Despite warning labels and requirements to wear protective gear, 85 people still died from exposure to a chemical found in paint thinners from 1980 to 2018 in the U.S.
That’s according to a study published online Tuesday in Journal of the American Medical Association. Methylene chloride is a halogenated organic solvent used in paint strippers, cleaners, adhesives, and sealants.
“Although U.S. regulatory policies have mandated product labeling and worker protections, fatalities continue to occur, with a greater proportion of recent deaths related to the use of paint-stripping products,” according to the study. “Prevention of methylene chloride–related fatalities should emphasize the use of safer substitutes, not hazard warnings or reliance on personal protective equipment.”
The study includes case studies of people who died. “In 2015, a 30-year-old man was refinishing a bathtub in a small, poorly ventilated bathroom in a public housing project with the bathroom door closed to keep vapors from escaping into the house,” according to the case study. “After two hours, the home leaseholder found him unconscious, slumped over the bathtub, and called 911. Resuscitation efforts were unsuccessful.
“The worker used a paint stripper containing 85 to 90 percent methylene chloride. He was not wearing a respirator or other personal protective equipment. Results of the autopsy found acute liver, lung and kidney congestion, mild cerebral edema, moderate pulmonary edema, and cardiomegaly but no significant coronary atherosclerosis.”
A month before he died, the worker had passed out similarly while stripping a bathtub. “His employer found and revived him, noting that the worker had slurred speech and burns (presumably chemical) on his face. After this episode, the employer reported providing the worker with a fan, a cloth scarf to protect against face and neck splashes, and a half-mask, powered air-purifying respirator for which the worker was expected to pay. When he died, neither a respirator nor a fan was found at the site or in the worker’s car.”
OSHA officials represented in study
The original investigation was conducted by Anh Hoang, Dr. Kathleen Fagan, and Dr. Dawn L. Cannon. Hoang is from the University at California San Francisco School of Medicine. Fagan and Cannon work in the Office of Occupational Medicine and Nursing, Occupational Safety and Health Administration, Washington, D.C.
The researchers explained their methodology. “For this case series, we conducted systematic searches of sources, including PubMed and government databases, for unintentional fatalities in the U.S. that were associated with exposure to methylene chloride or products containing methylene chloride between 1980 and 2018. We reviewed all available information, including inspection reports, autopsy reports, and medical records; data analyses were conducted from August 2018 to August 2020. Cases were categorized as those occurring in the home (consumer deaths) or at work (occupational deaths).”
Of 85 people who died, 94 percent were men. The median age of the deceased was 31, but the ages ranged from 24 to 46 years. “Paint strippers were the most common products involved in methylene chloride–related fatalities (60). The proportion of occupational fatalities related to paint stripping increased from 22 (55 percent) before 2000 to 30 (88 percent) after 2000,” according to the results. “Similarly, occupational fatalities associated with bathtub or paint stripping in bathrooms increased from two (5 percent) before 2000 to 21 (62 percent) after 2000.
“From 1985 to 2017, the American Association of Poison Control Centers documented 37,201 nonfatal methylene chloride cases, with a decrease in the annual number of cases starting in the late 1990s.”
What does the chemical do when inhaled?
When inhaled, the chemical causes people to pass out quickly. Some also experience skin and eye burns from the irritants.
“The most serious acute effect of methylene chloride is narcosis, ranging from light-headedness, nausea, and headache to respiratory depression and death,” according to the report. “Methylene chloride can also sensitize the myocardium to arrhythmias, a particular risk for people with cardiovascular disease. Other acute effects include skin burns from contact, corneal damage due to ocular splashes, and indirect consequences of narcosis (e.g., falls or other trauma).”
The chemical poses a host of other health dangers. “Methylene chloride is readily absorbed by ingestion, inhalation, and skin contact,” according to the research. “After a time lag, hepatic metabolism of methylene chloride generates substantial quantities of carbon monoxide (CO), a chemical asphyxiant, and formaldehyde, a known carcinogen. In turn, CO exerts additive cardiotoxicity and neurotoxicity with native methylene chloride through competitive displacement of oxygen from hemoglobin.
“Methylene chloride exposure also poses risks including cancer; liver, kidney, and reproductive toxic effects; and cognitive impairment.”
So why not outlaw these dangerous chemicals? “OSHA does not have authority to prohibit uses of substances or chemicals; the EPA has these authorities under the Toxic Substances Control Act,” the researchers explain. “In 2017, the EPA found that methylene chloride paint strippers posed unreasonable risks and proposed (but never finalized) a rule to prohibit these products in consumer and most commercial/industrial uses.”
If the prohibition can be accomplished it “may be effective in reducing consumer deaths because most consumer fatalities have been related to paint strippers,” according to the research.