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Case Presentation


 By: Rutgers University
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In this paper I summarize the current understanding of irritant exposures and asthma, as well as asthma associated with carpet-cleaning operations, and describe modeling of the exposure to carpet-cleaning compounds potentially received by the victim described in this case, based upon two independent exposure-modeling approaches.


Several studies linking the use of carpet-cleaning compounds to respiratory irritation and asthma among building occupants after carpet cleaning have been published over the past two decades. In 1982, Kreiss et al. (1) described two respiratory distress outbreaks associated with carpet cleaning. In one outbreak, employees of an office building experienced coughing, respiratory irritation, and difficulty breathing after the application of underdiluted carpet-cleaning compounds. In the other outbreak, employees and children of a day-care facility experienced respiratory irritation and breathing difficulty after carpet-cleaning activities. In 1983, a case of respiratory irritation and breathing difficulty was reported immediately after carpet-cleaning activities in a hospital clinic (2). Excessive respiratory irritation, coughing, and sneezing were also reported among conference participants following carpet cleaning in a motel (3). In each of these studies, recommendations were proposed for proper dilution of cleaning chemicals and for proper ventilation of rooms to be cleaned.

Chemical components and process description

According to the material safety data sheets, the carpet-cleaning solution used was a 90-95% TSP solution, which also contained low levels of DPGME and various fragrance compounds. None of the material safety data sheets report the components as allergens. This original powdered mixture was diluted to a 4% mixture in water before being introduced into the home. This material was further diluted to a 1 part in 30 mixture, using tap water at the home, and applied to the carpets and upholstery within the home using a high pressure application wand.

During application, high temperature water and cleaning chemicals are injected into the carpet via high pressure nozzles at the end of the application wand. Some of the moisture impacts the carpet surface and is absorbed or removed from the carpet via a vacuum system. The remaining moisture is either released into the air of the home as a mist, or remains in the carpet to dry over a 2-24-hr period. Approximately 8-40 gallons of diluted cleaning solution is applied within the home, 95% of which is removed and recaptured by the vacuum system.

Following the cleaning process, a deodorizer product containing approximately 2.1% glycol ethers and fragrance compounds was applied to the upholstery.

Irritant effects of chemicals used

TSP is an irritant powdered solid that may affect the skin and eyes. It injures cell tissue by alkaline caustic action, causing irritation of mucous membranes, with effects similar to those of lye (4). Because of respiratory hazards, the American Industrial Hygiene Association (AIHA) has established a recommended workplace environmental exposure level of 5 mg/m3 over a 15-min period as the maximum exposure level for this material for industrial workers. Glycol ethers such as DPGME can cause irritation, burning, and coughing after inhalation exposure. The American Conference of Governmental Industrial Hygienists has established a threshold limit value of 100 ppm and a 15-min short-term exposure limit of 150 ppm for DPGME (5).

Irritant exposure and asthma

The relationship between irritant chemical exposure and induction of asthma attacks in asthmatics is well established. Irritant chemical exposure causes bronchial epithelium injury. Persons with asthma are more susceptible to irritant and volatile organic chemicals than nonasthmatics and show greater bronchial hyperresponsiveness to irritant exposures than nonasthmatics (6). Several studies indicated respiratory irritation due to exposure to low levels of volatile organic compounds. In 1986, Molhave et al. (7) found that exposures to between 5 and 25 mg/m3 of volatile organic compounds resulted in eye, nose, and throat irritation. Exposure to 25 mg/m3 organic compounds produces asthma-like symptoms in asthmatics, resulting in forced expiratory volumes of approximately 90% after 90-min exposures, and also produces reduced pulmonary flow rates among persons suffering from sick building syndrome (8,9).

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