5245.0: Wednesday, October 24, 2001 - 5:15 PM

Abstract #24417

Rashes and respiratory disease among outpatient clinic and mental hospital workers associated with an unusual indoor air pollutant

James E. Cone, MD, MPH1, Emily Wersinger, MPH1, Andrew Deckert, MD2, Donnell Ewert, MPH2, and Peter Flessel, PhD3. (1) Occupational Health Branch, California Department of Health Services, 1515 Clay Street, Suite 1901, Oakland, CA 94612, , jcone@dhs.ca.gov, (2) Shasta County Health Dept., 2650 Breslauer Way, Redding, CA 96001, (3) Occupational and Environmental Health Laboratory, CA Dept. of Health Services, 2151 Berkeley Way, Berkeley, CA 94704

Employees of a local outpatient community health center and a county mental health hospital, both located in a two-story building, reported skin rash, skin itching, respiratory and other complaints beginning 11/13/2000, and continuing until the building was closed on 12/5/2000. Methods: Self-administered surveys were conducted. Medical records were reviewed. Wipe samples of work surfaces were analyzed using liquid chromatography and mass spectroscopy for the presence of contaminants. Results: Of the 310 employees who worked in the building, 41 (13%) reported recent pruritic rash OR two or more acute respiratory symptoms (SOB, cough, chest tightness). Logistic regression revealed increased hours working in the clinic was associated with increased risk of pruritic rash (OR 1.06 per hour worked, p<0.05). An allergist who examined four cases during the week prior to closure of the building diagnosed Rhus-like contact dermatitis. An interview of building maintenance workers revealed that during the weekends prior to and during the outbreak, there were agricultural burns near the building. Three of 15 youths participating in the burns reported poison oak-like rashes, and charred poison oak was found in a burn pile. Analysis of wipe samples confirmed the presence of relatively high levels of urushiol (active ingredient of poison oak) on work surfaces in the building and in remnants of the burn pile. Recommendations: Cleaning of horizontal surfaces with diluted trisodium phosphate, HEPA vacuuming of floors, changing air filters, establishing positive air pressure in the building compared with outdoors, and a ban on leaf/brush burning.

Learning Objectives: To understand the steps in investigating indoor environmental pollution episodes;

Keywords: Indoor Environment, Occupational Disease

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA