An increasing number of physicians have found objective evidence of chemical injury in patients who have symptoms attributed to carpet exposure. "At least 120 doctors and other health-care professionals from a variety of medical disciplines have signed a letter stating that they are seeing a large number of carpet-related health problems and other chemical injury problems in their patients," said Anthony Pollina, aide to Rep. Bernard Sanders (I-VT). The doctors submitted the letter to Congressman Sanders, who forwarded it to Carol Browner, head of the Environmental Protection Agency (EPA). Pollina stated the doctors are especially requesting that a uniform diagnostic test protocol or battery of objective tests be established.
"The doctors' letter is important because it confirms that yes, doctors involved in clinical practice are seeing these problems," said Pollina. "It certainly brings us past the point, we feel, of simply debating the animal tests, which were valid as well, but we always felt a real serious discussion of this issue needed to involve medical doctors who are seeing the patients."
Gunnar Heuser, M.D., Ph.D., F.A.C.P., immunotoxicologist and neurotoxicologist, has found consistent, objective evidence of injury in patients exposed to new carpet. "A full workup shows abnormalities that are consistent with other types of chemical injury, including abnormal neuropsychiatric exam consistent with what is typically found in head injury patients, altered natural killer cell function, increased TA1 cells of the immune system, autoimmunity [meaning that the body's immune system has mistakenly identified its own tissues or cellular components as foreign and directed antibodies against them] including autoantibodies to thyroid, myelin of the nervous system, and anti-nuclear antibodies," Heuser said.
Problems with concentration and memory are frequently reported by the people who react to carpet and other consumer products. Heuser stated the single-photon emission computer tomography (SPECT) scan is a well established test that provides objective evidence of brain abnormalities correlating well with those symptoms. "We have seen hundreds of patients who say low level exposure to the types of volatile organic compounds found in carpets and other products is making them ill," he said. "When we have conducted SPECT scans on these people, they have consistently shown that not enough blood flow is going into certain parts of the brain, and especially the part that has to do with concentration and memory."
Internal medicine and psychosomatic medicine specialist Stephen Schacher, M.D., of Seattle, Washington, said he is also finding abnormal SPECT scans on patients who attribute their symptoms to new carpet, as well as other toxic exposure victims. Schacher said the scans have evidenced brain injuries, especially in the parietal lobe, the deep temporal lobe and the posterior inferior frontal lobe.
This finding is consistent with the SPECT scan abnormalities found by environmental and occupational toxicology specialist Thomas Callender, M.D. of Lafayette, Louisiana, and neurologist Richard Nelson, M.D. of Billings, Montana. Both have found abnormalities in the frontal lobes, temporal lobes, basal ganglia, and thalamus of the brain. Another related test which studies metabolism in the brain, the positron emission tomography (PET) scan, has also consistently shown abnormalities, according to Nelson and Callender.
Heuser believes the problem is widespread. "If you take all the cases I have seen over the years, of people who say that new carpet either at work or at home makes them feel sick, it would come to a few hundred," he said. The worst case Heuser evaluated involved two children who spent much of their time playing directly on new carpeting. The children developed epileptic seizures verified by electroencephalogram (EEG) tracings. The seizures stopped when the children were no longer exposed to the carpet.
"We believe it was the carpet because while the entire family became ill with headaches, the adults and the two children who did not play on the carpet did not develop seizures and were overall much less ill than the children who did come into close, direct contact with the carpet," noted Heuser.
Part of the problem is the large number of chemicals involved in the manufacture of carpets. At least 1,000 chemicals are used, according to a toxicologist within the carpet industry. (1) "I believe this is a toxicity problem," stated Heuser. "Carpet and other consumer products are a complex mixture of chemicals. Very little research has been conducted to look at the synergistic and additive effects of chemical combinations. Also, when you combine chemicals, new unknown compounds can be formed that can be more toxic than the single chemicals."
Consistent abnormalities indicating cognitive deficits have also been found when the P300 component of EEG cognitive evoked potentials has been studied. Typically, the P300 is delayed in chemically injured patients. "What we have found in these patients is that it is taking longer for the signal to get where it is supposed to go -- and sometimes it doesn't even get there -- the signal is lost altogether," said Schacher. Nelson also commonly sees a delayed P300 in the patients as well as a number of other electrophysiological abnormalities with brain mapping. Because it is considered an objective measure not affected by motivational factors, (2) cognitive evoked potentials assessing the P300 component have been conducted under challenge testing conditions. First, a baseline reading is taken. Then the patient inhales fumes from a product such as perfume at very low levels typically found in real-life situations.
Simply inhaling fumes from a small carpet sample in a jar caused severe brain function abnormalities in a patient who was objectively assessed in a challenge EEG test measuring cognitive evoked potentials. The pre-exposure baseline reading was normal. After inhaling the low-level fumes for only 15 minutes, the patient's brain function was significantly altered. (3)
Another patient was challenge tested with a few drops of styrene-butadiene carpet adhesive. Bonnye Matthews had been disabled by central nervous system symptoms and occupational asthma caused by exposure to fumes off gassing from new carpet laid in her office with styrene-butadiene glue in 1987. Subsequent low-level exposures to petrochemicals found in carpet and other consumer products produced severe central nervous symptoms including difficulty concentrating, memory loss, and balance problems. Challenge testing with extremely low-level styrene butadiene fumes confirmed that cognitive deficits were caused by the fumes, leading Schacher to conclude, "Serious environmental concern should be given to carpet glue as a source of brain damage in previously normal individuals." (4)
Matthews' doctors also combined immune testing with her styrene butadiene challenge test. The tests confirmed that exposure to the volatile organic compounds off gassing from the glue caused the development of trimellitic anhydride (TMA) antibodies. Blood was drawn prior to exposure and on days 3, 7, 13, and 17 following the exposure. Before exposure there were no antibodies. On day 7, Matthews' blood showed positive IgM antibodies against TMA. The antibody test remained positive through day 17.
Antibodies to TMA have long been demonstrated in industry in people who have been exposed to it, so we know it is an acceptable antibody test," said immunotoxicologist Jack Thrasher, Ph.D. "The tests we have conducted on people who are exposed to carpet have nearly always been positive for either one or both IgM and IgG antibodies to TMA. It is also present in the medical literature that these antibodies to TMA cross-react to other chemicals that have a similar structure. One of the chemicals that it cross-reacts with is 4-vinylcyclohexene (4-VC) which is an off gassing component of new carpet. (5) Certain material safety data sheets (MSDS) that I have reviewed, reveal the presence of 4-VC in the latex backing of carpet. In order to be reported in an MSDS, the chemical must be present in a concentration of at least 1% of the total mixture. If it is below that concentration, it does not have to be reported on the MSDS. So putting two and two together, the TM antibodies we find in individuals exposed to carpeting, in our opinion, means that they have been exposed to aromatic or other cyclic compounds of similar structure."
Thrasher has also found a high incidence of autoimmunity in patients who report illness from carpet exposure. He has tested over 100 cases of people who report illness from new carpet, including 19 EPA workers and over 40 children in a grammar school that had installed new carpet.
"We are seeing a common denominator in the immune profiles," Thrasher states. "Those with central nervous system symptoms usually have autoantibodies to the myelin of the nervous system along with the antibodies to TMA. Another consistent finding we are seeing is elevated TA1 cells indicating a chronically activated immune system. I have heard from a number of clinicians who are finding the same thing."
One of those clinicians is occupational medicine specialist Grace Ziem, M.D., Dr. Ph.H., of Baltimore, Maryland. "I am seeing the presence of autoantibodies and changes in TA1 cells. A common sign of pathology I am finding is the presence of anti-myelin antibodies. The presence of these antibodies is very disturbing. It means there is damage to the nerve cells," stated Ziem.
Nelson also runs a battery of objective tests on patients who report chemical sensitivities and adverse symptoms from carpet exposure. His general findings include abnormalities in both the immune and nervous systems.
"Psychometric testing often shows alterations in memory and cognition as well as subtle alterations in motor skills, balance, and eye movement," said Nelson. He frequently sees elevated TA1 cells, evevated interleukin-1 and interleukin-2 (which are involved in the i nitiation of immune response including fever and the stimulation of other immune cells), and other immune abnormalities, including a high incidence of autoantibodies to the myelin of the nervous system.
Allergist William Meggs, M.D., Ph.D., reports that he is finding "markedly inflamed uper airways" in chemically sensitive individuals, including those made ill by carpet. He is seeing an asthma-like syndrome termed reactive upper airway dysfunction syndrome (RUDS), rhinitis, and cobblestoning of the nasal mucosa apparent through rhinolaryngoscopic examination. (6)
Beverly Shutt developed hypersensitivity pneumonitis from new carpet installed in her home. Within 24 hours of installation, she developed what she thought was the flu, but it gradually grew worse until six weeks later she was in critical condition. Doctors had to perform open chest surgery to remove part of her lung. Shutt says she has been warned by her doctors that her condition is so severe it may be terminal. She must be on oxygen all night and part of each day, and her activities in Searock, Oregon, where she now lives, are severely limited.
Pulmonary specialist Ganesh Rahgu, M.D., looked at all possible causative agents for Shutt's pneumonitis and slowly eliminated everything but the carpet. Subsequent tests at Anderson Laboratories found that air blowing over a piece of Shutt's carpet killed some of the mice and produced the same type of pathological changes and damage in the mice as in Shutt's lungs when tissue biopsies were compared. Dr. Rahgu is associate professor of medicine, chief of the chest clinic and medical director of the transplant program at the University of Washington School of Medicine, Division of Pulmonary Care.
If the Carpet and Rug Institute (CRI) continues to promote all carpeting as a safe product while downplaying all evidence to the contrary [see "Carpet Concerns" Part One, Part Two, and Part Three in previous issues of Informed Consent], a number of researchers have expressed concern for the most unsuspecting victims, the children. "I think one of the dangerous things about carpet is that children crawl and play on it, so they have a much greater breathing and dermal exposure than adults," stated Ziem. "And I am deeply concerned about the common practice of redecorating nurseries with toxic products and putting in new carpet before babies are born. That is the baby's 24-hour environment. It is a very dangerous risk to take."
"Little children are lying on carpet in day-care centers while they are playing and learning to read," said Mark Goldman, manager of Anderson Laboratories. "There is enough evidence about not just the chemical hazards but also the biological contaminants and the maintenance cost and problems of carpeting in schools to be able to say that schools are much better off without it. We have heard too many tragic stories and have seen too many devastating health problems from carpeting not to be profoundly concerned."
Congressman Sanders' office still plans to keep as much pressure on the carpet and rug industry as possible. "We know a number of the chemicals that off gas from carpet are in fact dangerous, and they do create health problems for people," said Pollina. "we want to see some serious research conducted to look at the specific health effects of the chemicals coming off of carpet. We want to see the manufacturers implement the kind of quality control that is necessary, and any new manufacturing methods that are necessary to see to it that they produce a safe product. Industry is supposed to come back to us with a research plan for testing both individual chemicals and combinations of chemicals. And we will hold them to it."
For more information, contact:
York State Attorney General
New York, NY 10271
Offers free copies of "Carpet and Indoor Air: What You Should Know," authored by four state attorneys general, June 1993
for Safe Carpet
P.O. Box 53344
Cincinnati, OH 45253-0344
Glen and Sharon Beebe, authors of "Toxic Carpet III," provide a support group and information exchange. The Book "Toxic Carpet III" is available at the above address for $12.95 PLUS $4.OO S&H.
Access Research Network (EARN)
P.O. Box 1089
Minot, North Dakota 58702-1089
For a list of carpet-related articles, studies, and reports available from EARN's photocopying service, send $1.00 and request "Carpet List."
Union NFFE 2050
P.O. Box 76082
Washington, DC 20013
Conducts biological health effects testing of carpet samples.
Duehring, C. "Carpet Concerns Part II: Carpet Installers Speak Out As the Medical Evidence Mounts." Informed Consent (January/February 1994) pp. 8-10, 44-48.
Morrow, L.A. "Delay in P300 Latency in Patients with Organic Solvent Exposure." Archives of Neurology 49:315-320 (1992)
Neurometric Assessment Patient Report for E.K. prepared by Richard A. Nelson, M.D., Diplomate American Board of Neurology and Psychiatry, Billings, MT. (January 15, 1993)
Patient report for Bonnye L. Matthews prepared by Stephen A. Schacher, M.D., Psychosomatic Medicine and Internal Medicine, Seattle, WA. (April 20, 1992)
Pliel, J.D.; Whiton, R.S. "Determination of Organic Emissions from New Carpeting." Appl. Occup. Environ. Hygiene 5:693-699 (1990).
Meggs, W.J., Cleveland, C.H. "Rhinolaryngoscopic Examination of Patients with the Multiple Chemical Sensitivity Syndrome." Archives of Environmental Helath 48(1):14-18 (1993).
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