Formaldehyde Exposures in a Gross Anatomy Laboratory -- Colorado

A recent study by the National Institute for Occupational Safety and Health (NIOSH) found significant exposures to formaldehyde in a gross anatomy laboratory at a medical school in Colorado (1).

In early December 1981, at the request of medical and dental students at the university, NIOSH investigators conducted an environmental evaluation of the anatomy laboratory and a medical evaluation of the students using it. They collected 55 personal breathing-zone air samples from students dissecting cadavers (25 for determination of formaldehyde exposure and 30 for determination of phenol exposure). In addition, they performed pulmonary function tests on 23 students.

Results of the environmental sampling showed formaldehyde levels ranging from less than 0.02 mg/M((3)) to 3.3 mg/M((3)) (0.02 parts per million (ppm) to 2.7 ppm), indicating exposures sufficient to cause symptoms of irritation in most of the exposed students. Phenol levels ranged from less than 0.01 mg/M((3)) to 12.2 mg/M((3)), all within the NIOSH-recommended maximum occupational exposure level of 19.0 mg/M((3)) (2).

Pulmonary function tests on the 23 students were normal. However, one student, tested after exposure, showed clinically significant decreases of 13.0% in forced vital capacity and 10.7% in forced expiratory volume in 1 second. This student had a history of adverse reactions to formaldehyde, presumably an allergic basis for these findings. Eleven other students who participated in post-exposure pulmonary function tests showed no significant decreases in pulmonary function. Reported by the Hazard Evaluations and Technical Assistance Br, Div of Surveillance, Hazard Evaluations, and Field Studies, NIOSH, CDC.

Editorial Note

Editorial Note: The sharp odor of formaldehyde can be detected at very low levels (less than 1 ppm). Exposure to concentrations ranging from 0.1 to 5.0 ppm can cause burning of the eyes, tearing, and general irritation to the upper respiratory passages. Low levels (0.3-2.7 ppm) have also been found to disturb sleep and to be irritating to some persons (3). Higher levels (10-20 ppm) may produce coughing, tightening in the chest, a sense of pressure in the head, and palpitations (4-6). Exposures of 50-100 ppm and above can cause serious injury, including pulmonary edema, pneumonitis, or death (7).

Dermatitis due to formaldehyde solutions or formaldehyde-containing resins is a well-recognized problem (8). After a few days of exposure, a sudden inflammatory skin reaction may develop on the eyelids, face, neck, scrotum, and flexor surfaces of the arms. Other surfaces of the body may also be involved, sometimes after years of repeated exposure.

Formaldehyde has been shown to induce a rare form of nasal cancer in both Fischer 344 rats and B6C3F1 mice (9) and may induce the same type of cancer in Sprague-Dawley rats. Although humans and animals may differ in their susceptibility to specific chemical compounds, any substance producing cancer in experimental animals, particularly in more than one species, should be viewed as a potential cancer-causing agent in humans. Formaldehyde has also demonstrated mutagenic activity in several test systems.

NIOSH recommends that formaldehyde be handled in the workplace as a potential occupational carcinogen (3). Safe levels of exposure to carcinogens have not been demonstrated, but decreasing exposure should reduce the possibility of developing cancer. The extent of cancer risk from exposure to formaldehyde levels at or below the current Occupational Safety and Health Administration (OSHA) standard of 3 ppm (10) has not yet been determined. As a prudent public health measure, NIOSH recommends that engineering controls and stringent work practices reduce occupational exposure to the lowest possible levels.

To minimize formaldehyde exposure in gross anatomy laboratories, NIOSH recommends the following:

1. Students and instructors should be aware of the potential health hazards of formaldehyde.

2. Persons handling formalin or preparing dilute formalin solutions should wear protective equipment, including rubber gloves, protective aprons, and eye and face protection.

3. Ventilation should provide a minimum of five air changes per hour to help lower formaldehyde concentrations.

References

1. National Institute for Occupational Safety and Health. Health hazard evaluation. Cincinnati, Ohio: National Institute for Occupational Safety and Health, 1982. (Report no. HETA 82-045-1108).

2. National Institute for Occupational Safety and Health. Criteria for a recommended standard: occupational exposure to phenol. Cincinnati, Ohio: National Institute for Occupational Safety and Health, 1976. (DHEW publication no. (NIOSH) 76-196).

3. National Institute for Occupational Safety and Health. Formaldehyde: evidence of carcinogenicity. Cincinnati, Ohio: National Institute for Occupational Safety and Health, April 15, 1981. NIOSH Current Intelligence Bulletin 34. (DHEW Publication No. (NIOSH) 81-111).

4. Committee on Toxicology. Formaldehyde--an assessment of its health effects. Washington, D.C.: National Academy of Sciences, March 1980.

5. Loomis TA. Formaldehyde toxicity. Arch Pathol Lab Med 1975;103:321-4.

6. Kerfoot EJ, Mooney TF. Formaldehyde and paraformaldehyde study in funeral homes. Am Ind Hyg Assoc J 1975;36:533-7.

7. National Institute for Occupational Safety and Health. Criteria for a recommended standard: occupational exposure to formaldehyde. Cincinnati, Ohio: National Institute for Occupational Safety and Health, 1977. (DHEW publication no. (NIOSH) 77-126).

8. Proctor NH, Hughes JP. Chemical hazards of the workplace. Philadelphia: Lippincott, 1978.

9. Chemical Industry Institute of Toxicology. Statement concerning research findings, Docket No. 11109. Research Triangle Park, North Carolina: Chemical Industry Institute of Toxicology. October 8, 1979.

10. Occupational Safety and Health Administration. OSHA safety and health standards. Washington, D.C.: Occupational Safety and Health Administration, 1980 (revised). (29 CFR 1910.1000).

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