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INVESTIGATION OF A CANCER CLUSTER IN A MULTIPLE STORY OFFICE BUILDING CONDUCTED JUNE, 2009

INVESTIGATION OF A CANCER CLUSTER IN A MULTIPLE STORY OFFICE BUILDING CONDUCTED JUNE, 2009. CIHC Annual Conference December 8, 2010 Westgate Hotel, San Diego, CA. Howard B. Spielman, PE, CIH, CSP, REHS President HEALTH SCIENCE ASSOCIATES 10771 Noel Street Los Alamitos, CA 90720

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INVESTIGATION OF A CANCER CLUSTER IN A MULTIPLE STORY OFFICE BUILDING CONDUCTED JUNE, 2009

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  1. INVESTIGATION OF A CANCER CLUSTER IN A MULTIPLE STORY OFFICE BUILDING CONDUCTED JUNE, 2009 CIHC Annual Conference December 8, 2010 Westgate Hotel, San Diego, CA Howard B. Spielman, PE, CIH, CSP, REHS President HEALTH SCIENCE ASSOCIATES 10771 Noel Street Los Alamitos, CA 90720 Phone: 714-220-3922 www.healthscience.com hspielman@healthscience.com

  2. BREAST CANCER CASES DIAGNOSED: • MARCH 2007 • JULY 2007 • MAY 2009

  3. BREAST CANCER CASES DIAGNOSED: • MARCH 2007 • JULY 2007 • MAY 2009 APRIL OR MAY 2009 ANOTHR EMPLOYEE DIAGNOSED WITH PRE-CANCEROUS CELLS IN HER UTERUS.

  4. BREAST CANCER CASES DIAGNOSED: • MARCH 2007 • JULY 2007 • MAY 2009 APRIL OR MAY 2009 ANOTHR EMPLOYEE DIAGNOSED WITH PRE-CANCEROUS CELLS IN HER UTERUS. ALSO, A CASE OF HODGKIN’S DISEASE.

  5. HSA’S SCOPE OF WORK • SITE VISIT FOR GENERAL ORIENTATION.

  6. HSA’S SCOPE OF WORK • SITE VISIT FOR GENERAL ORIENTATION. • INTERVIEW BUILDING MANAGER AND BUILDING ENGINEER.

  7. HSA’S SCOPE OF WORK • SITE VISIT FOR GENERAL ORIENTATION. • INTERVIEW BUILDING MANAGER AND BUILDING ENGINEER. • REVIEW PROPERTY’S PHASE I ENVIRONMENTAL SITE ASSESSMENT.

  8. HSA’S SCOPE OF WORK • SITE VISIT FOR GENERAL ORIENTATION. • INTERVIEW BUILDING MANAGER AND BUILDING ENGINEER. • REVIEW PROPERTY’S PHASE I ENVIRONMENTAL SITE ASSESSMENT. • CONDUCT LIMITED RESEARCH TO SEE IF ANY ENVIRONMENTAL AGENTS HAVE BEEN IDENTIFIED AS SUSPECTED CAUSES OF BREAST CANCER.

  9. HSA’S SCOPE OF WORK • SITE VISIT FOR GENERAL ORIENTATION. • INTERVIEW BUILDING MANAGER AND BUILDING ENGINEER. • REVIEW PROPERTY’S PHASE I ENVIRONMENTAL SITE ASSESSMENT. • CONDUCT LIMITED RESEARCH TO SEE IF ANY ENVIRONMENTAL AGENTS HAVE BEEN IDENTIFIED AS SUSPECTED CAUSES OF BREAST CANCER. • INTERVIEW TENANT PERSONNEL AND INSPECT TENANT’S PREMISES.

  10. HSA’S SCOPE OF WORK • SITE VISIT FOR GENERAL ORIENTATION. • INTERVIEW BUILDING MANAGER AND BUILDING ENGINEER. • REVIEW PROPERTY’S PHASE I ENVIRONMENTAL SITE ASSESSMENT. • CONDUCT LIMITED RESEARCH TO SEE IF ANY ENVIRONMENTAL AGENTS HAVE BEEN IDENTIFIED AS SUSPECTED CAUSES OF BREAST CANCER. • INTERVIEW TENANT PERSONNEL AND INSPECT TENANT’S PREMISES. • DETERMINE IF FOLLOW-UP AIR AND/OR SURFACE SAMPLING WOULD BE PRUDENT.

  11. BACKGROUND True cancer clusters rarely involve more than one type of cancer. To be considered a true cluster usually means it has one of the following characteristics.

  12. BACKGROUND TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS. • THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER.

  13. BACKGROUND TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS. • THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER. • THERE ARE LARGER THAN EXPECTED NUMBERS OF A MORE COMMON TYPE OF CANCER.

  14. BACKGROUND TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS. • THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER. • THERE ARE LARGER THAN EXPECTED NUMBERS OF A MORE COMMON TYPE OF CANCER. • IT IS A TYPE OF CANCER NOT USUALLY SEEN IN A CERTAIN GROUP OF PEOPLE.

  15. BACKGROUND TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS. • THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER. • THERE ARE LARGER THAN EXPECTED NUMBERS OF A MORE COMMON TYPE OF CANCER. • IT IS A TYPE OF CANCER NOT USUALLY SEEN INA CERTAIN GROUP OF PEOPLE. MOST WELL DOCUMENTED CANCER CLUSTERS HAVE NOT BEEN FOUND IN THE COMMUNITY, BUT HAVE BEEN IN THE WORKPLACE WHERE CERTAIN EXPOSURES TEND TO BE HIGHER AND LAST LONGER.

  16. BACKGROUND TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS. • THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER. • THERE ARE LARGER THAN EXPECTED NUMBERS OF A MORE COMMON TYPE OF CANCER. • IT IS A TYPE OF CANCER NOT USUALLY SEEN IN A CERTAIN GROUP OF PEOPLE. MOST WELL DOCUMENTED CANCER CLUSTERS HAVE NOT BEEN FOUND IN THE COMMUNITY, BUT HAVE BEEN IN THE WORKPLACE WHERE CERTAIN EXPOSURES TEND TO BE HIGHER AND LAST LONGER. BREAST CANCER INCIDENCE IN U.S. WOMEN IS 1 IN 8 (13%). MOST COMMONLY DIAGNOSED CANCER AMONG U.S. WOMEN (1 IN 4).

  17. INFORMATION DEVELOPED • 3 Breast Cancer cases said to be the same cell type. No family history.

  18. INFORMATION DEVELOPED • 3 Breast Cancer cases said to be the same cell type. No family history. • Durations of working here: 5 to 7 years prior to diagnosis.

  19. INFORMATION DEVELOPED • 3 Breast Cancer cases said to be the same cell type. No family history. • Durations of working here: 5 to 7 years prior to diagnosis. • Person with Hodgkin's diagnosed prior to starting work here.

  20. INFORMATION DEVELOPED • 3 Breast Cancer cases said to be the same cell type. No family history. • Durations of working here: 5 to 7 years prior to diagnosis. • Person with Hodgkin's diagnosed prior to starting work here. • From 2002 – 2009 the work force has varied from 5 to 9.

  21. INFORMATION DEVELOPED • 3 Breast Cancer cases said to be the same cell type. No family history. • Durations of working here: 5 to 7 years prior to diagnosis. • Person with Hodgkin's diagnosed prior to starting work here. • From 2002 – 2009 the work force has varied from 5 to 9. • In 2006/2007 carpeting was replaced and the suite repainted. Also, there was a roof leak with significant water intrusion.

  22. INFORMATION DEVELOPED • Noticeable dust from HVAC registers. Sample provided.

  23. INFORMATION DEVELOPED • Noticeable dust from HVAC registers. Sample provided. • Tenants wanted survey to assess incidence of Breast Cancer throughout the building.

  24. INFORMATION DEVELOPED • Noticeable dust from HVAC registers. Sample provided. • Tenants wanted survey to assess incidence of Breast Cancer throughout the building. • Many house plants in the suite.

  25. INFORMATION DEVELOPED • Noticeable dust from HVAC registers. Sample provided. • Tenants wanted survey to assess incidence of Breast Cancer throughout the building. • Many house plants in the suite. • Incense burner noted.

  26. INFORMATION DEVELOPED • Noticeable dust from HVAC registers. Sample provided. • Tenants wanted survey to assess incidence of Breast Cancer throughout the building. • Many house plants in the suite. • Incense burner noted. • MSDS’s for printer/copier chemicals requested.

  27. INFORMATION DEVELOPED • Noticeable dust from HVAC registers. Sample provided. • Tenants wanted survey to assess incidence of Breast Cancer throughout the building. • Many house plants in the suite. • Incense burner noted. • MSDS’s for printer/copier chemicals requested. • No asbestos in building materials.

  28. INFORMATION DEVELOPED • Noticeable dust from HVAC registers. Sample provided. • Tenants wanted survey to assess incidence of Breast Cancer throughout the building. • Many house plants in the suite. • Incense burner noted. • MSDS’s for printer/copier chemicals requested. • No asbestos in building materials. • Building tenant mix typical of a professional office building. No indication of chemicals or physical energy from other tenants.

  29. INFORMATION DEVELOPED • Environmental Site Assessment (2007) Concluded: No evidence of recognized environmental conditions in connection with the property.

  30. INFORMATION DEVELOPED • Environmental Site Assessment (2007) Concluded: No evidence of recognized environmental conditions in connection with the property. • MSDS’s for janitorial products, pesticides and HVAC maintenance revealed only one ingredient identified as a carcinogen – Ethanol, a minor component of disinfectants used in bathrooms.

  31. INFORMATION DEVELOPED • Environmental Site Assessment (2007) Concluded: No evidence of recognized environmental conditions in connection with the property. • MSDS’s for janitorial products, pesticides and HVAC maintenance revealed only one ingredient identified as a carcinogen – Ethanol, a minor component of disinfectants used in bathrooms. • Mild metal fume (welding) odor outside the building.

  32. INFORMATION DEVELOPED • Environmental Site Assessment (2007) Concluded: No evidence of recognized environmental conditions in connection with the property. • MSDS’s for janitorial products, pesticides and HVAC maintenance revealed only one ingredient identified as a carcinogen – Ethanol, a minor component of disinfectants used in bathrooms. • Mild metal fume (welding) odor outside the building. • 200 yards SW of building – a manufacturer of steel doors and frames.

  33. HVAC

  34. HVAC • Package units on roof.

  35. HVAC • Package units on roof. • Suite served by 3 at SW corner of roof.

  36. SAMPLING • Ethanol • Metals • Formaldehyde • Mold spores • Dust sample characterization

  37. SAMPLING Air Samples:

  38. SAMPLING Air Samples: 5 locations in suite of concern

  39. SAMPLING Air Samples: 5 locations in suite of concern 2 locations in management suite and an empty suite

  40. SAMPLING Air Samples: 5 locations in suite of concern 2 locations in management suite and an empty suite 2 locations outdoors at ground level and on roof at HVAC units

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