USA: Waterproofing Sprays Booted Off Market Over Illness

[pfpcnews]

Waterproofing Sprays Booted Off Market Over Illness

MedPage - May 8, 2006

DETROIT, May 8 - Two waterproofing sprays for boots have made more than 170 people ill with respiratory problems, researchers have reported.

DETROIT, May 8 — Two waterproofing sprays for boots have made more than 170 people ill with respiratory problems, researchers have reported.

"You basically Teflon your lungs," according to Susan Smolinske, Pharm.D., of the poison control center at the Children's Hospital of Michigan here.

Both sprays -- Jobsite Heavy Duty Bootmate and Rocky Boot Weather and Stain Protector - have been pulled from store shelves, Dr. Smolinske said, although the recall has not completely eliminated the problem. "You can't buy (them) but we continue to get a trickle of exposures" from people using products bought before the recall, said Dr. Smolinske.

Dr. Smolinske and colleagues in five states have identified 172 cases of respiratory illness related to the two waterproofing sprays plus 19 animal cases, they reported in the May 5 issue of the CDC's Morbidity and Mortality Weekly Report.

No deaths were reported among the human patients, but three pet cats died from exposure to the sprays.

Physicians should be aware of the risks of such sprays, Dr. Smolinske said. When treating patients with respiratory illness, she said, "they should ask the question: 'Were you using an aerosol waterproofing spray?'"

For consumers, she said, there are four guidelines:

* Hold your breath when using waterproofing sprays.
* Do the work outside.
* Limit other people's exposure
* Keep pets away.

The two sprays were meant to be used outdoors. But an analysis of the first 150 cases showed that 87% had been exposed while using the products indoors and 13% when using the products as directed. Some people were exposed when sprayed boots were brought indoors before the product had completely dried.

The two waterproofing sprays contain fluoropolymer particles, which combine with a hydrocarbon carrier, heptane. In the lungs, the combination prevents gas exchange, "and you asphyxiate," Dr. Smolinske said.

While there were no human deaths, the researchers found, 10% of the symptomatic patients were admitted to a hospital and one man was hospitalized for 19 days on a ventilator. "We had no deaths," she said, "but we did have one near-death."

Dr. Smolinske said there's little doubt that the waterproofing sprays caused the illness, which was characterized by coughing and shortness of breath. "It's a pretty high case rate," she said. "It's at least 1%, because they didn't make that many cans."

What's more, she said, some people who became ill later used the substance again - and got sick again. "One guy even did it a third time," Dr. Smolinske said.

Of the patients, 80 were known to have been evaluated in hospitals or hospital emergency departments. Pulse oximetry of patients evaluated in hospitals ranged from 61% to 100% (with a median of 94.9%). Chest radiographs were taken for 47 patients; 13 were positive for infiltrates.

Eight patients met the case definition for chemical pneumonitis. They had bilateral infiltrates suggestive of chemical pneumonitis and pulse oximetry of less than 95% on room air.

Dr. Smolinske added: "the problem is not going away" now that summer is coming. Similar risks are associated with sprays used to waterproof tents and other outdoor gear, as well as with the tile grout sealers used in home renovations.

Also, she said, new products using nano-scale particles - less than 10 microns in diameter - are coming on the market and "we're keeping en eye out for similar problems," she said. Nano-particles are easily able to get deep into the alveoli and interfere with gas exchange, she said.

Primary source: Morbidity and Mortality Weekly Report
Source reference:
Centers for Disease Control and Prevention. "Respiratory Illness Associated with Boot Sealant Products -- Five States, 2005-2006."

MMWR 2006;55:488-490.

SOURCE:
http://www.medpagetoday.com/PublicHealt ... th/dh/3244