UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
WASHINGTON, DC 20460

OFFICE OF CHEMICAL SAFETY AND
POLLUTION PREVENTION





s

I—^

MEMORANDUM

DATE:

March 23, 2018

SUBJECT: Science Review of the AEATF II Determination of Removal Efficiency of 1,2-
Benzisothiazol-3(2H)-one (BIT) from Hand Surfaces Using an Isopropyl Alcohol/Water Wipe and
Wash Procedure (AEATF II Study Number: AEA08; MRID 50521601).

FROM: Tim Leighton, Senior Scientist

Risk Assessment and Science Support Branch (RASSB)
OPP/Antimicrobials Division (7510P)

Jonathan Cohen, Ph.D.

Statistician

ICF (EPA Contractor)

Thru: Timothy Dole, CIH TXvnftAj/ C-

Risk Assessment and Science Support Branch (RASSB)
OPP/Antimicrobials Division (7510P)

TO:	Laura Parsons, Acting Branch Chief

Risk Assessment and Science Support Branch (RASSB)
OPP/Antimicrobials Division (7510P)

This memorandum presents the EPA/OPP Antimicrobials Division (AD) science review of the human
exposure hand wash removal efficiency study submitted by the Antimicrobial Exposure Assessment
Task Force II (AEATF II). The removal efficiency data as represented in this review are acceptable
and are recommended for use to correct/adjust the hand residue data collected in the AEATF II
brush/roller paint study (MRID 50521701) and upcoming airless paint sprayer study.

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EXECUTIVE SUMMARY

This document represents the USEPA, Office of Pesticides Program, Antimicrobials Division (AD)
review of the Antimicrobial Exposure Assessment Task Force II (AEATF II) hand wash removal
efficiency study. The AEATF II designed the study to develop a hand wash removal efficiency
correction factor to use in their painting exposure studies (i.e., brush/roller and airless paint sprayer
studies). The results of the hand wash removal efficiency study are reported herein. The protocol for
this completed study was previously reviewed by the EPA and the Human Studies Review Board
(HSRB) for ethical and scientific design. Both EPA and HSRB approved the protocol and provided
recommendations for modifications (discussed within this memo). This memo contains the scientific
review, recommended correction factors, and study limitations to be considered by users. The ethics
review is contained in a separate memo. Both reviews are to be presented to the HSRB on April 25,
2018.

The study investigators monitored the removal of BIT (l,2-benzisothiazoline-3-one) treated paint that
was intentionally placed onto the palms of test subject's hands. The hand wash procedure used in this
study was the same procedure used by the AEATF II in their brush/roller study (and will be the same
procedure in their upcoming airless paint sprayer study). All the test subjects were recruited from the
general population. A total of 20 subjects and two concentrations of BIT-treated paint were used; 10
subjects had each hand exposed to 50 uL of paint containing 154 ppm of BIT (the two hands were
combined as a single sample) and 10 subjects had each hand exposed to 50 uL of paint containing
547 ppm of BIT (combined as a single sample). The paint was allowed to dry on the subject's hands
for 45 minutes prior to the hand wash procedure. The hand wash procedure included both a wash and
a wipe and combined the left and right hand together for a single sample. The reader is referred to
Section 3.0 for a discussion on the data limitations.

The statistical analysis indicates that the results of the correction factors for the two BIT
concentrations (154 and 547 ppm) should not be combined since the means of the percentage removal
efficiencies at the two concentrations are statistically significantly different at the 5% level.

Therefore, the results will be used at the low and high concentrations (not combined) to correct the
hand exposure data for the completed brush/roller and upcoming airless paint sprayer studies.
However, it is important to note that the low and high level fortification levels used in this study are
relative. The use of these removal efficiency data based on fortification levels can be adjusted as
need be based on study specific paint concentrations. The results of the low level fortification (154
ppm BIT) indicate a 73.3% removal efficiency and the results of the high level fortification (547 ppm
BIT) indicate a 60.3% removal efficiency.

In the brush/roller study, three concentrations of paint were used, a low concentration of between 141
and 147 ppm BIT, a mid-level concentration of between 368 and 382 ppm BIT, and a high level
concentration of between 595 and 649 ppm BIT. It is reasonable to match the low concentration in
the brush roller study with the very similar low concentration in the hand wash removal efficiency
study and apply a correction factor of 73.3%. It is reasonable to match the high concentration in the
brush roller study with the very similar high concentration in the hand wash removal efficiency study
and apply a correction factor of 60.3%. Although the hand wash removal efficiency study did not
measure the removal efficiency at the mid-level concentrations of BIT, a reasonable approach is to
assume that the average removal efficiency is approximately linear in the BIT concentration, so that

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the estimated arithmetic mean correction factor of 66.8% can be applied to the mid-level
concentration data in the brush and roller study.

EPA intends to use this AEATF II hand wash removal efficiency study to correct the hand wash
residue data collected using the same hand wash procedure in the AEATF II brush/roller exposure
study as well as the upcoming airless paint sprayer exposure study.

1.0	Background

The AEATF II is developing a database representing inhalation and dermal exposure during many
antimicrobial handler scenarios. Two of the scenarios measure exposure to subjects while painting
(brush/roller and airless paint spraying). The dermal monitoring of the subjects during these two
painting studies include hand wash procedures to measure hand exposures. The AEATF II has
conducted this hand wash removal efficiency study as part of the method validation of the hand wash
sampling procedure. To determine the hand wash removal efficiency, the AEATF II recruited test
subjects from the general population, exposed the palms of their hands to paint fortified with BIT,
allowed the paint to dry for 45 minutes, and then performed a hand wash procedure to determine the
efficiency in which the BIT-treated paint is removed. The results of this study are being used in the
AEATF II's brush/roller study (MRID 50521701) to adjust the hand exposure for incomplete removal
of the BIT-treated paint from the hand wash procedure. Additionally, they also plan to use the results
in the upcoming airless paint sprayer study. Prior to conducting intentional exposure studies in
humans, the protocols are reviewed by the Human Studies Review Board (HSRB). The HSRB
reviewed this hand wash removal efficiency study protocol in April 2014.

1.1	Hand Wash Removal Efficiency Defined

The hand wash removal efficiency in this study is defined as... "The removal efficiency of BITfrom
the skin using the isopropyl alcohol/water wash and wipe procedure was determined by calculating
the amount of BIT removedfrom the hands of each subject. ... The removal efficiency was calculated
using the following equation.

Removal Efficiency (%) = Amount of BIT Removed from Hands (/us) x 100

Amount of BIT Applied to Hands (ug)

The removal efficiency of the isopropyl alcohol/water wash and wipe procedure was calculated by
averaging the removal efficiency determinedfor each individual subject(VI :32)

1.2	Study Objective

The AEATF II's stated in their study protocol that their objective is to "The primary objective of this
study is to determine the removal efficiency of BIT in latex paint ... from human hands. " (AEATF
2014). The results of this study are being used to adjust for losses on the test subject's hands
resulting from an identical hand wash removal sampling method used in both the paint brush/roller
and airless sprayer exposure studies.

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1.3 Protocol Modifications, Amendments, and Deviations
1.3.1 Protocol Modifications Based on EPA and HSRB Reviews

EPA and the HSRB provided science-based changes to the hand wash removal efficiency study
protocol during the review (EPA 2014 and HSRB 2014). The review comments and AEATF II
responses are summarized in Table 1.

Table 1. EPA/HSRB Review and AEATF II Responses.

Issue Raised (Agency)

Proposed Response

Options/Comments

Researchers should consider
video recording the procedure to
use for training purposes for
future studies. (EPA)

All the studies done for AEATF II
include video recording. This
study will include video.

Efforts will be made to get
sufficient footage for training.

Researchers should consider
whether glass capillary tubes
might break or cause injury
when used to spread test
material. (HSRB)

The protocol will be modified to
use a different tool to spread the
test material which has less
potential to break (e.g. solid
glass rod).

Although these tubes have been
used successfully on multiple
previous rat and human studies
there is some risk of breakage.
An alternative spreader will be
used.

The application of 500 piL of
paint to the palm may be
excessive. Researchers should
consider using less paint. (HSRB)

Guidance is needed from EPA as
paint volume was increased from
100 piLto 500 piL at EPA request
from earlier review.



The IPA application of 100 piLto
the palm may be excessive.
(HSRB)

The IPA group is to be eliminated
from the study in order to
increase the sample size of the
paint group.

Multiple prior studies have
applied 100 piL of IPA to the palm
or similar area of the forearm
without dripping.

The palm of the hand is known
to have lower dermal
permeability than other areas.
Researchers should consider
applying paint to the entire
hand.(HSRB)

No change to protocol is
planned.

The most common site of paint
exposure during the study will
likely be to the palm from
holding painting equipment.
Also, applying paint to the entire
hand will make it very difficult
for subjects to avoid touching
treated areas to surfaces or
themselves. Treating the palm
will allow subjects to sit with
their hands facing up on a
padded surface during the study
period.

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The amount of active ingredient
may be excessive along with the
amount of paint. Researchers
should consider reducing
amount of active ingredient.
(HSRB)

No change to protocol is
planned.

The concentration of active
ingredient in the paint is the
same as what will be used in the
brush and roller study. This will
provide the most direct
comparison when correcting
recoveries in that study.

Researchers should consider
whether it is practical for
subjects to avoid use of
their hands for 45 minutes.
Researchers should consider a
small pilot test with non-toxic
household item to test.
(HSRB)

No change to protocol is
planned.

Multiple human studies (pre-
HSRB) have been conducted
with 30 minute exposure times
without incident. Subjects will
be allowed to place hands face
up on a padded surface and will
be provided with TV during the
45 minute period. Any subject
who has difficulty can ask to end
their participation early.

The use of individual hands in
this removal efficiency study
may result in a removal
efficiency that is different from
the two hand procedure
planned for the brush and roller
study.

Researchers should consider
using the same technique for
both. Researchers should also
consider whether this change
will require a change in number
of subjects per group to
provide

adequate statistics. (HSRB)

The protocol will be modified to
consider two hands as one
sample and use the same wash
procedure as the brush and
roller study. The IPA dose groups
will be eliminated in order to
keep the total number of
subjects the same and still have
the same replicate number of
samples per group.

We felt that the one hand
procedure would be a good
approximation of the two hand
procedure, and any bias would
be conservative (less removed
with one hand wash
procedure). The one hand
procedure was chosen to
increase sample size with the
minimum number of subjects.
After reflection we agree with
modifying the protocol to be
identical with
brush and roller.

Researchers should consider
whether removal from the
dominant hand might be
different than the non-
dominant
hand. (HSRB)

The protocol will be modified as
stated above.

Both dominant and non-
dominant hands will be
tested together from each
subject.

1.3.2 Protocol Amendments

The study report (page 37) lists 2 protocol amendments. The amendments included (1) reducing
the volume of the paint to be applied to the subject's two hands from 500 uL to 100 uL (i.e., 50
uL per hand) as suggested by the HSRB; changed the inclusion criteria of residency for
recruitment to surrounding areas of Fresno County; and clarified the numbering of subjects, and
(2) corrected the analytical method number and title.

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1.3.3 Protocol, Method, and SOP Deviations

Three protocol and four SOP deviations were noted in the study (study report page 37). The
protocol deviations included not using the California Advocate during the advertisement for
study recruitment; a different wash solvent used to prepare BIT solution for dosing the paint; and
a single instead of duplicate field controls were used. The four SOP deviations included the
temperature of the refrigerator storing the reference calibration standard dropped below the set
temperature; minimum and maximum temperatures were not recorded for 3 weeks where the
internal standard and reference substance were being stored; "temperature of the freezer that
stored the internal standard raised above the allowed temperature of < -10 °C reaching-7 °C
and then -4 °C a week later "; and "An audit report was not addressed by the Study Director in
a timely manner ." EPA accepts the study author's conclusion that these deviations did not
adversely affect the outcome of the study.

1.4 Material & Methods

The following is a summary of the key field aspects of the study.

•	Study Location: The hand wash removal efficiency study was conducted at the Golden
Pacific Laboratories (GPL), LLC in Fresno, CA. The monitoring took place on April 7
and 9, 2015.

•	Substance Tested: The test substance monitored was l,2-Benzisothiazolin-3-one (BIT)
as the active ingredient; CAS number 2634-33-5.

•	Test System: The test subjects had a total of 100 uL of BIT-treated paint applied to both
the right and left palmer surface areas (i.e., 50 uL per hand). The washes from the two
hands were combined as a single sample. The residence time for the paint on the
subject's hands was 45 minutes. Two paint concentrations were used for two separate
groups of subjects. One set of subjects received paint with a concentration of 154 ppm of
BIT and the other 547 ppm of BIT. The test subjects and setup at the testing facility was
described in the study report as follows:

o "The subject numbers were randomized using a research randomizer program
accessible at the following internet website: http://www. randomizer, org. During
the enrollment period, a total of 40 subjects were enrolled to participate in the
study. The first 28 numbers in the generated randomized list determined the initial
group of participating subjects. "
o "On each day of the study, the conference room at GPL was used as the test site.
The conference room at GPL consists of a table with six chairs around it... [T]he
conference table was set for five subjects at a time... At each seat, anX-large
towel was folded and used to create a comfortable surface for the subjects to rest
their arms on during the testing period. ...a narrow table was set up for
conducting the removal of the paint from the subject's hands at the appropriate
time. The narrow table was covered with bench paper and on top of the bench
paper were absorbent pads, which were changed between each subject. The
bench paper was changed between each group session on each day of the study. A
large deep sided metal mixing bowl for collecting the wash, a package of dressing

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sponges, and a 1-liter glass jar pre-labeledfor the subject were set up on the
table."

"On the first day, ten subjects (five in the morning and five in the afternoon) had
a 100 uL aliquot ofpaint containing 154 ppm of BIT applied to their hands. On
the second day, ten subjects (five in the morning andfive in the afternoon) had a
100 uL ofpaint containing 547ppm of BIT applied to their hands. "

"The paint was applied to the first subject's hand using a positive displacement
micropipette containing approximately 100 uL of paint containing BIT. The
research associate applied the paint as evenly as possible between the two hands
and the Study Director/PI followed behind spreading the paint across the palms
using a glass stir rod with rounded annealed ends. The goal was to distribute the
paint consistently over the palmar surface. Once the paint was distributed, the
Study Director/PI started a timer unique to each subject and the time the paint
was applied was recorded. Ten minutes (± 1 minute) later, paint was applied to
the palms of the next subject in the same manner. The glass rods were unique to
each subject and were retained as a sample in properly labeled glass test tubes
for analysis. This process was continued until all five subjects had paint on their
palms. During the drying period, subjects sat with their palms facing up and
hands open. " Note: The BIT residues were extracted from the glass rods using
methanol/water (10:90, v/v) and the resulting residues were used to subtract from
the amount of BIT pipetted onto the subject's hands to account for BIT-treated
paint not applied to the palms.

After 45 minutes the hand wash procedure commenced as follows: "Over the
bowl, a small amount (~50 mL) of the premeasured 500 mL of isopropyl
alcohol/water (50:50, v/v) sample was poured over one of the gauze wipes
(BAND-AID® Johnson & Johnson Large Mirasorb® Gauze Sponges, 4 in. x 4
in.) and the subject's hands to moisten the dry paint. With the wet gauze wipe, the
Study Director scrubbed one hand, loosening and removing the paint. The second
gauze wipe was wet with some fresh isopropyl alcohol/water (50:50, v/v) and
used to scrub the second hand, loosening and removing the paint. The two gauze
wipes were added to the collection bowl. The Study Director then slowly poured
more of the isopropyl alcohol/water (50:50, v/v) over the subject's hands while
they rubbed and washed their hands together like one would when washing under
a faucet. The subject was instructed to rub and scrub their hands together. The
remainder of the premeasured 500 mL of isopropyl alcohol/water (50:50, v/v) was
slowly poured over the subject's hands while the Study Director directed them to
rub and rinse their hands without touching the grey water in the bowl for a final
clean rinse. Once the entire 500 mL of isopropyl alcohol/water (50:50, v/v) was
poured over the hands, the subjects were instructed to let the solution drip off,
then gently shake andflick their fingers slightly in order to collect as much as
possibleThe duration of the hand wash procedure itself was approximately 3 to
5 minutes.

Figure 1 illustrates photos of the 100 uL pipetted onto the subject's hands (i.e., 50
uL/hand); the paint spread on the palm; subjects seated around the table, palms
up; the wash procedure; and post-wash with paint removed.

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Figure 1. Photos of the hand fortification and wash procedure.

Sample Size: The study consisted of 20 subjects (12 males and 8 females) that
participated in the sampling. Each subject had their right and left hand (palm) fortified
with the BIT-treated paint and the two hand samples combined for one sampling result.
Therefore, the number of samples is 20 (n=20).

Duration: The residence time for the paint on the subject's hands is 45 minutes. The
duration of the brush/roller exposure study monitoring events averaged 113 minutes
(ranged from 48 to 173 minutes).

Amount of BIT: The amount of BIT fortified on the subject's hands (L+R) at the lower
BIT concentration was -22 ug/both hands and -16 ug/both hands at the higher
concentration of BIT. In the brush/roller study, the BIT residues collected on the test
subject's hands (uncorrected residues) ranged from 37.7 to 2424 ug/both hands (averaged
461 ug/both hands). The hand residues in the brush/roller study, when corrected for the
hand wash removal efficiency results in this study, range from 64 to 4045 ug/both hands
(averaged 770 ug/both hands).

Environmental Conditions: Environmental conditions (humidity and indoor
temperatures) are reported for each of the two days of monitoring, morning and
afternoon, on page 46 of the AEATF II study report. Indoor temperatures ranged from
69.6 to 71.8 F. The humidity indoors ranged from 36.2 to 48.3%.

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2.0 Results

2.1	QA/QC

Controls. The non-fortified laboratory and field control samples (blanks) were all non-detect.
The limit of quantitation (LOQ) for the hand wash was 1 ng/mL (hand wash samples were 500
mL per sample).

Method Validation. The results of the pre-study method validation (MRID 50549401) for the
sponge wipes averaged 99.9±3.23% and for the hand wash solution 96.8±3.04%. The dressing
sponges were fortified at 100 ng/sample, 10 ug/sample, and 100 ug/sample. The hand wash
solutions were fortified at 1 ng/mL, 100 ng/mL, and 1 ug/mL. Seven samples per fortification
were prepared and analyzed.

Laboratory Recoveries. The concurrent laboratory recovery values for the hand wash solution
with two gauze sponges averaged 94.2±5.47 % (n=4). Samples of the wash solution with the
two gauze sponges were fortified at the LOQ and 160x the LOQ. The hand wash removal
efficiency samples were not corrected for concurrent laboratory results.

Field Recoveries. The field recovery values for the hand wash solution with two gauze sponges
averaged 102±4.90 % (n=8). Samples were fortified at 44x the LOQ and 150x the LOQ. The
hand wash removal efficiency samples were not corrected for field recovery results.

2.2	Calculating Hand Wash Removal Efficiency

The hand wash removal efficiency was determined using the following equations:

Removal Efficiency (%) =

(Amount of BIT Removed from Hands ([j,g) ^ Amount of BIT on Hands ((J,g)) x 100
Where:

Amount of BIT on Hands ((_ig) =

Amount of BIT Applied ([j,g) - BIT Left on Glass Rod (jag)

Where:

Amount of BIT Applied ([ag) =

Concentration of BIT in Paint ((J-g/g) x Mass of Paint Applied (g)

2.3	Hand Wash Removal Efficiency Results

A summary of the individual and mean hand wash removal efficiency results is presented in
Table 2. The results of this hand wash removal efficiency study indicate an average 73.3 and
60.3 percent removal efficiency at BIT concentrations of 154 and 547 ppm, respectively.
Appendix A, includes various analyses of the removal efficiency data which are summarized

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here. The distributions of the hand wash removal percentages for each concentration were
examined. The percentages, their reciprocals, and the logarithms of the percentages were each
consistent with a normal distribution (based on the Kolmogorov-Smirnov test, other normality
tests, and on quantile-quantile plots). The fit is better at the higher concentration. Based on a
normal distribution, the 95% confidence intervals for the arithmetic means at the Low and High
concentrations were 73.3 (64.9 - 81.6) % and 60.3 (53.2 - 67.4) %, respectively. The observed
precision is within the range of the estimated precision from the protocol review that was based
on previous studies. T tests showed that the means of the Low and High concentration removal
efficiencies were statistically significantly different at the 5% level. This is also true for the mean
reciprocal and the mean logarithm. Thus, the removal efficiencies for the two concentrations
should not be combined. Instead, the low and high BIT concentration removal efficiencies
should be applied to the paint data at the same, or nearly the same BIT concentration. As
discussed above, for mid-level BIT concentrations a simple and reasonable approach is to apply
the average of removal efficiencies, making the approximation that the removal efficiency is
linear in the BIT concentration.

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Table 2. Summary of Hand Wash Removal Efficiencies.

BIT Level

Monitoring Event (ME)

BIT Applied (ug)

BIT Left on Glass Rod (ug)

BIT on Hands (ug)

Removal Efficiency (%)

Low

1

21.791

0.033

21.759

66.2

Low

2

21.806

0.120

21.686

58.1

Low

3

21.606

0.317

21.289

90.2

Low

4

22.361

0.036

22.325

86.5

Low

5

22.238

0.041

22.198

80.2

Low

6

21.683

0.071

21.612

65.7

Low

7

22.777

0.115

22.662

66.2

Low

8

23.008

0.044

22.964

71.4

Low

9

21.760

0.119

21.641

61.5

Low

10

22.684

0.108

22.576

86.8

High

11

76.854

0.370

76.484

54.1

High

12

77.619

0.282

77.337

62.8

High

13

76.361

0.055

76.306

43.6

High

14

75.595

0.236

75.359

64.1

High

15

74.720

0.305

74.415

59.8

High

16

76.252

0.077

76.175

58.3

High

17

77.510

0.174

77.336

55.2

High

18

76.033

0.189

75.844

72.6

High

19

77.182

0.996

76.186

53.8

High

20

76.197

0.254

75.943

78.6

Low

Empirical Mean

22.171

0.100

22.071

73.3

Low

Empirical SD

0.514

0.085

0.551

11.7

Low

Lognormal SRS Mean

22.172

0.101

22.072

73.4

Low

Lognormal SRS SD

0.512

0.084

0.550

11.6

High

Empirical Mean

76.432

0.294

76.139

60.3

High

Empirical SD

0.894

0.265

0.864

10.0

High

Lognormal SRS Mean

76.433

0.304

76.139

60.4

High

Lognormal SRS SD

0.896

0.292

0.866

10.1

All

Empirical Mean

49.302

0.197

49.105

66.8

All

Empirical SD

27.844

0.216

27.745

12.5

All

Lognormal SRS Mean

50.360

0.199

50.162

66.8

All

Lognormal SRS SD

35.505

0.229

35.392

12.6

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Let X; be the ith AaiH or unit exposure value and let Y; = ln(Xi).

	 18

Empirical Mean = X = ^X1/18

1=1

Empirical SD = Sx = ^^(X; - x)2 HI . Suppose X is lognormally distributed, so that Y = ln(X) is normally distributed with a
population mean |i and a population variance o2

Lognormal Simple Random Sample (SRS) Mean = Estimated population mean of X = Estimate of exp ([j, + V2 o2) = exp (Y +V2 SY2)

— 18	I 18 /

where Y = Ły;/18and SY=Jg(Yi-Yj /17 .

Lognormal Simple Random Sample (SRS) SD = Estimated population standard deviation of X = Estimate of
exp (^i + !/2 o2) ^/exp(a2)- 1 = exp ( Y + V2 SY2)-^/exp(SY2)-l.

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3.0 Discussion and Limitations

The need for account for the removal efficiency from a hand wash method has been discussed
previously (SAP 2007). The study protocol for this hand wash removal efficiency study was
previously reviewed by the EPA and HSRB (EPA 2014 and HSRB 2014). Suggestions and
recommendations were made during the review, not all of which were concise nor a consensus.
Many of the suggestions were easily incorporated by the AEATF II and are summarized in Table
1 above. The scientific design of this study, with caveats noted, is sufficient for the results to be
used to correct the hand exposure for method efficiency in the completed brush/roller study and
upcoming airless paint sprayer study. Additional research to better characterize the uncertainties
noted in the protocol review, mainly fortifying the palm versus the entire hand, does not
outweigh the timely conduct of the study, and was satisfied by having the researchers video tape
the hand wash procedures in the brush/roller study to visually assure removal of paint from the
entire hand as was done in this hand wash removal efficiency study (see discussion below and
photos in Figure 2). The following items are provided to potential users of these data to
characterize the results of this sampling effort:

•	The HSRB was concerned that the glass capillary tubes were likely to break while
applying the paint to the palms of the subjects. This comment was made under both the
science and ethics portion of their review. The researchers switched the glass capillary
tubes for glass stir rods to apply the paint to the subject's hands (based on personal
communication, none of the stir rods broke during the study).

•	The HSRB suggested using an estimate of 24 or 25 cm2 as the palmar surface area (single
hand) when the paint is applied up to 2 cm from edge of palm. EPA deferred to the
HSRB and the AEATF II used the 25 cm2 estimate of the area of palm to determine the
lower amount of paint to be used to fortify the subject's hands. Note: This area proposed
by the HSRB during the protocol review was only an estimate to determine the volume of
paint to use for fortification of the palms of the subjects; there were no proposals to make
hand measurements and no measurements were taken.

•	During the protocol review, the HSRB was concerned that using 500 uL of paint to
fortify the palms would yield a paint thickness of ~2 mm which was excessive (and
believed would result in an over-estimate of the recovery at lower loading levels
anticipated in the brush/roller study). The HSRB further stated that a 0.04 mm thick
layer (4 uL/cm2) would result if the proposed 500 uL was reduced to 100 uL and this
thickness would be less of concern. The AEATF II reduced the volume of paint applied
to 50 uL per hand, yielding 0.02 mm thickness (2 uL/cm2). The appropriateness of the
paint loading is dependent upon the results of the completed brush/roller study (Catch-
22). However, the AEATF has responded to the suggestions provided by the HSRB and
used a thinner paint thickness to fortify paint on the subject's hands. Note: The actual
loading on the hands from the now completed brush/roller study cannot be accurately
determined from a hand wash as paint exposure to the hands is not uniformly distributed
on the hands.

•	The same wash and wipe procedure using the same isopropyl alcohol/water concentration
and volume were used in both the removal efficiency study and brush/roller study.

•	The HSRB stated that the palm has the lowest dermal permeability of any body part and
was smooth and easy to clean which will bias recovery results upwards. The HSRB
recommended to dose all or most of the hand. The AEATF II only dosed the palmar
surface area of the hand. To overcome this short coming, EPA recommended that the
AEATF II video tape the hand wash procedure in the brush/roller study to ensure the

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visual removal of the paint. The photos in Figure 2, pulled from the video tape, illustrate
that the paint was removed during the scrubbing portion of the hand wash procedure (the
post scrubbing in this photo was followed up by the final rinse). Similar to the rat dermal
absorption study (MRID 46327901), BIT remained on the skin of the palms and not
easily washed off as evident in the recoveries of 60.3% and 70.3% in this study.

Figure 2. Start and Post-Scrubbing Portion of Fland Wash Procedure During Brush/Roller Study.

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4.0 Conclusions

EPA has reviewed the AEATF II hand wash removal efficiency study and concludes that
the AEATF II made the appropriate changes to the protocol proposed by the EPA and HSRB and
has successfully executed the study. The protocol deviations that occurred and were reported
have not adversely impacted the reliability of these data. The EPA recommends that the hand
wash removal efficiency correction factors generated in this study be used to correct the hand
exposure residues from the AEATF II painting studies (i.e., brush/roller and airless paint
sprayer). The following is a summary of our conclusions:

•	T tests showed that the means of the removal efficiencies were statistically significantly
different at the 5% level. This is also true for the mean reciprocal and the mean
logarithm. Thus, the removal efficiencies for the two concentrations should not be
combined when being applied to similar paint concentrations. Therefore, the results from
this study correspond to the low and high concentrations (not combined) to correct the
hand exposure data collected in the brush/roller and upcoming airless paint sprayer
studies.

•	Low level fortifications (154 ppm BIT) are represented by a 73.3% removal efficiency.

•	High level fortifications (547 ppm BIT) are represented by a 60.3% removal efficiency.

•	Mid level fortifications (350 ppm BIT) can be represented by a 66.8% removal
efficiency, assuming a linear relationship.

•	The "low" and "high" level fortification levels used in this study are relative. The use of
these fortification-level based removal efficiency correction factors may need to be
adjusted, on a case-by-case basis, for study-specific paint concentrations.

5.0 References

ACC. 2011. American Chemistry Council, Antimicrobial Exposure Assessment Task Force II
(AEATF II) Governing Document for a Multi-year Antimicrobial Chemical Exposure
Monitoring Program. Interim Draft Document. Version 3. July 8, 2011.

HSRB Report. 2014. EPA-HSRB-14-01, Subject: April 8-9, 2014 EPA Human Studies Review
Board Meeting Report, from Rebecca T. Parkin, PhD, MPH, Chair EPA Human Studies Review
Board to Robert Kavlock, Ph.D., Interim EPA Science Advisor, Office of the Science Advisor,
1200 Pennsylvania Avenue, NW, Washington, DC 20460, dated June 25, 2014.

MRID 50549401. Validation of Method GPL-MTH-081 and Freezer Storage Stability:
Analytical Method for the Determination of Benzisothiazolinone (BIT) in Paint, Dressing
Sponges, Hand Washes, Cotton Inner and Outer Dosimeters, Painter's Hats, Air Sampling Tubes
and Fiberglass Filters. GPL Study No.: 130478. Study Completion: March 1, 2017.

SAP. 2007. Memorandum: Transmittal of Meeting Minutes of the FIFRA Scientific Advisory
Panel Meeting Held January 9 - 12, 2007 on the Review of Worker Exposure Assessment
Methods. U.S. Environmental Protection Agency.

USEPA. 2014. Science and Ethics Review of AEATF II Paint Hand Wash Removal Efficiency
Protocol. Memorandum from Timothy Leighton, Kelly Sherman (USEPA) and Jonathan Cohen,
PhD. (ICF International) to Steven Weiss (USEPA), dated March 18, 2014.

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Appendix A

Statistical Review of the AEATF II Paint Hand Wash Removal Efficiency Study
(To be included as a separate electronic file)

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