IEQ

We have a customer that has MCS. They have a mold problem in their home and as a result have carpets and upholstery that they want us to clean with products that are non-toxic. They have had their carpets cleaned in the past with products that were...

Q.) We have a customer that has MCS. They have a mold problem in their home and as a result have carpets and upholstery that they want us to clean with products that are non-toxic. They have had their carpets cleaned in the past with products that were labeled non-toxic and still had a reaction. How do we determine what is non-toxic?

A.) Before we define non-toxic, we need to understand what toxic means. The word toxic has been defined as "Having a chemical nature that is harmful to health or lethal if consumed or otherwise entering into the body in small quantities."

According to the Environmental Protection Agency (EPA), "The toxicity of a substance is its ability to cause harmful effects. These effects can strike a single cell, a group of cells, an organ system, or the entire body. A toxic effect may be visible damage, or a decrease in performance or function measurable only by a test. All chemicals can cause harm. When only a very large amount of the chemical can cause damage, the chemical is considered to be relatively non-toxic. When a small amount can be harmful, the chemical is considered toxic."

The toxicity of a substance depends on three factors: its chemical structure, the extent to which the substance is absorbed by the body, and the body's ability to detoxify the substance (change it into less toxic substances) and eliminate it from the body.

Are "toxic" and "hazardous" the same?
No, toxic and hazardous are not the same. The toxicity of a substance is the potential of that substance to cause harm, and is just one of the factors used in determining whether a hazard exists or not. The hazard of a chemical is the practical likelihood that the chemical will cause harm. A chemical is determined to be hazardous based on the following factors:

Toxicity: how much of the substance is required to cause harm
Route of exposure: how the substance enters the body
Dose: how much of the substance enters the body
Duration: the length of time the subject is exposed to the substance
Reaction and interaction: other substances the subject is exposed to concurrently and their combined effect
Sensitivity: how the body reacts to the substance compared to its reaction in other subjects Some common everyday products that are generally safe for use can be considered toxic given an unusual set of circumstances. For example, water is necessary to sustain life; yet if the dose is significant enough, it can be considered toxic.

Drinking too much water can deplete the body of essential electrolytes. Electrolytes are substances that become ions in a solution and acquire the capacity to conduct electricity. The balance of electrolytes in the body is essential for the normal function of cells and organs. Too much water may cause water intoxication or hyponatremia. Electrolyte imbalance and tissue swelling can cause an irregular heartbeat, allow fluid to enter the lungs, and may cause fluttering eyelids. Swelling puts pressure on the brain and nerves, which can cause behaviors resembling alcohol intoxication. The swelling of brain tissues can cause seizures, coma and ultimately death. In September of 2005, it was reported that a 32 year old man in Liverpool, England died after drinking too much water. A Pathologist said that the water had washed the essential salts from his body causing him to fall into a coma. Likewise, there have been a number of similar cases reported in the United States within the past few years.

Once more, a cleaning product is considered non-toxic "When only a very large amount of the chemical can cause damage..." Cleaning products that meet that definition can be labeled as such. That means that most of the population will not have a noticeable reaction to their use. However, there is a segment of the population that is highly sensitive to the same chemicals. According to National Institute of Allergy and Infectious Diseases, Multiple Chemical Sensitivity or "MCS usually starts with either an acute or chronic toxic exposure, after which this initial sensitivity broadens to include many other chemicals and common irritants (pesticides, perfumes and other scented products, fuels, food additives, carpets, building materials, etc.)." Ohio State University published the following comments in an article on Multiple Chemical Sensitivity, "...there seems to be no single stimuli or predictor of reactions" and "...the unique ability of each body to respond to different chemicals in different ways makes it difficult to understand the effects of any one chemical in a particular concentration on any person. Just as some people react adversely to certain medications while others do not, the way one person reacts to a chemical in the environment may be entirely different than another person."

Working with MCS clients requires more research and understanding. They may have sensitivities to a broad range of chemicals. Because they are highly sensitive, the criterion that is normally used to determine what is acceptable does not apply. OSHA's "permissible exposure limits (PELs)" and the American Conference of Governmental Hygienists' (ACGIH) "threshold limit values (TLVs)" do not apply. Sometimes the only way to determine what cleaning products are usable in such a situation is trial and error. Additionally, what works with one MCS client may not work with the next MCS client. Some clients with MCS may know of products that they can tolerate versus others they cannot, others may fall into the category of not knowing what does and does not work for them at all. Clearly, providing cleaning services in these cases is highly complex and should be handled with the utmost care and concern.

According to John Banta, co-author of Prescriptions for a Healthy House, A Practical Guide for Architects Builders and Homeowners, there are some things you can do to help assure your success when working with clients that suffer from MCS.

People with MCS are often able to smell odors that can not be detected by others. Therefore, your cleaning equipment, hoses and supply tanks needs to be scrupulously clean. Any residual cleaners from previous jobs may contain perfumes or other components that may not be acceptable for your client. Just because you aren't bothered by the product, or can’t smell it doesn't mean it will be acceptable for them.

Your client may not be able to tolerate the odors on your clothes from previous jobs, your laundry detergent or fabric softeners. They may also have difficulties with residual smoke odors, antiperspirants, colognes or other fragrances you use or pick-up from places you have been.

One suggestion would be to provide the client with a sample of the cleaning chemicals, labeling and MSDS sheets for any product you plan to use. This will allow them to self-test, or consult with their physician to determine if the product will be acceptable. If your client already has a cleaning product that works for them, it may be helpful to use the product they supply.

Another possible strategy would be to test the cleaning product on a sample of the material you will be cleaning. Sometimes the cleaning product will react with the material or other chemical treatments creating an unacceptable odor or condition for the client. Some products have been specifically developed for individuals with MCS, but even they don’t work for everyone and require careful evaluation.

When asked to provide cleaning services for a client that has MCS, it is important to weigh the cost and time required to solve the problem versus the risk of failure to provide acceptable service. Solving such a problem can be very rewarding; however, it may not make good business sense to all professional cleaning firms. As the world population becomes progressively more sensitive to the environment, the increasing number of individuals with chemical sensitivities will increase the demand for professional cleaning firms to help solve the cleaning needs of their clients.

— Jim Holland

I was asked by a customer whether or not our cleaning of their carpets and upholstery would reduce their allergies. I told them that it would, but I am not sure if that is true. Is carpet and upholstery cleaning effective at solving allergy problems?

Allergy is defined as a "harmful, increased susceptibility to a specific substance," also known as “hypersensitivity." Allergies are triggered by substances called allergens. Allergic reactions to allergens stem from exposure to variety of sources and the list can be very extensive. Some of the more common indoor sources that might be reduced by cleaning include but are not limited to: molds; dust mites; skin flakes, urine, and saliva from cats and dogs; body parts and droppings from dust mites; body parts, secretions, and droppings from cockroaches; hair, skin flakes, urine, and saliva from rodents; secondhand smoke; nitrogen dioxide from combustion products; and more.

It is common that allergic reactions are mistakenly believed to be a cold. Some of the symptoms of a cold and allergies are similar: sneezing and a stuffy or runny nose. But, if the symptoms are accompanied with a fever, sore throat, aches and pains, then it is probably a cold. With allergies, there is never a fever, the nasal discharge is clear, and eyes may become red and itchy. Colds usually lasts about a week, allergies can last all year. Some other major differences between the two:

Colds:

Result from a virus infection;
Symptoms may also include a fever and aches and pains;
Usually takes a few days to hit full force; and
Symptoms should clear up within several days to a week.

Allergies:

Symptoms begin almost immediately after exposure to an allergen;
Symptoms last as long as they are exposed to the allergen; and
If the allergen is present year-round, symptoms may be chronic.

The American Academy of Allergy, Asthma and Immunology (AAAAI) estimates that allergies affect as many as 40 to 50 million people in the United States; allergic diseases affect more than 20% of the U.S. population; and that allergic diseases are the sixth leading cause of chronic disease in the United States. According to the American College of Ecology, Asthma and Immunology, 50% of all illnesses are caused by or aggravated by polluted indoor air.

Whether cleaning will reduce allergic reactions is dependent upon several factors. The first is the occupant's predisposition to react to allergens; secondly, are the allergens that the occupants will react to present in the living environment; and finally, are your cleaning services going to appropriately and thoroughly address the removal of those allergens.

You won't know whether your cleaning services will reduce allergic reactions if you don't know what the occupants will react to and whether or not those allergens are present in the environment that you are going to clean. If you are going to provide carpet and upholstery cleaning services to a portion of the home, then you will probably remove only a limited amount of the allergens that are present. Even if you clean the entire carpeted area of a home and all of the upholstered furniture, you may still leave pockets, sometimes referred to as a sink or reservoir, of allergens that will potentially cause reactions.

The only way to ensure that cleaning will reduce allergic reactions is to: develop a continuous program of thorough cleaning of all locations where allergens may be present; create a plan to control infiltration of bioaerosols by managing the source; maintain HVAC systems and change filters regularly; control pests such as cockroaches and rodents; limit exposure to pets that occupants are allergic to; use cleaning products that are less likely to cause reactions; avoid second hand smoke; and control moisture problems.

In the case of dust mites, occupants need to:

Wash and dry sheets weekly;
Launder pillows, blankets, comforters and mattress pads at least four times a year;
Encase pillows and comforters in allergen-impermeable covers;
Damp-mop hard floors (tile or hardwood, for example) once a day; and
Dust and vacuum once or twice a week to remove accumulated reservoirs of allergens.

If performed correctly, carpet and upholstery cleaning can help to reduce allergens. Since there are other sources of allergens, it is not likely that the reactions would be eliminated. Even if the reactions were reduced or eliminated, the relief would generally be temporary. A program of control and maintenance would be required to provide continued relief. There are companies that are starting to recognize that there is an opportunity to provide a greater range of services that can be designed to address asthma and allergy problems.

— Jim Holland

Is it acceptable to temporarily install ionizing air cleaners on a mold contaminated work site until we can get the remediation work started?

First of all we need to define "ionizing air cleaners." We are not talking about a HEPA air filtration device (AFDs) or negative air machine (NAM), such as those that are used on a mold remediation or asbestos abatement jobsite. Unlike the AFDs, or HEPA air cleaners that are designed to use in a residential environment, ionizing air cleaners create an electrical charge in the surrounding air space, that can result in charged molecules known as ions, which are suppose to cling to oppositely charged airborne particles and surfaces. Ionizing air cleaners, also known as electrostatic precipitators, add an oppositely charged collection plate designed to attract the particles.

The problems with some units are that they can produce ozone and may or may not produce the desired results of improving a contaminated air space even if they are producing negative ions. A recent Consumer Reports (www.consumerreports.com, May 2005) ran an article entitled, New concerns about ionizing air cleaners. With respect to the issue of ozone and ionizing air cleaners, Consumer Reports reported that:

"Unlike ozone in the upper atmosphere, which helps shield us from harmful ultraviolet rays, ozone near ground level is an irritant that can aggravate asthma and decrease lung function. Air cleaners need not meet ozone limits — not for the federal Environmental Protection Agency, which regulates only outdoor air, nor for the Food and Drug Administration, since it doesn't consider them medical devices, despite the health benefits that some ads imply. (See "Air cleaners: The truth behind the accolades.") Manufacturers often submit air cleaners to a voluntary standard that includes a test to see whether they produce more than 50 parts per billion (ppb) of ozone, the same limit the FDA uses for medical devices."

Consumer Reports selected 7 different ionizers and replicated the testing procedures. After two different tests in a sealed room and in an open lab, 5 of the units failed by producing more than the 50 ppb limit. In some cases, the levels ranged from 168-319 ppb. These levels were measured at a distance of 2 inches and 3 feet away from the unit. The reported levels were measured at the 2 inch distance. Ozone will dissipate as you move away from the unit. The OSHA permissible exposure limit (PEL) of ozone for an adult is 0.1 ppm or 100 ppb for an 8 hour exposure. For children the PEL is 0.04 ppm or 40 ppb for an 8 hour period.

In addition to the potential for creating ozone, these units do not move a lot of air. Therefore, their effectiveness is questionable as a solution for a mold contaminated area of a home. Even if the units were to move a greater volume of air, they still would not solve the contamination problem. If there is a mold problem, then there is a source. That source then disperses spores into the air space due to air flow or a negative pressure. When you install an air cleaner or purifier, or for that matter a HEPA filtered negative air machine in the vicinity of the source of contamination, then the air flow and negative pressure required to move the air through the system will also help draw mold spores from the source through the air space and hopefully into the unit. The result is that more spores are being moved from the source to the area of negative pressure.

Now, with respect to your question about whether you can “temporarily install ionizing air cleaners on a contaminated work site until you can get the work started.” If the area is contaminated, then it would seem to me to be prudent to contain the area, isolating it from the uncontaminated area. That way there is not going to be a continual dispersal of spores from a contaminated area to a clean area. Once contained, it really doesn’t matter if there is a continuation of the dispersal inside containment. The reality is that once remediation starts, the levels inside containment are going to increase anyway. Since there is going to be an increase in the spores levels, the use of an air purifying device whether ionizing or not, does not improve anything. It will only add cost or worse, leave you and the occupants with a false sense of security.

The other possibility is that you only suspect that the area is contaminated. If this is the case, then my concerns are still the same. Another interesting comment from Consumer Reports about the units that they did not recommend was that they “produced ozone and did a poor job cleaning the air.”

At this time the evidence is that most household ionizing air cleaners do not help and may in some cases make indoor air quality worse by the addition of ozone. It is my advice to stick with the IICRC S520 Standard and Reference Guide for Professional Mold Remediation that has been adopted for the industry and use containment with HEPA filtered air filtration devices as described above.

— Jim Holland

I recently heard about a case where carpet cleaners were blamed for a building evacuation because of high carbon monoxide levels. Is it possible that this could really happen?

Carpet cleaners and restorers frequently utilize equipment that if misused can result in elevated carbon monoxide (CO) levels. Many carpet cleaners use gasoline-powered truckmounts and restorers frequently use other types of gasoline-powered equipment, such as generators and pumps. Most carpet cleaners and restorers who operate equipment powered by gasoline know that the equipment should never be operated while in a garage or other enclosed space.

Seemingly trivial factors, however, can significantly impact the amount of CO that can be drawn into a building including anything that might slow the dispersal of the exhausted CO. Carports, overhangs, narrow alleys, semi-enclosed loading docks, and some shrubbery can contribute to a buildup of CO in the vicinity. Then, if air currents or pressure differentials are just right, CO can enter into the building, either through the door where the hoses enter the building or through a "fresh air" intake for the mechanical system. One of these conditions is probably what happened in the case mentioned above.

To prevent CO levels from becoming a problem, equipment should be located at a safe distance from the door and, if possible, situated so that the exhaust is aimed away from the building. High levels of CO can still be reached due to unusual air currents and pressure relationships even when equipment is located at what would seem to be an adequate distance from the doorway. Because CO has no warning properties, exposed persons can easily be overcome. Therefore, while working with combustion devices, monitoring the indoor air for combustion gases might not be a bad idea. (See the discussion of Monitoring below.)

What Is Carbon Monoxide?
Carbon monoxide is a colorless, odorless, tasteless, highly toxic gas that is usually a product of incomplete combustion. Some common sources of carbon monoxide include automobile exhaust, improperly vented fireplaces, and un-vented heating systems.

How Big a Problem is CO Poisoning?
According to a study conducted by the California Department of Health Services, unintentional carbon monoxide poisoning was responsible for 444 deaths in California over a ten year period.

The Colorado Department of Public Health and Environment has reported that 40% of work-related carbon monoxide poisonings were attributed to the use of gasoline-powered equipment. Pressure washers, compressors, floor buffers, and carpet cleaning equipment were specifically mentioned as the types of equipment that have contributed to these poisonings.

There is no comprehensive database that tracks carbon monoxide poisonings in the United States, but the U.S. Bureau of Labor Statistics has estimated that private industry had 900 incidents of work-related carbon monoxide poisoning in 1992, with 32 of these cases being fatal.

What Are the Symptoms of CO Poisoning?
The severity of symptoms is determined by three primary factors:

the concentration of CO
the length of exposure
the workload and breathing rate of the person exposed

Assuming a moderate level of activity, CO concentrations of 80 to 100 parts per million (ppm) for 1 to 2 hours can result in feelings of severe fatigue and may bring on chest pain and irregular heartbeat. Symptoms associated with CO concentrations of 100 to 200 ppm include headache, nausea and mental impairment. Exposure to concentrations of 700 ppm for one hour or more can cause more serious central nervous system effects, including but not limited to coma and death. Nervous system effects may include confusion, personality changes, and staggering. The resulting weakness and confusion may make it difficult for the victim to recognize and avoid further exposure. Symptoms may persist for days and up to weeks after exposure and some victims may suffer permanent physical harm.

Illnesses caused by exposure to CO often go unrecognized, as the symptoms are similar to those of many other diseases. Unless several people are affected at the same time, workers may not even consider the possibility of CO poisoning.

Regulations and Recommendations
Federal OSHA has established a permissible exposure limit (PEL) of 50 ppm as an 8-hour time-weighted average (TWA). [29CFR 1910.1000]

The National Institute of Occupational Safety and Health (NIOSH) has issued a recommended exposure limit (REL) of 35 ppm as an 8-hour TWA, with a ceiling limit (CL) of 200 ppm. A concentration of 1,200 ppm is considered an immediate danger to life and health (IDLH).

The American Conference of Governmental Industrial Hygienists (ACGIH) has adopted a CO threshold limit value (TLV) of 25 ppm as an 8-hour TWA.

NOTE: Of these recommendations, only the OSHA PEL is actually a regulation.

CO Generation
CO can be generated by small gasoline engines like those in truckmounts and they can produce deadly levels of CO in a remarkably short period of time. NIOSH performed a study of the CO levels generated by a 5.5 hp pressure washer operating inside an 8,360 cubic foot double car garage, using two different ventilation scenarios.

In the "worst-case" scenario, all the garage doors and windows were closed. CO levels reached 200 ppm in less than 5 minutes, IDLH (Immediately Dangerous to Life and Health) levels of 1,200 ppm in less than 15 minutes, and 1,500 ppm in 19 minutes.

In the "best-case" scenario, with both garage doors and a window completely open, CO levels reached 200 ppm (the NIOSH ceiling level) in less than 3 minutes and peaked at 658 ppm in 12 minutes.

This study showed that acute toxic levels of CO can be generated within 3 to 5 minutes by a small engine operated indoors, even with what would seem to be adequate ventilation.

Prevention
NIOSH recommends:

Gasoline-powered engines, tools, and other combustion sources must never be operated inside buildings or even in partially ventilated areas, such as parking garages. Such equipment should be operated outside and well away from air intakes or other building openings, with only the hose or cord run inside.
All workers should be trained to recognize the sources and conditions that can contribute to CO generation and accumulation, as well as the signs and symptoms of CO overexposure.
Workplace surveys should be conducted to identify potential sources of CO exposure.
Workers should use CO monitors with audible alarms whenever any potential carbon monoxide source is present.
If symptoms are noted, turn off equipment and evacuate occupants to an area with fresh air until it has been confirmed that acceptable conditions have been established in the work area.
Affected persons should not drive. Call 911, or have someone else drive the victim to receive medical attention.

NOTE: Standard air-purifying and powered air-purifying respirators provide no protection again CO.

Monitoring
Many carbon monoxide monitors are now available, with some priced under $50. Unfortunately, these types of monitors, usually installed in homes, are not designed for workplace environments and may not be adequate for monitoring worker safety.

Prices of active air pump monitoring devices for workers begin at around $300. Disposable badges are available starting at around $3 each, but such passive monitors are generally considered to be less effective than active devices.

Summary
The employer has a legal obligation to protect workers against hazards. Since personal protective equipment is not a realistic option for protection against CO, the employer must establish worksite controls, such as where vehicles can park, prohibiting equipment operation indoors, and monitoring indoor air levels to protect workers.

— Jim Holland