1 Evaluating Asbestos Exposure 1 Running head: EVALUATING ASBESTOS EXPOSURE Evaluating Asbestos Exposure, Testing, and Decontamination Within The Orange County Fire Authority Kirk B. Wells Orange County Fire Authority Irvine, California
2 Evaluating Asbestos Exposure 2 CERTIFICATION STATEMENT I hereby certify that this paper constitutes my own product, that where the language of others is set forth, quotation marks so indicate, and that appropriate credit is given where I have used the language, ideas, expressions, or writings of another. Assistance in obtaining internal agency documentation and outside vendor information was received by the following individuals: Mr. Jonathan Wilby, Industrial Hygienist; Mr. Joe Ortega, Materials Technician; Mrs. Monica Dorfmeyer, Purchasing Agent; and Mr. Russ Snider, Service Center Manager. All of these individuals are employed by the Orange County Fire Authority. Signed:
3 Evaluating Asbestos Exposure 3 Abstract The problem was that the Orange County Fire Authority has experienced difficulties in obtaining local testing, identification, and remediation of asbestos exposures following emergency incidents. The purpose of the research was to evaluate local methods of asbestos testing and decontamination for OCFA personnel and equipment. By using action research methods, the research reviewed factors of asbestos exposure, current methods of asbestos identification, current methods of testing, and current methods of decontamination and remediation. Utilizing a literature review, internet search, internal document review, collection and analysis of data, implementation of a national survey, and personal interviews, a new standard operating procedure and future recommendations were developed.. The researcher evaluated the following four questions: (a) What methods are other fire departments utilizing; (b) What are the industry standards for testing and decontamination; (c) What methods of local testing and decontamination are available; and (d) What is the feasibility of the OCFA to perform its own testing? The results indicated that firefighters are routinely exposed to asbestos products and other hazardous materials. Yet, even though the hazards are widely known and studied, firefighters continue to operate at emergency scenes without adequate respiratory protection. Additionally, although most fire departments within the United States consider asbestos exposure to be an important issue, few have procedures for adequate testing and remediation. This research has enabled the Orange County Fire Authority to develop new procedures for internal sampling, with local and out-of-state decontamination options identified. Results from this research may be found useful to other fire departments and industries facing similar concerns. Recommended were offered for the implementation of the new procedures and for future work to continue to improve firefighter safety and survival.
4 Evaluating Asbestos Exposure 4 Table of Contents Abstract...3 Table of Contents...4 Introduction...5 Background and Significance...6 Literature Review...9 Procedures...22 Results...26 Discussion...38 Recommendations...41 References...42 Appendices Appendix A: Examples for Fire Contaminants...46 Appendix B: Survey and Results...47 Appendix C: New Standard Operating Procedure...53 Tables Table 1: Summary of National Survey Findings...57 Table 2: Summary of Testing and Cleaning Expenses...59 Table 3: Local Vendor Cost Estimates...60 Table 4: Out of State Vendor Cost Estimates...61 Table 5: Summary of OCFA Costs for Testing and Cleaning...62
5 Evaluating Asbestos Exposure 5 Introduction The Orange County Fire Authority (OCFA) provides service to nearly 1.7 million residents in 23 cities, encompassing an area of approximately 575 square miles, including 175,000 acres of wild lands and wild land urban interface (WUI) regions (Orange County Fire Authority [OCFA], 2012b). Due to the prevalence of asbestos in buildings constructed prior to 1990 (Orange County Clerk Recorder [OCCR], 2003), OCFA s firefighters risk exposure to asbestos products during firefighting and overhaul operations. Exposure to asbestos and other toxic and carcinogenic substances pose a significant threat to the health of OCFA s firefighters (J. Wilby, personal communication, March 20, 2012) The problem is that the OCFA has experienced difficulties in obtaining local testing, identification, and remediation of asbestos exposures following emergency incidents. The purpose of this research is to evaluate local methods of asbestos testing and decontamination for OCFA personnel and equipment. Action research was utilized to study the historical and causal factors of asbestos exposure to firefighters; evaluate the current methods of identifying the presence of asbestos in buildings; evaluate the current methods of testing and exposure; evaluate current efforts of decontamination and remediation; utilize a survey to study the national trends; interview key personnel; develop a new standard operating procedure; and provide recommendations for future work. This research will address the following questions: (a) what methods are other fire departments utilizing; (b) what are the industry standards for testing and decontamination; (c) what local methods of testing and decontamination are available; and (d) what is the feasibility of the OCFA to perform its own testing and decontamination?
6 Evaluating Asbestos Exposure 6 Background and Significance Orange County, California, lies within the southern California coastal region and is bordered by the Pacific Ocean and three adjacent counties: Los Angeles County, San Diego County, and Riverside County. The County of Orange is composed of 34 incorporated cities and spans nearly 800 square miles. The populace of Orange County is considered moderately affluent, both for business and residence. The county contains a population of over 3 million residents. Geography of the county is a blend of urban, suburban, coastal, and natural wilderness areas. The county also has numerous residential developments which are directly adjacent to, and within, the wilderness lands (Orange County Fire Authority, 2012a). The OCFA is an all-risk agency which operates a regional delivery system. Emergency services are delivered from 71 fire stations by 1040 full-time firefighters, 49 chief officers, and 230 volunteer firefighters. The department also possesses a 20 acre headquarters complex, housing nearly 240 professional staff members. In addition to its contract cities, the OCFA provides protection to all county unincorporated areas, state responsibility areas, and federal responsibility areas. The department is governed by a 25 member board of directors, with one representative from each of the twenty three contract cities and two representatives from the County of Orange (OCFA, 2012b). In 2011, the OCFA responded to 87,958 emergency calls with 163,905 unit responses (OCFA, 2012b). The current annual operating budget for is $331 million dollars (Orange County Fire Authority, 2012c). Prior to the 1950s, Orange County was primarily an agricultural region, with crop production and cattle ranches being the most important part of the economy. Much of the county s growth in the first half of the 20 th century was fueled by new transportation: electric railways, highways, major boulevards, and major freeways. During World War II, several
7 Evaluating Asbestos Exposure 7 military installations were established, fueling the need for new housing and commercial construction. By the mid-1950 s, the county s farms and ranches were being replaced by new housing at a rate faster than any other community in the United States. Building continued through the 1960 s, with numerous master-planned communities being built on former farmland in the central and southern portion of the county (OCCR, n.d.). As late as the 1980s, asbestos has been utilized within the United States in building construction in various common materials: plaster, drywall, insulation, roofing, floor tiles, and adhesives. Some of the protective gear that firefighters utilized during this time also contained asbestos: gloves, blankets, and aluminized asbestos suits (Asbestos.net, 2012). Based on building permit data, the majorities of existing residential and commercial structures in Orange County were built prior to 1990, indicating that many forms of asbestos are contained in their building materials (Orange County Clerk Recorder, 2003). For the past several years, the OCFA has attempted to reduce the risk to its firefighters through exposure to asbestos. These efforts have ranged from the firefighters performing their own cleaning of personal protective equipment (PPE) at the emergency scene and the fire station; the agency performing cleaning of PPE, utilizing department laundering facilities; hiring outside laboratories to perform independent testing; and shipping the contaminated PPE out of state for cleaning, decontamination, and testing. The various procedures used by the OCFA have hampered the ability to provide timely information about the presence of asbestos products, both at the emergency scene and by exposure of these products to the firefighters (J. Wilby and R. Snider, personal communication, March 20, 2012). The significance in accurately identifying and mitigating asbestos exposure is the reduction of long-term health risks to the OCFA s firefighters. Minimal and chronic exposures
8 Evaluating Asbestos Exposure 8 have been shown to cause deleterious health effects such as asbestosis, mesothelioma, and various cancers. Due to the long-term nature of these illnesses, most often the effects and symptoms of these exposures are not known for ten to twenty years (American Lung Association [ALA], 2012). This research will evaluate the incidence of asbestos presence in constructed buildings; identify the short-term and long-term health effects of asbestos exposure; review historical and current procedures for identification, mitigation, and decontamination of firefighters and their PPE; and draft new procedures to be utilized within the OCFA. Results from this study could be used to better identify the need for timely and effective asbestos testing and decontamination to reduce the risks to firefighters and minimize long term effects of exposures. The results of this study may also be found useful to other municipalities, fire departments, construction industries, military personnel, mining operations, and individuals and industries facing similar issues. The research presented within this report is directly related to the goals and objectives of the United States Fire Administration (USFA) course, Executive Analysis of Fire Service Operations in Emergency Management. This course is delivered during the third year of the Executive Fire Officer Program at the National Fire Academy, in Emmitsburg, Maryland. The course curriculum is designed to prepare senior fire officers for the administrative skills necessary to manage fire and rescue operations. Specifically related to this research is the course focus on risk assessment, documentation, damage assessments, standards, legal mandates, and emergency operations. (United States Fire Administration [USFA], 2008). The USFA has identified five operational objectives to provide targets of achievement for America s fire service. This research may to help improve the capabilities of fire departments through two of the five objectives: Objective c: Reduce the loss of life from fire of firefighters,
9 Evaluating Asbestos Exposure 9 and Objective e: To respond appropriately in a timely manner to emerging issues (USFA, 2008, p. II-2). Literature Review The literature review for this research was focused on obtaining information pertaining to asbestos materials, building construction, health effects of asbestos exposure, and processes of identifying and mitigating asbestos exposure for firefighters and other workers. Reviewed literature included public and private research studies, journals, periodicals, web sites, and other documentation located via internet search engines. The author noted a significant amount of other literature and data regarding other industries, such as mining and shipbuilding. Selected bodies of work in these other industries were reviewed, however, it was noted that many contained similar or duplicate data as the works pertaining to the fire service with regards to asbestos exposure, identification, and health effects. Most of these other works were not included so as not to present redundant review. The literature from these other industries which contained data and information unique from the fire service, were reviewed and included for their relevancy to this research. According to the American Cancer Society ([ACS], 2010), asbestos is a naturally occurring mineral, found in soil and rocks, which are configured as bundles of fibers. Within the classification of asbestos, there are two types of fibers which are most common: serpentine and amphibole. Serpentine fibers are curly, are most commonly used in industrial applications, and are known as chrysotile, or white asbestos. Amphibole fibers are straight and needle-like, and are commonly known as amosite, crocidolite, tremolite, and anthophyllite. It is the amphibole fibers which are considered more likely to cause cancer. Asbestos fibers are strong, resistant to heat and chemicals, and do not conduct electricity.
10 Evaluating Asbestos Exposure 10 Until approximately 1990, asbestos continued to be utilized in building materials in the United States. These asbestos containing materials (ACM) included plaster, drywall, insulation, flooring tiles, roofing, and adhesives (Asbestos.net, 2012). During the second half of the 20 th century, better recognition of asbestos related cancers resulted in new measures to reduce the risks of exposure, including the establishment of exposure standards. Since the 1960 s, a dramatic decrease in the importation and use of asbestos fibers and the use of alternative materials has caused a dramatic drop in the incidence of asbestos exposure. However, a considerable risk of exposure continues to be problematic, due to its presence in older constructed buildings (ACS, 2010). Modern exposure typically occurs during renovations and deconstruction of these building materials, releasing asbestos fibers. However, minimal to no exposure occurs unless the ACM are disturbed and the fibers released into the air. Ingestion can also cause by the consumption of foods and liquids which are contaminated with fibers and dust. Exposure by Ingestion also been caused by the inhalation of asbestos fibers, coughing the asbestos into the mouth and throat, and swallowing the fiber-laden saliva into the digestive tract. (ACS, 2010). Exposure to asbestos causes two primary health effects, asbestosis and mesothelioma. According to the American Lung Association, (2012), asbestosis is caused by a scarring of the lung tissue. This is affected by the inhalation of asbestos fibers, which are lodged deep into the lungs, where scar tissue is built up by the lungs to protect the body against the foreign object. This causes the lung tissue and chest wall lining to thicken and harden, which results in difficulty breathing and a corresponding decrease in oxygen absorption at the alveolar and cellular level. Symptoms are typically not detected for over 20 years following exposure. Between 1994 and 2004, there were 3211 documented deaths in the United States due to asbestosis (ALA, 2012).
11 Evaluating Asbestos Exposure 11 Mesothelioma is a disease that affects the cells lining the lungs, and other thoracic and abdominal organs. Mesothelioma is identified as a form of cancer and is manifested by malignant tumors growing in the chest cavity. (ALA, 2012). Cancer Monthly (2012) offers that asbestos exposure is the major risk factor in the diagnosis of mesothelioma. Many theories exist as to how the asbestos fiber causes the disease. Some of these are the thought that the asbestos fiber can cause mutations to DNA at the cellular level and that the fibers may cause inflammatory issues which precludes the development of cancer. In the United States, mesothelioma is relatively uncommon, affecting 2000 to 3000 individuals annually. Common symptoms include shortness of breath, persistent cough, pain in the rib cage, weigh loss, abdominal pain, fever, anemia, and blood clotting problems. Symptoms of the disease are slow to appear, usually between 35 to 50 years following exposure. The disease primarily affects males over 65 years and is most common in the white race. Often, the disease is in its advanced stage by the times symptoms appear, with average survival following diagnosis of less than one year (ALA, 2012). The American Cancer Society (2010) states, Unfortunately, the risk of mesothelioma does not drop with time after exposure to asbestos; [rather], the risk appears to be lifelong. Asbestos exposure has also been shown to cause mesothelioma in individuals contaminated through secondary exposures. These exposures are noted to have been caused by having contact with other individuals who are contaminated with asbestos fibers on their clothing or in their hair. Cases have been identified of women who have been diagnosed with mesothelioma due to handling their husband s work clothing; and children who have hugged their fathers while they were wearing contaminated work clothing, causing the release and inhalation of fibers (Cancer Monthly, 2012).
12 Evaluating Asbestos Exposure 12 Various studies have also linked other types of cancers to workplace exposure to asbestos. Correlations have been drawn to cancers of the larynx, ovaries, esophagus, stomach, colon, and kidney. It is thought that swallowing asbestos fibers may be a contributing factor (ACS, 2010). As a naturally occurring mineral, asbestos can be found in outdoor air and drinking water. Naturally occurring asbestos exists in natural geologic deposits. In 50 of 58 counties within California, and in 19 other states, natural shallow deposits exist in close proximity to populated areas (Raloff, 2006). Due to the prevalence of asbestos contained within existing constructed buildings, firefighters are exposed to the product as well as other harmful substances at the fire scene (LeMasters et al., 2006). It has been long recognized that firefighters risk respiratory health issues as a result of their exposures during firefighting operations (Fabian et al., 2010). Fabian notes that firefighters face exposure to many products during firefighting: asphyxiants, irritants, allergens, and other carcinogenic materials. A table of fire contaminant examples and their toxicological effects developed by Barker (2005) can be reviewed in Appendix A. In 2000, the study, Characterization of firefighter exposures during fire overhaul, was conducted in Phoenix, Arizona at the Phoenix Fire Department. This study was commissioned to analyze personal and area samples of surface and air contamination (Bolstad-Johnson, et al., 2000) and was conducted by members of the Phoenix Fire Department (PFD), the University of Arizona, Arizona State University, and the City of Phoenix Personnel Department. This research was undertaken due to minimal available information pertaining to firefighter exposures during the overhaul phase of fire operations, when firefighters search for hidden fire inside walls, ceilings, and attics. Oftentimes, firefighters are performing these
13 Evaluating Asbestos Exposure 13 activities without respiratory protection. The authors note that although there are many studies which have discussed the need and value for the use of Self Contained Breathing Apparatus (SCBA) during firefighting activities, few [studies] suggest the need for respiratory protection during overhaul. The authors offer the following definition of overhaul: Fire overhaul is defined as the stage in firefighting where fire suppression is complete and firefighters are searching the structure for hidden fire or hot embers which may be found above ceilings, in between walls, or in other obscure areas. The overhaul phase of a fire lasts an average of 30 minutes. It is during this phase of a fire, when there is little or no smoke in the environment, that a firefighter is most likely to remove his/her respirator face piece and work in this environment without respiratory protection. (p. 5) Additionally, prior to the study, PFD utilized the presence of carbon monoxide (CO), as the primary measurement tool to determine whether respiratory protection was needed during overhaul operations. The measurement of CO by itself does not provide information on other hazardous substances, gases, and airborne particulates. During PFD study, samples were collected and tested for presence of asbestos, metals (Cd, Cr, Pb), and total dust. PFD hazardous materials firefighters were trained as industrial hygiene assistants and provided sampling supplies to use when responding to the structure fires. The firefighters were trained in sampling techniques and chain-of-custody techniques to ensure that purity of sampling was achieved. The sampling was conducted during the overhaul phase of 25 structure fires. Personal samples were collected for organic compounds, acids, dust, and cyanides. Gas analyzers were used to continuously monitor CO, hydrogen cyanide, nitrogen dioxide, and sulfur dioxide. Two sampling pumps were utilized in two areas at each fire scene: area of origin and an
14 Evaluating Asbestos Exposure 14 area adjacent to the origin where overhaul activities were occurring. Within each area, one pump was dedicated to the collection of airborne asbestos fibers and the other pump dedicated to collection of total dust and metals. All samples were submitted to an American Industrial Hygiene Association (AIHA) accredited laboratory for analysis. Following analysis, concentrations of most substances found exceeded the published ceiling values by accepted standards (NIOSH, ACGIH). Measurements of CO did not indicate other products of combustion during initial 10 minute averages. The results of the PFD study indicate that firefighters should use respiratory protection during overhaul and that measurements of CO should not be utilized as an indicator for other contaminants present. In 2006, a report was published in the Journal of Emergency Medicine: Cancer risk among firefighters: A review and meta-analysis of 32 studies. This meta-analysis was conducted by the University of Cincinnati College of Medicine. The objective of the researchers (LeMasters, et al., 2006) was to review 32 studies on firefighters using a meta-analysis to determine cancer risk. The authors offer in their preface that firefighters face many different exposures to gases, particulates, fumes, and other pyrolized materials. They note, These exposures can be volatile organic compounds, metals, minerals such as asbestos, and gases with toxic and acute effects (p. 1189). Unnecessary exposures can occur when respiratory protection is needed, yet not used. The attacks on the World Trade Center (WTC) in 1991 have heightened concerns regarding the falling debris and its effects from particulate exposure. Known products at the WTC include asbestos, pulverized glass, cement, soot, and other products.
15 Evaluating Asbestos Exposure 15 The results of the study indicate that there is a probable cancer risk for firefighters to contract multiple myeloma, non-hodgkin lymphoma, prostate, and testicular cancers. Eight other cancers are noted as probable for being associated with activities of firefighters. The authors conclude that their findings are consistent with previous studies that there is an elevated risk for multiple myeloma among firefighters, with a probable association with non-hodgkin lymphoma, prostate, and testicular cancers. Underwriters Laboratories (UL) developed a research study in 2010 by authors Fabian, et al. The focus of this research was to look at gaps identified in previous studies pertaining to exposures during firefighting operations from products of combustion. Part of the study was conducted within the Chicago Fire Department (CFD), by members performing personal gas monitoring during firefighting and overhaul operations. Following the fires, items which were easily replaceable (flash hoods and gloves) were obtained from the firefighters and analyzed to determine the chemical composition of the smoke residue. Additionally, the UL conducted nine full-scale tests at its laboratory, where full size props were constructed, incinerated, measured, and analyzed. A summary of the key findings from the research by Fabian, et al., (2010), indicates that when measuring products of combustion, that the results varied between different fires, depending on the size, chemical properties, and ventilation conditions of the materials being burned. A summary of specific findings which are related to this research are as noted: Synthetic materials produced more smoke than natural materials. Average particle sizes ranged from 0.04 to 0.15 microns with wood and insulation generating the smallest particles.
16 Evaluating Asbestos Exposure 16 For a given particle size, synthetic materials will generate approximately 12.5X more particles per mass of consumed material than wood based materials. Combustion of the materials generated asphyxiants, irritants, and airborne carcinogenic species that could be potentially debilitating. Ventilation was found to have an inverse relationship with smoke and gas production such that considerably higher levels of smoke particulates and gases were observed in contained fires than uncontained fires, and the smoke and gas levels were greater inside of contained structures than outside. Recommended exposure levels (IDLH, STEL, TWA) were exceeded during fire growth and overhaul stages for various agents (carbon monoxide, benzene, formaldehyde, hydrogen cyanide) and arsenic. 99+ % of smoke particles collected during overhaul were less than 1 micron in diameter. Of these 97+ % were too small to be visible by the naked eye suggesting that clean air was not really that clean. Carbon monoxide concentrations most often exceeded recommended exposure limits; however instances were observed where other gases other than carbon monoxide exceeded recommended exposure limits yet carbon monoxide did not. Collected smoke particulates contained multiple heavy metals including arsenic, cobalt, chromium, lead, and phosphorous. Carbon monoxide monitoring may provide a first line of gas exposure defense strategy but does not provide warning for fires in which carbon monoxide does not exceed recommended limits but other gases and chemicals do.
17 Evaluating Asbestos Exposure 17 The implications to health noted during this study are that during fire suppression and overhaul, multiple asphyxiants, allergens, and carcinogenic chemicals were found in the smoke. Additionally, some of the chemical compounds were noted to have the possibility for a dermal affect, where exposure through skin absorption would provide a path into the body. Many of the samples gathered during the fire incidents and at the UL laboratories contained the presence of chemicals and substances which exceeded exposure limits established by OSHA, NIOSH, and ACGIH. High levels of ultrafine particles, invisible to the naked eye and undetected through gas sampling, were noted during fire suppression and overhaul. The accumulated affects of chronic exposure to these particles have been shown to contribute to respiratory disease, and more recently, have been linked to cardiovascular diseases. The authors note the following pertaining to the inhalation of ultrafine particulates: The high efficiency of ultrafine particle deposition deep into the lung tissue can result in release of inflammatory mediators into the circulation, causing toxic effects on internal tissues such as the heart. Airborne toxics, such as metals and polycyclic aromatic hydrocarbons, can also be carried by the particles to the pulmonary interstitium, vasculature, and potentially subsequently to other body tissues, including the cardiovascular and nervous systems and liver. (p. v). It is further noted that it is possible that interactions between the individual elements during exposure could produce a synergistic effect between the agents, with future unknown deleterious effects possible. These effects could be increased respiratory complications, cardiovascular disorders, and cancers.
18 Evaluating Asbestos Exposure 18 As previously noted, the terrorist events occurring at the World Trade Center on September 11, 2001, caused a significant level of environmental and occupational exposure to the firefighters, emergency workers, and civilians who were present for the event, and who were present during the clean-up efforts. It is estimated that 12,500 firefighters employed by the Fire Department of New York (FDNY) were exposed to the dust and contaminants from the collapsed towers. Ten years after the event, a research study was released (Zeig-Owens et al., 2011), which examined the incidence of cancer to firefighters of the FDNY. This study focused on obtaining medical records and background information on FDNY members who were employed as of January 1, 1996 and in 2008, seven years after the 9/11 event. The researchers assessed 9853 men who had been employed as FDNY firefighters in 1996 and classified 8927 of them as WTC-exposed, and 926 non-wtc exposed. Cancer records through state tumor registries were obtained, with cancer cases confirmed by match. The researchers estimated the WTC-exposed rates and non-wtc exposed rates, adjusted for race, age, gender, and secular trends. The findings of the research indicated that the WTC-exposed firefighters had an approximately 10% higher incidence of cancer than of a similar demographic ratio of the general male population. When compared to non-wtc exposed firefighters, the incidence of cancer was approximately 32% higher. Additionally, a higher incidence of other disorders has been noted following 9/11: asthma, bronchitis, sinusitis, and acid reflux. The authors note that while firefighting has been associated with higher rates of cancer incidence, that previous studies have not identified clear cancer risks. This study identifies a modest excess of cancer cases to exposed firefighters, when compared to the non-wtc exposed firefighter group. Limitations to the research are noted, pertaining to ability of obtaining samples
19 Evaluating Asbestos Exposure 19 and records, differing rates of exposure at the WTC site due to length of work assignments, differing rates of exposure due to presence of light smoke versus heavy smoke, and other unintended biases. The authors discuss that they are cautious in their interpretations of their findings and conclusions, due to the short time interval following 9/11 and the expected long term nature of chronic exposures to these materials. At the time of the report, the correlation between chronic inflammation as a mediator and cancer remains speculative. Pilkington s (2009) research supports the interpretation of Zeig-Owens et al. (2011) that the recent increased numbers of firefighters and emergency workers who worked at the WTC site has begun to heighten fears that it may indicate the start of a delayed epidemic of cancer-related illness. (. 1) He notes that at the time of his article, that five firefighters and police officers had died of cancer within te past three months, the oldest at 44 years. Further, he notes that workers at the site were subjected to 90,000 liters of jet fuel, 1.8 million tons of debris, approximately 1000 tons of asbestos, as well as other pulverized building materials, office products, and chemicals. Other studies were reviewed for this research which focused on asbestos exposure, testing, and decontamination to PPE and other clothing. Of interest to this research is the review of materials used for protection utilized by workers other than firefighters. A research study conducted in Sheffield, England (Revell, 2002), investigated the towels and coveralls used by workers performing asbestos removal and remediation work. This study focused on the following three objectives: 1. Investigate the contamination of towels and coveralls used in asbestos removal hygiene units.
20 Evaluating Asbestos Exposure Investigate the effectiveness of the laundering process when decontaminating these towels and coveralls. 3. Investigate the laundries used to launder asbestos contaminated towels, particularly with regards to the safe handling of asbestos contaminated materials. (Summary section, n.p.) The research performed was based in England and focused on decontamination work for towels and asbestos worker coveralls. Safety standards at these laundries ranged from no precautions taken, to full laundry facilities installed with air locks, negative pressurization, filtering, and the use of extractors. The researchers sampled towels and coveralls from several facilities where these products were used by asbestos workers. Amosite fibers were found on the towels prior to laundering in densities of 154 f/mm 2 (fibers per square millimeter). To determine the release of fibers when agitated, the towels were placed in a rotating drum dustiness tester, producing released fiber samples of only 0.01 f/ml (fibers per milliliter). This finding was not noted as significant to the researchers, in which they note that the findings suggest that the fibers remained imbedded in the towel fabric, even after agitating in a rotating drum. The authors note that when taking into account normal workplace conditions, that the likelihood of the fibers being released from the fabric during normal use is low, reducing the exposure to workers from airborne asbestos release. Worker coveralls which were contaminated with asbestos fibers were laundered and tested in a similar manner. Laundering of the coveralls was found to be effective in removing the asbestos fibers from the fabric, with minimal fibers noted. This was an important finding and indicated to the authors that most likely the fibers were able to be removed from the coveralls