Environmental pollution and personal exposure to formaldehyde in a university hospital facility.
Keywords:Healthcare workers, Formaldehyde, Occupational exposure
Formaldehyde is a ubiquitous chemical used in many industrial and professional sectors due to its multiple properties. In the health sector it is used as a stabilizer and preservative for organs and biological tissues in surgical and endoscopic clinics, operating and autopsy theaters and Pathological Anatomy services. The aim of this study was to measure the levels of formaldehyde pollution and the consequent exposure of the health personnel of a large university hospital. The study involved, in addition to the services already mentioned, other environments in which the use of formaldehyde is envisaged, such as storage rooms, anatomical archives and funeral services, generally not subject to an assessment. The levels of formaldehyde in all analyzed areas, measured through environmental and personal sampling, were lower than both the transitional limit value currently adopted in Italy, and the more restrictive limit value in force from 2024 of 0.37 mg / m3 (range 0.002 -0.264 mg/m3). As expected, the highest values were measured in the Pathological Anatomy laboratories during the repeated manipulation of numerous anatomical samples preserved in formaldehyde. Levels not particularly low, albeit lower than the limit values, were also detected within the anatomical archives in relation to the high number of finds stored in non-hermetic containers (0.005-0.252 mg/m3). In such environments, however, the presence of personnel is occasional and of short duration, even if their remediation would reduce the dispersion of this chemical in adjacent rooms. In outpatient clinics, operating and autopsy theaters, where exposure to formaldehyde occurs exclusively when the anatomical samples are immersed in the collection vessels, on the contrary, the levels were particularly low (range 0.002-0.044 mg/m3). The personal exposure (0.016-0.897 mg/m3) in all services was found, in almost all cases, below the limit values and, consistently with the levels of environmental pollution: the highest values were those of the personnel of the Pathological Anatomy (average 0.148 mg/m3) where the only level over the limit value was measured.
Albertini, P., Mainardi, P., Mazzeo, N., Triassi, M., 2012. Experimental value of formaldehyde exposure to preserve anatomical findings. Ann. Ig., 24(3), 221-228.
Alessio, L., Franco, G., Tomei, F. in Trattato di Medicina del Lavoro, ed. Piccin, Padova (IT), 2015.
Bosetti, C., McLaughlin, J.K., Tarone, R.E., Pira, E., La Vecchia, C., 2008. Formaldehyde and cancer risk: a quantitative review of cohort studies through 2006. Ann Oncol., 19(1),29-43.
Cammalleri, V., Pocino, R.N., Marotta, D., Protano, C., Sinibaldi, F., Simonazzi, S., Petyx, M., Iavicoli, S., Vitali, M., 2022. Occupational scenarios and exposure assessment to formaldehyde: A systematic review. Indoor Air, 32(1), e12949.
Cavallo, D.M., Cattaneo, A., Spinazzè, A., 2017. Occupational exposure to formaldehyde: the proposal of Lombardy region. Ital. J. Occup. Environ. Hyg. 8(2), 48 – 52.
Collins, J.J., Esmen,N.A., Hall, T.A., 2001. A review and meta-analysis of formaldehyde exposure and pancreatic cancer. Am J Ind Med., 39(3),336-45.
Costa, S., Coelho, P., Costa, C., Silva, S., Mayan, O., Santos, L.S., Gaspar, J., Teixeira, J.P., 2008. Genotoxic damage in pathology anatomy laboratory workers exposed to formaldehyde. Toxicology, 252(1-3),40-8.
Costa, S., García-Lestón, J., Coelho, M., Coelho, P., Costa, C., Silva, S., Porto, B., Laffon, B., Teixeira, J.P., 2013. Cytogenetic and immunological effects associated with occupational formaldehyde exposure. J. Toxicol. Environ. Health A., 76(4-5),217-29.
D'Ettorre, G., Criscuolo, M., Mazzotta, M., 2017. Managing Formaldehyde indoor pollution in anatomy pathology departments. Work, 56(3), 397-402.
D'Ettorre, G., Caroli, A., Mazzotta, M., 2021. Minimizing formaldehyde
exposure in a hospital pathology laboratory. Work, 69(1), 209-213.
Fustinoni, S., Campo, L., Spinazzè, A., Cribiù, F. M., Chiappa, L., Sapino, A., Mercadante, R., Olgiati, L., Boniardi, L., Cavallo, D.M., Riboldi, L., Ferrero, S., Boggio, F., 2021. Exposure and Management of the Health Risk for the Use of Formaldehyde and Xylene in a Large Pathology Laboratory. Annals of Work Exposures and Health, 65(7), 805–818.
Ghelli, F., Bellisario, V., Squillacioti, G., Panizzolo, M., Santovito, A., Bono, R., 2021. Formaldehyde in Hospitals Induces Oxidative Stress: The Role of GSTT1 and GSTM1 Polymorphisms. Toxics, 9(8), 178.
Gori, G.P., Trevisan, A., Buzzo, A., Calzavara, V., Bressa, G., Cima, L., 1985. Inquinamento da formaldeide delle sale operatorie. Acta Anæsth Italica 36,755‐758.
Hauptmann, M., Lubin, J.H., Stewart, P.A., Hayes, R.B., Blair, A., 2004. Mortality from solid cancers among workers in formaldehyde industries. Am. J. Epidemiol., 159(12),1117-30.
IARC, 2006. Formaldehyde, 2-butoxyethanol and 1-tertbutoxypropan-2-ol. IARC Monogr. Eval. Carcinog. Risks, 88, 1–478.
Kim, S.U., Kim, T.R., Lee, E.S., Kim, M.S., Kim, C.K., Kim, L.R., Shin, G.Y., 2015. Formaldehyde and heavy metal migration from rubber and metallic packaging/utensils in Korea. Food Addit. Contam. Part B Surveill. 8(1),7-11.
Ladeira, C., Viegas, S., Carolinoa, E., Prista, J., Gomes, M.C., Britoa, M., 2011. Genotoxicity biomarkers in occupational exposure to formaldehyde—The case of histopathology laboratories. Mutat. Res., 721(1),15-20
Moayedi-Nia, S., Pasquet, R., Siemiatycki, J., Koushik, A., Ho, V., 2022. Occupational Exposures and Lung Cancer Risk - An Analysis of the CARTaGENE Study. J. Occup. Environ. Med., 64(4),295-304.
Nishikawa, A., Nagano, K., Kojima, H., Ogawa, K., 2021. A comprehensive review of mechanistic insights into formaldehyde-induced nasal cavity carcinogenicity. Regul. Toxicol. Pharmacol., 123,104937.
Paustenbach, D., Alarie, Y., Kulle, T., Schachter, N., Smith, R., Swenberg, J., Witschi, H., Horowitz, S.B., 1997. A recommended occupational exposure limit for formaldehyde based on irritation. J Toxicol. Environ. Health, 50(3),217-63.
Ryan, T.J., Burroghs, G.E., Taylor, K., Kovein, R.J., 2003. Video exposure assessments demonstrate excessive laboratory formaldehyde exposures. Appl. Occup. Environ. Hyg., 18, 450-457.
Roto, P., Sala, E., 1996. Occupational Laryngitis Caused by Formaldehyde: A case Report. Am J Ind Med. 29, 275-277.
Salthammer, T., Mentese, S., Marutzky, R., 2010. Formaldehyde in the Indoor Environment. Chem. Rev., 110(4), 2536–2572;
Scapellato, M.L., Maccà, I., Marcuzzo, G., Giangolzian, D., Gori, G., Bartolucci, G.B., 1999. Aldeidi in ambiente ospedaliero. Rischio da esposizione. G Ig Ind, 24, 11-17.
Siti Hajar, T., Anis, J.S., Normah, A., Mazrura, S., 2013. Exposure Assessment of Formaldehyde and its Sympoms among Anatomy Laboratory Workers and Medical Students; Asian J. App. Sc., 6, 50-55.
Vardoulakis, S., Giagloglou, E., Steinle, S., Davis, A., Sleeuwenhoek, A., Galea, K.S., Dixon, K., Crawford, J.O., 2020. Indoor Exposure to Selected Air Pollutants in the Home Environment: A Systematic Review. Int. J. Environ. Res. Public Health., 17(23),8972.
Viegas, S., Ladeira, C., Nunes, C., Malta-Vacas, J., Gomes, M., Brito, M., Mendonca, P., Prista, J., 2010. Genotoxic effects in occupational exposure to formaldehyde: A study in anatomy and pathology laboratories and formaldehyde-resins production. J. Occup. Med. Tox., 5(1), 25.
Vimercati, L., Carrus, A., Dell'Erba, A., Assennato, G. 2007. Occupational exposure to formaldehyde in autopsy room and in pathologic anatomy laboratories. G. Ital. Med. Lav. Ergon., 29(3 Suppl),266-268.
WHO. International programme on chemical safety: environmental health criteria,1989.