“It’s just like the paper we read in class.” That was the email message I received last week from a former undergraduate student from a class I used to teach called "Health and the Environment." She was referring to a report of two young children from the Cincinnati, OH area who were lead poisoned because the toxic metal wasn’t controlled at their father’s workplace. He worked at a facility that recycles electronic waste (e-scrap.)
My former student read about the case in the July 17, 2015 edition of the CDC’s Morbidity and Mortality Weekly Report (MMWR). The 2 year-old girl and 1 year-old boy had elevated blood-lead levels (BLL) of 14 µg/dL and 18 µg/dL, respectively. (CDC recommends that public health authorities take action when a child’s BLL is 5 µg/dL or greater.)
The authors of the MMWR case note that the children's primary care physician diagnosed the lead poisoning in 2010. The physician referred the family to the Cincinnati Children's Hospital Pediatric Environmental Health Specialty Units (PEHSU) which triggered an evaluation of the family’s home by the Cincinnati Health Department's Childhood Lead Poisoning Prevention Program. The Health Department’s investigators determined there was no lead paint in the home or at the children’s daycare facility. That led to inquiries about possible work-related take-home contamination.
“The father worked at an e-scrap recycler company, crushing cathode ray tubes. …The family reported there was frequently visible dust in his hair, and the children often touched his hair. The father's BLL was 25 µg/dL.”
The "it's just like the paper we read in class" was one published in 2005 in the American Journal of Industrial Medicine. That paper describes an individual with severe, recurring gastrointestinal symptoms and fatigue, and the round-about way he was ultimately diagnosed with work-related lead poisoning. His BLL, taken one week apart, were 159 and 164 µg/dL.
The gentleman worked as a "compounder" at a plant that manufactured customized PVC pellets. The authors described his job this way:
“This small employer custom compounds vinyl pellets from raw ingredients (powdered PVC resin, powdered stabilizer, and liquid lubricant). Lead sulfate was added as a stabilizer when formulating plastics for manufacturers of products such as insulated electrical wiring."
The compounders "frequently (often daily) mixed batches that used pure lead sulfate as the stabilizer. Fifty-pound bags of lead sulfate were cut open and left unsealed in the production area; for each batch, a compounder hand-scooped six to eight pounds of pure lead sulfate powder and dumped it into a large mixing vat while wearing a paper dust mask.”
Investigators with the California Department of Public Health identified two co-workers at the plant who had BLL of about 110 µg/dL. They also noted:
"The employer was unaware that lead sulfate posed a serious health hazard or of his responsibilities under the OSHA lead standard. He had relied on the product Material Safety Data Sheet (MSDS) for information on health effects and guidance on protecting his workers. The MSDS for this product did not mention the effects of lead on the central nervous system, blood-forming [or other health effects]... "and had inadequate information on appropriate respiratory protection.
The incomplete information on the MSDS, which was required to be prepared by the manufacturer of the lead sulfate, and the employer's failure to comply with a whole host of precautions for lead-exposed workers, were violations of OSHA standards.
The case report was rich with information and was why I used it in my class. The paper also had a one-sentence bonus:
"Follow-up BLL testing of workers’ children identified one child, a 3-month-old infant, with an elevated BLL (10 µg/dL).”
That was the line that triggered my former student’s email to me: “It’s just like the paper we read in class.”
It was because of the bonus line--- "a 3-month old infant with and elevated BLL"---that I especially liked using the paper in my class. It was a way for my students to recognize how toxic exposures in workplaces don't necessarily stay there. It's why OSHA regulations are not just about workers, but about the health and safety of families and communities.
The lead poisoning case reported in the July 17 MMWR has a second part of the story. The authors, researchers with CDC's National Institute for Occupational Safety and Health (NIOSH), note that they didn't know about the 2010 children's lead poisoning cases. They learned about it in 2012 as part of their agency's special initiative to learn more about hazards in the electronic waste-recycling industry. The NIOSH researchers happened to be evaluating the exact facility where the children's father had worked. They write:
"The PEHSU investigator became aware of the NIOSH evaluation through a notification to a local affiliated occupational medicine training program."
Among NIOSH's findings about the lead hazards in the father's e-scrap recycling workplace:
- "The local exhaust ventilation system at the cathode ray tubes crushing operation recirculated potentially contaminated air back into the production area. ...(Cathode ray tubes are made from leaded glass, with lead concentrations in the funnel glass up to 25% and in the frit (where the panel glass joins the funnel glass) up to 85%.)"
- "There were no showers in facility A, and employees used brooms to sweep the work area, creating airborne dust.""...The changing area for employees who broke cathode ray tubes was not adjacent to the cathode ray tubes work area.... Employees could track lead-containing dust through the facility. Personal items, food, and work clothing and equipment were stored together in the changing area."
- Lead (in lower concentrations) were found, among other places: the break room (e.g., floor, tables, and refrigerator handle), and the water fountain near the restrooms.
- "The hands of eight of 12 employees tested positive for lead, even though they had washed their hands with soap and water before testing. NIOSH also took a wipe sample from uniforms of employees' front shoulder area. Twelve of 13 uniforms tested positive for lead."
Had the employer been following OSHA's lead standard, the workplace would not have been so contaminated with the toxic metal. More details on NIOSH's findings are in the July 17 MMWR. NIOSH published last year its assessment of hazards in the e-scrap recycling industry, with a special focus on lead and cadmium exposures.
It's not the only time that parallel reports have been published on toxic exposures in the workplace and lead-poisoned children. NIOSH also published last year an evaluation of take-home lead contamination from a battery recycling plant in Puerto Rico. Investigators identified elevated BLL in children of the workers. Of 68 children aged <6 years who were tested, 39 (57%) had BLL ≥5 µg/dL. In this case, the company was violating OSHA standards, as well as EPA regulations.
There are plenty of lawmakers who disparage government regulations as burdensome and unnecessary. OSHA is often the target of their criticism. Maybe some of them might think twice if they realized the importance of workplace safety regulations for children's health.
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