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Work in confined spaces continues to present hazards to workers. The magnitude of this problem was recently addressed by the Occupational Safety and Health Administration in its Final Rule for "Permit-Required Control Spaces for General Industry" (29 CFR Parts 1910). Although illness and injury are typically due to asphyxiation, explosion, and drowning, toxic exposures also are an important risk. We describe herein four workers engaged in erosion-proofing enclosed chemical tanks with minimal ventilation and no respiratory protection. They were exposed to styrene-based solvents, styrene-based resins, silica, and fiberglass dust. Each experienced acute neurological effects and bronchitis. One worker developed a life-threatening pneumonia that resulted in numerous complications. The severity of the illness, which would likely not have otherwise occurred, resulted from impaired lung defense mechanisms due to the combined exposures. Several studies support the association of styrene exposure and respiratory illness that may be compounded by co-exposure to fiberglass in unique circumstances. To prevent the hazards of confined space, recommended procedures should be followed, including those established by the National Institute for Occupational Safety and Health and the Occupational Safety and Health Administration.
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