Persistent chemicals in healthcare mattresses raise concerns


High levels of toxic chemicals, including chemical flame retardants (CfRs) have been found in mattresses used in institutions, including hospitals and health care facilities in the Environmental Agency’s latest report [1]. The results of this study raise questions over the impacts on users, especially vulnerable patients, safe mattress disposal and why these toxic chemicals are still being used when they don’t improve fire safety [2] 

Environment Agency finds toxic chemicals in institutional mattresses 

The Environment Agency commissioned a study to investigate the presence of persistent organic pollutants (POPs) and hazardous substances in institutional mattresses[1]. The study is part of a broader initiative to assess the safety and recyclability of mattresses in the UK. A total of 608 samples including mattresses, foams and covers from healthcare, defence and border control facilities as well as mental health institutions and prisons were assessed. These samples were taken from 256 complete mattresses. 

The key findings were as followed: 

  • Deca-BDE, a chemical flame retardant now listed as a POP under Annex A of the Stockholm Convention[3], was identified at high concentrations (>10,000 mg/kg) in mattress covers used in healthcare and mental health institutions. The levels of this CfR were so high, that up to around 20% of healthcare and up to around 30% metal health institution mattresses likely exceed the polybrominated diphenyl ethers (PBDEs – group of brominated flame retardants) safety limit (1,000 mg/kg) due to the presence of decabromodiphenyl ether (decaBDE) in the mattress covers. 
  • Mattress foams were not found to contain brominated flame retardants [4], including decaBDE, in any of the 346 foam samples analysed. This suggests decaBDE are added to mattress covers and fabrics rather than foams.  
  • Mattresses from prisons and border control settings did not have any dangerous levels of POPs, bromine, or antimony (above 1,000 mg/kg). 
  • The majority of mattress samples taken from defence settings (89%) had high bromine concentrations.  
  • High concentrations of hazardous substances, such as phthalates (DEHP – often used as a plasticizer in mattress covers) and antimony (likely present as antimony trioxide, a flame retardant used in mattresses) were found in some mattress covers.  
  • A range of other POPs and compounds analysed in mattress samples were found to be present at smaller insignificant concentrations.  

Persistent chemicals are a burden to a safe circular economy

Chemicals found have been linked to serious health concerns  

The study highlights significant findings regarding the presence of hazardous substances in institutional mattresses. In England alone there are estimated to be 140,000 mattresses in health care facilities[5], suggesting thousands of individuals in vulnerable positions could be exposed to toxic chemicals like decaBDE whilst in care.  

DecaBDE is a brominated flame retardant belonging to the group of polybrominated diphenyl ethers (PBDEs) that have been linked to many serious health concerns including thyroid hormone disruption[6], cancer[7] and neurotoxicity[8]. DecaBDE was listed as a POP under the Stockholm convention in 2019 due to its persistent and bioaccumulative properties[3]. This means the marketing and use of decaBDE has been restricted under the REACH regulation since March 2019. However, the lifespan of mattresses (average 10 years), and evidence from this study clearly shows the presence of harmful POPs will remain in older consumer products for years to come.

Polybrominated diphenyl ethers (PBDEs) aren’t the only chemicals hiding in our mattresses; this study reveals that a host of other persistent organic pollutants (POPs) were also detected in mattress samples. While some of these chemicals were found at low concentrations, the real potential danger lies in the ‘chemical cocktail’ effect where the combined exposure to multiple chemicals can cause harmful outcomes, even if each substance is within its individual safety limits[9].

And it doesn’t stop there – the Environment Agency study didn’t report concentration levels for other potentially harmful chemicals that are known to still be used in UK mattresses. Tris(chloropropyl) phosphate (TCPP or TCiPP) for example, is the most used organophosphate flame retardant (OPFR) in the UK [10], despite the European Chemical Agency (ECHA) recommending a restriction on its use due to the risk for carcinogenicity to infants [11], it remains prevalent in UK mattresses, both institutional and domestic.

Impacts on the circular economy

In addition to the serious health risks POPs pose, they are also a serious burden to a safe circular economy. The UK and ministry of justice department have set ambitious targets for the circular economy including ‘achieving zero avoidable waste by 2050’ [12].  However, the presence of persistent chemicals, undermine efforts towards circularity. As new risk data emerges for chemicals used in long-lived items, such as mattresses, products in circulation, run the risk of contaminating waste streams as chemicals become newly restricted. Just as we have seen in this study with the detection of high levels of decaBDE in certain settings, underscoring the need for targeted waste management strategies to ensure safe disposal and recycling.

Why are there so many toxic chemicals in mattresses?

The leading chemicals of concern in UK mattresses are flame retardants. Although their use is not mandated, CfRs are seen as the most cost-effective way of passing current furniture and furnishings fire safety requirements[13]. The UK holds some of the most prescriptive flammability testing standards for domestic furniture, and even higher levels of fire resistance are required for institutional furniture, including mattresses. The UK’s fire safety requirements are more stringent than most other countries, resulting in some of the highest human and environmental exposure rates to chemical flame retardants in the world[14].

Fidra are calling for amendments to be made to the UK Furniture and Furnishings Fire Safety Regulations to enforce meaningful reductions in chemical flame retardant (CFR) use and support innovative furniture design. Support and read more about Fidra’s work: Sustainable Fire Safety – The Problem – Fidra

 

[1]        WRC and The Environment Agency, “An investigation into POPs in institutional mattresses,” 2024.

[2]        J. A. Lane and R. T. Hull, “Variation of flammability and smoke toxicity of upholstered furniture composites with fire retardant treatment,” J Mater Sci Technol, Apr. 2024, doi: 10.1016/j.jmst.2024.02.034.

[3]        UN environment programme, “DecaBDE – Stockholm Convention.” Accessed: Aug. 14, 2024. [Online]. Available: https://chm.pops.int/Implementation/Alternatives/AlternativestoPOPs/ChemicalslistedinAnnexA/cdecaBDE/tabid/5985/Default.aspx

[4]        “Brominated flame retardants | EFSA.” Accessed: Aug. 14, 2024. [Online]. Available: https://www.efsa.europa.eu/en/topics/topic/brominated-flame-retardants

[5]        Leo Ewbank, James Thompson, Helena McKenna, Siva Anadaciva, and Deborah Ward, “NHS hospital bed numbers,” 2021, doi: 10.1258/1355819011927099.

[6]        X. Wang et al., “Long-Term Exposure to Decabromodiphenyl Ether Promotes the Proliferation and Tumourigenesis of Papillary Thyroid Carcinoma by Inhibiting TRß,” Cancers (Basel), vol. 14, no. 11, Jun. 2022, doi: 10.3390/CANCERS14112772/S1.

[7]        B. Liu et al., “Exposure to Polybrominated Diphenyl Ethers and Risk of All-Cause and Cause-Specific Mortality Key Points + Supplemental content,” JAMA Netw Open, vol. 7, no. 4, p. 243127, 2024, doi: 10.1001/jamanetworkopen.2024.3127.

[8]        L. G. Costa and G. Giordano, “Developmental neurotoxicity of polybrominated diphenyl ether (PBDE) flame retardants,” Neurotoxicology, vol. 28, no. 6, pp. 1047–1067, Nov. 2007, doi: 10.1016/J.NEURO.2007.08.007.

[9]        CHEMTrust, “CHEMICAL COCKTAILS The neglected threat of toxic mixtures and how to fix it,” 2022.

[10]      S. Harrad, S. Brommer, and J. F. Mueller, “Concentrations of organophosphate flame retardants in dust from cars, homes, and offices: An international comparison,” Emerg Contam, vol. 2, no. 2, pp. 66–72, Jun. 2016, doi: 10.1016/j.emcon.2016.05.002.

[11]      ECHA, “Screening Report AN ASSESSMENT OF WHETHER THE USE OF TCEP, TCPP and TDCP IN  ARTICLES SHOULD BE RESTRICTED,” 2018.

[12]      “Circular economy strategy summary – GOV.UK.” Accessed: Aug. 21, 2024. [Online]. Available: https://www.gov.uk/government/publications/circular-economy-strategy-summary-moj/circular-economy-strategy-summary

[13]      “Toxic Chemicals in Everyday Life – Environmental Audit Committee – House of Commons.” Accessed: Aug. 21, 2024. [Online]. Available: https://publications.parliament.uk/pa/cm201719/cmselect/cmenvaud/1805/180502.htm

[14]      J. Page et al., “A new consensus on reconciling fire safety with environmental & health impacts of chemical flame retardants,” Environ Int, vol. 173, Mar. 2023, doi: 10.1016/j.envint.2023.107782.