INVESTIGATION OF A CANCER CLUSTER IN A MULTIPLE STORY OFFICE BUILDING CONDUCTED JUNE, 2009
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Transcript of INVESTIGATION OF A CANCER CLUSTER IN A MULTIPLE STORY OFFICE BUILDING CONDUCTED JUNE, 2009
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CIHC Annual ConferenceDecember 8, 2010
Westgate Hotel, San Diego, CA
Howard B. Spielman, PE, CIH, CSP, REHSPresident
HEALTH SCIENCE ASSOCIATES10771 Noel Street
Los Alamitos, CA 90720Phone: 714-220-3922
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CLIENT: BUILDING OWNER VIA LEGAL COUNSEL
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CLIENT: BUILDING OWNER VIA LEGAL COUNSEL
ISSUE: HIGH INCIDENCE OF BREAST CANCER IN A TENANT’S SUITE
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CLIENT: BUILDING OWNER VIA LEGAL COUNSEL
ISSUE: HIGH INCIDENCE OF BREAST CANCER IN A TENANT’S SUITE
BUILDING: 71,464 SQ.FT. CONSTRUCTED 1993
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CLIENT: BUILDING OWNER VIA LEGAL COUNSEL
ISSUE: HIGH INCIDENCE OF BREAST CANCER IN A TENANT’S SUITE
BUILDING: 71,464 SQ.FT. CONSTRUCTED 1993
TENANT: SINCE 2002. 2,231 SQ.FT. ON 3RD FLOOR. LOAN BROKERAGE
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MARCH 2007 JULY 2007 MAY 2009
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MARCH 2007 JULY 2007 MAY 2009
APRIL OR MAY 2009 ANOTHR EMPLOYEE DIAGNOSED WITH PRE-CANCEROUS CELLS IN HER UTERUS.
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MARCH 2007 JULY 2007 MAY 2009
APRIL OR MAY 2009 ANOTHR EMPLOYEE DIAGNOSED WITH PRE-CANCEROUS CELLS IN HER UTERUS.
ALSO, A CASE OF HODGKIN’S DISEASE.
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SITE VISIT FOR GENERAL ORIENTATION.
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SITE VISIT FOR GENERAL ORIENTATION. INTERVIEW BUILDING MANAGER AND
BUILDING ENGINEER.
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SITE VISIT FOR GENERAL ORIENTATION. INTERVIEW BUILDING MANAGER AND BUILDING
ENGINEER.
REVIEW PROPERTY’S PHASE I ENVIRONMENTAL SITE ASSESSMENT.
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SITE VISIT FOR GENERAL ORIENTATION. INTERVIEW BUILDING MANAGER AND BUILDING
ENGINEER. REVIEW PROPERTY’S PHASE I ENVIRONMENTAL SITE
ASSESSMENT. CONDUCT LIMITED RESEARCH TO SEE IF
ANY ENVIRONMENTAL AGENTS HAVE BEEN IDENTIFIED AS SUSPECTED CAUSES OF BREAST CANCER.
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SITE VISIT FOR GENERAL ORIENTATION. INTERVIEW BUILDING MANAGER AND BUILDING
ENGINEER. REVIEW PROPERTY’S PHASE I ENVIRONMENTAL SITE
ASSESSMENT. CONDUCT LIMITED RESEARCH TO SEE IF ANY
ENVIRONMENTAL AGENTS HAVE BEEN IDENTIFIED AS SUSPECTED CAUSES OF BREAST CANCER.
INTERVIEW TENANT PERSONNEL AND INSPECT TENANT’S PREMISES.
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SITE VISIT FOR GENERAL ORIENTATION. INTERVIEW BUILDING MANAGER AND BUILDING
ENGINEER. REVIEW PROPERTY’S PHASE I ENVIRONMENTAL SITE
ASSESSMENT. CONDUCT LIMITED RESEARCH TO SEE IF ANY
ENVIRONMENTAL AGENTS HAVE BEEN IDENTIFIED AS SUSPECTED CAUSES OF BREAST CANCER.
INTERVIEW TENANT PERSONNEL AND INSPECT TENANT’S PREMISES.
DETERMINE IF FOLLOW-UP AIR AND/OR SURFACE SAMPLING WOULD BE PRUDENT.
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True cancer clusters rarely involve more than one type of cancer. To be considered a true cluster usually means it has one of the following characteristics.
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TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS.
1. THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER.
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TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS.
1. THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER.
2. THERE ARE LARGER THAN EXPECTED NUMBERS OF A MORE COMMON TYPE OF CANCER.
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TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS.
1. THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER.
2. THERE ARE LARGER THAN EXPECTED NUMBERS OF A MORE COMMON TYPE OF CANCER.
3. IT IS A TYPE OF CANCER NOT USUALLY SEEN IN A CERTAIN GROUP OF PEOPLE.
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TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS.
1. THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER.
2. THERE ARE LARGER THAN EXPECTED NUMBERS OF A MORE COMMON TYPE OF CANCER.
3. IT IS A TYPE OF CANCER NOT USUALLY SEEN INA CERTAIN GROUP OF PEOPLE.
MOST WELL DOCUMENTED CANCER CLUSTERS HAVE NOT BEEN FOUND IN THE COMMUNITY, BUT HAVE BEEN IN THE WORKPLACE WHERE CERTAIN EXPOSURES TEND TO BE HIGHER AND LAST LONGER.
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TRUE CANCER CLUSTERS RARELY INVOLVE MORE THAN ONE TYPE OF CANCER. TO BE CONSIDERED A TRUE CLUSTER USUALLY MEANS IT HAS ONE OF THE FOLLOWING CHARACTERISITICS.
1. THERE ARE SEVERAL CASES OF A RARE TYPE OF CANCER.
2. THERE ARE LARGER THAN EXPECTED NUMBERS OF A MORE COMMON TYPE OF CANCER.
3. IT IS A TYPE OF CANCER NOT USUALLY SEEN IN A CERTAIN GROUP OF PEOPLE.
MOST WELL DOCUMENTED CANCER CLUSTERS HAVE NOT BEEN FOUND IN THE COMMUNITY, BUT HAVE BEEN IN THE WORKPLACE WHERE CERTAIN EXPOSURES TEND TO BE HIGHER AND LAST LONGER.
BREAST CANCER INCIDENCE IN U.S. WOMEN IS 1 IN 8 (13%). MOST COMMONLY DIAGNOSED CANCER AMONG U.S. WOMEN (1 IN 4).
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3 Breast Cancer cases said to be the same cell type. No family history.
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3 Breast Cancer cases said to be the same cell type. No family history.
Durations of working here: 5 to 7 years prior to diagnosis.
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3 Breast Cancer cases said to be the same cell type. No family history.
Durations of working here: 5 to 7 years prior to diagnosis.
Person with Hodgkin's diagnosed prior to starting work here.
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3 Breast Cancer cases said to be the same cell type. No family history.
Durations of working here: 5 to 7 years prior to diagnosis.
Person with Hodgkin's diagnosed prior to starting work here.
From 2002 – 2009 the work force has varied from 5 to 9.
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3 Breast Cancer cases said to be the same cell type. No family history.
Durations of working here: 5 to 7 years prior to diagnosis.
Person with Hodgkin's diagnosed prior to starting work here.
From 2002 – 2009 the work force has varied from 5 to 9.
In 2006/2007 carpeting was replaced and the suite repainted. Also, there was a roof leak with significant water intrusion.
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Noticeable dust from HVAC registers. Sample provided.
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Noticeable dust from HVAC registers. Sample provided. Tenants wanted survey to assess incidence
of Breast Cancer throughout the building.
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Noticeable dust from HVAC registers. Sample provided. Tenants wanted survey to assess incidence of Breast
Cancer throughout the building. Many house plants in the suite.
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Noticeable dust from HVAC registers. Sample provided. Tenants wanted survey to assess incidence of Breast
Cancer throughout the building. Many house plants in the suite. Incense burner noted.
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Noticeable dust from HVAC registers. Sample provided. Tenants wanted survey to assess incidence of Breast
Cancer throughout the building. Many house plants in the suite. Incense burner noted. MSDS’s for printer/copier chemicals
requested.
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Noticeable dust from HVAC registers. Sample provided. Tenants wanted survey to assess incidence of Breast
Cancer throughout the building. Many house plants in the suite. Incense burner noted. MSDS’s for printer/copier chemicals requested. No asbestos in building materials.
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Noticeable dust from HVAC registers. Sample provided. Tenants wanted survey to assess incidence of Breast
Cancer throughout the building. Many house plants in the suite. Incense burner noted. MSDS’s for printer/copier chemicals requested. No asbestos in building materials. Building tenant mix typical of a professional
office building. No indication of chemicals or physical energy from other tenants.
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Environmental Site Assessment (2007) Concluded: No evidence of recognized environmental conditions in connection with the property.
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Environmental Site Assessment (2007) Concluded: No evidence of recognized environmental conditions in connection with the property.
MSDS’s for janitorial products, pesticides and HVAC maintenance revealed only one ingredient identified as a carcinogen – Ethanol, a minor component of disinfectants used in bathrooms.
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Environmental Site Assessment (2007) Concluded: No evidence of recognized environmental conditions in connection with the property.
MSDS’s for janitorial products, pesticides and HVAC maintenance revealed only one ingredient identified as a carcinogen – Ethanol, a minor component of disinfectants used in bathrooms.
Mild metal fume (welding) odor outside the building.
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Environmental Site Assessment (2007) Concluded: No evidence of recognized environmental conditions in connection with the property.
MSDS’s for janitorial products, pesticides and HVAC maintenance revealed only one ingredient identified as a carcinogen – Ethanol, a minor component of disinfectants used in bathrooms.
Mild metal fume (welding) odor outside the building. 200 yards SW of building – a manufacturer
of steel doors and frames.
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Package units on roof.
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Package units on roof. Suite served by 3 at SW corner of roof.
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1. Ethanol
2. Metals
3. Formaldehyde
4. Mold spores
5. Dust sample characterization
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Air Samples:
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Air Samples:
5 locations in suite of concern
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Air Samples:
5 locations in suite of concern
2 locations in management suite and an empty suite
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Air Samples:
5 locations in suite of concern2 locations in management suite and an empty suite
2 locations outdoors at ground level and on roof at HVAC units
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In Suite:
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In Suite: 0.013 – 0.022 PPM
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In Suite: 0.013 – 0.022 PPM Control Suites:
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In Suite: 0.013 – 0.022 PPM Control Suites: 0.014 – 0.015 PPM
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In Suite: 0.013 – 0.022 PPM Control Suites: 0.014 – 0.015 PPM Outdoors:
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In Suite: 0.013 – 0.022 PPM Control Suites: 0.014 – 0.015 PPM Outdoors: <0.011 - <0.012 PPM
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In Suite: 0.013 – 0.022 PPM Control Suites: 0.014 – 0.015 PPM Outdoors: <0.011 - <0.012 PPM
Typical of norm. Outdoor levels generally 0.002 – 0.010 PPM. Indoor levels typically a bit higher.
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In Suite: 0.013 – 0.022 PPM Control Suites: 0.014 – 0.015 PPM Outdoors: <0.011 - <0.012 PPM
Typical of norm. Outdoor levels generally 0.002 – 0.010 PPM. Indoor levels typically a bit higher.
PEL: 0.75 PPM
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In Suite: 0.013 – 0.022 PPM Control Suites: 0.014 – 0.015 PPM Outdoors: <0.011 - <0.012 PPM
Typical of norm. Outdoor levels generally 0.002 – 0.010 PPM. Indoor levels typically a bit higher.
PEL: 0.75 PPM TLV: 0.30 PPM -C
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All results below limit of detection <0.17 - <0.019 PPM
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All results below limit of detection <0.17 - <0.019 PPM
PEL & TLV: 1,000 PPM
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All Results below limits of detection. Highest LOD was 3.2 µg/m³. Most <1.0 µg/m³.
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Total indoor concentrations were an order of magnitude lower than outdoors.
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Total indoor concentrations were an order of magnitude lower than outdoors.
Dominant genus indoors and outdoors was Cladosporium – typical of the norm.
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Cellulose 8% Synthetics32% Human Hair
10% Insect Fragments
20% Rust 20% Minerals 10%
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Cellulose 8% Synthetics 32% Human Hair 10% Insect Fragments 20% Rust 20% Minerals 10% Elemental analysis of the rust showed that the
primary components were iron, zinc and copper.
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1. Tenant concerns understandable.
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1. Tenant concerns understandable.
2. I.H. evaluation limited to I.H. State-Of-The-Art and focused on identifying environmental cancer risk potentials primarily within control of building owner. Included recognizable carcinogens in general.
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1. Tenant concerns understandable.
2. I.H. evaluation limited to I.H. State-Of-The-Art and focused on identifying environmental cancer risk potentials primarily within control of building owner. Included recognizable carcinogens in general.
3. Measurements of suspect carcinogens and non-carcinogens all not remarkable.
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1. Tenant concerns understandable.
2. I.H. evaluation limited to I.H. State-Of-The-Art and focused on identifying environmental cancer risk potentials primarily within control of building owner. Included recognizable carcinogens in general.
3. Measurements of suspect carcinogens and non-carcinogens all not remarkable.
4. Cancer clusters do occur randomly and this evaluation suggests that such is the case for this location.
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1. Tenant concerns understandable.
2. I.H. evaluation limited to I.H. State-Of-The-Art and focused on identifying environmental cancer risk potentials primarily within control of building owner. Included recognizable carcinogens in general.
3. Measurements of suspect carcinogens and non-carcinogens all not remarkable.
4. Cancer clusters do occur randomly and this evaluation suggests that such is the case for this location.
5. A full-blown evaluation that would include medical/epidemiological/greater geographic considerations requires resources such as may be available from NIOSH and/or Cal-DPH.
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FEAR AND ECOMONICS PREVAILED.
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FEAR AND ECOMONICS PREVAILED. LEASE WAS TERMINATED AND THE
TENANT MOVED OUT.
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