title: Health effects associated with faulty application of spray polyurethane foam in residential homes.
abstract: BACKGROUND
  Spray polyurethane foam (SPF) has become a popular form of home insulation in the United States, but there have been adverse health effects reported by home owners.
  
  
  METHODS
  We summarized adverse health effects in 13 adults from 10 households (age: 33-82) whose homes were improperly retrofitted with SPF. Subjects either were not asked to leave the premise or were told to return too early. In some cases, proper ventilation was not used or the foams were sprayed using the improper mixing technique. We correlated symptoms with volatile organic compounds (VOCs) in indoor air samples.
  
  
  RESULTS
  All subjects reported fishy odors and developed acute watery and burning eyes, burning nose, sinus congestion, throat irritation, cough, dyspnea and chest tightness. Twelve subjects (92.3%) reported acute neuropsychiatric symptoms, including headache, dizziness, forgetfulness, difficulty in concentrating and insomnia. Three subjects (23.0%) had nausea, vomiting and abdominal cramps and three (23.0%) developed skin rash. Subjects continued to experience symptoms long after SPF was done. These symptoms subsided after they left homes, but recurred upon returning. All subjects eventually vacated their homes. The methacholine challenge test was negative in 5 of 7 patients. Analysis of indoor air and headspace gas from the foams showed increased concentrations of VOCs derived from SPF and common indoor air pollutants. The levels of VOCs decreased after SPF was completely removed.
  
  
  CONCLUSIONS
  Faulty application of SPF was associated with acute and persistent pulmonary and extra-pulmonary symptoms. These symptoms may be associated with SPF-derived compounds as well as increased concentrations of indoor VOCs.
authors.affiliation: Department of Medicine, Duke University Medical Center, 1821 Hillandale Road, Suite 25A, Durham, NC 27705, USA. Electronic address: huang002@mc.duke.edu.
authors.forename: Yuh-Chin T
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Wayne
authors.initials: W
authors.lastname: Tsuang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016902:Air Pollution, Indoor; D004781:Environmental Exposure; D006798:Housing; D006801:Humans; D008875:Middle Aged; D011140:Polyurethanes / Q000009:adverse effects; D055549:Volatile Organic Compounds / Q000633:toxicity*
chemical_list: D011140:Polyurethanes; D055549:Volatile Organic Compounds
keywords: Building related illness; Indoor air; Isocyanates; Reactive airway disease; Volatile organic compounds