Tobacco Documents Online

CONTENTS ! • Occupational Hazards The Magaine of 5afety, Health and Envimnmental Managemenl j FEATURES 23 THE LEGACY OF LITTLE BOY The bomb dropped on Hiroshima helped build Oak Ridge, Tenn. In the first of our two-part series, we examine whether the environmental fallout from Little Boy could also destroy it. 28 REINVENTING INDUSTRIAL HYGIENE At an Occupational Hazards/American Industrial Hygiene Association roundtable, leading industrial hygiene managers examined the issues facing a profession immersed in change. 32 WHY EMPLOYEES ARE SICK OF INDOOR AIR Contaminants in building air can harm your workers' health, productivity, and morale. Our experts outline strategies for clearing the air of this $60 billion health problem. 37 BLOWING IN THE WIND? Protecting employees who complain about dangerous working conditions moves center stage in the OSHA reform debate. 41 TIPS FOR TERMINAL VISION Optometrist Edward Godnig explains how to avoid visual stress at computer VDTs. DEPARTMENTS 6 EDITORIAL Why the OSH Act - and OSHA - need revision. 8 LETTERS TO THE EDITOR A second opinion on workers' comp. 11 OSHA PEL rule struck down...N.C. reprieve. 17 EPA Air permit rule issued...Contracts overhaul promised. MARKETPLACE 21 SAFETY & HEALTH ACGIH adopts new cancer ratings. 44 CONTESTED CASES General duty and contractors' obligations. 47 WORKERS' COMP UPDATE Texas implements Extra Hazardous Employer Program. 50 PEOPtiE & PLACES Swanson named OSHA deputy assistant secretary. 58 ADVERTISERS' INDEX 53 PRODUCT SHOWCASE Safety signs and labels mustprovide information to a diverse workforce. 54 FREE LITERATURE COVER: Photograph by S.L. Smtlh. A LIG UST 1992 page 28 k, August 1992/Occupational Hazards 5 2074144212

0 0 WHY EMPL4YEES ARE OF INDOOR AIR Contaminants in building air can harm your worken' health, productivity, and morale. Our experts outline strategies for clearing the air of this $60 billion health problem. By Gregg LaBar I n indoor air qual- ity lingo, a major national commu- nications company had a "crisis building" on its hands, according to researcher Stephen J. Reynolds. Employees were complaining about the air quality and nearly all of them were exhibit- ing at least one adverse health effect, including coughing, throat irrita- tion, and disorientation, explained Reynolds, as- sistant professor in the Dept. of Preventive Medicine and Environ- mental Health at the University of Iowa, Iowa City, Iowa. In the course of events, the company did not docu- ment or investigate the problems. But when 31 employees sought emergency medical care, the company de- cided to evacuate the building and have tion than a dramatic example of what is a team of experts investigate. occurring in varying degrees through- The team uncovered problems with out the country. "Nearly all employers the heating, ventilation, and air condi- will end up with questions about indoor tioning (HVAC) system; improper air eventually," warns Henry B. Lick, chemical use throughout the facility;' -manager of industrial hygiene for Ford and microbial contamination. They also Motor Co., Dearborn, Mich., which op- concluded that had the company ad- erates some 2,000 facilities nationwide. dressed employee concerns sooner, American adults spend about 90 per- many of the problems could have been cent of their time indoors, where con- avoided. According to Reynolds, the centrations of some contaminants have episodecostthecompanyasmuchas$1 been found to be two to five times million to shut down operations, hire higher than outdoors. Experts estimate the necessary consultants, and renovate that between 800,000 and 1.2 million the HVAC system. commercial buildings have deficiencies Reynolds'case study is less an aberra- in indoor air quality. The Em ironmen- 32 Occupational Hazards/August 1992 tat Protection Agency (EPA) estimates that IAQ problems cost American business some $60 billion annu- ally, most of it the result of lost productivity. Workers' compensation and health care costs ac- count for several billion dollars of the total, ex- perts said. Healthy Buildings In- ternational Inc. (HBI), a Fairfax, Va., IAQ con- sulting firm, estimates that an employer with 667 employees in a "sick" office building can expect to suffer pro- ductivity losses of about $200,000 annually ($300 per employee) due to employee absenteeism, assuming an IAQ-re- lated absenteeism rate ~ of 1 percent. ~ "The majority of the f costs are hard to see be- cause they're related to absenteeism, morale, and quality of work," Iowa's Reynolds said. "Medical costs are probably less than 10 percent of the total loss. There just aren't a lot of cases where there is a physician-diag- nosable illness." Sheldon H. Rabinovitz, director of industrial hygiene and toxicology for Sandler Occupational Medicine Asso- ciates, a Melville, N.Y., consulting firm, notes that while few indoor air situations are life-threatening, em- ployers still need to address IAQ con- cerns for health and economic rea- sons. "If there are complaints, the employer must do what he can to 2074144213

eliminate the problem. He cannot live with the problem," Rabinovitz said. Wide Range of Effects The variety of maladies associated with poor indoor air ranges from an- noyances and comfort concerns to seri- ous infections and even death. The more serious problems have sparked interest in indoor air quality, but the less severe problems are far more common. The case that probably did more than any other to alert Americans to "build- ing-related illness" occurred in Philadel- phia in 1976, with the outbreak of Le- gionnaires' disease (an example of microbial contamination) among guests at the Bellevue-Stratford Hotel. Twenty- nine people ultimately died after breath- ing bacteria-contaminated air that was disseminated through the hotel's duct- work systems. Since then, several other outbreaks of Legionnaires' disease have been reported, as well as deaths result- ing from inhalation of fungi. In addition to the severe acute effects, a number of chronic effects can also have fatal consequences. For example, according to EPA, chronic exposure to asbestos and radon in the indoor envi- ronment is responsible for thousands of cancer deaths a year. Regular exposure to environmental tobacco smoke has been linked to thousands of excess can- cer and heart disease cases annually. At the less severe end of the spec- trum, the most common complaints in- clude eye irritation, dry throat, runny nose, headache, fatigue, skin irritation, shortness of breath, cough, dizziness, and nausea. There is no one-to-one cor- respondence between cause and effect, and in manycases, it is difficult to iso- late a specific cause or causes. According to Healthy Buildings tech- nician Michael A. Price, allergenic fungi, dusts, low relative humidity, bacteria, and chemical off-gassing from carpeting and furniture are the most common causes of IAQ problems. The pollutants remain in the air, Price said, due to poor maintenance, inefficient air filtration, poor ventilation in tltiF inter- est of conserving energy, or changes in the design and use of a building. What makes indoor air quality issues especially difficult to manage is that ef- fects can vary widely among people. For example, workers with allergies or weakened immune systems may be more susceptible to indoor air maladies than other employees. In addition, many experts believe that ergonomics and work area lighting can affect worker perceptions of the quality of the breathing air and worker comfort. Therefore, they recommend consider- ing those issues along with indoor air - a strategy of addressing the more inclu- sive concept of "indoor environmental quality" (see sidebar on these pages). There are also theories that psychqso- cial factors - stress, job satisfaction, and labor-management relations - may impact who will complain about problems they associate with poor in- door air quality. Some experts believe that generally unhappy and/or lower- paid workers are more likely to com- plain of IAQ-associated health effects. Ford's Lick estimated that psychoso- cial factors are present in about 60 per- cent of the indoor air complaints Ford receives. However, he noted that work- ers at all different levels - general man- agers to entry-level clerks - have been known to voice their concerns. He said, "In some instances, we've had every- body asking us to please do something. We knew we had a problem then." Preventing Problems Ideally, experts said, employers should be thinking about indoor air quality before their employees do. This would include, they said, making good indoor air a contractually binding re- quirement in the lease signed with the building manager. The incentive is there for both em- ployers and building managers. There have been several cases, for example, INDOOR ENVIRONMENTAL QUALITY Just when employers, employees, and govern- ment officials were be- coming comfortable with the idea of addressing in- door air quality (IAQ), a new, more comprehen- sive concept is coming into vogue: "indoor envi- ronmental quality" (IEQ). According to Philip J. Bierbaum, director of physical sciences and en- gineering for NIOSH, IAQ-associated com- AT3T's Mitler. •Total Indoor enelranmental quality Is a better, monr arate, but we can't look at indoor air without con- sidering the other issues." "Total indoor environ- mental quality is a better, more inclusive term for dealing with the concerns of white-collar workers," added AT&T industrial hygienist Al Miller, who serves as chairman of the National Environmental Development Assn.'s To- tal Indoor Environmental Inclusive term...• Q I' TIEQ C 1'ti ua tt ( ) oa t on plaints of eye, nose, and throat irrita- tion, headaches, dizziness, fatigue, and nausea cannot always be explained by indoor air factors (chemical and micro- biological contaminants, inadequate ventilation, and environmental tobacco smoke) alone. He said NIOSH, which is pushing the IEQ concept, has found that these symptoms are a result of multiple factors, with indoor air, er- gonomics, workplace stress, worksta- tion lighting, and other concerns proba- bly playing a role. "We're getting away from using the term indoor air quality because what we've found is you can solve the indoor air problem and not eliminate the symptoms," Bierbaum said. "A lot of consequences of psychosocial stress are the same as what we might expect from poor air quality. We don't know if these effects are additive, synergistic, or sep- y , a Washington, D.C., nonprofit business group formed earlier this year. "When you look at the irritant-level health ef- fects people are alleging in most cases, I think it's questionable that they could be occurring only because of the indoor air. But if you add some stress and er- gonomic concerns, perhaps that's when the problems start to show up. Psy- chosocial factors [how people interact] also appear to be a factor, but we don't know how important they are." Experts predicted that we'll be hearing much more about indoor environmental quality, which they said will focus on en- suring that employees are comfortable and productive, as well as free from ill- ness and disease - a kind of worksite- specific wellness program. Look for EPA and OSHA to take a similar tack in future research, rulemaking, and enforcement activities, experts advised. Aueu,t 1992 /Occupational Hazards 33

. 0 0 I where building owners have been sued by a tenant company's employees al- leging adverse health effects. Employ- ees have also sought, and won, work- ers' compensation benefits for IAQ health effects. As a preventive measu re, experts rec- ommend that the minimum airflow in buildings from the outside be main- tained at 20 cubic feet per minute per person, as suggested by the American Society of Heating, Refrigerating, son employers and building owners be- go in and start monitoring or do a me- come interested in indoor air quality. chanical evaluation," Reynolds said. "I For example, a couple of years ago, after really believe in talking to the people receiving a number of IAQ complaints, first, especially if psychosocial factors AT&T Senior Industrial Hygiene Engi- appear to be involved. Generally, the neer Al Miller assembled a task force things people are complaining about and convened a two-day conference for should get first priority." key company managers on indoor air Some individual worker problems are quality. These events ultimately led tott not difficult to resolve and can be solved the drafting of the company's 88-page of without additional investigation. But book of IAQ guidelines. It includes ad- in a lot of other cases, Reynolds said, in- vice on investigating IAQ concerns and vestigators should take the next step and WHAT 00 THESE SYMPTOMS SUGGEST? Thermal discamfort Check HVAC condition and measure temperature and humitlity. Also check for drafts and stagnant areas. Headache, lethargy, nausea, drowsiness, dizziness Congestion; swelling, itching, or irritatlon of eyes, nose, or throat; dry throat; or nonspecific symptoms Cough; shortness of hreath; lever, chills, and/or fatigue Diagnosed infection If onset was acute, arrange tor medical evaluation, because carbon monoxide poisoning may be the problem. Check combustion sources and overall ventilation. May be allergic il small number of people allecled. II many people affecled look for sources of irritating chemicals such as folmaldehyde, Check for gross microbial canlaminalion due lo sanilalion problems, waier damage, or contaminated HVAC system. May be Legionnaire's disease or hisloplasmosis, related to hactelia or fungi. Contact the state or local health depadmeni. Sourm "euiltlingAirGualilyAGuidefareuitdingownersantlFacililyManagers; EPAMIDSN.Decembert991. and Air-Conditioning Engineers (ASHRAE) voluntary consensus stan- dard 62-1989. ASHRAE standard 55- 1981 on "Thermal Environmental Con- ditions for Human Occupancy" recommends that office buildings have a temperature of between 68.5-76.0 F in winter'and 73-79 F in summer for maxi- mum worker comfort. Employers should also be aware of potential IAQ problems during times of renovation and maintenance, advised Randall J. Dean, a building contractor defense attorney with the Los Angeles law firm of Chapman & Glucksman. "If there is a red flag for indoor air, it's, the impact that renovation can have," Dean said. "What was adequate for nor- mal operations may not be adequate during renovation or after it's been done." Dean noted that many experts recommend that the main H V AC system be isolated from the areas being reno- vated and that redesigned work areas be closely monitored for changes in airflow. Employee complaints are a major rea- 34 Occupational Hazards/August 1992 diagnosing IAQ health effects. The AT&T guidelines, which are sim- ilar to those in the EPA/NIOSH publi- cation "Building Air Quality: A Guide for Building Owners and Facility Man- agers," stress the need for a multidisci- plinary approach to investigating IAQ complaints, involving occupational health professionals, engineers, physi- cians, facilities experts, and human re- sources staff. Consultants are useful, Ford's Lick said, when a facility lacks in-house expertise or when there needs to be a third-party "tiebreaker" be- tween the building owner and tenant or between employees and the employer. Most experts say employee complaints are enough to spark indoor air quality in- vestigations and should be the basis of those investigations. Professor Reynolds recommends starting with people who have seen a doctor for their problems, have taken other documented action (i.e. left work early), or are complaining of some type of unique symptom. "The temptation of many people is to determine the extent of the problem by talking to people in other work areas and on other floors. "Indoor air is an area where if you do something for some people and not for others, people could feel slighted," HBPs Price said. Getting Feedback Experts differ on the best way to eval- uate overall worker perceptions of the indoor air quality. Some people, inctud- ing consultant Rabinovitz, advocate the use of surveys to target problem areas. "If management is thinking about do- ing something, you've already reached the stage where everybody assumes there's a problem. Employees are prob- ably upset and think management is hiding something. You may as well get the issue out in the open and get the employees involved," Rabinovitz said. Though supporting employee in- volvement, other experts don't neces- sarily like the idea of doing broad- based surveys. Ford's Lick, for example, uses focus groups as an alter- native way to gain employee input. "The one thing we definitely don't recommend is doing a buildingwide questionnaire," HBI's Price said. "Some percentage of people are going to say they have a problem just because you asked them," "If you do a survey, you have to re- member what you're getting," attomey Dean said. "Solicited complaints have to be looked at svith a greater degree of skepticism than unsolicited complaints. If you do a survey and 20 percent of the people say they have problems, that may not be significant. But if 20 percent of the people come forward on their own, that is significant." Walk-throughs, visual inspection of the ventilation system, and analyzing employee complaints will usually tell you if you have IAQ problems and where the hot spots are. Sampling for individual contaminants, i.e. formalde- rownlnn paYr 36 2074144215

GOVERNMENT ON THE BANDWAGON • ut re ,d d a .r r- Y e ,f S. C . 16 EPA and other federal agencies are bet- ter-equipped than ever to address the is- sue of indoor air quality (IAQ), Robert Axefrad, director of EPA's Indoor Air Div., said at a roundtable session during the American Industrial Hygiene Confer- ence & Exposition (AIHCE) in June. In 1990, EPA's Science Advisory Board identified poor indoor air quality as one of the top five environmental risks to human health. Since then, Axelrad said, the agency has stepped up its efforts to re- spond to indoor air problems. He noted that EPA spent only $350,000 of its multi- billiondollar budget on IAQ in fiscal 1989. However, for fiscal 1993, which begins Oct. 1,1992, Axelrad reported that EPA has asked for $6 million to fund its IAQ policy- making program and $7 million to fund ' IAQ research. "Indoor air is moving up the agenda;' Axeirad said. "This is a lot of money to spend on an area where we don't have a specific legislative mandate (like EPA does for outside air or solid waste). We could be looking for a smoking gun in the indoor air business for a long, long time. What we're trying to do is transfer what we already know to the key people." Axelrad said EPA has been focusing on the development of guidelines to help building managers address indoor air quality during design, construction, maintenance, renovation, and routine operation of public and private facilities. EPA has installed IAQ coordinators in each of its 10 regional offices to provide - technical assistance to building owners and facility managers. In December 1991, EPA and NIOSH published a 230-page manual, "Building Air Quality: A Guide for Building Owners and Facility Man- agers" agers" (No. S/N 055-000-00390-4), which :'is available for $24 from: New Orders, Superintendent of Documents, Box ~ 371954, Pittsburgh, PA 15250-7954. : In the area of research, EPA is studying . sources and emission rates of pollutants, a variety of neurobehavioral and sensory health effects, and the assessment,Qf in- door air risks. Axelrad said a mulfimil- lion-dollar long-term study, the Building Assessment Survey and Evaluation (BASE) program, is aimed at developing . standardized solutions to IAQ problems. EPA is one of more than 20 federal agencies, along with OSHA, NIOSH, Dept. of Defense, and General Services - Administration, on the Interagency Com- mittee on Indoor Air Quality (CIAQ), which is coordinating the federal govern- ment's indoor air efforts. OSHA OSHA has received some 1,200 com- ments in response to its Sept. 29, 1991, Bierbaum said that NIOSH, which spends 2 percent of its $103 million FY 1992 budget on indoor air, is also doing research on•sampling methods for volatile organic compounds (VOCs) and biological agents. IAQ request for information on the ne& . Congressional Pressure for an indoor air regulation, according to EPA's Axelrad acknowledged that Debra A. Janes of OSHA's health stan- dards office. Janes told AIHCE attendees in early June that OSHA had not decided if it will proceed with the rulemaking. She hinted that that decision might not be made until after the November general election. If OSHA does attempt rulemak- ing, she said, it will likely focus on venti- lation performance, worker training, source control, and technical assistance. Since issuing a compliance directive on some of the federal agencies' interest in indoor air is the result of recent Congressional pressure. In an October 1991 report, Congress' General Ac- counting Office concluded that "fed- eral efforts are not effectively address- ing" indoor air pollution, mostly due to insufficient funding. Several congressmen have offered legislative solutions. In the Senate, the Indoor Air Act of 1991(S. 455), authored OSHA's Debra Janes: "The lack of a standard hinders the solving of indoor air quality problems." indoor air quality in September 1990, by Sen. George Mitchell (D, Maine), Janes said, OSHA has conducted 140 in-would authorize $48.5 million for IAQ spections in response to employee com-research. The bill passed the full Senate, plaints about poor indoor air quality. If 88-7, late last year. citations are warranted, the agency uses In the House, an IAQ bill originally the general duty clause in the absence of a introduced by Rep. Joseph Kennedy (D, standard. "The lack of a standard hinders Mass.), H.R. 1066, was being reworked the solving of indoor air quality prob- at press time, with the assistance of Rep.. 11 lems;" Janes acknowledged. - . . Robert Andrews (D, N.J.). The less strin- In March, the AFL-CIO petitioned gent revision is expected to mandate OSHA to issue an indoor air quality stan- that OSHA write an IAQ standard only dard "promptly." In addition, for several if a specific number pr percentage of years, Action on Smoking and Health has ` workers complain of IAQ-related prob- been urging OSHA to regulate, and even- lems, and to more closely mirror the tually ban, workplace smoking. Despite Senate bill's focus on research. The orig- thepefitions,Janessaid,OSHA'stimetable inal bill would have required that is unlikely to change. - OSHA issue an IAQ standard. - At press time, it appeared unlikely NIOSH . that the House bill would get to the Philip J. Bierbaum, director of floor for a vote before the November. NIOSH's Div. of Physical Sciences and general election. The House could de- Engineering, reported at the AIHCE cide to vote on the Senate bill, and if it's that his agency has responded to more approved, send it to President Bush for than 1,100 requests for technical assis- , his possible signature. Throughout the tance on indoor air quality issues since current 102nd Congress, however, Bush the late 1970s. NIOSH also receives Administration officials have opposed about 200 IAQ-related inquiries a lAQlegislationandarguedthatcurrent month through its 800 number (800-356- efforts and funding levels are enough to 4674), he reported. address the indoor air problem. Augu,t 1992/Occupational Hazards 35

• roMinurd jronr lagN1 hyde, and comparing the results with established industrial standards i5 sel- dom warranted. "Air sampling is a last resort because it really doesn't tell you anything," Ford's Lick said. "We have our own lab that can analyze 150,000 different chemicals, but we know the levels we're dealing with will be way below the permissible exposure limits." Monitoring for carbon dioxide and carbon monoxide can be useful, how- ever. High levels of carbon dioxide, AT&T's Miller said, would indicate that not enough outdoor air is getting inside. According to Price, levels of carbon monoxide should not exceed 9 ppm, the maximum outdoor concentration rec- ommended by EPA, and be nowhere near the 35 ppm permissible exposure limit set by OSHA. "If you had a level of 35 ppm of carbon monoxide in the office environment, you'd be taking workers out on stretchers," he said. Controls According to HBI research, the most common solutions to indoor air prob- chemical'orp Tomakeweldin ..., g product created ~umes andodors disappear quickly Coppus offers: industrial quality super strong •"~ portable ventilators - air, eledrij, lems are improving maintenance of the HVAC system and ensuring that the system is meeting ASHRAE's rec- ommendations. In case after case, these simple measures have substan- tially reduced complaints about a vari- ety of health effects, according to Bill Borwegen, director of health and safety, Service Employees Interna- tional Union, which gets more com- plaints from its members on indoor air quality than any other health and safety issue. Another option is to simply ban cer- tain activities that are likely contribu- tors to indoor air problems. This could include, Reynolds said, banning the use of certain chemicals, renovation and maintenance activities during the workday, and workplace smoking. If smoking is permitted, Reynolds said, certain areas should be set aside for this purpose and should be separately ven- tilated to the outdoors. "You could do nothing else but ban smoking, and I think that would have a noticeable impact," Reynolds said. However, he noted that complaints about a smoky environment are proba- steam, water, gas models. AII excelRent for fume removal, confined space, 1 product and people cooling. Don't Gamble with the Health and Safety of Your Employees. WRITE OR FAX FOR CATALOG. r~ l.q'S..lri1 Asr'M6ia ~t ENGINEERING CORP. Box Number 15003 Warcester, MA 01615-0003 USA Tel: (508) 756-8393 Fax: (508) 799-9531 Also Zurich, Switzerland; Singapore e 1991 Coppus Eng. Corp. Circle no, 100 on reader service card 30 ttuaupatianal Haaard./Auguat 100 bly an indicator of poor ventilation - a more pervasive problem. "In most of the cases I've seen, ban- ning smoking has not changed the fre- quency of complaints," Rabinovitz said. "What that suggests is that com- r4aints about smoking are a symptom of a much larger indoor air problem or that psychosocial factors do play a very large role. People want to know that their needs are being addressed." HBI's Price said the goal of indoor air quality programs should be to make at least 80 percent of the people feel healthy and comfortable, and move to- ward accommodating everyone. To ac- complish this, he said, the more the em- ployer or building manager believes psychosocial factors are impacting worker perceptions about indoor air quality, the more important it is to in- volve workers in the program. Price's advice to employers: "If there was a problem, admit it, fix it, and be glad the employee pointed it out because, otherwise, your people costs are going to continue to go up and your productivity is going to con- tinue to go down." YOV'VE NEVER I3AD IT SO GOOD . . . TheYdZS Whole HouseAlrQeanerfram TRION now comes with the exclusive A7C sensor. The A7C is an advancGd electronic sensor capable of detecting air movement 10 trmes mo re eff e ctively tha n conventional mechanical switches, found in other air cleaners. The YAS g isup to95Xeffictentinremov- Ing airborne pollutants such as particu- late tobacco smoke, animal dander, crook- ing grease, dust, mold, and pollen. The advanced duct-mounted MAX 5 air cleaner comes with these feamres: • Inpl aua auroul -li.e. LEn Indlnw,. • aVP,Beqi,m6'pW.epm.er^,pp1Y • on. pMuvrt.pncund.W ubietup.Lle nf.uppnrtlna a 1UU TA aun.o • 'Iw4, pe,m.nenl ayLwnclmer wn.cen( m. • opacaridWmJwrtor.. The YAIg tseasfly tnsta9edand requires minimal matntenance. Several siu opp tlons make the at.1Z a Ideal for any cen- tral heating or cooling system. For reliability, performance, value, and the latest technology ... TRUST TRIONt Trion Incorporated P.O. Box 760 Sanford, NC 27330 Phone (919) 775-2201 Fax:(919)7748771 Circle no. 101 on reader service card