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Case Presentation

 

 By: Rutgers University
Why Clean Green
Case Studies
Poison Guide

Conclusions


Respiratory distress associated with carpet-cleaning activities has been reported in the literature for decades. The absence of exposure-monitoring data for carpet cleaning may be attributable to a perception of little danger associated with this activity and a high variability of the locations and types of cleaning performed, among other factors. The modeling conducted in this study demonstrates that significant exposures to TSP and volatile organic compounds may be possible during some carpet-cleaning activities where hot water mist is released into the room. The modeled exposures from this incident may approach levels considered to be of concern for workers, who are often more healthy than older adults or children. The two approaches used during modeling showed comparable estimates of exposure, with ranges overlapping between 5 and 17 mg/m3 TSP exposure, which is 1.0-3.4 times the recommended short-term exposure limit for workers.

If the findings of this study are indicative of other exposures to carpet cleaners using a hot water mist cleaning method, then asthmatics who are susceptible to irritant-induced asthma attacks may be particularly at risk after carpet cleaning. Companies that perform carpet cleaning should provide asthmatics with specific warnings about potential risks before cleaning operations begin and take steps to minimize hazardous exposure to these individuals. Preventative steps may include a) reducing cleaning chemical concentrations used to reduce airborne exposures and residual solid cleaner in carpets after moisture has dried; b) reducing the total volume of water and cleaner used within asthmatics' homes; c) instructing the asthmatic to avoid returning to the home until all surfaces have dried; and d) ensuring the availability of a medicinal inhaler in case of an emergency. Modeling also suggests that asthmatics should not accept deodorizing treatments.

More detailed industrial hygiene studies are warranted for characterizing carpet-cleaning exposures. This information would be valuable not only to susceptible individuals and their attending physicians seeking to avoid harmful exposure but also to carpet cleaners and chemical manufacturers in developing appropriate hazard labeling and safety precautions for their workers.

Editor's note:


This issue's Grand Rounds in Environmental Medicine represents something of a departure from convention in that it was written by a nonphysician and deals in large part with modeling concentrations of chemicals in air. However, it is instructive. Lynch takes a case scenario that is relatively common in the clinical practice of occupational/environmental medicine--new onset of asthma in relation to chemical exposures--and analyzes the circumstances surrounding the use of chemical carpet shampoos to estimate the likely dose inhaled by the patient. This is not merely an exercise in industrial hygiene theory. The information provided (dose reconstruction) forms an essential part of the chain of causation that would allow a clinician to determine the likelihood that a particular chemical exposure is responsible for illnesses observed. In this case, Lynch's analysis also informs us of an underrecognized danger inherent in carpet shampooing that may ultimately assist in public health efforts to prevent future occurrences of chemically related exacerbations of asthma. Appreciation of the value of this kind of analysis is vital to the interdisciplinary discipline that is environmental medicine. We look forward to additional contributions from other disciplines in future Grand Rounds.

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