If you’re in the market for a paint remover and head to your local hardware store, most of the products you’re likely to find will contain methylene chloride. These products’ containers promise “professional results” – that they remove paint “in 10 minutes” – and that they are “specially formulated for antiques and fine furniture.” One called “Dad’s Easy Spray,” suggests it can be used to remove paint from fabrics and rugs. Also available are adhesive removers and “prepaint” products that contain methylene chloride. Some of these come in aerosol dispensers.

These products all carry hazard warnings that say “Danger!” and “Poison” along with cautionary statements about the chemical’s nervous system effects and the possibility that exposure can cause blindness, birth defects, cancer and respiratory harm. But there’s little – if anything – to suggest such products are so hazardous that they were responsible for at least 14 deaths in the United States between 2000 and 2011. Among those who died using these products was a man in Houston who was removing the finish from the walls of his bathroom; a worker removing paint from a church’s baptismal font; a worker hired to refinish an apartment bathtub; a worker cleaning a paint-mixing tank and the co-worker who tried to rescue him. Yet another such fatality occurred on December 16, 2014 when a worker in New York died while refinishing a bathtub.

Also called dichloromethane (DCM), methylene chloride is a potentially deadly neuro- and respiratory toxicant that may also cause cancer. Its acute effects can include skin, eye and respiratory irritation, headache, dizziness, nausea, depression of the central nervous system, lack of coordination, unconsciousness and death. Chronic effects include kidney, liver and central nervous system damage. The U.S. National Toxicology Program classifies methylene chloride as reasonably anticipated to be a human carcinogen while the International Agency for Research on Cancer (IARC) classifies it as possibly carcinogenic to humans. The U.S. Occupational Safety and Health Administration (OSHA) considers methylene chloride a potential occupational carcinogen. The U.S. Environmental Protection Agency (EPA) estimates that more than 230,000 U.S. workers are directly exposed to DCM from paint-strippers.

The Toxic Use Reduction Institute (TURI) at the University of Massachusetts Lowell also notes that “high, short-term exposures” to methylene chloride “can be lethal.” In addition, says TURI, methylene chloride’s “extreme volatility makes it especially dangerous since it is very easy to create unsafe airborne concentrations through evaporation.” Once in the body methylene chloride can be converted to carbon dioxide, which is toxic to the brain and nervous system. It can damage blood cells and has been linked to brain, liver and biliary system cancers. Animal studies have linked the substance to lung cancer and to breast and salivary gland tumors.

While such products continue to be sold in the U.S., the health risks associated with them prompted the European Union to prohibit sale of such methylene chloride-based products beginning in 2012. In 2013, citing “just two of many similar cases,” in which a worker died while refinishing a bathtub using a methylene chloride-based product, OSHA – along with the National Institute of Occupational Health and Safety (NIOSH) – issued a “Hazard Alert” for these products.

In an analysis of three deaths caused by methylene chloride exposure through paint-strippers, researchers with the California Department of Health (CDPH) concluded that “although the cases” they examined “involved occupational exposures, both products were consumer-available formulations, one of which was purchased at a local hardware store. DCM-containing paint strippers are sold in U.S. retail stores, placing consumers at risk for similar injury.” The researchers also note that these cases “illustrate that warnings alone do not ensure safety, and even personal protective equipment (such as respirators) may fail to protect.” The continued occurrence of fatal exposure to such paint-strippers, they write, “argues for a more aggressive regulatory approach to protect both workers and consumers.”

In August 2014 the EPA released its final risk assessment for DCM under the Toxic Substances Control Act. It found “health risks to both workers and consumers who use these products and to bystanders in workplaces and residences where DCM is used.” EPA is now considering what it calls “a range of possible voluntary and regulatory actions to address” these concerns.

In 2014, as part of its Safer Consumer Products Regulations, the California Department of Toxic Substances Control (DTSC) “identified” paint and varnish removers that contain methylene chloride as proposed “priority products.” If approved for listing as a “priority product,” manufacturers of these products would have to perform analyses to find safer alternatives and measures to reduce adverse health and environmental impacts. DTSC can – as part of its “regulatory response” to the outcome of the law’s “priority product” process – require that a hazardous product be taken off the market. California is expected to begin the rulemaking phase for the first proposed “priority products” by the end of March of 2015.

Safer alternatives?

So are there safer alternatives to methylene chloride-based paint removers and if so, why are these exceptionally dangerous products still on U.S. store shelves?

In comments submitted to California DTSC in 2014, Savogran, a Massachusetts-based company that makes paint and varnish removers wrote, “No known substitute chemical removes paint as effectively as methylene chloride. The alternatives on the market are not functionally acceptable.” In its comments to the DTSC, the Halogenated Solvents Industry Association (HSIA) said similarly that no alternatives exist for DCM in these products. HSIA, which also suggested that federal and California occupational safety standards should be sufficiently protective, made similar comments to the EPA in 2013.

Meanwhile, the European trade association Eurochlor noted in an earlier white paper: “Chlorinated solvents have been used extensively for many years. During this time, the fatalities or serious injuries which have occurred have been due to massive over-exposure through a total disregard for good operating practices, or through deliberate misuse. When solvents are stored, used and disposed of correctly, there is no risk to human health.”

When it comes to other types of paint-removers, there are a number – like several found on my neighborhood hardware store shelves – that contain a chemical called N-methyl-2-pyrrolidone (NMP). According to Savogran’s coments to DTSC, these “performed reasonably well” but may not be truly safe because NMP is considered “a chemical of concern.” TURI deputy director Liz Harriman explains that “N-methly-2-pyrrolidone (NMP) is a reproductive toxin.” While products with NMP are for sale in the U.S., they are now being phased out in Europe due to toxicity concerns.

Meanwhile, the EPA is in the process of evaluating NMP and has released a draft risk assessment of the chemical. The assessment is not final but based on findings thus far, EPA says the agency recommends minimizing exposure to NMP-containing paint strippers.

So what’s out there besides paint-removers based on methylene chloride and NMP? To help potential users sort through the confusing array of product CDPH has developed a guide to such products that it shared during a presentation at the 2014 American Public Health Association meeting. It rates these products on a scale that goes from Red – “Not Recommended,” through Orange – “Use with extreme caution,” Yellow – “Use with caution,” to Green – “Preferred.” Among the products on this list include those based on benzyl alcohol, soy-based paint strippers, and others based on hydroxide, formic acid and various esters (dimethyl gluterate and dimethyl adipate).

CDPH found that most paint-removers now on the market fall into the red, “not recommended” category. They also found that most workers are now using “red” category products. Workers interviewed also reported experiencing symptoms that include chemical burns, skin, eye and respiratory irritation, headaches and dizziness while using these products.

CDPH researchers also investigated how well retailers and product users understood the relative safety of these products and precautions required for safe use. They found – not surprisingly – that retailers were hazy on the details, assumed that contractors and other professionals knew how to use all such products safely, and that personal protective equipment would provide adequate protection. CDPH also found that contractors said they wanted to have the ongoing option of using DCM-based products and were surprised that available alternatives were not 100 percent safe. Workers surveyed by CDPH reported that a paint-remover made without methylene chloride worked far less well than one containing DCM.

At the same time, the CDPH survey found conractors and retailers reporting a decrease in sales and use of DCM-based products. Despite this apparent trend, the CDPH researchers concluded: “Consumption [and] demand will not shift unless policy and regulations change and R&D [research and development] rushes in to meet new demand.”

So where does this leave US workers and do-it-yourselfers?

While Europe has banned methylene chloride-containing paint-removers and is phasing out a hazardous replacement, U.S. store shelves remained filled with the most toxic of these products. While waiting for the outcome of regulatory deliberations, the EPA “recommends that consumers check” product labels and take precautions to reduce exposures. At the same time, California public health experts have concluded that warnings – and current regulations – offer inadequate protection. And so, this situation raises what are now familiar questions about the U.S. chemical regulatory system’s ability to restrict even the most obviously hazardous substances.

Elizabeth Grossman is the author of Chasing Molecules: Poisonous Products, Human Health, and the Promise of Green Chemistry, High Tech Trash: Digital Devices, Hidden Toxics, and Human Health, and other books. Her work has appeared in a variety of publications including Scientific American, Yale e360, Environmental Health Perspectives, Mother Jones, Ensia, Time, Civil Eats, The Guardian, The Washington Post, Salon and The Nation.