Risk assessment of inhalation exposure to formaldehyde among workers in medical laboratories
Article Sidebar
Main Article Content
Abstract
Formaldehyde (FA) is widely used in medical laboratories and has been classified by International Agency for Research on Cancer (IARC) as a group 1 carcinogen. The aim of this study was to assess the health risk of inhalation exposure to formaldehyde among staff in medical laboratories such as those in pathology, anatomy, forensics, and parasitology. A total of 33 staff members were included in the study. Data on FA exposure were collected by air monitoring in the laboratory areas by using Gasmet DX-4030, and the human health risk was assessed by the guidelines of the US. Environmental Protection Agency (2009). The study showed that 21.21% of the personnel exposed to FA had health risks with non-carcinogenic effects (hazard quotient range = 0.02 to 11.4), and with regard to cancer risk, the highest risk was found to be in pathology technicians (6.51x10-4), followed by investigative mortuary personnel, residents (sixth-year medical students), embalming mortuary personnel, and instructors or those working in forensic laboratories (3.25x10-4, 6.07x10-5, 3.39x10-5, and 1.27x 10-5, respectively). Those staff had a higher than acceptable risk of cancer (>10-6). It is recommended that workers' FA exposure should be reduced by working with formalin in a fume hood, reducing exposure h and using respiratory cartridges.
Article Details
References
Edrissi B, Taghizadeh K, Moeller B, Yu R, Kracko D, Doyle-Eisele M, et al. N6 Formyllysine as a biomarker of formaldehyde exposure: formation and loss of N6 formyllysine in nasal epithelium in long term, low-dose inhalation studies in rats. Chem Res Toxicol. 2017;30:1572-1576.
International Agency for Research on Cancer. IARC Monographs on the evaluation of carcinogenic risks to humans. Vol 88-Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol, Lyon, France [Internet]. 2006 [cited 2019 Jan 5]. Available from: https://monographs.iarc.fr/wp-content/uploads/ 2018/06/mono88.pdf.
Nowshad F, Islam N, Khan MS. Analysis of the concentration and formation behavior of naturally occurring formaldehyde content in food. In: Baby S, editor. 4th International Conference on Food Security and Nutrition (ICFSN 2017); 2017 Mar 13-15; Prague, Czech Republic. Singapore: IPCBEE; 2009. p. 71-75.
Solta P, Konnerthb J, Gindl AW, Kantner W, Moser J, Mitter R, et al. Technological performance of formaldehyde-free adhesive alternatives for particle board industry. Int J Adhes Adhes. 2019;94:99-131.
Driscoll T, Carey R, Peters S, Glass D, Benke G, Reid A, et al. The Australian work exposures study: prevalence of occupational exposure to formaldehyde. Ann Occup Hyg. 2015;60(1):132-138.
Kwon JW, Park HW, Kim WJ, Kim MG, Lee SJ. Exposure to volatile organic compounds and airway inflammation. Environ Health. 2018;17(65): e104069. PMID:30086760.
Elshaer NS, Mahmoud MA. Toxic effects of formalin-treated cadaver on medical students, staff members, and workers in the Alexandia Faculty of Medicine. Alexandria J Med. 2017;53(4):337-343.
Tantipanjaporn T, Boonyayothin V, Chantanakul S, Siri S. Symptoms of formaldehyde exposure among embalming staffs of hospitals in Bangkok. In: Sangkhamalai P, editor in chief. The 4th STOU graduate research conference; 2014 Nov 26-27; Bangkok, Thailand. Nonthaburi: STOU press; 2016. p. 1-10.
Promtes K, Kaewboonchoo O, Harncharoen K, Ekpanyaskul C. Cancer risk assessment of inhalation formaldehyde exposure among medical students during anatomy laboratory. Thai J Toxicol. 2014;29
(1-2):8-22.
Ashely K, Connor P, editors. NIOSH manual of analytical method 5th ed [Internet]. Washington: The National Institute for Occupational Safety and Health (NIOSH); 1970 [cited 2021 Jan 21]. Available from: https://www.cdc.gov/niosh/nmam/default.html.
Office of Superfund Remediation and Technology Innovation. Risk assessment guidance for superfund volume I: human health evaluation manual (Part F, supplemental guidance for inhalation risk assessment) [Internet]. Washington: U.S. Environmental Protection Agency; 1970 [cited 2018 Jan 17]. Available from: https://www.epa.gov/sites/production/files/2015-09/documents/partf_200901_final.pdf.
Kimbell JS, Overton JH, Subramaniam RP, Schlosser PM, Morgan KT, Conolly RB, et al. Dosimetry modelling of inhaled formaldehyde: binning nasal flux predictions for quantitative risk assessment. Toxicol Sci. 2001;64(1):111-121.
Pokorski M. Pulmonary care and clinical medicine. 1st ed. London: Springer Nature; 2017.
Integrated Risk Information System (IRIS). Formaldehyde CASRN 50-00-0 | DTXSID7020637 [Internet]. Washington: U.S. Environmental Protection Agency; 1970 [cited 2018 Jan 28]. Available from: https://cfpub.epa.gov/ncea/iris2/chemicalLanding.cfm?substance_nmbr=0419.
Mahosot S. Announcement of hazardous chemical concentration limits (in Thai) [Internet]. Bangkok: Department of Labor Protection and Welfare; 1992 [cited 2019 Jan 29]. Available from: http://cste.sut.ac.th/csteshe/wp-content/lews/Law28.pdf.
Gurbuz N, Caskun ZK, Liman FA, Anil A, Turgut HB. The evaluation of formaldehyde exposure in the anatomy laboratories and the preventive measure. Gazi Med J. 2016;27(2):98-103.
Scarselli A, Corfiati M, Marzio DD, Iavicoli S. National estimates of exposure to formaldehyde in Italian
workplaces. Ann Work Expo Health. 2017;61(1):33-43.
Ohmichi K, Komiyama M, Matsuno Y, Takanashi Y, Miyamoto H, Kadota T, et al. Formaldehyde exposure in a gross anatomy laboratory--personal exposure level is higher than indoor concentration. Environ Sci Pollut Res Int. 2006;13(2):120-124.
Zain SM, Azmi WN, Veloo Y, Shaharudin R. Formaldehyde exposure, health symptoms and risk assessment among hospital workers in Malaysia. J Environ Prot Sci. 2019;10(6):861-879.
Rovira J, Roig N, Nadal M, Schuhmacher M, Domingo JL. Human health risks of formaldehyde indoor levels: an issue of concern. J Environ Sci Health. 2016;51(4):357-363.
Orsière T, Minodier IS, Iarmarcovai G, Botta A. Genotoxic risk assessment of pathology and anatomy laboratory workers exposed to formaldehyde by use of personal air sampling and analysis of DNA damage in peripheral lymphocytes. Mutat Res. 2016;605(1-2):30-41.
Hsu Y, Chao H, Shih S. Human exposure to airborne aldehydes in Chinese medicine clinics during moxibustion therapy and its impact on risks to health. J Environ Sci Health A Tox Hazard Subst Environ Eng. 2015;50(3):260-271.
Huang L, Mo J, Sundell J, Fan Z, Zhang1 Y. Health risk assessment of inhalation exposure to formaldehyde and benzene in newly remodeled buildings, Beijing. Plos One. 2013;8(11):e79553. PMID: 24244522.
Tunsaringkarn T, Prueksasit T, Kitwattanavong M, Siriwong W, Sematong S, Zapuang K, et al. Cancer risk analysis of benzene, formaldehyde and acetaldehyde on gasoline station workers. J Environ Eng Sci. 2012;1:1-5.
Office of Superfund Remediation and Technology Innovation. Risk assessment guidance for superfund volume I human health evaluation manual (part A) [Internet]. Washington: U.S. Environmental Protection Agency; 1970 [cited 2018 Jan 17]. Available from: https://www.epa.gov/sites/production/files/
-09/documents/rags_a.pdf.
The Persistent Organic Pollutants (POPs) Toolkit. Slope factors (SF) for carcinogens [Internet]. Washington: U.S. Environmental Protection Agency; 1970 [cited 2018 Feb 3]. Available from: http://www.popstoolkit.com/tools/HHRA/SF_USEPA.aspx.
Ho S, Cheng Y, Bai Y, Ho K, Dai W, Cao J, et al. Risk assessment of indoor formaldehyde and other carbonyls in campus environments in northwestern China. Aerosol Air Qual Res. 2016;16(8):1967-1980.
Chaiklieng S, Pimpasaeng C, Thapphasaraphong S. Benzene exposure at gasoline stations: health risk
assessment. Hum Ecol Risk Assess. 2015;21(8):2213-2222.