Researchers say they found an “unacceptable” number of deaths from paint stripper chemicals in a recent study, despite the known dangers of the chemical, methylene chloride. Most of the victims died while working, mostly in paint stripping and bathtub refinishing.

“It is unacceptable that these workers died simply because they were doing their job,” said the lead author of the study, Annie Hoang, a UC San Francisco medical student and research fellow. “I hope the EPA will do its job to protect our workers and save lives.” The chemical’s dangers have been known since the 1800s, when it was sometimes used as an anesthetic.

The Environmental Protection Agency counted 53 fatalities connected to the chemical from 1980 to 2018. The new study, conducted by the Occupational Safety and Health Administration (OSHA) and UC San Francisco, identified 85 deaths over the same period, 87% of them in occupational settings. The study was published April 19, 2021, in JAMA Internal Medicine

The study is the first comprehensive review of fatalities linked to the deadly chemical in the United States and identified more deaths than previously reported. 

The researchers believe that methylene chloride fatalities are undercounted in the United States due to fragmented public health reporting. To identify deaths from the chemical, the researchers undertook a massive search of different sources, including published scientific papers and government databases, compiling information that included medical records and autopsy findings, where available.

Their analysis found an increase since 2000 in occupational fatalities related to both paint stripping and to bathroom construction, due to stripping bathtubs.

Workers still at risk

California Department of Health

In early 2017, EPA proposed a rule banning almost all methylene chloride strippers in both the workplace and for consumer use. But in 2019 under new leadership, EPA limited the ban to consumer products while still allowing commercial use to continue unchecked. 

“Based on our findings, workers are still at risk from methylene chloride products,” said Kathleen Fagan, MD, MPH, former Medical Officer in the Office of Occupational Medicine and Nursing at OSHA and one of the study’s researchers. “Health care providers have a critical role to play in preventing deaths by counseling at-risk patients on risk reduction and providing resources on safer alternatives to methylene chloride.”

“Safer alternatives to methylene chloride are available and in widespread use,” said senior author Veena Singla, PhD, a senior scientist at the Natural Resources Defense Council. Previously, she was director of science and policy with UCSF’s Program on Reproductive Health and the Environment. 

“The science is clear,” Singla said. “It is past time to eliminate this deadly chemical and prevent any further tragic loss of life.” 

More than 200 million pounds

Far from being phased out, methylene chloride is still in wise use, with an estimated 200 million pounds produced each year. It was used as an anesthetic in the 1800s but was abandoned because of the thin line separating unconsciousness from death.

Poisonings of U.S. workers began being reported in 1936 and have been increasing in recent years, even as the chemical’s dangers have been more widely recognized.

In 1976, physicians reported the death of a man who had been hospitalized twice after using the chemical as a paint stripper on two separate occasions. Neither the man nor his physicians knew of the chemical’s dangers. When the patient used the paint stripper a third time, he suffered a fatal heart attack. Since then, physicians have been urged to inform their patients of the dangers of methylene chloride.

More recently, Drew Wynne died in 2017 after using a paint stripper containing methylene chloride that he bought at a local hardware store, according to a CBS News report. His family campaigned to have the products pulled from retailers’ shelves and the EPA banned its sale to consumers in 2019 but it is still being used by workers in industrial and commercial settings.

OSHA described a typical fatality in a 2016 newsletter:

A temporary worker died while removing the coating from a bathtub in a residential building. The worker was alone in a small bathroom where he poured paint remover containing 85-90% methylene chloride into the bathtub and began scraping. The only ventilation was a partially open window. Two hours later, the apartment resident found the worker unconscious and slumped over the bathtub. The resident pulled the worker away from the bathtub and called an ambulance. The worker was taken to the hospital, where attempts to resuscitate him were unsuccessful. The coroner determined that asphyxiation, combined with acute methylene chloride toxicity, caused the worker’s death.

OSHA Fatal Facts, No. 13-2016

OSHA said that in the case of the worker, who was 30, the employer had previously taken the worker to the hospital after a similar incident. “The employer, though knowledgeable about the chemical’s hazards, did not institute and enforce safe work practices, or adhere to OSHA’s methylene chloride standard requirements,” according to OSHA.

One of the less apparent dangers of methylene chloride is that its vapors are heavier than air. Therefore, the vapors can linger in the bottom of a bathtub, exposing workers to the fumes for a longer period.

“The extreme hazards of using products with this chemical in bathtub refinishing need to be clearly communicated to employers, workers and the general public,” said Kenneth Rosenman, chief of Michigan State University’s Division of Occupational and Environmental Medicine, in a 2012 study. “Safer methods using alternative products should be recommended.”

The Michigan researchers also noted that the number of deaths attributed to the chemical is likely an underestimate because national databases do not include self-employed workers or consumers and additional deaths among bathtub refinishers might have been ascribed to heart disease when they were actually caused by methylene chloride.

Methylene chloride is among a number of toxins inked to autism in a 2014 study. Researchers at the University of Pittsburgh said the analysis was “an addition to the small but growing body of research that considers air toxics as one of the risk factors for ASD.”