Document gMBNwZzz8YxwgEgxepGwwpRJ

p. 1 ' Atdclu'gan Departmenl ~ ~ ~ nf .Ginu~urnit} tleallh Children's Hospital' Y ~ p, ~,s HoCM ~ ~ +'MkLrr ./ Syach.e. .y,ry Regional Poison Center i q M ., of Michigan Jennifer M . Granhoim. Governor De eiDi1 Med'oaf Center/Wayne State University Janet 013zewski, Director Advisory : Acute respiratory illness associated with aerosolized waterproofing products f REPORT ALL PATIENTS TO POISON CONTROL AT 1-800-222-1222 The Michigan Department of Community Health (MDCH) and the Michigan Poison Control Centers have received numerous reports of respiratory illness in people and their pets associated with exposure to leather, tent and other waterproofing products that come in spray cans . Many individuals required hospitalization for supportive care . Although there have been no documented deaths in humans, at least three cats have died as a result of exposure. As a result, the MDCH and the Poison Control Centers are issuing this advisory to hospital emergency departments and physicians . Clinical presentation : Presenting symptoms included shortness of breath, cough, chest pain, nausea/vomiting and headache that began within several hours of spraying waterproofing product . Wheeze and crackles were the most common signs of clinical toxicity, followed by tachycardia and tachypnea . Pulse oximetry was often less than 90% on room air. Chest x-rays were positive for bilateral infiltrates in some cases . Treatment : Supplemental oxygen, bronchodilator therapy, and oral corticosteroids . Implicated products: The current outbreak of 195 cases throughout the Midwest includes 108 cases in Michigan . Two brand names have frequently been identified : Jobsite Heavy Duty Bootmate and Rocky Boot Weather and Stain Protector . Both products are manufactured by Assured Packaging in Ontario and distributed by Manakey, Inc . in Grand Rapids, M1 . Patients in this and previous outbreaks have also cited similar products sold under multiple brand names . A cluster of hospitalized cases in 2004 was primarily, but not entirely, associated with a product titled Kenyon Water Repellent, manufactured by Kenyon Consumer Products in Rhode Island . Another cluster in Michigan and other Midwest states was associated with a product called Stand 'n Seal Grout Sealer. This p. 2 product was recalled by the Consumer Product Safety Commission in 200 5 and was reissued after reformulation . What is being done to prevent this problem ? The Consumer Product Safety Commission is investigating the products distributed by Manakey. Because there have been a number of reports of clusters of chemical pneumonitis associated with aerosolized waterproofing agents in the U .S ., Canada, and Europe, the Michigan Department of Community Health and the Centers for Disease Control and Prevention are taking actions to evaluate the toxic etiology of these products. The American Association of Poison Control Centers has refined its toxicosurveillance to be able to quickly identify further outbreaks and associated products . How can health care providers heir) with prevention effo rts? 1 . Repo rt all patients with acute illness associated with use of aerosolized waterproofing products to Poison Control at 1-800222-1222 . 2 . Instruct patients to do the following : Keep the can in case public health officials need to obtain the can for testing . Write a letter to the company listed on the can, notifying the company of their illness . Agency C ontacts : o Michigan Department of Community Health : Martha Stanbury, MSPH, stanburym@michigan .gov or 517-335-8364 . o Regional Poison Control Center at Children's Hospital of Michigan, Detroit Medical Center : Susan Smolinske, PharmD, ssmolins@dmc .org or 313-745-5711 . o Regional Poison Center at DeVos Children's Hospital, Spectrum Health : Bernard Eisenga PhD, MD, bernie_eisenga@spectrum-health .org or 616-391-9098 . Page 1 of 2