Vol. 4 No. 1 November 8, 1983



I. Pesticide Waste Disposal
II. Niacin Intoxication - Bagels
Ill. Respiratory Illness - Carpet Cleaning
IV. Lead Poisoning - Mexican Folk Remedies
V. Lead Poisoning - Hmong Folk Remedies
VI. Notice - Newsletter Subscriptions


In March of 1983 1 wrote to the Department of Health Services Hazardous Waste Management Office asking about the disposal of unused and unwanted pesticides. The concern has usually been for large quantities, but I have received a number of inquiries from small farmers and homeowners too. I received a reply from Dr. David Storm, Acting Chief of the Alternative Technology and Policy Development Section that addressed these questions. I asked Dr. Storm for permission to print these suggestions in my newsletter and he agreed. The following is taken directly from that letter, and contains some very useful suggestions for dealing with small quantities of pesticide waste.

"In response to your letter addressing the problem of small quantities of pesticides and to devise a means of recycling these unused materials. You pointed out that the material came from households, or pest control officers, and are in quantities of 10 gallons or less. Often times the person has had the pesticide for extended periods of time. Sometimes the registration has lapsed.

I agree with you that disposing of small quantities of pesticides is a special problem. It is especially difficult for householders who have no knowledge of the Hazardous Waste Regulations and are unprepared to pay for the rather extensive disposal costs. No commercial recyclers that we are aware of are interested in working with these pesticides, primarily because the volume is too small, there is virtually no retail market for them, the hazards associated with some pesticides are very significant.

Currently when a citizen requests alternatives to disposal, we suggest the following:

  1. Contact the County Agricultural Commissioners. Some agricultural commissioners as a service to the citizens of their county will take unused pesticides and attempt to recycle the material by giving it to anyone who can use it. Needless to say they are not always able to find a user and periodically they send all the material to a Class 1 site. This has been a very effective program in many counties for several years.
  2. Contact city, county or other public officials and see if they will take the pesticide for use. Often those agencies which are responsible for the maintenance of parks, right-of-ways, golf courses, public buildings etc. use a great deal of pesticide and can use the material.
  3. Contact a local pesticide retailer and request they take the material as a public service. Some pesticide operators are aware of the public's concern about pesticides and as a public service will take small amounts of pesticides in order to assure that it will be properly handled. Usually the amount is small in comparison to their total waste volume, so that it makes no difference to them.

The Department is aware that the above alternatives are not a complete solution to the problem. Some counties, such as Sacramento County, are experimenting with different ways of handling hazardous household wastes. We will be glad to consider any suggestions that you can make."

II. Niacin Intoxication from Pumpernickel Bagels - New York

On April 27, 1983, 14 (20%) of 69 persons attending a brunch had acute onset of rash, pruritis, and sensation of warmth. The illness was of relatively short duration, with an incubation period of approximately 30 minutes after consumption of one or more pumpernickel bagels served at the brunch. Of 25 persons who ate the bagels, 14 (56%) became ill, whereas none of the 44 persons who did not eat pumpernickel bagels became ill. The bagels had been produced at a local bagel factory from a batch of dough originally prepared on April 23.

Because the pumpernickel bagels were very light in color, the ingredients were suspected. Investigation revealed that, in an attempt to enrich the pumpernickel flour, a large quantity of niacin had been added, apparently from an improperly labeled container. Laboratory studies revealed 60 times the normal level of niacin in the pumpernickel flour. On the basis of these data, each bagel contained approximately 190 mg of niacin; the recommended dietary allowance for niacin is 6.6 mg/1000 calories or about 13 mg/day for the average adult.

Editorial Note: Acute ingestion of excessive amounts of niacin (nicotinic acid, one of the B-complex vitamins), such as in this instance, can produce an acute syndrome of cutaneous vasodilation of the face and trunk, pruritis and sensation of heat. Gastrointestinal distress has also been noted. Although alarming, these symptoms usually resolve spontaneously over several hours without sequelae. Outbreaks of this syndrome have previously been reported in association with inappropriate food additive use or with mislabeled food ingredient containers. An unusual color of the implicated food was also noted in the latter outbreak.

Excessive, chronic use of high doses of niacin, which may occur in persons taking large amounts of vitamins, has been related to the occurrence of hepatitis.

MMWR, Vol. 32/No. 23, June 17, 1983

III. Respiratory Illness Associated with Carpet Cleaning at a Hospital Clinic - Virginia

On November 8, 1982, eight (47%) of 17 employees on one floor of a hospital clinic had cough and throat irritation after entering their work environment. Symptoms disappeared that day when windows were opened or when workers left the building. Inspection of the building and its heating and air conditioning systems by an industrial hygienist failed to uncover any obvious source of chemical or carbon monoxide exposure. Recommendations were made to improve ventilation, but work-related symptoms continued until November 25. Three employees who saw physicians had sore throats of unknown etiology.

Carpeting on that floor had been shampooed the weekend before earliest onset of illness. Employees on another floor had experienced a similar illness after carpet cleaning the previous weekend.

Given the temporal and physical association between illness and recently cleaned carpets, the cause of illness was suspected to be dried carpet shampoo aerosolized by employees walking on the carpets. The active ingredient of this shampoo was sodium dodecylsulfate (sodium lauryl sulfate). This type of shampoo had not previously been used in that building. The manufacturer states that "overuse of this superconcentrated product can cause an irritating powder to be formed after drying". Although underdilution of the shampoo concentrate and inadequate vacuuming of the carpet containing dried shampoo were suspected as responsible for the outbreak, neither could be confirmed.

Ongoing surveillance revealed no new cases after thorough vacuuming and steam cleaning of the carpets.

Editorial Note: The prevalences of the various symptoms reported here are similar to those reported in two previously published outbreaks, except that eye irritation (50%-60% in the previous outbreaks) and sneezing and nasal congestion (30%-40%) were not mentioned in this outbreak, and gastrointestinal symptoms, except nausea, did not occur in the other outbreaks. The reported respiratory symptoms are not specific for sodium dodecylsulfate, but are common to numerous irritant particulates, aerosols, and gases. Nevertheless, the temporal association between use of carpet shampoo and the outbreak, and the absence of further cases after vacuuming and steam cleaning the carpet, tend to implicate carpet-shampoo residue as the etiologic agent.

As in the previous outbreaks, underdilution of shampoo concentrate was the suspected reason for shampoo residue remaining in the carpet. Since commercial cleaning products may contain a variety of irritating or potentially toxic compounds (e.g., sodium carbonate, sodium perborate, sodium phosphates, ammonium compounds, borax, pine oil, trichlorethylene, perchloroethylene, naphtha, naphthalene, kerosene, petroleum solvents, alkyl benzene sulfonate, alkyl aryl sodium sulfonate), concentrates should be fully diluted before use according to manufacturers' directions, and all such products, especially "heavy-duty" or "industrial strength" varieties, should be used only where there is adequate ventilation.

MMWR, Vol. 32/No. 29, July 29, 1983

IV. Lead Poisoning from Mexican Folk Remedies - California

In May 1982, a 15-month-old California child and his 3-year- old sibling were treated in Mexico with multiple doses of azarcon (lead tetroxide) for chronic diarrhea that had been unsuccessfully treated with ampicillin. In June, the children were taken to a San Diego hospital where the younger child was found to have a blood lead level measurement of 124 ug/dl; the 3- year-old expired with seizures. It was not known whether an autopsy was performed, but azarcon-induced lead encephalopathy was suspected as a cause of death.

Because of these cases, in June 1982, the Los Angeles County Department of Health Services surveyed residents of six predominantly Hispanic, geographically representative census tracts in an attempt to estimate exposure to and knowledge of azarcon and greta (lead oxide). A total of 545 systematically selected households were included. Familiarity with the substances was greatest among Mexican-Hispanics, and prior use was exclusive to this group. Respondents in approximately one- quarter of Mexican-Hispanic households were familiar with one or both of the substances by means other than media announcements. An estimated 7.2%-12.1% of Mexican-Hispanic families admitted prior use from "years ago" to within the past month. One respondent provided interviewers with azarcon from the family medicine cabinet. Since investigators noted a reluctance to admit using azarcon or greta, the incidence of ingestion might have been greater than results of the survey indicated.

Editorial Note: Greta and azarcon are fine powders with total lead contents varying from 70% to greater than 90%. As powder, they provide a large surface area for potential absorption. These remedies apparently are most often administered to infants and children, who are the most susceptible in terms of clinical impact and the capacity to absorb lead.

With the identification of multiple cases of lead poisoning and indication of significant exposure, major media efforts publicizing the dangers of azarcon and greta have been directed at Hispanic communities in California. Until recently, these substances were available at herb shops and from folk healers on both sides of the Mexican-American border.

Health education material in Spanish and English is available from the State of California and Los Angeles County Departments of Health Services and from the Sunrise Community Health Center, P.O. Box 245, Greely, Colorado 80632.

MMWR, Vol. 32/No. 42, October 28, 1983

V. Folk Remedy-Associated Lead Poisoning in Hmong Children - Minnesota

Between January 1, and June 30, 1983, 35 children with lead toxicity were identified through routine screening by the St. Paul, Minnesota, Division of Public Health. Of these, 24 (69%) were Hmong refugees from Northern Laos. This represents a twofold to threefold increase in the number of Hmong children found to have lead toxicity in St. Paul compared with previous years. One source of lead poisoning appears to be a Hmong folk remedy used for treating infants and children with fevers.

Officials have been unable to obtain samples of the folk remedy from the parents of other Hmong children with lead poisoning. The remedy, generally referred to as "pay-loo-ah", consists of red and orange powders, the composition and source of which often vary; therefore, a more exact description of the material remains difficult. Believed to have originated in China or Southeast Asia, pay-loo-ah is fed to children as a cure for fever or rash. Samples of folk remedies were obtained from several Hmong households in the community, and the U.S. Food and Drug Administration confirmed that two contained lead (1% and 90%). Arsenic was found in three samples at concentrations of 70%-80%. These folk remedies were in wide use and were easily available through local Asian food stores or Hmong peddlers. To date, no cases of arsenic poisoning in the Hmong children have been reported.

Editorial Note: Hmong refugees, who have emigrated from North Laos, have an estimated total population over 50,000 and live in many parts of the United States, with the largest concentrations in Fresno, Stockton, and San Diego, California, in addition to St. Paul.

Health-care providers for Hmong and Southeast Asians should be aware of this unusual lead source. Screening for elevated blood lead levels is necessary to identify additional cases, because symptoms of lead toxicity generally have not been reported by the Hmong. Reporting of cases to local or state health departments is recommended. Appropriate health education will be necessary to inform the Hmong of the health consequences associated with this folk remedy.

MMWR, Vol. 32/No. 42, October 28, 1983


In the past, the Environmental Toxicology Newsletter was funded by Cooperative Extension through Berkeley independent of my Supplies and Expenses (S&E) account. Starting in January 1984, this will not be the case and so it will be necessary to pay for the newsletter out of this S&E or start providing it on a subscription basis. I currently do not have enough S&E to pay for the newsletter and still run an office so we are investigating going to subscriptions as a means to keep the newsletter alive. I have found it to be an effective means for distributing needed information directly to those of you who need it and I would like to keep it in operation. You will be hearing more about this in January and I hope that you will continue to support the Environmental Toxicology Newsletter.

Art Craigmill
Extension Toxicologist
U.C. Davis