Dozens of students sickened as fumes from cured-in-place pipe lining project strikes school

Students and staff at Merrimack Valley High School were halfway through fourth period when a harsh odor permeated classrooms and hallways throughout the two-story brick building nestled along a wooded area bordering New Hampshire’s capital city, Concord.

The scent was potent and nauseating. And it soon caused trouble, as it sickened one person after another.

Dozens of teenagers streamed into the school health office complaining of headaches, lightheadedness, watering eyes, sore throats, irritated noses and vomiting. At least 40 students and six staff members fell ill, and about 50 were dismissed early as school officials scrambled to identify the source of the smell.

It originated, they soon learned, from a nearby sewer project that used an increasingly popular, but problematic, method for rehabilitating old or damaged underground utility lines called cured-in-place pipe lining.

And it happened on April 4, just five days after a USA TODAY investigation shed light on dozens of similar incidents from coast to coast sparked by errant emissions from such repair projects.

“In my 19 years in public education in New Hampshire,” principal David Miller told USA TODAY, “I have never experienced any incident like this.”

Cured-in-place pipe lining creates a new pipe inside an old one by inserting a soft, resin-soaked liner into the existing structure, inflating it with pressurized air, then heating it so it hardens. Because it’s faster and less expensive than traditional pipe rehabilitation, cities across the country are turning to cured-in-place contractors to upgrade their old underground lines. 

But those cost savings can come at a price.

Hazardous air pollutants released during the heating process can enter homes, schools and other buildings and sicken the people inside. 

Styrene, a probable carcinogen and key ingredient in many cured-in-place projects, can be especially toxic and causes a constellation of symptoms like those reported at Merrimack Valley High School – headaches, nausea, vomiting, loss of balance and, sometimes, unconsciousness. 

Similar exposures across the country have landed people in the hospital, required building evacuations and sparked claims of lasting injuries and even death, USA TODAY found. 

Sarena Quintanilla, whose daughter attends Merrimack Valley High School, said the teen suffered severe congestion with a burning in her sinuses and throat after the incident. Even now, weeks later, Quintanilla said, her daughter continues to experience headaches she believes are caused by exposure to the fumes.

“I called poison control” the next day, Quintanilla said, “but they said there was nothing to be done at that point.”

Read the original investigation:A popular, but noxious, piping fix is sickening people. And it's throughout America's sewers.

School not warned about styrene-tainted fumes

Despite the growing list of incidents, the cured-in-place pipe-lining industry is completely unregulated when it comes to public health. No state or federal agency actively monitors work sites or requires safety protocols to eliminate or prevent harmful emissions from leaking into the environment.

The project that sickened students and staff at Merrimack Valley involved the relining of several portions of Concord’s municipal sanitary sewer system, including a section roughly 500 feet from the school. 

City officials had informed the campus facilities director about the project in March, Miller said, but they gave no warning it might produce fumes or what chemicals those fumes would contain.

“Given the odor and the impact it had on our students and staff, I am disappointed that the Concord Department of Public Works failed to provide advance notice that the sewer line work … would produce such a strong odor, and potentially impact the orderly operation of school,” Miller said in an email to USA TODAY.

Inquiries from USA TODAY to Concord’s Public Works Department were directed to the Engineering Department and then to Concord spokeswoman Stefanie Breton, who asked for questions to be sent in writing. USA TODAY provided them on April 10, then sent several follow-up emails.

Questions included whether the incident violated city ordinances or the city’s agreement with the contractor, how the city addressed the incident with the contractor, whether the city was aware of any similar incidents involving cured-in-place pipe projects under its purview, and whether the city would require the capture or control of emissions on cured-in-place pipe projects going forward.

Although Breton initially said the Engineering Department was working on the questions, on May 31 she responded that she had no additional information to provide. 

Public records obtained by the media organization show the cured-in-place sewer lining contract in effect at the time of the incident was awarded to Inliner Solutions Inc., one of the country’s largest trenchless rehabilitation companies, with offices across the United States. 

Nate Holmes, who until May 31 was Inliner Solutions’ manager for the region including New Hampshire, said the company does a good job but otherwise declined to answer any questions and referred USA TODAY to the corporate office. 

No one at Inliner Solutions’ corporate office returned calls or emails from USA TODAY.

‘I’m disappointed in the responsible party’s lack of preparation’

The incident at Merrimack Valley High School not only underscores the unchecked public health risks of cured-in-place pipe rehabilitation, but it also showcases the chaos and confusion provoked by such exposures.

As students and staff fell ill, Miller and his team raced to locate the origin of the fumes while also trying to determine whether they were toxic, how to contain them and the best course of action to keep his school of about 900 people safe. 

Not everyone was happy with how it unfolded.

“I’m displeased with the school’s handling of the entire situation, including failure to communicate with some parents during the incident and the decisions they made to keep the students in school for the remainder of the day,” Quintanilla said. “’I’m disappointed in the responsible party’s lack of preparation and warning of not only local schools but the entire community, including local residents.”

Based on the information he had at the time, Miller said, he made what he thought was the best decision for the school. 

At first, he said, nobody knew where the odor was coming from. Teachers thought it came from the wood shop because it smelled like polyurethane wood stain. 

“However, we quickly realized this was not the case,” Miller said. “After opening some windows within the school, it was clear that the smell was coming from outside.”

It's still not clear exactly how the odor traveled from the job site into the two-story brick school building from a distance of more than a football field away. 

Emissions from cured-in-place pipe projects typically enter buildings through several paths. 

The most obvious is through the lateral connections that link the main utility pipe under the street to the properties it serves. Most sink and toilet pipes are designed with a U-shape bend to trap enough water from daily washes and flushes to block odor from the sewer, but sometimes these bends get dry, giving fumes an opportunity to get inside. 

Fumes also can seep in through cracks in foundations, doors, windows and air intakes.

Concord Engineering Department field notes from that cold and cloudy day, obtained through a public records request, provide one clue about how it might have happened. 

“The moist weather is keeping the steam from dissipating and going to atmosphere quickly,” according to the notes, which were signed by Greg Meagher, a city engineering technician. 

At that point, the notes reflect, the school’s facilities director, Fred Reagan, had approached the job site to complain about the odor permeating the school and, apparently, ask about its chemical composition. 

Reagan “needs the SDS sheet for the lining product,” Meagher wrote, referring to the Safety Data Sheet, a standard industry document required by the Occupational Safety and Health Administration for any product containing hazardous chemicals. Such sheets include information about a chemical’s properties, environmental and health hazards, safety precautions for its handling and what to do in case of exposure.

Meagher gave Reagan the safety data sheet for the styrene-based product used in the Concord sewer project at 11:45 a.m., the notes show. 

The document, obtained by USA TODAY, states that inhaling the substance “may cause irritation of the nose and upper respiratory system and other effects” that match the reports from Merrimack High School, “including headaches, nausea, vomiting, dizziness, drowsiness, confusion, loss of coordination, impaired judgment and general weakness.” 

It also mentions possible central nervous system damage, reproductive effects and liver injury, as well as an increased incidence of lung tumors in mice from a recent inhalation study – though it calls the relevance of the animal study to effects on humans “uncertain.”

In case of inhalation, the document says, people should be moved to a safe, well-ventilated area with fresh air and provided oxygen if they experience difficulty breathing. 

That’s not what happened at Merrimack. 

Miller said that because the odor was outside and all around the school, he and the other administrators decided it made more sense to keep students indoors while trying to air out the building.

Reagan shut off the building’s HVAC system to prevent it from drawing the odor into the school, Miller said, as teachers strategically propped up fans inside open windows to draw the tainted air out. Others set up large commercial fans in the hallways. 

“The fans worked well to seemingly dissipate the odor prior to the end of the school day,” Miller said, “but there were pockets within the school where the odor remained through the next morning.” 

Miller also notified parents, students and staff about the situation via email “within moments'' of realizing its impact, he said. An email from Miller obtained by USA TODAY and time-stamped at 11:34 that morning alerted recipients to the odor, its origin and the school’s attempts to mitigate it. He also noted that the city’s Public Works Department told the school that “the fumes are not toxic.”

Quintanilla said she did not receive the email but is aware that other parents did.

Additionally, Miller told USA TODAY, the Concord Fire Department arrived around 1 p.m. to test the air quality and reported that no fumes or toxic air had been found. It’s unclear, though, whether the worst of the leak had dissipated by then, what type of monitoring equipment was used or whether the equipment was designed to measure styrene gas concentrations. 

Styrene emissions are considered harmful at 20 parts per million for short-term exposures and 10 parts per million for long-term exposures, according to threshold limits recommended for worker safety by the American Conference of Governmental Industrial Hygienists. 

Styrene levels at the school were likely “very low,” said Richard Lent of the Lawson Group, a Concord-place firm that provides workplace safety services, in an April 10 email to Reagan that USA TODAY obtained through its public records request.

“Of course this does not mean that some people will not have symptoms associated with the odor,” Lent said, adding that “some people will have headaches and other discomfort even at the low levels expected” at the school.

Children are particularly at risk to exposure from toxicants like styrene, said Timothy Nurkiewicz, director of West Virginia University’s Center for Inhalation Toxicology. Children breathe faster, and their airways are shorter than those of adults, for whom the exposure limits are typically set, he said. 

Children also have less protective coating, like mucus, in their lungs.

“When air is inhaled, the mucus layer is usually capable of protecting the airway from the toxicant, and it doesn’t contact the lung,” Nurkiewicz said. “With kids, their airways are shorter and so there’s less protective coating deeper in their lungs, so gases get to more impactful places more quickly.”

If people are experiencing headaches, nausea, dizziness or vomiting, Nurkiewicz said, they should not just open windows and hope for the best.

"You physically need to move out of the area if responses are that severe,” he said. “Staying there, it’s only going to get worse. As you breathe more, you are exposed to more. So get out and get assistance.”

Emily Le Coz is a reporter on the USA TODAY investigations team. She can be reached at elecoz@usatoday.com or @emily_lecoz.