Fiberglass and Other Flame-Resistant Fibers in Mattress Covers.

Public complaints have raised concerns that some mattresses in the current marketplace may be potential sources of airborne fiberglass. Although mattress foam is often marketed as chemical-free, their cover compositions are not as well understood by the general public. To fill these basic information gaps, the covers of four newly purchased mattresses were sampled and analyzed using polarized light microscopy, SEM-EDS, and FTIR microspectroscopy. Two of the mattress covers contained over 50% fiberglass in their inner sock layers. Up to 1% of the fiberglass had migrated to adjacent fabric layers, representing a potential risk of consumer exposure if the zipper on the outer cover is opened. The observed fiberglass fragments had calculated aerodynamic diameters ranging between 30 and 50 µm, suggesting they are potentially inhalable into the nose, mouth, and throat, but are likely too large to penetrate deeper into the lungs. No fiberglass was observed on the brand new mattresses' outer surfaces. Synthetic fibers also present in the sock layers were consistent with flame resistant modacrylic containing vinyl chloride and antimony. The use of fiberglass and other chemicals in mattress covers poses a potential health risk if these materials are not adequately contained. The apparent non-inclusion of mattress covers in chemical-free certifications suggests that further improvements are needed in mattress labeling and education of consumers.

Cancer and Non-Cancer Risk Concerns from Metals in Electronic Cigarette Liquids and Aerosols.

We evaluated metal concentrations in e-liquids and e-aerosols from eight studies and estimated the range of corresponding cancer and non-cancer risks. Chromium and nickel were the leading contributors to cancer risk, with minor contributions from cadmium, lead, and arsenic. The increased cancer risks, assuming exposure to 2 mL/day, ranged from 5.7 to 30,000 additional cancers in a million e-cigarette users. The average cancer risk was 3 in 1000. Cancer risks in the mid to upper end of these ranges exceed acceptable levels. The hazard quotient (HQ) approach was used to evaluate non-cancer risks. Hazard quotients exceeding 1.0 indicate the possibility for non-cancer adverse health effects. Estimated exposures at the maximum reported concentrations of nickel, chromium, and manganese resulted in HQ values of 161, 1.1, and 1.0, respectively, with additional contributions from lead. The average concentration of nickel resulted in an HQ value of 14. We conclude from these studies that exposure to metals in e-cigarette liquids and aerosols may pose a significant cancer and non-cancer health risk at the mid and upper end of the reported ranges. The device design and heating elements appear to be the main source of metals in e-aerosols. The large range of metals within and across e-cigarette brands indicate the need for improvements in product design, enforced product safety regulations and manufacturing quality control. Implementation of such measures could reduce metal exposure in e-cigarette users.

Sulfuryl Fluoride Poisonings in Structural Fumigation, a Highly Regulated Industry-Potential Causes and Solutions.

Structural fumigations using sulfuryl fluoride for the extermination of dry-wood termites are conducted by the thousands in California and other warm-weather states. Sulfuryl fluoride is an odorless gas that targets the nervous system and can cause respiratory irritation, pulmonary edema, nausea, vomiting, seizures, and death. Structural voids or compartments such as wall sockets, crawl spaces, cabinets, or cells in air mattresses may create ongoing exposure after a structure has been certified as safe. The authors describe a case of potential sulfuryl fluoride exposure to a family following home fumigation. Despite regulation, sulfuryl fluoride poisonings from structural fumigations continue to occur. This article examines the physical characteristics of sulfuryl fluoride and the regulatory oversight of its application, in an effort to understand how and why these poisonings happen. Increasing aeration times of fumigated structures, overseeing monitoring efficacy, and using technology to capture clearance data could reduce sulfuryl fluoride exposure and illness.

Inhalational Chlorine Injuries at Public Aquatic Venues - California, 2008-2015.

In June 2015, personnel from California's Contra Costa Health Services Environmental Health and Hazardous Materials (hazmat) divisions were alerted to a possible chemical release at a swimming pool in an outdoor municipal water park. Approximately 50 bathers were in the pool when symptoms began; 34 (68%) experienced vomiting, coughing, or eye irritation. Among these persons, 17 (50%) were treated at the scene by Contra Costa's Emergency Medical Services (EMS) and released, and 17 (50%) were transported to local emergency departments; five patients also were evaluated later at an emergency department or by a primary medical provider. Environmental staff members determined that a chemical controller malfunction had allowed sodium hypochlorite and muriatic acid (hydrochloric acid) solutions to be injected into the main pool recirculation line while the recirculation pump was off; when the main recirculation pump was restarted, toxic chlorine gas (generated by the reaction of concentrated sodium hypochlorite and muriatic acid) was released into the pool. A review of 2008-2015 California pesticide exposure records identified eight additional such instances of toxic chlorine gas releases at public aquatic venues caused by equipment failure or human error that sickened 156 persons. Chemical exposures at public aquatic venues can be prevented by proper handling, storage, and monitoring of pool chemicals; appropriate equipment operation and maintenance; training of pool operators and staff members on pool chemical safety; and reporting of chemical exposures.

Physical, Mental, and Financial Impacts From Drought in Two California Counties, 2015.

OBJECTIVES: To evaluate health impacts of drought during the most severe drought in California's recorded history with a rapid assessment method. METHODS: We conducted Community Assessments for Public Health Emergency Response during October through November 2015 in Tulare County and Mariposa County to evaluate household water access, acute stressors, exacerbations of chronic diseases and behavioral health issues, and financial impacts. We evaluated pairwise associations by logistic regression with pooled data. RESULTS: By assessment area, households reported not having running water (3%-12%); impacts on finances (25%-39%), property (39%-54%), health (10%-20%), and peace of mind (33%-61%); worsening of a chronic disease (16%-46%); acute stress (8%-26%); and considering moving (14%-34%). Impacts on finances or property were each associated with impacts on health and peace of mind, and acute stress. CONCLUSIONS: Drought-impacted households might perceive physical and mental health effects and might experience financial or property impacts related to the drought. Public Health Implications. Local jurisdictions should consider implementing drought assistance programs, including behavioral health, and consider rapid assessments to inform public health action.

Injuries and Traumatic Psychological Exposures Associated with the South Napa Earthquake - California, 2014.

On August 24, 2014, at 3:20 a.m., a magnitude 6.0 earthquake struck California, with its epicenter in Napa County (1). The earthquake was the largest to affect the San Francisco Bay area in 25 years and caused significant damage in Napa and Solano counties, including widespread power outages, five residential fires, and damage to roadways, waterlines, and 1,600 buildings (2). Two deaths resulted (2). On August 25, Napa County Public Health asked the California Department of Public Health (CDPH) for assistance in assessing postdisaster health effects, including earthquake-related injuries and effects on mental health. On September 23, Solano County Public Health requested similar assistance. A household-level Community Assessment for Public Health Emergency Response (CASPER) was conducted for these counties in two cities (Napa, 3 weeks after the earthquake, and Vallejo, 6 weeks after the earthquake). Among households reporting injuries, a substantial proportion (48% in Napa and 37% in western Vallejo) reported that the injuries occurred during the cleanup period, suggesting that increased messaging on safety precautions after a disaster might be needed. One fifth of respondents overall (27% in Napa and 9% in western Vallejo) reported one or more traumatic psychological exposures in their households. These findings were used by Napa County Mental Health to guide immediate-term mental health resource allocations and to conduct public training sessions and education campaigns to support persons with mental health risks following the earthquake. In addition, to promote community resilience and future earthquake preparedness, Napa County Public Health subsequently conducted community events on the earthquake anniversary and provided outreach workers with psychological first aid training.

Mercury Toxicity and Contamination of Households from the Use of Skin Creams Adulterated with Mercurous Chloride (Calomel).

Inorganic mercury, in the form of mercurous chloride, or calomel, is intentionally added to some cosmetic products sold through informal channels in Mexico and the US for skin lightening and acne treatment. These products have led to multiple cases of mercury poisoning but few investigations have addressed the contamination of cream users' homes. We report on several cases of mercury poisoning among three Mexican-American families in California from use of mercury-containing skin creams. Each case resulted in widespread household contamination and secondary contamination of family members. Urine mercury levels in cream users ranged from 37 to 482 µg/g creatinine and in non-users from non-detectable to 107 µg/g creatinine. Air concentrations of up to 8 µg/m³ of mercury within homes exceeded the USEPA/ATSDR health-based guidance and action level of <1.0 µg/m³. Mercury contamination of cream users' homes presented a multi-pathway exposure environment to residents. Homes required extensive decontamination, including disposal of most household items, to achieve acceptable air levels. The acceptable air levels used were not designed to consider multi-pathway exposure scenarios. These findings support that the calomel is able to change valence form to elemental mercury and volatilize once exposed to the skin or surfaces in the indoor environment.

Geothermal Gases--Community Experiences, Perceptions, and Exposures in Northern California.

Lake County, California, is in a high geothermal-activity area. Over the past 30 years, the city of Clearlake has reported health effects and building evacuations related to geothermal venting. Previous investigations in Clearlake revealed hydrogen sulfide at levels known to cause health effects and methane at levels that can cause explosion risks. The authors conducted an investigation in multiple cities and towns in Lake County to understand better the risk of geothermal venting to the community. They conducted household surveys and outdoor air sampling of hydrogen sulfide and methane and found community members were aware of geothermal venting and some expressed concerns. The authors did not, however, find hydrogen sulfide above the California Environmental Protection Agency air quality standard of 30 parts per billion over one hour or methane above explosive thresholds. The authors recommend improving risk communication, continuing to monitor geothermal gas effects on the community, and using community reports and complaints to monitor and document geothermal venting incidents.

A collaborative effort to address the distribution of plutonium-contaminated sludge in Livermore, California.

Plutonium releases from the U.S. nuclear weapons laboratory in Livermore, California resulted in the contamination of sewage sludge. Two research models to address the potential public health impacts of plutonium-contaminated sludge distribution were undertaken. One model was a collaborative approach that emphasized incorporating local knowledge into the scientific analysis and fostering the growth of mutually respectful relationships between scientists, governmental, and non-governmental collaborators. The second was a dose-assessment approach that utilized existing data to estimate radiological doses from exposure to plutonium contaminated sewage sludge and compared the estimated doses with those that have caused sickness or death. The two models reached different conclusions; neither addressed issues of intergenerational equity and primary prevention of exposure. Advancing an ethical research agenda will involve looking upstream of the contamination and working toward sustainable solutions to security that do not involve the public health threats embedded in the global embrace of nuclear weapons.