Health hazard evaluation report: HETA-2011-0109-3162, Legionnaires' disease at an automobile and scrap metal shredding facility, New York.
Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HETA 2011-0109-3162, 2012 Aug; :1-77
On May 11, 2011, the National Institute for Occupational Safety and Health (NIOSH) received a request from the management of an automobile and scrap metal shredding facility regarding cases of Legionnaires' disease that had been identified among their workers. The request listed concerns about dusts, mists, and vapors generated during the process of shredding automobiles and scrap metal. The health concerns were Legionnaires' disease and respiratory disease. During telephone discussions with the New York State Department of Health (NYSDH), NIOSH learned that four employees from the shredding facility had been diagnosed with Legionnaires' disease: one in 2009, two in 2010, and one in May 2011. All performed shoveling and/or picking activities; the latter involves manually removing copper and other material passing on a moving conveyor. In December 2010, NYSDH identified Legionella bacteria on a swab sample taken from a conveyor belt that exited the shredder and from water dripping from that same belt. An additional water sample obtained in May 2011 from the same conveyor belt also contained Legionella. Prior to our initial site visit, NIOSH investigators contacted management and recommended that any employee with respiratory, flu-like, or gastrointestinal symptoms (e.g., fever, chills, cough, shortness of breath, muscle aches, nausea, vomiting, diarrhea) be removed from his or her job and seek evaluation for Legionnaires' disease from a healthcare provider. We also recommended that employees who work near any aerosols or mists wear fit-tested N-95 respirators. On June 1-2, 2011, NIOSH investigators visited the facility. We spoke briefly with all available facility employees about Legionnaires' disease and any symptoms they may have or have had; none reported current symptoms consistent with Legionnaires' disease. We observed large quantities of standing water throughout the facility grounds. We also observed workers standing and shoveling in or around the water; vehicles driving through puddles of water; and front-end loaders picking up and setting down materials in and around standing water. We observed no employees wearing respirators. We collected air, water, and swab samples at multiple locations around the facility to be tested for Legionella bacteria. We also collected area air samples to be analyzed for metals, volatile organic compounds (VOCs) and dust. Legionella was identified in water dripping from the exterior of the shredder onto the exit conveyor belt that contained the shredded material and in multiple puddles of water. Metals detected in the air samples were below applicable NIOSH recommended exposure limits (RELs) and the Occupational Safety and Health Administration (OSHA) permissible exposure limits (PELs), where standards existed. Toluene, ethyl benzene and xylene isomers, and some alkyl benzenes were the major VOCs identified. The dust samples were below the OSHA particulates not otherwise regulated standard of 5 milligrams per cubic meter (mg/m3) for respirable particles. At the end of the walk-through visit, we again recommended implementing a formal respiratory protection program that would require employees working around or near aerosols or mists to wear fit-tested N-95 respirators. We also discussed the possibility of Legionella in the standing water which could be aerosolized during shoveling activities and while driving or walking through the puddled water. We reiterated that symptomatic employees should be removed from their jobs until they are evaluated for Legionnaires' disease by a healthcare provider. We recommended that the groundwater drainage system be improved to eliminate the pools of water and that shoveling activities be avoided as much as possible during shredding operations because of the potential for generating aerosols. We recommended the shredder, conveyor systems, and any mobile equipment be cleaned and sanitized. Following our initial site visit, a fifth employee was diagnosed with Legionnaires' disease in June 2011. He had recently been hired at the facility, worked in the picking shed, and had not worn a respirator. On September 23, 2011, we revisited the facility to conduct a follow-up assessment. Facility grounds had been cleared of a build-up of dirt, improving drainage and revealing a previously blocked drain. A new shredder had been installed which required only half the previous water flow. The plant manager reported that the picking room had been cleaned and sanitized but not the rest of the facility. Some puddles of water still existed, and Legionella was detected in water samples taken from multiple puddles. Legionella was not detected in swab samples taken from the conveyor system. We observed workers wearing N-95 respirators; none had been fit-tested, and some were wearing their respirators incorrectly. In each of these cases, we showed the worker how to wear the respirator. We also hung posters in the break room and mechanical room that showed how to put on and take off an N-95 respirator. We recommended that workers wearing respirators be fit-tested. We also recommended that the ground drainage be improved to remove the remaining standing water, and that the rest of the facility be cleaned and sanitized.
Region-2; Respiratory-protective-equipment; Respiratory-protection; Respiratory-system-disorders; Pulmonary-system-disorders; Pulmonary-disorders; Dusts; Aerosols; Bacteria; Bacterial-disease; Bacterial-infections;
Author Keywords: Recycled material merchant wholesalers; Legionnaires' disease; Legionella; respiratory disease; personal protective equipment; PPE; water; shredding