Workplace Medical Mystery: What is causing a recycling worker’s respiratory distress?
Posted on June 19, 2018 by R. Reid Harvey, DVM, MPH; Michelle R. Martin, MS; and Julie Tisdale-Pardi, MA
Joe worked at a metal recycling facility in Nevada. His typical job duties included operating a material handler to load scrap metal into a shear for crushing. During his shift at the recycling facility, Joe looked up to see a plume of thick yellow smoke swirl around a pile of scrap metal and was suddenly overcome with shortness of breath, coughing, chest pressure, and eye irritation. He thought about grabbing a fire extinguisher but then ran away from the smoke until the air cleared. Joe’s supervisor saw that he was in distress and called 9-1-1. When medical help arrived, Joe’s blood oxygen saturation was 87% and increased to 94% with supplemental oxygen (normal saturations are within the range of 95% to 100% while breathing room air). Emergency response personnel transported him to a local hospital. Although alert, he had an elevated heart rate and difficulty breathing and quickly developed respiratory failure with inadequate blood oxygen levels. He was intubated and placed on mechanical ventilation roughly 20 min after arriving at the hospital. He was also administered inhaled nitric oxide to improve oxygenation. X-rays of his chest showed fluid in the lungs (pulmonary edema), and bloodwork revealed an acid-base disorder (respiratory and metabolic acidosis). Additional tests led to the diagnosis of acute respiratory distress syndrome or ARDS. Joe’s supervisor remembered that the system for scanning incoming metal for radioactive material had been malfunctioning. He relayed this information to the paramedics.
Prior to this sudden onset of respiratory failure, Joe’s only chronic medical problems were high blood pressure and a heart rhythm disorder called atrial fibrillation. He was a nonsmoker and had no past history of lung disease. His hobby was woodworking. His wife reported that he had stripped and restored an antique dining table the previous weekend.
What was causing Joe’s illness?
Check back on Friday for the next installment of Workplace Medical Mysteries to see what is making Joe sick. Think you know? Tell us what you think it is in the comment section below.
This is heavy metal exposure from torch cutting or fires.
The smoke comes from cutting metal with torches or from fire when vehicle gas tanks aren't drained properly. Explosions can occur when propane tanks are fed into the maw of the crushers.
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Danger in air near metal recyclers
Metal recyclers emit carcinogenic pollutant
By Ingrid Lobet December 29, 2012 Updated: January 9, 2013 2:54pm
Photo: Nick De La Torre, Staff
Derichebourg Recycling USA in Houston has invested millions of dollars to address problems with smoke, fire and explosions.
The calls to the city of Houston's 311 help line came in the early morning and the middle of the night - complaints of red smoke, yellow smoke, explosions, fire, a child having trouble breathing.
Reports like these - 189 of them over the last five years - led Houston air authorities to discover a previously unrecognized and dangerous source of air pollution: metal recyclers and car crushers, according to interviews and documents obtained by the Houston Chronicle.
The smoke comes from cutting metal with torches and from fire when vehicle gas tanks aren't drained properly. Explosions can occur when propane tanks are fed into the maw of the crushers.
Descriptions of shattering noise, cracked walls and smoke were significant enough that the city had to "dedicate a good amount of effort responding to these complaints," said Arturo Blanco, chief of the city's Bureau of Pollution Control and Prevention.
Subsequent testing outside five Houston metal recycling operations found dangerous levels of hexavalent chromium. Chrome VI, as it's also called, is a high priority for air experts.
"People were complaining about smoke, and it turns out there were carcinogenic metals," said Loren Raun, an environmental statistician at Rice University. "And we found them only around these facilities, not in other areas we tested, not even in other industrial areas of the city."
New pollution source
When inhaled, hexavalent chromium is deposited in the lungs, can penetrate cells and cause free radicals, which damage DNA, ultimately causing lung cancer. When California gained the authority to regulate air pollution hazards in the 1980s, hexavalent chromium shared top priority, along with benzene. The state considers Chrome VI one of the most potent carcinogens known.
Forty years after the passage of the Clean Air Act, it's rare to find a new source of air pollution. But new sources can appear as the economy changes. The materials economy is evolving. What once was a sideline industry - recycling - is becoming central to manufacturing.
Many of the minerals that make the screens, toys and cars used every day are finite in the Earth's crust. Others are simply expensive. For every material - aluminum, lead, steel, sulfur, mercury - there is a point where it's cheaper or safer to recover it from our garbage than to mine or forge it fresh.
As international prices for materials rise, more batteries are being recycled. More TVs are being recycled. More cars are being recycled.
Sometimes, that comes with a price.
"When you weld or cut, you are vaporizing metal," said Don Richner, an industrial hygienist and analytical chemist also with the Bureau of Pollution Control and Prevention. "All the missing metal is vapor in the air."
Houston appears to be the first to examine metal emissions from the industry, and in so doing may have flagged a national problem. The Environmental Protection Agency does not regulate the facilities, though there are now 6,000 of them in the United States, according to Joe Pickard, chief economist with the Institute of Scrap Recycling Industries Inc.
Assessing the risk
For Houston, the complaints began in older neighborhoods like Magnolia Park and Manchester, though researchers would later find surprising results even in the Washington Avenue area, where few people complained.
The city team initially measured particles. Some scrap yards had no appreciable emissions. But enough did that researchers felt they had to do more. With little in guidance available from other jurisdictions, they decided to create a scoring tool to help compare risk among processors.
Richner and colleagues scored each metal recycler based on several questions: how close it was to dense neighborhoods, how many complaints it had received, how many violations, and whether the operator used torches to cut metal.
The company with the highest priority score on the matrix was Holmes Road Recycling near Houston's Sunnyside neighborhood. Since then, company vice president Sheldon Tuffyas said, it has reduced torch-cutting at the plant by 85 percent and taken a number of steps to reduce airborne particles. The city says the company's efforts are significant.
After this initial scoring, the city took a deeper look at the smoke and particles emanating from some of the recycling yards. Raun, who also is a senior environmental analyst with the city, chose five midsize metal recyclers in different neighborhoods. They also tested air at 10 locations with no metal processors, so as not to blame the industry for contaminants that might be widespread in Houston's air.
The researchers visited each shredder multiple times (between six and 13), and examined its emissions for chrome, cobalt, nickel, cadmium and other metals. They took into account Houston's changeable breezes, subtracting for the time the wind would be blowing pollution away. They determined that people living near these facilities would still have an increased risk of developing cancer.
Depending on the yard, they estimated there would be between 7 and 600 extra cancers per million people, the latter a risk 600 times higher than what is acceptable to federal health scientists. Among these five plants, a small sample of all those in the city, the highest cancer risk was estimated outside the Cronimet metal processor in Harrisburg/Magnolia Park and Allied Alloys in South Park.
David Porco, vice president of quality and administration at Cronimet Corp., based in Aliquippa, Pa., said Houston air officials shared their findings with him, and the company already has instructed managers at its Houston yard to reduce burning while it looks into options for capturing the metals, such as a bag house.
"We're taking a proactive approach. We want to make sure we limit emissions that come from the facility," Porco said.
Allied Alloys said in a statement that it "is proud of our history of commitment to the environment and the safety of our workers and the communities in which we operate. We believe that our positive net impact is defined by the re-purposing of thousands of tons of metal that does not further deplete our natural resources."
Chrome was in the air outside all five of the plants where the Bureau of Pollution Control and Prevention sampled: Cronimet, Allied Alloys, Holmes Road, Spectrum Metal Recycling, and Rose Metal Processing off Washington Avenue.
TCEQ aware
Agency records show the Texas Commission on Environmental Quality also has become aware of potential problems associated with shredding and torch-cutting metals. Neighbors of metals plants across Texas have called in complaints 300 times in the last five years, a Chronicle analysis shows.
A single Houston recycler, Texas Port Recycling in the Manchester neighborhood, had 41 fires and explosions over the four-month period from Oct. 12, 2007, to Feb. 6, 2008, according to state records.
Since the time of those fires, Texas Port Recycling also has taken steps to reduce emissions and explosions, and Richner said the city has not detected levels of concern outside the plant. Residents, however, say they believe frequent smoke in the neighborhood and explosions are coming from Texas Port Recycling. The company did not respond to requests for comment.
Rose Metal Processing also did not respond. Spectrum Metal Recycling declined to comment.
"We want the recyclers here. We don't want them to move out. But maybe they've been flying under the radar," said Blanco, director of the Bureau of Pollution Control and Prevention.
Richner, the industrial hygienist, said he's concerned not only for residents near the recycling operations but also for the people who work cutting metal inside.
"Metals typically have coatings. Sometimes those coatings are lead paint. Who is telling these people: 'This could be lead paint, this could be cadmium, this could be chromium'?" he asked.
Inside the plants, he said, "some people are not wearing personal protective equipment and they are cutting metal. My concern is: Are they getting the health and safety training they deserve? I don't know."
In the neighborhoods alongside the plants, there are indications the calls to the city's 311 line may be only the tip of the iceberg.
In Manchester, several neighbors who said they've never complained to the city noted that smoke and loud noises are still an almost daily occurrence.
Neighbors fearful
And in one of the oldest historically Hispanic neighborhoods in the city, Magnolia Park, on the edge of another metal yard, pieces of carburetor thunder into a listing barge on Brays Bayou. A few feet away, Amanda Martinez and her husband clean metallic dust off their patio. "I have pulmonary hypertension. I worry what I'm breathing," she said.
Ginny Norton said there is frequent smoke around the quiet home her parents bought long ago. And there are explosions. "I'm afraid this little house is going to shatter and fall on my head," she said.
Just across Navigation Boulevard, the metals processor Derichebourg Recycling USA flattens and shreds scrap metal and cars. It set up its large operation a few years ago on Wharf Road, residents said, when a wave of ruined vehicles was coming in from Louisiana after Hurricane Katrina.
In 2009, the Derichebourg plant signed a compliance agreement with the city, which found it had a problem with smoke, fire and explosions.
Manager Philippe Leonard points out that the company has purchased a slow shredder that can prevent gas tank fires when vendors fail to remove the tanks. It put in watering systems and paving to eliminate dust and spent $4 million on a 40-foot wall with sound insulation. "We have done everything we can for our neighbors," he said.
The changes made at Derichebourg may come to be regarded as industry standards.
In the meantime, said Blanco, whose pollution agency is part of the department of Health and Human Services, there are unaddressed health issues. "We are promoting wellness. We're promoting excellent health, but we're not making the connection."