P. F. is a 54-year-old woman who was in good health until 1981 when she moved into a new mobile home. Shortly thereafter she developed a digestive disorder with gas and bloating, severe insomnia, and a chronic cough with frequent episodes of bronchitis. By the following year she was suffering from persistent fatigue and frequent respiratory infections, including her first case of pneumonia. She became sensitive to most products containing formaldehyde, especially press — board. She noted that she experienced "brain fog" while shopping at the local mall. Her symptoms continued to worsen, and now included allergies, hypoglycemia, and lethargy.
P. F. consulted with several healthcare practitioners, including a pulmonary specialist, psychiatrist, hypnotist, nutritionist, and acupuncturist. None of them ever questioned her about the air quality in her home. Eventually she received the diagnosis of multiple chemical sensitivity from a physician with similar symptoms, and was finally educated about the underlying cause of her health problems. In 1992, P. F. moved into a house that contained low formaldehyde levels, alleviating some of her symptoms. Her house contained several healthful features such as radiant heat in concrete floors and the absence of pressboard and particleboard in its construction.
However, further modifications were necessary before her health could be stabilized and improved. All gas appliances were removed; filtration was installed for both air and water; and the mechanical room was vented to the outside. By 1996, P. F. had regained her health. However, as is typical in such cases, she still becomes symptomatic on reexposure to toxic fumes and must diligently maintain a"safe"environment for herself.
Discussion
Indoor formaldehyde is gaining recognition as a severe health hazard for occupants of homes and office buildings where chronic exposure occurs. Several organizations, such as the American Lung Association, have recommended that formaldehyde levels not exceed 0.1 part per million. People who have already become sensitized to formal-
minor cracks. To maintain a good barrier, these gaps should be filled with an acceptable sealant. Since most of the initial cracking will take place during the first 18 months while the house is settling, it makes sense to wait and do all of these minor repairs at once. In pumice — crete, clay/straw, and adobe construction, the plaster may be applied directly to the wall material (see Division 4).
Although most plasters are inert, some contain polyvinyl additives that are subject to outgassing and should be avoided. Verify the presence of additives with the manufacturer prior to purchase.
One potential health hazard associated with plaster lies in the method by which it is dried. Because new plaster releases a significant amount of moisture, it is necessary to dry it out quickly so that other building materials are not adversely affected. This is especially problematic in the winter months, when cold temperatures and lack of ventilation slow down the rate of evaporation. The standard solution is to use gasoline or kerosene heaters, dehyde will have reactions at levels as low as 0.02 part per million. Approximately 50 percent of the population is exposed on a daily basis in the workplace to levels that exceed the 0.1 part per million limit. Mobile homes are notorious for causing health problems because of the extremely high levels of formaldehyde emitted from the plywood and particleboard used in their construction.3
Individuals who develop permanent health problems associated with formaldehyde exposure often relate the onset of their symptoms to a flulike illness, which is diagnosed as a viral infection. However, the affected individual usually does not totally recover from this so-called flu and is left with general malaise, fatigue, and depression. Other symptoms can include rashes, eye irritation, frequent sore throats, hoarse voice, repeated sinus infections, nasal congestion, chronic cough, chest pains, palpitations, muscle spasms, joint pains, numbness and tingling of the extremities, colitis and other digestive disorders, severe headaches, dizziness, loss of memory, inability to recall words and names, and disorientation. Formaldehyde is an immune system sensitizer, which means that chronic exposure can lead to multiple allergies and sensitivities to substances that are entirely unrelated to formaldehyde. This is known as the "spreading phenomenon."
P. F. was typical of people whose multiple chemical sensitivities stem from formaldehyde exposure in that she consulted numerous physicians and specialists in an attempt to obtain a diagnosis. Physical examinations and standard testing usually fail to identify the cause of such health problems. Sometimes it is suggested that the patient is a hypochondriac or in need of psychiatric evaluation. When asked if there might be a connection between the symptoms and formaldehyde, most physicians either do not know or believe that formaldehyde merely causes irritation. As a result, the patient’s health continues to deteriorate from continued exposure.
a. Jack Thrasher and Alan Broughton. The Poisoning of Our Homes and Workplaces: The Indoor Formaldehyde Crisis. Seadora. 1989, pp. 50-72.
but we do not recommend this practice. The byproducts of combustion generated by this machinery are readily absorbed into the plaster and other building materials. The heaters also create an unhealthy environment for the workers exposed to their fumes. Electric heaters tend to be more expensive to run, with far less BTU output. We recommend a combination of dehumidifiers when necessary and careful scheduling so that the plasterwork is done during a warm, dry period. Although heat may be required for the comfort of the construction team, it is far less significant than dehumidification to the proper drying of wet building materials. In summary, we suggest that the following instructions be included in your specifications:
• Plaster shall be free of additives.
• The use of gas — or kerosene-generated heaters within the building envelope is prohibited.
• Turbo high-velocity heaters, other electric heaters, and blow-in heaters with combustion sources outside the building envelope are acceptable for adding heat to a building during cold-weather construction.
• If plaster is applied when weather conditions do not permit the building to remain open and well-ventilated, electric dehumidification should be used. At temperatures under 70 degrees Fahrenheit, moisture levels should be maintained at approximately 45 percent relative air humidity using electric dehumidification until the building is dry enough to consistently maintain this range without the use of this equipment. Interior surface temperatures shall remain above 50 degrees. Refrigerant dehumidifiers may not work well when temperatures drop below 65 degrees Fahrenheit.
