How can asking such a simple question be so complicated

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or..How can asking such a
simple question get be so darn complicated??????
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• To ponder
• The life cycle of a splint - from fabrication to
  landfill
• and
• Recyclablity? are there alternatives to
  landfill?

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• Photo of rounded portion of splint being heated
  up by heat gun

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GOOD QUESTION

• WHAT IS THIS
• STUFF MADE OF?

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TIME GOES BY
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Photo of complicated journey?
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• JUST ASK PHOTO OF DETOUR?

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• 2 green paintings

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• SHIFT IN GOAL
• Original Goal Is this material recyable?
• depends on what it is made of?
• Current Goal
• Is it safe for therapists and patients to
  breathe the fumes generated in heat gunning this
  plastic?
• AND
• What is the risk/benefit ratio of this common
  clinical practice?

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• Painting or something?

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• Photo of heat gunning again

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• Photo of heat guns

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• Photo of kids

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• Trust slide?

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• photo of msds sheet more than one and details
  of what it said

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• Surprise 1 many large regulatory bodies and
  agencies that appear to be the right call - are
  broad in their appearance but have super focused
  and narrow mandates which means it may not be
  within their jurisdiction or their problem to
  deal with

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• And it can get very complicated
• Surprise 2

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Needs working on re print out for example
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• Surprise 2
• there is uncertainty in the science not
  everything has been proven already many studies
  conclude further investigation is advised

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• Photo of family room

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• 1. Thermal Desorption Testing
• 2. Head space testing
• Qualatative and Quantatative
• Answers

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• A workers Right to know

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• Time goes on calenders clip art?

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Surprise 3 that a worker bee had to work
so hard in addition to all of the regular work
duties. to answer the question... am I being
put at any risk by performing my job duties?
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• QUESTION IS IT SAFE OR NOT?
• ANSWER WE NEED THE SCIENCE!

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• How much is too much?
• talc, silica, calcium silicate, powdered slate,
  titanium dioxide. styrene-butadiene-styrene and
  styrene-isoprene-styrene triblock copolymers,
  benzoylperoxide, phthalate plasticiser

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• Plume toxicity and photo or OR

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• Surprises 4
• Emails get better response than phone inquiries
  and leave an accountable paper trail.

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• Surprise 5
• Mentioning that you are speaking publicly about
  this increases followup and accountability

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• the NIH/NIEHS, the Canadian Centre for
  Occupational Health and Safety, Canadian
  Standards Association,(CSA) Medical Devices
  Bureau (Health Canada),Air Health Effects
  Division (Health Canada), National
  Office/National Secretariat of the Workplace
  Hazardous Materials Information System, Food and
  Drug Liaison Office( FDALO)(Health Canada),
  Health Products and Food (Health Canada), Water,
  Air and Climate Change Bureau (Health Canada),
  Canadian Centre for Occupational Health and
  Safety.

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• Hazardous Materials Information Review
  Commission, Industrial Health and Safety Program
  (Ontario Ministry of Labour), Office of the
  Worker Advisor (OWA, Ontario Ministry of Labour),
  Workplace Safety and Insurance Board (WSIB),
  WHMIS, American Conference of Governmental
  Industrial Hygienists, National Institute for
  Occupational Health and Safety (Centre For
  Disease Control and Prevention), International
  Occupational Safety and Health Information Centre
  (CIS), New Jersey Department of Health, numerous
  contacts considered to be experts in the field.

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• combustion and thermal decomposition products of
  isoprene when heated are carbon monoxide, carbon
  dioxide plus toxic and irritating fumes,
  especially if incomplete combustion occurs

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• isoprene ( beta-methylbivinyl or
  methylbutadiene) can affect you when inhaled..
  it should be handled as a CARCINOGEN- WITH
  EXTREME CAUTION
• no occupational exposure limits have been
  established for isoprene, however it may pose a
  health risk..
• isoprene may be a carcinogen in humans and there
  may be NO safe level of exposure to a carcingoen,
  so all contact should be reduced to the lowest
  possible level.
• Isoprene (Right to Know Hazardous Substance Fact
  Sheet 1069)

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• Chronic health effects after long term exposure
  to isoprene can include a cancer hazard as it has
  been shown to cause liver, lung, mammary gland
  and other types of cancer in animals.
• .may also have the potential for causing
  reproductive damage in humans.
• can irritate the lungs .repeated exposuremay
  cause bronchitis. ventilation needed
• .odor thresholds vary greatly do not rely on
  odor alone to determine potentially hazardous
  exposures
• you have a right to this information under the
  New Jersey Worker and Community Right to Know Act
  if you are a public or a private worker in new
  Jersey

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• TOXICONKINETICS OF ISOPRENE IN RODENTS AND HUMANS
  (Filser J.G. et al, TOXICOLOGY 1996)
• further research is needed before the PT
  (physiological toxicokinetic) model can be fully
  validated as a means of estimating the
  carcinogenic risks of isoprene to humans.

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CHRIS

• Isoprene
• a flammable irritating vapor
• toxic vapors generated on heating
• Toxicity by inhalation information currently
  not available
• avoid contact with vapors, move to fresh air,
  harmful to aquatic life in very low
  concentrations
• NFPA class 2 Blue health hazard materials
  which on intense or continued exposure could
  cause temporary incapacitation or possible
  residual injury unless prompt medical treatment
  given

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Ontario Ministry of Labour
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• The International Occupational Safety and Health
  Information Centre (CIS) notes safe occupational
  exposure limits have not been established and
  that effects of long-term or repeated exposure
  may result in lungs being affected and this
  substance is possibly carcinogenic to humans

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CIS continued..

• prevent generation of mists!
• lungs may be affected by repeated or prolonged
  exposure
• harmful to aquatic organisms

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CIS concludes..

• Data are insufficiently available on the effect
  of this substance on human health, therefore
  utmost care must be taken

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• The National Institute of Environmental Health
  Sciences (NIH/NIEHS)
• Thank you for your question about the
  potential health risks associated with the
  heating of thermoplastic splinting materials.
  According to the Eleventh Report on Carcinogens,
  a document published by our National Toxicology
  Program, isoprene is reasonably anticipated to be
  a human carcinogen based on sufficient evidence
  of tumor formation at multiple organ sites in
  multiple species of laboratory animals.
  Inhalation exposure of mice to isoprene vapors
  induced increased incidences of neoplasms of the
  lung, liver, harderian gland, forestomach,
  hematopoietic system, and circulatory system.
  Inhalation exposure of rats to isoprene vapors
  induced increased incidences of neoplasms of the
  mammary gland, kidney, and testis. No adequate
  human studies of the relationship between
  exposure to isoprene and human cancer have been
  reported.

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• Mrs Ludlow.the best course of action is what
  you suggested To perform head space and thermal
  desorption testing to determine the thermal
  volatilization products.
• I did find in the National Library of Medicines
  hazardous Substance Data Bank (HSDB) that
  isoprene liberates toxic combustion products

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WHMIS -

• we encourage you to pursue any health and safety
  issues relating to the subject product..and to
  this end the national WHMIS office would
  appreciate if you would keep us apprised of any
  findings which suggest that the health and safety
  of workers could be compromised through the use
  of such products..

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• Fume hood photo here

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• molded plastic splinting materials are
  classified as Class l medical devices which are
  not subject to pre-market review and licensing .
  Therefore, we have no safety data on file from
  the manufacturers.

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• We need to consider
• How much is too much?
• Other materials?

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• Be patient
• Persevere
• Break down your goals
• into manageable steps
• Look at months and years rather than days or
  weeks

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• Dear sir,
• Blah blah blah blah blah blah blah blah blah .
  and the compliance coordinator does not appear to
  give
• a flying !!! ..blah blah blah.
• Sincerely , Kara Ludlow

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Goggles?

• Query the risk/benefit ratio of what we do

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• RIPPLE EFFECT