Indoor Air Quality: Chemical and Biological Impacts in Public Schools

1. Dr. Gary Rodabaugh, CHMM (Master) Ferris State University Indoor Air Quality:Chemical and Biological Impacts in Public Schools Responding To A New Environment Emergency Response at Schools of Public Health September 9-10, 2002

2. Dr. Gary Rodabaugh, CHMM • Certified Hazardous Materials Manager (Master Level) • Professor: Environmental Health and Safety Management Program • Ferris State University • 200 Ferris Drive, VFS 300 • Big Rapids, Michigan 49307 • Ph: 231-591-2308, FAX: 231-591-3788 • Rodabaugh@ferris.edu

3. Background Certified Hazardous Materials Manager (Master) Professor of Industrial Hygiene, Hazardous Materials Management, Industrial Safety 15 years in construction Avid sportsman Licensed Ontario Gold Prospector Dr. Gary Rodabaugh, CHMM

4. History/Background • IAQ was not an issue when buildings had lots of ventilation via leaks and lack of insulation. • Energy efficient buildings without windows that open initiated much of the problem identified as “sick building syndrome”. • Average business building, hotel relies heavily on recirculated air.

5. History/Background • Since recirculated air is expensive to heat/cool, minimal or no fresh air is available to occupants. • Rarely the 15-20 cfm per occupant required for basic health and occupant comfort.

6. History/Background • Lack of air circulation, humidity control, decreasing quality of structural design/building increases possibility of the combination of moisture/temperature/nutrients that are the direct cause of our current problems with microbiological contaminants and IAQ. • Chemical contaminants also an issue because of lack of ventilation. • Chemicals used in the lab, cleaning or maintenance are often distributed throughout the structure via the recirculating ventilation system.

7. Typical Recirculating System

8. The Issue • How do you respond to public buildings where more than 20% of the occupants report health problems that seem to go away when they leave the building? • How do you respond to irate parents when their children have difficulty breathing, sinus infections, breathing problems, upper respiratory infections and rashes?

9. The Typical Responses • Denial • “It’s all in their heads – no one else is complaining” • Placation • Run inadequate air tests with poorly trained staff and say the air is OK. • Pass the buck • “not our problem” • Contractor installed something wrong • Someone used wrong materials • Kid was sick before he/she got here

10. What are the Risks? • Risk calculations are always “risky” when dealing with the public. • Explaining that the risk is 1:1000 or that there is “very little risk” does not satisfy the average parent of a sick child. • Let’s look at some of the very real risks associated with microbiological and chemical exposures in public buildings.

11. Microbiological Risks • Loss of productivity through illness, discomfort • Increased sick time and absenteeism • Debilitating illness in some individuals • Increased risk of disease/death in sensitized individuals

12. Microbiological Risks • Symptomolgy that may include headaches, nausea, upper respiratory illnesses/infections, difficulty breathing, malaise, irritated eyes and many other symptoms. • Often called “sick building syndrome”

13. Chemical Risks • Chemical related illnesses • Some well known disorders such as benzene induced leukemia or sensitization to isocyanates • Symptomology often easier to track because of symptoms associated with specific chemical exposures are usually well documented. • For example, skin rash, headaches, dizziness, unable to concentrate, difficulty breathing associated with many VOCs.

14. Actual vs Perceived Risk

15. Actual – remember, we are surrounded by fungi and bacteria virtually everywhere we go. As a species, we have developed tolerances to most of them. Ganoderma sp. is commonly found in many IAQ samples Actual vs Perceived Risk: Microbiological

16. Actual vs Perceived Risk: Microbiological • However, we now often live in “caves” for long periods of time rather than spending most of our waking hours outside. • New types of fungi in higher concentrations, in an enclosed space spell trouble.

17. Actual vs Perceived Risk: Microbiological • Actual Risk • Depends on the individual exposed and the microbiological agent in question. • Depends on the mixture of micro agents • Depends on the sensitivity of the individual to the microbiologicals in question • Many people may live in a house and only one person be impacted negatively by the exposures.

18. Actual vs Perceived Risk: Microbiological • Actual Risk (cont.) • Hundreds of people in a building may be exposed and only a select few have problems – too easy to dismiss this group • Don’t forget to evaluate bacterial exposures as well as fungal. Although fungi get the press, bacteria can present extreme hazards under some circumstances. (Legionella)

19. Actual vs Perceived Risk: Microbiological • Perceived Risk • Black mold scare common now, although not all black mold is the toxic type (Stachybotrys) • Since symptoms are often difficult to connect to exposure, people think all symptoms are related to their work environment

20. Actual vs Perceived Risk: Microbiological • Perceived Risk (cont.) • Headlines like “Toxic Mold Found in Elementary School” create unreasonable anticipation of harm, among parents and concerned citizens. • Public not well informed and thinks all mold is bad • Mold/bacteria always make people sick

21. Actual vs Perceived Risk: Chemical • Actual Risk • Many chemicals extremely toxic and well known to cause extreme health effects • Although many chemicals create immediate/acute reactions to exposure, many chronic exposures cause chemical-related diseases that may take years/decades to manifest themselves

22. Actual vs Perceived Risk: Chemical • Perceived Risk • “better living through chemistry” • “bought it at WalMart, must be safe!” • “if it was bad, the government wouldn’t let them sell it”

23. Response process: Public Information and Industrial Hygiene • Public Information • Communicate actual risk • Communicate that most individuals are not at risk but that sensitive individuals may be at much greater risk than the general population. Though they are in the minority, their issues cannot be ignored. • Provide interpretations/information on specific microbiologicals where possible. • Provide information on specific chemicals of concern where possible.

24. Response process: Public Information and Industrial Hygiene • Industrial Hygiene • Microbiologicals • Use AirOCells for survey work • Use swabs to identify genus species (always go to species because some genera have very toxic and non-toxic representatives, depending on species) • Use Anderson samplers (pulls air past agar plates to grow out microorganisms)

25. Response process: Public Information and Industrial Hygiene • Industrial Hygene (Cont.) • Use resources like those listed here to determine health effects • Atlas of Clinical Fungi (2nd ed), ISBN 90-70351-43-9 • Manual of Clinical Microbiology (7th ed), ISBN 1-55581-126-4 • Manual of Environmental Microbiology, ISBN 1-55581-087-X • Sick Buildings, ISBN 0-87371-346-X • Bioaerosols Assessment and Control, ISBN 882417-29-1

26. Response process: Public Information and Industrial Hygiene • Industrial Hygene (Cont.) • Some Internet Resources • http://www.bio.psu.edu/people/faculty/whittam/apdbase/fungus.html • http://www.emlab.com/app/fungi/Fungi.po;jsessionid=abNE4eOQunu6uWytqAZcFejF(2A8c5iMo) • http://www.doctorfungus.org/ • http://www.botany.utoronto.ca/researchlabs/mallochlab/malloch/moulds/Index_of_Descriptions.html • http://www.epa.gov/iaq/pubs/index.html • http://www.epa.gov/iaq/schools/tfs/guidtoc.html • http://www.dehs.umn.edu/iaq/fungus/ • http://www.emsl.com/mold_testing.html • http://www.epa.gov/iaq/pubs/insidest.html • http://www.epa.gov/iaq/molds/moldguide.html#Mold%20Basics

27. Response process: Public Information and Industrial Hygiene • Industrial Hygene (Cont.) • Chemicals • If exact chemical is known, IH testing is relatively straightforward. IH can select and implement appropriate testing and interpretation. • If exact chemical is not known, such as strange odors or symptoms without identified origin of exposure, TDT scans can be used. • You can get more information about TDT scans at http://www.pati-air.com/index.html

28. Public Health Infrastructure

29. Public Health Infrastructure • Rarely prepared on a local level to deal with chronic/acute chemical or biological exposures. • Few trained industrial hygienists in public health. • Public health departments rarely have access to proper testing equipment or the training to use it.

30. Public Health Infrastructure • Laboratory analysis is not normally available locally • Accredited laboratories are expensive and can quickly deplete local budgets. Average investigation cost for a residence is $1,000 (4 AirOCells @ $60 ea, 4 swabs for bacteria/fungus @ $140 ea plus consultant labor). • Average cost for business is $3,000-10,000.

31. Curriculum Design

32. IAQ Training • One excellent source of IAQ training for public health workers is the American Council of Governmental Industrial Hygienists (ACGIH) • This group provides training on ventilation, IAQ, air sampling and many other IH topics. • (http://www.acgih.org/home.htm)

33. Recommended Curriculum • IAQ inspection techniques (8 hours) • Building structure and leak points • Problem building materials • Problem building techniques • Common locations of microbiological materials • Common locations for chemical contaminants

34. Recommended Curriculum (cont.) • Health effects (8 hours) • Health effects from chemical exposure • Health effects of microbiological materials

35. Measurement and sampling techniques (12 hours) Moisture meters AirOCell samplers TDT scan tubes Charcoal tubes Anderson Sampling Swab samples Microbiological VOC sampling Relative humidity Carbon dioxide as indicator of fresh air entrainment Carbon monoxide sampling Blueprint reading – HVAC systems Use of Velometer to verify air flow Recommended Curriculum (cont.)

36. Recommended Curriculum (cont.) • Litigation (4 hours) • Working with attorneys • Sampling, labeling, shipping and chain of custody for environmental samples • Giving testimony • Standards of care in legal cases • Lack of laws on environmental exposure to mold in industrial setting • Lack of laws on exposure to chemical/mold in residential environments

37. Recommended Curriculum (cont.) • Remediation technologies (8 hours) • Protecting workers • Protecting occupants • Standard operating procedures • Technologies • Encapsulation • Removal • Isolation • Replacement

38. Environmental Economics • The impact of bioaerosols, mold, bacteria and/or chemical exposure in public buildings is likely to be very costly. • One school in Michigan paid over $50,000 in consulting fees and $200,000 in remediation.

39. Environmental Economics • Another school has been charged over 1 Million dollars when they made the mistake of awarding a “no bid” contract to a company with limited expertise. • With no bid criteria, no supervision, no limits, no contract and no clue, the school was sued for over $1,000,000 by the contractor and consultants. • The issue is still not resolved (lawyers are everywhere!)

40. Sample Symptoms from Exposure to Fungal Species

41. Aspergillus sp. • Extrinisic asthma: cough, wheezing, chills, malaise, aches, pains, eosinophilia; similar to asthma caused by dander or pollen • Extrinsic alergic alveolitis: chronic; occurs in people with repeated exposure; cough, dyspnea,fever, chills, ronchi but not wheezing; no peripheral eosiophilia

42. Aspergillus sp. • Allergic bronchopulmonary aspergillosis: symptoms similar to asthma, but more chronic and severe

43. Penicillium spp. • Rare human infections; symptoms would be bronchopulmonary (pneumonia); keratitis; peritonitis • May cause problems for those allergic to Penicillium.

44. Aspergillus/Penicillium • These species are often found growing together.

45. Cladosporium sp. • Very common, especially air, decaying vegetation, food contaminant; opportunist • Uncommon human pathogen

46. Alteraria • Opportunistic pathogens particularly in patients with immunosuppression; Cases of onychomycosis, sinusitis, ulcerated cutaneous infections, and keratitis, as well as visceral infections and osteomyelitis due to Alternaria have been reported. • Most commonly associated with Sinusitis, asthma

47. Stachybotrys • Most infections are associated with hayfever-like symptoms; some strains produce mycotoxins: adverse effects on the central nervous system, eyes, skin, and upper and lower respiratory tract, and, possibly, chronic fatigue.

48. Stachybotrys • Other adult symptoms are immune suppression, bleeding and adverse reproduction effects; most serious diseases associated with S. chartarum (atra).

49. Documents on CD • List of health impacts of several different bacterial and fungal species found in indoor and outdoor environments. • See next few pages for more information on CD contents.

50. Building action plan Building air quality checklist Adobe reader Tools for Schools Bacteria & fungus list Classroom activities IAQ case studies Pittsburgh IAQ software This report Building occupants guide Building air quality