Take-home toxins – Safety+Health Magazine

When workers’ jobs expose them to hazardous substances, safety awareness can’t end when the shift does. Workplace toxins “very well may be riding with you on the car ride home,” cautions James Couch, chief of NIOSH’s Hazard Evaluation and Technical Assistance program.

That’s because toxins can accumulate on a worker’s skin, hair, clothing and shoes, lunchbox, phone, and watch during a shift. Then, after the workday ends, they may spread to the family vehicle and home. This can put others at risk of exposure to these “take-home toxins.”

Lead and other heavy metals, asbestos, pesticides, and crystalline silica are only a few examples.

“My father was a coal miner,” Couch said. “I can’t tell you how many times he brought coal dust home with him.”

Diana Ceballos is an assistant professor at the University of Washington and previously worked for NIOSH. She’s studied exposures to take-home toxins and says they’re a public health issue.

“Worker health has been traditionally siloed,” Ceballos said. “When we think about public health, we can’t just think about the individual. And it’s not just the worker and their family being affected, but whole communities.”

The issue affects workers – and by extension their families – in numerous industries, from construction, manufacturing and agriculture to health care, firefighting and more.

Prolonged and repeated exposures can lead to various cancers; reproductive health issues; and damage to the brain, nervous system, blood and kidneys.

A longtime problem

Researchers, including Ceballos and those at NIOSH, have tracked health concerns stemming from exposure to take-home toxins since the 1970s.

“It feels like we’ve been dealing with take-home exposures since the beginning of civilization,” Couch said. “It’s bringing home a number of different toxins, and each one of those toxins has associated adverse health effects.”

Lead is one of the more well-known take-home toxins.

“When you’re talking about take-home exposures,” Couch said, “your average health and safety person immediately thinks of lead – and with good reason.”

In the construction industry, exposure to lead and asbestos is common.

OSHA’s standard on toxic and hazardous substances for general industry (1910 Subpart Z) includes asbestos (1910.1001), while its 1926.62 standard is focused on lead in construction.

“When it’s known – let’s say with lead and asbestos – you can properly plan,” said Kevin Cannon, director of safety and health services at Associated General Contractors of America. “It’s not much of a concern for new construction; it’s more your repairs and renovations of older structures.”

Toxins aren’t only an issue for big industries, however.

“They can occur in large and small workplaces,” Couch noted, “and even home-based businesses, the cottage industries.”

Emerging issues

Although lead and asbestos have been long-standing concerns, NIOSH has identified other toxins and workplace settings with potential for take-home exposures.

In health care, for instance, many chemotherapy drugs are metal-based and “migrating out of the workplace,” Couch said.

Similarly, firefighters often use flame retardants. Results of a 2023 National Institutes of Health study show that these retardants expose users to per- and polyfluoroalkyl substances, or PFAS – commonly referred to as “forever chemicals” because they break down slowly over time.

Another concern is persistent organic pollutants, introduced after World War II. Known as POPs, they’re synthetic chemicals introduced in industrial production, crop production and pest/disease control. They can accumulate in water and soil, the Environmental Protection Agency says, and be dispersed by wind and waterways.

“For a lot of us safety and health folks, that traditional model of take-home exposures is changing,” Couch said.

With PFAS, for instance, Couch maintains that it’s difficult to determine the difference between exposures at work and at home.

Talking about health

All exposures to work-related toxins – whether they happen on the job or at home – should be discussed with health care providers.

“Make sure you’re telling your health care provider about the environment you work in and the hazards you work with,” Couch said. “Have everybody in the household tell their primary health care provider the same information.”

Pediatricians can use the information to track child development, along with any potential hearing and speech issues.

For adults, exposures can affect reproductive health and, in some instances, have been linked to miscarriage, premature birth and infertility, the Centers for Disease Control and Prevention says.

“It’s going to be an issue not just for the young child, but for the mother and the worker’s reproductive organs,” Ceballos said.

Workplace policies specific to preventing take-home exposures can help protect workers and their families. “Workers can follow procedures that are in place,” Ceballos said. “If they’re not in place, create some alternative options for them to try to protect their families.”

Best practices

Couch offers basic advice for workers and safety professionals: “Prevention is the key for all of these things. I tell folks to focus on prevention. If you keep that contamination from happening, then you don’t have to worry about cleaning it up.”

Risk assessments in construction, Cannon said, can help in “educating and training crews on how to properly assess whether there’s a likelihood of lead and asbestos.”

This step can lead to laying out the proper procedures and processes for when toxins are encountered.

Experts and federal agencies also advise workers to:

• Shower at work, if possible, or at home immediately after a shift.
• Store food and beverages in disposable containers.
• Regularly wash hands, especially before eating, drinking or touching their face.
• Change out of work clothes and shoes before going home.
• Put all work clothes in a plastic bag and wash them separately.
• Carry wipes to clean off electronic devices and personal items.
• Leave tools, scrap and packaging at work.
• Clean vehicles and homes often, using wet cleaning methods for hard floors and furniture.

In addition, a number of resources and tools are available for safety pros.

The NIOSH Health Hazard Evaluation is a free service that evaluates U.S. workplaces for health hazards. A search of “take home” on the website yields reports from dozens of evaluations in a variety of industries.

OSHA and NIOSH offer lead-related resources. Ceballos, during her work at Boston University, published a prevention manual for construction workers with a take-home prevention worksheet and planning template.

For safety pros, “education is the most fundamental thing you can do, regardless of what industry you’re in,” Couch said, stressing that multilingual, industry-specific resources are vital.

“Giving the worker tangible examples for their workplace really hits home to them,” he said. “It’s easy to lose the audience. Very targeted, customized educational trainings go a long way in preventing take-home exposures.”