas (621-1,606 ppm), but measurements of
lead in clothing were not reported. However, in an earlier study of these cable
splicers [Venable et al. 1993], their clothing was found to contain lead at 600-
4,800 yg/ft? (5.7-45 ug/cm’), and their cars contained up to 12,400 ug/ft? (17
xg/cm’). Most workers took their soiled clothing home and many of them
washed their work clothes with other laundry. Taken together, these two
reports, [Venable et al. 1993; Rinehart and Yanagiswa 1993] provide evidence
that the electric cable splicers’ clothes were contaminated, resulting in
subsequent contamination of their homes.

Supporting studies. Other studies that provide information on either lead
contamination of homes or clothing support the inference of contaminated
clothing as a source of lead in homes.

Lead concentrations in dust from seven battery factory workers’ homes were
studied and found to be highest (average 31,840 ng/g, maximum 84,000 ng/g)
in closets where the work clothes were stored [CDC 1977b; Dolcourt et al.
1978]. The average concentration of lead in dust of cars that were driven to
work was 2,770 wg/g. Measurements of the lead-contaminated clothing were
not made, but paint, water supply and air were ruled out as sources of lead.

Lead at 1,700 ppm was found in the dust of the home of a worker engaged in
cutting down old cables [Osorio 1994]. He wore his work clothing home and
laundered it with the family laundry. In a report on workers who soldered or
welded with lead, wipe samples were taken from two workers’ shoes and the
floor under the gas pedal of a car. Shoes had lead at 4-20 xg/cm’ and the floor
had 4 g/cm? [CDC 1992a].

Kaye et al. [1987] measured lead up to 3,400 ppm in vacuum cleaner dust of
homes of workers making ceramic-coated capacitors and resistors.
Measurements of clothing contamination were not made; however, lead
concentrations in the workplace were 50-1,700 ug/m’ (OSHA PEL 50 ug/m*)

38


CHAPTER 2. SOURCES OF WORKERS’ HOME CONTAMINATION

CHAPTER SUMMARY

Sources of contamination of workers homes and poisonings of workers’ family
members reviewed in this chapter include: work clothing; the worker's body; tools
and equipment; taking items home from work (such as scrap material); cottage
industries (where work is done in or adjacent to the home); farms; and visiting a
family member’s workplace.

Clothing contamination was documented in 18 reports: 1 on beryllium; 7 on lead; 7
on pesticides; and 1 each on PCB's, an estrogenic substance (zeranol), and 3,4-
benzo(a)pyrene. For lead, measurements of both clothing and home contamination
were included in some studies. However, these were inadequate for establishing a
quantitative relationship between the two. Other evidence of clothing as a source of
home contamination includes: high levels of contamination in areas of homes where
soiled clothing is stored and laundered (lead, mercury); contamination of washing
machines (mercury) or dryers (3,3’-dichlorbenzidine, MOCA); and poisoning of
launderers (beryllium, asbestos, lead, kepone).

The workers’ body has been considered as a source of home contamination, and
showering before leaving work has often been recommended as a preventive
measure. However, reports have only documented contamination of workers’ hands.

Hand tools and other equipment have been found to contribute to home and vehicle
contamination by mercury and pesticides. The potential for contamination of homes
by tools was also demonstrated for PCB’s and radioactive substances.

Items taken home from work (beryllium-ore bags, cotton shipping-bags for asbestos,
cloths from discarded filters, metal drums, contaminated milk, and radioactive scrap
lumber) have resulted in serious, and sometimes fatal, poisonings of workers’ family
members.

Cottage industries, where work is undertaken in the same building or on the property
where the family resides have been recognized as a hazard to family members since
at least 1914. Cottage industries are the subject of 22 reports of home contamination
or family poisonings from asbestos, lead, parathion, and mercury which are reviewed
in this chapter. The levels of contamination were often extremely high and the
poisonings were severe.

Farms are similar to cottage industries in that families live on the property where
work is performed. Three types of products used on farms: pesticides; caustic
substances; and estrogenic substances have resulted in several cases of poisoning of
family members.




Lillie et al {1981]

Pesticide
(water solubility)

Diazinon (40 mg/L)
Chlordane (1 mg/L)

Carbaryl (120 mg/L)
Prometon (750 mg/L)

Bromacil (800 mg/L)
Propoxur (2 g/L)

Malathion (200 mg/L)

Table 16. (Continued) Studies on Laundering Pesticides from Contaminated Clothing.

Formulation

Emulsifiable
concentrate
Emulsifiable
concentrate
Wettable powder
Emulsifiable
concentrate

Oil formulation
Emulsifiable
concentrate

Oil formulation

Fabrics

100% Cotton
100% Polyester

Laundry or Decontamination Variables

One-speed washing machine, 68
agitations/min. 43°C wash cycle, non-
phosphorus detergent, 14 minute wash, 2
rinses, gas dryer. Effect of 30°C, 43°C,
and 60°C water temperatures on removal
from 100% cotton fabric.

Results
ee

Absorption by cotton was greater
than for polyester with chlordane,
diazinon, and prometon.
Penetration was greater for the
polyester. The particles of the
wettable powder of carbaryl were
probably large enough to prevent
penetration. 90-99% of all
pesticides were removed by
washing. Hotter water removed
more pesticide except for chlordane
where there was no effect of water
temperature.

213



Bierbaum [1993] reported on the occurrence of hyperestrogenic syndromes in
children of workers who repaired feedlots in Kansas. The diethylstilbestrol was
added to feed used in the feedlots, a practice that was abandoned during the
course of the investigation.

ASTHMATOGENS/ALLERGENS
There are three references dealing with six incidents of asthma (Table 14). They
are case reports involving various occupations. Wilken-Jensen [1983] discussed
two cases of asthma in children in Denmark. The children developed asthmatic
symptoms whenever the fathers (one a veterinarian, the other a miller) returned
from work. In another case from Wilkens-Jensen, a boy developed fever, dyspnea
(difficulty breathing), and general malaise regularly when exposure to mushroom
mycelium occurred on the farm where he lived. These symptoms required
multiple admissions to a local hospital.

Venables and Newman-Taylor [1989] discussed two cases of spouses (in the
United Kingdom) who exhibited symptoms of asthma whenever the other spouse
returned from work. In one case, the wife was a laboratory animal handler and
the husband developed asthma. The husband’s symptoms were most severe when
he had contact with his wife on her return from work. These symptoms resolved
after his wife started wearing different clothes at home than at work and
showering and washing her hair before leaving work. In the other case, the
husband worked with precious metals (platinum salts) and the wife developed
asthma. The wife’s symptoms resolved after the husband’s company started a
policy that employees should shower and change clothes before leaving the
workplace. In both cases, symptoms improved when better work practices were
instituted.

The third reference is from the hearings on the Workers’ Family Protection Act
[U.S. Senate 1991a]. It consists of a physician’s testimony on cases of asthma
among the children of workers at a hazardous waste incinerator in North
Carolina. The childrens’ asthma improved when the fathers ceased working at the
incinerator.

Occupational asthmatogens generally are characterized by one of the following
groups:

e airborne organic dusts with high molecular weights, generally plant or animal
proteins;

© low molecular weight reactive chemicals (e.g., diisocyanates, platinum salts);
¢ pharmacologic bronchostrictors; or

© non-sensitizing respiratory tract irritants.

25


‘Table 19. (Continued) Federal Agency Involvement in Lncidents of Workers’ Home Contamination and Related Activities

FEDERAL AGENCY

US. Air Force

U.S. Atomic Energy

| Commission and

U.S. Weather Bureau

Bisenbud et al, [1949] Non-occupational Beryllium poisoning. Measured concentrations of beryllium generated during laundry, folding of clothes, etc,

US. Atomic Energy
Commission

] Sterner & Eisenbud [1951] Epidemiology of Beryllium intoxication. The literature on concentrations of beryllium related to development of diseases was reviewed, and related to “hygiene”
measures. Exposure levels for workers, and for air in vicinity of beryllium plant and recommended laundering of workers’ clothing to prevent contamination of
workers’ homes.

247


rickettsiae (e.g., Rocky Mountain spotted fever), bacteria (e.g., Lyme disease)
or viruses (e.g., encephalitis) through bites.

Aerosols containing infectious agents may be generated when an individual
coughs, sneezes, sings, or talks. Also, aerosols may be generated by other
methods in normal work situations such as those found in slaughterhouses,
rendering plants, or autopsy rooms as well as during accidents in microbiology
laboratories. Droplet nuclei are aerosols that contain infectious particles that are
made by the evaporation of fluid from the droplets formed during the production
of aerosols. Unlike droplet spray that may remain airborne only for a few feet
that are associated with direct transmission of disease, droplet nuclei may remain
suspended in the air for long periods of time and are associated with respiratory
diseases (e.g., tuberculosis, influenza, mumps). Some infectious diseases that are
normally spread via aerosols may also be spread via fomites (e.g., in dust from
contaminated clothing or bedding, combs, floors, soil, etc.) such as the
microorganisms that cause Q fever, coccidioidomycosis, and anthrax. Droplet
nuclei and dust particles in the 1-5 micrometer size range may remain suspended
in the air for long periods and, unlike larger particles, may easily be drawn into
and retained in the alveoli of the lungs bypassing many of the defense
mechanisms of the respiratory system.

Infectious diseases that most likely meet the criteria of being transported to
workers’ homes "on workers,” their clothing, or other materials brought from the
workplace include those (1) that are spread through direct skin-to-skin contact or
direct contact with contaminated clothing such as parasites (e.g., mites or lice),
(2) via arthropod vectors such as ticks (e.g., Lyme disease) or (3) those that may
be transmitted on dust particles that are inhaled (e.g., Q fever, anthrax and
possibly fungal diseases). The possibility appears to exist for bloodborne diseases
such as HIV or HBV to be transported home on a worker's clothing soiled with
body fluids from an infected person. However, the transmission of a bloodborne
pathogen on soiled linen is considered to be negligible [CDC 1987}.

Infectious diseases that are spread by routes other than "on workers" were not
intended to be covered by the legislation. Diseases such as tuberculosis, which is
spread by breathing air contaminated with bacteria from infected individuals, is
not included nor are HIV infections that may be transmitted to spouses during
intercourse. However, it should be noted that virtually any infectious disease
contracted by a worker at the workplace will be "brought home” and can
potentially infect members of his or her household. For example, at a recent
scientific symposium, a case of a correction officer with occupationally acquired
multidrug resistant tuberculosis (MDR-TB) was discussed. At the time, the
correction officer was sharing a hospital room with his 2-year-old son who had
acquired the disease from his father [Boyles and Boggan 1994a].

Diseases that appear likely to be transmitted to the home “on the worker" include

29


RULE/CFR NO.

Table 18. (Continued) Regulations of Federal Agencies Relevant to Workers’ Family Protection

DESCRIPTION OF RELEVANT ELEMENTS

Worker Protection Standard EPA ‘This standard generally applies to the use of pesticides on agricultural establishments for the production of plants for commercial

[40 CFR 170] purposes. The owners of agricultural establishments need not assure that the protective measures are provided to themselves and
members of their immediate family while they are performing tasks related to production of agricultural plants on their own
agricultural establishment, although they are encouraged to do so. The standard delineates restrictions on entering areas treated
with pesticides; defines protective clothing, and its use and decontamination; storage requirements for clean protective clothing: a
requirement that contaminated clothing be stored and washed separately from other clothing or laundry; a requirement that persons
cleaning or laundering protective clothing be informed of the contamination and correct ways to handle and clean it; a requirement
that all clean personal protective equipment be stored separately from personal clothing and apart from contaminat ed areas. The
agricultural employer must not allow or direct any worker to wear home or take home personal protective equipment contaminated
with pesticides.

Certification of Pesticide Applicators EPA ‘This standard generally requires that applicators be competent in the use and handling of pesticides they use, that they can read and

(40 CFR 171] understand the label and instructions for use, storage, and disposal of the pesticides and containers.

National Oi! and Hazardous Substances Pollution | EPA ‘The purpose of the plan is to provide organizational structure and procedures for preparing for and responding to discharges of oil

ncy Plan and releases of hazardous substances, and contaminants, The plan defines size classes of releases, includes the National Priorities

[40 CFR 300] List of hazardous waste sites, provides for worker protection in responding to releases and working at hazardous waste sites, and
community right-to-know provisions.

Designation, Reportable Quantities, and EPA Lists hazardous substances and their reportable release quantities.

Notification

[40 CFR 302]

Worker Protection EPA Applies 29 CFR 1910,120 to State and local government employees engaged in hazardous waste operations in States that do not

(40 CFR 311] have an OSHA approved State occupational safety and health plan.

Asbestos EPA Extends worker protection of the OSHA asbestos standard for construction to employees of local education agencies who perform

[40 CFR 763} operations, maintenance repair activities involving Asbestos-Containing Materiats (ACM). Extends construction standard to

employees of State and local governments not covered by OSHA, an approved OSHA State plan, or State asbestos regulation which
EPA determines is comparable to or more protective than this standard (40 CFR 763). Appendix C to Subpart E (Asbestos-
Containing Materials in Schools) entitled “Asbestos Model Accreditation Plan for States" requires asbestos workers training to

239



Finley et al. [1977] demonstrated that delaying entering a field for 4 days after
spraying with methyl parathion reduced clothing contamination by 99% from that on
the first day after spraying. Thus delayed entry would substantially reduce exposure
of launderers and potential for contamination of laundry equipment.

A number of publications have addressed hazards to workers and to workers’ family
members and advised on preventive measures [Wyant-McNutt 1983; Lavy 1988;
Branson and Henry 1982; Rigakis et al. 1987; Easley et al. 1981a; Laughlin and Gold
1989c; Stone and Wintersteen 1987; Anonymous 1994; Finley et al. (no date)].
Several of these publications are pamphlets produced and distributed by Agricultural
Experiment Stations and Extension Services to advise workers and their families on
proper procedures for handling and laundering the pesticide contaminated clothing,
based on research reviewed in Chapter 5 and summarized in Table 16. Briefly the
recommendations in these publications and pamphlets for handling and laundering
clothing contaminated with pesticides include:

e Discard or burn heavily contaminated clothing (e.g., after a spill);

e Store soiled clothing separately from other clothing;

© Use rubber gloves when handling soiled clothing;

e Launder soiled clothing separately from other clothing;

e Launder contaminated clothing after each use, and on the day of use, if possible;

e Laundry methods should include a pre-wash treatment, heavy duty detergent, hot
water (e.g., 60°C), a complete wash cycle, full water volume, a wash time of 12-14
minutes, and a double rinse;

e Clean the washing machine after laundering contaminated clothing by running the
machine through a complete cycle with a full volume of water and detergent; and

e Line air dry the clothes to avoid contamination of an automatic dryer and to allow
sunlight and time to further reduce the toxic residues.

Four surveys on how workers and workers’ family members handle pesticides or
contaminated clothing have been reported. The first survey, conducted in 1982, was
of licensed professional agricultural workers in Louisiana [Cloud et al. 1983]. More
than half of the respondents were unaware of the existence of disposable protective
garments, and the common clothing worn was short sleeved shirts and denim or khaki
pants. Home laundering was the rule, the clothes were usually stored in clothes
hampers and laundered within two days of use. About 30% of the respondents
laundered the contaminated clothing with other family clothing, and none reported
using any pretreatments.

38


GLOSSARY
rickettsiae - small microorganisms that, like viruses, grow within host cells and may produce disease.
Unlike viruses, these organisms, have a more complicated structure, multiply like bacteria, and are
susceptible to antibiotics. Rickettsial diseases are frequently transmitted by bites from ticks or lice.

sarcoidosis - a multiple organ system disease of unknown cause which can involve the lymph nodes,
lungs, skin, and eyes.

status epilepticus - a condition in which one major attack of epilepsy (i.e. seizures) succeeds
another with little or no intermission.

transbronchial - across a bronchus (the breathing tubes of the lung).

viruses - the smallest organisms that produce disease. They grow within host cells and take over
the metabolic functions of the host organism to reproduce themselves.

wrist drop (double wrist drop) - paralysis of the extensors of the wrist and fingers from a lesion of
the nerve supply. Double wrist drop would mean both wrists are affected.

zoonotic diseases - a disease in man acquired from animals.

281 # U.S. GOVERNMENT PRINTING OFFICE: 1995: 750-176/20021


Kim CJ, Taylor L, Selman F [1993]. Effect of herbicide formulation on atrazine residue
removal from chemical plant workers’ protective clothing. Bull Environ Contam Toxicol
50:811-816.

Kim CJ, Wang Q [1992]. Residue removal of granular formulation atrazine and its dust
from workers’ protective clothing by laundering. In: McBriarty JP, Henry NW eds.
Performance of protective clothing, Vol. 4, ASTM STP 1133. Philadelphia, American
Society for Testing Materials. pages 830-839.

King GW [1954]. Acute pneumonitis due to accidental exposure to mercury vajor (sic).
Ariz Med 11(9):335.

Kiviluoto R [1965]. Pleural plaques and asbestos: Further observations on endemic and
other nonoccupational asbestosis. Ann NY Acad Sci 132:235-239.

Klemmer HW, Leitis E, Pfenninger K [1975]. Arsenic content of house dusts in Hawaii.
Bull Environ Contam Toxicol 14(4):449-452.

Klorfin I, Bartine B [1956]. Diethylstilbestrol intoxication in a pharmaceutical factory,
members of their families and a poulterer. Harefush 51:57-60.

Knappmann J [1972]. [Observations made at post mortem examination of 251 cases of
mesothelioma in Hamburg (1958-1968)] (in German). Pneumonol 148:60-65.

Knishkowy B, Baker EL [1986]. Transmission of occupational disease to family contacts.
Am J Ind Med 9(6):543-550.

Koehler JW [1994]. Letter of February 9, 1994 re: workers’ home contamination in
Florida to Richard W. Niemeier, Education and Information Division, National Institute
for Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 6 pages.

Koike S [1992]. [Health effects of non-occupational exposure to asbestos] (in Japanese).
Jpn J Ind Health 34(3):205-215.

Kominsky JR [1984a]. Letter of October 3, 1984 re: PCB analysis of protective clothing
used by fire fighters to Bill Robertson. Available in Cincinnati, OH: Docket Office,
Education and Information Division, National Institute for Occupational Safety and
Health, Centers for Disease Control, Public Health Service, U.S. Department of Health
and Human Services, Cincinnati, OH, NIOSH Report No. HETA 84-490 (close-out).

Kominisky JR [1984b]. Letter of March 28, 1994 re: contamination of firefighters’

protective clothing to Lieutenant Phil Eddins. Available in Cincinnati, OH: Docket
Office, Education and Information Division, National Institute for Occupational Safety

120


Fischbein A, Wolff MS [1987]. Conjugal exposure to polychlorinated biphenyls (PCBs).
Br J Ind Med 44(4):284-286.

Fish BR, Walker RL, Royster GW Jr., Thompson JL [1967]. Redispersion of settled
particulates. In Fish BR ed. Surface contamination. Proceedings of a symposium held
at Gatlinburg, Tennessee, June 1964. New York, Pergamon Press. pages 75-81.

Fisher LJ [1991]. EPA’s answer to Senator Reid’s questions from February 21 hearing
on lead in the environment. Washington, DC: U.S. Environmental Protection Agency.
pages 29-30.

Forsch KL [1994]. Letter of January 28, 1994 re: workers’ home contamination in South
Dakota to Ms. Diane Manning, Education and Information Division, National Institute
for Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 1 page.

Fowler C [1994a]. Letter of February 3, 1994 re: investigation in the past of cases of
childhood pesticide poisoning from storage of pesticides in beverage containers in
Arizona to Dr. Bob Mason, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 12 pages.

Fowler C [1994b]. Memorandum of March 22, 1994 re: workers’ home contamination by
mercury in Arizona to Dr. Bob Mason, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services.

7 pages.

Frank Diehl Farms v. Secretary of Labor, 696 F.2d 1325 (11th Cir. 1983).

Fulton WB, Matthews JL [1936]. A preliminary report of the dermatological and
systemic effects of exposure to hexachloro-naphthalene and chloro-diphenyl. Harrisburg,
PA: Bureau of Industrial Standards. Special Bulletin No. 43. 15 pages.

Ganelin RS, Mail GA, Cueto C Jr. [1964]. Hazards of equipment contaminated with
parathion. Arch Environ Health 8:826-828.

Gardner MJ, Saracci R [1989]. Effects on health of non-occupational exposure to
airborne mineral fibers. In: Bignon J, Peto J, Sarcci R eds. Non-occupational exposure
to mineral fibers. Lyon, France. International Agency for Research on Cancer. IARC
Scientific Publications No. 90. pages 375-397.

Garner JS, Favero MS [1987}. Guideline for hand washing and hospital environmental

control, 1985. Atlanta, GA: U.S. Department of Health and Human Services, Public
Health Service, Centers for Disease Control. HHS Publication No. 99-1117.

113


TABLE OF CONTENTS

Estrogens .. 2... cece cect cee ete eet eee e eens 42

Other Substances 22... 0... occ e eee eees 43
Infectious Agents ... 0.0... cee eee eect eee een eee 43
Radioactive Substances ... 22.2... cee cece eee eens 43

THE WORKER’S BODY ........ 2... cc ccc cc eee eee eee eee ee eens 43
TOOLS AND EQUIPMENT ......... 0.0... cece eee eect eee e eens 44
TAKING ITEMS HOME FROM WORK ..........-. 0. cece eee eee 44
Beryllium 2... ce ete e ete eee eee 44
ASDESIOS 26. eee ee eee ete teen eset eee en ees 45
bE 45
Pesticides 2.0... 2... ccc cece te eect eee e eee 45
Estrogens 2... 0.2.2 cece ce cee ete nent eee eens 45
Radioactive Substances 2.2.0... ete teenies 45
COTTAGE INDUSTRIES .... 2.2... ce eect teen eens 45
FN 1) 0) 46
Lead 2... ccc cece cece eee teen e teen eee eens 46
Pesticides 2.0... oe ee cc ee tenet eee teens 47
Mercury... cc cece e ete eee tenn eee 47
FARMS 2.0... eee cee eee cece teen cence eee t erat eens 47
FAMILY VISITS TO WORKPLACE .........- 0-0 cee eee eee teens 48
CHAPTER 3. LEVELS OF CONTAMINATION IN HOMES AND CARS ...... 49
CHAPTER SUMMARY  ......... 0. ccc cece eect e ener enaee 49
ASBESTOS ... 50
DBS > 50
Concentrations of Lead in Dust 50
Lead Loading $1
MERCURY 52
CHLORINATED HYDROCARBONS 52
PESTICIDES . 2.0... cece eee ete cette teeta eaee 52
PN SAS) £3 0 | ( OS 53
INFECTIOUS AGENTS ..........-. cece cece eee eee eet e teens 53
CHAPTER 4. PREVENTIVE MEASURES .... 2... 2. c eee eee eee eee 54
CHAPTER SUMMARY ....... 0... eee c eee cee cee tte e eee e eens 54
BERYLLIUM ..... 2... cece cece cece cence eet neers eee teees 54
ASBESTOS 2.0.0... cee cece cece eee cent eee t eet eee ereeee 55
LEAD 2.22 eee eee eee eee eee ence enneeee 55
CAUSTIC FARM PRODUCTS ........ 0.6. c cece ee eee eee eees 357
PESTICIDES .... 0... eee cee cece eee eee teen een nnes 57
HORMONES ..... 2... cee eee eee eee tee ete e eee etnies 59
ASTHMATOGENS/ALLERGENS ........... 5000 e eee e eee cee eet eees 60


Oct, 26

FIRE ADMINISTRATION AUTH. ACT

contamination through the of literature and
records ing past investigations and enforce-
ment actions

health standards in accordance
ofeach Act (29 USC. 657 and
Department ee eens apeacios Gacluding the

Prucection Agency) eattbe Direser nay etme
to be a;

te;
Gi) evaluate current statu! , Tegulatory, and vol-
smal’ mediun large employers to prevent or

and 2 compile a summary of the
aS ait came 2 Rey
eral sate, Bistovies conducted on incid
the effectiveness of workplace housekeeping

Practices and protective ipment in
preventing such incidents; om

srure.on workers sad theirfaeakess ne
exposure on workers and their families;

rade, Hectivgness of normal house

environment;

{V) methods for differentia exposure health
reg expensing eee hel

106 STAT. 3421

258

PLL. 102-522
See. 209


Goo DM [1994]. Memorandum of January 31, 1994 re: Workers’ Family Protection Act -
Honolulu, Hawaii to Diane Manning, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 2

pages.

Good CK, Pensky N [1943]. Halowax acne ("cable rash"). Arch Dermatol Syphilol
48(3):25 1-257.

Goodman CJ, Laughlin JM, Gold RE [1988]. Strategies for laundering protective
apparel fabric sequentially contaminated with methyl parathion. In: Mansdorf Z, Sager
R, Nielsen AP, eds. Performance of protective clothing: Second symposium, ASTM
STP989. Philadelphia, American Society for Testing Materials. pages 671-679.

Grandjean P, Bach E [1986]. Indirect exposures: The significance of bystanders at work
and at home. Am Ind Hyg Assoc J 47(12):819-824.

Graves JB, Finley EL, Morris HF, Harmon CW, Marshall JG, Summers TA, Koonce KL
[1980]. Reducing permethrin residues on clothing worn in cotton fields. Louisiana
Agriculture 23(3):12-13.

Greenberg M, Davies TAL [1974]. Mesothelioma register 1967-68. Br J Ind Med 31:91-
104.

Griffin P, O’Malley M [1992]. Childhood poisoning associated with the insecticide
Aldicarb. Sacramento, CA: California Environmental Protection Agency, Department of
Pesticide Regulation, Worker Health and Safety Branch. Report No. HS-1648. 3 pages.

Grundy GW, Miller RW [1972]. Malignant mesothelioma in childhood: Report of 13
cases. Cancer 30:1216-1218.

Gunter BJ, Richardson F, Anderson KE [1987]. Health Hazard Evaluation Report:
Bondar-Clegg, Lakewood, Colorado and Sparks, Nevada. Cincinnati, OH: U.S.
Department of Health and Human Services, Public Health Service, Centers for Disease
Control, National Institute for Occupational Safety and Health, Report No. HETA 86-
438-1795, HETA 86-534-1795. 10 pages.

Haddad JK, Stenberg E Jr. [1963]. Bronchitis due to acute mercury inhalation—Report
of two cases. Am Rev Resp Dis 88:543-545.

Hallee TJ [1969]. Diffuse lung disease caused by inhalation of mercury vapor. Am Rev
Resp Dis 99:430-436.

Hardy HL [1965]. Beryllium poisoning-Lessons in control of man-made disease. New
Eng J Med 273(22):1188-1199.

115


and bloating. It is most often contracted from fecally contaminated water or
food but may be transmitted person-to-person. In 1979, the Minnesota
Department of Health conducted an evaluation of an outbreak of giardiasis at a
rural public school system. Of the 60 employees of the school system, 19 met
the case definition for giardiasis. Three members of the employees’ households
also had persistent diarrhea consistent with giardiasis infection [Osterholm et al.
1981].

RADIOACTIVE SUBSTANCES
Several incidents of home contamination are discussed in Chapter 7 “Responses to
Incidents of Workers’ Home Contamination.". However, since no adverse health
effects of these incidents were reported they are not discussed in this Chapter.

33




Martensson et al.
[1984]
Sweden

Asbestos
(foundry)

Table 5. (Continued) Health Effects of Take-Home Asbestos Exposure (Case Reports)

Familial pleural
mesothelioma

Sister and brother

AGE(S) AT DEATH
OR DIAGNOSIS

Brother dead, sister survived, Father's work clothes hung in
kitchen when they were children,

Krousel et al.
(1986)
USA

Familial pleural
mesothelioma

Mother, son and daughter of a
lumber and shingle company worker.

74, 40, and 38.

‘Son was only one with possible occupationat exposure, but
diagnosis at age 35 suggests childhood exposure.

Magee et al,
[1986]
Italy

Chrysotile ore
contaminated
with tremolite
and actinolite,

Mesothelioma

Singte male case.

Indirect exposure to asbestos from Canari Mine in Corsica.
Exposed as child in pub in house. Analysis of lung mineral
content showed chrysotile at background and elevated levels of
tremolite and actinolite asbestos. Fiber size and mesothelial
carcinogenesis discussed, Paper contains data on lung fiber
burden.

Huncharek et al. Asbestos Pleurat Single case (female) % Indirect exposure to husband, a shipyard machinist, who

[1989] mesothelioma dismantled boilers and other related machinery for 34 years. She

USA laundered his clothes. Paper contains data on lung fiber burden,

Liet al. Asbestos Familial 2 Female cases. Father worked in 32, 49 Cotton cloth sacks in which molded asbestos insulation had been

[1989) mesothelioma asbestos plant, transported had been used to make diapers for children. Results

USA were the deaths of the mother, a sister, and a young uncle who
lived there and worked as insulator, In addition, the father died
of asbestosis. Mother laundered asbestos-contaminated diapers
and work clothes.

Otte et al. Amosite Familial Family cluster of 3 deceased, 74, 79, 45. Family produced asbestos cement in their home. Used dry hand

[1999] asbestos cement | mesothelioma mixing procedure. Mother, father and a son died of

Denmark mesothelioma; 2 sons and a daughter survived. All decedents

smoked.

152



Table 12. Health Effects of Take-Home Chlorinated Hydrocarbons Exposure

AUTHOR INDUSTRY HEALTH EFFECT #/RELATIONSHIP COMMENTS AND ISSUES

YEAR

LOCATION

Fulton and Matthews | Manufacture of Acne-like dermatitis Wife Workers exposed to hexachloronaphthalene and chlorodiphenyl used in coating
1936] insulated wire and (Chloracne) 1 Daughter wire and electrical cable developed chloracne. The wife, 11-month-old daughter
Pennsytvania electrical cable 1 Son and 24-year-old son of one of these workers also developed chloracne, The

father wore dirty work clothes home and played with his son without changing
into clean clothes. It was recommended that adequate protective clothing,
lockers, and other sanitary facilities should be provided to the workers.

Good and Pensky Marine electrical Acneform dermatitis, Wives 52 electricians exposed to Halowax in shipbuilding developed chloracne, as did a

[1943} work lassitude, occasional few of their wives, After this outbreak, preventive measures were initiated which

New York impotence, weight loss, stressed the importance of cleanliness, frequent showering and changing clothes,
taste disturbances Work uniforms were provided.

Jensen et al. 2,4,5-trichlorophenol Chloracne 1 Son Workers at a factory producing 2,4,5-trichlorophenol developed chloracne

[1972a) manufacture 1 Wife following an explosion, Contaminants at the plant after the explosion included

Jensen et al. 2,3,6,7-tetrachlorinated dibenzodioxin, Later 2 pipefitters working on a tank that

[19720] had been steam cleaned developed chloracne. The son of 1 of these who played

May [1973] with his father while he was wearing his dirty work clothes, and the wife of the

Derbyshire, Britain other developed chloracne, As a result of this outbreak, the plant initiated a

program for laundering work clothes and encouraged the workers to shower
regularly, wear clean undergarments, and to change into clean clothing before

leaving work,
Fischbein and Wolff | Transformer Elevated serum or adipose | 2 Wives 2 railway maintenance workers who repaired transformers containing PCBs
(1987) maintenance polychlorinated biphenyl developed chloracne. Their serum PCB levels (77 ng/mL, 101 ng/mL) had a
New York (PCB) levels PCB pattern resembling Aroclor 1254. Wives of the workers did not have

significantly elevated levels of PCBs but the PCB pattern also resembled Aroclor
1254, Both wives reported laundering their husbands work clothes. Prudent
industrial hygiene measures were recommended to prevent the transmission of
chemical from the workplace to the home.

Baker et al. (1980) Municipat Sewage Elevated cerum 19 Family members After PCB was released into the municipal sewage treatment plant by an
CDC [1978] ‘Treatment polychlorinated biphenyl electrical manufacturing firm, PCB levels in the serum of workers, thelr family
Bloomington, Indiana (PCB) levels members, community residents and people who applied sludge from the plant on

thelr yards were determined, The mean PCB values were: 17.4 ppb in 89 people
who had applied sludge to their yards; 75.1 ppb in 18 sewage treatment workers;
33.6 ppb in 19 family members of the workers; 24.4 ppb in 22 community
residents without unusual exposure. No chloracne or systemic poisoning was
reported. It was suggested that family members may have contacted PCBs on
the shoes, clothing, skin or hair of the workers,

ATSDR [198%] Specialty plastics Not addressed Potential exposure of an A study was conducted in 1980 to determine the presence of MOCA in homes of
Hesse (1991) manufacture unspecified number of family employees of the Roto-Finish Company. Vacuum cleaner dust and dryer lint
Kalamazoo, members to 4,4’-methylene-bis(2- contained # maximum level of 2.6 and 0.65 ppm MOCA, respectively, Maximum
Michigan chloroanitine) (MOCA). MOCA concentrations in urine of 12.1 ppb in a family member and 746 ppb In

an employee were found,

176


Table 15, (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Author [year] Contaminant
Basis for Study Industrial Hygiene Methodology Industrial Hygiene Observation Comments or Recommendations
a
Hartle et al. Polychlorinated biphenyl | Aluminum extrusion Wipe samples Wipe sample results up to 900 ug NIOSH pro; wipe-tample
11987} (PCB) using PCB PCB/m?, Hand wrench 308 ug limit 50-250 g/m? for low contact
Indiana contaminated hydraulic PCB/m?, Lunch pail 14 ug PCB/m?, surfaces. Change room & company
fluids Gloves 36-160 ppm PCB. laundered coveralls were
recommended,
Hartle (1987} Polychlorinated biphenyl! | Maintenance workers Wipe samples with hexane Wipe samples from bottom of ‘Wipe sampling of clothes and
Pennsytvania (PCB) working in PCB- moistened gauze pads, maintenance pit averaged 90,000 ug worker-owned tools were not
contaminated building PCB/m?. Other wipe samples allowed. ‘The workers might have
ina rail yard indicated PCB contamination on also contaminated their own homes
floors of lunch room, locker rooms, from clothes, shoes and personal
supply room, and foreman's office. tools taken home with them.
Kominsky (1987a] | Polychlorinated biphenyl | Plrefighting at a PCBs extracted from pre-wash After soap and water wash PCB's in Safe level of PCB's in clothing not
Florida (PCB) transformer oil samples using toluene. Samples of | clothing 15-1,060 ug/g. known.
reclamation facility. incident-contaminated clothing & After RADKLEEN® treatment PCB's
Decontamination of "spiked" clothing. Detergent and 1.8-25 ug/g in incident-contaminated
protective clothing. water wash, RADKLEEN® clothing. RADKLEEN@ efficiency
clothing decontamination system was 66 to 99% for incident-
with Freon®, contaminated and >90% for "Spiked"
samples,
Orris and Polychlorinated biphenyl | Transformer fire at @ Wipe samples at a school. Initial surface contamination < 0.0S PCBs were not detected after
Kominsky (1984) (PCB) school Decontamination of surfaces by to 20 ug/100em2, Some surfaces cleaning.
Minnesota washing with liquid alkaline required 2 washes.
synthetic detergent.
Price and Welch Polychlorinated biphenyl General population Human tissue analyses PCBs were found in human tissues
[1972] (PCB) House-dust samples from homes of | during autopsies, Several house-dust
Michigan workers occupationally exposed to. | samples contained up to 180 ppm
PCBs. PCBs,
Doherty [1984] Dioxin Community Soil samples Dioxin in soil 48 ppb in front of
Missouri (2,3,7,8- contamination Carpet samples inside house house; 2.6 ppb in carpet, post clean-
tetrachlorodibenzodioxin Post clean-up vacuum samples up.
) Replaced carpet Dioxin in vacuum dust less than lab
detection limit.

199


Wolfe HR, Durham WT, Walker KC, Armstrong JF [1961]. Health hazards of discarded
pesticide containers. Arch Environ Health 3:531-537.

Woody RC, Kearns GL, Brewster MA, Turley CP, Sharp GB, Lake RS [1986]. The
neurotoxicity of cyclotrimethylenetrinitramine (RDX) in a child: A clinical and
pharmacokinetic evaluation. Clin Toxicol 24(4):305-319.

WFPA [1991a]. Workers’ Family Protection Act of 1991, 102d Cong., Ist Sess, H.R. 845.
10 pages.

WFPA [1991b]. Workers’ Family Protection Act of 1991, 102d Cong., Ist Sess., S. 353.
Congressional record 137(24) (5 February, 1991):S1594-1595,

WFPA [1991c]. Workers’ Family Protection Act of 1991, 102d Cong., 1st Sess., H.R. 845.
Congressional Record 137(26) (7 February, 1991):E476.

Wyant-McNutt S [1983]. Be aware of pesticide dangers. Safety Management 9(9):33-35.

Young N [1994]. Memo of March 10, 1994 re: Alkali ingestion/children on farms to
Barb Lee and Dean Stueland, National Farm Medicine Center. Available in Cincinnati,
OH: Docket Office, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services.

Zalesak ME [1994]. Letter of June 24, 1994 re: mercury contamination of homes and
cars to Bob Mason, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 30 pages.

Zey JN [1984]. Health Hazard Evaluation Report: J. Butler, D.D.S, Wellston, Ohio.
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service,
Centers for Disease Control, National Institute for Occupational Safety and Health,
NIOSH Report No. HETA 84-090-1533. 23 pages.

Zey JN [1988]. Health Hazards Evaluation Report: Rothan and Rothan, D.D.S.,
Cincinnati, Ohio. Cincinnati, OH: U.S. Department of Health and Human Services,
Public Health Service, Centers for Disease Control, National Institute for Occupational
Safety and Health, NIOSH Report No. HETA 87-147-1873. 18 pages.

Zirschky J [1990]. Employee transported contaminant releases. Haz Waste Haz Mat
7(2):201-209.

Zirschky J, Gentry B, Marcus P [1987]. Superfund and contamination of workers’
homes. Am Ind Assoc Hyg J 48:A718-A724.

141


permissible occupational exposure limit for inorganic mercury vapor is 50 yg/m’ as
an 8-hr. time-weighted average (30 CFR 57.5001).

The few reported measurements of workers’ home contamination by pesticides,
chlorinated hydrocarbons, arsenic, and fungi also demonstrated high levels of
contamination.

ASBESTOS

Only one report on measurements of asbestos contamination in workers’ homes was
found. Nicholson et al. [1980] reported that chrysotile asbestos in 13 air samples
from homes of miners and millers in California and Newfoundland ranged from less
than 50 to somewhere in the range of 2,000ng/m’ to 5,000 ng/m’ (1,000 ng/m’°
equates to about 0.01 fiber/cm’ {Cossette 1984]). The OSHA maximum permissible
concentrations for workplace exposures are 0.1 fiber/cm’ as an 8-hr. average and 1.0
fiber/cm’ as a 30-minute average (29 CFR 1910.1001; 1915.1001; 1926.1101).

LEAD

Most of the measurements of lead contamination in workers’ homes and cars are of
lead concentration in dust expressed as ppm (or the equivalent ug/g) or of lead
loading on surfaces expressed as ug/m’ or wg/ft’ (1 wg/ft? = 10.76 ug/m’). Similar
units are used for expressing measurements of contamination of carpets, furniture,
and cars.

Concentrations of Lead in Dust. Concentrations of lead in house dust of control
homes were reported in several studies. Baker et al. [1977] found lead at an average
of 404 ppm in control homes for a study of smelter workers in Tennessee, and Rice
et al. [1978] found 1,240 ppm in control homes of secondary smelter workers. In
control homes for a study of ceramic workers in Colorado, Kaye et al. [1987] found
lead concentrations from non-detectable levels up to 320 ppm. For a study of
electric cable splicers, Rinehart and Yanagiswa [1993] found 121-879 ppm, in control
homes. Watson et al. [1978] found lead at an average of 718 ppm in housedust of
control homes used for a study of battery manufacturing workers in Vermont. As a
guideline for cleaning lead contaminated homes in Idaho, an action level of 500 ppm
was used [CH,M Hill 1991].

By contrast to these control measurements, Baker et al. [1977] found an average
concentration of lead in house dust of smelter workers of 2,687 ppm, Rice et al.
[1978] found 3,310 ppm in homes of secondary lead smelter workers, Kaye et al.
[1987] found lead up to 3,400 ppm in homes of the ceramics workers, Rinehart and
Yanagiswa [1993] found lead up to 1,600 ppm in homes of electric cable splicers, and
Watson et al. [1978] found an average of 2,239 ppm in homes of battery
manufacturing workers.

High concentrations of lead in house dust were also found in other studies of
smelter workers, cable workers, and battery manufacturing workers. Smelter workers’

50


[1957] reported on five persons with beryllium disease who had exposure to
clothing of beryllium extraction workers.

Other authors [DeNardi et al. 1949; Sussman et al. 1959; Eisenbud and Lisson
1983] discuss varying numbers of contact (household) cases. The cases discussed
by these authors are likely included in the Beryllium Case Registry, but it is
difficult to be certain of this because detailed descriptions are not always given.

According to the literature review, there were no more contact (household) cases
added to the registry after Hardy et al. [1967] until the article by Newman and
Kreiss [1992] who reported on a 56-year-old woman with chronic beryllium
disease who had first been diagnosed with sarcoidosis. When it was determined
that her husband was a beryllium worker, she was evaluated for beryllium disease.
The clinical picture was compatible with beryllium disease and her blood test
showed beryllium sensitization.

Because of the long period of time between the prior contact cases and this case,
a review of her exposures to beryllium is useful. She was a non-smoker who had
always lived in Ohio. She was self-employed and had sold cosmetics, done
babysitting, brought up her children, and from 1973 until the time of the article,
had done stockroom work for a retailer. Her husband had worked from 1959 to
the current time at a beryllium production plant, with daily exposure to beryllium.
When working directly with beryllium, he always changed clothing after work,
showered before leaving for home, and did not bring his work clothing home.
The family had always lived at least 28 miles from his work. She sought medical
attention for this illness in November 1988. Her exposures consisted of the
following:

She took a tour of the plant in the 1960's;

° She took another tour in the 1970’s at a time when it was not operating;
During some months in 1976, her husband was an advisor to a new
ceramics plant, where he did not do hands-on work and wore street clothes,
which his wife cleaned on several occasions. Thus although beryllium was
used at the plant, clothes worn to work were not left at work;

. A hydrogen furnace containing beryllium oxide exploded in her husband’s
face in February 1979. He was sent to the emergency room in his
contaminated work clothes. When he was discharged from the emergency
room, she was given the contaminated clothes which she put in a plastic
bag at home before returning them to the plant guardhouse. Over the next
several months, she scrubbed her husband’s face several times daily with a
motorized rotating brush to remove embedded metallic debris; and

° The husband injured his ankle while at work in September 1987. When
she picked him up at the hospital, he was still wearing work clothes. He
rode home in her car and she placed the dusty clothes in a plastic bag.


years [Neidich 1993; Edmonson 1987; Young 1994; Pelegrin 1995; Geisinger Medical
Center 1991; Leach and Leach 1992]. Similar poisonings have been reported from
Norway [Christensen 1994]. Often the poisonings result from children drinking the
caustic solutions from other than the original containers, e.g., soda bottles. These
Poisonings have caused second degree burns to the esophagus, esophageal
perforation, and in one case death.

Estrogenic substances used in animal feed resulted in poisonings of farm children
[Bierbaum 1993]. Farm homes have been shown to be contaminated with fungal
spores from barns [Pasanen et al. 1989]. Livestock or wild animals may serve as

reservoirs for infectious agents.

FAMILY VISITS TO WORKPLACE .

Visiting the workplace is a source of poisoning of family members that has been
identified and is relevant to the concept of workers’ family protection. Although it
deviates somewhat from the concept of the worker contaminating the home by
bringing contaminated items home from work, it is similar to cottage industry and
farm situations where family members enter the work area.

Lundquist [1980] discussed the hazards of lead contaminated grounds outside the
plant where a parent works. Not only can the workers’ shoes become contaminated
while walking to the car, but also while waiting to pick up a working parent, children
may play on the contaminated grounds.

A nursing mother regularly spent her lunch hour with her husband in his dry cleaning
establishment [Bagnell and Ellenberger 1977]. Her infant developed obstructive
jaundice and her breast milk contained tetrachloroethylene at 1.0 mg/dL. In another
study, Aggazzotti et al. [1994] collected alveolar air samples from family members of
dry cleaners, and from family members in control homes. Perchloroethylene
(tetrachloroethylene) concentrations in alveolar air of family members who visited
the workplace were nearly as high at 4.1 mg/m’ as they were in the dry cleaners (6.56
mg/m’). For family members who did not visit the workplace the alveolar air
concentration averaged 0.27 mg/m’ compared to 0.008 mg/m’ for controls.

Wilken-Jensen [1983] reported that children of a veterinarian suffered from asthma
every time they went to work with their father.


LIA [1993a]. Lead Industries Association offers industry specific videos on exposure to
lead as part of product stewardship program. New York, NY: Lead Industries
Association, Inc. News Release, 2 pages.

LIA [1993b]. Lead Industries Association, Inc. presents: Control of lead exposure in the
ceramics industry. New York, NY: Lead Industries Association, Inc. Videocassette.

LIA [1991]. Lead and your health. New York, NY: Lead Industries Association, Inc.
Tri-fold Brochure, 1 page.

LIA [1989]. Employee guide to OSHA lead standard. New York, NY: Lead Industries
Association, Inc. Brochure, 42 pages.

Lieben J, Pistawka H [1967]. Mesothelioma and asbestos exposure. Arch Environ
Health 14:559-563.

Lieben J, Williams RR [1969]. Respiratory disease associated with beryllium refining
and alloy fabrication—1968 follow-up. J Occup Med 11(9):480-485.

Lieben J, Metzner F [1959]. Epidemiological findings associated with beryllium
extraction. Am Ind Hyg Assoc J 20(12):494-499.

Lilis R [1986]. Mesothelioma. Occupational Respiratory Diseases, DHHS (NIOSH)
Publication No. 86-102:671-687.

Lillie TH, Hampson RE, Nishioka YA, Hamilton MA [1982]. Effectiveness of detergent
and detergent plus bleach for decontaminating pesticide applicator clothing. Bull
Environ Contam Toxicol 29:89-94.

Lillie TH, Livingston JM, Hamilton MA [1981]. Recommendations for selecting and
decontaminating pesticide applicator clothing. Bull Environ Contam Toxicol 27:716-723.

Lillington GA, Jamplis RW, Differding JR [1974]. Conjugal malignant mesothelioma
[letter] New Eng J Med 291 (11):581-582.

Litzistorf G, Guillemin MP, Buffat P, Iselin F [1985]. Influence of human activity on the
airborne fiber level in paraoccupational environments. J Air Pollut Control Assoc
35(8):836-837.

London M [1994]. Letter of January 21, 1994 re: workers’ home contamination in New
York to Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, Department of Health and Human Services. 25 pages.


Two wives who washed the clothes of workers engaged in the manufacture of
kepone developed signs of kepone poisoning [Cannon et al. 1978].

Chlorinated Hydrocarbons

Contamination of homes by 3,3’-dichlorobenzidene and 4,4’-methylene-bis(2-
chloroaniline) (MOCA) with some evidence of contaminated clothing as the
source have been reported. 3,3’-Dichlorobenzidene in vacuum cleaner dust of
homes of workers engaged in its production was found at concentrations up to
10.5 ppm and in dryer lint up to 0.74 ppm [ATSDR 1991b]. MOCA was found
in vacuum cleaner dust of homes of workers engaged in plastics manufacture at
concentrations up to 2.6 ppm and in dryer lint up to 0.65 ppm [ATSDR 1989b].

Contamination of firefighters protective clothing was documented by Kominski
[1987a] who found polychlorobiphenyls (PCBs) up to 1,060 ug/g of clothing
following a transformer fire. This study adds credibility to the assumption of
clothing contamination by PCBs in the several cases where workers’ family
members developed chloracne.

Mercury

Evidence for clothing as a source of workers’ home contamination with mercury
derives from observations of clothing contamination, and the finding of elevated
mercury concentrations in areas of homes where soiled clothing was stored and
laundered. There are no quantitative data on levels of mercury contamination

of clothing.

In a study where mercury was used to calibrate scientific glassware, Danzinger
and Possick [1973] reported that mercury particles became embedded in the
workers’ clothing, especially in knitted fabrics. No measurements of mercury
contamination in the homes were made, but the author stated that some female
workers would shake mercury particles out of their clothing at home.

Workers milling cinnabar ore wore their mercury-contaminated clothing home
and contaminated their cars and their homes [Zalesac 1994]. Mercury
contamination of workers’ clothes contained in plastic bags was confirmed by
sampling the air in the bags; mercury was found in workers’ cars at 30-60
»g/m’, and in workers’ homes near washers and dryers at 5-50 zg/m’. The
occupational exposure limit for inorganic mercury in mining is 50 4g/m’ as an
8-hr. time-weighted average (30 CFR 57.5001).

Additional support for contaminated clothing as a source of home
contamination by mercury is provided by Hudson et al. [1985, 1987] and
ATSDR [1990a].

Workers exposed to mercury in a thermometer manufacturing plant also
brought work clothes and shoes home and contaminated their homes [Hudson

41


In conducting the study and preparing the report, NIOSH has taken a broad approach to
the problem of workers’ home contamination in order to ensure that relevant
information is included. Some reports that may relate to hobbies were included because
the distinction between hobby and "cottage industry” is not always clear and the
situations may be similar. Reports where family members were exposed by visiting the
workplace were included, as were reports where living quarters adjacent to workplaces
were contaminated. Studies of contamination of homes from other sources were
included if they provided relevant information about levels of contamination, methods of
measurement, or decontamination. As intended by Congress, infectious agents are
included as hazardous substances to the extent that pathogens can be transported on a
worker’s person or clothing. Congress did not intend for the Workers’ Family Protection
Act to apply to the spread of infectious diseases by other means.

In July 1993, a working group was formed with representatives from each NIOSH
Division to plan and implement a strategy to conduct this study. Specific task areas were
assigned to members of this working group. Several Federal agencies including the
Agency for Toxic Substances and Disease Registry (ATSDR), the Environmental
Protection Agency (EPA), the Occupational Safety and Health Administration (OSHA),
the Department of Energy (DOE), the Mine Safety and Health Administration (MSHA),
and the Centers for Disease Control and Prevention (CDC) provided assistance in
conducting the study.

The NIOSH working group obtained information for this report through a variety of
routes. On November 15, 1993, a notice entitled “National Institute for Occupational
Safety and Health: Request for Existing Information Relevant to Implementing the
Workers’ Family Protection Act" was published in the Federal Register (Appendix 2).
The notice requested information on several topics including measurements of home
contamination, reports on government actions occurring as a result of home
contamination incidents, preventive measures used by employers, and effectiveness of
industrial hygiene practices. This notice was announced in CDC’s Morbidity and
Mortality Weekly Report (MMWR) on December 10, 1993 (Appendix 2), by electronic
mail to State agencies involved in NIOSH occupational health programs and cooperative
agreements and to county agriculture extension agents. A request for information was
also distributed to Poison Control Centers.

In January 1994, NIOSH sent over 1,100 letters to associations and State and Federal
agencies and programs requesting information relevant to this study. The Federal
Register Notice was enclosed with these letters. The mailing lists used and copies of
written responses are available from the NIOSH Docket Office.

Over 50 written and several telephone responses were received. Working group
members followed up on several Federal, State, and local agency responses. All State-
plan occupational safety and health offices were contacted by telephone to obtain a copy
of relevant State laws on occupational safety and health.


In general, cohort studies have found that lead workers’ children have
significantly higher BLLs than control children after controlling for relevant non-
occupational factors, such as neighborhoods and income. The BLLs for exposed
children across all studies ranged from 10.2 to 81 yg/dL, while the BLLs for
control children ranged from 6.2 to 27 ng/dL.

Community Studies. The community studies (Table 8) addressed worker
take-home exposure as part of community investigations. The majority of the
studies were conducted in smelter communities. Of the 14 studies reviewed, all
but 3 were conducted outside the U.S. Four studies were conducted in Germany.
All but one of the studies reported an association between children’s exposure to
lead (as measured in blood, hair, or teeth) and parental occupation in a lead
industry.

The community study that reported the highest BLLs was conducted in a
large smelter community in Brazil [Carvalho et al. 1984]. Children (ages 1-9) of
lead workers had a significantly higher mean BLL (67.5 xg/dL) than similarly
aged children of non-lead workers from the same community (56.6 zg/dL). The
most recent study in the U.S. was reported by Cook et al. [1993] who found that
the mean BLL in children in a smelting/mining community was 10.1 ug/dL (range
0.5-30.1 zg/dL). In this study, children whose parents were miners had higher
BLLs than children whose parents were not occupationally exposed to lead.

Case Reports and Case Series. The case report and case series collection
of studies (Table 9), dating back to the first report in 1952, illustrates the breadth
of industries in which take-home lead exposure has been documented. More
unusual industries include a polyvinyl chloride (PVC) factory, cutlery tempering,
plaque production, propane tank manufacturing, cable cutting and salvage, and
trucking. The most striking case report was from North Carolina where battery
factory workers were taking home discarded battery casings and burning them as
fuel in their home [Dolcourt et al. 1981]. The highest BLLs among 22 family
members were observed in a 3-year-old male and 3-year-old female (256 and 220

ug/dL).

Review of Studies of Other Health Effects

All 34 U.S. reports (Tables 7-9) with quantitative blood lead information reported
children with BLLs at or over the CDC intervention level of 10 ug/dL. In 24 of
the 34 reports, children with BLLs greater than 25 ug/dL were identified,
including 15 reports of children with BLLs at or over 40 ug/dL, and 3 reports of
children with BLLs greater than 80 zg/dL. Specific health effects or lead
poisoning severe enough to require chelation therapy were found in 12 of the 34
reports. In two reports, health effects were not found. The remaining 20 reports
did not address health effects.

15


Scalzini A, Barni C, Bertelli D, Sueri L [1992]. A hospital outbreak of scabies. J Hosp
Inf 22:167-168.

Schneider T [1986]. Manmade mineral fibers and other fibers in the air and in settled
dust. Environ Int 12:61-65.

Schneider T, Petersen OH, Eriksen P, Vinzents P, Hansen BK [1989]. A simple method
for the measurement of dust on surfaces and the effectiveness of cleaning. Environ
Internat 15:563-566.

Schreiber JS, House S, Prohonic E, Smead G, Hudson C, Styk M, Lauber J [1993]. An
investigation of indoor air contamination in residences above dry cleaners. Risk Analysis
13(3):335-344.

Schuhmacher M, Domingo JL, Llobet JM, Corbella J [1991]. Lead in children’s hair, as
related to exposure in Tarragona Province, Spain. Sci Total Environ 104(3):167-173.

Schultz RH [1994]. Letter of January 31, 1994 re: workers’ home contamination in
Idaho to Ms. Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 3 pages.

Schuster MK [1994]. Letter of January 31, 1994 re: workers’ family protection in
Oregon to Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 337 pages.

Seixas N, Ordin D [1986]. Health Hazard Evaluation Report: Friction Division
Products, Trenton, New Jersey. Cincinnati, OH: U.S. Department of Health and Human
Services, Public Health Service, Centers for Disease Control, National Institute for
Occupational Safety and Health, NIOSH Report No. HETA-84-262-1734. 51 pages.

Seligman PJ [1984]. Memorandum of July 7, 1994 re: HETA 84-169 to John Kominsky,
Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services.

Sherlock JC, Barltrop D, Evans WH, Quinn MJ, Smart GA, Strehlow C [1985]. Blood
lead concentrations and lead intake in children of different ethnic origin. Human
Toxicol 4:513-519.

Sider L, Holland EA, Davis TM Jr., Cugell DW [1987]. Changes on radiographs of
wives of workers exposed to asbestos. Radiology 164(3):723-726.

135


‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

Residential Lead-Based Paint | PL 102-550 (25 U.S.C. § 2681 &
Hazard Reduction Act of Title X Seq) ore Program to promote lead exposure abatement
19 Subtitle B ‘The Administrator, in cooperation with other appropriate Federal departments and
agencies, shall conduct a comprehensive program to promote safe, effective, and
affordable monitoring, detection, and abatement of lead-based paint and other lead
exposure hazards,
(c) Exposure studies
(1) The Secretary of Health and Human Services (hereafter in this subsection referred to
as the *Secretary’), acting through the Director of the Centers for Disease Control
(CDC), and the Director of the National Institute of Environmental Health Sciences, shall
Jointly conduct « study of the sources of lead exposure in children who have elevated
blood lead levels (or other indicators of elevated lead body burden), as defined by the
Director of the Centers for Disease Control.
(3) The studies described in paragraphs (1) and (2) shall, as appropriate, examine the
relative
contributions to elevated lead body burden from each of the following:
{A) Drinking water
(B) Pood
(C) Lead-based paint and dust from lead-based paint
(D) Exterior sources auch as ambient air and lead In soit
(B) Occupational exposures, and other exposures that the Secretary determines to be
appropriate.
Federal Insecticide Public Law 92-516 (7 US.C. § 136) $ 136g. Storage, disposal, transportation, and recall
Pungicide, Rodenticide Act

(a) Storage, disposal, and transportation
(1) Data requirements and registration of pesticides
‘The Administrator may require under section 136(a) or 136(4) of this title that-

(A) the registrant or applicant for registration of a pesticide submit or cite data or
information regarding methods for the safe storage and disposal of excess quantities of
the pesticide to support the registration or continued registration of a pesticide;

(B) the labeling of a pesticide contain requirements and procedures for the
transportation, storage, and disposal of the pesticide, any container of the pesticide, any
ringate containing the pesticide, or any other material used to contaln or collect excess or
spilled quantities of the pesticide; and

(e) Container design

(1) Procedures

(A) Not later than 3 years after the effective date of this subsection, the Administrator
‘shall, in consultation with the heads of other interested Federal agencies, promulgate
regulations for the design of pesticide containers that will promote the safe storage and
disposal of pesticides.

222



Visiting the workplace of a family member has been shown to be a hazard for
families of dry cleaners and veterinarians.

CONTAMINATED CLOTHING
Overview
This section reviews reports that provide evidence for clothing worn, or otherwise
taken home from work, as a source of home contamination. The reports are
summarized in Table 15. In the health effects studies reviewed in Chapter 1,
home contamination and family exposures were often attributed to contaminated
clothing brought home from the workplace. This attribution was based on:
information elicited by questioning household members; descriptions of
workplaces and work practices; and the practice of wearing and laundering work
clothes at home. Clothing contamination was documented in 18 reports reviewed
below: 1 on beryllium; 7 on lead; 7 on pesticides; 1 on chlorinated hydrocarbons
(PCBs); 1 on an estrogenic substance (zeranol); and 1 on 3,4-benzo(a)pyrene.
Only for lead were measurements of both clothing contamination and home
contamination included in the same studies; these few studies are inadequate for
establishing any quantitative relationship between clothing contamination and
home contamination.

Other evidence of clothing as a source of home contamination includes: the
findings discussed below of high levels of contamination in laundry areas of
workers’ homes and in areas where contaminated clothing is stored (lead,
mercury); contamination of washing machines (mercury) or dryers (3, 3’-
dichlorbenzidine, MOCA); and poisoning of home launderers (beryllium, asbestos,
lead, kepone). Estimates of exposure levels that could have occurred during
home laundering of beryllium and asbestos suggest that such exposures could have
exceeded OSHA occupational exposure limits for these substances.

Beryllium

There were no reports of measurements of home contamination by beryllium,
although the case histories and epidemiology studies generally assumed that
cases of berylliosis in workers’ family members were due to laundering
contaminated clothing. In support of this assumption, the following studies on
clothing contamination indicate that substantial amounts of beryllium dust could
have been brought into the workers’ homes by contaminated clothing.

Fabrics experimentally exposed at a beryllium production worksite contained
beryllium up to 2.8 mg/m’ [Bohne and Cohen 1985]. In a subsequent study
Cohen and Positano [1986], found that work shirts contained from 12 to 37
mg/m’ of beryllium. It is likely that inhalation exposures of workers’ family
members occurred during laundering of the contaminated clothing, since
resuspended beryllium dust concentrations in air from unwashed shirts at up to
0.64 g/m’ were found. In an earlier laboratory study, Eisenbud et al. [1949]
found beryllium concentrations in air at 125-1,200 xg/m* when soiled clothes

35


Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

Sections Relevant to Workers’ Family Protection

Asbestos Hazard Emergency | Public Law 99-519 [15 U.S.C. § 2642 & $ 2646 Contractor and laboratory accreditation
Response Act of 1986 Seq.}
(b) Accreditation by State
(1) Model plan
(B) Plan requirements
(xi) Housekeeping and persona! hygiene practices, including the necessity of showers,
and procedures to prevent asbestos exposure to an employee's family.
Residential Lead-Based Paint | PL 102-550 [15 U.S.C, § 2681 & § 2681 Definitions
Hazard Reduction Act of Title X Seq. For the purposes of this subchapter:
1992 Subtitle B (1) Abatement

‘The term “abatement” means any set of measures designed to permanently eliminate lead-
based paint hazards in accordance with standards established by the Administrator under
this subchapter, Such term includes+

{A)the removal of lead-based paint and lead-contaminated dust, the permanent
containment or encapsulation of lead-based paint, the replacement of lead-painted
surfaces or fixtures, and the removal or covering of lead-contaminated soil; and

(B) all preparation, cleanup, disposal, and postabatement clearance testing activities
associated with such measures,

(11) Lead-contaminated dust

‘The term “lead-contaminated dust" means surface dust in residential dwellings that
contains an area or mass concentration of lead in excess of levels determined by the
Administrator under this subchapter to pose a threat of adverse health effects in pregnant
women or young children,

(12) Lead-contaminated soil

‘The term "lead-contaminated soil” means bare soil on residential real property that
contains lead at or in excess of the levels determined to be hazardous to human health by
the Administrator under this subchapter.

§ 2683 Identification of dangerous levels of lead

Within 18 months after October 28, 1992, the Administrator shall promulgate regulations
which shall identify, for purposes of this subchapter, and the Residential Lead-Based

Paint Hazard Reduction Act of 1992 [42 U.S.CA. § 4851 et seq.], lead-based paint
hazards, lead-contaminated dust, and lead-contaminated soil.

221



CHAPTER 1. HEALTH EFFECTS OF WORKERS’ HOME CONTAMINATION

CHAPTER SUMMARY

Reports of health effects among workers’ family members from beryllium, asbestos,
lead, caustic farm products, pesticides, chlorinated hydrocarbons, mercury, estrogenic
substances, asthmatogens/allergens, arsenic, cadmium, fibrous glass,
cyclotrimethylenetriamine, and infectious agents are reviewed in this chapter.

Beryllium was responsible for approximately 40 cases of chronic beryllium disease
among workers’ family members; the most recent case was reported in 1992
suggesting that cases may still be occurring.

Asbestos contamination of workers’ homes has been a world-wide problem resulting
in all forms of asbestos disease among workers’ family members, including over 100
identified deaths from mesothelioma in the United States. Although many uses of
asbestos have been abandoned and occupational exposures are regulated, potential
exposures of workers’ family members may still exist in the United States, especially
in the construction industry.

Lead contamination of workers’ homes resulting in elevated blood lead levels (BLLs)
of workers’ children and other household members is currently a substantial problem
in the United States. Elevated BLLs have been correlated with hematologic
abnormalities and abnormalities of neurologic and neurobehavioral testing, especially
in children. Nearly 80 reported incidents of workers’ family exposure to lead were
identified in 22 published retrospective cohort studies, 14 published community
studies, and 30 case series or case reports, of which 10 are unpublished reports or
letters. Of the 34 reports on BLLs of workers’ children, 19 have appeared since
1990. These included five reports that identified children with BLLs in excess of 40
g/dL. The 19 reports suggest that workers’ home contamination by lead is a current
health problem in the United States.

Of the 80 reported incidents, about 8% (5 reports/6 cases) involved elevated BLLs in
adult family members. In all six cases, BLLs exceeded 10 pg/dL. In two of these,
BLLs exceeded 40 yxg/dL, one of which reported a BLL greater that 50 xg/dL.
These indicate a concern for the health of workers’ adult family members, and for
prenatal exposure.

Accidental ingestion and skin contact with caustic farm products have been
responsible for over 40 cases of poisonings of farm children. Effects of ingestion of
caustic farm products include chemical burns of the mouth and esophagus which can
be fatal. Accidental body contact can cause chemical burns of the skin and eyes.
Since most of these 40 cases have been reported in the last S years, this is a current
problem.


Krousel T, Garcas N, Rothschild H [1986]. Familial clustering of mesothelioma: A
report on three affected persons in one family. Am J Prevent Med 2(4):186-188.

Lander F, Viskum B [1985]. [The incidence of benign pulmonary changes in the spouses
of previous asbestos workers] (in Danish). Ugeskr Laeger 147(22):1805-1806.

Landrigan PJ [1976]. The exposure of children to lead from industry: Epidemiology and
health consequences. In: Carnow BW ed. Health effects of occupational lead and
arsenic exposure. A symposium. Cincinnati, OH: U.S. Department of Health,
Education, and Welfare, Public Health Service, Center for Disease Control, National
Institute for Occupational Safety and Health, HEW Publication No. (NIOSH) 76-134.
pages 147-156.

Landrigan PJ, Baker EL [1981]. Exposure of children to heavy metals from smelters:
Epidemilogy and toxic consequences. Environ Res 25:204-224.

Landrigan PJ, Tamblyn PB, Nelson M, Kerndt P, Kronoveter KJ, Zack MM [1980].
Lead exposure in stained glass workers. Am J Ind Med 1(2):177-180.

Lang L [1994]. Beryllium: A chronic problem. Environ Health Perspectives 102(6-
7):526-531.

Laughlin J, Easley C, Gold RE [1985]. Methyl parathion residue in contaminated
fabrics after laundering. In: Dermal exposure related to pesticide use, ACS Symposium
Series No. 273, pages 177-187.

Laughlin JM, Easley CB, Gold RE, Tupy DR [1981]. Methyl parathion transfer from
contaminated fabrics to subsequent laundry and to laundry equipment. Bull Environ
Contam Toxicol 27:518-523.

Laughlin J, Gold RE [1988]. Cleaning protective apparel to reduce pesticide exposure.
Review Environ Contam Toxicol 101:93-119.

Laughlin J, Gold RE [1989a]. Evaporative dissipation of methyl parathion from
laundered protective apparel fabrics. Bull Environ Contam Toxicol 42:566-573.

Laughlin J, Gold RE [1989b]. Methyl parathion redisposition during laundering of
functionally finished protective apparel fabrics. Bull Environ Contam Toxicol 42:691-
698.

Laughlin J, Gold R {1989c]. Laundering pesticide contaminated clothing. NebGuide
G89-943 (revised). Lincoln, Nebraska, Cooperative Extension, Institute of Agriculture
and Natural Resources. 3 pages.


Other clothing decontamination methods that have been studied include storage with
and without air flow, and chemical decomposition by heat. Laughlin and Gold
[1989a] found that residues of methyl parathion remaining in fabrics after a single
wash decreased when stored in moving air up to six months. Alachor was found to
degrade rapidly in contaminated fabrics heated in a convexion oven at 200°C and
after 30 minutes when heated at 150°C; at 150°C for 60 minutes, the residue was
0.005% of the contamination level [Kim 1989]. Microwaves of 2,450 MHZ at S50W,
250W, and SOOW for up to 200 seconds were not very effective.

CHLORINATED HYDROCARBONS

Kominsky [1984b, 1987a] reported on decontamination of clothing contaminated by
PCBs during a fire at an electric transformer oil reclamation facility. In one setting,
the Nomex® protective clothing was dipped into a tub containing detergent followed
by a water rinse in a second tub. The procedure reduced the PCB surface
contamination (from 15.8 pg/cm? to 0.35 - 7.2 4g/em’), but may have increased the
concentration of PCBs in the fabric (0.76 - 601 xg/gm fabric before washing; 14-1050
xg /gm fabric after washing).

Subsequently, Kominsky [1987a] conducted a dry-cleaning experiment on Nomex®
clothing that was contaminated during the same fire. The clothing contained PCBs at
5.3-480 ng/g fabric. Laboratory-contaminated Nomex® clothing containing PCBs at
10,000-1,000,000 g/g fabric were also included in the study. A
trichlorotrifluoroethane (Freon® 113)-based dry cleaning machine with a revolving
chamber system was used. This process reduced site-contaminated garment PCB
levels by an average of 88%, and of laboratory-contaminated garments by 99%.

Since safe levels of surface contamination are not known, it could not be stated if this
would protect workers or prevent home contamination.

Homes were contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) when
contaminated waste oil was used for dust suppression in two neighborhoods [Hess
1988; Doherty 1984]. Hess [1988] reported on decontamination of eight residences
and three commercial buildings in one of the areas. After vacuuming with a high
efficiency electric vacuum equipped with a HEPA filter, every surface was wiped with
a damp cloth and detergent wash. The procedure resulted in non-detectable levels of
dioxin in the eight residences and two commercial buildings, and reduced the level in
the most contaminated building from 36.6 ppb to 13 ppb. In the other area, Doherty
[1984] removed the contaminated carpet, then thoroughly vacuumed and washed the
Tesidence with a detergent solution. A post-clean-up vacuum dust sample was
negative for dioxin.

Homes contaminated with MOCA, including homes of exposed workers, were
cleaned by a commercial carpet cleaner [Hesse 1991]. In the more contaminated
homes, the amount of MOCA removed by vacuuming carpets before commercial
cleaning was 30-300 times that collected after commercial cleaning. However, in a
laboratory study, a single commercial cleaning technique removed only 31% of the

68


Appendix 2.
Request of Existing Information Relevant
to Implementing the Workers’ Family Protection Act
FR58:60202 - 60204
and

Notice to Readers, MMWR 42(48):943

261


McEwen et al. (1971)

Scotland

‘Table 4. (Continued) Health Effects of Take-Home Asbestos Exposure (Case-Controt Studies)

Industry/
Population at Risk

Population-based

Study Design

Matched case-control, 83 mesothelioma cases who
died 1950-1967 from all pathology departments in
Scotland. Two control groups were matched on age
and gender to the nearest chronologic pathology
report from the same hospital: (1) coronary artery
disease deaths, and (2) lung and gastric carcinoma
cases were matched to pleural and peritoneal
mesothelloma cases, respectively.

Results

Only a few cases and controls had
shared households with asbestos
workers. No statistically significant
differences between these two groups.

ST)

Comments

‘The number of non-
occupational cases was not
reported in the publication,
‘The case of a woman who
washed the clothes of her
husband who was a
dockworker is described.

Rubino et al. [1972]

Italy (Piedmont)

Various industries;
Piedmont
produces only
chrysotile

‘Case-control study of 50 confirmed cases of pleural
mesothelioma admitted to 2 Turin clinical settings
1960-1970, Controls were 50 patients from the same
institution matched on gender and age.

12% of mesothelioma reported in the
case series were in workers’ family
members; 3 cases (2 men and 1 woman)
had lived with persons employed in the
asbestos industry, compared with none
in the control group,

‘The wife of a man worked In
the asbestos industry, and 1
woman's brother worked in
an asbestos cement factory.
Occupational exposure was
unequivocally demonstrated
in $ men. Asbestos bodies
were found in only one case,

Ashcroft and
Heppleston (1970)

Britain

Shipbuilding

Case-control study of 23 cases of mesothelioma (20
pleura, 3 peritoneum; 19 males, 4 femates) that came
to autopsy compared with 46 hospital controls

matched on sex and age, free from malignant disease,

150

91% of the cases had a history of
exposure to asbestos vs. 41% of 46
matched controls (p<0,001); 1 of the
cates resulted from domestic exposure.

A widow of an asbestos
worker was exposed for

3 years to asbestos dust
brought home on her
husband's clothes, hair and
shoes. Paper includes table of
fiber and atbestos body

counts.



MERCURY
Overview
As summarized in Table 13, there are six reports of workers’ homes being
contaminated by mercury. The most severe cases of family poisonings, requiring
hospitalization, occurred in cottage industry-type gold extraction operations, but
family members of chlor-alkali plant workers and workers engaged in
thermometer manufacturing were also exposed to mercury.

Background

Acute exposure to mercury may produce gastrointestinal disturbances, pharyngitis,
dysphagia, and shock. Chronic exposure results in central and peripheral nervous
system and renal effects.

Mercury is the only metal that is liquid throughout usual temperature ranges.
Mercury, found in all classes of rocks, can be recovered from ores by heating.
Major uses of mercury are in chlor-alkali plants and in manufacture of electrical
apparatus.

Mercury exposures occur among dentists, gold extractors, jewelers, laboratory
workers, miners, and thermometer makers. Low levels of elemental mercury are
difficult to measure in humans and the environment. This difficulty should be
kept in mind when considering several of the reports reviewed in this section
which found that levels of mercury in either air or urine of exposed family
members were not elevated above background (control) levels.

Review of Studies

Occupational exposure to mercury in a thermometer-manufacturing plant,
followed by home contamination, was described by Ehrenberg et al. [1986, 1991},
Trost [1985], and Hudson et al. [1985, 1987]. Company records showed mercury
vapor levels from 24-308 g/m’ (time-weighted averages). Mercury levels in the
urine of the workers ranged from 1 to 345 ug/g creatinine [Ehrenberg et al. 1986].
Hudson et al. [1985, 1987] investigated the exposure to mercury in children of the
workers. These investigators reported that the median mercury concentrations in
the homes was 0.25 uzg/m’ (range 0.02-10 g/m’) and that the levels of mercury in
the urine of the children averaged 25 ug/L, some five times higher than that
reported in controls. Mercury in the urine of one child was in excess of 50 ng/L
and for another child it was in excess of 100 ug/L. There was a significant
correlation between the mercury levels in the urine of the workers’ children and
the mercury levels in the urine of the parents. Neurological studies of 23 workers’
children compared to 32 control children found no significant effects of the
exposures.

A recent report [ATSDR 1990a] summarizes the exposures of workers in a chlor-

alkali chemical plant. The workers were exposed to high levels of mercury during
a scheduled maintenance operation which involved removing old pipes and

22


longer than 5 y that were generated by wearing the coat before cleaning were around
2/cc whereas after cleaning the concentrations were about 0.5/cc. Since the fibers
were part of the fabric, the study may underestimate the ability of laundry procedures
to remove asbestos from contaminated clothing. Asbestos fibers were transferred to
sport coats dry cleaned with the coat containing asbestos.

In a laboratory study, asbestos-contaminated carpets were cleaned for about 65
minutes by either dry vacuuming or hot water extraction, using vacuum cleaners
equipped with high efficiency particulate air (HEPA) filters [Kominsky et al. 1990].
The carpets were artificially contaminated with 9.3 x 10‘ and 9.3 x 10’ asbestos
structures per meter squared (s/m*), based on levels found in carpets from an
asbestos-containing building. Dry vacuuming removed little or no asbestos from the
carpets whereas hot water extraction removed about 70%. An important aspect of
this study was the effect of the cleaning procedures on airborne asbestos
concentrations. During carpet cleaning, by either method and at either level of
carpet contamination, average asbestos concentrations in room air of 0.15-0.25 s/cm’
were generated. The OSHA permissible exposure limit for asbestos is 0.1 fiber/cm’
as an 8-hr. time-weighted average [29 CFR 1910.1001; 29 CFR 1915.1001; 29 CFR
1926.1101].

Resuspension of asbestos fibers was observed with a fiber aerosol monitor during a
daily cleaning period of a classroom by Litzistorf et al. [1985]. Resuspension of dust
by cleaning activities is an important consideration not only for the decontamination
process, but also for persons living in the home and performing routine cleaning
operations.

LEAD

No studies on laundering of clothes contaminated with lead were found. However,
Simonson and Mecham [1983] showed that a workplace airshower removed from 5%
to 72% of lead oxide dust from clothing samples contaminated with about 1 mg/cm’,
and from 23% to 69% from samples contaminated with about 0.6 - 2.5 mg/cm’ in
laboratory studies. A smal] amount of lead was blown through the clothing to the
underclothing and body of the workers (up to 1% of the dust loading).

Ewers et al. [1994b] studied the effectiveness of dry vacuuming for removal of lead
from carpets taken from homes of children who had high BLLs. These carpets were
highly contaminated with surface lead loadings of 114,000 »g/m’ to 5,650,000 ng/m’.
The carpets were vacuumed with commercially available vacuum cleaners intended
for industrial use. The vacuum cleaners were equipped with HEPA filters and fitted
with a commercial beater bar nozzle. The carpets were vacuumed 10 times for 1
min/m’ each time. Surface loadings and amount of lead removed were measured
after each vacuuming. After some of the earlier vacuumings, lead loading on the
surface increased by up to four times, but by the tenth vacuuming the surface lead
loading was reduced to 6%-61% (average 20%) of the initial loading. The

63


CERCLA & SARA

‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

(42 U.S.C. § 9601 et
req.)

Sections Relevant to Workers’ Family Protection

(G) The purpose of health assessments under this subsection shall be to assist in
determining whether actions under paregraph (11) of this subsection should be taken to
Teduce human exposure to hazardous substances from a facility and whether additional
information on human exposure and associated health risks is needed and should be
acquired by conducting epidemiotogical studies under paragraph (7), establishing &
registry under paragraph (8), establishing a health surveillance Program under paragraph
(9), or through other means. In using the results of health assessments for determining
additional actions to be taken under this section, the Administrator of ATSDR may
consider additional information on the risks to the potentially affected population from alt
sources of such hazardous substances including known point or nonpoint sources other
than those from the facility in question.

(EH) At the completion of each health assessment, the Administrator of ATSDR shall
Provide the Administrator of EPA and each affected State with the results of such
assessment, together with any recommendations for further actions under this subsection
of otherwise under this chapter. In addition, if the health assessment indicates that the
release or threatened release concerned may pose a serious threat to human health or the
environment, the Administrator of ATSDR shall #0 notify the Administrator of EPA who
shall promptly evaluate such release or threatened release in accordance with the hezard
ranking system referred to in section 9605(a)(8)(A) of this title to determine whether the
site shall be placed on the National Priorities List or, if the site is already on the list, the
Administrator of ATSDR may recommend (o the Administrator of EPA that the site be
accorded a higher priority.

(7)(A) Whenever in the judgment of the Administrator of ATSDR it is appropriate on
the basis of the results of a health assessment, the Administrator of ATSDR shall conduct
a pilot study of health effects for selected groups of exposed individuals in order to
determine the desirability of conducting full scale epidemiological or other health studies
of the entire exposed population,

(B) Whenever in the judgment of the Administrator of ATSDR it is appropriate on the
basis of the results of such pilot study or other study or health assessment, the
Administrator of ATSDR shall conduct such fult scale epidemiological or other health
studies way be necessary to determine the health effects on the population exposed to
hazardous substances from a release or threatened release. If a significant excess of
disease in a population is identified, the letter of transmittal of such study shall include an
assessment of other risk factors, other than a release, thal in the Judgment of the
peer review group, be associated with such disease, if such risk factors were not taken into
account in the design or conduct of the study.

(8) In any cese in which the results of a health assessment indicate « potential significant
risk to human health, the Administrator of ATSDR shall consider whether the
establishment of a registry of exposed persons would contribute to accomplishing the
purposes of this subsection, taking into account circumstances bearing on the usefulness
of such a registry, including the seriousness of unique character of identified diseases or
the likelihood of population migration from the affected area.

232



60202 Fedcral Register / Vol. S8. No. 218 / Monday. November 15, 1993 / Notices
—

GENERAL ACCOUNTING OFFICE
Federal Accounting Standards
Advisory Board; Meeting Cancellation

AGENCY: General Accounting Office.
ACTION: Cancellation of November
meeting.

‘SUMMARY: Pursuant to section 10{a)(2) of
the Federal Advisory Committee Act
(Pub. L. 92-463), as amended. notice is
hereby given of cancellation of the
November 18 meeting of the Federal
Accounting Standards Advisory Board.
Notice of the meeting was previously
published in the Federa! Register of
November 8. ft is currently anticipated
that the December meeting will be held
as scheduled. Due notice of it will be
published at a later date in t'.e Federal
Register.

FOR FURTHER INFORMATION CONTACT:
Ronald S. Young. Staff Director, 750
First Street NE., room 1001.
Washington, DC 20002, or call (202)
512-7354.

Authority: Federal Advisory Committee
Act. Pub. L. 92-463. Section 10(a¥2}, 86 Stat.
770, 774 (1972) (current version at 5 U.S.C
app. section 10(aX2) (1988)}: 41 CFR 101-
6.1015 (1990).

Dated: November 9, 1993.
Ronald S. Young,
Executive Director.
(FR Doc. 93-28001 Filed 11-12-93: 8:45 am]
BALING CODE s610-01-08

Bulletin, “Carcinogenic Potential of
Occupations! Exposure to Asphalt Products.”
with # panel of invited participants selected
by NIOSH for their expertise and background
in this ere. The scientific review will
Provide NIOSH with individual input and
opinion from experts outside the Institute
péior to finalizing the Current Intelligence
Bulletin for publication and transmitial to the
Department of Labor. The review will focus
on the health effects related to occupational
exposures to asphalt products and on data
from carcinogenicity studies in animals.
Viewpoints end suggestions from industry.
labor, academia. other government agencies.
and the public are invited.

Contact persons for additional
information: General Information may be
ubtsined from Pam Graydon, NIOSH. CDC,
4676 Columbia Parkway. Mailstop C-30.
Cincinnati. Ohio 45226. telephone $13/533-

Technical information may be obtained
from Crystal Ellison NIOSH. CDC 4676
Columbis Parkway. Mailstop C-31.
Gincinnati, Ohio 45226, telephone $13/533-

Dated: November 8, 1993.

Associate Director for Policy Coordination,
Centers for Disease Control and Prevention

AFR Coc. 93-27949 Filed 11-12-93: 8:45 amj
(R.LNO CODE 4100-10-08

DEPARTMENT OF HEALTH AND
HUMAN SERVICES

Centers for Disease Control and
Prevention

Sctentific Review of Oraft Current
Intelligence Bulletin on the
Carcinogenic Potential of Occupational
Exposure to Asphait Products;
Meeting

The National Institute for
Occupational Safety and Health
(NIOSH) of the Centers for Disease
Control and Prevention {CDC}
announces the following meeting.

Name: Scientific Review of Draft Current
Intelligence Bulletin on the Carcinogenic
Potential of Occupational Exposure to
Asphalt Products.

Times and Dotes: @ 2.m.~5:30 p.m.
Decomber 1, 1993: 8 a.m.-12 noun, December
2,193.

Place: Robert A. Taft Laboratories.
Auditorium. NIOSH. CDC. 4676 Columbia
Parkway. Cincinnati, Ohio 45226.

Status: Open to the public. limited only by
the specu evailable.

Purpose: Tha purpose is to review and
discuss the draft of Current Intelligence

Control of Chemical Exposures and
Ergonoic Risk Factors in Commercial
Dry Cleaners; Meeting

‘The National Institute for
Occupational Safety and Health
(NIOSH) of the Centers for Disease
Control and Prevention (CDC)
announces the following meeting.

Name: Control of Chemical Exposures aad
Ergonomic Risk Factors in Commercial Dry

time and Date: 1 p.m.—5 p.m., December

Place: Alice Hamilton Laboratory.
Conference Room C, NIOSH. CDC. 5555
Ridge Avenue. Cincinn:

‘Status: Open to the public, limited only by
the space available.

Purpose: The purpose of this meeting is to
review the protocol for a
study entitled “Control of
Exposures and Ergonomic Risk Factors in
Comme:cia! Dry Cleaners.” This study would
evaluate perchioroethyienc exposures
associated with the use of various
cleaning control technologies. It would elso
evaluste chemical exposures during the
spotting process and ergonomic risk factors
during pressing. The goal of this study is to
identify technologies elective in reduciug
these hazards to the dry cleaning worker.
Viewpoints and suggestions from industry,
labor, ecademia. other government agencies,
and the public are invited.

Contoct Person For Additional
Information: Gary S. Earnest. NIOSH. CDC,
4676 Columbia Parkway, Mailstop R-5.

262

Cincinnati, Ohio 45226, telephone $13/841-
4370.

Dated: November 8, 1993.
Associate Director for Policy Coordination
CEOGT for Disease Control aud Prevention
{FR Doc. 93-27348 Filed 11-12-93; 8:45 aml
en.uma CODE 4180-10-40

National institute for Occupational
‘Safety and Health; Request for
Existing Information Relevant to
implementing the Workers’ Family
Protection Act

AGENCY: National Institute for
Occupational Safety and Health
(NIOSH). Centers for Disease Control
and Prevention (CDC), Public Hes!th
Service (PHS), Department of Health
and Human Services (DHHS).
ACTION: Notice of request for evxusting
information.

Summary: NIOSH is requesting existing
information on the contamination of
workers’ homes by hazardous chemicals
and substances transported from the
workplace on equipment, clothing. or
the worker's person. This information
would include existing reports uf
incidents resulting in familial
poisonings or illnesses. methods of
preventing and remediating such
incidents, relevant statutes and
regulations to prevent such incidents,
and past investigations, enforcement
actions, and the role of governmental
‘agencies in preventing and responding
to such incidents.

DATES: Information in response to this
notice should be submitted by February
14, 1994.

ADDRESSES: Please submit two copies of
any information to Diane Manning,
Docket Offa Manager, Division of
Standards Development and Technology
Transfer, NIOSH, 4676 Columbia
Parkway, C-34, Cincinnati, Ohio 45226.
FOR FURTHER INFORMATION CONTACT: Dr.
Steven Galson, Division of Standards
Development snd Technology Transfer,
NIOSH, 4676 Columbia Parkway, C-14,
Cincinnati, Ohio 45226, telephone 513/
533-8302.

‘SUPPLEMENTARY INFORMATION: The
Workers’ Family Protection Act (29
U.S.C. 671a), hereafter referred to es
“the Act,” was enacted on October 26,
1992, ns section 209 of Public Law 102-
522, the “Fire Administration
Authorization Act of 1992." The
purpose of the Act is to protect the
health of workers and their families
from hazardous chemicals and
substances, including infectious egents,
transported from the workplace to the

15:18 Mow 12, 1903 VerOese CO-NOV-E3 id 1S0257 PO.OOD0D Frm0003S Fi 4703 Sire 4703 EMAFMAPISNODPT! pirn03


‘Table 6. Health Effects of Take-Home Asbestos Exposure (Case Series)
—

INDUSTRY HEALTH @/RELATIONSHIP AGE AT DEATH COMMENTS/
EFFECT EXPOSURB ISSUES
a a ————_
‘Lieben and Pistawka Asbestos Mesothelioma: S-year-old girl whose father worked 3, 40, 67. Of 42 mesothelioma cases reported from 152
[1967] (insulation, shipbuilding) 1 pleural and with asbestos insulation. Pennsytvania hospitals 1958-1963, 3 were
USA 2 peritoneal. No numerical family members of asbestos workers,
40-year-old woman whose father and | exposure data given.
brother were asbestos insulation
workers,
67-year-old woman whose two sons
were shipyard asbestos insulation
workers.
Dalquen et al. Asbestos Pleural plaques 22 cases among domestic contacts 133 cases of pleural plaques and 145 cases of
{1970 asbestosis from the Hamburg area are
Germany reviewed. Of 92 cases of pleural plaques
with a history of exposure to asbestos dust, 34
were occupationally exposed, 22 domestically,
21 by urban dwelling and 10 by multiple
cause. S had no history of asbestos exposure.
‘The latency period for plaques was 40.2 years.
Heller et al. Asbestos Pleural mesothelioma woman. Washed pipefitter Radiological review of a series of 10 cases of
[1970] husband's asbestos-contaminated pleural mesothelioma seen at Massachusetts
USA work clothes. General Hospital 1960-1967, 1 case was the

wife of an asbestos worker.

Bittersohl and Ose
1971)
Germany

Asbestos (insulation and
products such as cords, seals,
plates, etc.)

Pleural mesothelioma

1 woman whose husband was
exposed to asbestos insulation at a
chemical plant. She laundered his
work clothes.

Exposure data given in
terms of East German
standard,

26 cases of pleural mesotheliomas from
chemical plants in the district of Merseburg,
East Germany. This group is made up of 22
patients from the Leuna Chemical combine, 2
patients from the Beuna Chemical Combine,
1 patient from a metal foundry, and 1 case in
the wife of a chemical plant workers.
Chemical plant workers were exposed to
asbestos insulation. All occupational cates had
been exposed to dust levels exceeding the
East German standard. This group includes
workers not directly working with asbestos,
but working near-by, Of the cases, 46%
occurred after retirement.



‘Table 15. (Continued) Workers’ Home Contaminatioa-Industrial Hygiene Aspects

Kawai et at, Lead Cottage industries: Air and surface sampling of dust in | Air in workshop: 2 to $0 g/m?
[1983] quench-hardening & 2 homes where family members Surface: 260 to 20,386 ppm of lead in
Japan type-printing. had elevated BLL. total dust,
Workshop surfaces:
Floor 3,000 to 20,000 ppm
Desk 4,500 ppm
‘Window frame 1,400 ppm.
Living area surfaces:
‘Carpets 1,000 to $,000 ppm
‘Window frame 260+ ppm
Television 380 ppm
Dining room floor 678 ppm.
Kaye et al, (1987] | Lead Electronics Workplace area samples contained | Lead in 11 dust samples from No protective clothing or worksite
Colorado components plant fead at 60-1,700 ve/m3, Dust workers’ homes, ranged up to 3,400 showers were used to prevent dust
making ceramic-coated samples were taken from vacuum ppm, and in 9 samples from non- from being taken home from the
capacitors & resistors. cleaners of both worker and non- worker homes it ranged from up to plant.
worker homes, and were analyzed 320 ppm.
for lead content,
Kelly (1994) Lead Manufacturing of Dust samples from carpets, ‘Carpets: 625 to 7,200 ppm
Ohio pewter products window sills, automobiles, soll and Other floors: 800 to 3,700 ppm
exterior surface dust of 3 workers’ ‘Window silts: 1,700 to 25,000 ppm
homes, Auto floor carpet: 700 ppm
Exterior dust & toil: < 16 to 8,200,
Koplan et al, Lead Pottery cottage 22 wipe samples of dust in work 20 samples had lead in dust > 1,000
[1977] industry leadglazing and living areas of 6 dwellings. #6/g: 13 samples from living areas
Barbados averaged 5,000 yzg/g. Lead in dust
ranged from 393 ug/g from a floor in
the dining room in one home to
325,892 ug/g from a table surface
where glazing was done.
Landrigan et al. Lead Stained glass window Lead levels in bulk-dust samples in | Mean lead concentration in studio (3
{1980) production in 1 home and 1 studio, samples) was 10,696 ppm. Mean
Georgia commercial studios concentration in home (2 samples) «
355 ppm.
Lundquist (1980) Lead Manufacturing of lead Informing workers of hazards of
USA batteries, home contamination and
Preventive measures.

190


Animal allergen

‘Table 14. (Continued) Health Effects of Take-Home Exposure to Other Substances

Veterinary medicine

Children suffered from asthma every
time they went to work with their father

Children were not exposed to animat
hairs in the home,

Denmark or every time he came home from work.
Grain dust Miller Case report Son developed asthma if the father did
not change clothes when he came home
from the mill.
Mushroom Mushroom farming Case report The son developed allergic symptoms
mycelium when mushroom mycelium was
exchanged.
Venables and Animal allergen Laboratory animal work ‘Cate report Husband developed asthma due to Tnitlal sensitization probably due to pet
Newman-Tayior animal allergens brought home on the rat but specific asthma symptoms
[1989] wife's person, ‘occurred specifically after contact with the
United Kingdom wife, an animal handler.
Platinum Precious metal refining Case report Wile developed recurrence of asthma Symptoms occurred when husband
after change in husband’s job. retumed from work. No symptoms on
weekends, Positive skin prick tests to
platinum salts used in his job.
US, Senate [1991] Otto fuel Hazardous waste ‘Cate report 2 children developed severe asthma after | The children’s illnesses improved after the
North Carolina incineration exposure to hazardous waste (primarily fathers stopped working at the
thought to be Otto fuel) on parental incinerator,
clothing.
Klemmer et al, Arsenic Wood treatment: pesticide Survey of arsenic in Higher values were found in the homes of
[1975] use house dust employees of pest control firms or firms
Hawaii dealing with wood preservation with
chemicals,
Falk et al. Arsenic Copper smelter Cate report Hepatic angiosarcoma, Exposure from fathers clothing, outside
(1981) environment and water supply.
United States

180



Several reports on contamination of clothing were found; however no associated
measurements of home contamination were found. Finley and Rogillio [1969]
found up to 12 ppm methyl parathion and up to 136 ppm of dichlorodiphenyl-
trichloroethane (DDT) in cloth worn by workers for 8 hrs. in a cotton field the
day after spraying. Clothing worn for 30 minutes while working in a freshly
sprayed cotton field was analyzed for methyl and ethyl parathion by Ware et al.
[1973]. Blue jeans contained 6-16 mg of methyl parathion and about 8 mg of
ethyl parathion, whereas T-shirts contained less than 1 mg of each of these
contaminants. Finley et al [1977] found methyl parathion at up to 32 ppm in
samples of cloth worn during 6 hours of work in a freshly sprayed cotton field,
and Graves et al. [1980] found permethrin at 25.8 ppm in a similar study of
cotton field workers.

A Study of corn-field sprayers’ clothing contamination by a water dispersible
granule of the herbicide atrazine after 4 hours of work in the field was reported
by Oakland et al. [1992]. Atrazine at up to 7 xg/cm’ of fabric was found.

A pair of coveralls that had been worn during pesticide applications for 4
seasons and washed after each use were analyzed for residual pesticides by
Stone and Stahr [1989]. Treflan® was found in samples of the coveralls at up to
43 ng/cm’, Lorsban® at up to 92 ng/cm’, and Counter at up to 15 ng/cm’,
demonstrating the persistence of these substances in contaminated clothing.

Clothing contaminated by pesticides can contaminate laundry equipment
[Laughlin et al. 1985; Laughlin et al. 1981; Laughlin and Gold 1988, 1989b] and
clothing washed with [Clifford and Nies 1989; Easely et al. 1983; Finley et al
1974; Kim and Wang 1992; Kim et al. 1993; Oakland et al 1989; Braun et al.
1989], or subsequent to [Laughlin et al. 1985; Laughlin and Gold 1989b;
Laughlin et al. 1981), the contaminated clothing. Clifford and Nies [1989]
found that a uniform on which ethyl parathion was spilled contained 7 g of
ethyl parathion/100g of clothing (70,000 ppm) after two washings. Clothes that
had been laundered with the originally contaminated uniform contained ethyl
parathion at 135-1,500 ppm. Other pesticides that have been shown to transfer
to clean clothing when washed with contaminated clothing include: 2,4-
dichlorophenoxyacetic acid(2,4-D)ester and amine [Easely et al. 1983]; methyl
parathion, toxaphene and DDT [Finley et al. 1974]; atrazine [Kim and Wang
1992; Oakland et al. 1989]; diazinon [Oakland et al. 1989]; and pyrazophos
[Braun et al. 1989].

Two reports of family poisonings associated with pesticide-contaminated
clothing also provide information on clothing as a source of home
contamination. West [1959] found that shoes worn home by a crop sprayer
were sufficiently contaminated with demeton to poison the worker's child who
contacted either the shoes or the paper towels that were used to clean them.

40


STATE AGENCY

Table 22, (Continued) Responscs of State Agencies to Incidents of Workers’ Home
Contamination — Publication in the Literature from State Agencies

REFERENCE

FINDINGS

Pennsylvania Department of Labor and
Industry

Fulton and Mattews (1936)

1936 - Report on effects of exposure to naphthalene and chlorodiphenyl (dermatological and
systemic effects) - case of dermatitis in child whose father had worked at plant and wore soiled
clothes home. The father played with child without changing clothes. The wife also had
dermatitis, as did an 11-month-old infant.

Tennessee Department of Public Health

CDC [1976]

1976 - Children of workers in secondary lead smelters. Children of workers had elevated BLLs,
supposedly because of parents’ contaminated clothing.

Vermont State Department of Health

Zirschy and Witherall [1987]

Hudson et al. {1985, 1987]

Watson et al. [1978]

1987 - Study of mercury from clinical thermometer plant being carried home on workers’ clothing.
Found increased air mercury levels in some of workers’ homes and increased urine mercury levels
in some children’s urine, Plant was closed and company was required to clean up workers’ homes.
Subsequently hired consultant, who developed protocol describing all cleaning procedures,
disposition of waste, personnel to be used and procedures to determine the success of the
decontamination. Paper describes contents of this protocol.

1985 + Study of the children of the thermometer plant workers, Mercury was found in urine of
workers’ children.

Children of workers exposed to lead at a battery plant had high BLLs and their homes had
elevated lead levels in house dust.

Virginia Commonwealth University

Garrettson [1988]

1987 - This is a report of a study of a radiator mechanics’ child with lead poisoning.

253


investigators concluded that it may be more practical to replace than clean
contaminated carpets.

In a study of contaminated homes near a lead smelter, the carpets were first
vacuumed with a high efficiency particulate vacuum cleaner equipped with a beater
bar attachment, then shampooed three times with an industrial grade shampooer
[CHM Hill 1991]. The carpets in this study had lead loadings of 130,000 pg/m* to
2,500,000 g/m’. The cleaning procedures reduced the loadings by only 0.9%-13.5%.
The authors estimated that 74 separate shampooings would be needed to remove all
lead from the carpets.

Vacuuming of lead-containing carpets with a power carpet beater followed by steam
cleaning with a commercial carpet cleaner containing a water-detergent mixture was
also found by Milar and Mushak [1982] to have little effect on the level of lead
contamination. Two steam cleanings 24 hours apart using detergent in the vacuum
cleaner reduced the concentration of lead in dust by 12% and the lead loading by
38%. When a Calgon® (sodium hexametaphosphate) solution (1 Ib/5 gal water) was
used for the initial steam cleaning followed a day later by steam cleaning with
detergent, lead concentration in the carpet dust was reduced by 61% and the lead
loading by up to 91%. The authors suggested that Calgon® coats the particulate
surface with phosphate or polyphosphate groups, reducing electrostatic interaction
with carpet fiber and allowing easier removal by detergent. When this method was
applied to decontaminating a home where a worker took home battery casings to use
for fuel in the family stove, a surface lead loading of 4,125 xg/m* was reduced to
1,961 »g/m? [Dolcourt et al. 1981].

Decontamination of other surfaces is generally more effective than cleaning carpets.
Farfel and Chisolm [1990] reported that the ability to reduce lead dust levels on
household surfaces after lead-paint abatement activities depended on their condition.
Smooth floor surfaces such as vinyl tile and linoleum tended to have lower dust levels
than wooden floors which tended to be pitted, splintered and worn.

HEPA vacuuming of bare wooden floors for 1 min/m’, removed from 14% to 62% of
the total lead removable (95% of that present) by vacuuming for 5 min/m? followed
by washing with tap water [Ewers et al. 1994b]; the condition of the floors was not
described. For linoleum floors, most of the lead dust that could be removed by
vacuuming for 5 min/m’ (75% of total dust present) was removed in the first two
minutes. With linoleum floors, about 20% of lead dust was removed by the post-
vacuuming washing, whereas less than 5% was removed by the post-vacuuming
washing of bare wooden floors.

PESTICIDES

Twenty-eight studies on decontaminating clothing contaminated with pesticides are
summarized in Table 16. Many of these studies were included in a review article by
Laughlin and Gold [1988]. The studies involve 33 pesticides with a wide range of

64


January 10, 1994

Dear Sir/Madam:

The National Institute for Occupational Safety and Health (NIOSH) has recently
published a Federal Register (FR) Notice (see enclosed) requesting information
relevant to implementation of the Workers‘ Family Protection Act (29 USC
671a).

The Act charges NIOSH with conducting a study of hazardous chemicals and
substances, including infectious agents, that are carried home by the worker.
The FR Notice describes the NIOSH responsibilities under the Act, including
the development of a report that will describe the extent of the home
contamination problem, the efficacy of actions taken to prevent home
contamination, and the role of government agencies in responding to incidences
of home contamination.

A task force mandated by the Act will review the report prepared by NIOSH and
determine if additional research data are needed to fully address the problem
of home contamination. If additional data are needed, the task force will
develop a strategy to obtain this information.

Since your organization may have access to information on take-home toxins, we
would greatly appreciate your assistance in obtaining information for the
NIOSH report. The types of information needed are described in the enclosure
and include clinical and legal case reports, laws or regulations, and any
other relevant data. We would also appreciate your sharing this request with
other interested agencies and groups. Information should be sent by
February 14, 1994 to Ms. Diane Manning (NIOSH Mail Stop C-34). If you have
any questions, please call Mr. John Whalen, at 513/533-8306.

Sincerely yours,

Richard W. Niemeier, Ph.D.

Director

Division of Standards Development
and Technology Transfer


REFERENCES

Abbritti G, Briziarelli L, Cicioni C, Siracusa A, Morucci P, Bellucci E, Greco M [1979].
[Increased lead absorption in children living in an area of concentrated ceramic
production] (in Italian). Med Lav 4:323-333.

Abbritti G, Cicioni C, Gambelunghe M, Fiordi T, Accattoli MP, Morucci P, Bellucci E.
Bauleo FA [1988]. Blood lead levels in children living in three communities at different
risks of lead pollution. Biomed Environ Sci 1(4):363-371.

Abbritti G, Muzi G, Cicioni C, Accattoli MP, Fiordi T, Morucci P [1989]. Effects of low
doses of lead on children’s health [Abstract]. Ann Ist Super Sanita 25(3):437-447.

Abel RR [1966]. Washing machine and fiberglass. Arch Dermatol 93:78.

Aggazzoti G, Fantuzzi G, Righi E, Predieri G, Gobba MR, Paltrinieri M, Cavalleri A
[1994]. Occupational and environmental exposure to perchloroethylene (PCE) in dry
cleaners and their family members. Arch Environ Health 49(6):487-493.

Agnew-Watson v. County of Alameda [1994]. 30 Cal. App. 4th 626.

Alabama Department of Public Health [1991]. Final Report. Child lead exposure study.
Leeds, Alabama. Atlanta, GA: U.S. Department of Health and Human Services, Public
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Registry, Report No. ATSDR/HS-92-13, NTIS No. PB92-123793.

Amato CA [1994]. Letter of February 14, 1994 re: home contamination in Virginia to
Ms. Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 2 pages.

Anderson H, Lilis R, Daum S, Fischbein A, Selikoff IJ [1979a]. Household exposure to
asbestos and risk of subsequent disease. In: Lemen R, Dement J, eds. Dusts and
disease. Chicago, Pathotox Publishers, Inc. pages 145-156.

Anderson HA [1983]. Family contact exposure. In: Proceedings of world symposium on
asbestos. Montreal, Canada, Canadian Asbestos Information Center. pages 349-362.

Anderson HA, Lilis R, Daum SM, Fischbein AS, Selikoff J [1976]. Household-contact
asbestos neoplastic risk. In: Saffiotti U, Wagoner JK, eds. Occupational carcinogenesis.
Ann NY Acad Sci 271:311-323.

Anderson HA, Lilis R, Daum SM, Selikoff TH [1979b]. Asbestosis among household
contacts of asbestos factory workers. Ann NY Acad 330:387-399.

99


Table 10, Health Effects of Take-Home Exposure to Caustic Substances

173

STUDY
CONTAMINANT INDUSTRY DESIGN RESULTS COMMENTS:
eee a a
‘Caustic Products Agriculture Cases were reported of milk pail cleaner Reports were of hospitalizations, Decrease attributed
potsonings. to media campaign generating awareness,
Denmark
Neidich Caustic Farm Products Agriculture Case report 14 children identified as receiving emergency 8/14 cases incurred second degree esophageal burns.
[1993] medical care, 6/7 CIP product ingestions occurred from other than
South Dakota the original containers.
‘Young Caustic CIP products Agriculture Case report 9 cases of caustic exposure requiring treatment 4 cases were liquid CIP ingestions (all admitted to
[1994] among farm children were identified in Wisconsin | hospital), 4 cases were eye injuries by caustic cleaning
Wisconsin for alkali injuries during February 1990 through agents, and 1 was a skin burn from liquid CIP.
October 1992.

Edmonton Caustic Alkali Agriculture Case report 10 children in Wisconsin were identified in which All 10 cases for farm children involved liquid dairy pipe
(1987) Ingestions CIP poisoning occurred over a period of 10 years | line cleaner (sodium hydroxide or potassium hydroxide).
‘Wisconsin (Clean-in-Place or CIP and presented to 4 WI hospitals.

products)
Pelegrin Caustic Atkali Agricutture Case report 4 children were admitted to Wisconsin hospital All 4 suffered esophageal burns (2 severe) and 1
{1995} Ingestion from March 1993 to Jan 1995. incurred gastric bums, too.
Wisconsin
Geisinger Medical Caustic Alkali Agriculture Case reports 4 children were identified that had been admitted | 1 fatality, a 17-month-old boy, was attributed to CIP
Center Ingestions to a mid-state hospital in PA. during a year period } products and a 2¥eyear-old sustained esophageal
(1991) (Clean-in-Place or CIP in 1990-91, stricture and perforation,
Pennsylvania products)
Leach and Leach CIP products and pipe} Agriculture Case report 19-month-old boy swallowed about 1 teaspoon of | He suffered esophageal burns resulting in scar tissue
[1992] line cleaner heavy duty CIP and pipe line cleaner. build-up in the esophagus.
Maryland
Jorgenson ‘Cleaner Agriculture Case report 21-month-old girl swallowed cleaner while in bam | Girl suffered second and third degree burns in her
1990) with parents, mouth, throat and esophagus.
Wisconsin.

Ue



Department of Health and Human Services, Public Health Service, Centers for Disease
Control, National Institute for Occupational Safety and Health, NIOSH Report No.
HETA 82-257-1571. 48 pages.

Bagnell PC, Ellenberger HA [1977]. Obstructive jaundice due to a chlorinated
hydrocarbon in breast milk. Can Med Assoc J 117:1947-1948.

Baker EL Jr., Folland DS, Taylor TA, Frank M, Peterson W, Lovejoy G, Cox D,
Housworth J, Landrigan PJ [1977]. Lead poisoning in children of lead workers: Home
contamination with industrial dust. N Eng J Med 296(5):260-261.

Baker EL Jr., Landrigan PJ, Glueck CJ, Zack, MM Jr., Liddle JA, Burse VW,
Housworth WJ, Needham LL [1980]. Metabolic consequences of exposure to
polychlorinated biphenyls (PCB) in sewage sludge. Am J Epidemiol 112(4):553-563.

Ballentine K [1994]. Letter of March 21, 1994 re: workers’ home contamination in
Alaska to Richard W. Niemeier, Education and Information Division, National Institute
for Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 1 page.

Barnett M [1994]. Letter of February 14, 1994 re: home contamination in Oregon to
Ms. Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 3 pages.

Beaudoin DE [1994]. Letter of February 9, 1994 re: workers’ home contamination in
Utah to Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 5 pages.

Beegle BB, Forslund BL [1990]. Letter of October 18, 1990 re: asbestos related house
cleaning activities to Bill Steuteville, Region HI, U.S. Environmental Protection Agency.
Available in Cincinnati, OH: Docket Office, Education and Information Division,
National Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 90

pages.

Belanger PL, Elesh E. Flesch JP [1979]. Health Hazard and Technical Assistance
Report: Kentile Floors, Inc., Chicago, Illinois. Cincinnati, OH: U.S. Department of
Health and Human Services, Public Health Service, Center for Disease Control, National
Institute for Occupational Safety and Health, NIOSH Report No. HE 78-73-612. 24

pages.
Bellin JS [1981]. Don’t take your “work” home with you. Occup Health Safety June:39-
42.

102


deaths among 663 observed deaths for this cohort. In evaluating the significance
of the mesothelioma mortality observed among these household contacts of
amosite asbestos factory employees, Nicholson [1983] estimated the expected
number of mesothelioma deaths to be 0.04, assuming an ambient air
concentration of 200 ng/m’. The standardized mortality ratio (SMR) for lung
cancer was 152 (25 observed vs. 16.4 expected); after 20 years latency, an SMR of
185 was observed [Anderson 1983]. Among females, those with 20 or more years
latency had an SMR of 170 (8 observed vs. 4.7 expected). Among males with 20+
years latency, there were 12 lung cancer deaths observed vs. 6.1 expected

(SMR = 197).

A retrospective cohort mortality study of 1,964 wives of asbestos cement
workers in Italy was conducted by Magnani et al. [1993]. The wives had no
history of occupational exposure. Cancer of the pleura was significantly elevated,
with an SMR of 792.3 with a 95% confidence interval of 215.9-2,028.8. The
women who died from respiratory disease had washed their husband’s work
clothes in the home for more than 10 years.

The prevalence of hyaline pleural calcification in the general population in
one area of Czechoslovakia was compared with three groups exposed to asbestos
by Navratil and Trippe [1972]. All three exposed groups had a statistically
significant increased risk of pleural plaques (p<0.01) compared with the general
population group. Pleural calcification was found in 0.34% (28/8,127) of the
general adult population who lived in the same district as the factory and who
were more than 40 years old, compared with 5.3% (42/800) among 800 asbestos-
exposed workers, 5.8% (9/155) among people living in the neighborhood of the
asbestos factory, and 3.5% (4/114) for relatives of asbestos workers, who were
more than 20 years old.

Community-Based Cohort Studies. Shipyard workers, most of whom had
bystander (secondary) exposure to asbestos on the job, and their families were
studied by Kilburn et al. [1985, 1986]. The prevalence of radiographic evidence of
asbestosis was 11% among their wives, 8% among their sons, and 2% among their
daughters (Table 3).

Case-Control Studies. Six of seven case-control studies (Table 4)
documented cases of mesothelioma among household contacts of asbestos
workers. Newhouse and Thompson [1965] found 9 (7 female; 2 male) family-
member cases among 76 mesothelioma cases versus only 1 control who was an
asbestos worker’s family member. Most of the women with mesothelioma had
laundered their husband’s work clothes. Whitwell et al. [1977] found a case of
mesothelioma in a man whose father brought home gas mask canisters for packing
with asbestos; there were no cases of domestic exposure to asbestos in the 100
case controls.


Richter ED, Neiman S, Yaffe Y, Gruener N [1980]. Lead exposure: Effects in Israel.
Israel J Med Sci 16(2):89-95.

Rigakis KB, Martin-Scott S, Crown EM, Kerr N, Eggertson B [1987]. Limiting pesticide
exposure through textile cleaning procedures and selection of clothing. Agr For Bull
10(2):24-27.

Rinehart RD, Yanagisawa Y [1993]. Paraoccupational exposure to lead and tin carried
by electric-cable splicers. Am Ind Hyg Assoc J 54(120):593-599.

Risberg B, Nickels J, Wagermark J [1980]. Familial clustering of malignant
mesothelioma. Cancer 45:2422-2427.

Rom WN, Lockey JE [1982]. Diffuse malignant mesothelioma: A review. West J Med
137(6):548-554.

Rubino GF, Scansetti G, Donna A, Palestro G [1972]. Epidemiology of pleural
mesothelioma in North-western Italy (Piedmont). Brit J Ind Med 29:436-442.

Rucker MH, McGee KM, Chordas T [1986]. California pesticide applicators’ attitudes
and practices regarding the use and care of protective clothing. In: Barker RL, Coletta
GC, eds. Performance of protective clothing. ASTM STP 900. Philadelphia, American
Society for Testing Materials. pages 103-113.

Rusby NL, [1968]. Pleural manifestations following the inhalation of asbestos in relation
to malignant change. J Royal Naval Med Serv LIV(2):142-148.

Ruyack JH [1994]. Letter of February 4, 1994 re: workers’ home contamination in
Indiana to Ms. Diane Manning, Education and Information Division, National Institute
for Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 1 page.

Sabes J [1994]. Letter of February 17, 1994 re: workers’ home contamination in
‘Wyoming to Richard W. Niemeier, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services.

1 page.

Satoh M [1979]. Photochemical reaction of chlorothalonil in organic solvents. Bull
Environ Contam Toxicol 22:590-597.

Sawyer RN [1977]. Asbestos exposure in a Yale building: Analysis and resolution. Env
Res 13:146-149.


Asbeatos (shipyard, sodium

‘Table 6, (Contiaued) Health Effects of Take-Home Asbestos Exposure (Case Series)

#/RELATIONSHIP

AGE AT DEATH
EXPOSURE

COMMENTS/
ISSUES

workers) included in the study.

Bianchi et al. Mesothelioma 6 women had history of domestic 92 malignant mesotheliomas were diagnosed
[1993] carbonate factor) exposure (laundering asbestos- between Oct. 1979 and April 1992 at
Itaty contaminated clothing of family Monfatcone Hospital. 6.5% of these were
members), associated with domestic exposure. 75 cases
had occupational history of exposure to
asbestos. One case had a history of probable
environmental exposure,
Lander and Viskum Asbestos work Pleura plaques, ‘Of 63 women (spouses of workers Adult women ‘The researchers attempted to enroll 125
(1985) Pleural calcification, exposed to asbestos) with indirect spouses of asbestos-exposed workers. 90
Denmark Pulmonary fibrosis, (non-occupational) exposure to participated in the study, 20 were excluded
Asbestosis asbestos, 9 (17%) had radiological due to lack of exposure (X-rays were normal).
changes characteristic of exposure to 5S were excluded due to occupational exposure
asbestos. Exposure consisted of (one had pleural plaques), 2 were excluded
laundering asbestos-contaminated for other pulmonary diseases,
work clothes.
Gibbs et al. Asbestos Pleural 1 male and 12 femaies with non- 47-2 84 cases diagnosed 1979-1986 chosen because
(1989) mesothelioma occupational exposure (Zielhuis the history of asbestos exposure was absent,
Wales group Il, eg, the wives of asbestos indirect, of ill-defined. 3 purposes of study

were: 1. correlate tung mineral count with
Zielhuis (1977) occupational exposure
groupings; 2. determine whether any
mesotheliomas were unrelated to asbestos
exposure; and 3, compate the role of
amphiboles and chrysotile in causation.
Conclude that: 1. Zielhius method too
complex; 2. mesotheliomas may develop in
absence of asbestos exposure; and 3,
amphiboles are more important than
chrysotile. Electron microscope mineral fiber
analysis data provided by exposure group.

157


Under the Occupational Safety and Health Act of 1970 (Public Law 91-596), NIOSH
research assessing the health of workers has also addressed the exposure of their families
to workplace contaminants, resulting in recommendations to prevent home
contamination. The Occupational Safety and Health Administration (OSHA) regulations
and actions intended to protect workers also help assure that families are protected. In
addition, OSHA can promulgate standards to protect workers’ family members when
workers are required to live in housing provided by the employer as a condition of
employment. Under the Federal Mine Safety and Health Act of 1977 (Public Law 95-
164), the Mine Safety and Health Administration (MSHA) has limited regulatory
authority to address issues of workers’ home contamination.

The U.S. Environmental Protection Agency (EPA) has broad authority under the Toxic
Substances Control Act (Public Law 94-469) to regulate chemicals and to obtain
information about the adverse effects of chemicals. In addition, EPA has specific
authority and responsibility regarding the use of asbestos and lead. Under the Federal
Insecticide, Fungicide, and Rodenticide Act (Public Law 92-516), EPA also regulates the
use and disposal of pesticides (which also helps to protect workers’ families). EPA and
the Agency for Toxic Substances and Disease Registry (ATSDR) are authorized under
the Superfund Amendments and Reauthorization Act of 1986 (Public Law 99-499) to
address hazardous waste and releases of hazardous substances that may relate to
identifying contamination of workers’ homes and assuring decontamination.

Thirty States and Puerto Rico responded to the requests from NIOSH for information
about State laws. Most indicated that there were no laws specific to workers’ home
contamination or protection of workers’ family members. Some States identified laws
requiring the reporting of cases of elevated blood lead levels and pesticide poisonings to
a State agency; other States identified laws related to work at hazardous waste sites and
emergency responses to releases of hazardous substances. An examination of
occupational safety and health regulations of States with OSHA-approved occupational
safety and health programs revealed none more stringent than Federal OSHA
regulations - with respect to the protection of workers’ families. However, extension of
occupational safety and health regulations to State and local government employees in
these States also helps protect the families of public employees’ in these States.

Responses to Incidents of Workers’ Home Contamination

Several Federal agencies have responded to incidents of workers’ home contamination,
often working together with State or local government agencies. These responses have
resulted in identification of workers’ home contamination, decontamination of workers’
homes, and recommendations for instituting workplace changes that would prevent
further contamination. NIOSH has conducted approximately 40 health hazard
evaluations that address potential home contamination. In several cases, Federal
agencies have referred incidents to State or local health departments for follow-up
actions.


‘Table 15, Workers’ Home Contamination~Industrial Hygiene Aspects

Industrial Hygiene Methodology
ER
Bohne and Cohen | Beryllium Beryllium production Fabrics exposed at worksite. Electrostatic charges increased fabric
{1988} contamination of cotton, but not
Ohio Nomex® fabric toading up to
2,800 ug/m?,
Chamberlin et al. Beryllium Beryllium plant S patients were family members of The authors state: "The
{1957] beryillum workers and cleaned their introduction of proper industelal
Pennsylvania dusty clothes. hygiene measures has evidently
reduced the number of new cases
of chronic granulomatous
Pheumonitis due to secondary
transfer, since none has been seen
by us for the past three years.”
Chesner (1950] Beryllium Beryllium plant Case histories of chronic Woman used empty berytilum ore
Ohio pulmonary granulomatosis ‘bags for dish clothes. She got the
bags from @ neighbor who worked at
the plant,
Cohen and Beryilium Beryllium refinery New and used shirts worn at work Beryllium concentrations ranged from Concentrations of resuspended dust
Positano [1986] were analyzed for beryllium in the 12 to 37 mg/m? in unwashed shirt from old, unwashed shirts up to
Ohio fabric, Fabrics were agitated in a fabric. Air concentration of beryllium 0.64 we/m? were found.
glove box to measure re-suspended measured in refinery was only @
beryllium. fraction of the PEL of 0.002 mg/m?,
‘The old shirts also showed
significantly higher concentrations of
beryllium and resuspended
significantly higher quantities of
beryllium to the air than newer shirts.
Elsenbud et al. Beryllium Beryllium production. Study of dust generated by laundry Alr concentrations of beryllium:
(1949) procedures using 100 uniforms shaking soiled clothes 0.1-1.2 mg/m,
Ohio worn for one day by plant scrubbing 3-7 g/m shaking and
employees. folding washed clothes 4-6 ug/m?.
Estimated inhalation dose during:
single home-cleaning of work clothes
was 17 ug of beryllium,
Anderson Asbestos Amosite asbestos Evatuate health status of 679 Family contacts had no other known Plant did not have change rooms or
et al. (1979) product manufacturing household contacts of asbestos asbestos exposure, 35% of household change of clothing available;
New Jersey workers, Interviews, X-rays, contacts had radiographic clothes were washed at home,
physical exams, abnormalities vs. $% of controls.

184



Hild DN, Laughlin JM, Gold RE [1989]. Laundry parameters as factors in lowering
methyl parathion residue in cotton/polyester fabrics. Arch Environ Contam Toxicol
18:908-914.

Hodous TK, Melius JM [1986]. Clinical Presentation. Occupational Respiratory
Diseases. Cincinnati, OH: U.S. Department of Health and Human Services, Public
Health Service, Centers for Disease Control, National Institute for Occupational Safety
and Health, DHHS (NIOSH) Publication No. 86-102:669-670.

Hofstetter I, Ewers U, Turfeld M, Freier I, Westerweller S, Brockhaus A [1990].
[Exposure to lead and cadmium of children living in a lead smelter area (Stolberg, West
Germany)] (in German). Off Gesundh-Wes 52(5):232-237.

Holt LE [1923]. Lead poisoning in infancy. Am J Dis Child 25:299-233.

Hooper CB [1991]. Letter of August 29, 1991 re: Frit Industries at Humboldt, Iowa for
Senator James M. Jeffords (Vermont). Available in Cincinnati, OH: Docket Office,
Education and Information Division, National Institute for Occupational Safety and
Health, Centers for Disease Control, Public Health Service, U.S. Department of Health
and Human Services, Cincinnati, OH.

Hudson PJ, Vogt RL, Brondum J, Witherell L, Myers G [1985]. Elemental mercury
exposure and uptake among children of thermometer plant workers. Burlington, VT:
Vermont State Department of Health, Division of Epidemiology. Available in
Cincinnati, OH: Docket Office, Education and Information Division, National Institute
for Occupational Safety and Health, Centers for Disease Control, Public Health Service,
U.S. Department of Health and Human Services. 16 pages.

Hudson PJ, Vogt RL, Brondum J, Witherell L, Myers G, Paschal DC [1987]. Elemental
mercury exposure among children of thermometer plant workers. Pediatrics 79(6):935-
938.

Huitink G [1994]. Letter of April 6, 1994 re: literature relevant to home contamination
in Arkansas to Ms. Diane Manning, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 34

pages.

Huncharek M, Capotorto JV, Muscat J [1989]. Domestic asbestos exposure, lung fibre
burden, and pleural mesothelioma in a housewife. Br J Ind Med 46(5):354-355.

Hung I-J [1980]. Lead poisoning in two families. J Formosan Med Assoc 79(8):740-748.

Jacobs DE [1994]. Guidelines for the evaluation and control of lead-based paint hazards
in housing: Clearance Draft. Report prepared by the National Center for Lead-Safe

117


ACKNOWLEDGEMENTS

The following individuals from the Centers for Disease Control and Prevention (CDC) participated
in the study of home contamination and the preparation of this report.

Karen E. Brewer

Secretary (Office Automation)

Information Resources Branch

Education and Information Division

National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

Peter A. Briss, M.D.

Medical Epidemiologist

Lead Poisoning Prevention Branch
Division of Environmental Hazards
and Health Effects

National Center for Environmental
Health

Centers for Disease Control and
Prevention

4770 Buford Highway, Mailstop F42
Atlanta, Georgia 30341

Mary Ann Butler, Ph.D.
Toxicologist (Research)
Experimental Toxicology Branch
Division of Biomedical and
Behavioral Science

National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

Henry S. Chan, M_P.H.

Senior Research Officer

Information Resources Branch

Education and Information Division

National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

271

Sharon L. Cheesman

Program Assistant

Risk Analysis and Document
Development Branch

Education and Information Division
National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

Joseph Costello, M.S.

Statistician

Epidemiological Investigation Branch

Division of Respiratory Disease
Studies

National Institute for Occupational
Safety and Health

1095 Willowdale Road

Morgantown, West Virginia 26505

Nancy J. Cox, Ph.D.

Chief, Influenza Branch

Division of Viral and Rickettsial
Diseases

National Center for Infectious Diseases
Centers for Disease Control and
Prevention

1600 Clifton Road, N.E., Mailstop G16
Atlanta, Georgia 30333

Jerome P. Flesch, M.S.

Industrial Hygienist

Risk Analysis and Document
Development Branch

Education and Information Division
National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226


Lundquist M [1980]. Surviving the OSHA lead standard. #9 Protecting workers’
families. Battery Man 22(11):27-28.

Lussenhop DH, Parker DL, Barklind A, McJilton C [1989]. Lead exposure and radiator
repair work. Am J Pub Health 79(11):1558-1560.

Lyngbye T, Hansen ON, Grandjean P [1991]. Lead concentration in deciduous teeth
from Danish school children. Dan Med Bull 38(1):89-93.

MacDonald JR [1988]. Quail Run, Gray Summit, Missouri. OSC FINAL REPORT,
SINV/EP&R/ENGV, March 3, 1988.

MacMillan AB [1964]. Accidental parathion poisoning. Appl Therap 6:128-131.

Madoff MA [1962]. Dermatitis associated with fibrous glass material. Tufts Folia Med 8
(July-Sept):100-101.

Magee F, Wright JL, Chan N, Lawson L, Chung A [1986]. Malignant mesothelioma
caused by childhood exposure to long-fiber low aspect ratio tremolite. Am J Ind Med
9(6):529-533. .

Magnani C, Terracini B, Ivaldi C, Botta M, Budel P, Mancini A, Zanetti R [1993]. A
cohort study on mortality among wives of workers in the asbestos cement industry in
Casale Monferrato, Italy. Br J Ind Med 50:779-784.

Mangum J [1994]. Memorandum of January 27, 1994 re: Tire and battery follow-up
investigation to the Epi File of the State of Alabama, Department of Public Health. 5
pages. Available in Cincinnati, OH: Docket Office, Education and Information Division,
National Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services.

Maravelias C, Hatzakis A, Katsouyanni K, Trichopoulos D, Koutselinis A, Ewers U,
Brockhaus A [1989]. Exposure to lead and cadmium of children living near a lead
smelter at Lavrion, Greece. Sci Total Environ 84:61-70.

Marceleno T, Donaldson H, Wallingford K [1974]. Survey of Grace Bleachery, Springs
Mills, Incorporated, Lancaster, South Carolina. Department of Health, Education and
Welfare, Health Services and Mental Health Administration, Center for Disease Control,
National Institute for Occupational Safety and Health, NIOSH Report No. IWS 33.17.

18 pages.

Marmon BP, Stoker MPG [1956]. The varying epidemiology of Q fever in the South
East region of Great Britain. II. In two rural areas. J Hyg 54:547.

125


Federal Insecticide
Pungicide, Rodenticide Act

Public Law 92-516

Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

(7 U.S.C. § 136]

(B) The regulations shall ensure, to the fullest extent practicable, that the containers-
@) accommodate procedures used for the removal of pesticides from the containers and
the rinsing of the containers;

(il) facilitate the safe use of the containers, including elimination of splash and leakage
of pesticides from the containers;

(iii) facilitate the safe disposal of the containers; and

(iv) facilitate the safe refill and reuse of the containers,

(2) Compliance
The Administrator shall require compliance with the regulations referred to in paragraph
(1) not later than $ years after the effective date of this subsection.

(€) Pesticide residue removal

(1) Procedures

(A) Not later than 3 years after the effective date of this subsection, the Administrator
shall, in consultation with the heads of other interested Federal agencies, promulgate
regulations prescribing procedures and standards for the removal of pesticides from
containers prior to disposal,

(B) The regulations may-

()) specify, for each major type of pesticide container, procedures and standards
providing for, at a minimum, triple rinsing or the equivalent degree of pesticide removal;

(li) specify procedures that can be implemented promptly and easily in various
circumstances and conditions;

(iil) provide for reuse, whenever practicable, or disposal of rinse water and residue; and

(iv) be coordinated with requirements for the rinsing of containers imposed under the
Solid Waste Disposal Act (42 U.S.C. $ 6901 et seq.).
(C) The Administrator may, at the discretion of the Administrator, exempt products
intended solely for household use from the requirements of this subsection,

(2) Compliance

Effective beginning $ years after the effective date of this subsection, a State may not
exercise primary enforcement responsibility under section 136w-1 of this title or certify an
applicator under section 136i of this title, unless the Administrator determines that the
State is carrying out an adequate program to ensure compliance with this subsection.



Obendorf SK, Solbrig CM [1986]. Distribution of malathion and methyl parathion on
cotton/polyester unfinished and durable press fabrics before and after laundering as
determined by electron microscopy. In: Barker RL, Coletta GC, eds. Performance of
protective clothing. ASTM STP 900. Philadelphia, American Society for Testing
Materials. pages 187-204.

Oern S, Odden S, Osnes M [1991]. [Familial clustering of asbestos-related disease] (in
Norwegian). Tidssker Nor Laegeforen 111(9):1099-1101.

Oliver T [1914]. Lead poisoning: from the industrial, medical, and social points of view.
PB Hoeber, New York. 286 pages.

Orris P, Kominisky JR [1984]. Health Hazard Evaluation Report: Hill-Murray High
School, Maplewood, Minnesota. Cincinnati, OH: U.S. Department of Health and
Human Services, Public Health Service, Centers for Disease Control, National Institute
for Occupational Safety and Health, NIOSH Publication No. HETA 82-310-1475. 26

pages.

Osorio AM [1994]. Letter of February 25, 1994 re: take-home exposures from
investigations of occupational and environmental hazards and illness to Richard W.
Niemeier, Education and Information Division, National Institute for Occupational
Safety and Health, Centers for Disease Control and Prevention, Public Health Service,
U.S. Department of Health and Human Services. 38 pages.

Osterholm MT, Forfang BA, Ristinen TL, Dean AG, Washburn JW, Godes JR, Rude
RA, McCullough JG [1981]. An outbreak of foodborne giardiasis. N Eng J Med 304:24-
28.

Otte KE, Sigsgaard TI, Kjaeruff J [1990]. Malignant mesothelioma: clustering in a family
producing asbestos cement in their home. Br J Ind Med 47(1):10-13.

O’Tuama LA, Rogers JF, Rogan W [1979]. Lead absorption by children of battery
workers [letter]. JAMA 241(18):1893.

Pacynski A, Budzynska A, Przylecki S, Robaczynski J [1971]. [Hyperestrogenism an
occupational disease among workers in pharmaceutical companies and their children] (in
Polish). Endokr Pol (Warsaw) 22(2):149-154.

Pacynski A, Robaczynski J [1968]. [Hyperestrogenism among the female employees of a
pharmaceutical works employed in the production of stilbestrol] (in Polish). Med Pracy
19(6):594-597.

Palmore CM [1994]. Letter of January 31, 1994 re: workers’ home contamination in

Kentucky to Richard W. Niemeier, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and

B1


mg/dL, suggestive of continued exposure. Concentrations of mercury in
her home dissipated over time.

ESTROGENIC SUBSTANCES
Overview
Children of pharmaceutical and agricultural workers exposed to substances with
estrogenic activity have developed hyperestrogenic syndromes as documented by
studies reviewed in this section and summarized in Table 14.

Background

Estrogenic substances include: the steroid female sex hormones estradiol, estrone,
and estriol; the synthetic estrogen diethylstilbestrol; and some naturally occurring
compounds such as coumestrol and genestin found in certain plants such as clover,
soybeans, and tulips; and zearalenone, a mycotoxin produced by numerous species
of Fusarium; and zeranol, a hydrated form of zearalenone [NTP 1982].

Occupational exposure to estrogenic substances primarily occurs in the
pharmaceutical industry, although, as discussed below, there are also exposures to
agricultural workers. Embalmers may also be exposed [Finkelstein et al. 1988;
Bhat et al. 1990]. If the exposures are not sufficiently controlled, workers and
family members may develop hyperestrogenic syndromes.

Hyperestrogenic syndromes consist of menstrual irregularities in women, breast
development in adult men and boys, and early onset of breast development and
menstruation in young girls. There is also concern that exposure to estrogenic
materials may be associated with breast cancer.

Review of Studies

There are seven references in Table 14 summarizing exposures of workers’ family
members to estrogenic substances. Two references {[Katzenellenbogan 1950;
Klorfin and Bartine 1956] describe an incident where five children of workers
engaged in the manufacture of diethylstilbestrol in Israel developed
hyperestrogenic syndromes. Three references [Budzynska and Robaczynski 1968;
Pacynski et al. 1967, 1971] describe a similar incident in Poland of hyperestrogenic
syndromes occurring among children of pharmaceutical workers exposed to
diethylstilbestrol. In both incidents, the chemical was brought home on
contaminated clothing. In Poland milk that had been contaminated at work was
also taken home for consumption. The children in Poland improved with
reduction of parental exposure or job change.

Aw et al. [1985] conducted a health hazard evaluation of a pharmaceutical
manufacturer in Indiana where five children of workers exposed to zeranol
developed enlarged breasts. Industrial hygiene recommendations were made to
prevent further contamination of the workers’ homes.


‘Table 17, (Continued) Federal Laws Relevant to Workers’ Home Contamination

‘Sections Refevant to Workers’ Family Protection

Comprehensive
Environmental Response,
Compensation, and Liability
Act of 1980 (CERCLA)

Superfund Amendments and
Reauthorized Act of 1986
(SARA)

Public Law 96-510

Public Law 99-499

[42 U.S.C. § 9601 et
seq]

$9601 Definitions

(8) "environment" means (A) the navigable waters, the waters of the contiguous zone,
and the ocean waters of which the natural resources are under the exclusive management
authority of the United States under the Magnuson Fishery Conservation and
Management Act (16 U.S.C.A. § 1801 et seq.], and (B) any other surface water, ground
water, drinking water supply, land surface or subsurface strata, or ambient air within the
United States or under the jurisdiction of the United States;

(9) “facility” means (A) any building, structure, installation, equipment, pipe or pipe line
(including any pipe Into a sewer or publicly owned treatment works), well, pit, pond,
lagoon, impoundment, ditch, landfill, storage container, motor vehicle, rolling stock, or
aircraft, or (B) any site or area where a hazardous substance has been deposited, stored,
disposed of, or placed, or otherwise come to be located; but does not include any
consumer product in consumer use or any vessel;

(14) "hazardous substance" means (A) any substance designated pursuant to section
1321(b)(2)(A) of Title 33, (B) any element, compound, mixture, sotution, or substance
designated pursuant to section 9602 of this title, (C) any hazardous waste having the
characteristics identified under or listed pursuant to section 3001 of the Solid Waste
Disposal Act [42 U.S.C.A. § 6921] (but not including any waste the regulation of which
under the Solid Waste Disposal Act (42 U.S.C.A. § 6901 et seq.] has been suspended by
‘Act of Congress), (D) any toxic pollutant listed under section 1317 (a) of Title 33, (E)
any hazardous air pollutant listed under section 112 of the Clean Air act [42 US.CA. §
7412], and (F) any imminently hazardous chemical substance or mixture with respect to
which the Administrator has taken action pursuant to section 2606 of Title 15. The term
does not include petroleum, including crude oil or any fraction thereof which is not
otherwise specifically listed or designated as a hazardous substance under subparagraphs
(A) through (F) of this paragraph, and the term does not include natural gas, natural gas
liquids, liquefied natural gas, or synthetic gas usable for fuel (or mixtures of natural gas
and such synthetic gas).

(18) "onshore facility* means any facility (including, but not limited to, motor vehicles
and rolling stock) of any kind located in, on, or under, any land or nonnavigable waters
within the United States;

(22) "release" means any spilling leaking, pumping, pouring, emitting, emptying,
discharging, injecting, escaping, leaching, dumping, or disposing into the environment, but
excludes (A) any release which results in exposure to persons solely within a workplace,
with respect to a claim which such persons may assert against the employer of such
persons, (B) emissions from the engine exhaust of a motor vehicle, rolling stock, aircraft,
vessel, or pipe line pumping station engine, (C) release of source, byproduct, or special
nuclear material from a nuclear incident, as those terms are defined in the Atomic Energy
Act of 1954 [42 U.S.CA. § 2011 et seq], if such release is subject to requirements with
respect to financial protection established by the Nuclear Regulatory Commission under
section 170 of such Act [42 U.S.C.A. § 2210], or, for the purposes of section 9604 of this
title of any other response action, any release of source byproduct, or special nuclear

225



‘Table 15. (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Kominsky et al. Asbestos ‘Wet & dry vacuuming Transmission electron microscopy ‘Wet vacuuming reduced carpet Air concentrations increased 2-4
[1999] to remove asbestos was used to analyze air samples contamination by 70%. There was no times during vacuuming compared
Ohio fibers from collected during vacuuming. significant evidence of change to prevacuuming levels.
contaminated carpets An EPA method was used for following dry vacuuming.
and determination of analysis of carpet samples.
airbome levels during Carpets contaminated at 1 million
vacuuming. and 1 billion asbestos
structures/ft?.
Decontamination by HEPA
filtered dry vacuum and hot-water
extraction cleaners,
Nicholson et at. Asbestos Workers’ home Air samples were collected in 13 Chrysotile asbestos samples ranged ‘These are the only measurements
[1980] contamination from homes of asbestos workers, from > 50 to > 2,000 < 5,000 ng/m3, of asbestos concentrations in
California & mining and milling workers’ homes,
Newfoundland asbestos.
NIOSH (1971) Asbestos Laundering-transfer of An asbestos-containing coat (8% Demonstrated substantial transfer of
Ohio fibers to other clothes asbestos) was dry cleaned with fibers to other clothes and to the dry
and cleaning solution, non-asbestos containing clothes, cleaning fluid.
Sawyer [1977] Asbestos Laundry Air samples collected on Asbestos fibers/em?: In this asbestos abatement project,
Connecticut membrane filter analyzed by phase Picking up clothing 0.4 controls were substantial so these
contrast mi . Samples Loading washer 04 are probably minimum estimates of
collected in building laundry, not Loading dryer 0.0 many home laundry exposures in
homes. Personal 0.4 (up to 1.2) the past. Clothes only wom for 4
hours.
Seixas and Ordin Asbestos Brake shoe Work clothing was vacuumed as ‘Vacuum samples from all work Potential for home contamination
[1986] manufacturing employees left work and dust was clothes contained chrysotile asbestos via clothes brought home by the
New Jersey analyzed using potarized light fibers. Quantitative data not workers. Provide clean uniform or
microscopy and X-ray diffraction. presented. disposable ones to all employees,
Separate solled work clothes from
Street clothes.
Abbritt et al. Lead Ceramic factories & Sampling of house dust. Mean lead concentrations in house
(1989) workshops at home Methodology not reported, dust were 2.7 and 4,7 mg/m* where
Ttaty workers were exposed in factories and

where workshops were adjacent to
houses, respectively (vs. 0.8 mg/m? In
controls).

186


‘Table 15. (Continued) Workers’ Home Contamination-Industrial Hygiens Aspects

Masek et al. 3,4-Benzo(a)pyrene. Pitch coking plant. 3,4-Benzo(a)pyrene in workers 34-Benzo(a)pyrene In underwear Author states that current washing
[1972] clothing. (pants) 31-930 g/g; (shirts) 410- method does not ensure effective
Czechoslovakia 1,100, in work clothes (pants) 7,760- removal of contaminant. Residual
35,000 ug/g; In shirts 1,400-14,000 contaminant after washing
ug/g. In washed clothes 12-5% pyg/g. increases with time of use, 41 pg/g.
at 2 wks, 315 ug/g at 12 months.
Versen and Bunn Diatomaceous earth Mining, processing, Air sampling in laundry area of Total dust 0.02-0.06 mg/m? inside
[1989] packaging home and outside home. Analysis home, 0,02-0.08 mg/m” outside home.
USA diatomaceous earth. via X-ray diffrection. Silica was detected but amount was
Laundering of work ‘below quantitation level.
clothing in employees
homes.
Weeks et al. Aromatic amines Not applicable Method development~chemical The spot tests can detect low levels of
11976) ‘spot tests (visualization & UV aromatic amines on surfaces; on paint
detection). 5-150 ng/em’; ‘on metal 15 ng/em?;
smooth concrete $00-S,000 ng/em2,
rough concrete 200-8,000 ng/em?,
Woody et al, ‘Cyclotrimethylene Explosives Mother reported seeing child
{1986] trinitramine (RDX) manufacture chewing on clumps of the
Arkansas plasticized RDX carried home on
work boots and clothing worn
home.
Pasanen et al. Pung Farming Air sampling with impactor; In farm homes: e to 104 colony ‘Study suggests that fungal spores
[1989] cultivation; SEM, forming units/m?; total spores at 1 were carried on clothes from cow
Finland to 10° spores/m” were 10-1,000 times bars to farmers’ homes.
levels in urban homes, Certain fungat
genera were measured in cow barns
and farmers homes but not in control
{ homes, |

204


e Preventing family members from visiting the workplace;

e Laundering contaminated clothing separately from family laundry when it is necessary
to launder contaminated clothing at home; and

e Informing workers of the risk to family members and of preventive measures.

Other preventive measures that need to be used include:

e Educating physicians and other health professionals to inquire about potential work-
related causes of disease;

e Developing surveillance programs to track health effects that could be related to
home contamination; and

e Educating children, parents, and teachers about the effects of toxic substances.

Procedures for Decontaminating Homes and Clothing

Decontamination procedures include air showers, laundering, airing, vacuuming and
other methods of surface cleaning, and destruction and disposal of contaminated items.
These procedures appear to have widely varying effectiveness, depending on the specific
methods employed, the contaminants, and the surfaces. In general, hard surfaces can be
far more easily decontaminated than clothes, carpets, and soft furniture. In most cases
effective decontamination requires relatively intensive methods. Normal house cleaning
and laundry practices appear to be inadequate for decontaminating workers’ clothes and
homes. Lead, asbestos, pesticides, and beryllium contamination can be especially
persistent. In some instances even intensive decontamination procedures may be
ineffective.

Another serious concern is that decontamination methods can increase the hazard to the
person performing the operation and to others in the household. Home laundering of
contaminated clothing exposes the launderer. Vacuuming of floors contaminated with
mercury can substantially increase air concentrations, and vacuuming of carpets
contaminated with lead can increase lead concentrations on the carpet surface.

The difficulty of decontaminating work clothing, the prominence of clothing as a source
of home contamination, and the potential exposure of the launderer are problems that
can be avoided through the use of disposable work clothing. The use, availability, and
cost of this alternative need to be assessed.

Federal and State Laws

Seven statutes provide Federal agencies with some mechanisms for responding to or
preventing workers’ home contamination. Twenty rules or standards in the Code of
Federal Regulations (CFR) address workers’ home contamination or have elements that
serve to protect workers’ families.


Federal Mine Safety and
Health Act of 1977

Public Law 91-173
Public Law 95-164

Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

[30 US.C. § 801 &
Seq)

$813 Inspections, investigations, and recordkeeping

Note 14. Refusal of owner-operators to permit an authorized representative of the
Secretary of Labor to enter upon and to conduct an inspection of their mine constituted a
continuing threat to the health and safety of miners and interfered with, hindered and
delayed the Secretary and his authorized representatives in carrying out the provisions of
this chapter, D.C. PA 1980, 491F, Supp. 1123,

Note 15. Where operator of small, family-owned rock quarry and his wife excavated rock
and marketed their product without the assistance of any employees and in view of fact
that the excavation of decorative rock was not subject to the type of license and reporting
requirements which place some business proprietors on notice of extensive federal
oversight, circumstances did not permit conclusion that the operator of the quarry
implicably consented to warrantless inspections of his quarry by representatives of the
Secretary of Labor pursuant to this chapter, C.A. Cal, 1980, 628P, 241255,

$877(I) The Secretary may require any operator to provide adequate facilities for the
miners to change from the clothes worn underground, to provide for the storing of such
clothes from shift to shift, and to provide sanitary and bathing facilities.

$951 Studies and research
(a) [The Secretary of Health and Human Services shall conduct studies}

(11) to determine upon written request by any operator or authorized representative of
miners, specifying with reasonable particularity the grounds upon which such request is
made, whether any substance normally found in a coal or other mine... . has potentially
hazardous effects, and shall submit such determinations to both the operators and the
miners as soon as possible[.)

(12) for such other purposes as... deem[ed] necessary to carry out the purposes of
this chapter.

(0) Activities under this section in the field of coal or other mine health shall be carried
out by the Secretary of Health and Human Services through the National Institute of
Occupational Safety and Health ....

(4) The Secretary of Health and Human Services shall also conduct studies and research
into matters involving the protection of life and the prevention of diseases in connection
with persons, who although not miners, work with, of around the products of coal or
other mines in areas outside of such mines and under conditions which may adversely
affect the health and well-being of such persons.

218



since 1990 indicate that pesticide exposure may continue to be a risk for families
of applicators and farmworkers.

Background

Pesticides are substances intended for preventing, destroying, repelling or
mitigating an insect, rodent, nematode, fungus, weed, or other life or for use as
plant regulators, defoliants or desiccants [McConnell 1994]. About 1,200
pesticides are registered for use in the United States. Pesticides can be classified
in various ways. When classified by use, the categories are:

e insecticides;

@ herbicides;

© fungicides;

e fumigants and nematocides; and
© rodenticides.

Insecticides include: organophosphates and carbamates, both of which inhibit the
enzyme acetylcholinesterase resulting in neurotoxicity; the naturally occurring
pyrethrum which may cause allergic reactions; the synthetic pyrethroids which may
cause digestive system symptoms, neurotoxicity, and death; and organochlorine
compounds which can cause neurotoxicity, liver damage, and cancer.

Other pesticides include: herbicides, most of which have low acute toxicity but
some of which are animal carcinogens; fungicides, which encompass a wide variety
of chemical classes, generally have low acute toxicity but have a wide spectrum of
effects such as enzyme inhibition and carcinogenicity; fumigants and nematocides,
a chemically diverse group of substances with high vapor pressure, can effect the
respiratory system and also act as systemic poisons; and rodenticides which
destroy the blood-clotting mechanism.

Most of the reports reviewed in this section involve the acetylcholinesterase
inhibiting insecticides, but reports on organochlorine insecticides and a fumigant
are also included.

Review of Studies

A 1%-year-old girl was poisoned by demeton when her father, a crop sprayer
came home with contaminated shoes [West 1959]. He cleaned the shoes with
paper towels, placed the towels in a wastebasket and left the shoes in the
bathroom. The child contacted either the towels or the shoes and became
unconscious. After treatment for organophosphate poisoning she recovered.

Three reports in the literature describe how poor hygiene practices in a chemical
plant that manufactured the pesticide kepone led to contamination of the homes
of workers [Cannon et al. 1978; Taylor et al. 1978; Kelly 1977]. Of the family
members that were examined, 94% had detectable levels of kepone in their blood,

18


CHAPTER 8 - RECOMMENDATIONS AND CONCLUSIONS

Based on the information.compiled and reviewed in this report a number of
recommendations for research and education needed to prevent workers’ home
contamination are identified in this Chapter. Also, a number of conclusions can be
drawn from the report, as discussed below.

Recommendations for Research and Education

The prevalence of health effects of contaminants transported from the workplace need
to be determined. One possible approach would be to conduct surveys among
occupational and environmental medicine health care providers and clinics.
Employment practices and controls that work best in preventing the transport of
contaminants from the workplace to the home should be identified, and the special
needs and problems of individuals who work in home or cottage industries need to be
identified.

Educational programs to prevent home contamination should be developed for
employers, workers, children, teachers, and parents, physicians, and other health
professionals.

Conclusions

Workers’ home contamination may pose a serious public health problem. Health
effects and deaths from contaminants brought home from the workplace have been
Teported in 28 countries and 36 States. The extent to which these health effects occur
is not known because there are no information systems to track them, and physicians
do not always recognize the occupational contribution to various common diseases.
About half of the reports of health effects from home contamination are less than 10
years old. The literature on the health effects involved approximately 30 different
substances or agents. The potential exists for many of the thousands of other
chemicals used in commerce to be transported to workers’ homes or to be used in
home-centered businesses.

Health effects and deaths from contaminants brought home from the workplace are
preventable using known effective measures, however educational programs are needed
to promote their use. Preventive measures are necessary because normal house
cleaning and laundry practices are often inadequate for decontaminating workers’
homes and clothing and can increase the hazard to the person performing the tasks
and others in the household.

Only two Federal laws have elements that directly address workers’ home
contamination. However, other laws provide agencies with certain mechanisms for
responding to, or preventing workers’ home contamination. Under existing laws,
OSHA, MSHA, DOE, ATSDR, EPA, and CDC, including NIOSH and the National
Center for Environmental Health have responded to incidents of workers’ home
contamination, made preventive recommendations, and conducted relevant research.

98


Milar and

Mushak [1982]
North Carolina

‘Table 15, (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Home contamination
of carpets containing
1,152-11,148 ppm of
lead

Caigon® solution in Steamex®
carpet cleaner followed by
detergent cleaner 24 hours later.

Detergent cleaning alone had little
effect on lead expressed either as ppm
in dust or lead in ug/m?, Calgon®
treatment followed by detergent
reduced contamination by 60% on the
average,

Details of decontamination
procedure are given. Effectiveness
demonstrated by concomitant
reduction in child’s blood tead.

cpc Lead Battery factory Lead in air, dust, paint & drinking No lead contamination in paint or ‘The employer made changes to
(1977 ‘water from 7 workers’ homes and ‘water and no airbome lead exposures reduce worker & family exposures,
See also soll samples from cars that were from factory emissions or busy including exhaust ventilation,
Dolcourt et at. driven to work, roadways. Lead in house dust 1,695 providing coveralls & improved
[1978} to 84,074 ug/g. Highest levels were shower facilities. Contaminated
North Carolina from closet where work clothes were homes were thoroughly cleaned,
stored (mean 31,840 ug/g). Mean
lead level in dust from cars was 2,770
vole.
cpc Lead Welding and soldering | Wipe samples. Shoes had lead at 4-20 g/cm,
[1924] with lead Floor of car had lead at 4 ug/em?,
Utah
Morton et al. Lead Battery making Questionnaires designed to Blood lead levels in children related ‘The authors recommend controts:
(1982) ascertain potential lead exposure to workers’ potential for exposure to showering, shampooing, changing
Oklahoma in homes. lead and to work practices, clothes and shoes before leaving
work. They also noted that only
changing clothes did not reduce the
risk.
Nelton and Clift Lead Poundry ‘Samples were collected from Lead was detected in all homes with
[1992] homes of foundry & non-foundry levels in carpets ranging from 10S
Oklahoma workers in & rural town. Samples ppm to 1,535 ppm.
collected included duet from
carpeting, dash of work vehicle,
and clothing. Samples were
analyzed by atomic absorption with
‘a graphite furnace,
Otorio Lead Cutting down Lead in worker's home and yard. Lead in backyard soll at 1,500 ug/L; Worker wore dirty clothing home
[1994] lead-sheathed cable lead in indoor housedust at 1,700 and laundered it with family
California ppm. laundry. Also took lead-

contaminated used telephone poles
‘home for fire wood.

192


INTRODUCTION

Because of repeated reports of contamination of workers’ homes in their States, identical
bills [WFPA 1991a], S. 353 [WFPA 1991b] and H.R. 845 [WFPA 1991c], were introduced
in 1991 by Mr. Jeffords (Vermont) and Mr. Ballenger (North Carolina) in the U.S.
Senate and the U.S. House of Representatives, respectively. The Senate Subcommittee
on Labor of the Committee on Labor and Human Resources held a hearing on S. 353 on
July 26, 1991 [U.S. Senate 1991a]. Following the hearing, the Committee on Labor and
Human Resources revised S. 353 and issued a report on November 27, recommending
the revised bill to the Senate [U.S. Senate 1991b]. The revised bill was incorporated into
the Fire Administration Authorization Act of 1992 (Public Law 102-522) as Section 209
of that law, which was enacted on October 26, 1992. Section 209, the Workers’ Family
Protection Act, appears in the United States Code at 29 U.S.C." § 671a (Appendix 1).

The Workers’ Family Protection Act requires the National Institute for Occupational
Safety and Health (NIOSH) to conduct a study on workers’ home contamination in
cooperation with the Secretary of Labor, the Administrator of the Environmental
Protection Agency, the Administrator of the Agency for Toxic Substances and Disease
Registry and other appropriate Federal Government agencies. The purpose of the study
is to evaluate contamination of workers’ homes with hazardous chemicals and substances,
including infectious agents, transported from the workplaces. The study is to consist of:
(1) a review of past incidents of hoge contamination reported in the literature and in
the records of NIOSH, the Occupational Safety and Health Administration (OSHA), the
States, and other governmental agencies, including the Department of Energy (DOE)
and the Environmental Protection Agency (EPA); and (2) an evaluation of current
statutory, regulatory, and voluntary industrial hygiene or other measures used by small,
medium, and large employers to prevent or remediate home contamination.

The Act directs NIOSH to report existing research and case histories conducted on
incidents of employee transported contaminant releases, including:

e The health effects, if any, of the resulting exposure on workers and their families;

© Methods for differentiating exposure health effects and relative risks associated with
specific agents from other sources of exposure inside and outside the home;

e The effectiveness of workplace housekeeping practices and personal protective
equipment in preventing home contamination;

© The effectiveness of normal house cleaning and laundry procedures for
decontaminating workers’ homes and personal clothing; and

e Indoor air quality, as the research concerning such pertains to the fate of chemicals
transported from a workplace into the home environment.

"United States Code.


TABLE OF CONTENTS

CHAPTER 5. DECONTAMINATION PROCEDURES ............-.-+ weeee 61
CHAPTER SUMMARY .......... 2 ccc ccc cect eee teen teen ees 61
DECONTAMINATION GUIDELINES ..............0 202 cece cee eee 61
REVIEW OF DECONTAMINATION PROCEDURES ...............-.55 62
BERYLLIUM ........ 0... cece cc cee eee eee e ere ene e eee nees 62
ASBESTOS 2.0.0... cece ec ee cee eee eee e teen e een eeee 62
LEAD . 2... eee eee teen ret ne ete en ee ternes 63
PESTICIDES 2.0... ccc ee cece ee eee cence eee eee e ence 64
CHLORINATED HYDROCARBONS eee cee eet eee teen tenet enee 68
MERCURY ... 2... ec cee ete eee tenet ete n cree eeeee 69
OTHER SUBSTANCES ........ 02. cece eee cece etter eee eens 70
INFECTIOUS AGENTS ........ 00. ccc e eect e ete eee eeeeee 70

CHAPTER 6. REVIEW OF EXISTING FEDERAL AND STATES LAWS ..... 72
CHAPTER SUMMARY ......... 0. c eee cece eect e eect nents 72
FEDERAL LAWS .... 2.1.22 cece eect tenet eee e teenies 72
STATE LAWS ... 2.02 cence eee eee teen ee eee eees 73
BACKGROUND .... 2... eee eee ere eee eee eter ence eet eteneees 73
REVIEW OF RELEVANT FEDERAL STATUTES AND RULES .......... 7S

Occupational Safety and Health Act of 1970 (OSH Act) ...........2.045 15
COS) 9 7 aaa 71S
NIOSH. 2.0.01 eee cc etree tee tence teen etnies 77

Federal Mine Safety and Health Act of 1977 (Mine Act) ............... 77

Toxic Substances Control Act (TSCA) .......-- 0... e eee eee ee eens 78

Asbestos Hazard Emergency Response Act of 1986 .........-...--+-5- 79

Residential Lead-Based Paint Hazard Reduction Act of 1992 ............ 79

Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) ........... 719

Comprehensive Environmental Response, Compensation, and Liability Act
(CERCLA) and Superfund Amendments and Reauthorization Act (SARA) 81

REVIEW OF STATE LAWS .... 0... cece cece ere cece rete ree ee rece 82
CHAPTER 7. RESPONSES TO INCIDENTS OF HOME CONTAMINATION ... 84
CHAPTER SUMMARY ....... 00.0. cece cece cece ete e eee eeeeee 84
RESPONSES OF FEDERAL AGENCIES ... 84
OVERVIEW ... 0... ccc ccc ccc cece cee cece rece een e rene teen ceeeene 84
Centers for Disease Control and Prevention (CDC) ..............---+- 85
National Center for Environmental Health (NCEH) ...........-.-.-- 85
National Institute for Occupational Safety and Health (NIOSH) ........ 86
ASDEStOS 20.6 ee ce eee teen net eeene 86

Lead 6... ccc cece cc cc cece cence eee eee e eee eceeees 87
Chlorinated Hydrocarbons ............ 2c cece cece eee eee eee 87

Mercury «0... ee cee eee tener nent ete eeee 87
Estrogenic Substances wee e eee cece eee tate en ence 87


EXECUTIVE SUMMARY

The Workers’ Family Protection Act of 1992 (Public Law 102-522, 29 U.S.C. § 671a)
directed the National Institute for Occupational Safety and Health (NIOSH) to conduct
a study of contamination of workers’ homes with hazardous chemicals and substances
(including infectious agents) transported from the workplace. NIOSH found that
contamination of workers’ homes is a worldwide problem; incidents have been reported
from 28 countries and from 36 States in the United States. Such incidents have resulted
in a wide range of health effects and death among workers’ families exposed to toxic
substances and infectious agents. About half of the reports of health effects have
appeared in the last 10 years, revealing new sources of contamination.

In completing the study, NIOSH solicited information from Federal and State health,
labor, and environmental agencies, groups with special circumstances such as firefighters,
and the public. NIOSH then reviewed and compiled the information received along with
information in published reports on contamination of workers’ homes by substances
brought home from the workplace. The report includes a survey of reported health
effects, information on sources and levels of contamination, preventive measures,
decontamination procedures, a review of Federal and State laws, and responses of
agencies and industry to incidents involving contamination of workers’ homes. This
report is being considered by the Workers’ Family Protection Task Force, which is
charged under the Workers’ Family Protection Act with evaluating the need for
additional research.

Health Effects of Workers’ Home Contamination

Workers can inadvertently carry hazardous materials home from work on their clothes,
skin, hair, tools, and in their vehicles. As a result, families of these workers have been
exposed to hazardous substances and have developed various health effects. Health
effects have also occurred when the home and the workplace are not distinct--such as on
farms or in homes that involve cottage industries. For some contaminants, there are
other potential sources of home contamination such as air and water pollution and
deteriorating lead paint in the home. Only a few of the studies found in the literature
used epidemiologic methods to estimate the relative risks of health effects from the
contaminant transported home by the worker independent of health risks due to other
sources of the contaminant in the home.

Little is known of the full range of health effects or the extent to which they occur as a
result of workers’ home contamination. There are no information systems to enable
tracking of illnesses and health conditions resulting from these circumstances. Many of
the health effects among workers’ family members described below were recognized
because of their uniqueness their clear relationship to workplace contaminants, or their
serious nature.


Easley CB, Laughlin JM, Gold RE, Tupy D [1983]. Laundering procedures for removal
of 2,4-dichlorophynoxyacetic acid ester and amine herbicides from contaminated fabrics.
Arch Environ Toxicol Contam 12(1):71-76.

Easter E [1983]. Removal of pesticide residues from fabrics by laundering. Test Chem
Color 15(3)29-33.

Easter EP, DeJonge JO [1985]. The efficacy of laundering captan and guthion®
contaminated fabrics. Arch Environ Contam Toxicol 14:281-287.

Edge JR, Choudhury SL [1978]. Malignant mesothelioma of the pleura in Barrow-in-
Furness. Thorax 33:26-30.

Edmonson MB [1987]. Caustic alkali ingestions by farm children. Pediatric 79(3):413-
416.

Edouard JC [1994]. Letter of January 28, 1994 re: workers’ home contamination in New
York to Ms. Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 1 page.

Ehrenberg RL, Smith AB, McManus KP, Hannon WH, Brightwell WS, Lowry LK, Anger
WK, Vogt RL, Brondum J, Hudson PJ [1986]. Health Hazard Evaluation Report: Staco,
Inc. in Poultney, Vermont. Cincinnati, OH: U.S. Department of Health and Human
Services, Public Health Service, Centers for Disease Control, National Institute for
Occupational Safety and Health, NIOSH Report No. HETA 83-465-1674. 81 pages.

Ehrenberg RL, Vogt RL, Smith AB, Brondum J, Brightwell WS, Hudson PJ, McManus
KP, Hannon WH, Phipps FC [1991]. Effects of elementary mercury exposure at a
thermometer plant. Am J Ind Med 19:497-507.

Eisenbud M, Lisson J [1983]. Epidemiological aspects of beryllium-induced
nonmalignant lung disease: A 30-year update. J Occup Med 25 (3):196-202.

Eisenbud M, Wanta RC, Dustan C, Steadman LT, Harris WB, Wolf BS [1949]. Non-
occupational berylliosis. J Ind Hyg Toxicol 31(5):282-294.

Eitzman DV, Wolfson SL [1967]. Acute parathion poisoning in children. Am J Dis
Child 114:397-400.

Elwood WJ, Clayton BE, Cox RA, Delves HT, King E, Malcolm D, Ratcliffe JM, Taylor

JF [1977]. Lead in human blood and in the environment near a battery factory. Br J
Prev Soc Med 31:154-163.

110


Lawrence Q. Foster, M.S.LS.

Head Librarian

Information Resources Branch
Education and Information Division

National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

David L. Hard, Ph.D.

Safety and Occupational

Health Specialist

Analysis and Field Evaluations
Branch

Division of Safety Research
National Institute for Occupational
Safety and Health

1095 Willowdale Road
Morgantown, West Virginia 26505

Denise Hill, B.S.

Writer/Editor

Training and Educational

Systems Branch

Education and Information Division
National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

Christopher C. Gjessing, B.A.
Public Health Advisor
Office of the Director
Division of Physical Sciences
and Engineering
National Institute for Occupational
Safety and Health
4676 Columbia Parkway
Cincinnati, Ohio 45226

Thomas K. Hodous, M_D.

Acting Chief of Injury Prevention
Analysis and Field Evaluations Branch
Division of Safety Research

National Institute for Occupational
Safety and Health

1095 Willowdale Road

Morgantown, West Virginia 26505

James H. Jones, CIH

Acting Deputy Director

Division of Physical Sciences and
Engineering

National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

Theodore M. Katz, B.A.

Supervisory Program Analyst

Office of the Director

National Institute for Occupational
Safety and Health

1600 Clifton Road

Atlanta, Georgia 30333

John Kelly, M.S.

Industrial Hygienist

Hazard Evaluations and Technical
Assistance Branch

Division of Surveillance, Hazard
Evaluations, and Field Studies

National Institute for Occupational
Safety and Health

4676 Columbia Parkway
Cincinnati, Ohio 45226

Bonita D. Malit, M.D., M_P.H.
Medical Officer

Education and Information Division
National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

Robert W. Mason, Ph.D.

Biologist

Risk Analysis and Document
Development Branch

Education and Information Division

National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226


promoter. Zeranol was brought home on contaminated work clothing. NIOSH
made recommendations to prevent home contamination [Aw et al. 1985]. NIOSH
also participated in a study on poisoning of farm children by diethystilbestrol
[Bierbaum 1993].

Agency for Toxic Substances and Disease Registry (ATSDR)

The Agency for Toxic Substances and Disease registry has conducted several studies
of hazardous waste sites that are relevant to workers’ home contamination. An
investigation of a chemical manufacturer in Adrian, Michigan showed detectable
levels of MOCA in the urine of workers’ families. The workers’ homes were
contaminated [ATSDR 1989a, 1990b, 1993b] by MOCA that may have been tracked
out of the workplace on the employees’ clothing and shoes. The homes were
decontaminated.

An investigation at the Bofors-Nobel, Inc. Company in Michigan found 3,3’-
dichlorobenzidene contamination in workers’ homes and 3,3’-dichlorobenzidene in
the urine of some workers and family members [ATSDR 1991b].

Other ATSDR reports describe investigations of contamination by MOCA [ATSDR
1989b], lead [ATSDR 1991a], and mercury [ATSDR 1990a]. In other cases, attempts
by ATSDR to evaluate workers’ home contamination failed because of inadequate
participation by workers’ families [ATSDR 1993a, Alabama Department of Public
Health 1991].

Occupational Safety and Health Administration (OSHA)

Although in general OSHA’s jurisdiction is limited to the workplace, through
interactions with State and local health departments some reports on workers’ home
contamination have resulted from its investigations. In addition, a recent review
article [McDiarmid and Weaver 1993] addresses issues of poor industrial hygiene,
cottage industries, and physician awareness as they relate to workers’ home
contamination.

[Natarajan 1994] described an OSHA investigation of a workplace in Texas after
learning of high BLLs in a child. The child's father (who also had an elevated
blood lead level) worked as a radiator repairman. Recommendations were made to
prevent further contamination.

The local health department in Kankakee, Illinois referred a case to OSHA of gross
lead contamination of a home [Wiehrdt 1994]. Two children were hospitalized and
chelated for lead poisoning. OSHA conducted a comprehensive inspection of the
battery plant where the father worked and found that he was bringing lead home on
his clothing.

OSHA suspected a potential home contamination problem while inspecting a local
plant in 1984 in Indianapolis, Indiana and referred the potential problem to the

88


Three cases of severe lead poisoning in children whose fathers manufactured lead
storage batteries in their homes were reported from the Philippines in 1952
[Anonymous 1952]. An Alaskan battery manufacturing shop investigated by Apol
and Single [1980] was located in the building where the owner and his family
lived; three of the owner’s children who also worked in the shop had elevated
BLLs. In a home where battery recycling took place, two children had BLLs of
about 65 4g/100 mL [Dolcourt et al. 1981].

Other cottage industries where family exposures to lead have occurred include:
(1) backyard smelters in Jamaica (lead on floors of children’s’ area at up to
109,000 g/m”) [Matte et al. 1991); (2) recovery of gold from scrap jewelry in
India [Joshua et al. 1971]; (3) quench hardening of cutlery in Japan; and (4) type
printing in Japan [Kawai et al. 1983].

Pesticides

Parathion contaminated sheets that had been purchased by a salvage dealer
operating out of his home were used by the family; one child who slept in the
sheets was severely poisoned on two occasions [Anderson et al. 1965].

Mercury

Mercury poisoning resulting from its use in homes for extracting gold from sand
has been reported on four occasions [Haddad and Stenberg 1963; Hallee 1969;
Hatch 1990; King 1954). In all of these reports, the person doing the extracting
was hospitalized; in two cases family members were also hospitalized [Haddad
and Stenberg 1963; Hallee 1969]. Mercury excreted in urine over 24 hours by 2
of the extractors were 557 yg and 2,100 ug; for family members 22-176 ug. One
of the extractors had a blood mercury level of 193 mg/dL.

FARMS

Farms and ranches are similar to cottage industries in that families live on the
property where work is performed. Three types of products used on farms ~
pesticides, caustics, and estrogenic substances have resulted in several incidents of
poisoning of family members.

Children playing with discarded pesticide containers [Wolfe et al. 1961; Johnston
1953} and pesticide contaminated items [Johnston 1953; Eitzman and Wolfson 1967]
on farms have resulted in poisonings by toxaphene and parathion. Farm children
also have been poisoned by: drinking from containers, such as cups and soft drink
bottles containing pesticides [McGee et al. 1952; Eitzman and Wolfson 1967]; and by
playing with or eating pesticides that have been improperly stored [Johnston 1953;
Simon 1963; MacMillan 1964].

Caustic products used on farms including dehorning products, disinfectants, drain

cleaners and pipe line cleaners containing sodium and potassium hydroxide have
been responsible for poisoning of over 40 children on United States farms in recent

47


Table 15. (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Process
———————S

Belanger et al. Asbestos Vinyl asbestos & Personal & area sampling Separate lockers for clean and dirty Recommendations were made to
[1979] asphalt asbestos floor clothes, Coveralls provided, Showers change clothes and leave all work
Minois covering manufacturing provided. clothes at work. Specifically, work
clothes must not be taken home to
be washed as this could expose
others at home.
Bianchi et al. Asbestos Asbestos related Interviews to determine For women, cleaning work clothing
(1987) industries occupational histories and practices | was the main source of exposure,
Teaty of washing clothes at home. Many women were exposed in this
way for more than 20 years.
Driscoll and Asbestos Manufacturing of Vacuumed samples of work clothes | Vacuum Samples: all clothing (n=7) Recommendation included leaving
Etott (1990) asbestos brake linings; and car seat via phase contrast was contaminated with asbestos, 4 of contaminated clothing at work and
Michigan production of microscopy (PCM) and 6 samples from workers car seats showering before leaving.
adhesives, seaters and transmission electron microscopy ‘were contaminated with asbestos.
paints, (TEM).
Giarelli et al. Asbestos A variety of work Review of 170 clinical cases in 5 cases had domestic exposures to
(1992) performed by shipyard | which necropsies were performed. | asbestos in cleaning the work clothes
Ttaly workers, dock workers of their husbands who were employed
and sailors in shipyards.
Gibbs et al. Asbestos Shipyard, lagging Study of 10 non-occupational cases 9 cases were due to exposures to
[1990] building and ordinance | of mesothelioma asbestos from washing husbands' work
United Kingdom work clothes.
Huncharek et al. | Asbestos Exposure of spouse to. | Post mortem fiber counts from Fibers/g of wet lung tissue: Husband was a shipyard machinist
(1989) contaminated clothing | removed lung Chrysotile 1.72 x 1 whose work clothes became
USA for 34 years. Amocite/crocidotite 59 x 103 covered with dust. His wife
Tremolite/actinolite/anthophyllite regularly laundered these clothes at
221 x 10°. home.

185


Pesticide poisoning resulted in fatal cases and serious non-fatal cases in workers’
children and adult contacts. Although most of the reports are dated 1980 or before,
the three reports since 1990 indicate that pesticides continue to be of concern for
families of applicators and farmworkers.

Chlorinated hydrocarbons resulted in five reports of health effects in family members
of exposed workers. There were other cases in which chlorinated hydrocarbons in
the urine or blood of family members were measured, but no adverse health effects
were reported.

Mercury was responsible for six incidents of workers’ homes being contaminated.

The most’severe cases of family poisonings occurred in cottage-industry type gold
extraction operations, but family members of chlor-alkali plant workers and workers
engaged in thermometer manufacturing were also exposed to mercury in recent years.

Exposure to estrogenic substances resulted in children of pharmaceutical and
agricultural workers developing hyperestrogenic syndromes consisting of menstrual
irregularities in women, breast development in men and boys, and premature onset of
breast development and menstruation in girls.

Asthmatic and allergic reactions of family members were associated with animal
allergens, platinum salts, mushrooms, grain dust, and Otto fuel.

Arsenic in mine and smelter dust brought home on a worker's clothing was
considered to be one source of poisoning of his child which resulted in a liver
angiosarcoma.

Cadmium contamination of lead-smelter workers’ homes resulted in elevated
concentrations of cadmium in the blood and hair of the workers’ children.

Fibrous glass contaminated clothing has been shown to contaminate other clothing
during laundry operations and to result in dermatitis of workers’ family members.

Cyclotrimethylenetrinitramine (RDX) resulted in an episode of status epilepticus in a
child due to ingesting RDX. The child’s mother worked in an explosives
manufacturing plant and transported clumps of RDX home on clothing and shoes.

Infectious agents as workers’ home contaminants was verified by five reports of
household members being infected with contagious diseases brought home on the
worker. In these 5 reports, 35 household members were reported to have been
infected with scabies, Q fever, mites, or giardiasis. It is believed that many additional
cases exist that were either not reported in the literature or were reported in such a
manner as to make them difficult to locate.


and Health, Centers for Disease Control, Public Health Service, U.S. Department of
Health and Human Services, Cincinnati, OH, NIOSH Report No. HETA 84-169.

Kominisky JR (1984c]. Letter of May 18, 1984 re: malathion and diazinon in firefighters’
protective clothing to Robert Chase. Available in Cincinnati, OH: Docket Office,
Education and Information Division, National Institute for Occupational Safety and
Health, Centers for Disease Control, Public Health Service, U.S. Department of Health
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Kominsky JR [1987a]. Health Hazard Evaluation Report: Jacksonville Fire Department,
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Kominsky JR, Freyberg RW, Chesson J, Cain WC, Powers TJ, Wilmoth RC [1990].
Evaluation of two cleaning methods for the removal of asbestos fibers from carpet. Am
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Kominisky JR, Singal M [1987]. Letter of March 24, 1987 re: electrical capacitor fire to
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Information Division, National Institute for Occupational Safety and Health, Centers for
Disease Control, Public Health Service, U.S. Department of Health and Human Services,
NIOSH Report No. HETA 84-276.

Konetzke GW, Beck B, Mehnert WH [1990]. [Remarks on occupational and non-
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Koplan JP, Wells AV, Diggory HJP, Baker EL, Liddle J [1977]. Lead absorption in a
community of potters in Barbados. Int J Epidemiol 6(3):225-229.

Kreibel D, Brain JD, Sprince NL, Kazemi H [1988]. The pulmonary toxicity of
beryllium. Am Rev Respir Dis 137:464-473.

Kreiss K, Newman LS, Mroz MM, Campbell PA [1989]. Screening blood test identifies
subclinical beryllium disease. J Occup Med 31(7):603-608.

Kress J, Crispell KR [1944]. Chemical pneumonitis in men working with fluorescent
powders containing beryllium. Guthric Clinic Bull 13:91-95.

121


Federal Mine Safety and
‘Health Act of 1977

Public Law 91-173
Public Law 95-164

Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

[30 USC. § 801 &
Seq.]

$802 Definitions

(g) “Miner” means any individual working in @ coat or other mine;

(h){1) “coal or other mine" means (A) an arca of land from which minerals are extracted
in non-liquid form or, if in liquid form, are extracted with workers underground, (B)
private ways and roads appurtenant to such area, and (C) lands, excavations, underground
passageways, shafts, slopes, tunnels and workings, structures, facilities, equipment,

machines, tools, or other property including impoundments, retention dams, and tailings
ponds, on the surface or underground, used in, or to be used in, or resulting from, the
work of extracting such minerals from their natural deposits in non-liquid form, or if in
liquid form, with workers underground, or used in, or to be used in, the milling of such
minerals, or the work of preparing coal or other minerals, and includes custom coal
preparation facilities. In making @ determination of what constitutes mineral milling for
purposes of this chapter, the Secretary shall give due consideration to the convenience of
administration resulting from the delegation to one Assistant Secretary of all authority
with respect to the health and safety of miners employed at one physical establishment;

Note 3. Coal or other mine
Definition of *coal mine” under subsection (h) of this section includes a commercial
purpose requirement, CA. 3, 1984, 748F. 24176.

Note 5, Miner

Owner operators who work the mines are ‘miners* within this chapter and fall within the
category of persons whose safety Congress desired to protect, D.C. PA. 1980, 491F Supp.
1123, This chapter's broad definition of *miner” as any individual working in a coal mine
rebuts any inference that a miner cannot also be an owner or operator. D.C, PA. 1978,
46SP, Supp. 838.

§ 803 Mines subject to coverage

Each coal or other mine, the products of which enters commerce, or the operations or
products of which affect commerce, and each operator of such mine and every miner in
such mine shall be subject to provisions of this chapter.

Note 5. One man, owner operated coal mine the products of which were sold totally intra
State, was not subject to requirements of this chapter, D.C. PA. 1973, 373F. Supp. 797.

Note 7. This chapter applied to smail coal mine even though only miners working therein
were four brothers who owned and operated the mine. C.A. PA. 1979, 604P, 24231,

Provisions of this chapter are applicable even though owner operators work the mine.
D.C. PA. 1980, 491F, Supp. 1123.

Ovwner-operated mine is not outside provisions of this chapter. D.C. PA. 1980, 487F,
Supp. 1376.

‘This chapter covers mines that are totally owned and operated by the same persons, that
is, those mines where the only persons working therein are the owners themselves. D.C.

217


e Normal house cleaning and laundry practices are often inadequate for
decontaminating workers’ homes and clothing and can increase the hazard to the
person performing the tasks and others in the household.

e Only two Federal laws have elements that directly address workers’ home
contamination. However, other laws provide agencies with certain mechanisms for
responding to, or preventing workers’ home contamination. Operating under existing
laws OSHA, MSHA, DOE, ATSDR, EPA, and CDC, including NIOSH and the
National Center for Environmental Health have responded to incidents of workers’
home contamination, made recommendations to prevent such incidents, and conducted
relevant research.


Kavanaugh E [1994]. Letter of May 31, 1994 re: workers’ home contamination in
Wisconsin to Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 3 pages.

Kawai M, Toriumi H, Katagiri Y, Maruyama Y [1983]. Home lead-work as a potential
source of lead exposure for children. Int Arch Occup Environ Health 53:37-46.

Kaye WE, Novotny TE, Tucker M [1987]. New ceramics-related industry implicated in
elevated blood lead levels in children. Arch Environ Health 42(2):161-164.

Keaschall JL, Laughlin JM, Gold RE [1986]. Effect of laundering procedures and
functional finishes on removal of insecticides selected from three chemical classes. In:
Barker RL, Coletta GC, eds. Performance of protective clothing. ASTM STP 900.
Philadelphia, American Society for Testing Materials. pages 162-176.

Kelly B [1977]. Allied chemical kept that kepone flowing. Business and Society Review
No. 2 Spring 1977:17-22.

Kelly RM [1994]. Letter of January 6, 1994 re: home contamination with lead to Steve
Galson, Education and Information Division, National Institute for Occupational Safety
and Health, Centers for Disease Control and Prevention, Public Health Service, U.S.
Department of Health and Human Services. 6 pages.

Kiefer M [1994]. Health Hazard Evaluation Report: Rosebud Company, Atlanta,
Georgia. Cincinnati, OH: U.S. Department of Health and Human Services, Public
Health Service, Centers for Disease Control and Prevention, National Institute for
Occupational Safety and Health, NIOSH Report No. HETA 93-0844-2411. 18 pages.

Kilburn KH, Lilis R, Anderson HA, Boylen T, Einstein HE, Johnson S-JS, Warshaw R
[1985]. Asbestos disease in family contacts of shipyard workers. Am J Pub Health
75(6):615-617.

Kilburn KH, Warshaw R, Thornton JC [1986]. Asbestos diseases and pulmonary
symptoms and signs in shipyard workers and their families in Los Angeles. Arch Intern
Med 146:2213-2220.

Kim CJ [1989]. Effects of convection-oven and microwave-oven drying on removal of
alachlor-residues in a fabric structure. Bull Environ Contam Toxicol 43:904-909.

Kim CJ, Stone JF, Coats JR, Kadolph SJ [1986]. Removal of alachlor residues from
contaminated clothing fabrics. Bull Environ Contam Toxicol 36:234-241.

Kim CJ, Stone JF, Sizer CE [1982]. Removal of pesticide residues as affected by
laundering variables. Bull Environ Contam Toxicol 29:95-100.

119


Axthor (year)

‘Table 7. (Continued) Health Effects of Take-Home Lead Exposure (Cohort Series)

Industry

Study Design

Results

Comments

Katagiri et al,
[1983]

Pottery
manufacturing

Cohort

89 3-yr olds from homes where.
pottery was made

70 S+yr olds from homes where
parent
works in pottery factory

947 3-yr olds from homes where no
‘one works in pottery

‘768 3-yr old controls

Children in groups 1 and 2 had
significantly higher urinary lead levels
(15.8 and 13.6 g/dL) compared to
control children (10.6 g/dL) and
compared to their mothers

(108 ug/AL).

Urine samples are questionable in
evaluating lead exposure.
8-aminolevulinic acid in urine was
not different between groups.

Coproporphyrin in urine was slightly
elevated in home pottery children,

Richter et al, (1985)

Battery factory

Cohort

18 Exposed children
‘729 Control chitdren

Among exposed children > 10 years
old, zine protoporphyrin > 40 ug/dL
was 4.1 times higher and among
exposed children < 10, zine
protoporphyrin > 40 ug/dL was 2.9

times higher than controls.

No BLLs were measured, Elevated
zine protoporphyrin can also be
influenced by iron deficiency. Other
health effects not reported,

Piccinini et al. Italy Ceramic tile Cohort Children in group 1 had a mean BLL | Used capillary sampling. No sex
[1986] 22 Children of tile workers exposed of 13.5 4g/4L compared with group 2 | differences found. No health effects
to lead mean of 12.2 and group 3 mean of | reported,
27 Children of tile workers not 10.7, Hair lead levels for the 3
exposed to lead groupe were 17.0, 9.8 and 7.8
2% Control children respectively.
Kaye et al, (1987) Colorado, USA Blectrical Cohort Exposed family members had No significant differences between
CDC [1985] components plant 89 Exposed family members significantly higher mean BLL groups in hemoglobin levels.
62 Clinic controls (10.2 g/dL) compared to unexposed
(6.2 ug/AL).
Abbritt et al. Italy Ceramic pottery Cohort Exposed children had higher mean Many of the pottery factories were
[1988) factories 136 Exposed children BLL (10.7 yg/dL) compared to home-operated. No differences
199 Community children community children (9 zg/dL) found by age or sex of child. No
(p<0.05). health effects reported,
Wang et af, (1989] | Taiwan Multiple Cohort Mean cord BLL of exposed Paternal contribution to cord BLL

105 Newborns of lead workers
102 Non-exposed newborns.

newborns was significantly higher
(88 ug/dL) than mean cord BLL of
unexposed newborns (6.9 ng/dL),
Birth weights and gestational age not
effected.

appears to be through either
working at home (n= 12 fathers) or
bringing lead dust home and
exposing mother.

162


asbestos fibers which results in reduced lung volumes and difficulty in breathing.
Pleural and hyaline plaques are localized thickenings which may be evident on
radiographs 20 or more years after exposure. Pleural and hyaline plaques
generally occur without symptoms but do provide a clinical marker of asbestos
exposure.

Mesothelioma has occurred following short term asbestos exposures of only a few
weeks, and can result from very low levels of exposure. There may be a latency
period of 40 years or longer between exposure and clinical disease. Symptoms
include chest pain, shortness of breath, and weight loss. Analysis of tissue
obtained by biopsy (or at autopsy) is required for a definitive diagnosis [Dement
et al. 1986]. Treatment is ineffective, with rapid disease progression and death
[Lilis 1986}.

Lung cancer may be associated with a range of symptoms including cough,
shortness of breath, bloody sputum, and weight loss. Definitive diagnosis is made
by tissue biopsy. Metastasis is common, and may present as bone pain or
fracture, seizure, or various other syndromes. Progression of lung cancer is
generally rapid, and treatments (including surgery, chemotherapy, and radiation)
are unlikely to result in long term survival [Hodous and Melius 1986]. Although
increased risk of lung cancer among household contacts of asbestos workers has
been observed, the high prevalence of cigarette smoking among lung cancer cases
frequently makes it difficult to detect cases which may be caused by exposure to
asbestos resulting from workers’ inadvertent contamination of the home.

Review of Studies

Information on exposure of family members has been elicited by questioning
patients or relatives about the practice of bringing work clothes home and
laundering the asbestos contaminated clothing at home. Other identified sources
of exposure of workers’ family members to asbestos include taking contaminate
items home from work and using asbestos in cottage industries [Magee et al. 1986;
Bittersohl and Ose 1971]. Additional evidence that exposures occurred in the
homes of asbestos workers is the finding of asbestos in lungs of asbestos workers’
family members who had no known exposures, other than contact with an exposed
worker {Whitwell et al. 1977; Ashcroft and Heppleston 1970; Huncharek et al.
1989; Gibbs et al. 1989, 1990; Giarelli et al. 1992].

Most cases of asbestos disease among workers’ family members occurred in
households where information indicated that asbestos-contaminated work clothing
was brought into the home and women were exposed during home laundering of
the contaminated work clothing [Ashcroft and Heppleston 1970; Dalquen et al.
1970; Edge and Choudhury 1978; Lander and Viskum 1985; Konetzke et al. 1990}.
Children were exposed by playing in areas where asbestos-contaminated shoes and
work clothes were located, or where products containing asbestos were used or
stored. It is of interest to note that male children of asbestos workers appear to

7


Table 1. (Continued) Health Effects of Take-Home Beryttium Exposure (Case Reports/Case Series)

Hardy (1965) Beryllium Case Registry 40 cases from household contact. All exposed to contaminated work clothes; 13

Hardy et al. (1952-1966) also exposed by alr pollution.
[1967]

144


‘Table 22. Responses of State Agencics to Incidents of Workers’ Home
Contamination — Publication in the Literature from State Agencies

CDC [1985; Kaye et al 1987]

STATE AGENCY RETERENCE FINDINGS
Alabama Department of Public Health CDC [1992b] 1991 - Battery reclamation workers had elevated BLLs and BLLs of some of the workers’ children
were high. Workers had inadequate hygiene practices; wore work clothes home, didn’t shower at
work, Closed plant.
California West and Lim [1968] 1968 - Mercury workers contaminated their homes with mercury from boots and work clothing,
Anonymous [1968] 1968 - Agencies developed a document on how to prevent mercury poisoning, including showering
before leaving work and company taundering of clothes.
West [1959] A child whose father was a crop sprayer was poisoned when his father wore contaminated shoes
home.
Colorado Department of Health Cook et al. [1993] 1993 - Assessed BLLs of children living in mining and smelting communities. Found that the

sources of exposure to lead were lead brought home on clothes and contaminated soil in yards,

Electrical component manufacturer. High BLLs in workers who wore work clothes home and
exposed children, significantly higher BLLs in workers’ children.

Lussenhop et al. [1989]

CDC [1989b] Elevated BLLs in workers who manufactured lead belt buckles, Wives and childrens’ BLLs were
elevated, Noted the importance of getting occupational histories from patients admitted for
treatment of lead poisoning.

Minnesota Department of Health ‘Winegar et al. [1977] 1977 - Lead smelter workers and families - BLLs and house dust concentrations of lead were

measured. BLLs up to 44 mg were found, Also found elevated house dust lead levels in workers’
homes and lead on workers and their clothing.

1989 - Some radiator repair workers had elevated BLLs, Screened 16 children - BLLe were
normal.

Vianna and Polan (1978)

New Jersey Department of Health Czachur (1995) 1994 - Conducted a pilot study on children of workers with elevated BLLs and found lead
contaminated clothing to be a source of elevated BLLs in the children,
New York Department of Health Nunez et all [1993] 1993 + Radiator repair - study of workers’ children and workers (67% of auto radiator repair

workers in 89% of shops in city), None of children’s BLLs were in excess of current guidelines,

1978 « Non-occupational exposure to asbestos in females (8 women with domestic exposures
because of husbands’ occupation had malignant mesothelioma).

North Carolina Wake County Department CDC (1977)

1977 « Take-home lead from battery plant employees, 72% of children of plant employees had

of Health increased BLLa. High concentrations of lead were found in cars and in closets where shoes and
work clothes were stored,

Oklahoma Department of Health Morton et al, [1982] 1982 « Studies of children of workers in Icad related industries « assessed exposure and measured
BLLa and personal hygiene practices of workers, Only good personal hygiene before leaving work
was effective for lead containment (showering, washing hair, changing clothes).

Pennsytvania Department of Health Licben and Williams (1969] 1969 + Respiratory diseases associated with beryllium refining in alloy fabrication « 95 workers and

“contact” cascs, some of whom were relatives of workers,

252



Table 8, Health Effects of Take-Home Lead Exposure (Community Studies)

Author (ear) Results
Martin et al, England Lead factory Community screening Of 4 children < age 5 with highest BLLs, 3 with No clinical symptoms of lead
(1974) 39 Children < age 5 tiving within levels of 75, 74, and 65 ug/mL were living close to poisoning. Not clear whether
400 m of factory factory and 2 of these had fathers working at these four were examined,
80 Children living 400-500 m from factory. Five of 10 surveys in vicinity of other lead
factory works found elevated BLLs in families of workers
252 Children at local schools (no other data available),
Landrigan and Texas, USA Ore smelting Community survey No children in worker households had BLL No health effects reported,
Baker (1981) 3 Households in survey include 240 pg/L.
smelter workers
Ewers et al. Germany Lead smelting Community survey Children of lead workers had higher BLLs than Capillary sampling; blood
[1982] 302 Exposed children other children (geometric mean = 19,7 vs, 14.2 samples were collected from
86 Children in control area Hg/AL; p < .05). Higher tooth lead levels were only a sample of children
associated with father's occupational exposure to (n=83), No health effects
lead. reported,
Carvalho et al. Brazil Lead smelting Community survey Exposed children had a significantly higher mean Results originally reported in
[1984] 104 Children (age 1-9) of lead BLL (67.5 g/dL) than unexposed children ‘an unpublished thesis by
workers. ($6.6 g/dL). Variation in hemoglobin levets was Carvalho (1982).
357 Children (age 1-9) of non-lead not associated with BLLs.
workers
Chenard et al. Canada Copper smelting Community survey All exposed children had significantly higher BLLs Additional sources of lead
(1987) 128 Children than control children, BLL ratios of exposed expoture such as hobbies and
Group 1 (35) exposed through groups 1, 2, and 3 to non-exposed were 1.83, 1.79, home assessment not
residence and father's work and 1.23 respectively. Al! BLLs in workers’ measured, Free erythrocyte
Group 2 (63) exposed through. children < 30 ug/dL. protoporphyrin is not
residence only significantly different between
Group 3 (30) exposed through exposed and control.
father’s work only
189 control children from nearby
community
Brockhaus et al. Germany Lead smelter Community survey Children of lead workers had significantly higher No health effects reported.
[1988] 9 Children of lead workers (age 4-5) mean BLL (18.4 g/dL) than controls (10.4

19S Control children (age 4-5)

e/6L).

164


Table 20, How State Agencies Respond to Incidents of Workers’ Home
Contamination — States that Have Their Own OSHA Program

INFORMATION FROVIDED TO NIOSH

Alaska Department of Environmental ‘The Department reported that it does not evaluate contaminated homes of workers (Ballentine 1994},
Conservation
Department of Labor ‘The Department reported that it has no jurisdiction to inspect homes and has no tracking mechanism [Study 1994].
Arizona Department of Health ‘The Department reported cases of childhood lead poisoning where take-home lead was probably the cause. The

State has blood lead reporting law which also covers pesticides. The Department had no referrals from the State
OSHA for take-home cases. Childhood pesticide exposure from workers storing pesticides in beverage bottles had
occurred; the Arizona Department of Agriculture now includes training on storing pesticides. The Department of

Health also submitted a case study of home extraction of gold with mercury, and provided a detalled description of
its occupational lead poisoning program [Fowler 1994a,b; Hatch 1990}.

California Department of Health Services ‘The California Department of Health reported that it has a surveillance system for BLLs. This information is
collected from all clinical labs for children under 16, Notification letters are sent to local health departments
where children with high BLLs are found. Forms for case management follow-up Include information on potential
take-home exposures, Local health departments are notified to investigate take-home exposures, Of cases with
elevated BLLs, 10% had a potential take-home cause. Case studies were submitted to NIOSH, The Department
also reported that California law requires physicians to report pesticide-related illnesses to the Pesticide Illness
Surveillance Program by notifying local health departments. One report was submitted to NIOSH on childhood
exposure to pesticides where farmworker children had elevated exposures, Recommendations are made for
changing, storing, and laundering contaminated clothing [Osorio 1994).

Environmental Protection Agency ‘The Department of Pesticide Regulation provided a report on childhood poisoning by pesticides (Griffin and
O'Malley 1992}.
Connecticut Department of Public Health and The Connecticut Department of Health investigated one case of possible contamination of worker's home by lead
Addiction Services carried home - two children were exposed (Jung 1994).
Indiana Department of Health ‘The Indiana Department of Health reported that it has no laws or rules on contamination of workers’ homes, but

were aware of # report [Baker et al. 1980] on « study conducted by CDC of persons in Indiana exposed to PCBs
from contaminated sewage sludge [Ruyack 1994; Steele 1994].

Department of Labor ‘The Department found one case of lead poisoning in a child whose father was exposed to lead. The company
provided for washing the worker's car and socks (Molovich 1991}.
lowa Department of Employment Services ‘The Department reported that the Bureau of Labor had investigated a plant where exposures to lead exceeded the
standard and one child was identified with lead poisoning (Hooper 1991).
Kentucky Department of Health Services ‘The Department of Health reported that it has no formal reporting system for home contamination incidents, they
are handled on a case-by-case basis [Auslander 1994],
Labor Cabinet ‘The Agency reported that it has no rules, regulations, or reports related to contamination of workers’ homes
(Palmore 1984].
Maryland Department of the Environment ‘The Department has investigated cases of lead exposure of children and provided NIOSH with coples of the case

feports, Maryland has a childhood lead registry and an adult lead registry which report overlapping canes to each
other (cross-matches) {de Sitva 1994], See also: Table 9.

248


FEDERAL AGENCY

Table 19. (Continued) Federal Agency Involvement in Incidents of Workers’ Home Contamination and Related Activities

RESPONSE

Hartle [1987]

Driscoll and Eliott [1990]

Matte and Burr [1989]

Gittleman et al, [1991]

Venable et al. [1993]

McCammon et at. (1991]

Donovan {1994a,b]

Kominsky and Singal [1987]

Kominsky (1984¢] Fabric samples from protective clothing of 3 firefighters were analyzed for malathion and diazinon. Laundry decontamination procedures were recommended,
Kominsky [19846] PCB contaminated firefighters clothes - Decontamination procedures for clothing were insufficient.
Selignman [1984] Follow-up. Evaluated health complaints of firefighters.
Kominsky [19876] Close out in 1987. Restated contents of previous 2 memos.
Kominsky [19840] Measured PCB concentrations in firefighters’ clothing worn at a fire. Clothing was replaced.
Orris and Kominsky [1984] | Maplewood, Minnesota, PCBs in high school. Made recommendation about laundering clothing to remove PCBs.
|| Kominsky [19874] Jacksonville, Florida. Firefighter suits contaminated with PCBs from fire at transformer oil reclamation facility, Recommendations made for decontaminating
garments, based on study of two different laundry methods,
Kiefer [1994] Atlanta, Georgia. Lead abatement recommendations for renovation of antique building-concem for workers and for occupants of house.

‘This was a joint request to NIOSH from EPA and ATSDR for technical assistance in connection with a PCB contaminated Amtrak railyard. NIOSH
recommendations to prevent contamination of workers’ cars and homes included shoe covers, personal protective equipment, and leaving tools onsite.

Chrysler Chemical Division, Trenton, Maine. Exposure to asbestos, solvents and lead. Found asbestos contamination of workers’ clothing, autos, and on workers
leaving for home. Recommended change facilities, showers, and company provision of work clothing.

Jamaican Ministry of Heatth, Kingston, Jamaica. Backyard battery repair shop - measured lead in houses and blood levels of family members. Found significant
contamination and recommended thet there should be separate entrances for shops and houses, that dust in workplaces be controlled, that work clothing, laundry
facilities, and showers be provided.

GT. Jones Tire and Battery Distributing, Inc., Birmingham, Alabama, Lead exposure from battery recycling. Took samples from workers’ autos. Found lead in
autos, which was not consistent with reports that most of workforce showered before leaving and maintained good hand-washing hygiene. Observed that only 20%
of workers showered before leaving work and 1/3 did not change work clothes at end of day. Recommended good personal hygiene (showers, clothing changes,
hand-washing).

Boston Edison Company, Boston, Massachusetts, Work in underground utility vaults. Wipe samples for lead from work surfaces, service vehicles, employee
clothing, and hands. Recommended hand-washing procedures, showering, and changing into non-contaminated clothing at the end of day.

New England Lead Burning Company, Salt Lake City, Utah, Wipe samples showed contaminated clothing, shoes (which wore home) and lead in workers’ cars.
Opportunity for lead exposure probably increased by lack of showering and practice of wearing work clothes home. Made recommendation to prevent home
contamination,

Kessler Studios, Loveland, Ohio. Home-based stained glass window studio, Did not appear that lead was migrating into house - results indicated that ventilation
and hygiene practices employed by the artists minimize their exposure and the contamination of their house with lead.

Firefighters in Groveport, Ohio. PCB contamination, Recommended disposable protective clothing to ultimately reduce problems of decontaminating equipment.

245


Despite the enforcement limitations implied by the decision in Diehl, OSHA has been
successful in promulgating several standards that serve, indirectly, to protect workers’
families from take-home contamination. These rules include the substance-specific
standards for asbestos, lead, arsenic, and cadmium. While these standards contain
provisions that reduce workers’ home contamination, the specific purpose of these
provisions is to prevent excessive worker exposure to these contaminants (i.e., employers
need not comply with these provisions unless workplace contamination exceeds
permissible exposure limits). These standards require, in part, that employers clean or
replace contaminated work clothes periodically, train workers to handle and store
contaminated work clothes properly, and provide shower and washing facilities for
employee use after each work shift. (See Table 18 for a detailed listing of these
requirements. Note, however, that these decontamination requirements do not apply to
the hundreds of hazardous substances regulated by OSHA under 29 CFR 1910.1000.)

Several of these standards recognize the importance of preventing workers’ home
contamination. For example, a statement in the preamble to the cadmium standard [S7
Federal Register 42349 (1992)] notes that "wearing contaminated street clothing outside
the worksite would lengthen the duration of the employee’s exposure and could cause
cadmium to accumulate in employees’ cars and homes, exposing other individuals to the
hazard." Later, at 57 Federal Register 42350, the preamble mentions that, to prevent
this contamination, the cadmium standard requires employees “to change out of work
clothes, which are then segregated from their street clothes, to shower before leaving the
plant, and to leave work clothing at the workplace, [which] significantly reduces the
movement of cadmium from the workplace." The purpose of this provision is to limit
additional worker exposure to cadmium and to “provide added protection to employees
and their families.”

Statements in the preamble to OSHA’s asbestos standards [59 Federal Register 49964
and 41012 (1994)] recognize the hazard of asbestos to workers’ family members, noting
that "studies have documented that in the past workers have brought asbestos
contaminated clothing home with them and thereby caused exposure and asbestos-related
disease among family members." OSHA found that this situation warranted “special
consideration"; therefore, the asbestos standards for construction and shipyards [29 CFR
1926.1101 and 29 CFR 1915.1001, respectively) require that employers control the
release of asbestos particles from contaminated work clothing using several different
procedures depending on the type (or class) of work being performed by the employees.

OSHA's lead standards [29 CFR 1910.1025, 29 CFR 1915.1025, and 29 CFR 1926.62]
have similar hygiene requirements. Appendix B of these standards, entitled “Employee
Standard Summary,” advises that “contaminated work clothing or equipment must be

willingness of a court to recognize a child’s claims as independent from any cause of action that could be
asserted by a parent.

76


Housing for the U.S. Department of Housing and Urban Development. pages 5-42 to 5-
47.

Jensen NE, Sneddon IB, Walker AE [1972a]. Chloracne: three cases. Proc Royal Soc
Med 65(8):687-688.

Jensen NE, Sneddon IB, Walker AE [1972b]. Tetrachlorobenzodioxin and chloracne.
Trans St John’s Hosp Dermatol Soc 58(2):172-177.

Joint Committee on Healthcare Laundry Guidelines [1994]. Guidelines of healthcare
linen service-1994. Hallandale, FL: Joint Committee on Healthcare Laundry Guidelines.
12 pages.

Johnston JM [1953]. Parathion poisoning in children. J. Pediatr 42:286-291.

Jorgensen NK [1981]. [Pleura plaques after indirect, non-occupational exposure to
asbestos] (in Danish). Ugeskr Laeg 143(9): 548-550.

Jorgenson D [1990]. Cleaners leading cause of poisoning among farm children.
Wisconsin Dairies May 1990.

Joshua GE, Ratnaike N, Benjamin V [1971]. Lead poisoning in a family of 18 members
in Vellore Town. Indian J Med Res 59(9):1496-1507.

Joubert L, Seidman H, Selikoff UJ [1991]. Mortality experience of family contacts of
asbestos factory workers. Ann NY Acad Sci 643:416-418.

Jung BC, [1994]. Letter of January 24, 1994 re: home contamination with lead in
Connecticut to Ms. Diane Manning, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 2

pages.

Katagiri Y, Toriumi H, Kawai M [1983]. Lead exposure among 3-year-old children and
their mothers living in a pottery-producing area. Int Arch Occup Environ Health 52:223-
229.

Katz L [1994]. Letter of February 14, 1994 re: workers’ family protection in New Jersey
to Ms. Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 1 page.

Katzenellenbogen I [1956]. [A dermato-endocrinological syndrome and problems
connected with the production and use of stilbestrol] (in Hebrew). Harefuah 50:240-241.

118


DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control
National Institute for
Occupational Safety & Health
Robert A. Taft Laboratories
4676 Columbia Parkway
Cincinnati OH 45226-1998

January 20, 1994

Dear Sir/Madam:

The National Institute for Occupational Safety and Health (NIOSH) has recently
published a Federal Register (FR) Notice (see enclosed) requesting information
relevant to implementation of the Workers’ Family Protection Act (29 USC
671la).

The Act charges NIOSH with conducting a study of hazardous chemicals and
substances, including infectious agents, that are carried home by the worker.
The FR Notice describes the NIOSH responsibilities under the Act, including
the development of a report that will describe the extent of the home
contamination problem, the efficacy of actions taken to prevent home
contamination, and the role of government agencies in responding to incidences
of home contamination.

Since your organization may have access to information on take-home toxins, we
would greatly appreciate your assistance in obtaining information for the
NIOSH report. The types of information needed are described in the enclosure.
I am requesting your assistance especially in regard to relevant state or
local laws, any actions that may have been taken, or could be taken by your
Agency in cases of home contamination, and methods and procedures used for
decontamination and prevention of future incidents. Information should be
sent by February 14, 1994 to Ms. Diane Manning (NIOSH Mail Stop C-34). If you
have any questions, please call Mr. John Whalen, at 513/533-8306.

Sincerely yours,

LAA (Lo

ichard W. Niemeier, Ph.D.
Director

Division of Standards Development
and Technology Transfer

269


MOCA contained in a carpet from a worker’s home. In this study, it was found that
dry vacuuming with a good household style vacuum was equal to or better than the
wet commercial method for removing MOCA from carpet.

When a transformer in a school building malfunctioned, dielectric fluid was vented
into the transformer vault {Orris and Kominsky 1984]. Contamination by PCBs,
trichlorobenzene, and tetrachlorobenzene occurred to varying degrees throughout the
building. All vertical and horizontal surfaces in the building were washed with liquid
alkaline synthetic detergent formulated for penetration and removal of PCBs. The
cleaning procedure reduced PCB surface concentration in the most contaminated
area by 98%, from 2,620 4g/100 cm’ to 46 4g/100 cm*. The cleaning procedure was
also effective in reducing concentrations of PCBs, trichlorobenzene, and
tetrachlorobenzene in air by 90-98%.

MERCURY
No information was found on decontamination of clothing contaminated with

mercury; however contamination of washing machines after laundering contaminated
clothing has been found [ATSDR 1990a; Hudson et al. 1985, 1988; Zalesak 1994].

Workers’ homes contaminated with mercury have been successfully decontaminated
[Zirschky and Witherell 1987; ATSDR 1990a; CDC 1995]. However, unless special
techniques are used, mercury vapor can be generated in the cleanup process [Votaw
and Zey 1991; Zey 1988] and vacuum cleaners can become contaminated [Tubbs and
Galson 1989; Zey 1984; Zey 1988]. An employee’s exposure to mercury while
vacuuming in a dental office was at 69 ug/m’* compared to 8.5 xg/m’ when not
vacuuming [Votaw and Zey 1991; Zey 1988]. Workers’ family members who
vacuumed and mopped floors in workers’ contaminated homes were found to be at
increased risk for elevated levels of mercury in urine [ATSDR 1990a].

Methodology used to successfully decontaminate workers’ homes includes vacuum
cleaners specially designed for mercury and use of mercury suppressants for cleaning
surfaces [Zirsky and Witherell 1987; ERM Southeast, Inc. 1989; ATSDR 1990a, CDC
1995].

Vacuum cleaners for mercury are equipped with a suction hose, vacuum pump, inline
mercury trap, charcoal filters to remove mercury vapor and HEPA filters to remove
mercury droplets [Reisdorf and D’Orlando 1984]. Mercury suppressants chemically
combine with mercury, enhancing the ability to remove it from contaminated surfaces
[Murphy 1978}. Using these procedures, 25 workers’ homes in Tennessee were
decontaminated to mercury concentrations that were less than 0.5 ug/m’ from
decontamination levels that were up to 5.0 ug/m’ [ATSDR 1990a]. The homes of
thermometer plant workers were decontaminated to levels below 1 g/m’ (Zirschky
and Witherell 1987]; the contaminant levels were not well described, but one report
indicated the levels may have been as high as "4 times the levels allowed at work"
[Trost 1985]. In a recent report of homes contaminated by children playing with

69


‘Table 15, (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Industrial Hygiene Methodology Industrial Hygicne Observation
Cannon et al, Kepone Manufacture Kepone in whole blood, Kepone in blood of family members 2 women who washed husbands
(1978) Interviews. 0,003-0.39 ppm; other residents 0.008- ] clothes developed symptoms of
Virginia 0.033 ppm. kepone poisoning.
Clifford and Nies Ethyl parathion Manufacture Laundry After spill, uniform was washed twice Potential poisoning of family
(1989) and still contained parathion at members was avoided because
Colorado 70,000 ppm; clothes washed with it company routinely laundered work
contained 135-150 ppm. clothes.
Finley and 1,2-bis-(p-Chlorophenyl)- | Cotton field work in 5 shirting-type fabrics were worn in | Up to 12 ppm of methyl parathion
Rogillio [1969] 2,2,2-trichloroethane. treated fields the field for 8 hours, and 136 ppm of DDT were found in
Louisiana (DDT) and methy! the exposed fabrics,
parathion
Finley et al. Pesticide (methyl Cotton field work in Cotton & cotton/polyester blends All-cotton fabric residue Recommended delaying reentry to
[1979] parathion) treated fields were wom by workers into a concentrations (21 ppm on day 1) day 4 and wearing 2 layers of
Louisiana cotton field treated with methyl were 49-68% of the cotton-blend clothing.
See Satoh [1979] parathion. Samples were collected residues (35 ppm on day 1), Clothing
‘on Ist, 2nd, and 4th days after contamination level on day 4 was 1%
spraying. of that on day 1.
‘Undergarments attained 55% of the
outer garment residue levels.
Ganetin et al. Parathion Pesticide application Case studies Non-fatal poisonings of pesticide All equipment which has been used
11964) application workers exposed to for apptication or handling of toxic
Arizona equipment previously used for insecticides must be considered
organophosphorus insecticide contaminated and dangerous until a
‘application. thorough decontamination is
performed. Such equipment shoutd
be kept in areas forbidden to those
who are uninformed of hazards.
Graves et al. Permethron Farming Fabrics worn for 6 hours in cotton Fabrics contained permethron at
[1980] field, about 25 ppm.
Louisiana

197


Amato [1994]

Virginia, USA.

Table 9. (Continved) Health EXfects of Take-Home Lead Exposure (Case Reports/Case Scrics)

Industry

Radiator repair

Study Design

Cate reports
1 Worker
2 Children

ba RE

Children had elevated BLLS (no other
data reported)

No health effects reported.

Propane tank 1 Worker Family member had elevated BLL (no
manufacturing 1 Family member other data reported)
Battery Number of workers not given Children had "mildly elevated" BLLs (no.
manufacturing 2 Children other data reported)
Barnett (1994) Oregon, USA Bronze foundry Case report 2 children under 2 years of age had BLLs No health effects reported.
2 Children of exposed workers of 14 and 23 g/dL.
Czachur et al. [1995] New Jersey, Construction; Case series 8 children (29%) had BLLa 10-19 g/dL; Study was a follow-back of
USA Battery manu- 15 Workers highest BLL was 26 g/dL. workers with BLLS over 25
facturing; 28 Children #8/4L from adult blood lead
General registry; 46% response rate.
manufacturing No health effects reported,
Jung (1994) Connecticut Painting Case report Children’s BLLs were 16 and 19 yg/dL. No health effects reported.
USA 1 Worker Worker's BLL was 29.9 g/dL.
2 Children
Natarajan [1994] USA Radiator repair (Case report Child was found to have a BLL of Worker changed clothes
1 Worker 2A ug/SL. Father had BLLs of 52 and before going home but did not
1 Child 64 g/L. shower. No health effects

reported.

171



TABLE OF CONTENTS

FOREWORD ....... 02... cece e ccc eee ne cee teen eee eee eee neee iti
PREFACE .... 0.2... cece eee ec ee eee e eee eeseenes v
EXECUTIVE SUMMARY ........... 2.2. c cece cece eee e eee eee eens vii
Health Effects of Workers’ Home Contamination .................000e00e vii
Measures for Preventing Home Contamination .............. 2... eee ix
Procedures for Decontaminating Homes and Clothing . x
Federal and State Laws «0.22... cece eee cece eect e eee enee x
Responses to Incidents of Workers’ Home Contamination ..................-- xi
Limitations of the Report .... 2.2... cece cece cee ee ence eee eens xii
Recommendations for Research and Education . . . - xiii
Conclusions ......... 00... ce cece eee eee eee ee eeees xiii
INTRODUCTION ..... 0... ccc cee eee teen ene e eee e eee xxiii
CHAPTER 1. HEALTH EFFECTS OF WORKERS’ HOME CONTAMINATION . 1
CHAPTER SUMMARY .. 1
BERYLLIUM .......... 3
Overview ... 3
Background ...... 3
Review of Studies . . 4
ASBESTOS ......... 6
Overview ... -. 6
Background ...... 2.0... cece eect eee nee eee e en eeeeeee 6
Review of Studies 2.2.2... 0... eee teen e eee 7
Cohort Studies ...................0.0. 8
Community-Based Cohort Studies. ....... 9
Case-Control Studies ..............0-. 9

Case Reports 10
Case-Series 11

LEAD ......... 11
Overview ... 11
Background 12
Review of Studies of Blood Lead Levels .... 13
Cohort Studies ..................00008 14
Community Studies. .................. 15

Case Reports and Case Series .......... 15

Review of Studies of Other Health Effects ... se. 15
CAUSTIC FARM PRODUCTS ............. 00. c ee cece eee eee eee 16
Overview 2... ccc cece eee eee cece eens 16


REVIEW OF RELEVANT FEDERAL STATUTES AND RULES

Occupational Safety and Health Act of 1970 (OSH Act)

The purpose of the OSH Act is to protect workers while they are at their place of
employment. Workers’ home contamination has been addressed only in a limited
fashion by the two principle agencies established under the OSH Act, the Occupational
Safety and Health Administration (OSHA, responsible for the promulgation and
enforcement of occupational safety and health standards) and the National Institute for
Occupational Safety and Health (NIOSH, responsible for research needed to identify and
prevent occupational safety and health problems).‘

OSHA. In general, OSHA appears to have limited authority under the OSH Act to
develop and promulgate standards for protecting workers’ families directly; under this
authority, OSHA can protect workers’ families from workplace contaminants if workers
are required to reside in employer-provided housing as a condition of employment. This
determination was made by a federal appellate court in Frank Diehl Farms v. Secretary
of Labor. In this case, the employer (i.e., Frank Diehl Farms) provided employees, who
were seasonal workers, with temporary housing while they were harvesting vegetables;
employee use of this housing was voluntary. The housing was readily available, and little
or no rent was paid by the employees for the housing; nevertheless, some employees
chose to stay elsewhere. On inspecting this housing, OSHA cited the employer under
the standard that regulated temporary labor camps; this standard is codified at 29 CFR
1910.142. This enforcement action was based on an OSHA instruction interpreting the
standard to apply to any housing provided by employers to employees, whether or not
employee use of the housing was voluntary. The federal appellate court that reviewed
this case, however, interpreted OSHA’s authority differently. Finding that the term
“workplace” is commonly and ordinarily defined as "the place where one must be in
order to do his job,” the court held that OSHA could enforce this standard “[oJnly if
company policy or practical necessity force workers to live in employer provided housing
...." This decision, therefore, implies that OSHA could cite an employer for
contamination of workers’ homes only if these workers were forced to reside in the
housing as a condition of employment or because no reasonable alternative housing was
available.*

“Section 20(a)(6) of the OSH Act authorizes NIOSH to conduct health hazard evaluations. This section
requires that HHEs be performed after NIOSH receives “a written request by any employer or authorized
representative of employees..." Requests submitted by individual employees, members of their families, or
other parties do not satisfy this requirement.

While injury or death to employees resulting from workplace hazards usually are addressed under state
or federal workers’ compensation systems, family members who suffer health effects associated with workers’
home contamination may, under some circumstances, bring tort actions against culpable employers through
the appropriate state or federal courts. Even children who have been injured in utero as a result of their
parents’ exposure to workplace hazards have brought negligence claims against the responsible employers
(see, for example, Widera v, Ettco Wire & Cable Corp. [1994] and Agnew-Watson v, County of Alameda
[1994]; the outcome of these cases, however, has been mixed, and appears to depend in large part of the

7S


Silvany-Neto et al.

{1989]

‘Table 8. (Continued) Health Effects of Take-Home Lead Exposure (Community Studies)

Industry

Lead smelting

Study Design

Community surveys
1980 Survey

131 Children of lead workers
457 Community children

1985 Survey
108 Children of lead workers
142 Community children

Results

Children of lead workers had a significantly higher
mean ZPP level than controls both in the 1980
survey (35.4 vs. 24.9 g/dL) and in the 1985 survey
(26.3 vs. 22.8 ug/AL).

SE I ESR TR

‘Comments

Other health effects in workers
children not presented,

Maravelias et al. Greece Lead smelting Community survey ‘The mean BLL for the children of unskilled No health effects reported.
[1989] 514 Children living in smelting town workers (many of whom worked at the smelter)
was 23.3 g/dL. This was significantly higher than
the mean BLL of children of other workers.
Hoffstetter et al. Germany Lead and other Community screening Mean BLL 6.3 1g/dL (range 2.6-15.5 g/dL), BLLs significantly lower in
(1990) metal smelting 229 Children ages 6-7 Factors significantly associated with higher BLL, 1989 than in previous test
were: living in urban area, second-hand smoke, years (back to 1974). No
living in a family of foreigners or with a lead health effects reported,
worker.
ATSDR [1991] Pennsylvania, Lead plant Community survey Children (age 0-5) whose parents had a job with Poor response rate (27.7%);
USA 736 Study participants "definite" lead exposure had a mean BLL of numbers very small; no results
12.7 wg/AL compared with children whose parents statistically significant.
were unexposed (9.0 ug/AL). Erythrocyte protoporphyrin
levels for workers’ family not
reported separately.
Miesen [1991] Germany Metalturgicat Community screening Of schootchildren living with lead-exposed family No effects on red blood cells,
plant 491 Exposed (19 children < age 6) members, 16.7% had BLLs over 25 g/dL. hemoglobin, hemotocrit and
porphyrin.
Lyngbye et al. Denmark Multiple lead Community survey A positive association (4-fold relative risk) was Only half of eligible children
{1991} industries 101 First grade children with high found between dental fead and parental contributed a tooth for

dentine lead concentrations (above
18.7 ug/g).

99 Control children with low dental
lead (below 5 ug/g).

employment as a shipyard worker, welder, auto
mechanic or car painter.

analysis, No health effects
reported,

165


tules that protect workers’ families. These standards include: Child Resistant Packaging
[40 CFR 157]; Certification of Pesticide Applications [40 CFR 171]; Labeling
Requirements for Pesticides and Devices [40 CFR 156]; and the Worker Protection
Standard [40 CFR 170].

The provisions of the Worker Protection Standard contain requirements that, at least
indirectly, prevent workers’ home contamination. The principal purpose of this standard
is to protect workers from exposure to pesticides that are used during normal pesticide
operations by the agricultural, nursery, greenhouse, and forestry sectors; with regard to
the agricultural sector, this standard also requires prevention of accidental exposure of
workers and other persons to pesticides. The phrase "other persons” would include
family members (of both workers and the owners of agricultural establishments) who
may be in the vicinity of pesticide operations. Another provision of this standard [40
CFR 170.112] requires owners of agricultural establishments to prevent workers from
entering pesticide-treated areas until the pesticides have dissipated from these areas.
This provision also requires that protective clothing be: wom by workers while applying
pesticides; cleaned daily after use according to clothing manufacturers’ instructions and
instructions provided on pesticide-product labels;* cleaned separately from other
clothing; and stored, after cleaning, away from contaminated areas and separately from
other clothing. In addition, those who launder protective clothing must be informed of
the: pesticide-contamination problem; harmful effects of pesticide contamination; correct
methods of handling and cleaning protective clothing; and procedures to use in
protecting themselves from contamination. While the requirements of this provision
could, indirectly, do much to prevent workers’ home contamination, prevention is
incomplete because the owners of agricultural establishments are not required to provide
this protection for themselves or members of their immediate families; the standard
does, however, encourage them to do so.

The Certification of Pesticide Applications standard [40 CFR 171] requires certification
of pesticide applicators, including farm owners and farm workers, who apply restricted-
use pesticides; these applicators must be certified for each restricted-use pesticide they
apply. To be certified, these applicators must be able to read and understand the
pesticide-product label, and have practical knowledge of the correct use, storage,
handling, and disposal of pesticides and pesticide containers. Full compliance with these
certification requirements would do much to prevent workers’ home contamination.

The provisions of 40 CFR part 165, authorized under FIFRA at 7 U.S.C. 136(q), address
specifically the storage and disposal of pesticide containers. If these provisions were
properly implemented, the incidence of child poisoning resulting from improper disposal

“The Labeling Requirements for Pesticides and Devices standard requires that labels on pesticide
containers provide information regarding worker protection. These labels, however, are not required to
prescribe the decontamination procedures to be used on protective clothing. Shirts, short pants, shoes, and
other items of ordinary work clothing are not considered protective clothing and, therefore, are not subject to
these requirements.

80


‘Table 15, (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Industrial Hygiene Methodology

Industrial Hygiene Observation

Stasiuk [1993] Perchloroethylene Dry cleaning Survey of dry-cleaning 18% (471) of dry cleaners in New
(see also (PCE) establishments York State are in residential
Schneider et al. buildings.
[1993] PCE concentrations ranged from 15
New York to 197,000 g/m? in apartments above
dry cleaners using transfer machines,
160-55,000 g/m” above vented di
to-dry machines, and 6-1,910 g/m’
above non-vented dry-to-dry
machines.
ATSDR Mercury Chlor-alkall Decontamination method not Initial mercury concentration in, S Vacuuming and floor washing were
[1990a] Chemical plant described homes Mid 0.92(<2.0-5.0) g/m; risk factors for increased mercury
See atso Workers’ homes 5.0 ug/m? in livin ing quarters of ie absorption by workers! wives,
ERM Southeast contaminated homes. 54 g/m? over washing
Ine, [1989] machines, 7 g/m? over sinks, and 8-
Tennessee 10 wg/m” in workers’ cars. After
decontamination concentrations in
homes were 0 to 0.5 mg/m,
Benning [1958] Mercury Carbon-brush Plant had poor housekeeping, no Provide cotton smocks, clean at
Ohio manufacturing ventilation, no shower facilities or start of work shift, to be left at
change of work clothing policy so that | plant each day and laundered.
“workers could not avoid taking a
certain amount of contaminant home."
Danziger and Mercury Scientific glassware Observation Mercury particles became embedded The authors recommend that
Possick 1973} manufacturing; in workers’ clothing, especially in workers not wear knitted clothing
New Jersey calibration of knitted fabric. Some female workers and that they wear impervious
Blassware. would shake mercury out of their aprons,
clothes when they arrived home.
Ehrenberg et al. Mercury ‘Thermometer and Flame absorption spectroscopy The NIOSH trailer which workers The measurements obtained in the
{1986] glass production for entered for medical exams became NIOSH trailer suggest the
Vermont scientific use. contaminated; air samples 2) possibility of offsite mercury

contained mercury at 23.4 and
215 g/m.

contamination via workers
inadvertently carrying mercury
home on their clothes, shoes, hair,
or skin.

201



GLOSSARY
acetylcholinesterase - an enzyme that catalyses the hydrolysis of acetylcholine to choline and acetic
acid.

angiosarcoma - a malignant tumor that originates from blood vessel elements in muscle and other
soft tissue.

allergen - a substance, often a protein, that stimulates cellular responses in the body resulting in
allergic symptoms.

allergy - hypersensitivity of the body cells to a specific substance (allergen) that results in various
types of allergic reaction.

anthrax - a disease from infection with the bacteria Bacillus anthracis.

arthropod vectors - arthropods (e.g., ticks, fleas, and mosquitoes) may transmit diseases to humans.
For example, Lyme disease may be transmitted through a bite from a tick and malaria is
transmitted to humans from mosquito bites.

asthma - a disease marked by shortness of breath and trouble breathing due to reversible
constriction of the bronchial tubes of the lung. It is often related to allergic conditions.

asthmatogen - a substance which triggers asthma attacks.

asbestosis - a fibrotic disease of the lungs caused by asbestos fibers, which results in reduced lung
volumes and difficulty in breathing.

berylliosis - a granulomatous disease of the lung related to inhalation of beryllium.
bronchoalveolar lavage - the washing out of the lung by multiple injections and removals of fluid.
blood lead level - the concentration of lead in the blood determined by laboratory methods.
chlamydia - small organisms that, like viruses, grow within host cells. However, their structure is
similar to bacteria. Chlamydia cause a number of human diseases including trachoma (a scarring

eye disease) and psittacosis (a pneumonia transmitted from birds to humans).

chloracne - an eruption of the skin resembling acne and resulting from exposure to chlorine or its
compounds.

conjunctiva - the mucous membrane covering the anterior (front) surface of the eyeball and lining
the lids.

coccidiomycosis - a systemic mycotic disease caused by the fungus Coccidioides immitis.

278


‘Table 14, Health Effects of Take-Home Exposure to Other Substances

(YEAR)

LOCATION CONTAMINANT INDUSTRY STUDY DESIGN RESULTS COMMENTS
Katzenellendogen Diethylstilbestro! Pharmaceutical Case reports 5 children of pharmaceutical workers 2 children improved after the parent
(1956) manufacturing developed hyperestrogenic syndromes. changed employment.

Klorfin and Bartine

[1956]

Terael

Budzynska et al. Diethytstilbestrol Pharmaceutical Cate report 6 children of employees who worked Exposure through in utero exposure vs.

[1967] manufacturing with estrogens developed take-home exposure was discussed,

Pacynski and hyperestrogenic syndromes. However, a stepchild who did not live

Robaczynski with the worker until the child was 4-year

(1968) old ruled out in utero exposure in that

Poland case.

Pacynski et al. Diethylstilbestrol Pharmaceutical Case report 6 children of employees who worked Same children as in prior 2 articles,

1971} manufacturing with estrogens developed However, in this article it stated that after

Poland hyperestrogenic syndromes. the workplace was investigated and
recommendations were carried out, the
hyperestrogenic syndromes disappeared in
all the children and diminished in the
workers.

Aw etal. Zeranol Pharmaceutical Cross-sectional study 3 male children of current workers and In the children of former workers, the

(1985) manufacturing of employees working | two children of former workers breast enlargement diminished after the

Indiana with hormones determined to have breast enlargement. parent left employment at this workplace.

Bierbaum Diethyistilbestrol Feedlot repair ‘Case reports 1976 NIOSH memos dealing with 4 ‘The 2 fathers of these 4 children repaired

{1993} children (ages 3 and 6) with feedlot bins containing feed supplemented

Kansas gynecomastia and pubic hair. with diethylstilbestrol.

179



‘Table 9, (Continued) Health Effects of Take-Home Lead Exposure (Case Reports/Case Series)

Fischbein et al. (1991, USA Pottery Case report Worker and her daughter had BLLs of 48 Physical exams, complete

1992} 1 Worker and 54 4g/100ml, respectively. Spouse's blood counts and routine
2 Exposed family members BLL was 20 4g/100mI. biochemistry screens were

within normal limits.
Erythrocyte protoporphyrin
levels in artist 225 ug/100 mL
of reé blood cells.

CDC (19924) Utah, USA Construction Case report BLL« in 1 family all < 4 ug/dL. Other Daughter 162 2g/100 mL of
2 Workers (number of family family had a 7 mo old with BLL of red blood cells, 8-
members not reported) 17 wg/dL. Home inspection revealed no aminolevulinic acid in urine

other sources of lead exposure. abnormal in all famity
members, No health effects
reported,

State of Alabama [1992] Alabama, Pottery Case report Children (age 2 and 14 mos) had elevated Pottery shop adjacent to

USA manufacturing 2 Workers (parents) BLLs (no other data reported) home.
2 Children No health effects reported.

Anonymous [1992] Virginia, USA | Not available Case report A 1-year-old child had a BLL of 56 Child received erythrocyte
1 Child of 2 workers g/dL. Mother (BLL=67 g/dL) and protoporphyrin 73 g/dL

father (BLL=21 g/dL) both worked in chelatin therapy, No other
a lead industry. health effects reported.
Nuneg et al. [1993] New York, Radiator repair Case series Mean blood lead level 10 g/dL (range 4 Over 30% of radiator shops
USA 7 Children of workers 21 wg/GL); 3 children had levels = 10 declined to participate. No
ug/4L. 79% of workers reported usually health effects reported,
changing their clothes and shoes before
teaving work,
eo Silva [1993] Maryland, Construction Caso report Construction worker with elevated BLL No health effects reported,
USA Adult blood tead registry (86 yg/4L) had a child with BLL of 26

2 Children

ug/4L. Second report was of »
construction worker with BLL of 35
ug/dL who had a child with BLL of 17
we/dL.

170


1991}. Action taken to prevent further contamination of the home included
washing the worker's car once per week and the company laundered his socks.

The New Jersey Department of Health [Stanbury 1994; Czachur et al. 1995]
conducted a pilot study of home contamination by lead in 1992. Elevated BLLs (>
40 g/dL) were identified in 98 persons through the State’s occupational lead
Tegistry and 45 were contacted, interviewed about their occupations and age of their
homes, and offered free blood lead testing for their children. BLLs were obtained
on 28 children from the families of 15 of these workers. Nine (32%) of these
children had BLLs considered to be a potential risk for adverse health effects (> 10
g/dL). The parents brought their work clothes home for laundering. Of six
children whose parents did not bring their clothes home to be laundered, none had
BLLs at 10 xg/dL or above.

Pesticides

Agricultural extension services in Arkansas [Lavy 1988; Huitink 1994), Florida
{Anonymous 1994], Iowa [Stone and Wintersteen 1988], Louisiana [Finley et al. no
date}, Michigan (Branson and Henry 1982], and Nebraska [Easley et al. 1981a;
Laughlin and Gold 1989c] have developed informational materials for farmers that
advise on preventive measures. These advisories include:

e training courses for pesticide safety;
e brochures describing safe application practices;

e brochures on proper laundering techniques for clothes worn during application;
and

e brochures on proper disposal of pesticides containers.

Other

A 1936 study by the Pennsylvania Department of Labor and Industry on the effects
of hexachloronaphthalene and chlorodiphenyl (PCB) exposure of wire insulation
workers attributed dermatitis in a young child to exposure from his father bringing
home contaminated work clothes [Fulton and Matthew 1936].

Hardy [1948] (a physician with the Massachusetts Department of Labor), in a
published paper on beryllium exposure and disease, cited a case of beryllium disease
in the mother of a beryllium worker. The suspected source of beryllium was
exposure to her daughter’s contaminated clothes. In the 1960’s, cases of beryllosis
among workers’ family members were investigated by the Pennsylvania Department
of Health [Lieben and Williams 1969].

96


Other Substances

Masek et al. [1972] found 3,4-benzo(a)pyrene at up to 14,000 ug/g of clothes in
the clothing of workers in a pitch coking plant. No measurements of home
contamination were made in this study.

Fibrous glass from contaminated work clothes can be transferred to non-
contaminated clothing washed with the contaminated clothing [Peachey 1967;
Abel 1966; Madoff 1962].

In the case of silica, one small study indicated that laundering contaminated
clothing could be done without contamination of the home area [Versen and
Bunn 1989).

Infectious Agents

There is one example where an infectious agent was isolated from clothing
contaminated at work [Marmon and Stoker 1956]. In this case, C. burnetti was
isolated from a shepherd’s clothing following an outbreak of Q fever among the
shepherd’s contacts. In another case, Q fever occurred in family members of
workers at a sheep research station. The family members had no contact with
infected animals and their infection may be explained by fomite spread [Rauch
et al. 1987], perhaps from contaminated clothing.

Radioactive Substances

Documented cases of home contamination by thorium, americium, and an
unidentified radioactive substance exist in the Occurrence Reporting and
Processing System (ORPS) database of the Department of Energy (DOE)
[Boyle 1994]. In the case of thorium, contaminated clothing was taken home
and a pillow case became contaminated, the americium was detected on a
worker's hat and his child’s diaper, and in the other case, the radioactive
material was found in the home on personal clothing worn home the previous
day.

Files of the U.S. Nuclear Regulatory Commission (NRC) were found to contain
three reports of nuclear power workers’ clothing being contaminated with
potential for, but unconfirmed, contamination of the workers’ homes [Brockman
1993}. These files also contain two reports of laboratory workers shoes being
contaminated by radioactive phosphorus (P-32) with subsequent contamination
of their cars; however, no mention of home contamination was made in the two
cases.

THE WORKER’S BODY

Although it is considered good industrial hygiene practice for many work situations to
shower before leaving work, and this practice is often recommended to prevent home
contamination, there is no quantitative information about contamination of workers’
bodies, except for the hands.

43


Toxic Substances Control
Act

‘Table 17. (Continued) Federal Lawa Relevant to Workers’ Home Contamination

[15 U.S.C. § 2601 &
Seq.)

$ 2605. Regulation of hazardous chemical substances and mixtures

(a) Scope of reguiation.—if the Administrator finds that there is @ reasonable basis to
conclude that the manufacture, processing, distribution in commerce, use, or disposal of a
chemical substance or mixture, or that any combination of such activities, Presents or will
Present an unreasonable risk Of injury to health or the environment, the Administrator
shall by rule apply one or more of the following requirements to such substance or
mixture to the extent necessary to protect adequately against such risk using the least
burdensome requirements:

(6)(A) A requirement prohibiting or otherwise regulating any manner or method of
disposal of such substance or mixture, or of any article contalning such substance or
mixture, by its manufacturer or processor or by any other perton who uses, or disposes
of, {t for commercial purposes.

(7) A requirement directing manufacturers or processors of such substance or mixture

(A) to give notice of such unreasonable risk of injury to distributors in commerce of
such substance or mixture and, to the extent reasonably ascertainable, to other persons in
Possession of such substance or mixture or exposed to such substance or mixture,

(B) to give public notice of such risk of injury, and

(C) to replace or repurchase such substance or mixture as elected by the person to
which the requirement is directed,

§ 2607 Reporting and Retention of Information

(c) Records-Any person who manufactures, processes, or distributes in commerce any
chemical substance or mixture shall maintain records of significant adverse reactions to
health or the environment, as determined by the Administrator by rule, alleged to have
been caused by the substance or mixture. Records of such adverse reactions to the health
of employees shall be retained for a period of 30 years from the date such reactions were
first reported to or known by the person maintaining such records. Any other record of
such adverse reactions shall be retained for a period of five years from the date the
information contained in the record was first reported to or known by the person
maintaining the record, Records required to be maintained under this subsection shall
include records of consumer allegations of personal injury or harm to health, reports of
Occupational disease or injury, and reports or complaints of injury to the environment
submitted to the manufacturer, processor, or distributor in commerce from any source,
Upon request of any duly designated representative of the Administrator each person who
is required to maintain records under this subsection shail permit the Inspection of such
records and shall submit coples of such records.

(€) Notice to Administrator of substantial risks-Any perton who manufactures, Processes,
Or distributes in commerce a chemical substance or mixture and who obtains information
which reasonably supports the conclusion that uch substance or mixture Presents a
substantial risk of injury to health or the environment shall immediately inform the
Administrator of such information unteas such person has actual knowledge that the
Administrator has been adequately informed of such information.

220


CHAPTER 3, LEVELS OF CONTAMINATION IN HOMES AND CARS

CHAPTER SUMMARY

Measurements of contamination in workers’ homes and cars were reported for
asbestos, lead, pesticides, mercury, a few chlorinated hydrocarbons, arsenic, and fungi
(Table 15). However, for the other substances reviewed as contaminants of workers’
homes, data on levels of contamination have not been reported; this is true for
beryllium, estrogenic substances, asthmatogens, cadmium, fibrous glass, and
radioactive substances.

For asbestos, there are no studies of contaminated surfaces, but in one study of the
air of workers’ homes asbestos concentrations up to one-half of the current 8-hr.
time-weighted average OSHA exposure limit for workers were found.

There are many studies of workers’ home contamination by lead that document the
substantial contamination that has occurred. Lead contamination of surfaces is
measured either as concentration of lead in dust, expressed as ppm or as the amount
of lead covering an area of surface, expressed as weight of lead per unit of area, and
referred to as lead loading.

e When the concentration of lead in household dust was measured, average
concentrations in workers’ homes ranged from 1,600 ppm to 5,000 ppm with
maximum values up to 84,000 ppm. In control homes, concentrations were usually
less than 1,000 ppm.

e When lead contamination was measured as weight/unit area, workers’ homes had
lead loadings that were greater than 2,500 ug/m’, ranging up to 109,000 4g/m’*.
Control houses had lead loadings that were less than 1,000 xg/m’.

e Lead loadings in workers’ cars ranged from 1,000 to 300,000 g/m’. Control cars
had lead loadings that were less than 1,000 ng/m’.

While measurements of lead in control homes provide some basis for evaluating
contamination of workers’ homes, guidelines for critical levels of contamination are
needed. A value of 500 ppm for the concentrations of lead in dust was used in one
study as a threshold for cleaning homes. For lead loading after lead-based paint
removal, 2,152 ug/m’ has been used for floors as a practical, not health-based level.
A level of 1,500 g/m? has been stated as a level of concern for children’s health.

In three studies of workers’ homes contaminated with mercury, concentrations of
mercury in air ranging from 0.02 ug/m’* to 50 ug/m’ were found. In one study of
control homes, concentrations in air ranged from 0.01-1 4g/m’. Mercury
concentrations in contaminated automobiles were 8-60 ug/m’. The MSHA

49


‘Table 13. Health Effects of Take-Home Mercury Exposure

Ehrenberg et al. Vermont Thermometer 60 Workers’ children Workers’ children had urine mercury NIOSH trailer in which workers
2986, 1991] plant 32 Control children levels of 25 ug/L vs 5 ug/L controls. were examined became
Hudson et al, Childrens’ urine levels corretated with contaminated with mercury
[1985, 1987] worker parents’ levels, No clinical (225 ug/m>), Workers’ homes
effects were found in the children. were alto contaminated, The
median concentration of mercury
in alr was 0.26 g/m”, range 0.02-
10 g/m”.
ATSDR Tennessee Chemical 115 Members of exposed workers’ Urine mercury levels of family Individuals living in households
[19908] workers families. members in normal range, mean that were vacuumed were more
5.1444 ng/mL, likely to have elevated urine
mercury values than those who
did not, Floor washing was aiso
associated with higher levels of
mercury in urine,
Haddad and California Gold extraction Cate report Husband and wife had acute
Stenberg (1963] in the home bronchitis, fever, chille and nausea.
Urine mercury tevels, $40 ug/L in
husband, 80 ug/L in wile.
Hatlee Washington Gold extraction Case report Husband, wife and three children had
[1969] in the home ‘acute interstitial pneumonia, nausea,
hypoxemia and headaches, Urine
mercury excretion, 33-560 4g/24 hrs.
King Arizona Gold extraction ‘Case report Husband had severe coughing,
[1984] in the home. vomiting and cyanosis; wife did not
report symptom,
Hatch Arizona Gold extraction Case report ‘Woman had gastrointestinal 26 alr samples in home 6 weeks
[1990] in the home listurbances, Blood mercury level after incident

178

ler 3 weeks of chelation was 193

mg/dL,

mg/m



TABLES

Table 1. Health Effects of Take-Home Beryllium Exposure (Case Reports/Case
BTS 9 (a 143

Table 2. Health Effects of Take-Home Asbestos Exposure (Cohort Studies) ...... 145
Table 3. Health Effects of Take-Home Asbestos Exposure (Community Studies) .. 147

Table 4. Health Effects of Take-Home Asbestos Exposure (Case-Control Studies) . 148

Table 5. Health Effects of Take-Home Asbestos Exposure (Case Reports) ....... 151
Table 6. Health Effects of Take-Home Asbestos Exposure (Case Series) ........ 154
Table 7. Health Effects of Take-Home Lead Exposure (Cohort Studies) ........ 160
Table 8. Health Effects of Take-Home Lead Exposure (Community Studies) ..... 164

Table 9. Health Effects of Take-Home Lead Exposure (Case Reports/Case Series) 167

Table 10, Health Effects of Take-Home Exposure to Caustic Substances ......... 173
Table 11. Health Effects of Take-Home Pesticide Exposure ..............+.-- 174
Table 12. Health Effects of Take-Home Chlorinated Hydrocarbons Exposure ..... 176
Table 13. Health Effects of Take-Home Mercury Exposure ............-.-+4-- 178
Table 14. Health Effects of Take-Home Exposure to Other Substances .......... 179
Table 15. Workers’ Home Contamination—Industrial Hygiene Aspects .......... 184
Table 16. Studies on Laundering Pesticides from Contaminated Clothing ........ 206
Table 17. Federal Laws Relevant to Workers’ Home Contamination ............ 216

Table 18. Regulations of Federal Agencies Relevant to Workers’ Family Protection 237

Table 19. Federal Agency Involvement in Incidents of Workers’ Home Contamination
and Related Activities .......... 60 cee cece eee eee ence teers 240

Table 20. How State Agencies Respond to Incidents of Workers’ Home
Contamination — States that Have Their Own OSHA Program ........-. 248


Todd, AS, Timbie CY [1979]. Industrial hygiene report—Preliminary survey of wood
Preservative treatment facility at Koppers Company, Inc., Forest Products Group,
Florence, South Carolina. Cincinnati, OH: U.S. Department of Health, Education, and
Welfare, Public Health Service, Center for Disease Control, National Institute for
Occupational Safety and Health, Contract No. 210-78-0060. 13 pages.

Townsend JC, Bodner KM, VanPeenen PFD, Olson RD, Cook RR [1982]. Survey of
reproductive events of wives of employees exposed to chlorinated dioxins. Am J
Epidemiol 115(5):695-713.

Trost C [1985]. Mercury exposure of workers ignites Vermont controversy. Des Moines,
Iowa. Wall Street J 65(240 September 24).

Tubbs RL, Galson SK [1989]. Health Hazard Evaluation Report: Joseph T. Lutmer,
D.D.S., Cincinnati, Ohio. Cincinnati, OH: U.S. Department of Health and Human
Services, Public Health Service, Centers for Disease Control, National Institute for
Occupational Safety and Health, Division of Physical Sciences and Engineering, NIOSH
Report No. HETA 87-265-1975. 17 pages.

US. Senate [1991a]. Hearing on S. 353 (Workers’ Family Protection Act of 1991)
before the Subcommittee on Labor of the Committee on Labor and Human Resources,
United States Senate, 102nd Congress, 1st session. Washington, DC: U.S. Government
Printing Office. 72 pages.

U.S. Senate [1991b]. Report on S. 353 (Workers’ Family Protection Act of 1991) by Mr.
Kennedy from the Committee on Labor and Human Resources, United States Senate,
102nd Congress, 1st session, Report 102-253, Calendar No. 388.

Valdés WM [1994]. Letter of March 3, 1994 re: workers’ home contamination in Puerto
Rico to Ms. Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 1 page.

VanOrdstrand HS, Hughes R, Carmody MG [1943]. Chemical pneumonia in workers
extracting beryllium oxide: Report of three cases. Cleve Clin Q 10:10-18.

Venable HL, Moss CE, Connon CL, Kinnes GM, Freund E, Seitz TA, Kaiser EA [1993].
Health Hazard Evaluation Report: Boston Edison Company, Boston, Massachusetts.
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service,
Centers for Disease Control and Prevention, National Institute for Occupational Safety
and Health, Division of Physical Sciences and Engineering, NIOSH Report No. HETA
90-075-2298. 60 pages.

Venables K, Newman-Taylor A [1989]. Asthma related to occupation of spouse.
Practitioner 233(1470):809-810.

138


‘Table 16. (Continued) Studies on Laundering Pesticides from Contaminated Clothing

(water solubility) Formulation Fabrice Laundry or Decontamination Variables Results
a
Kim et al. (1993} Atrazine (30 mg/L) Water dispersable 100% Cotton heavy weight twill 60°C wash, heavy duty liquid detergent, 2 More than 99% of all atrazine
Metolachlor ($30 granules rinses, machine dried. formulations were removed, but
mg/L) Wettable powder only 90% of metolachlor.
Flowable liquid Emuisifier appeared to inhibit
Emulsiflable removal of the more soluble
concentrate metolachior. Atrazine in transfer
1 gram sewed into cloths was 13-50% of residues in
sockets contaminated cloths, but only 0.2%
for metolachlor,
Kim et al. (1982) Fonofos Emulsifiable 100% Cotton 6 oz. shirt wt. 40°C, 49°C, 60°C, detergent/no detergent, Remaining residues after laundry
(13 mg/L at 20°C) concentrate 14 oz. pants wt, denim immediate wash/24-hr wash, 2 cold rinses, (ratio of residue peak to standard
Alachlor (242 mg/L at alr dried, 150 mL water, 30 steel balls. peak) 42-81% for fonofos, 2-47%
28°C) for alachior, Heavier fabrics
contained more residues, hot water
removed more of both substances
from heavier fabrics, detergents
resulted in lower residues, as did
immediate washing.
Kim et al {1986} Alachior Emulsifiable 100% Cotton and 6$/35 49°C, 60°C, 150 mL water, standard Hot water removed more alachlor
concentrate polyestercotton broadcloth. detergent with 12.4% phosph than warm water. Dryer drying
100% and 65/35 polyester-cotton commercial detergent with 6.1% reduced residues compared to air.
wilt, phosphate, heavy duty detergent with no Light fabrics had much lower
phosphate, three pre-treatments: residues than heavy fabrics; 65/35
denatured ethyl alcohol (7.5 mL/1S0 mL); |  polyester-cotton twill had more
perchioro- ethylene (7.5 mL/1S0 mL); residue than 100% cotton twilt.
istilled water 150 mL each for 2 minutes Perchlorethlene removed
at 49°C; 9-minute wash, 2 rinses at 49°C. significantly more alachlor than
Air and machine dry. alcohol or water. Phosphate
detergents decreased residues in
l broadcloths,

210


removed in change rooms and not worn home or you will extend your exposure and
expose your family since lead from your clothing can accumulate in your house, car, etc.”

The OSHA standards addressing hazardous-waste operations and emergency response
{29 CFR 1910.120, and 29 CFR 1926.65] have requirements for wearing protective
clothing, decontaminating employees, and decontaminating or disposing of contaminated
clothing and equipment before leaving the worksite. These standards, however, contain
no specific advisory information regarding contamination of workers’ automobiles and
homes.

OSHA’s hazard-communication standards {29 CFR 1910.1200, 29 CFR 1915.1200, and 29
CFR 1926.59] require that employees be advised about hazards with which they work.
While not required by OSHA under these standards, information on workers’ home
contamination could be included in Material Safety Data Sheets that accompany
hazardous chemicals, and could be incorporated as well into employee training.

NIOSH. NIOSH’s research authority to study occupational safety and health hazards [29
U.S.C. 669] enables the agency to identify instances for which the potential for home
contamination exists, and to make preventive recommendations regarding this problem.
NIOSH also is authorized to recommend safety and health standards to OSHA [29
U.S.C. 671(c)]. Operating under the same limitations as OSHA, the basis of NIOSH-
recommended standards must relate directly to the protection of workers, but the
recommendations may be equally effective in protecting the workers’ families. Under
this authority, the agency compiled information regarding workers’ home contamination
in NIOSH criteria documents for asbestos [NIOSH 1972a, 1977], beryllium [NIOSH
1972b], and mercury [NIOSH 1973}). In a recommended standard on the manufacture
and formulation of pesticides, NIOSH recommended that work clothing not be worn or
taken home to be laundered, and that the clothing be laundered by the employer
[NIOSH 1978].

Federal Mine Safety and Health Act of 1977 (Mine Act)

The Mine Act at 30 U.S.C. 802 and 803 provides indirect authority for preventing
workers’ home contamination. These sections require that an employer who also is an
employee in his/her workplace (i.e., an owner-miner of a mining operation) must comply
with applicable safety and health rules developed under the statute by the Mine Safety
and Health Administration (MSHA). If a mine, for example, is located on the owner’s
home/family property, and the owner is the only miner involved in extracting minerals
from the mine, the owner must provide himself/herself with the safety and health
measures prescribed by the appropriate MSHA rules. Under these circumstances,
compliance with the MSHA rules will reduce exposure of the owner-miner’s family to
mineral dusts and other mining contaminants.

Having more general implications for the protection of miners’ families, § 811 of the
Mine Act grants MSHA authority to establish rules to protect miners from exposure to

77


Several previous review articles provided an entry to the world literature [Bellin 1981;
Chisolm 1978; Lehmann 1977; McDiarmid and Weaver 1993].

Key-word literature searches were conducted in various databases, including TOXLINE
and NIOSHTIC. Articles and reports identified in these searches were obtained and
reviewed for relevance. In most cases, cited references from these reports and articles
were retrieved and reviewed as well.

The report is arranged to address the issues identified in the Act. In Chapter 1, the
studies relating to health effects are reviewed. Details of the studies for each
contaminant are presented in Tables 1-14 and overviews of the findings for each
contaminant are presented in the text. In Chapter 2, the sources of contamination are
discussed by contaminant, where information was available. Chapters 3, 4, and 5 present
discussions of the studies for each contaminant on: levels of contamination; preventive
measures; and procedures for decontamination, respectively. Table 15 presents the
details on industrial hygiene studies cited in Chapters 2-5 by contaminant, incorporating
the process, the industrial hygiene methodology, observations, and comments or
recommendations. Studies on laundry procedures for pesticides which are discussed in
Chapter 5 are summarized in Table 16.

In Chapter 6, Federal and State laws that are operative are discussed. The Federal
statutes are summarized in Table 17 and rules of various Federal agencies found in the
Code of Federal Regulations are tabulated and explained in Table 18. In Chapter 7, the
responses of Federal and State agencies and industry to incidents of home contamination
are reviewed; these are summarized in Tables 19-23.


example, tuberculosis spread by an infectious emergency service worker to family
members via aerosols would not be included nor is HIV infection that may be
transmitted to a spouse during intercourse. However, it should be noted that any
infectious disease contracted by a worker at the workplace will be brought home
and can potentially infect members of his or her household.

Based on these criteria, diseases that appear to most likely be transmitted from
the worksite to the home “on" workers or their clothes include parasitic (mites and
lice), vector-borne (lyme disease), and air-borne diseases (Q fever) that may be
transmitted via fomites (e.g., dust).

Five reports of household members being infected with contagious disease
brought home on the worker were identified. In these 5 reports, 35 “household”
members were reported to have been infected with scabies, Q fever, mites, or
giardiasis. It is believed that many additional cases exist that were either not
reported in the literature or were reported in a manner that made them difficult
to identify in the literature.

Background

Microorganisms are ubiquitous in nature. In humans, they are found naturally in
many locations of the body including the skin, hair, and even internally in several
locations such as the GI tract. These normal microbial flora help protect the host
from pathogens and do not constitute any problems for healthy individuals. In
fact, only a few of the bacteria, viruses, fungi, mycoplasmas, chlamydiae,
tickettsiae, or protozoa found in nature are capable of causing disease in humans.
For those organisms that are effectively able to invade and cause disease, there
are several ways that they may be transported from infected workers to other
members of the household. These include [Benenson 1985]:

¢ The transmission of infectious materials may occur by direct contact between
individuals through a receptive portal of entry by touching (e.g., scabies), biting
(e.g., hepatitis B virus [HBV)]), kissing (e.g., Epstein-Barr virus), or sexual
intercourse (e.g., human immunodeficiency virus [HIV]). When individuals
sneeze, cough, sing, or even talk they exhale a cloud of tiny droplets of saliva.
Direct projection of this droplet spray (usually in close proximity to the source -
1 meter or less) onto the conjunctiva or mucous membranes of another
individual can transfer disease (e.g., common cold). Some diseases can also be
transmitted transplacentally from mother to child (e.g., rubella, HIV).

e Indirect transmission of infectious agents may occur by contact with
intermediates such as contaminated inanimate materials (e.g., toys, clothing,
eating utensils, bedding) as well as contaminated food, water, milk or biological
products such as blood, tissues, or organs. Also, zoonotic diseases may be
transmitted by contact with animals that serve as reservoirs for infectious agents
such as rabies. In addition, arthropod vectors such as ticks may transfer

28


The Environmental Protection Agency (EPA) has general authority under the Toxic
Substances Control Act to regulate chemicals and to obtain information on the adverse
effects of chemicals, thereby permitting EPA, at least indirectly, to prevent workers’
home contamination. EPA has specific authority to prevent workers’ home
contamination under the Asbestos Hazard Emergency Response Act of 1986 and the
Residential Lead-Based Paint Hazard Reduction Act of 1992.

Under the Federal Insecticide, Fungicide, and Rodenticide Act, EPA has broad authority
to regulate the application and disposal of pesticides; EPA has used this authority, at
least to a limited extent, to promulgate standards that prevent workers and farm owners
from contaminating their homes with pesticides.

The Comprehensive Environmental Responses, Compensation, and Liability Act, and the
Superfund Amendments and Reauthorization Act, authorize EPA and the Agency for
Toxic Substances and Disease Registry to regard workers’ contaminated homes as
hazardous-waste-release sites, thereby allowing these agencies to take those measures
necessary to decontaminate workers’ homes and to control the sources of home
contamination.

STATE LAWS

Thirty States, and Puerto Rico, responded to requests from NIOSH for information
regarding State laws on this topic. These respondents indicated they had no laws
currently in force relating directly to the protection of workers’ families. Some of these
States identified laws requiring that cases of elevated blood lead and pesticide poisoning
be reported to a State agency, as well as laws addressing work practices at hazardous-
waste sites and during emergency responses to the release of hazardous substances.
Examination of occupational safety and health laws of States with OSHA-approved
occupational safety and health programs did not find any laws that were more stringent
than the commensurate Federal laws. Extension of occupational safety and health laws
to State and local government employees in these States, however, provides added
protection to their family members that is not available in States without OSHA-
approved programs.

BACKGROUND

The first laws addressing workers’ home contamination were enacted in England between
1903 and 1911 [Oliver 1914]. The purpose of these laws was to prevent workers from
exposing their families to lead dust that was deposited on the workers’ clothing during
the work process. Enactment of these laws occurred after Oliver observed lead
poisoning among workers’ wives, and attributed this poisoning to the wives being exposed
to lead while washing their husbands’ work clothes. The following industries or work
activities were subject to these laws: manual file cutting; manufacturing batteries, paints
and colors, decorative pottery, and lead-containing compounds; heading lead-dyed yarn;
and smelting lead-containing materials. The laws required employers to provide their

73


Occupational Safety and
Health Act of 1970

Pubtic Law 91-596

‘Table 17. Federal Laws Relevant to Workers’ Home Contamination

Seq]

$651 Congressional Statement of Findings and Declaration of Purpose and Policy
The Congress declares it to be its purpose and policy... . to assure 80 far as possible
every working man and women in the Nation safe and healthful working conditions ....

Note 9, This chapter was created for the sole purpose of Protecting health and safety of
workers and improving physical working conditions on employment premises CA. 5,
1979P. 24622.

Note 16, This chapter covers only housing that is a condition of employment and does
hot apply to housing which is work related but which is not conditions of employment
CA, 11, 1983, 696F, 241325, rehearing denied 704F, 241253,

$654 Duties of Employers and Employees

Each employer shall furnish to each of his employees employment and a place of
employment which are free from recognized hazards that are causing or are likely to cause
death or serious physical harm to his employees,

Note 84. This chapter does not create duties between employers and invitees, only
between employers and their employees. CA. Tex. 1981, 653P, 24915, rehearing denied
661P. 24931,

Note 86, Secretary should be able to extend coverage of this chapter to certain
‘employer-provided means of transportation and certain employer-provided housing even
though such extension exceeds plain language of this chapter, CA. 11, 1983, 696F.
241325, rehearing denied 704P, 241253,

$669 Research and Related Activities

$ 669(a)(4) The Secretary of Health and Human Services shalt also conduct special
research, experiments, an demonstrations relating to occupational safety and health as are
necessary to explore new problems, including those created by new technology in
occupational safety and health, which may require ameliorative action beyond that which
is otherwise provided for in the operating provisions of this chapter,

$ 669{a)(6) The Secretary of Health and Human Services... shall determine following
a written request by any employer or authorized representative of employees, specifying
with reasonable particularity the grounds on which the request is made, whether any
substance found in the place of employment has potentially toxic effects in such
concentrations as used or found . .

$ 66%(¢) The functions of the Secretary of Health and Human Services under this chapter
shall, to the extent feasible, be delegated to the Director of the National Institute for
Oceupational Safety and Health established by Section 671 of this title.

$671 The Institute is authorized to - (1) develop and establish recommended
occupational safety and health standards,

216



These case reports provide information on exposure scenarios not usually
elicited in other types of studies. Epler et al. [1980] reported on two brothers
who developed pleural changes as young adults. As children, they played in a
room that was used as an automobile muffler repair shop. Magee et al. [1986]
reported on an a case of mesothelioma in a 41-year-old male with no occupational
exposure. He was exposed as a child in Corsica to tremolite asbestos in a room in
his home that was used as a local bar. The patrons of this bar were miners at the
Canari asbestos mine and came into the bar in their dusty work clothes. As a
child, this man had used asbestos ore from the mine to filter wine. Li et al.
[1989] reported on a family of four in which the father worked in an asbestos
products plant. The father brought home cotton cloth sacks in which molded
asbestos insulation had been transported. The mother cut the sacks into diapers
for her children. The mother and one daughter died of mesothelioma. The
father died of asbestosis. A young uncle who lived in the home and worked
briefly in an asbestos-exposed job also died of mesothelioma. Otte et al. [1990]
studied a family who produced asbestos cement in their homes. The mother,
father and one son died of mesothelioma.

Case-Series. Table 6 summarizes 22 papers describing studies of case
series [Lieben and Pistawka 1967; Dalquen et al. 1970; Heller et al. 1970;
Bittersohl and Ose 1971; Vianna et al. 1981; Grundy and Miller 1972; Greenberg
and Davies 1974; Milne 1976; Edge and Choudhury 1978; Bianchi et al. 1982;
Bianchi et al. 1987; Bianchi et al. 1990; Bianchi et al. 1991; Bianchi et al. 1993;
Lander and Viskum 1985; Gibbs et al. 1989; Gibbs et al. 1990; Konetzke et al.
1990; Kiviluoto 1965; Martensson et al. 1984a; Sider et al. 1987; Giarelli et al.
1992].

These reports are on series of patients seen and/or autopsied at large
hospitals or clinics in urban areas. The reports may include cases with
occupational and community exposures in addition to cases due to workers’ home
contamination. Sixteen of the reports were of studies on mesothelioma and six
were reports on asbestosis and pleural plaques.

Fiber type and size distribution in a series of mesothelioma cases occurring
among family members of asbestos-exposed workers were reported by Gibbs et al.
[1990]. These cases had various forms of asbestos fibers in their lungs reflecting
the types of asbestos to which the working family member was exposed.

LEAD
Overview
Based on the reports reviewed in this section, children and adult family members
of lead workers have been at risk of developing lead poisoning from
contamination of their homes with lead. These reports also raise concern about
the effect of prenatal exposure as a result of an adult family member being
exposed to lead.

11


Treble 2. (Continued) Health Effects of Take-Home Asbestos Exposure (Cobort Studies)

Joubert et al.
[1991]

New Jersey

Amosite asbestos workers

Cohort study.

Followed household contacts of
amosite asbestos workers employed at
a single facility 1941-1954, Of 4,044
household contacts, 878 were
examined 1973-1976,

Vital status follow-up through January 1990 indicates that
28% died of lung cancer, 23% died from cancer of the
gastrointestinal tract, and 9% died of mesothelioma, The
authors state that cancer deaths were 2 times expected
based on national estimates,

Some figures reported in
the paper seem
contradictory,

‘This appears to be
additional follow up of the
Anderson et al. studies,

Navratil and
‘Telppe (1972)

Caechosiovakia

Chrysotile asbestos product
processing

Cohort study,

Prevalence of pleural calcification in
three asbestos exposed groups
compared with prevalence in non-
exposed residents of the same area
(Group #4).

Grovp #1
800 workmen employed for more than
10 years at a factory.

Grovp #2
15S persons living in the neighborhood
of the factory.

Grovp #3
114 persons older than 20 years who
were relatives of factory employees.

Grovp #4

8,127 persona over the age of 40 who
lived in the came district as the factory
but not in the same neighborhood as
the factory.

146

Each group was evaluated by X-ray for the prevalence of
pleural calcification, with or without other signs of
asbestosis, Observed statistically significant (p<0.01)
increased risk of calcification among each asbestos exposed
group compared with Group #4.

Grovp #1

42/800 ($.3%) observed vs. 2.75 expected
Group #2

9/155 ($:8%) observed va. 0.53 expected
Group #3

4/114 (3.5%) observed vs. 0.39 expected

Group #4
28/8127 (0.34%)

In group #2, 5 were also
relatives but were counted
In group #2 rather than
group #3.

Blood relations were
assumed to have increased
exposure due to contact
with workers wearing
contaminated work clothes.



Energy and Commerce Committee [1986]. House Report No. 99-253(1), 99th Congress,
2nd Session. In: Superfund Amendments of 1986 (P.L. 99-499): Legislative History. U.S.
Code Cong & Admin News 4:2835-2844.

EPA [1992]. Lead poisoning and your children, Report No. 800-B-92-0002. Washington,
DC, United States Environmental Protection Agency. 7 pages.

EPA [1986]. Air quality criteria for lead: Volume I. Research Triangle Park, NC: U.S.
Environmental Protection Agency, Environmental Criteria and Assessment Office,
Report No. EPA-60D/8-83/028aF.

Epler GR, Fitz-Gerald MX, Gaensler EA, Carrington CB [1980]. Asbestos-related
disease from household exposure. Respiration 39:229-240.

ERM-Southeast, Inc. [1989]. Protocol for monitoring and cleaning homes. Report of
decontamination procedures prepared for ERM-Southeast, U.S. Environmental
Protection Agency, and the Agency for Toxic Substances and Disease Registry (February
22, 1989). Brentwood, Tennessee: ERM Southeast, Inc.

Ewers L, Clark S, Menrath W, Succop P, Bornschein R [1994b]. Clean-up of lead in
household carpet and floor dust. Am Ind Hyg Assoc J 55(7):650-657.

Ewers LM, Piacitelli GM, Whelan EA [1995]. Health Hazard Evaluation: George
Campbell Painting Company, Grotin, Connecticut. Cincinnati, OH: U.S. Department of
Health and Human Services, Public Health Service, Centers for Disease Control and
Prevention, National Institute for Occupational Safety and Health, NIOSH Report No.
HETA 93-0502-2503.

Ewers LM, Piacitelli GM, Whelan EA [1994a]. Methods for evaluating construction
workers’ exposures to lead. In: American Industrial Hygiene Conference and Exposition
Abstracts. Fairfax, VA, ATHCE. Page 40.

Ewers U, Brockhaus A, Winneke G. Freier I, Jermann E, Kramer U [1982]. Lead in
deciduous teeth of children in a non-ferrous smelter area and a rural area of the FRG.
Int Arch Occup Environ Health 50(2):139-151.

Falk H, Herbert JT, Edmonds L, Heath CW Jr., Thomas LB, Popper H [1981]. Review
of four cases of childhood hepatic angiosarcoma-Elevated environmental arsenic
exposure in one case. Cancer 47(2):382-391.

Farfel MR, Chisolm JJ Jr. [1990]. Health and environmental outcome of traditional and

modified practices for abatement of residential lead-based paint. Am J Public Health
80(10):1240-1245.

111


TABLES

Table 21. How State Agencies Respond to Incidents of Workers’ Home
Contamination -- States that Do Not Have Their Own OSHA Program .... 250

Table 22. Responses of State Agencies to Incidents of Workers’ Home
Contamination — Publication in the Literature from State Agencies ....... 252

Table 23. Responses of Industry to Incidents of Workers’ Home Contamination ... 254

APPENDICES
Appendix 1. The Workers’ Family Protection Act..........: 0: ee esse eee eeees 255
Appendix 2. Federal Register Notice 58 FR 60202 - 60204. .......------.-005 261
Appendix 3. Letters Requesting Information. .............--eee sees eee eens 266
Appendix 4. Acknowledgements. .... 2.2.0... eee eee cree eect eee eet eeee 270
Appendix 5, Glossary .. 0.6... 6c e eee eee teee ett eee n eens 277


Henryka U. Nagy, Ph.D.

Chemist

Information Resources Branch
Education and Information Division

National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

Benjamin K_ Nelson, Ph.D.
Toxicologist (Research)

Applied Psychology and Ergonomics
Branch

Division of Biomedical and
Behavioral Science Branch
National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

Diana L. Ordin, M.D., M.P.H.
Deputy for the Associate Director
for Surveillance

Surveillance Branch

Division of Surveillance, Hazard
Evaluations, and Field Studies
National Institute for Occupational
Safety and Health

4676 Columbia Parkway
Cincinnati, Ohio 45226

John E. Parker, M.D.

Acting Chief, Epidemiology
Investigation Branch

Division of Respiratory Disease
Studies

National Institute for Occupational
Safety and Health

1095 Willowdale Road

Morgantown, West Virginia 2650S

Patricia A. Sullivan, M.S.
Research Epidemiologist
Epidemiological Investigations
Branch
Division of Respiratory Disease
Studies
National Institute for Occupational
Safety and Health
1095 Willowdale Road
Morgantown, West Virginia 26505-2888

Naomi G. Swanson, Ph.D.

Chief, Motivation and Stress
Research Section

Applied Psychology and Ergonomics
Branch

Division of Biomedical and
Behavioral Science

National Institute for Occupational
Safety and Health

4676 Columbia Parkway
Cincinnati, Ohio 45226

Theodore F. Tsai, M.D., M.P.H.

Assistant Director for Medical Sciences
Division of Vector-Borne Infectious
Diseases

National Center for Infectious Diseases

Centers for Disease Control and
Prevention

P.O. Box 2087, Foothills Campus

Fort Collins, Colorado 80522

John J. Whalen, M.S.

Education and Information Division
National Institute for Occupational
Safety and Health

4676 Columbia Parkway

Cincinnati, Ohio 45226

Elizabeth A. Whelan, Ph.D.
Epidemiologist

Industrywide Studies Branch
Division of Surveillance, Hazard
Evaluations, and Field Studies
National Institute for Occupational
Safety and Health

4676 Columbia Parkway
Cincinnati, Ohio 45226


the workers wore no protective clothing and there were no shower facilities at
work, suggesting that contaminated clothing could have been a source of home
contamination.

Lead loadings were determined at various sites in the homes of workers
exposed to lead at a bridge site in Ohio [Piacitelli and Whelan 1995].
Measurements of clothing contamination were not reported, except for the
highest lead loading of clothing (2,278 ug/m’), and of the sofa or chair (639
g/m’) used by the worker. Paint in the home was excluded as a potential
source of the lead contamination.

Cook et al. [1993] found lead in floor dust up to 11,000 ppm, and in window
sill dust up to 28,000 ppm in a study of 105 homes in Leadville, Colorado. An
unspecified number of workers were engaged in lead mining and smelting;
children of those who wore their work clothing home had elevated BLL’s.
Czachur et al. [1995] found that elevated BLLs of children of workers in a
variety of industries were related to the practice of washing dirty work clothing
at home. Similarly, Morton et al. [1982] found a significant correlation between
the practice of battery workers bringing dirty clothing home and BLLs of their
children. Pichette et al. [1989] found that BLLs were elevated in family
members who laundered the clothing of battery recycling workers.

Contamination of clothing by lead was documented without any information
on home contamination for: (1) workers engaged in abrasive blasting of lead-
based paint on a bridge by Ewers et al. [1994a, 1995] who found lead levels as
high as 300 g/cm’ on work shirts; (2) secondary lead smelter workers by
Grandjean and Bach [1986] who found lead up to 2 g/pair of socks; and (3)
workers engaged in lining tanks with lead plates (up to 20 zg/cm* on shoes and
up to 2 g/cm’ on shirt collars) [McCammon et al. 1991].

Baker et al. [1977] assumed that contaminated clothing was the source of
lead contamination (up to 89,000 ppm) in the homes of the secondary lead
smelter workers they studied. This assumption is supported by clothing
contamination and house dust studies of smelter workers by Winegar et al.
[1977], Grandjean and Bach [1986], and Cook et al. [1993].

Pesticides

A single report of measurements of contamination of workers’ homes by
pesticides was found [Osorio 1994]. Although this study demonstrated much
higher levels of diazinon, chlorpyrifos and propoxur in house dust from floors of
farm workers’ homes than from floors of non-farm workers’ homes, no
information on clothing as a source of the contamination was included in the
Teport.

39


‘Table 15, (Continued) Workers’ Home Contamination-Industrial Hygiene Aspects

Author [year] Contaminant
a hn I eo bina inn Mei ae en
I
State of Alabama Lead Pottery making, Lead wipe samples in home and Wipe samples in mobile home = 16 Author notes HUD interim
[1992] cottage industry workshop, to 390 we/t in workshops 440- guidelines for clearance criteria for
Alabama 177,000 pg/ft*. specific indoor surfaces: floor =
200 agit window sills = $00
ug/ft*; window wells = 800 ug/tt2,
Grandmother's living quarters
should be moved from the
ceramic/pottery shop. Make shop
off limits to family's children.
‘Shower and change into clean
clothes before entering house.
Venable et al. Cable splicing in a Air sampling. Wipe samples from TWA exposures to lead at 0.22 to Although most employees
(1993) utility company surfaces, employee clothing, boots, | 17 4g/m>, below OSHA PEL showered and changed clothes at
Massachusetts and hands before and after (50. g/m). Lead loadings: Service the end of the day 91% took work
washing. vehicles 48-12,400 ast; clothes 600- clothes home and 22% washed
4,800 yg/ft“; hands before washing work clothes and other laundry
1,800-4,900 ug/tt?; after 250-680 together,
pe /nt?,
‘Watson et al. Lead Battery manufacturing ‘Lead samples in homes; ead in Households of workers had higher Authors note that even with a plant
(1978) house dust, drinking water and concentrations of lead in dust program of showering and changing
Vermont paint. Dust samples analyzed via (2,239 ppm) than controls (718 ppm). clothes, apparently enough lead
an anodic stripping voltmeter, lead reaches the workers homes (on
paint samples were analyzed by an hair, skin, clothing) to result in
X-ray source detector, and water higher lead levels.
samples were analyzed via atomic Recommendation that plant
absorption spectrophotometry. provide laundered uniforms at
work.
Wiehrdt [1994] Lead Not identified OSHA learned that 6 children of Lead in wipe samples ranged up to
Indiana, Ilinoi workers had elevated lead levels, 240 pg/wipe.
Ohio and conducted wipe samples in

children’s homes.

195



Cossette M [1984]. Defining asbestos particulates for monitoring purposes. In: Levadie
B ed; Definitions for asbestos and other health-related silicates, ASTM STP 834.
American Society for Testing and Materials, Philadelphia, PA. 46 pages.

Cohen BS, Positano R [1986]. Resuspension of dust from work clothing as a source of
inhalation exposure. Am Ind Hyg Assoc J 47(5):255-258.

Cook M, Chappel WR, Hoffman RE, Mangione EJ [1993]. Assessment of blood lead
levels in children living in a historic mining and smelting community. Am J Epidemiol
137(4):447-455.

Czachur M, Stanbury M, Gerwel B, Gochfeld M, Rhoads GG, Wartenburg D [1995]. A
pilot study of take-home lead exposure in New Jersey. Am J Ind Med 28:289-293.

Dalquen P, Hinz I, Dabbert AF [1970]. [Pleural plaques, asbestos and asbestos
exposure, an epidemiologic study in Hamburger Raum] (in German). Pneumonol
143:23-42.

Danziger SJ, Possick PA [1973]. Metallic mercury exposure in scientific glassware
manufacturing plants. J Occup Med 15(1):15-20.

Davies JE, Enos HF [1980]. Pesticide monitoring and its implications. Occup Safety
Health 49(3):68C-68H.

Dement JM, Merchant JA, Green FHY [1986]. Asbestosis. In: Merchant JA, ed.
Occupational Respiratory Diseases. Cincinnati, OH: U.S. Department of Health and
Human Services, Public Health Service, Centers for Disease Control, National Institute
for Occupational Safety and Health, DHHS (NIOSH) Publication No. 86-102. pages 287-
327.

DeNardi JM, Van Ordstrand HS, Carmody MG [1949]. Chronic pulmonary
granulomatosis: Report of ten cases. Am J Med 7(Sept):345-355.

de Silva SR [1994]. Letter of February 3, 1994 re: Take-home lead exposure; Maryland
experience to Richard W. Niemeier, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 5

Pages.

Devries J, Devries I [1993]. Cover protects children from chemicals. Hoard’s Dairyman
March 1993:271.

Doherty PE [1984]. Final Report: CERCLA Fund - Immediate removal action Lacy
Manor Drive/Sandcut Road, Jefferson County, Missouri Superfund Site #A6. Jefferson

108


A worker in a fuel cycle facility was burned by a radioactive acid solution.
Although no contamination was discovered during the worker’s self-frisk before
he was transported to the hospital, external contamination was subsequently
detected on the acid burn areas.

Low-level contamination was found on the accelerator pedal of a worker's
vehicle during employee screening after detection of P-32 contamination in a
laboratory.

Four contract workers set off portal monitors when reporting to work at a
nuclear power reactor for the first time.

No additional information is available for any of these reports.

A search of 1985-92 NRER data identified 80 contamination events resulting in off-
site contamination. The reports generally lack detail, but those which raise the
possibility of take-home contamination include:

In the 1970s, in accordance with his employer's policy at the time, a worker used
waste lumber from his workplace to construct a garage in his home. The
employer manufactured catalysts containing depleted uranium. In 1991,
following newspaper articles concerning radioactive contamination at the site, the
employee contacted the State department of health. Surveys of the garage
Tevealed contamination in excess of the NRC release criteria. The licensee
teplaced the garage. There were no reports of adverse health effects.

Phosphorus P-32 was spilled in a university laboratory over a weekend; the spill
was discovered when contamination was found on an individual’s shoes.
Contamination was found in the laboratory, in the building outside the
laboratory, in at least one automobile, and on the shoes of about 40 individuals.
Contaminated areas were isolated and cleaned up and all contaminated items
were impounded and decontaminated. There were no reports of adverse health
effects.

A contamination event at a hospital resulted in contamination of a pharmacy
truck driver, his truck, and a transport box. No additional information available.

Radioactive sand from a Federal facility was disposed of in a septic tank on a
farm. No additional information available.

"Small areas of contamination" were found in a worker’s residence. No
additional information available.

Contamination found at a residence recently vacated by the owner of a licensed
laboratory. No additional information available.

92


‘Table 18, (Continued) Regulations of Federal Agencies Relevant to Workers’ Family Protection

A
RULE/CFR NO. AGENCY DESCRIPTION OF RELEVANT ELEMENTS

Lead OSHA ‘The PEL is 50 we/m3 as an 8-hr. average, Where employces are exposed above 50 ye/m3 the employer must: provide clean

[29 CFR 1910,1025) (general industry) Protective clothing at least weekly (daily if exposures exceed 200 g/m*); Provide clean change rooms equipped with separate

[29 CFR 1915.1025)] (shipyards) storage facilities for work and street clothes which prevent cross-contamination; provide showers and ensure that employees shower
at the end of the work shift; and ensure that employees required to shower do not leave the workplace wearing any clothing or
equipment worn during the work shift. Appendix B to these standards advises the worker of the benefits imparted to the family by
these requirements,

[29 CFR 1926.62] (construction) In addition to the requirements for general industry and shipyards, for many construction operations, until the employer has
demonstrated that exposures are not above the PEL (50 pg/m?), the employer must provide the protective clothing and showering
requirements discussed above for general industry and shipyards,

Mandatory Health Standards - Surface Coal MSHA Requires each operator of a surface coal mine to provide bathing facilities and clothing change rooms in a convenient location with

Mines and Surface Work Arcas of Underground individual storage container or lockers for miners’ clothing during and between shifts,

‘Coal Mines

[30 CFR 71.400-71.404)

Mandatory Safety Standards - Underground Coal | MSHA Requires each operator of an underground coal mine to provide bathing facilities (showers with both hot and cold water) and

Mines change rooms with individual storage containers or lockers and tufficient room to permit the use of the facilities by all miners

[30 CPR 75.1712] changing clothes prior to and after each shift.

Labeling Requirements for Pesticides and EPA Among the several requirements for labels are: a child hazard warning "keep out of reach of children” must appear on every

Devices pesticide product label, with few exceptions; clearly stated directions for use, including worker protection statements required by the

{40 CFR 156.10) worker protection standard; specific directions for storage and disposal of the pesticide and its container. Worker protection

{40 CFR 156.20} statements required on pesticide labels for products to be used in the production of agricultural plants on any agricultural
establishment include statements on: restricted entry; worker notification; and personal protective equipment.

Packaging Requirements for Pestickies and EPA This rule requires child-resistant packaging for pesticide products and devices, however a product restricted to use by of under the

Devices supervision of a certified applicator is exempt from this requirement unless EPA determines that the product poses a risk of serious

(40 CFR 157] accidental injury or illness which child-reristant packaging would reduce. Certain products packaged in large-sized containers are
alto exempt uniess EPA determines that it is to be sold to homeowners or other members of the general public.

Regulations for the Acceptance of Certain EPA Procedures for storage and disposal of pesticides and pesticide containers are recommended, but are mandatory only for EPA in

Pesticides and Recommended Procedures for the carrying out its disposal and storage operations, Recommendations for disposal of small quantities include rinsing empty containers

Disposal and Storage of Pesticides and Pesticide three times, adding the rinse liquids to spray mixtures in the field, burning, where permissible, in open fields, or buried singly in

Containers open fields by the user.

[40 CFR 165]

238



Establishment.

LAWS OF 102nd CONG.—2nd SESS. Oct. 26

agents from other sources of exposure inside and
nec i teen es
es
in to incidents of home con!

through (iv), and

worker and family icies
ended od tay proton ese astatan
and i to the apprope committees of
with respect

(2) DEVELOPMENT OF INVESTIGATIVE STRATEGY.—
"ASK FORCE.—Not later than 12 months after the
date of enact . ogee the “Worke: ca anit
a , to as re
‘(ak Force”. The Task Force shall— y
(i) be of not more than 15 individuals
to be appointed by the Director from among individuals
who are ntative of workers, industry, scientists,
industrial hygienists, the National Research Council,
government agencies, exce that not more than

one such individual shall be each appropriate
government agency and the number of individuals
appointed to represent industry shall be

umber,
nas rvieTM the report submitted under paragraph
vw),
(iii) determine, with respect to such report, the
additional data needs, if any, and the need for addi-
tional evaluation of the scientific issues related to and
the feasibili of developing such additional data; and
(iv) if additional data are determined by the Task
Force to be needed, develop a recommen¢ investiga-
tive strategy for gee in ob obtaining such information.

—The investigative strategy developed
under subparagraph (AMiv) shall identify gaps
that can and be assumptions

uncertainties associated with various components of
such strategy, a timetable for the implementation of
beeeitbarie rf and methodologies to gather any
ceed invergave striogy undef lish the
investigative under s
i) for publie comment and other methods,
juding technical nat and Uiilize other 1 for the
are Siapetaining comments concerning the pro-
Gii) FINAL STRATEGY.—After the peer review and
comment is conducted under clause (ii), the
, in consultation with .the heads of other

porsmment ageocen, shall propose a final strat
i westigatiog jerase related te home contarinatins
106 STAT. 3422

259


hand washing or showering facilities at the worksite. Work clothing was laundered at
home, and a lead concentration of 1,700 ppm was found in a composite sample of
dust in the home. In addition, the home’s back yard was contaminated with lead
from lead contaminated telephone poles which were brought from the worksite and
stored in the back yard for firewood. The State industrial hygienist recommended
and the company complied with the following preventive measures:

© test all workers blood lead levels;

© provide a medical monitoring program;
© provide a testing facility;

© provide protective clothing;

© provide worker training;

e provide an air monitoring program; and
e implement safe clean-up methods.

The Minnesota Department of Health investigated the potential for elevated blood
lead levels among household contacts of employees of a lead smelter [Winegar et al.
1977}. Data gathered as a result of this study showed high levels of lead in the
workers’ clothing and hair and elevated blood lead levels in some children of the
workers. This smelter reclaimed lead from old batteries. Home contamination
incidents from similar battery manufacturing, recycling, or reclamation operations
were investigated by health departments in several States:

e Ina Tennessee case investigated by the State’s Department of Public Health
and the local county health department, 49% of the battery reclamation
workers’ children (50 of 102) had elevated BLLs equal to or greater than 30
ug/dL [CDC 1976]. The source for lead appeared to be the parents’
contaminated clothing.

e Oklahoma investigators found similar results in an investigation of BLLs in
children of battery manufacturing workers [Morton et al. 1982].

e In North Carolina, 72% of the children of battery plant workers had BLLs of 30
Hg /dL or above [CDC 1977b].

e An investigation by the Alabama Department of Health in 1991 of a battery
recycling operation revealed elevated BLLs in most of the workers. When the


P.L. 102-522
Sec. 207

36 USC 5206.

36 USC 5207.

Workers’ Family
Protection Act.
BUS Gla

LAWS OF 102nd CONG.—2nd SESS. Oct. 26

SEC, 207. AUDITS, REPORT REQUIREMENTS, AND PETITION OF ATTOR-
NEY GENERAL FOR EQUITABLE RELIEF.

(a) AUDITS.—For purposes of the Act entitled “An Act to provide
for audit of accounts of private corporations established under Fed-
eral law’, approved August 30, 1964 (36 U.S.C. 1101 et seq.),
the Foundation shall be treated as a private corporation established
under Federal law.

(b) REPorT.—The Foundation shall, within 4 months after the
end of each fiscal year, prepare and submit to the appropriate
committees of the Congress a report of the Foundation’s proceedings
and activities during such ear, including a full and complete state-
ment of its receipts, nditures, and investments.

(c) RELIEF FOR CERTAIN FOUNDATION ACTS OR FaILuRES To
Act.—If the Foundation—

(1) engages in, or threatens to engage in, any act, practice,
or policy that is inconsistent with the purposes set forth in
section 202(b); or

(2) refuses, fails, or neglects to discharge its obligations
under this title, or threatens to do so,

the Attorney General may petition in the United States District
Court for the District of Columbia for such equitable relief as
may be necessary or appropriate.
SEC. 206, DAMUNITY OF THE UNITED STATES.

The United States shall not be liable for any debts, defaults,
acts, or omissions of the Foundation nor shall full faith and
credit of the United States extend to any obligation of the
Foundation.

SEC. 208. WORKERS’ FAMILY PROTECTION.

(a) SHORT TrTLE.—This section may be cited as the “Workers’
‘amily Protection Act”.
(b) Finpincs AND PuRPOSES.—
(1) Finpincs.—Congress finds that—

(A) hazardous chemicals and substances that can
threaten the health and safety of workers are being trans-
ported out of industries on workers’ clothing and persons,

(B) these chemicals and substances have the potential
to pose an additional threat to the health and welfare
of workers and their families;

(C) additional information is needed concerning issues
related to employee transported contaminant releases; and

(D) additional regulations may be needed to prevent
fature releases of this type.

(2) PuRPOsE.—It is the purpose of this section to—

(A) increase unders' ing and awareness concerning
the extent and possible health impacts of the problems
and incidents described in paragraph (1),

(B) prevent or mitigate future incidents of home
contamination that could adversely affect the health and
safety of workers and their families;

(C) clarify regulatory authority for preventing and
responding to such incidents; and

(D) assist workers in redressing and responding to
such incidents when they occur.

(c) EVALUATION OF EMPLOYEE TRANSPORTED CONTAMINANT

106 STAT. 3420

257


‘Table 17. (Continued) Federal Laws Relevant to Workers’ Home Contamination

CERCLA & SARA [42 U.S.C. § 9601 et
sq.)

(23) "remove" or "removal" means the cleanup or removal of feleased hazardous
substances from the environment, such actions as may be necessary’ taken in the event of
the threat of release of hazardous substances into the environment, such actions as may
be necessary to monitor, assess, and evaluate the release or threat of release of hazardous
substances, the disposal of removed material, or the taking of such other actions as may
be necessary to prevent, minimize, or mitigate damage to the public health or welfare or
to the environment, which may otherwise result from a release or threat of release. The
term Includes, in addition, without being limited to, security fencing or other measures to
limit access, provision of alternative water supplies, temporary evacuation and housing of
threatened individuals not otherwite provided for, action taken under section 9604(b) of
this title, and any emergency assistance which may be provided under the Disaster Rellef
Act of 1974 [42 U.S.CA, § 5121 et seq,];

So in original. Probably should be "necessarily*,

(25) "respond" or "response® means remove, removal, remedy, and remedial action;

(33) The term "pollutant or contaminant* shall include, but not be limited to, any
element, substance, compound, or mixture, including disease-causing agents, which after
felease into the environment and upon exposure, ingestion, inhalation, or assimilation into
any organism, either directly from the environment or indirectly by ingestion through food
chains, will or may reasonably be anticipated to cause death, disease, behavioral
abnormalities, cancer, genetic mutation, physiological malfunctions (including malfunctions
{n reproduction) or physical deformations, in such organisms or their offspring; except
that the term “pollutant or contaminant" shall not include petroleum, including crude oil
or any fraction thereof which is not otherwise specifically listed or designated as a
hazardous substance under subparagraphs (A) through (F) of paragraph (14) and shall
not include natural gas, liquefied natural gas, or synthetic gas of pipe ne quality (or
mixtures of natural gas and such synthetic gas),

Note 3, Hazardous substances

To be considered hazardous substance under Comprehensive Environmental Response,
Compensation, and Liability Act (CERCLA), substance need only be defined as
hazardous under Solid Waste Disposal Act, Clean Air Act, Federal Water Pollution
Controt Act or Toxic Substances Control act or be so designated by Environmental
Protection Agency pursuant to its authority under CERCLA. State of NJ., Dept. of
Environmental Protection and Energy v. Gloucester Environmental Management Services,
Inc,, D.N.J. 1993, 821 F.Supp 999.

Any compound of cadmium, chromium, and lead, @ toxic pollutant under the Clean Water
Act, is hazardous substance under CERCLA. Clty of New York v. Exxon Corp,
S.D.N.Y.1991, 766 P.Supp. 177,

Hazardous substances under CERCLA include all substances #0 designated under other
‘statutes pursuant to the grant of authority contained therein, in addition to substances so
designated by the Environmental Protection Agency (EPA) pursuant to the grant of
authority in CERCLA. U.S. v. Alcan Aluminum Corp., N.D.N.Y.1991, 785 F.Supp. 531, i

226


Chronic beryllium disease

This potentially fatal lung disease has occurred in families of workers exposed to
beryllium in the nuclear and aviation industries and workplaces involved in the
production of beryllium and fluorescent lights and gyroscopes.

Asbestosis and mesothelioma

Fatal lung diseases have occurred among family members of workers engaged in the
manufacture of many products containing asbestos, including thermal insulation
materials, asbestos cement, automobile mufflers, shingles, textiles, gas masks, floor
tiles, boilers, ovens, and brakeshoes and other friction products for automobiles.
Families have also been exposed to asbestos when workers were engaged in mining,
shipbuilding, insulating (e.g., pipe laggers and railway workers), maintenance and
repair of boilers and vehicles, and asbestos removal operations.

Lead poisoning, neurological effects, and mental retardation

These health effects have occurred in children of workers engaged in mining,
smelting, construction, manufacturing (pottery, ceramics, stained glass, ceramic tiles,
_electrical components, bullets, and lead batteries), repair and reclamation of lead
batteries, repair of radiators, recovery of gold and silver, work on firing ranges, and
welding, painting, and splicing of cables.

Deaths and neurological effects from pesticides
Farm families and families of other workers exposed to pesticides have suffered these
serious effects.

Chemical burns from caustic substances

Chemical burns of the mouth and esophagus and fatalities from ingesting caustic
substances have occurred in farm families when hazardous substances were
improperly used and stored on farms.

Chloracne and other effects from chlorinated hydrocarbons

Family members have been exposed when these substances were transported home on
clothing of workers manufacturing or using these compounds in the production of
insulated wire, plastic products, ion exchange resins, and textiles. Family members
have been similarly exposed when workers’ clothes became contaminated during
marine electrical work, transformer maintenance, municipal sewage treatment, rail
transportation, wood treatment, and application of herbicides.

Neurological effects from mercury

Family members have developed various neurological effects as a result of being
exposed to mercury carried home on clothing of workers engaged in mining,
thermometer manufacture, and cottage-industry gold extraction.


themselves are not contaminated with the hazardous biological materials [Garner and
Favero 1987; McKay-Ferguson and Mortimer 1977}.

71


Reports of cases requiring chelation therapy, and cases of encephalopathy and
elevated erythrocyte protoporphyrin (EP) were associated with BLLs greater than
50 »g/dL. Health effects reported at BLLs greater than 30 g/dL included
elevated erythrocyte protoporphyrin, metaphyseal lead lines in the long bones, and
one case of possible learning and behavioral problems. The two studies that
found no effects on measures of hemoglobin synthesis had BLLs in the range 8-44
ug/dL in one case and an average of 10.2 zg/dL in the other case. In all of the
20 studies in which health effects were not addressed, BLLs exceeded 10 pg/dL;
in 10 of them BLLs were greater than 25 g/dL and in 4 of these the BLLs
exceeded 40 ypg/dL.

CAUSTIC FARM PRODUCTS
Overview
Over 40 cases of poisonings by caustic farm products are documented by the
Teports reviewed in this section and summarized in Table 10. Effects of caustic
farm products include chemical burns of the mouth and esophagus, eyes, and skin
which may be fatal. Most of these cases have been reported in the last 5 years.

Background
Caustic products used on farms include dehorning products, drain cleaners,

disinfectants, and dairy pipe line cleaners. The caustic substances include sodium
and potassium hydroxide and sulfuric and phosphoric acid.

Review of Studies

There are eight reports on ingestions of caustic alkali (sodium hydroxide) and acid
products (sulfuric and phosphoric) on farms. Almost all of the cases involved
children, although there was at least one case where an adult ingested liquid dairy
pipe line cleaner when it was in a container other than the original (a glass
tumbler) in his barn [Edmonson 1987]. Christesen [1994] compared aspects and
prevention of caustic alkali ingestion by children in Denmark. He noted the
incidence of children being poisoned by milk pail cleaners, while originally high,
decreased over the period of his study, due to an educational campaign
implemented by the popular press during the same time period.

Neidich [1993], noted 14 case reports over a 5-year period for 2 pediatric
inpatient facilities in Sioux Falls, South Dakota. Seven children ingested solid
caustics (three were calf dehorning products, two were used as disinfectants and
cleaners, and two were being used as drain cleaners). All seven of the liquid
caustics were being used as dairy pipe line cleaners. Six of the seven children
ingested the product from containers other than the original. The non-original
containers were smaller than the original containers and included empty cans and
soft drink bottles. The caustic was transferred several times a day to these
smaller and more convenient containers, from which the children ingested the
product. By comparison, all seven solid caustic ingestions occurred directly from
the original containers. All 14 cases were found to have mouth burns at initial

16


Silvany-Neto AM, Carvalho FM, Chaves MEC, Brandao AM, Tavares TM [1989].
Repeated surveillance of lead poisoning among children. Sci Total Environ 78:179-186.

Simon RD [1963]. Parathion: A case report. Amer J Dis Child 105:527.

Simonson AV, Mecham CC [1983]. Evaluation of airshowers and shoecleaners as
exposure controls in secondary lead smelters. Final Technical Report Demonstration
Project Number Ten, September, 1983. Cincinnati, OH: U.S. Department of Health and
Human Services, Public Health Service, Centers for Disease Control, National Institute
for Occupational Safety and Health, Division of Physical Sciences and Engineering,
NIOSH Contract No. 210-81-7106.

Smith AH, Fisher DO, Pearce N, Chapman CJ [1982]. Congenital defects and
miscarriages among New Zealand 2,4,5-T sprayers. Arch Envir Health 37(4):197-200.

Sprince NL, Kazemi H [1980]. U.S. beryllium case registry through 1977. Environ Res
21:44-47.

Sprince NL, Kazemi H, Hardy HL [1976]. Current (1975) problems of differentiating
between beryllium disease and sarcoidosis. Ann NY Acad Sci 278:654-64.

Stanbury M [1994]. Letter of February 15, 1994 re: workers’ family protection from lead
in New Jersey to Richard W. Niemeier, Education and Information Division, National
Institute for Occupational Safety and Health, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services. 6

pages.

Stasiuk W [1993]. Letter of November 18, 1993 re: home contamination from dry-
cleaners to Mr. Bruce Jordan, U.S. Environmental Protection Agency. Available in
Cincinnati, OH: Docket Office, Education and Information Division, National Institute
for Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 14 pages.

State of Alabama [1992]. Department of Public Health memoranda of June 9 and 12,
1992 to James W. Cooper, Director, Bureau of Environmental and Health Service
Standards re: elevated blood lead levels and home contamination. Available in
Cincinnati, OH: Docket Office, Education and Information Division, National Institute
for Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 6 pages.

Steele GK [1994]. Letter of February 9, 1994 re: workers’ home contamination in
Indiana to Diane Manning, Education and Information Division, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, Public
Health Service, U.S. Department of Health and Human Services. 7 pages.

136


Benenson AS ed. [1985]. Control of communicable diseases in man. 14th ed.
Washington DC: American Public Health Association. 485 pages.

Benning D [1958]. Outbreak of mercury poisoning in Ohio. Ind Med Surg 27:354-363.

Berry G [1986]. Chrysotile and mesothelioma. Accomplishments in oncology: The
biological effects of chrysotile, Wagner JC, ed. Philadelphia, J.B. Lippincott Co. pages
123-132.

Bhat N, Rosato EF, Gupta PK [1990]. Gynecomastia in a mortician: A case report.
Acta Cytologica 34(1):31-34.

Bianchi C, Brollo A, Bittesini L, Ramani L [1987]. [Hyaline pleural plaques and
domestic exposure to asbestos] (in Italian). Med Lav 78(1):44-49.

Bianchi C, Brollo A, Ramani L [1990]. Hyaline pleural plaques and asbestos exposure.
In: Proceedings of the Vth international pneumoconioses conference, Part I.
Pittsburgh, PA, August 23-26, 1988. Cincinnati, OH: U.S. Department of Health and
Human Services, Public Health Service, Centers for Disease Control, National Institute
for Occuaptional Safety and Health, DHHS (NIOSH) Publication No. 90-108 Part I,
919-923.

Bianchi C, Brollo A, Ramani L, Berte R [1991]. Exposure to asbestos in Monfalcone,
Italy. A necropsy-based study. In: Riboli E, Delendi M, eds. Autopsy in Epidemiology
and Medical Research. LARC Sci Publ 112:127-140.

Bianchi C, Brollo A, Ramani L, Zuck C [1993]. Asbestos-related mesothelioma in
Monfalcone, Italy. Am J Ind Med 24:149-160.

Bianchi C, Giarelli L, Di Bonito L, Grandi A, Brollo A, Bittesini L [1982]. Asbestos-
related pleural mesothelioma in the trieste area. In: Levy E, Laboratory Medicine:
Advances in Pathology (Anatomic and Clinical), ed. 1: Proceedings of the XIth Triennial
World Congress of the World Association of Societies of Pathology (Anatomic and
Clinical). pages 545-548.

Bierbaum P [1993]. Memorandum of November 19, 1993 re: take-home toxins from Phil
Bierbaum, Division of Physical Sciences and Engineering to Diane M. Manning,
Education and Information Division, National Institute for Occupational Safety and
Health, Centers for Disease Control and Prevention, Public Health Service, U.S.
Department of Health and Human Services.

Bittersohl G, Ose H [1971]. [The epidemiology of pleuramesotheliomas] (in German).
Z Gesante Hyg 17:861-864.

103


Oct. 26 FIRE ADMINISTRATION AUTH. ACT

Be na be inplemented the Nationa! Institute
pens peg geenr age gam i Feces!
: a to
agencies for *, i fie pocessary r
under subparagraph (AX iii).
coasted aes oe . raed
as
fBrestigating idvane related & Ime contamineten wing
frigting Procedures until such time as a final strategy
is ped or from taking actions in addition to those
D IMPLEMENTATION. OF. INVESTIGATIVE STRATEGY.—Upon
seperti of fie investigative etpatery under, subparagraph

1ONS.—

(1) IN GENERAL.—Not later than 4 years after the date
of enactment of this Act, and periodically thereafter, the Sec-
retary of Labor, based on the information under
subsection (c) and on other information available to the Sec-
retary, shall—

(A) determine if additional education about, emphasis
on, or enforcement of existing tions or standards

pursuant to 's authori! the
Bocupa toni! Safety and Reali het ot ion eae Ue abe
@t seq.), such i or as determined to be
appropriate not than 3 years after such determination.

106 STAT. 3423

260

P.L. 102-522
See. 209


toxic substances, and specifically grants MSHA the authority to establish rules addressing
suitable protective equipment. As with OSHA standards, these rules can ultimately
protect both miners and their families.

Additional protection against home contamination by miners is provided implicitly in §
877 of the Mine Act. This section authorizes MSHA to require that employers make
sanitary and bathing facilities available at the worksite for use by miners in removing
mining-related contaminants; also, these facilities must be adequate for miners to change
and store their work clothes between work shifts. These requirements have been
incorporated into regulations for coal mines [30 CFR 71.400-404 and 30 CFR 75.1712].

NIOSH has authority under § 951 of the Mine Act to conduct research on the health
effects of exposure to mining operations, and to make preventive recommendations.

Toxic Substances Control Act (TSCA)

The Environmental Protection Agency (EPA) has extensive authority under TSCA to
regulate chemical hazards. Under 15 U.S.C. 2604 and 2605, EPA can regulate the
manufacturing, processing, use, distribution in commerce, and disposal of new and
existing chemicals, respectively. While another section, 15 U.S.C. 2682, does not refer
explicitly to the hazard of take-home lead to workers’ families, paragraph (a)(1) of this
section directs EPA to "promulgate final regulations governing lead-based paint activities
to ensure that individuals engaged in such activities are properly trained, that training
programs are accredited, and that contractors engaged in such activities are certified.”
This provision states further that “[sJuch regulations shall contain standards for
performing lead-based paint activities, taking into account reliability, effectiveness, and
safety.” A later provision of this section requires a “Study of Certification,” and states
that "[t]he Administrator [of EPA] shall conduct a study of the extent to which persons
engaged in various types of renovation and remodeling activities in target housing...are
exposed to lead and create a lead-based-paint hazard on a regular or occasional basis.”
A subsequent paragraph of this section requires that regulations promulgated under
paragraph (a)(1) of this section be amended as appropriate using the results of such a
study. Should such a study find hazards to the health of workers’ families resulting from
the workers’ lead-based paint activities, EPA is obligated to establish training and
certification requirements to reduce or eliminate the risk of injury to these families.

The following provisions of the TSCA also are useful in reducing the risk of workers’
home contamination: 15 U.S.C. 2604 (requiring an evaluation by EPA of the health and
environmental effects of new chemicals, and of significant new uses of existing chemicals,
prior to the manufacture, or new use, of these chemicals); 15 U.S.C. 2605(a) (mandating
that chemical manufacturers and processors provide notice of unreasonable risk of injury
resulting from their chemicals); 15 U.S.C. 2607(c) (providing that chemical
manufacturers, processors, and distributors maintain records of significant, adverse health
effects resulting from chemicals for which they are responsible); and 15 U.S.C. 2607(e)
(imposing on chemical manufacturers, processors, and distributors a duty to report

78


compared to 19% of community residents. In addition, two wives of workers had
signs of kepone poisoning, displaying the same type of tremors seen in many of
the workers. Both wives reported that they washed their husbands’ work clothing.

In 1992, the California Department of Health Services conducted a pilot study of
pesticide contamination of farmworkers’ and non-farmworkers’ homes located
within one-quarter of a mile of agricultural fields [Osorio 1994]. In total, 12
different pesticides were detected in house dust samples. Pesticides were detected
in all five of the farm workers’ homes and in three of six non-farmworkers’ homes.
Levels of diazinon, chlorpyrifos, and propoxur were higher in farmworkers’ homes
than in non-farmworkers’ homes. Wipe samples were taken from the hands of 1
child aged 1-5 years in each of the 11 households. Measurable levels of diazinon
and chlorpyrifos were found only on hands of farmworkers’ children; three
children had diazinon (52-220 ng/wipe) and two of these had chlorpyrifos (20-100
ng/wipe). Based on dust levels and hand contamination, children residing in the
homes with the highest diazinon levels were at substantially increased risk for
acetylcholinesterase inhibition.

Reports in the literature describe incidents in which children were poisoned from:
residual pesticides left in discarded containers [Johnston 1953; MacMillan 1964;
Eitzman and Wolfson 1967]; from improper storage [Johnston 1953; Simon 1963),
and from pesticides held in improper containers such as soda bottles and tin cups
[Eitzman and Wolfson 1967; McGee et al. 1952; Fowler 1994a]. The children
were often poisoned after they played with items that were contaminated with
pesticides, or ingested pesticides from containers used to store or mix pesticides.
For example, the 4-year-old son of a farmer was admitted to the hospital in a
moribund condition after his mother discovered that he had played with a bag of
parathion insecticide stored in the barn [Simon 1963]. In another case, a brother
and sister died after playing in a swing that they made from a burlap sack heavily
contaminated with parathion [Eitzman and Wolfson 1967]. Other similar
poisonings are described in Table 11.

Another source of poisonings of workers’ families has been items taken home
from work. McGee et al. [1952] reported several unrelated poisonings by
toxaphene, including one in which strips of metal from flattened storage drums
were used to cover the walls of a garden shed. The drums were contaminated
with toxaphene and a 2-year-old boy died after playing nearby. Anderson et al.
[1965] described a near-fatal incident of parathion poisoning in two boys 5 and 12
years old, who became ill after sleeping on flannelette sheets that had been
brought home by the father of one of the boys. The father operated a salvage
dealer business from his home. He bought damaged sheets from an insurance
adjustor which were contaminated with parathion.

The Health Division of the Oregon Department of Human Resources submitted a
case report of illness caused by chloropicrin [Barnett 1994]. When an employee

19