Document 3e2ppRomJXZB00D8LMp5nV27E

* L. D ' > 1973 Research Rupert No. Copy No. 31 PPG E-IPUSTP-IES CHEMICAL DIVISION Barber con > Chic Subject: Pi chloroncetoiene (PGA.) HnzarCharier'" _I_, Visit :o V. G, _: cudies iVn~ i-ale By Fred C. Tr,,ger Pate: February in, 1973 Distribution: 1. Mr. <J. W. Moore 2. Dr. W. E. Bissinger 3. Dr. D. A. Reich U. Mr. W. Graybill 5. Mr. D. Metzger 6. Dr. E, Gorton 7. Patent Department/Central File 8. Author - Mr. Fred C. Trager 9.-11. Technical Information File Keyword :j : Chloroacetyj enes Dichloroanetyiene Hazard Sondy Explosion Tests Flammability Toxicology SL 029378 On Thursday, February 8, 1973j Dr. D. Reich, Dr. E. Gorton (Lake Charles), and the writer visited the U. S. Navy Toxicology Unit, National Naval Medical Center, Bethesda, Maryland, to discuss the haz ards of DCA. The personnel at the Medical Center have done consider able work on DCA and have published numerous papers on its preparation and toxicology. We were met by Lt, Commander L. Jenkins, Mr. R. A. Jones, and Mr. L, Kurlansik. Mr, Kurlansik had to leave for about 30 minutes so the preliminary discussions were with Jenkins and Jones. Commander Jenkins evidently had not done any of the work him self but he had supervised it. Mr. Jones had done considerable DCA work in the past but recently Mr. Kurlansik had taken over. Therefore, Jenkins and Jones could not supply us with any details of the most re cent work. However, the following pertinent facts were revealed by them*. 1. The British had done some earlier toxicology work on-DCA and we were supplied with copies of references which we did not have. A copy of these references was forwarded to Mr. D. Metzger. 2. The Navy did not develop any treatments for DCA exposure or for skin contact with DCA so lutions. No information was available on DCA absorption through the skin. (Later, Mr. Kur lansik stated that he accidentally spilled some ether-DCA solution on himself and suf fered no bums or other ill effects except bad eye irritation.) 3. Jenkins and Jones would be interested in ob taining any information on treatment for DCA exposure that we might obtain. I4. These men were especially interested in a reported news item which (according to Mr. C. Cormany of the Solvents Group) appeared in a Cleveland paper and mentioned the haz ard of DCA in large public buildings. Pre sumably the DCA came from the reaction of leaking air conditioning reagents (Freons) with alkaline materials used in routine cleaning of the buildings. A later check with Mr. Cormany indicated that indeed the item did appear in a Cleveland paper but he did not remember which paper or when it appeared. 5. Mr. Jones, when asked about the relative toxicity of MCA and DCA, stated that at one time they had checked the toxicity of MCA on rats during very limited experiments. SL 029379 2- - They found no deaths with 18 animals when they administered up to 10 times as much MCA as with DCA. They concluded that the toxicity of MCA was not severe. They did not pursue this work further. 6. DCA should be considered as toxic as phosgene. Although they had no treatment experience, they saw nothing wrong with the routine treatment given phosgene victims when applied to DCA. At this point, Mr, Kurlansik appeared and the remainder of the discussions were with him. Following is a summary of the pertinent points discussed: 1. No DCA work is being carried out at the present time. However, Kurlansik is about to publish two papers on DCA, one of which contains vapor pressure data. Advance copies of these papers could not be given to us but we were. assured of copies as soon as the information was re leased. The other paper dealt with the reaction of DCA with amines. 2. During all the work, only solutions of DCA in either ether or trichloroethylene (TCE) were made. No pure DCA was isolated. During all `.the preparations a N2 blanket was used and the solutions were stored at dry ice temperatures for up to four weeks. - 3. Kurlansik had no experience with methyl chloro form (MC) or vinylidene chloride (VDC) as sol vents for DCA. However, he predicted that so lutions of DCA in these materials would be stable in air. 1*. Kurlansik had no explosions during all of his work. As a matter of fact, most of the DCA solution preparation work was done by a tech nician with only limited education. Protec tion of personnel was by double shielding with safety glass. When asked about the shock sen sitivity of DCA solution, Kurlansik said he had no data but that he accidentally dropped a flask of DCA solution (presumably ether-TCE) . and there was no explosion. . The flask merely broke and the solution spilled out. When asked what to do about spills or how to get rid of excess DCA solutions, Kurlansik said that the reaction with ethanol was very fast and has been used to neutralize DCA. Or dinarily, however, they just pour the DCA so lution into a safety waste can (which may con- SL 029380 -3- tain other lab wastes) and then dispose of the contents (presumably in a dump) at a later date. When asked if methanol or other alcohols would work, Kurlansik thought they would but added that he always used ethanol. Kurlansik did not elaborate further on this reaction. (Dr. E. Gorton mentioned privately later that he was going to try this reaction as a possible method for DCA removal in some of the Lake Charles streams.) 6. Some of the reagents mentioned which should be kept away from DCA solutions because of re actions are amines, ammonia and hydrazinej the last compound giving rise to an explosive mix ture. 7. Mr. Kurlansik then sketched on the board the apparatus he used for the preparation of DCAether and DCA-TCE solutions. The apparatus has been fully described in J. Org. Chem. 3199 (1970) by Siegel, Jones and Kurlansik and will not be repeated here. However, by questioning Mr. Kurlansik, the following de tails were revealed: a. Silicone grease does not react with DCA (however, it might dissolve it) but Tef lon sleeves on standard tapered joints were used for all -connections. b. A Carbowax column was used for the GLC analyses. c. The charge to the stirred reaction flask was 600 g of technical grade KOH (8$%) and 200 g of ethylene glycol. About 100 cc per min. of N2 was passed through the system while about one liter of a 1:1 mole solution of TCE and ether was pumped into the stirred mixture kept at lliO C for about 6 hours. The products were condensed, the water layer separated, and the solution dried with magnesium sul fate. (Mr. Kurlansik warned against us ing calcium chloride or potassium carbon ate because of the heat evolved. He said that sodium sulfate would be satisfactory.) The dried solution was then distilled through a Widmer column collecting the fraction between 31-33 C. The reactor residue was reusable for about two cycles. d. A mercury-sealed rather than a Trubore stirrer was used to eliminate static SL 029381 -u- electricity build up when ether solutions were involved. e. Although a baffled flask was not used. Hr. Kurlansik thought that its use was recom mended. 8. Mr. Kurlansik stated that 20-30$ DCA in TCE was stable in air and that 50*60$ DCA in ether was likewise stable, 9. It was further revealed that washing of the ether solution with' water would remove some of the ether and a higher concentration of DCA would result. Distillation through a very efficient column would accomplish the same result. These two practices are to be avoided due to the danger of explosion of the highly concentrated products. During the vist all three Navy men were very cordial and free with their information. They did not seem to hold back any of their knowledge or their experiences. Signed Fred C. Trager * Approved Date" SL 029382 Carbon Tetrachloride Toxicity Potentiated by Isopropyl Alcohol Investigation of an Industrial Outbreak David S. Folland, MD; William Schaffner, MD; H. Earl Ginn, MD; Oscar B. Crofford, MD; David R. McMurray Fourteen workers in an isopropyl alcohol packaging plant became ill af ter accidental exposure to carbon tetrachloride. In four, renal failure or hep atitis developed. Isopropyl alcohol potentiation of carbon tetrachloride tox icity has been shown previously only in rats. Acetone, a product of isopropyl alcohol metabolism, is a major potentiator of carbon tetrachloride toxicity. Workers had elevated levels of acetone in samples of expired alveolar gas and thus were metabolically predisposed to carbon tetrachloride injury. Stricter limits for industrial carbon tetrachloride exposure should be estab lished where concomitant isopropyl alcohol use occurs. (,JAMA 236:1853-1856, 1976) CARBON TETRACHLORIDE has been recognized for many years as one of the most toxic solvents in com mon use.1 Despite the passage of regulations on acceptable levels of in dustrial exposure and the substitu tion of alternative materials, carbon tetrachloride remains a serious threat to health.2 It is estimated that over a billion pounds of the compound were produced in the United States in 1974 and that approximately 160,000 per sons may be exposed to it each year at their work-places.31 The number who suffer toxic effects is not known. The increased severity of hepatic and renal toxicity caused by carbon tetrachloride in persons who also in gest ethyl alcohol is well known.5-7 Animal experiments have shown that other alcohols share the capacity to augment hepatic toxicity."s The most substantial potentiation is produced From the Epidemic Intelligence Service, Bu reau of Epidemiology. Center for Disease Con trol. Atlanta (Dr Folland); the Department of Medicine, Vanderbilt University Hospital, Nash ville, Tenn (Drs Schaffner, Ginn, and Crofford); and the Epidemiology Section and the Division of Occupational and Radiological Health, Ten nessee Department of Public Health, Nashville (Dr Folland and Mr McMurray). Use of trademarks does not imply endorse ment by the Public Health Service or the US De partment of Health. Education, and Welfare. Reprint requests to Vanderbilt University Hos pital, Nashville, TN 37232 (Dr Folland). by isopropyl alcohol. These experi ments have suggested that simulta neous exposure of workers to carbon tetrachloride and other alcohols used in industry may result in chemical hepatitis.9-"1 This theoretical hazard was real ized when employees of a drug com pany that packages isopropyl alcohol were accidentally exposed to carbon tetrachloride. The results of the en suing epidemiologic and clinical in vestigation are the subjects of this communication. OUTBREAK The company packages a variety of drugs and chemicals into quantities suitable for retail sale. Liquid prod ucts are bottled in a large room at ten production lines. Plastic scoops and other small devices are usually cleaned with acetone in the northern end of the packaging room. On the af ternoon of the exposure, the company had run out of acetone. One employee suggested using carbon tetrachloride from a 198-liter drum that had been obtained a year earlier when the com pany bought out a smaller drug firm. The company had no specific plans for use or disposal of the carbon tet rachloride, and the drug had been left on a loading dock that opened into the packaging room. From 2 to 4 pm on the afternoon of Nov 8, 1974, two men used approximately 15 liters of the carbon tetrachloride to clean equipment. They put the solvent in buckets and cleaned the equipment with rags. Working in the northern end of the building, they were 12 to 15 m from an isopropyl-alcohol-pack aging line. There was minimal crossventilation from three exhaust fans and several small windows just below the ceiling. Within 12 hours, eight of 43 persons working in the plant became ill. In six additional workers, symptoms devel oped within 48 hours (Fig 1). A case was defined by manifestation of three of the following symptoms: nausea, vomiting, headache, weakness, or ab dominal pain. The illness was charac- Fig 1.--Time between carbon tetrachloride exposure and onset of illness of 13 work ers in isopropyl alcohol packaging plant. Exact time of onset in one additional pa tient is not known. Shaded squares repre sent hospitalized workers. Hours After Exposure to Carbon Tetrachloride JAMA, Oct 18, 1976-Vol 236, No. 16 Carbon Tetrachloride--Folland et al 1853 SL 029383 terized by the gradual onset of nau sea (93%), vomiting (86%), weakness (86%), headache (79%), and abdominal pain (71%). Additional symptoms of dizziness (36%), diarrhea (28%), and blurred vision (21%) were also re ported. The illness lasted an average of seven days (range, 2 to 21 days). There was no correlation between ill ness and race, sex, prior ethyl alcohol ingestion, or history of underlying disease. Attack rates increased with prox imity to the northern end of the plant (Table 1). Ten of 14 persons who worked exclusively in the northern end of the plant became sick, while none of the ten persons who worked only at the southern end became ill (P^.0005, Fisher one-tail exact test). Four workers were hospitalized (Table 2); all worked at the northern end of the plant. Two patients had both renal and liver involvement; one had primarily renal damage, and the other had only liver enzyme elevation. Three patients were treated for renal failure with diet and fluid restriction, but one patient required dialysis. Her history is presented. REPORT OF A CASE A 21-year-old woman who worked as a "dumper," placing bottles on the isopropyl alcohol packaging line approximately 18 m from where the carbon tetrachloride was being used, was exposed from 2 to 4 pm. That evening at approximately 7:30 pm she experienced headache, backache, and nau sea, and began vomiting. She felt weak and drowsy, but slept poorly. Nausea and vomiting persisted for three days. She was then admitted to a community hospital where she had a temperature of 38.3 C, blood urea nitrogen (BUN) level of 70 mg/100 ml, and total bilirubin value of 6.7 mg/100 ml. Electrolyte and serum gluta mic oxaloacetic transaminase (SGOT) lev els were normal (Fig 2). The following day she was noted to have a puffy face, de creased urine output, and diffuse abdomi nal pain. She was transferred to Van derbilt University Hospital on the sixth day after exposure. She gave no history of using cleaning solutions (specifically de nying exposure to carbon tetrachloride), drinking ethyl alcohol, or taking drugs be fore her illness. Her blood pressure was 146/105 mm Hg, and she had an edematous face and abdominal tenderness, especially over the right flank. The urine contained 5 to 10 red blood cells and 5 to 10 white blood cells (WBC) per high-power field, no casts, and glucose (2+) and protein (2+) by dipstick. Laboratory studies had these val ues: WBC count, 8,200/cu mm; hematocrit, 38%; BUN, 126 mg/100 ml; serum creati nine, 12.9 mg/100 ml; uric acid, 19.5 mg/100 ml; phosphate, 5.7 mg/100 ml; SGOT, 500 units/liter; lactic dehy drogenase, 310 units/liter; alkaline phosphatase, 100 units/liter; total bili rubin, 3.3 mg/100 ml; and conjugated bili rubin, 2.8 mg/100 ml. Serum electrolyte values were within normal limits except for a bicarbonate level of 20 mEq/liter. Radioimmunoassay for the hepatitis B sur face antigen was negative. She was treated for acute renal failure with fluid restriction, a 500-mg sodium and 35-gm protein diet, allopurinol, Shohl solu tion, and aluminum hydroxide gel (Amphojel). She was oliguric (200 to 400 ml urine per day), the BUN level rose to 148 mg/100 ml, and the phosphate value was 13.8 mg/ 100 ml. Peritoneal dialysis was instituted. The initial dialysis fluid returns were bloody, and vaginal bleeding that necessi tated transfusion therapy developed. She Table 1.---Attack Rate of Carbon Tetrachloride-Isopropyl Alcohol Poisoning by Working Position on Day of Exposure Working Position in Plant North North & south Middle South Workers --__ _ . Ill Total 10 14 3 12 17 0 10 Attack Rats, % 71 25 14 0 required a subsequent hemodialysis. The bleeding ceased, and on the sixteenth day after exposure, diuresis began. On a follow-up visit 91 days after expo sure she was in good spirits, had no physi cal complaints, and had a normal blood pressure. Tests of renal and hepatic func tion were within normal limits. The physicians caring for this patient made repeated attempts to secure a his tory of toxic exposure, especially to carbon tetrachloride. Unwittingly, the patient de nied any contact with the solvent. Shortly, two additional workers were admitted to the same hospital with similar, albeit milder, illnesses. A medical student then visited the drug company, found the car bon tetrachloride, and initiated the investi gation by the Tennessee Department of Public Health. METABOLIC STUDIES Approximately two months after the outbreak, the plant was visited while isopropyl alcohol was being bot tled. No changes in ventilation had been made, although the temperature was cooler and there was reportedly less spillage that day than on the day of the outbreak. Samples of ambient air from the northern end of the plant were collected as well as samples of expired alveolar gas from workers at northern and middle positions in the plant. Analyses for concentrations of isopropyl alcohol and acetone were performed by gas chromatography.11 The mean concentration of isopro pyl alcohol in the ambient air at the northern end of the plant was 410 parts per million (ppm); in the middle of the plant it was 140 ppm (Fig 3). All determinations of alveolar isopro pyl alcohol concentrations were less than this value, indicating that the alcohol was being absorbed and me tabolized. The mean concentration of isopropyl alcohol in alveolar gas from four persons at the northern end of the plant working on the bottling line was 100 ppm, while that of nine work ers in the middle of the plant was 56 ppm (P < .05, Wilcoxson rank sum test). Table 2.--Clinical Features of Four Hospitalized Workers Exposed to Carbon Tetrachloride and Isopropyl Alcohol* Pa tient 1 2 3 4 Oliguria Yes No No No Hyper tension, mm Hg 158/94 No 200/110 No Peak BUN, mg/100 ml 120 95 89 12 Peak SGOT, units/liter 500 13,390 50 7,250 *BUN indicates blood urea nitrogen; SGOT, serum glutamic oxaloacetic transaminase. Peak ' Bilirubin, mg/100 ml 3.1 9.0' 0.6 2.4 Dialysis Yes No No No Days Hos pitalized 21 t6 10 5 1854 JAMA, Oct 18, 1976-Vol 236. No. 16 Carbon Tetrachloride--Folland et-al SL 0293-84 Blood Urea Nitrogen, mg/100 ml Serum Creatinine, mg/100 ml Hospitalization Hemodialysis | Peritoneal | I Dialysis | 180 ' 120 - . bU ^ 12* 6" Maximum Dally Systolic Blood Pressure, mm Hg 150 " \ 30 - Urine Output, ml/24 hrs 2400- 1800` 1200 - 600- Discharge I SGOT, units/mt 500250* ..... Total 6" Bilirubin, mg/100 ml 4' 2- ------------------------------- 0- .... 1 1 1--1 1 1 1 1 1 i it 1 // y 2 4 6 8 10 12 14 16 18 20 22 24 26 91 Days After Exposure to Carbon Tetrachloride Fig 2.--Renal and hepatic function studies in a hospitalized patient who underwent dialy sis. Fig 3.--Concentrations of isopropyl alcohol and acetone in samples of ambient air and expired alveolar gas obtained from northern and middle parts of plant. Normal range for acetone in alveolar gas is indicated; isopropyl alcohol is not normally detected. Isopropyl Alcohol Ambient Air Alveolar Air North Middle North Middle Acetone Ambient Air North Alveolar Air North Middle 560- 540- t 360- 340 320- 180 160140120 100H 80 60 40 20 38 Normal. 24 22 20 Dffl 18 T3o 3 16 14 -12 -10 8 6 -4 2 In contrast, acetone could not be detected in the two samples of am bient air. Nevertheless, all specimens of expired alveolar gas from workers contained striking amounts of ace tone. The mean concentration of ace tone in the alveolar gas from the four persons on the bottling line was 19 ppm, while that from ten persons in the middle of the plant was 7.5 ppm (P>.05). COMMENT The evidence indicates that com bined isopropyl alcohol and carbon tetrachloride exposure produced tox icity among the workers involved in this outbreak. Carbon tetrachloride had not been used previously in the plant. Two workers chose it as a cleaning agent on a single afternoon because they had exhausted their sup ply of the usual cleaning solvent. On the other hand, isopropyl alcohol was a standard production item. Eleven air samples taken at the packaging line 12 months and 9 months before the outbreak contained an average of 471 ppm of isopropyl alcohol. This, to gether with the samples obtained two months after the outbreak, suggests that the atmosphere, particularly at the northern end of the plant, regu larly had a high concentration of isopropyl alcohol. Concentrations of alcohol in the air vary with amount of spillage, am bient temperature, and ventilation. Many employees reported that on the day of exposure there was more than the usual spillage of isopropyl alcohol, with puddles on the floor and strong vapors in the air. The isopropyl alco hol packaging area and the carbon tetrachloride cleaning operation were adjacent. The air concentrations of carbon tetrachloride would have been highest in the immediate vicinity of the cleaning operation and alcohol concentrations highest around the packaging line. The highest attack rates of illness were in these two areas. It appears that carbon tetrachlo ride uncommonly causes illness severe enough to require hospitalization in the absence of potentiation by alco hol. Five authors, reporting a total of 50 patients hospitalized after expo sure to carbon tetrachloride vapors, elicited a history of ethyl alcohol con sumption in In contrast, all Isopropyl Alcohol, ppm SL 029385 four hospitalised patients in this study denied using alcoholic bever ages during the two days before ex posure. All, however, were exposed to isopropyl alcohol vapors. Also, the two most severely affected individuals (longest hospitalization and highest bilirubin and BUN levels) worked on the isopropyl alcohol line, whereas the other two hospitalized patients worked directly in the cleaning area. Elevated concentrations of acetone have been found previously only when fatty acid metabolism is greatly accelerated: in patiens with poorly controlled diabetes and ke tosis, in persons undergoing stren uous weight loss regimens, and in children with seizure disorders treated with a "ketogenic diet."11 On the basis of our observations, chronic exposure to isopropyl alcohol vapors can now be considered an additional cause of elevated alveolar acetone concentrations. Acetone in alveolar gas is directly related to that in the pulmonary ar tery blood.15 The blood acetone con centrations in the workers exposed to isopropyl alcohol were calculated to be 3 to 30 times above the normal range. It is quite probable that these elevated concentrations of acetone played an important role in the path- ogenesis of the carbon tetrachlorideinduced toxicity seen in this outbreak. In a series of studies in rats, Traiger16 and Plaa17 have shown that the effect of ethyl alcohol in potentiating car bon tetrachloride toxicity could be attributed directly to unmet'abolized ethanol. In contrast, the potentiating effect of isopropyl alcohol could not be related entirely to concentrations of the unmetabolized alcohol, but also involved a metabolic product. Isopro pyl alcohol is slowly oxidized to ace tone.18 In rats, the effect of this nas cent acetone on hepatic microsomes has been shown to have the major role in the potentiation of carbon tet rachloride hepatitis.1119 Thus, the workers in this drug-packaging firm were metabolically predisposed to sustain injury when accidentally ex posed to carbon tetrachloride. The American Conference of Gov ernmental Industrial Hygienists cur rently recommends a threshold limit value of 10 ppm for carbon tetrachlo ride exposure.80 They state that the margin of safety provided by this limit probably decreases in proportion to the ethyl alcohol consumption of the exposed worker. This outbreak suggests that increased toxicity is also related to concomitant isopropyl alcohol exposure. Stricter limits for carbon tetrachloride exposure should be considered for industrial settings where isopropyl alcohol is also used. This industrial accident has certaiM disquieting similarities to childhood poisoning episodes. Many childhood intoxications also involve unsecured cleaning agents, and children fre quently obtain drugs or toxic agents when there is some break in family routine. Similarly, the two main tenance men in the plant were pre sented with an uncommon circum stance when their usual cleaning solvent was unavailable. The ne glected drum of carbon tetrachloride provided an opportunity they could not resist. Although carbon tetrachloride poi sonings have decreased in recent years, they still occur in homes and industrial settings. Physicians should be aware of this possibility when they see combined hepatitis and renal fail ure. Myron J. Frank, MPH, and G* Phillip Blakeslee, MS, collected alveolar air samples. Nancy Rogers, MA, performed the laboratory studies. Alan Hinman, MD, and Rulon Rawson, MD, aided in preparation of this communication. Nonproprietary Name and Trademark of Drug Allopuri no)--Zyloprim. 1. Hamilton A, Hardy- HL: Industrial Tox icology, ed 3. Acton, Mass, Publishing Sciences Group Inc, 1974. 2. Criteria for a Recommended Standard.* Oc cupational Exposure to Carbon Tetrachloride, US Dept Health, Education and Welfare publication NIOSH 76-133, National Institute for Occupa tional Safety and Health, 1975. 3. Synthetic Organic Chemicals: United States Production and Sales, 1973, publication 728. US International Trade Commission, 1975. 4. Priority List for Criteria Development for Toxic Substances and Physical Agents, Cincin nati, Office of Occupational Health Surveillance and Biometrics, National Institute of Occupa tional Safety and Health, 1974. 5. Guild WR, Young JV, Merrill JP; Anuria due to carbon tetrachloride intoxication. Ann In tern Med 48:1221-1227, 1958. 6. New PS, Lubash GD, Scherr L, et al: Acute renal failure associated with carbon tetrachlo ride intoxication. JAMA 181:903-906, 1962. 7. Moon HD: The pathology of fatal carbon tetrachloride poisoning with special reference to References the histogenesis of the hepatic and renal lesions. Am J Pathol 26:1041-1057, 1950. 8. Cornish HH, Adefuin J: Potentiation of car bon tetrachloride toxicity by aliphatic alcohols. Arch Environ Health 14:447-449, 1967. 9. Traiger GJ, Plaa GL: Differences in poten tiation of carbon tetrachloride in rats by ethanol and isopropanol pretreatment. Toxicol Appl Pharmacol 20:105-112, 1971. 10. Traiger GJ, Plaa GL: Chlorinated hydro carbon toxicity: Potentiation by isopropyl alco hol. Arch Environ Health 28:276-278, 1974. 11. Trotter MD, Sulway MJ, Trotter E: The rapid determination of acetone in breath and plasma. Clin Chim Acta 35:137-143, 1971. 12. Smetana H: Nephrosis due to carbon tet rachloride. Arch Intern Med 63:760-777, 1939. 13. Joron GE, Hollenberg CH, Bensley EH: Carbon tetrachloride: An underrated hazard. Can Med Assoc J 76:173-175, 1957, 14. Markham TN: Renal failure due to carbon tetrachloride. J Occup Med 9:16-17, 1967. 15. Widmark EMP: Studies of the "acetone concentration in blood, urine, and alveolar air: Part III. The elimination of acetone through the lungs. Biochem J 14:379-394, 1920, 16. Traiger GJ, Plaa GL: Relationship of alco hol metabolism to the potentiation of CC1< he- patoxicity induced by aliphatic alcohols. J Pharm Exp Ther 183:481-487, 1972, 17. Plaa GL, Traiger GJ: Mechanism of poten tiation of CC1,-induced hepatoxicity, in Proceed ings of the 5th International Congress of Phar macology, San Francisco, 1972. Basel, S Karger, vol 2, pp 100-113. 18. Kemal H: Beitrag zur kenntnis der schicksale des isopropylalkohols im menschlichen orga- nismus. Biochem Z 187:461-466, 1927. 19. Traiger GJ, Plaa GL: Effect of amino- triazole on isopropanol-and acetone-induced po tentiation of CCi, hepatoxicity. Can J Physiol Pharmacol 51:291-296, 1973. 20. Documentation of the Threshold Limit Values for Substances in Workroom Air, ed 3. Cincinnati, American Conference of Govern mental Industrial Hygienists, 1971. 1856 JAMA, Oct 18, 1976-Vol 236, No. 16 Carbon Tetrachloride--Holland et al SL 029386 Airborne Contaminant ACETONE ALUMINA AhMDNIA KAISER ALUMINUM & CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Summary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATICNS Principal Use or Source o Emission HEALTH EFFECTS M5DICAL SURVEILLANCE (1) TLV Air Sampling(2) Solvent; present in fast drying paints or laoquecs Irritation of respiratory tract and mucous membranes; narcosis; dermatitis Interval History 1000 ppm Charcoal tubes Detector tubes i 00 1 CO 0> CM O C/3 Respiratory Protection or Other Controls (3) Air-purifying respirator with cartridge for organic vapors Rubber gloves Potrooms; materials handling areas; kilns; refractories Lung overload; no fibrosis Interval History 10 mg/ro^ (4) Gelman VM-1 membrane filter; nuclepore 0.4 micron filter Air-purifying respirator with filter for nuisance dust Spent pot relinings; cryolite recovery find pot repair; dross reclamation; cleaners; pcetreatment of printed packaging Irritation of respiratory tract and mucous membranes Chest x-ray Lung function 25 ppm (50 ppm ceiling) Detector tubes Impinged in acid Air-purifying respirator with cartridge for ammonia ANTIMONY PENTACHIORIDE Catalyst Gastro intestinal and heart disorders; respiratory irritation ERG Chest x-ray Lung function 0.5 mg/Tn^ Millipore AA filter Air-purifying respirator with filter for nuisance dust Stibine may be generated under reducing conditions "Adapting to Medical Surveillance Requirements11 Paper presented at American Occupational Health Conference, New Orleans, April 12, 1978 James P. Hughes, M.D., Medical Director Kaiser Aluminum & Chemical Corp. 300 Lakeside Drive Oakland, CA 94643 2/14318/p 3/30/77 02938r KAISER ALUMINUM & CHEMICAL CORPORATION OCCUPATIONAL HEALTH SUHVEILIANCE CHARTS Sunnary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations t-7 W MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Airborne Contaminant Principal Use or Source of Emission HEALTH EFFECTS MEDICAL SURVEILLANCE (1) TLV Air Sanplinq(2) Respiratory Protection or Other Controls(3) ASBESTOS Insulation; coverings; lagging materials; marinite; molten metal control; brake linings Fibrosis of lung; bronchogenic carcinema; mesothe liana; cancer of stonach, colon, and rectum Chest x-ray Lung function Sputum cytology (OSHA reauirement- Annual medical surveillance) 2 fibers per Millipore AA ml >5 microns, filter with a ceil ing of 10 (OSHA requirementsemiannual fibers/cc not sampling) to exceed 15 min per hr up to 5 hrs per 8 hr day Dependent upon concentrat .Positive pressure respira Power filtered respirator Filter respirator Vacuum sweeping Local exhaust ventilation J BAUXITE {May contain silica) Materials handling Lung overload Chest x-ray Lung function 10 mg/n^ (4) Gelman VM-1 filter Air-purifying respirator with filter for nuisance dust BERYLLIUM Metal alloying Fibrosis of lung; dermatitis Chest x-ray Lung function Skin inspection 0.002 mgAi^ Millipore AA filter ESP Full-face respirators positive pressure; Air-purifying with filter for hiqhly toxic particulate and fume BUTANOL Solvent; present in fast drying paints or lacquers Irritation of respiratory tract and mucous membranes; narcosis; dermatitis Interval History 1000 ppm Charcoal tubes Detector tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves Z/14318/p 3/30/77 Airborne Contaminant BUTYL CELLOSOLVE (2-BUTOXY ETHANOL) KAISER ALUMINUM S CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Surrmary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Emission HEALTH EFFECTS MEDICAL SURVEILLANCE (1) TLV Air Sanplinq(2) Solvent; present in fast drying paints or laoguers Irritation of respiratory tract and mucous membranes; narcosis; dermatitis; red cell hemolysis CBC 50 ppm Charcoal tubes Detector tubes co CO <Jy IN' O J cn Respiratory Protection or Other Controls(3) . Air-purifying respirator with cartridge for organic vapors Rubber gloves CADMIUM OXIDE Ol Silver soldering and brazing Pulmonary edema; fibrosis of lung; kidney damage Chest x-ray Lung function *Cadmium and protein in urine Urinalysis 0.05 mg/m^ (ceiling) Iirpinger Millipore AA filter Nuclepore 0.45 micron filter Air-supplied respirator or hood Air-purifying respirator with filter for hiqhly toxic particulate/fume Local exhaust ventilation CARBON DIOXIDE Potrooms; anode baking pits; combustion sources; kilns Asphyxiation None 5000 ppm Detector tubes Air-supplied respirators Local exhaust ventilation General dilution ventilation CARBON MONOXIDE By-product of Asphyxiation; incomplete cotnbus- disturbed tion in: potrocms, consciousness furnaces, internal combustion engines; inert gas furnaces; kilns; enclosed spaces, tanks & silos Interval Exam *Ca r boxyhemoglobin if intoxication suspected 50 ppm Detector tubes Direct reading instrument Air-supplied respirator or hood Universal canister gas mask Z/H318/1? 3/30/77 Airborne Contaminant CARBON TETRACHLORIDE KAISER ALUMINUM i CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Snonary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Emission HEALTH EFFECTS M3DICAL SURVEILLANCE (1) TLV Air Sanplinq(2) Fluorocarbon plant; laboratory reagent Narcosis; liver and kidney injury Liver function Urinalysis 10 ppm Charcoal tubes Detector tubes Halide meter Gas chromatography I O O' CO O' OJ O vJ m Respiratory Protection or Other Controls(3) Air-supplied respirator - or hood Ait-purifying respirator with filter for organic vapors CELLOSOLVE Solvent; present Irritation of Interval ACETATE in fast drying respiratory History (2-ETHQXY- paints or laaquers tract and mucous I ETHYL ACETATE) H <T> membranes; narcosis; dermatitis 100 ppm Charcoal tubes Detector tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves CHLORINE and CHLORIDES Fluxing in casting operations; water treatment Irritation of respiratory tract and mucous membranes; eye and skin burns Chest x-ray Lung function' 1 ppm Detector tubes Impinger Air-supplied hood Air-purifying respirator with cartridge for acid gases CHLOROFORM Fluorocarbon plaint; laboratory reagent Narcosis; liver and kidney injury Liver function Ur inalysis 50 ppm Charcoal tubes Detector tubes Halide meter Gas chromatography Air-supplied respirator or hood Air-purifying respirator with filter for organic vapors Z/14318/p 3/30/77 KAISER ALUMINUM s, CHEMICAL CORPORATION O' CO O' Cv! o. OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Summary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations Airborne Contaminant Principal Use or Source of Emission CHROMATES Paint (lead and zinc) pigments CHROMIC ACID Sonic test tank; corrosion inhibitor; metal cleaning; bonding agent in refractories MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS HEALTH EFFECTS MEDICAL SURVEILLANCE (1) TLV Irritation of Chest x-ray respiratory tract Lung function and mucous membranes; CBC possible bronchogenic carcinoma 0.1 mg/m3 .001 mg/m3 (proposed) Skin sensiti zation; skin burns; irritation of respiratory tract and mucous membranes Chest x-ray Lung function CBC 0.1 mg/m3 Air Sampling (2) Respiratory Protection or Other Controls(3) Hillipore AA filter;Nuclepore 0.4 micron filter Millipore AA filter Air-purifying respirator with cartridge foracid mists t toxic dusts Protective gloves & clothing CHRCMITE ORE (Cr2p3) Refractories additive; master aluminum alloy Lung overload Chest x-ray Lung function 10 mg/m-* (4) Gelman VM-1 filter Nuclepore 0.45 micron filter Air-purifying respirator COKE and CALCINED COAL Carbon, paste, and coke plants; iraterials handling; potrooms Lung overload; eye and nose irritation Interval History 10 mg/m3 (4) Gelman VM-1 filter; Nuclepore 0.4 micron filter Air-purifying respirator with filter for nuisance dust 17- COPPER FUME and DUST Anode rods and flex; electrical connectors; metal alloying; brazing Metal fume fever; irritation of respiratory tract; nasal septum perforation Interval History 0.2 mg/m3 (fume) 1.0 mg/m3 (dust) Millipore AA filter Air-purifying respirator Nuclepore 0.4 micron filter Z/14318/p 3/30/77 Airborne Contaminant CYANIDE EPOXY RESIN ETHYL ACETATE FLUORIDES Gaseous, Liquid and Particulate KAISER ALUMINUM & CHEMICAL CORPORATICN ,, OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Sumaary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Emission HEALTH EFFECTS MEDICAL SURVEILLANCE (1) TLV Air Sanplinq(2) CM ,Ocn' I ' O' CM ,O w Respiratory Protection or Other Controls(3) Pot soakingi cryolite recovery Mold manufacture; antennae project; glue; sealant; in side can coating Weakness, headache, confusion, nausea, vomiting; collapse, rapid death Skin sensitizer Interval Exam Skin inspection Interval Exon 5 mg/m^ Variable, see specific hardener (amine) Millipore AA filter Air-purifying respirator Under acidic conditions hydrogen cyanide is liberated Iirpinger; silica gel tubes for amines Local exhaust ventilation Neoprene gloves; Washing after skin contact Solvent Irritant of eyes Interval History and mucous membranes; narcosis 400 ppm Charcoal tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves Cryolite plant; Pot roans; Pot repair; Solid fluxes; metal treatment; welding flux; dross recovery Acute - nose Chest x-ray bleed, vomiting; Lung function respiratory Urinalysis irritation. **Fluoride in urine Chronic - **Pelvis x-ray increased bone {q. 6 years) density; aggravates broochitis/asthma 2.5 mg/m* Millipore AA filter in series with pad treated with sodium carbonate or formate; or RAC filters Nuclepore filter Air-supplied hood . Air-purifying respirator with cartridge for . acid gases, in addition to filter for toxic particulate Z/14318/fe 3/30/77 Airborne Contaminant FLUORO CARBONS GRAPHITE HEXANE HYDROGEN HYDROGEN CHLORIDE KAISER ALUMINUM i CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Summary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AM) INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Emission HEALTH EFFECTS MEDICAL SURVEILLANCE (1) TLV Air Sairplinq(2) Fluorocarbon plant Sensitize heart to effects of epinephrine Interval History 500 or 1000 ppm depending on com pound Detector tubes Halide meter Gas chroma tography i 'CO CO O' CM O Jcn Respiratory Protection or Other Controls(3) Air-sipplied hood Additive to refractories; anode stub parting compound "Graphite" Pneumoconiosis Chest x-ray Lung function 5 mg/m^ (respirable) Gelman VM-1 filter Nuclepore filter - Air-purifying respirator Solvent; degreaser Peripheral neuropathy; irritation of respiratory tract and mucous membranes; narcosis; dermatitis Neurologic Exam 100 ppm Charcoal tubes Detector tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves By-product of battery charging Highly explosive in air; simple asphyxiant None None Detector tubes Direct reading instrument Local exhaust ventilation; general dilution ventilation Casting; (Formed from chlorine in presence of water); demineral izers Respiratory irritation Chest x-ray Lung function 5 ppn (ceiling) Detector tubes Impinged in water Air-supplied hoods Air-purifying respirator with cartridge for acid gases Z/14318/fc 3/30/77 Airborne Contaminant HYDROQSN SULFIDE KAISER ALUMINUM 6 CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILIANCE CHARTS Stannary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Emission HEALTH EFFECTS MEDICAL SURVEILLANCE (1) TLV Air Samplinq(2) By-product from incombustion of sulfur and sulfur containing materials; refractory additive Eye irritation; respiratory irriation; collapse; rapid death Chest x-ray Lung function 10 ppm Detector tubes ,,Oi cn ,CNI O to Respiratory Protection or Other Controls (3) Adequate ventilation; airpurifying respirator with cartridge for acid gases ISOPHORCNE Solvent; present in Irritation of Interval History 25 ppm fast drying paints respiratory or lacquers tract and mucous 1 to membranes; narcosis; o dermatitis t Charcoal tubes Detector tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves LEAD Metal alloying; Lead colic; solders; die lubricants; neuromuscular paint pigments; dysfunction; anemia; teratogenesis Lead in blood or urine Neurologic Exam C8C Urinalysis 0.15 mg/m^ Millipore AA filter ESP Air-supplied hood Air-purifying respirator with filter for toxic particulate and fume LIME (HYDRATED) Bonding agent in refractories; waste water neutralization Irritation of respiratory tract and mucous membranes; skin burns Interval History 5 mg/in^ Gelman VM-1 filter Air-purifying respirator with filter for nuisance dust Z/l4318/p 3/30/77 Airborne Contaminant KAISER ALUMINUM k CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Summary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Emission HEALTH EFFECTS MEDICAL SURVEILLANCE (1) TUV Air Sanplinq(2) in cJ eo O' CM o Vi Respiratory Protection or Other Controls(3) LIME (QUICKLIME) (Calcined Dolomite) R material in magnesia precipita tion Extreme irrita tion of respira tory tract and mucous mem branes; skin burns Chest x-ray Lung function Inspection of skin and nose examination for pneumonia 2 mg/nP (proposed internal standard) Gelman VM-1 Air-purifying respirator with filter for highly toxic dust MAGNESIUM Magnesium Lung overload I to H OXIDE (MAGNESIA) production; remelt skim I Interval History MANGANESE Fume Metal alloying Lung overload; nerve damage; possible anemia Lung function Chest x-ray Neurologic Exam CBC Urinalysis 10 mg/m^ Gelman VH-1 filter 5 mg/to-* (ceiling) Millipore AA filter ESP Air-purifying respirator with filter for nuisance dust Air-supplied welding hood Air-purifying respirator with filter for toxic particulate and fume MERCURY Rectifiers, laboratories, porosimeters and densitometers Brain damage; nerve damage *Mercury in blood and urine Neurologic Exam Urinalysis 0.05 mg/nr^ Mercury vapor detector Impinger Vapor badge Air-purifying respirator with canister for mercury vapor, dusts, and mists Z/14318/fe 3/30/77 Airborne Contaminant METHANOL KAISER ALUMINUM b CHEMICAL COKPORATICN OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Simmary of ALL AIRBORNE CONTAMINAOTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND DEXJSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Qnission HEALTH EFFECTS MEDICAL SURVEILLANCE (1) TLV Air Sanplincr(2) Solvent; paints and lacquers Irritation of respiratory tract and mucous membranes; narcosis; dermatitis; diminished vision Interval History 200 ppm Silica gel tubes Detector tubes i O O' m O' CM o t/i Respiratory Protection or Other Controls(3) Air-purifying respirator .with cartridge for organic vapors Rubber gloves 22- METHYL Chlorinated solvent; Irritation of i CHLOROFORM present in fast drying respiratory Interval History (1,1,1-TRI- paints or lacquers; tract and mucous CHIOROETHANE) degreaser; electric membranes; motor and equipment narcosis; cleaner dermatitis 350 ppti Charcoal tubes Detector tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves METHYL ETHYL KETONE (2-BUTANCNE) Solvent; present in fast drying paints or lacquers Irritation of respiratory tract and mucous membranes; narcosis; dermatitis Interval History 200 ppm Charcoal tubes Detector tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves METHYL I90BUTYL KETONE (2-HEXOE) Solvent; present in fast drying paints or lacquers Irritation of respiratory tract and mucous membranes; narcosis; dermatitis Interval History 100 ppm Charcoal tubes Detector tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves Z/14318/fe 3/30/77 Airborne Contaminant NITRIC ACID KAISER ALUMINUM f. CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Summary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Emission HEALTH EFFECTS EEDICAL SURVEILLANCE (1) TLV Air Sanpling(2) Metal cleaning and etching; agricultural chemical Irritant of Chest x-ray respiratory tract Lung function and mucous membranes; erosion of exposed teeth 5 mg/nP Inpinger with alkaline adsorbent ''Ch CO O' 1 CM o CO Respiratory Protection or Other Controls(3) Rubber gloves and aprons; air-purifying respirator with cartridge for acid vapors NITRIC OXIDE tsj CO Thermally induced by-product during welding, calcining; usually found with nitrogen dioxide; inert gas furnaces Respiratory irritation caused by con cern tent exposure to nitrogen dioxide Chest x-ray Lung function 25 ppm Detector tubes Ispinger Air-supplied welding hood NITROGEN DIOXIDE Thermally induced by-product during welding, calcining; inert gas furnaces Respiratory irritation Chest x-ray Lung function 5 ppm Detector tubes Irrpinger Air-supplied welding hood NUISANCE DOST Materials handling throughout plant Lung overload; eye and nose irritation Interval History 10 mg/tc? (4) Gelman VH-1 filter; Nuclepore 0.45 micron filter; ESP Air-purifying respirator with filter for nuisance dust Z/14318/fc 3/30/77 Airborne Contaminant OIL MIST Particulate KAISER ALUMINUM k CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Summary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Omission Coolant or lubricants for mills, saws, metal forming, cans, refractories HEALTH EFFECTS Lipoid pneumonitis; dermatitis MEDICAL SURVEILLANCE (1) Interval History TLV 5 mg/n3 Air Sampling (2) Millipore AA filter or glass fiber filter ESP i 'tO O' CO 1 O' ol o Respiratory Protection or Other Controls(3) Air-purifying respirator with cartridge for organic vapors and particulate OZONE By-product in electrical Respiratory discharge and welding irritation Chest x-ray Lung function 0.1 mg/nr* Inpinger Detector tubes Air-supplied welding hood PARTICULATE Binder for elec to u I POLYCYCLIC trodes, Soderberg ORGANIC HATTER potrooms, carbon {FORMERLY and paste plants; Photochemical skin burns; possible cancer of lungs, Chest x-ray Lung function CBC Skin inspection CTFV) pot relining; tar leukemia, Urinalysis bonded/impregnated lymphones ****Sputum cytology brick; magnesium anode sealer 0.2 mg/m3 (benzene soluble fraction) Silver membrane, filter with glass fiber filter ESP Air-supplied hood Air-purifying respirator Barrier creams PERCHLOROETHYLENE (TETRACHLORDETHYLENE) Chlorinated solvent; degreaser Irritation of respiratory tract and mucous membranes; narcosis; dermatitis; liver injury Liver function 100 ppm Detector tubes Halide meter Gas chromatograph Air-purifying respirator with cartridge for organic vapors. Rubber gloves PHOSGENE Combustion product of halides; Note; no welding in confined space in presence of chlorinated solvent or other halide Pulmonary irritation;, pulmonary edema Chest x-ray Lung function 0.1 ppm Detector tubes Gas chromatograph Air-eupplied respirator or hood; Local exhaust ventilation Z/U318/P 3/30/77 KAISER ALUMINUM & CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Summary of ALL AIRBORNE CONTAMINANTS AND FHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CCNSIDERATIONS Airborne Contaminant PHOSPHINE Principal Use or Source of Emission Gaseous by-product of dross and water HEALTH EFFECTS Severe irritation of lungs; delayed pulmonary edema; narcosis; nausea; vomiting EEDICAL SURVEILLANCE (1) Interval History TLV 0.3 ppm Air Sanplinq(2) Impinger Detector tubes PHOSPHORIC to ACID Oi I Refractory bonding agent; metal treatment Irritation of respiratory and mucous membranes; skin burns Interval History 1 mg/m^ Inpinger; Nuclepore 0.45 Micron filter POLYCHLORINATED Electrical equipment BIPHENYLS dielectric and coolant (Chlorodipbenyl- 42% chlorine; Chlorodiphenyl- 54% chlorine) Chlorine; liver damage Liver function Skin Exam 0.5 mg/m^ Impinger 1 O' O' on O' <N O J to Respiratory Protection or Other Controls(3) Air-purifying respirator with cartridge for acid gases Contaminant in acetylene; often identified incorrectly as acetylene Air-purifying respirator with cartridge for acid gases Protective clothing; closed containers; disposal by incineration Z/l4310/p 3/30/77 Airborne Contaminant SILICA KAISER ALUHIHH i CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Sunnary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Emission Clay refractories; diatanaceous earth (filter media); sand blasting; finished carbon HEALTH EFFECTS Silicosis KDICAL SURVEILLANCE (1) Chest x-ray Lung function Tuberculin test TLV 0.05 mg/m^ Air Sanplinq(2) Gelman VM-1 filter with cyclone at 1.7 1pm. O O O' CM O U5 Respiratory Protection or Other Controls(3) Air-purifying respirator with cartridge for toxic <kists Air-sqpplied hood SODIUM Cryolite plant; Respiratory HYDROXIDE caustic chlorine irritation plant; i bayer plant; to precipitators; pot 01 soaking; siphon deeming; water treatment Chest x-ray Lung function 2 mgAf* Inpinger Air-purifying respirator with cartridge for alkaline mists SODIUM SILICATE Refractories additive; sealer Respiratory irritant; corneal burns; skin burns Interval History 10 mgA^ (4) Gelman VM-1 Air-purifying respirator STODDARD SOLVENT Solvent; degreaser Irritation of Interval History respiratory tract and mucous mentor anes; narcosis; dermatitis 100 ppm Charcoal tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves Z/14318/p 3/30/77 KAISER ALUMINUM i CHEMICAL CORPORATION o < CT> og o OCCUPATIONAL HEALTH SURVEILLANCE CHARTS Summary o ALL AIRBOFNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations Airborne Contaminant SULFUR DIOXIDE MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Use or Source of Bnissicn HEALTH EFFECTS MEDICAL SURVEILLANCE (1J TLV By-product of Respiratory ccnbustion of coke, irritation; coal, anodes, oil synergistic and gas; surface shield with dust in magnesium production; waste water treatment Chest x-ray Lung function 5 ppm Air Sanplinq (2) Detector tubes Impinger Respiratory Protection or Other Controls(3) Air-purifying respirator with cartridge for acid gases SULFURIC r ACID to o i Ploorochemical plant; chlorine plant; waste water treatment Respiratory irritation Chest x-ray Lung function 1 mg/rn^ Iopinger Air-purifying respirator with cartridge for acid gases TOLUENE Solvent; present in fast drying paints or lacquers Irritation of respiratory tract and mucous mesbranes; narcosis; dermatitis Interval History Analysis of urine for hippuric acid Urinalysis 100 ppm Charcoal tubes Detector tubes Air-purifying respirator with cartridge for organic vapors Rubber gloves TRICHLORO ETHYLENE Solvent; degreaser Irritation of Interval Exam respiratory tract and mucous membranes; narcosis; dermatitis 100 ppm Charcoal tubes Detector tubes Halide meter Air-purifying respirator with cartridge for organic vapors Rubber gloves Z/14318/p 3/30/77 029402 1 KAISER ALUMINUM i CHEMICAL CORPORATION OCCUPATIONAL HEALTH SURVEILIANCE CHARTS Suntnary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations CO MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Physical Stress Principal Source of Emission HEALTH EFFECTS EEDICAL SURVEILLANCE (1) TLV Survey Equipment Protective Devices HEAT l>0 t> Potroans; finished carbon; casting; kilns; calciners, driers; metal production Weakness; irritability; muscle cramps; cardiovascular strain Physical Exam Electrocardiogram Proposed TLV; Thermometers Black globe; Variable Wet bulb; exposures Dry bulb; above Anemometer 25.0 WBOT; no exposures permitted above 32.2 WBC?T unless certain criteria met Shielding Air movement Acclimatization Hater and salt balance Cool-off rooms Air-ooled hood or garment Air plenums; Hearing loss pneumatic tools; ball nulls; fans; saws; power production compressors; solenoids; vibrators; screens; wire drawers and stranders; can manufacture Audionetrie test of hearing acuity (OSHA proposed requirement annual audiometry 8 hrs at 85 dBA) 16 Hrs at 85 dBA; 6 Hrs at 90 dBA; 4 Hrs at 95 dBA; 0.5 Hrs at 110 cBA; 0.25 Hrs at 115 cA; 0 Hrs at >115 dBA (5) Type II sound level meter; audio dosimeters Ear muffs Ear plugs; sized or custom molded Disposable ear protectors Z/14318/p 3/30/77 SL 029403 Physical Stress RADIATION VIBRATION U o KAISER ALUMINUM i CHEMICAL CORPORATION OCCUPATIONAL HEALTH SUHVEILIANCE CHARTS Summary of ALL AIRBORNE CONTAMINANTS AND PHYSICAL STRESSES in Corporate Operations MEDICAL AND INDUSTRIAL HYGIENE CONSIDERATIONS Principal Source of Emission Medical and analytical x-ray units; slurry gauges; density gauges HEALTH EFFBCTS Genetic damage; bone marrow depression; skin burns EEDICAL SUHVEILIANCE (1) Film badges Physical Exam TLV 5 ran/ year (6) Survey Equipment Protective Devices Geiger counters Scintillation counters; ionization chamber Shielding Distance Hand tools; jackhammers; mobile equipment Neurovascular changes in the fingers Physical Exam None None Shock mounting Rubber handles 2/14318/p 3/30/77 <1) An interval medical history should be obtained with each procedure. -a -a O' (S o I ^ Frequency of medical examination depends upon severity of exposure and health status of the individual; annual re examination is recommended if exposures exceed action level.*** All procedures to be performed only by a physician approved ty the Medical Director, or ty designated paramedical personnel under the direct supervision of such a physician. Results to be interpreted only by an approved physician. `Selection of testing laboratory and analytical method to be approved ty Medical Director; specimens to be collected only ty an approved physician or under his direct supervision. *`Medical examinations are to be repeated on an annual basis, except that the radiologic examination of the pelvis shall be conducted every 6 years when the average of preshift urinary fluoride concentrations for the preceding 6 years exceeds 4,0 mg/liter. Urinary postshift fluoride analysis shall be made available at an interval not exceeding every 3 months to at least one-fourth of all workers subject to occupational exposure to fluoride in dust. Participating workers shall be rotated to provide all exposed workers the opportunity for urinalysis every year. Spot urine saitples shall be collected at the conclusion of the workshift after 4 or more consecutive days of exposure. Urinary preshift analysis for fluoride shall be made available to all exposed workers at least annually. Preshift spot samples shall be collected at the start of the workshift at least 48 hours after a previous occupational exposure. Results shall be corrected for ^ a specific gravity of 1.024. W i--i If an individual's postshift urinary fluoride level exceeds 7.0 mg/liter, preshift spot urine samples shall be collected t within 2 weeks at the start of a workshift at least 48 hours after a previous occupational exposure and a repeat postshift spot sanple shall be collected at the conclusion of the workshift. This shall be done at the end of the workweek in which the preshift sample is collected. If the fluoride level of the second sample is above either the preshift limit of 4.0 mg/liter or the postshift limit of 7.0 mg/liter, steps shall be taken to evaluate dietary sources, personal hygiene, basic work practices, and environmental controls. National Institute for Occupational Safety and Health, U.S. Department of Health, Education, and Welfare; Criteria for a recamended Standard... .Occupational Exposure to Inorganic Fluorides, HEW Publication No. (NIOSH) 76-103, U.S. Government Printing Office, Washing, D.C., 1975. *** Action level is defined as 0.5 times the 8-hour tine-weighted TLV. **** At the time of initial assignment to an area where there is exposure to Particulate Polycyclic Organic Matter (Coal Tar Pitch Volatiles) there shall be a sputum cytology examination. Thereafter, sputum cytology examinations shall be con ducted annually for employees with 5 or more years of exposure to PPOH/CTPV or who are 45 years of age or older. Specimens are to be collected only ty personnel trained for this purpose. Selection of pathology laboratory will be made ty J. P. Hughes, M.D., Corporate Medical Director. (2) Gravimetric and chemical analyses are to be submitted to Industrial Hygiene Laboratory at CFT. Engineering, administrative or personal protective equipment control is recommended if exposures exceed action level.*** Z/14318/p 3/30/77 (3) Employees mist not be assigned to tasks requiring use of a respirator until a designated physician has determined physical ability to perform the work and use the equipment without undue risk. (See OSH Rules and Regulations, Paragraph 1910.134-b-10). Respirators must have NIOSH approval for specific contaminant at exposure level. All enplcyees whose exposure is controlled by respirators are included in medical control program. (4) Federal MESA, Section 55.5 (Dec. 19, 1970) and the American Conference of Governmental Industrial Hygienists reconmends 10 mg/m-5; Federal OSH Standards, Section 1910.93 allows 15 mg/m3 (August 13, 1971). (5) See Pederal OSH Standards, Section 1910.95, subpart (b)(3). (6) See Federal 06H Standards, Section 1910.96, sutpart (b)(1). q29405 I I to to t Z/14318/jp 3/30/77