Excessive levels of formaldehyde exposure to thousands of displaced persons, living in temporary housing units following Hurricane Katrina

James P. Kornberg, MD, Sc.D and Stephen King, Ph.D, MPH Following the massive destruction caused by Hurricane Katrina that struck the Gulf Coast of the United States on August 28 and 29, 2005 and the subsequent additional damage caused by Hurricane Rita on September 24, local, state and federal governments faced the challenging task of assisting the hundreds of thousands of displaced persons (DPs) by providing them with food, clothing and shelter. In addition to distributing other aid, the housing effort was led by the United States Federal Emergency Management Agency (FEMA) that provided, through subcontractors, temporary housing units (THUs) purchased from several different trailer manufacturers. Most of these trailers were RVs (recreational vehicles) on wheels and were not designed for housing DPs for more than a few weeks. Many DPs, however, occupied the THUs for 1-2 years or longer. During occupancy, moreover, many DPs complained of various medical symptoms, including aggravation of asthma, eczema, constitutional symptoms, and irritation of the eyes and throat. The sources of many of these problems were traced to the presence of formaldehyde that emanated from fiberboard and luan plywood used for trailer flooring and cabinetry. Some individuals were probably exposed for many months to levels or formaldehyde exceeding 0.100 ppm or 100 ppb with excursions up to 500 ppb. The scientific literature clearly demonstrates that formaldehyde is capable of causing the symptoms reported above at the levels both measured and predicted in the THUs. These levels also exceed those for residential indoor air recommended by several US and international authorities. For example, NIOSH (National Institute of Occupational Safety and Health - part of the US CDC or Center for Disease Control) REL (Recommended Exposure Level - an occupational level) is 16 ppb as a time weighted average. The US ATSDR (Agency for Toxic Substances and Disease Registry - a branch of US Health and Human Services) has set an MRL (Minimum Risk Level) of 8 ppb for exposure in excess of 365 days. Formaldehyde is also known to be a human carcinogen (IARC Class 1). Exposure has been related to several cancers, but especially cancer of the nasopharynx. The EPA has established a Risk Based Concentration (RBC) of 0.19 g/m3 or 0.155 ppb for airborne exposure to formaldehyde that is associated with one in a million (E-6)

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increased risk for developing cancer. Such increased risk can occur if an adult sustains resident airborne exposure to the RBC for 30 years (hence, the sustained dose is 4.65 ppb-years). It is probable that many DPs who were exposed to the previously mentioned residential levels of formaldehyde and who lived in their THUs for only a year or two sustained overall doses (exposure x time) well in excess of 4.65 ppb-years and, therefore, incurred significant increased risk of developing formaldehyde-related cancer. Our sad experience here in the US should be a lesson to Israel and other countries who often extend the humanitarian gesture of providing temporary housing to displaced persons following a disaster, or, for that matter, electively in non-emergency situations. These THUs should be tested for formaldehyde levels before utilizing them for human inhabitation.