Changes in the CDC/ATSDR Formaldehyde in Laminate Flooring Report

On February 10, 2016, CDC/ATSDR released a report entitled Possible Health Implications from Exposure to Formaldehyde Emitted from Laminate Flooring Samples Tested by the Consumer Product Safety Commission. On February 12, CDC/ATSDR was notified that a private individual who reviewed the report suspected that a conversion error might have been made. CDC/ATSDR staff reviewed the report and discovered that an incorrect value for ceiling height was used in the indoor air model.  As a result, the health risks were calculated using airborne concentration estimates about 3 times lower than they should have been. Neither CDC/ATSDR nor the report’s peer or partner reviewers or reviewers noticed the error.

Change in conclusion for short-term health effects

After correcting the measurement error in the model, CDC/ATSDR revised the report’s conclusion about possible health effects from exposure to formaldehyde. In the report that used an incorrect value for ceiling height, we concluded that exposure to the low end of the modeled levels of formaldehyde in the CPSC-tested laminate flooring could cause increased irritation and breathing problems for children, older adults, and people with asthma and Chronic Obstructive Pulmonary Disease (COPD). In the updated report, which used the correct value for ceiling height, we concluded that irritation and breathing problems could occur in everyone exposed to formaldehyde in the laminate flooring, not just sensitive groups and people with pre-existing health conditions.

Change in conclusion for long-term health effects

We also increased the estimated lifetime cancer risk from breathing the highest levels of formaldehyde from the affected flooring all day, every day for 2 years. The lifetime cancer risk increased from the previous estimate of 2 to 9 extra cases for every 100,000 people to between 6 and 30 extra cases per 100,000 people. To put these numbers into perspective, the American Cancer Society estimates that up to 50,000 of every 100,000 people may develop cancer from all causes over their lifetimes.

Our recommendations remain the same.
Although the conclusions in the report have been revised, CDC/ATSDR recommendations to protect health have not; we continue to recommend that people with the affected laminate flooring:

• Reduce exposure –  We provide information on how residents can reduce exposure to sources of formaldehyde in their homes
• See a doctor for ongoing health symptoms – We recommend that residents who have followed the steps to reduce formaldehyde in their homes and still have ongoing health symptoms (breathing problems or irritation of the eyes, nose, or throat) only in their homes, should see a doctor to find out what is causing the symptoms.
• Consider professional air testing if irritation continues.

To ensure the accuracy of the revised report, CDC/ATSDR spent five weeks taking these steps:

• Updating  the model parameters and re-running the indoor air model
• Double-checking the model against other air models
• Conducting a quality review of the revised results
• Re-evaluating the possible health implications
• Requesting peer review of the revised report by outside experts and experts from CPSC, the U.S. Environmental Protection Agency (EPA), and the U.S. Department of Housing and Urban Development (HUD)
• Addressing these peer reviewers’ comments
• Revising communication materials to ensure affected people understand the new results.

For more details on the laminate flooring testing report, visit http://www.cdc.gov/nceh/laminateflooring/default.html.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES