Carolyn Reeb-Whitaker

Characterizing the Health and Safety Needs of the Collision Repair Industry

Production workers in the collision repair industry are potentially exposed to many harmful chemicals, including isocyanates. Of particular concern is the burden of work-related asthma in this industry that likely reflects exposures to the isocyanates in two-part paints. The main objectives of this study were to gather information about: (i) the collision repair industry business model, (ii) the number of collision repair production workers potentially exposed to isocyanates, (iii) additional chemical and physical exposures of concern, (iv) current health and safety practices in the industry, (v) the health and safety perceptions and needs of business owners and managers, and (vi) strategies to reduce exposure and increase employer and worker awareness. Data were gathered using a combination of key informant interviews, field investigations, and a statewide needs assessment survey. Although a response bias cannot be excluded, the 69% response rate suggests that the survey results are likely representative of Washington States collision repair industry. Collision repair was determined to be a male-dominated industry chiefly comprising small, nonunionized, family-run businesses. Many shops face numerous safety and health challenges resulting from a combination of misinformation within the industry, insufficient funds to address workplace health and safety concerns, and social barriers to enforcing best practices within the shops. Most notably, inappropriate selection and use of respirators and gloves likely contribute significantly to isocyanate exposures. Collision repair workers are potentially exposed to a variety of additional chemical and physical hazards that deserve attention. This industry requires health and safety intervention of both an educational campaign and technical assistance. Any such intervention must account for the financial, demographic, and social characteristics of this industry.

Airborne isocyanate exposures in the collision repair industry and a comparison to occupational exposure limits.

Isocyanate exposure was evaluated in 33 spray painters from 25 Washington State autobody shops. Personal breathing zone samples (n = 228) were analyzed for isophorone diisocyanate (IPDI) monomer, 1,6-hexamethylene diisocyanate (HDI) monomer, IPDI polyisocyanate, and three polyisocyanate forms of HDI. The objective was to describe exposures to isocyanates while spray painting, compare them with short-term exposure limits (STELs), and describe the isocyanate composition in the samples. The composition of polyisocyanates (IPDI and HDI) in the samples varied greatly, with maximum amounts ranging from up to 58% for HDI biuret to 96% for HDI isocyanurate. There was a significant inverse relationship between the percentage composition of HDI isocyanurate to IPDI and to HDI uretdione. Two 15-min STELs were compared: (1) Oregons Occupational Safety and Health Administration (OR-OSHA) STEL of 1000 μg/m3 for HDI polyisocyanate, and (2) the United Kingdoms Health and Safety Executive (UK-HSE) STEL of 70 μg NCO/m3 for all isocyanates. Eighty percent of samples containing HDI polyisocyanate exceeded the OR-OSHA STEL while 98% of samples exceeded the UK-HSE STEL. The majority of painters (67%) wore half-face air-purifying respirators while spray painting. Using the OR-OSHA and the UK-HSE STELs as benchmarks, 21% and 67% of painters, respectively, had at least one exposure that exceeded the respirators OSHA-assigned protection factor. A critical review of the STELs revealed the following limitations: (1) the OR-OSHA STEL does not include all polyisocyanates, and (2) the UK-HSE STEL is derived from monomeric isocyanates, whereas the species present in typical spray coatings are polyisocyanates. In conclusion, the variable mixtures of isocyanates used by autobody painters suggest that an occupational exposure limit is required that includes all polyisocyanates. Despite the limitations of the STELs, we determined that a respirator with an assigned protection factor of 25 or greater is required to protect against isocyanate exposures during spray painting. Consequently, half-face air-purifying respirators, which are most commonly used and have an assigned protection factor of 10, do not afford adequate respiratory protection.

Development of a Permeation Panel to Test Dermal Protective Clothing Against Sprayed Coatings

OBJECTIVES Design, construct, and characterize an apparatus to evaluate dermal protective clothing for resistance to polymerizing materials. Specifically, we evaluated the permeation of the most common glove material used in automotive collision repair (0.10-0.13 mm or 4-5 mil latex) with representative isocyanate-containing clear coats. Our ultimate goal is to make informed recommendations on dermal protective materials to prevent isocyanate exposures and reduce the likelihood of occupational illness in automotive collision repair and other industries. METHODS A novel permeation panel was developed to assess dermal protective clothing. With this apparatus, up to eight test materials may be evaluated under typical-spray application conditions. Solid collection media comprised of 1-(2-pyridyl)-piperazine (2-PP)-coated fiberglass filters or colorimetric SWYPE™ pads were placed behind test materials to capture permeants. The 2-PP-coated filters were subsequently analyzed using a modified OSHA42/PV2034 method. Color change in the SWYPEs provided an immediate field estimate of breakthrough time. In addition, Teflon filters were mounted proximal to the permeation cells to measure the mass of clear coat applied to the panel and to evaluate loading homogeneity. This study evaluated the permeation of isocyanates through 0.10-0.13 mm latex glove material at a fixed time (30 min post-spraying) and over a time course (6-91 min post-spraying). RESULTS Monomers 1,6-hexamethylene diisocyanate (HDI) and isophorone diisocyanate (IPDI) permeated through (0.10-0.13 mm) latex glove material under typical glove use conditions (30 min). The latex glove material exhibited immediate breakthrough, with a permeation rate of 2.9 ng min(-1) cm(-2). The oligomeric forms of HDI and IPDI did not permeate the latex glove material. The spray application at 71 ± 5 °F was fairly homogeneous (33.7 ± 8 mg weight of dry clear coat per 5 cm(2)). CONCLUSIONS The permeation panel is a viable method to assess dermal protective clothing performance against polymerizing materials. Thin (0.10-0.13 mm) latex gloves were determined to be ineffective barriers to the isocyanates commonly found in clear coats. Because this type of glove is used frequently in auto body shops, the potential for isocyanate exposure is of concern. Permeation tests with other dermal protective clothing materials and other clear coat formulations are needed to make recommendations about alternative materials.

Work-Related Asthma in Washington State

Objective. Asthma is a common and costly public health problem. Occupational exposures contribute to the burden of asthma. Identifying workplace exposures and industries and occupations at risk can lead to more effective prevention measures. Methods. Data from Washington State’s work-related asthma (WRA) surveillance program from October 2001 to December 2008 were analyzed. Workers’ compensation records, physician reports, and telephone interviews were used to describe the occurrence of WRA during this time, in order to identify contributing exposure sources and industries and occupations that are associated with WRA in Washington. Results. There were 1343 identified WRA cases in Washington State during this time. Of these, 1285 were workers’ compensation claims, with a total medical cost for State Fund claims of approximately

Prevention Guidance for Isocyanate-Induced Asthma Using Occupational Surveillance Data

3 million dollars. The top three sources identified were miscellaneous chemicals and materials, mineral and inorganic dusts, and plant material. Plant material claims proved to be widespread throughout various industries, were largely classified as new-onset asthma cases, and had higher median medical cost and higher median time loss days than cases associated with other exposure sources. Conclusions. Washington State has an abundance of plant-material-related WRA cases among US states conducting WRA surveillance. Washington State’s industry mix might explain the higher prevalence of cases, particularly its logging and wood processing industries and as a world leader in hops production. In Washington, further WRA prevention efforts should emphasize workplaces working with plant materials.

Survey of Dermal Protection in Washington State Collision Repair Industry

Data from Washington States work-related asthma surveillance system were used to characterize isocyanate-induced asthma cases occurring from 1999 through 2010. Injured worker interviews and medical records were used to describe the industry, job title, work process, workers’ compensation cost, and exposure trends associated with 27 cases of isocyanate-induced asthma. The majority (81%) of cases were classified within the surveillance system as new-onset asthma while 19% were classified as work-aggravated asthma. The workers’ compensation cost for isocyanate-induced asthma cases was

Distribution of asthma by occupation: Washington State Behavioral Risk Factor Surveillance System Data, 2006–2009

1.7 million; this was 14% of the total claims cost for all claims in the asthma surveillance system. The majority of cases (48%) occurred from paint processes, followed by foam application or foam manufacturing (22%). Nine of the asthma cases associated with spray application occurred during application to large or awkward-shaped objects. Six workers who did not directly handle isocyanates (indirect exposure) developed new-onset asthma. Two cases suggest that skin contact and processes secondary to the isocyanate spray application, such as cleanup, contributed to immune sensitization. Surveillance data provide insight for the prevention of isocyanate-induced respiratory disease. Key observations are made regarding the development of work-related asthma in association with a) paint application on large objects difficult to ventilate, b) indirect exposure to isocyanates, c) exposure during secondary or cleanup processes, and d) reports of dermal exposure.

Occupational Carbon Monoxide Poisoning in Washington State, 2000–2005

Substantial exposure to isocyanates may occur during spray painting in autobody shops, yet information is lacking on the efficacy of the protective clothing used during spray painting. We investigated the personal and workplace factors associated with painters’ dermal protection use during a large-scale exposure assessment study. Survey data indicated that 69% of painters always used gloves, with latex gloves (47%) and nitrile gloves (34%) used most frequently. Among latex glove users, 53% used thin latex (0.05–0.13 mm), 6% used medium latex (0.15–0.20 mm), and 12% used thick latex (> 0.20 mm). Among nitrile glove users, 27% used thin nitrile and 45% used medium nitrile. Sixty-three percent of painters always used coveralls, 44% preferring one particular brand. Although overspray presents an opportunity for dermal exposure to the neck and face, only 19% of painters protected these areas with personal protective equipment. Painters who always used coveralls were more likely to use gloves (odds ratio = 7.9, p = 0.061). Painters who reported ever having smoked cigarettes used gloves (p = 0.05) and coveralls (p = 0.04) more frequently. Painters who sprayed more than 34 clear coat jobs per month used coveralls most frequently (p = 0.038). Exact logistic regressions along with random sample calculations indicated that the survey results were independent of the shops. Because of the small sample size in this study, future research is warranted to corroborate these results. Studying the effectiveness of gloves and coveralls against polyurethane paints and understanding the underlying motivators and preferences for painters and business owners is needed for the development of best practices for the selection and use of dermal protection.

Testing of Glove Efficacy against Sprayed Isocyanate Coatings Utilizing a Reciprocating Permeation Panel

Abstract Objective: To estimate the prevalence of asthma in workers by occupation in Washington State. Methods: Data from the 2006–2009 Behavioral Risk Factor Surveillance System (BRFSS) and the BRFSS Asthma Call-Back Survey (ACBS) in Washington State (WA) were analyzed. Using state-added and coded Industry and Occupation questions, we calculated prevalence ratios (PRs) for 19 occupational groups. Results: Of the 41 935 respondents who were currently employed during 2006–2009, the prevalence of current asthma was 8.1% [95% confidence interval (CI) 7.8–8.5%] When compared with the reference group of executive, administration and managerial occupations, three occupational groups had significantly (p < 0.05) higher PRs of current asthma: “Teachers, all levels, and Counselors’ (PR 1.3, 95% CI 1.1–1. 6%); ‘Administrative Support, including Clerical” (PR 1. 5, 95% CI 1.2–1.9%); and “Other Health Services” (PR 1.5, 95% CI 1.2–1.9). Half of the 2511 ACBS respondent workers (55.1%) indicated that they believed exposure at work had caused or worsened their asthma, but only 10.7% had ever spoken with a health care professional about their asthma being work related. Conclusions: Some occupations have a higher prevalence of current asthma than other occupations. The systematic collection of industry and occupation data can help identify worker populations with a high burden of asthma and can be used to target disease prevention efforts as well as to aid clinician recognition and treatment. Workers indicated that work-related asthma exposures are not discussed with their health care provider and this communication gap has implications for asthma management.

Field comparison of air sampling methods for monomeric and polymeric 1,6-hexamethylene diisocyanate.

Washington State workers’ compensation data can be used to guide prevention efforts focused on occupational carbon monoxide (CO) poisoning. Between 2000 and 2005, a total of 345 individual claims comprising 221 different exposure incidents were identified for the 6-year time period. The construction industry had 43 (20%) CO incidents, followed by wholesale trade with 32 (15%), and agriculture with 27 (12%) incidents. Fuel-powered forklifts caused 29% of all incidents, while autos/trucks/buses were responsible for 26%. The number of forklift incidents in fruit packing and cold storage companies declined significantly from 1994 through 2007 (Spearmans rho = 0.6659, p < 0.01). While this study used multiple medical records from workers’ compensation claims to identify CO poisoning, a surveillance system that lacks extensive medical records may rely principally on carboxyhemoglobin (COHb) tests. This study demonstrated that 71% of the identified workers’ compensation claims had associated COHb tests. The recurrence and timing of CO poisoning as well as control of the CO-generating source were determined. Approximately 8% of all work sites had recurring CO poisoning incidents. Two percent experienced a recurrent incident within 16 days of the initial incident, and 6% experienced a recurrent incident between 16 days and 3 years after the initial incident. Sixty-seven percent of claimants exposed to CO were not in direct control of the CO-generating source; this has implications for CO prevention and underscores the need for all employees to be trained on CO hazards.