Occupational and Environmental Medicine 1994;51:181-186

Occupational exposure to water based paint andsymptoms from the skin and eyes

G Wieslander, D Norback, C Edling

AbstractWater based paints contain organic sol-vents and many additives, such as bio-cides, surfactants, pigments, binders,mines, and monomers. The chemicalcomplexity may introduce new potentialhealth hazards to house painters, in par-ticular irritative and allergic disorders.This study was performed to comparehow house painters experience work withwater based paints or solvent basedpaints, and to evaluate whether exposureto water based paints increases mucousmembrane and dermal symptoms amonghouse painters. 255 male house paintersaged 20 to 65 were invited to participatein the study. Controls were two indus-trial populations, in total 302 men, with-out exposure to water based paints. Selfadministered questionnaires were usedto assess the painter's experiences ofworking with different types of paintsand the occurrence of symptoms in theexposed and unexposed groups. Hygienemeasurements were performed duringnormal working days when only waterbased paints and no solvent based paintswere used. The painters were exposed tolow concentrations of dust, metals,ammonia, formaldehyde, and volatileorganic compounds. The work environ-ment was considered better when work-ing with water based paints than withsolvent based paints. There were morecomplaints of frequent urination whenworking with water based paint. Taste orolfactory disturbances were less com-mon. General as well as work related eyeand skin irritation was more commonamong the exposed workers. For othersymptoms no significant differences werefound. The study indicates that the intro-duction of water based paints hasimproved the work environment forhouse painters. Water based paints causeless discomfort and airway irritationthan the earlier solvent based paints.Adverse general health effects seem low.Some of the painters may have dermnalsymptoms caused by the components inwater based paints.

(Occup Environ Med 1994;51:181-186)

The chemistry of paints has changed overtime, and so have the potential health hazardsfor house painters. At the beginning of the

20th century, arsenic was often used as a pig-ment in paints and wall paper, and causedsystemic poisoning.' Before the second worldwar, turpentine was used as a solvent inbuilding paints, and both kidney dysfunction2and contact allergy' related to exposure toturpentine was reported. Later, turpentinewas replaced by organic solvents such aswhite spirit, butanol, methyl ethyl ketone(MEK), and ethyl acetate or butyl acetate.'These compounds are more volatile than tur-pentine, and consequently resulted in a highexposure to organic solvents both in the paintindustry and among house painters. Initially,this exposure to solvents was considered tohave no major adverse effects. During thepast few decades, however, several epidemio-logical studies have shown that occupationalexposure to organic solvents may cause acuteand chronic dysfunction of the peripheral andcentral nervous system.4 Therefore, the paintindustry started to develop new types ofpaints, with considerably smaller amounts oforganic solvents. These new so called waterbased paints contain an emulsion of pigmentsand polymers in water with small amounts ofvarious chemicals such as volatile organiccompounds (organic solvents) and biocides.

In Sweden the use of solvent based paintfor professional indoor painting has graduallydecreased, from 40% in 1970 to 10% in1985. The Swedish painters union in 1987urged their members to further minimise theuse of solvent based paints and use waterbased paints when possible. In 1992 the useof solvent based paints among house paintersin Sweden was only 4% of the total paintconsumption.One advantage of water based paints is that

they reduce the exposure to organic solvents.The chemistry of water based paints is, how-ever, more diverse and complex than that ofsolvent based paints. Water based paints con-tain many additives, such as biocides, surfac-tants, pigments, binders, amines, monomers,and solvents.56 This chemical complexity mayintroduce new potential health hazards tohouse painters. Swedish painters have re-ported skin irritation, frequent urination andstomach problems when using water basedpaints. Ulfvarson et al recently published astudy in which they found a temporaryincrease in urine excretion and a decrease inurine density as well as a small increase inmean red cell volume and a decreased forcedexpiratory volume in one second (FEV1)among painters exposed to experimentalwater based paints.7 In another study on

Department ofOccupationalMedicine, UniversityHospital, S-751 85,Uppsala, SwedenG WieslanderD NorbackC EdlingRequests for reprints to:Dr C EdlingAccepted 28 June 1993

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painters who worked with water based paints,the authors reported a possible effect on thekidneys, measured as an increased excretionof albumin in the urine.8 To elucidate furtherthe health consequences of exposure to waterbased paints we have started field studiesamong active house painters. The interest isfocused on the exposure situation, symptoms,lung and kidney function, and skin allergy.This is the first part of the health relatedstudies.Our study had two aims. The first was to

evaluate how the painters experienced workwith solvent based and water based paints,regarding the general work environment, mal-odour, and some work related symptoms.The second was to evaluate whether housepainters exposed to water based paints hadmore mucous membrane and dermal symp-toms than workers without such exposure.

Material and methodsSUBJECTSThe study took place in the counties ofGavleborg and Dalecarlia in mid-Sweden.During March 1989, all major (>20 employ-ees) painting companies in the region wereidentified with the help of the RegionalConstruction Industry's Organisation forWorking Environment, Safety, and Health. Intotal, five privately owned companies, andone trade union owned company with morethan 20 employees were identified. Toincrease the homogeneity of the exposed pop-ulation and the comparability with the con-trols, the study was restricted to include onlymale house painters aged 20 to 65 employedby the five privately owned companies. All255 painters in this age group were invited toparticipate in the study. As controls we usedtwo industrial populations available from twoof our other studies.910 One group comprised109 male dairy workers (age 20 to 65)employed in a large privately owned dairy inthe county of Dalecarlia. The other controlgroup included 193 male packers (age 20 to65) employed at the paper pulp stores inthree private pulp industries in the twocounty regions. None of the controls wasoccupationally exposed to organic solvents orwater based paints. Also, workplace monitor-ing among the packers showed that the expo-sure to dust (02 mg/M3n) and volatile organiccompounds (0-5 mg/M3) was very low. I0

ASSESSMENT OF EXPOSUREWe collected information from the super-visors of the different companies duringApril 1989 about the use of different types ofpaint. Also, each painter was asked to esti-mate the average number of hours he workedwith water based and solvent based paint.

Monitoring of the workplace was per-formed on 12 painters from different compa-nies during normal workdays when onlywater based paints and no solvent basedpaints were used. We measured dust, metals,ammonia, formaldehyde, and volatile organiccompounds. The painters did normal work

tasks, such as painting, removal of old wallpaper, manual sanding of walls with abrasivepaper, manual filling, and sizing of wet roomwall papers. No spray filling work was doneduring the measurements. Six full days weremeasured during work in new buildingsunder construction and six full days duringwork in old buildings. Also, peak exposure toammonia, formaldehyde, and volatile organiccompounds were measured by short termsampling. All measurements of exposure werecarried out by personal sampling in thebreathing zone of the painter.The total dust concentration was measured

by gravimetric analysis of dust collected on28 mm cellulose acetate filters with a poresize of 0-8 um."1 The organic dust concentra-tion was measured as the weight differencebefore and after low temperature ashing ofthe total dust samples collected on the filters.The concentrations of metals in the dust weremeasured by a quantitative x ray fluorescencetechnique.The long term exposure to ammonia was

determined by diffusion sampling with adirect reading tube (Drager diffusion tubeammonia 20/a-D). The peak exposure toammonia was measured by direct readingdetector tubes (Drdger 2/a). Both types oftubes are based on a colour reaction betweenammonia and bromophenol blue. Besidesammonia other basic volatile compounds,such as amines, would also be detected, butwith different sensitivity.Long term exposure to formaldehyde was

measured by diffusion sampling, with chemo-sorption on 2,4-dinitrophenyl hydrazine (2,4-DNF) coated glass fibre filters. 12 Peakexposure to formaldehyde was measured withglass fibre filters impregnated with 2,4-DNF,with the air rate at 1 I/min for 15 minutes.'3The filters were analysed by liquid chromato-graphy.

Volatile organic compounds were sampledon charcoal sorbent tubes (SKC 226-01),with an air sampling rate of 50-250 ml/min.The charcoal tubes were desorbed with 1 mlof carbon disulphide before analysis, whichwas performed within two weeks of the sam-pling day on a gas chromatograph (HewletPackard 5880) equipped with a flame ionisa-tion detector and- packed columns. Sixteencommon solvents were identified and quanti-fied with the external standard technique, bycomparing the retention times on two differ-ent columns. When quantifying low boilinguncalibrated hydrocarbons (C3-C 12) theresponse factor of n-decane was used; highboiling unknown hydrocarbons (>C12) usedthe response factor of a mixture of high boil-ing hydrocarbons (dodecylbenzenes). Thetotal concentration of the identified andunidentified hydrocarbons in air was calcu-lated and expressed as mg/m.3To identify unknown compounds, and to

be able to detect a wider range of com-pounds, gas chromatography and mass spec-trometric analyses were also performed on airsamples drawn through sorbents other thancharcoal (Teenax, XAD-2 and XAD-7).

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Teenax was desorbed thermally and the othertypes of sorbents were desorbed by 2 ml ofmethylene chloride mixed with 5% ofmethanol.

ASSESSMENT OF THE EXPERIENCE OFDIFFERENT TYPES OF PAINTSTo evaluate how the painters experiencedwork with solvent based paints and waterbased paints they were asked to answer a setof questions on the general work environ-ment, degree of malodour, and some workrelated symptoms. Two self administeredquestionnaires were mailed to the subject'shome address in April 1989. One question-naire inquired about the painter's experiencesof working with different types of paints, theother about symptoms. The questions askedin the first questionnaire were: How do youconsider the work environment when workingwith water based paints or solvent basedpaints (two questions)? The answer alterna-tives were: very good, good, bad, and verybad. What is the degree of malodour from thewater based paints or solvent based paints(two questions)? Do you experience any air-way irritation when working with water basedpaints or solvent based paints (two ques-tions)? The alternative answers to these twoquestions were: none, slight, moderate,strong. Finally, there was an open endedquestion: Do you have any other symptomsor complaints that you consider to be due toyour work with water based paints or solventbased paints.

ASSESSMENT OF SYMPTOMSThe occurrences of mucous membrane anddermal symptoms in the exposed and unex-posed groups were recorded by a question-naire we used in a previous study regardingthe sick building syndrome.'4 The question-naire inquired about smoking habits, atopy(asthma, hay fever, or a history of eczema inchildhood), hyperreactivity, and sick leave. Italso contained questions with yes or noanswers on 12 questions on symptoms frommucous membranes, eyes, and skin.Furthermore, it included eight questions onwork related mucous membrane and dermalirritation. All questions covered the preva-lence during the previous two years. Noinformation on the severity of the symptomswas gathered.

Also, work stress and work satisfaction

Table 1 Selected demographic data for exposed house painters and two unexposed controlgroups

Painters Dairy workers Packers Two tailedCharactenstics % (n = 236) % (n = 102) % (n = 137) p valued

Current tobacco smokers 20 21 29 NSSubjects with signsof atopy* 19 16 18 NSNon-specific airwayhyperreactivityt 23 29 20 NSFrequent consumption of

medicine 8 12 13 NS

*Subjects with a history of asthma, hay fever, or eczema in childhood.tEasily irritated respiratory tract during exposure to non-specific irritants (tobacco smoke,exhaust gases, organic solvents).*Calculated by x2 test for 2 x 2 contingency tables.

were measured in both groups by analoguerating scales.'4

ASSESSMENT OF SELECTION EFFECTSInformation about workers who left the sixcompanies during the two year period preced-ing the study (1 January 1987 to 15 April1989) was collected from the administrationoffices of the companies by checking theirregisters. These included information onmigration to other regions, change ofemployer, retirement, work related diseasesapproved by the national social insurance ser-vice, other diseases, and deaths.

STATISTICAL METHODSDifferences in mean values of work stress andwork satisfaction were calculated by Student'st test. As most variables were not normallydistributed we used non-parametric tests.The Mann-Whitney U test was used to testdifferences in exposures when working in newv old buildings. Paired comparisons of theexperience of different types of paints weremade by Wilcoxon matched pairs signed ranktest. Differences in proportions were calcu-lated by the two tailed X2 test or when therewere small numbers, by Fisher's exact test for2 x 2 contingency tables. Geometric meansand geometric SDs, as proposed bySaltzman,'5 were used in calculating the aver-age exposure to different compounds. Thelevel of significance was set at 5% in all statis-tical analyses. For each symptom, an oddsratio (OR) with a 95% confidence interval(95% CI) was calculated. The Mantel-Haenszel procedure was used to calculate thetotal ORs and stratification was used to calcu-late ORs for multiple categories.

ResultsIn the exposed group, 236 of 255 painters(93%) answered the questionnaires. Theresponse rate among dairy workers was 94%(102 of 109) and among storage workers 71%(137 of 193). The mean age was 36 for thepainters and 37 in both control groups. Mostof the painters had a previous exposure ofmore than 10 years to solvent based paint, asthey had worked, on average, for 18 years ashouse painters. The prevalence of smokers,persons with atopy, and non-specific hyperre-activity, as well as regular use of medicinewas about the same in the exposed and thetwo control groups (table 1). The prevalenceof both general and work related symptomswas not significantly different between thetwo control groups. Therefore, the twogroups were combined in the analyses.The use of paint (ceiling paint, wall paint,

paints for window frames) per person, mea-sured in litres, was of the same magnitude inthe different companies.

For technical reasons only two measure-ments of volatile organic compounds per-formed in old buildings could be analysed.The hygiene measurements (table 2) showedthat the painters were exposed to low concen-trations of a complex mixture of various types

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Table 2 Average eight hour exposure (mg/r3) of 12 painters to dust, metals,formaldehyde, ammonia, and volatile organic compounds (VOC) in various brands ofwater based paints

Arithmetic Geometric Geometric Range SwedishType of exposure mean mean SD (min-max) PEL*

Total dust 4-1 2-5 2-9 0-4-14 10Organic dust 1-4 0-8 3-6 0-1-3-7 5Calcium 0-3 0-2 2-5 0-1-0-9 2tIron 0-02 0-02 2-1 0 004-0 05 3-5Titanium 0-01 0-01 3-3 <0-001-0-05 5tZinc 0-02 0-004 7-1 <0-001-0-08 5tLead 0-001 0-001 2-2 <0-001-0-003 0-1Cobalt 0-001 0-001 1-7 <0-001-0-003 0 05Formaldehyde 0 05 0-04 1.9 <0-03-0-1 0-6Ammonia 0 9 0-7 3-6 <0 4-3.9 18VOCt 2-1 1*6 2-1 07-49 -

*Current Swedish occupational permissible exposure limit (PEL) for eight hour time weightedaverage exposure.tPEL value for metal oxides.tVolatile organic compounds; measurements available from eight subjects.

Table 3 Paired comparison of different aspects on waterbased paints and solvent based paints, as judged by thehouse painters (n = 236)

Water based Both types Solvent basedpaint better equal paint better

Aspect (%) (%/) (%/0)Malodour 92 8 0 4***Airway irritation 56 41 3***General work

environment 49 50 1***

***p < 0001 by Wilcoxon matched pairs signed rank test

Table 4 The percentage ofpainters who reported urinary,gastrointestinal, and taste or olfactory disturbances inrelation to use of water based and solvent based paints(n = 236)

At work At workwith water with solventbased based

Type ofdisturbance paint (%o) paint (%)Frequent urination 4 0**Gastrointestinal problems 4 4Taste or olfactory disturbance 0-4 3*

*p < 0 05; **p < 0-01 both by Fisher's exact test.

Table 5 Symptom prevalence during previous two years, and ORs with 95% CIs inexposed house painters and non-exposed controls

Painters ControlsCharacteristics % (n = 236) % (n = 239) OR (95% CI)

Eye irritation 22 15 1-7 (1-03-2-7)Swollen eyelids 6 4 1-4 (0-6 -3-3)

Nasal catarrh 18 21 0-8 (0-5 -1-3)Blocked up nose 22 21 1-1 (0-7 -1-6)Dryness in the throat 11 14 0-8 (0 4- 1-3)Sore throat 7 8 0-8 (0-4- 1-7)Irritative cough 11 8 1-5 (0-8- 2-7)

Facial itch 8 6 1-3 (0-7- 2-7)Facial rash 9 7 1-3 (0-7- 2-5)Itching on the hands 17 10 1-9 (1-1- 3 3)Rashes on the hands 14 12 1-2 (0-7- 2-0)Eczema 12 11 1-1 (0-6- 1-9)

Table 6 Two year prevalence ofwork related symptoms(>once a week), and ORs with 95% CIs in exposed housepainters and non-exposed controls

Patients Controls

Characteristics (n=236) (n=239) OR (95% CI)Eye irritation 8 4 2-3 (1-03-5-1)Blocked up nose 11 12 0 9 (0-5- 1-5)Dryness in the throat 11 12 0-9 (0 5- 1-6)Sore throat 2 2 1-0 (0-3- 4-1)Irritative cough 5 5 1-0 (0 4- 2-4)Cough with sputum 7 5 1-5 (0-7- 3 3)Facial itch 2 4 0-4 (0-2- 1-4)Itching on the hands 4 3 1-3 (0 5- 3-3)

of volatile organic compounds, metals,formaldehyde, and ammonia. The averageexposure to organic and inorganic dust wasconsiderably lower than the present occupa-tional exposure limit values in Sweden,although the Swedish permissible exposure tototal dust was exceeded on a few occasions.The dust exposure emanated from work tasksother than painting, such as removal of oldwallpaper, manual filling and sanding ofwalls. A significantly higher exposure toorganic dust could be shown, in renovationwork in old buildings (2X1 mg/mi) than innew buildings, (0 7 mg/M3). There was anon-significant tendency (Mann-Whitney Utest) to a higher average exposure to ammo-nia during work days in new (14 mg/M3)compared with old buildings (0-4 mg/M3).The highest peak concentrations of ammonia(13 mg/M3) and formaldehyde (014 mg/M3)were measured when the painters used specialwet room paints in bathrooms in newly con-structed apartments.Some organic solvents typical of solvent

based paints, such as iso-butanole, toluene,xylene, trimethyl benzene, n-nonane, n-decane, and n-undecane are also emittedfrom water based paints, but in concentra-tions less than 1% of those from solventbased paints. Also, water based paints werefound to emit different polar compounds,such as glycols and glycol ethers. Detailedresults on the exposure to various types ofvolatile organic compounds during work withdifferent types of water based paints will bepublished separately.The painters judged the general work envi-

ronment to be better when they used waterbased paints compared with solvent basedpaints (table 3). They also reported less mal-odour and airway irritation when they paintedwith water based paints (table 3). In the openended questions most workers complained ofergonomic problems regardless of type ofpaint used. Concerning problems related tochemical exposure, the painters complainedabout taste or olfactory disturbances, gastro-intestinal disorders, and urination problems(table 4). They noticed less taste or olfactorydisturbances when working with water basedpaints. They needed to urinate more oftenwhen they used water based paints whereasthe complaints of gastrointestinal disorderswere of the same magnitude regardless oftype of exposure. The differences were all sta-tistically significant.

Nine out of the 12 different symptomswere more common during the previous twoyears among the painters than the controls(table 5). Eye irritation (OR = 1.7) and itch-ing on the hands (OR = 1 9) had the highestprevalence. Nasal catarrh, dryness in thethroat, and sore throat were less commonamong the painters than the controls.The work related symptoms eye irritation

(OR = 2-3), cough with sputum (OR = 1X5),and itchy hands (OR = 1-3), were all morecommon (more than once a week) amongpainters than controls (table 6). For workrelated itching of the hands the OR was

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Table 7 Odds ratios correlated with average number of hours working with solvent basedpaints among 52 painters with and 182 painters without eye irritation

Eye irritation

Work hours with solvent based paint With Without OR (95% CI)

<1 hour/week 17 87 1 0-1-5 hours/week 24 73 1-7 (0 8-3-4)6-20 hours/week 5 16 1-6 (0-5-49)>20 hours/week 6 6 5-1 (1 6-16-3)Mantel-Haenszel estimate 52 182* 2-0 (1-2-3-4)

*Incomplete answer from two painters.

increased to 3-6 (95% CI 2 0-6 2) if definedas more than once a month.To investigate the finding of work related

eye and skin symptoms further, a dose-response analysis was performed. The average

number of work hours with water based andsolvent based paint was used as the exposurevariable. These analyses showed that eye irri-tation was related to the number of hours thepainter worked with solvent based paints(table 7). No dose-response relation withinthe exposed group of painters could be foundfor water based paints and eye irritation, or

work related skin irritation.The painters reported a higher degree of

work satisfaction and more work stress thanthe controls. These differences were signifi-cant (Student's t test).

During the two year period (1987-88) pre-ceding the study, 75 patients had left theiremployment. Most of them (60) left becauseof regional migration or change of employerin the same region. Five painters had retiredand two had died. Eight painters had leftbecause of what they judged to be workrelated problems, although the diseases werenot approved by the National SocialInsurance Service. The disorders were fourcases of neck and shoulder problems, twocases of eczema, and two cases of asthma.

DiscussionThis study showed that the change from sol-vent based paints to water based paints hasimproved the work environment for housepainters. They are less exposed to solventsand have fewer complaints. Some irritativesymptoms still exist and need further evalua-tion. Exposure measurements show generallylow concentrations of solvents in the air.Total dust exposures can be temporarily highand peaks of formaldehyde and ammonia stilloccur at an unacceptable frequency. Forexample, poor ventilation during bathroompainting might cause acute irritative symp-toms and malodour due to ammonia andformaldehyde exposure.A cross sectional study design may have

certain drawbacks due to the selectionprocesses, work organisation, and the numberof available employees, thus limiting thevalidity of the study. The most obvious draw-back is a possible underestimation of a trueeffect because people with pronounced symp-toms or effects have left their jobs, (a healthbased selection of workers). To estimate sucheffects we gathered information on thosepainters who left the five companies during

the two years preceding the study. A few ofthe painters had left because of possible workrelated diseases such as neck and shoulderproblems, eczema, or asthma. Most paintersleft their employment because of reasonsother than health.

Selection bias can occur both from incor-rect study design and a low response rate. Inthis study both the exposed painters and oneof the control groups (dairy workers) partici-pated to a high degree and the loss of individ-uals was small, 7% and 6%. In the othercontrol group (storage workers) the non-participation rate was higher (29%), and thusa selection bias could occur. As the preva-lence of symptoms was similar in the twonon-exposed groups, it is not likely that suchselection bias had any major influence on theresults of this study. To minimise regionaldifferences between exposed and controlgroups we chose two different control groupswithin the two county region. This alsoallowed us to get an acceptable number ofcontrols to include in the study.

Response bias due to awareness of expo-sure may influence the result and may cause asystematic bias in the reporting of symptomsin the exposed group. In our study the preva-lence of most symptoms did not differ signifi-cantly between exposed and unexposedworkers. The only significant differences werein eye irritation and skin itching. Work satis-faction as well as work stress could influencehow a worker responds to questions aboutwork related symptoms. Work stress mightincrease the possibility of over reporting,whereas work satisfaction could lead to anunder reporting of symptoms. The paintersreported a higher degree of work satisfactionand a higher degree of work stress than thecontrols and this might balance the possibilityof over or under-reporting of symptoms.Thus we do not think that the result of our

study is biased by selection or response. Thecross sectional design of the study could,however, underestimate the true effect of theexposure, particularly for eczema and asthma.The painters' attitude toward water based

paints was generally positive, and mostpainters considered water based paints tocause less airway irritation and less malodourthan the earlier solvent based paints. Thereports of the painters correspond to thehygiene measurements during work withwater based paints. The eight hour exposureto total volatile organic solvents was very low(0 7-4-9 Mg/M3).

Besides exposure to volatile organic sol-vents the painters were exposed to ammonia,formaldehyde, metals, organic, and inorganicdust. The time weighted average exposures toammonia, formaldehyde, and measured met-als were less than 10% of the Swedish per-missible exposure limits (PELs). The totaldust, however, was higher and sometimesexceeded the Swedish PEL of 10 mg/M3.Hansen et al made a toxicological evaluationof common Danish water based paints.5 Theyrecommended that substances like formalde-hyde and turpentine should be avoided

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because of risks of irritation or skin allergy. Inour study we found that during paint work inbathrooms where the general ventilation waspoor and special wet room paint was usedsome painters complained about malodour.Such situations were associated with the high-est concentrations of formaldehyde andammonia.Our finding of a perceived increased fre-

quency of urination while working with waterbased paints is in accordance with the reportof Ulfvarson et al.7 They found an increase inurine excretion and a decrease in urine den-sity among workers who were experimentallyexposed to different water based paints. Theauthors suggested that exposure to benziso-thiazolinone was the cause of these effects.The exposed painters had significantly

more work related eye irritation. The eye irri-tation was most common in a subgroup ofpainters partly working with solvent basedpaints and clearly related to the number ofhours the painters worked with these paints.We have not found any other human studythat reports on the effect of water basedpaints on the skin or eyes. In one experimen-tal animal study, however, the sensory irrita-tion of the trigeminal nerve was studied fordifferent types of Danish building materials.'6In that study a significant irritative effect wasfound for an acid cured paint, but not for thetested latex type of water based paints. Eyeirritation because of exposure to organic sol-vents has been reported and verified by mea-surements of tear film stability.'7 In anexposure chamber study even a moderateexposure to n-decane (58 mg/M3 over sixhours) resulted in a decreased tear film stabil-ity. An important solvent in solvent basedpaint is white spirit, which contains n-decaneas a major component. Therefore, it seemsmore likely to interpret the findings of eyeirritation as due to exposure to organic sol-vents than to water based paints.The painters also reported more problems

with itching hands than did the controls. Skinirritation could be caused by the irritativeeffects of the sanding dust or when puttyingand gluing glass fibre fabric.The water basedpaints, however, also comprise many addi-tives with known irritative and allergic prop-erties. To evaluate this about 200 paintershave undergone a skin test with 46 differentsubstances including components in waterbased paints.The preliminary results indicatea high prevalence of allergic reactions topreservatives, especially benzisothiazolinone.'8

In conclusion our study indicates that theintroduction of water based paints hasimproved the work environment for housepainters. The actual brands of water basedpaints cause less malodour and airway irrita-tion than the earlier solvent based paints.The

general adverse health effects seem low. Afew painters may, however, have dermalsymptoms caused by some components inwater based paints. From a practical point ofview we suggest the use of airway protectiondevices when painting with wet room paintsin confined spaces.We acknowledge the help of Ingegerd Michel and StaffanBohlin. This study was supported by a grant from the SwedishWork Environment Fund.

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2 Chapman E. Observations on the effect of paint on thekidneys with particular reference to the role of turpen-tine. Journal of Industrial Hygiene and Toxicology 1941;23:277-89.

3 International Agency for Research on Cancer. Monographson the evaluation of carcinogenic risks to humans. Vol 47.Some organic solvents, resin monomers and related com-pounds, pigments and occupational exposures in paintmanufacture and painting. Lyon:IARC; 1989:329-85.

4 World Health Organisation/Nordic Council MinistersWorking Group. Chronic effects of organic solvents on thecentral nervous system and diagnostic criteria.Copenhagen:WHO, 1985.

5 Hansen MK, Larsen M, Cohr KH. Waterborne paints: areview of their chemistry and toxicology and the resultsof determinations during their use. Scand J WorkEnviron Health 1987;13:473-85.

6 Van Faassen A, Borm PJA. Composition and health haz-ards of water-based construction paints: results from asurvey in the Netherlands. Environ Health Perspect 1991;92:147-54.

7 Ulfvarson U, Alexanderson R, Dahlqvist M, Ekholm U,Bergstrom B, Scullman J. Temporary effects from expo-sure to water-borne paints. Scand J Work EnvironHealth 1992;18:376-87.

8 Askergren A, Beving H, Hagman M, Kristensson J.,Lnroth K, Vesterberg 0, Wennberg A. Biologicaleffects of exposure to water-thinned and solvent-thinnedpaints in house painters. Arbete och Halsa 1988;4:1-64(in Swedish with English summary).

9 Norback D, Rand G, Michel I, Amcoff S. The prevalenceof symptoms associated with sick buildings and pollutedindustrial environments as compared to unexposed ref-erence groups without expressed dissatisfaction.Environment International 1989;15:85-94.

10 Michel I, Edling C, Lundin A, Hedenstrom H,StAlenheimS, Ekblad B. Pyrolysis products from poly-ethene-exposure levels and health effects. In: proceed-ings of 39th Nordic Meeting of Work Environment.Aulanko, Finland: Finnish Institute for Work Hygiene,1990:19-20 (in Swedish).

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