Assessing respiratory exposure to harmful evaporations in a manufacturing company

Abstract

Introduction: Using Hypochlorite Sodium in producing bleaches in order to disinfect and shine surfaces has been an ordinary method since 200 years ago. 10-15% solutions with PH=13 have been used for industrial purposes and 5% solutions with PH=11 have been used for domestic use. AIHA (American Industrial Hygienists Association) has announced the maximum standard exposure to this substance equal to 2mg/m3 in a period of 15 minutes. It should be noted that, based on material safety data sheet and NFPA rating explanation guide, the mentioned substance is mildly unstable (code 1), carries oxidation hazard (ox), and serious respiratory hazard (code 3).

Methods: This survey has been conducted with statistical society of 39, average age of 29.82±3.66 and work experience of 2.46±6.02 who were exposed to Hypochlorite Sodium in 2019. The reference of analyzing the data include medical check-up inventory, spirometry FEV1, FVC, and FEV1/FVC relativity, using SPSS ver16, and T-test.

Results: The statistical society (39 participants) had a normal distribution, with a very pleasant correlation amounts in (FEV1/FVC, FVC, FEV1) considering sig=0.13, andless possibility than (P≤0.05). therefore, the amounts before and after FEV1, and FEV1/FVC, had a meaningful difference statistically, however, taking the amount of sig=0.68 into account which was P≤0.05, no meaningful difference was observed for FVC amounts before and after respiratory exposure to Hypochlorite Sodium.

Conclusion: Considering the reduction in amount of FEV1, and FEV1/FVC among the workers of the manufacturing site who were exposed to Hypochlorite Sodium, they are likely to have pulmonary obstruction, and therefore they are required to be changed in position and location of their jobs, and also appropriate ventilation system must be installed in the location of Hypochlorite Sodium evaporations. Keeping in mind the instability and corrosiveness of Hypochlorite Sodium, all employees had better use respiratory masks (preferably FFP3 in case of dusty materials), proper face shields, anti-acid gloves, anti-acid overalls, and chemical resistant boots.

Keywords: Respiratory exposure assessment, Occupational Asthma, Hypochlorite Sodium, Bleach, FEV1, FVC, FEV1/FVC, CANCER.

Introduction

Using Hypochlorite Sodium in producing bleaches in order to disinfect and shine surfaces has been an ordinary method since 200 years ago [1]. 10-15% solutions with PH=13 have been used for industrial purposes and 5% solutions with PH=11 have been used for domestic use [2][3].

AIHA (American Industrial Hygienists Association) has announced the maximum standard exposure to this substance equal to 2mg/m3 in a period of 15 minutes. The nasty and gross smell of Hypochlorite Sodium is because of Hypochlorous Acid (HOCL), for which no standard exposure has been mentioned in international resources [4].

As a result of mixing Hypochlorite Sodium with water, Sodium, Hypochlorite, and Hydroxyl ions are produced. Hydroxyl ions have the ability to oxidize organic compounds in addition to altering the acidity of water [5].

NAOCL + H2O↔NAOH + HOCL ↔NA + OH + H + OCL

Most of international resources have mentioned in the reactivity part of the NFPA rating explanation guide, that Hypochlorite Sodium is oxidizing and corrosive, in the hygiene part its mild health hazard [6][7], and in some health hazard resources, serious health hazard is mentioned [8]. In the conducted investigations in this regard, in case of accidental ingestion of Hypochlorite Sodium, the most common symptoms are going to be nausea, vomit, coughing, etc. Accidental ingestion of 1.5 glasses of this substance no longer required endoscopy, and conventional medicines have had an acceptable result [9]. It should be added that in cases of inhalation of Hypochlorite Sodium evaporations, no abnormal growth in the pulmonary cells were observed on rats and mice; however, toxicities symptoms were observed after exposure to Chlorine evaporations caused by decomposition of Hypochlorite Sodium. In similar studies, while cleaning toilets, kitchens, etc. due to extreme exposure caused by combination of bleaches containing Hypochlorite Sodium or Ammonia, with acidic launders, Chlorine gas will be evaporated, which is the most frequent and ordinary reason of poisoning in housewives [10]. Recent occupational studies have revealed that the possibility of suffering from asthma is more probable in female employees who are working in homecare production sites [11][12]. Considering the mentioned explanations, we have been studying and assessing the Hypochlorite Sodium exposure influences on employees between 2013 and 2017.

Materials and Methods

This survey has been conducted with statistical society of 39, average age of 29.82±3.66 and work experience of 2.46±6.02 who were exposed to Hypochlorite Sodium in 2019. Since spirometry is the most affordable, yet the most effective method of analyzing pulmonary [13] insufficiencies, and also is one of the most important tools in screening pulmonary diseases, and measures volumes and capacities of lungs, we have chosen it as the resource of collecting data for this research [14]. The most important respiratory capacity variations in diagnosing diseases include: FEV1 (the amount of air exhaled strongly from the lungs in one second) [15] and FVC (the amount of air exhaled after the FEV1) and the relativity of these two [16][17]. According to the scientific investigations in Iran, reduction in amount of FEV1 and FEV1/FVC can indicate a gradual blockage, and reduction in amount FEV1 and stability of the mentioned parameter indicates can indicate a pulmonary limitedness disease [18]. Therefore, the data collected from the spirometry check-ups is used as the reference of the survey. It should also be mentioned that based on the legislation of labor office and ministry of health, the standard working hour for an employee is 7.33 hours a day, and 44 hours a week; while during conducting this research, working hours and over time has been taken into account [19]. Data analysis has been done by SPSS ver16, and T-test.

Results

The results and amounts achieved through pollution measurement has been precisely and accurately calculated. (The devices were already calibrated and in real situations two samples of Hypochlorite Sodium were measured). The results showed that the amounts were within standard limit, and spirometry indexes FEV1, FVC, and the relativity FEV1/FVC was exploited from medical check-up data(Table 1).

The results are as follows:

- The average age of target group who were exposed to Hypochlorite Sodium was 25.82± 3.66 at the beginning of the experiment in 2013, and equated to 29.82± 3.66 at the end of the survey.

- The average work experience of the target group was 2.46± 2.02 in the beginning of the survey in 2013, and it was 6.46± 2.02.

- Considering the number of participants surpassed 30, therefore the data had a normal distribution.

- The exploited amounts (the former and latter FEV1, FVC, and FEV1/FVC) had a very pleasant correlation.

- Keeping in mind that sig=0.13, and since P≤0.05 indicates a meaningful difference among the data, therefore, the amount of former and latter FEV1, and FEV1/FVC in exposure to Hypochlorite Sodium had a meaningful difference.

- Considering that the amount of sig=0.68 surpasses the amount of P≤0.05, the amount of FVC before and after exposure to Hypochlorite Sodium had no meaningful difference statistically.

In conclusion,taking the collected data into account, as well as the remarkable reduction of FEV1, and FEV1/FVC (as mentioned earlier, the reduction of these two parameters indicates blockage diseases) among the workers in a homecare manufacturing site who are exposed to Hypochlorite Sodium, we can conclude that these employees are suffering from a blockage disease. It is suggested that besides further examination of their health, required actions must be taken into consideration in order to change their work stations and also proper ventilations must be installed in the locations. The results from this study are suggested to be carried out along other similar surveys [11][12]. however, considering the statistical society of this research (39 participants) and the specificity of their exposure to Hypochlorite Sodium, we can conclude that these results are best applicable to creation of occupational asthma caused by the exposure to this substance. Also considering the instability and corrosiveness Hypochlorite, it is crucial to use proper respiratory masks (at the time of exposure to Hypochlorite Sodium powder, using FFP3 mask, and at the time of exposure to Hypochlorite Sodium evaporation, using full face, or half-face shield with yellow taped filters, based on NIOSH [19], EN 371 , and EN 141 2000), anti-acid gloves, anti-acid overalls, and chemical resistant boots. The employer is required to supervise full and proper use of the mentioned PPE, and take necessary disciplinary actions against all violators. Based on similar investigations, Salbotamol spray had better be used in future medical check-ups to ensure avoiding occupational asthma [19]. The important factor is that using bleaches and cleaning materials is used completely irregularly especially in case of their mixture with other materials, without even using proper ventilation, by housewives in order to clean houses (the ventilation system installed in restroom is not adequate enough which causes the hypochlorite Sodium evaporations to enter the respiratory system). Therefore, more studies need to be taken into consideration for this stratum of society. Also based on the same studies, users of these bleaches, are in danger of suffering from asthma and other respiratory symptoms, just like all employees who are exposed to Hypochlorite Sodium evaporations [20][21][22]. Besides holding an appropriate hygiene plan for using Hypochlorite Sodium, it is essential to execute a convenient emergency response plan, since this substance is instable, and has a strong oxidizing power; therefore, if it is mixed with strong and instable acids, it will turn into decomposition followed by releasing heat which increases the risk of fire [23]. Eventually it is noted that no sign of cancer caused by Hypochlorite Sodium was observed in the target group. Based on the above article, the results form this survey fully comply with the results from IARC (International Agency research on Cancer). This agency has categorized Hypochlorite Sodium (including liquids and solids) as category 3 carcinogenic (not carcinogenic to humans.) [24][25][26][27][28][29].

References

References

1. Racioppi F., Daskaleros P.A., Besbelli N., Borges A., Deraemaeker C., Magalini S.I., Martinez Arrifta R., Pulce C., Ruggerone M.L., Vlachos P.. Household bleaches based on sodium hypochlorite: Review of acute toxicology and poison control center experience. Food and Chemical Toxicology. 1994; 32(9)DOI
2. Omidi S, Noorinezhad M, Mirbakhsh M, Marzbani A, Mohammad Nejad J. An Investigation on the possibility of utilization of chemical material for mitigation of Cochlodinium sp. bloom and their impact on the Litopenaeus vannamei shrimp. 2016.
3. Quirce S, Barranco P. Cleaning agents and asthma. J Investig Allergol Clin Immunol. 2010; 20(7):542-550.
4. Association AWW. Water chlorination/chloramination practices and principles: Amer Water Works Assn; 2006.
5. Estrela Carlos, Estrela Cyntia R.A., Barbin Eduardo Luis, Spanó Júlio César E., Marchesan Melissa A., Pécora Jesus D.. Mechanism of action of sodium hypochlorite. Brazilian Dental Journal. 2002; 13(2)DOI
6. Estrela C, Figueiredo JAPd. Endodontia: princípios biológicos e mecânicos.. Endodontia: princípios biológicos e mecânicos1999.
7. Escudero-Oñate C. Survey of sodium and calcium hypochlorite. Skin. 2014; 7681:52-59.
8. Exh G, Exh A. Return of Private Foundation. SAGE. 2005; 10:38.
9. ACGIH D. HAZARD SUMMARY. 1996.
10. Wolf D. Two-Year Inhalation Exposure of Female and Male B6C3F1 Mice and F344 Rats to Chlorine Gas Induces Lesions Confined to the Nose. Fundamental and Applied Toxicology. 1995; 24(1)DOI
11. Tarlo SM, Lemiere C. Occupational asthma. New England Journal of Medicine. 2014; 370(7):640-649.
12. Siracusa A., De Blay F., Folletti I., Moscato G., Olivieri M., Quirce S., Raulf-Heimsoth M., Sastre J., Tarlo S. M., Walusiak-Skorupa J., Zock J.-P.. Asthma and exposure to cleaning products - a European Academy of Allergy and Clinical Immunology task force consensus statement. Allergy. 2013; 68(12)DOI
13. Heederik D.. Cleaning agents and disinfectants: moving from recognition to action and prevention. Clinical & Experimental Allergy. 2014; 44(4)DOI
14. Wanger Jack, Irvin Charles G.. Office Spirometry: Equipment Selection and Training of Staff in the Private Practice Setting. Journal of Asthma. 1997; 34(2)DOI
15. Subbarao Padmaja, Lebecque Patrick, Corey Mary, Coates Allan L.. Comparison of spirometric reference values. Pediatric Pulmonology. 2004; 37(6)DOI
16. Ioanna Tsiligianni, Kocks Janwillem, Tzanakis Nikolaos, Siafakas Nikolaos, van der Molen Thys. Factors that influence disease-specific quality of life or health status in patients with COPD: a systematic review and meta-analysis of Pearson correlations. Primary Care Respiratory Journal. 2011; 20(3)DOI
17. Karkhanis VS, Joshi J. Spirometry in chronic obstructive lung disease (COPD). J Assoc Physicians India. 2012; 2(60):22-26.
18. Hyatt RE, Scanlon PD, Nakamura M. Interpretation of pulmonary function tests: Lippincott Williams & Wilkins. 2014.
19. Saeidabadi H , Nikpey A. Respiratory exposure with acrylonitrile butadiene styrene particle in appliance company workers. J Qazvin Univ Med Sci. 2018; 21(1):31-41.
20. No A. Guide to implementing an effective respiratory protective device programme.
21. Zock Jan-Paul, Kogevinas Manolis, Sunyer Jordi, Almar Enrique, Muniozguren Nerea, Payo Félix, Sánchez José Luis, Antó Josep Maria. Asthma risk, cleaning activities and use of specific cleaning products among Spanish indoor cleaners. Scandinavian Journal of Work, Environment & Health. 2001; 27(1)DOI
22. Arif A. A., Hughes P. C., Delclos G. L.. Occupational exposures among domestic and industrial professional cleaners. Occupational Medicine. 2008; 58(7)DOI
23. Matulonga Bobette, Rava Marta, Siroux Valérie, Bernard Alfred, Dumas Orianne, Pin Isabelle, Zock Jan-Paul, Nadif Rachel, Leynaert Bénédicte, Le Moual Nicole. Women using bleach for home cleaning are at increased risk of non-allergic asthma. Respiratory Medicine. 2016; 117DOI
24. Health UDo, Services H. Agency for Toxic Substances and Disease Registry-ATSDR. 1999.
25. Cancer IAfRo. Chlorinated drinking-water; chlorination by-products; some other halogenated compounds; cobalt and cobalt compounds. IARC Monogr Eval Carcinog Risks Humans. 1991; 52
26. Program NT. NTP Toxicology and Carcinogenesis Studies of Chlorinated Water (CAS Nos. 7782-50-5 and 7681-52-9) and Chloraminated Water (CAS No. 10599-90-3)(Deionized and Charcoal-Filtered) in F344/N Rats and B6C3F1 Mice (Drinking Water Studies). National Toxicology Program technical report series. 1992; 392(1)
27. Yari Saeed, Asadi Ayda Fallah, Varmazyar Sakineh. Assessment of Semi-Quantitative Health Risks of Exposure to Harmful Chemical Agents in the Context of Carcinogenesis in the Latex Glove Manufacturing Industry. Asian Pacific Journal of Cancer Prevention. 2016; 17(sup3)DOI
28. Yari S, Asadi AF, Nourmohammadi M. Occupational and Environmental Cancer. Asian Pacific Journal of Environment and Cancer. 2018; 1(1)
29. Yari S, Asadi AF, Jarrahi AM, Nourmohammadi M. CARcinogen EXposure: CAREX. Asian Pacific Journal of Environment and Cancer. 2018; 1(1)