NEHA November 2022 Journal of Environmental Health

26 Volume 85 • Number 4 A D VANC EME N T O F T H E PRACTICE is the most tested contaminant in the limited CIPP studies. Styrene vapor levels have ranged from the low 10s to potentially 1,824 ppm at work sites. Air quality model simulations have predicted levels exceeding 300 ppm indoors (Noh et al., 2022a). The acute reference exposure for residential and commercial building occupants is 4.9 ppm (California Department of Public Health, 2017). The U.S. EPA reference level and no-observed-adversee‹ect-level are 0.23 and 8 ppm, respectively. The Agency for Toxic Substances and Disease Registry (ATSDR) previously declared a public health hazard because styrene vapor levels (0.32 ppm) from a CIPP project exceeded its minimum acceptable chronic exposure level (0.06 ppm), resulting in an o“ce building being contaminated for 3 months (WDHFS & ATSDR, 2005). Few studies have investigated health e‹ects from CIPP air pollution. Cell toxicity assessments of the waste discharged into the air exhibited di‹erential toxicity in mouse cell lines representative of the pulmonary system (Kobos et al., 2019). Cytotoxicity, inflammation, and alterations in immune signaling were also observed. The researchers found that minor compounds, not just styrene, contributed to di‹erential toxicity between the exposures. Although styrene is an important contributor to toxicity, continued focus solely on the styrene component of CIPP emissions has limited understanding of the human Strategies for Preventing and Mitigating Exposures Based on Literature Review and Work Group Feedback Prevention Stage Issues and Gaps Key Steps Stakeholders Primary Utility practice Require waste capture and/or treatment, thereby limiting discharge; develop pollutant monitoring or controlling guidelines of the overall CIPP practice Health officials, industry, regulatory agencies Curing technology Investigate emissions released from nonstyrene-based CIPP products Industry, researchers Secondary Measurement technology Evaluate real-time monitoring equipment for atmospheres impacted by CIPP-caused emissions and provide information to stakeholders Health officials, NIOSH, industry, firefighters, researchers VOC pathways Require prevention of waste leaving the work site and air testing to confirm prevention method was effective Health officials, NIOSH, industry, code officials Public exposure Notify the nearby population to contact the health department to report exposures Health officials, industry, firefighters Occupational exposure Conduct air testing; provide air testing results to stakeholders; notify workers to contact NIOSH or OSHA with concerns Health officials, NIOSH, industry Incident response Conduct training to improve the safety of workers overseeing a project or responding to an incident Health officials, firefighters Plumbing system Recognize building plumbing can have sewer connections that building owners, pipe owners, and contractors are unaware of; encourage water seals in drains but acknowledge water seals might not prevent chemical entry Industry, code officials, NIOSH Tertiary Generated wastes Examine the composition of emitted wastes; identify the secondary contamination of the emission (e.g., micrometer and nanometer plastic formation) Health officials, industry, academic researcher Mitigation technology Examine the applicability of emission capture and/or contaminant removal at the CIPP work site (granular activated carbon filtration was proposed during work group sessions) Health officials, industry Toxicity and health effects Determine which chemicals and concentrations are present near and away from work sites; determine the toxicological impact of different resins and installation conditions; compare air concentrations to public exposure levels; determine if the matrix effect is important; provide triage advice to firefighters and health officials Health officials, NIOSH, industry Emergency management Determine the efficacy of available real-time testing devices for atmospheres impacted by CIPP-caused emissions; provide triage advice to firefighters and health officials Health officials, emergency responders Risk assessment Identify risk of chemical mixtures generated from installation; determine the appropriate risk assessment tool for CIPP installations Health officials, NIOSH, industry Health equity Recognize some infrastructure is located in lower socioeconomic areas; recognize people might not reach out for help even if they are exposed or harmed Health officials, firefighters, physicians Note. CIPP = cured-in-place pipe; NIOSH = National Institute for Occupational Safety and Health; OSHA = Occupational Safety and Health Administration; VOC = volatile organic compound. TABLE 3