MMWR: CDC Examines Antimony Toxicity Outbreak in Firefighters

According to CDC, an estimated 1.1 million U.S. firefighters wear garments containing antimony oxides, which are used as flame retardants in fabric.

The CDC analysis was prompted when a fire chief reported an antimony toxicity outbreak in a Florida fire department in October 2008. A firefighter at the department, who had been experiencing neurological symptoms, underwent a hair test that indicated an elevated antimony level. Following this test, all 199 firefighters at the department underwent hair sample testing for heavy metals; 29 reportedly had elevated antimony levels. The testing resulted in 44 workers’ compensation claims at the department from Sept. 17 to Nov. 11, 2008. Additional claims followed later.

The local firefighters union suspected the firefighters’ antimony-containing uniform pants caused the exposure. As a result of the test, the fire department advised using 100-percent cotton pants instead of the antimony-containing pants.

Urine Tests Yield Different Results
CDC initiated a health hazard evaluation to investigate the issue. CDC analyzed urine samples and questioned 20 of the firefighters at the department who did not wear pants with fabric containing antimony, as well as 42 firefighters at another Florida fire department who did wear antimony-containing pants for a mean of 92 hours during the preceding 2 weeks.

One hundred percent of the 20 firefighters at the first department and 98 percent of the 45 firefighters at the other department exhibited “urine antimony concentrations below or within the laboratory reference range.”

“CDC concluded that wearing pants made from antimony-containing fabric was not associated with elevated levels of urinary antimony,” MMWR stated.

By October 2009, 77 of the department’s workers’ compensation claims related to antimony either were withdrawn by the firefighters or dropped by the city.

“Only validated methods (e.g., urine testing) should be used for the determination of antimony toxicity,” the report stated. “Accurate and timely risk communication during suspected workplace exposures should underscore the importance of using validated tests, thereby refuting an unproven hypothesis, allaying unsubstantiated concerns, and enhancing public trust.”

According to CDC, antimony oxides have been used in fabrics for decades, but there have been no published studies examining the effects of dermal exposure. Fire departments across the nation continue using uniforms that contain antimony.