What Instructions Should Be Given to Patients Exposed to PCBs?

Learning Objective

Upon completion of this section, you will be able to

  • Describe appropriate instructions for patients exposed to PCBs.
Introduction

All patients exposed to PCBs need basic guidance on

  • Self care, so they can minimize further risks and avoid complications to the extent possible, and
  • Clinical follow-up, so they understand when and why to return for further medical attention.

ATSDR has developed a patient education sheet on PCBs that you might find useful. It can be found at https://www.atsdr.cdc.gov/csem/pcb/docs/pcb_patient_education.pdf [PDF – 93KB]

Self Care Guidance for Patients

Patients should be advised to avoid exposures and conditions that might further increase their risk of disease or worsen their existing condition.

At Work

  • Eliminate PCBs from the workplace, or implement engineering changes to isolate the PCBs. If neither of these approaches is feasible, use special PCB-resistant gloves and protective clothing.
  • Maintain adequate ventilation during spill cleanup or maintenance of vessels containing PCBs. If this is not possible, provide approved respirators.
  • Make provisions for proper decontamination or disposal of contaminated clothing or equipment.
  • Dispose of existing PCBs through appropriate toxic waste facilities.
  • Conduct environmental sampling as necessary to ensure adequate worker protection or safety for public reentry to contaminated areas.
  • Establish reentry or cleanup levels for dioxins and PCBs to protect workers who reoccupy buildings after a PCB fire.
  • Report persistent health effects (e.g., unexplained weight loss, muscle pain, frequent coughing, and sleep problems). These symptoms may be due to stress or recall bias and may not be specifically linked to the toxic effects of PCBs.

At Home

  • Open all windows and use fans in your workspace when conducting maintenance or repairing any products containing PCBs.
  • If ventilation is poor, wear a respirator and protective gloves.
  • Seek medical attention immediately if an acute exposure occurs.
  • Lower exposure to PCBs by looking for and following health advisories issued by states, Native American tribes, or U.S. territories when eating fish or wildlife caught from locations contaminated with PCBs.
Clinical Follow- up Guidance for Patients

PCBs have been implicated as a potential cause of cancer in humans. Screening tests are available for breast cancer and melanoma. If patients believe that they are being exposed to PCBs, advise them how to stop the exposure. Also tell them how to contact worksite or environmental regulatory agencies that will assess exposure risks and prescribe protective actions.

Advise patients with suspected or confirmed historic exposure to PCBs to be seen by you or their primary care provider periodically and monitored for signs of disease and changes in health status.

Advise patients to consult their physicians if they develop signs or symptoms of PCB exposure such as

  • Appetite loss,
  • Joint pain,
  • Nausea,
  • Skin disorders, changes, or discoloration,
  • Breast changes or lumps, and/or
  • Stomach distress and pain.

ATSDR’s patient education sheet on PCBs includes a more detailed checklist that you can use to indicate which types of follow up are relevant for a given patient.

Key Points
  • Advise patients to avoid PCB exposures and conditions that might further increase their risk of disease or worsen their existing condition.
  • Advise patients to contact their physicians if they develop skin problems or other health changes.