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Kerner AM, Biedermann U, Bräuer L, Caspers S, Doll S, Engelhardt M, Filler TJ, Ghebremedhin E, Gundlach S, Hayn-Leichsenring GU, Heermann S, Hettwer-Steeger I, Hiepe L, Hirt B, Hirtler L, Hörmann R, Kulisch C, Lange T, Leube R, Meuser AH, Müller-Gerbl M, Nassenstein C, Neckel PH, Nimtschke U, Paulsen F, Prescher A, Pretterklieber M, Schliwa S, Schmidt K, Schmiedl A, Schomerus C, Schulze-Tanzil G, Schumacher U, Schumann S, Spindler V, Streicher J, Tschernig T, Unverzagt A, Valentiner U, Viebahn C, Wedel T, Weigner J, Weninger WJ, Westermann J, Weyers I, Waschke J, Hammer N. The chemicals between us-First results of the cluster analyses on anatomy embalming procedures in the German-speaking countries. ANATOMICAL SCIENCES EDUCATION 2023; 16:814-829. [PMID: 37183973 DOI: 10.1002/ase.2285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/20/2023] [Accepted: 04/22/2023] [Indexed: 05/16/2023]
Abstract
Hands-on courses utilizing preserved human tissues for educational training offer an important pathway to acquire basic anatomical knowledge. Owing to the reevaluation of formaldehyde limits by the European Commission, a joint approach was chosen by the German-speaking anatomies in Europe (Germany, Austria, Switzerland) to find commonalities among embalming protocols and infrastructure. A survey comprising 537 items was circulated to all anatomies in German-speaking Europe. Clusters were established for "ethanol"-, formaldehyde-based ("FA"), and "other" embalming procedures, depending on the chemicals considered the most relevant for each protocol. The logistical framework, volumes of chemicals, and infrastructure were found to be highly diverse between the groups and protocols. Formaldehyde quantities deployed per annum were three-fold higher in the "FA" (223 L/a) compared to the "ethanol" (71.0 L/a) group, but not for "other" (97.8 L/a), though the volumes injected per body were similar. "FA" was strongly related to table-borne air ventilation and total fixative volumes ≤1000 L. "Ethanol" was strongly related to total fixative volumes >1000 L, ceiling- and floor-borne air ventilation, and explosion-proof facilities. Air ventilation was found to be installed symmetrically in the mortuary and dissection facilities. Certain predictors exist for the interplay between the embalming used in a given infrastructure and technical measures. The here-established cluster analysis may serve as decision supportive tool when considering altering embalming protocols or establishing joint protocols between institutions, following a best practice approach to cater toward best-suited tissue characteristics for educational purposes, while simultaneously addressing future demands on exposure limits.
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Affiliation(s)
- Alexander Michael Kerner
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Uta Biedermann
- Institute of Anatomy I, University Hospital Jena, Jena, Germany
| | - Lars Bräuer
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Svenja Caspers
- Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sara Doll
- Department of Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
| | - Maren Engelhardt
- Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
| | - Timm J Filler
- Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Stefanie Gundlach
- Institute of Anatomy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | | | - Stephan Heermann
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Laura Hiepe
- Institute of Anatomy, Rostock University Medical Center, Rostock, Germany
| | - Bernhard Hirt
- Institute of Clinical Anatomy and Cell Analysis, University of Tübingen, Tübingen, Germany
| | - Lena Hirtler
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Romed Hörmann
- Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Kulisch
- Institute of Functional Anatomy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Lange
- Institute of Anatomy I, University Hospital Jena, Jena, Germany
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rudolf Leube
- Department of Anatomy and Cell Biology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Annika Hela Meuser
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | | | | | - Peter H Neckel
- Institute of Clinical Anatomy and Cell Analysis, University of Tübingen, Tübingen, Germany
| | - Ute Nimtschke
- Institute of Anatomy, Technical University Carl Gustav Carus Dresden, Dresden, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Prescher
- Department of Anatomy and Cell Biology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Michael Pretterklieber
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Stefanie Schliwa
- Institute of Anatomy, Anatomy and Cell Biology, University of Bonn, Bonn, Germany
| | - Katja Schmidt
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Andreas Schmiedl
- Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Christof Schomerus
- Institute of Anatomy, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Gundula Schulze-Tanzil
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, Nuremberg, Germany
| | - Udo Schumacher
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Schumann
- Institute of Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Volker Spindler
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Johannes Streicher
- Department of Anatomy and Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Thomas Tschernig
- Institute of Anatomy and Cell Biology, Saarland University, Homburg, Germany
| | - Axel Unverzagt
- Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Ursula Valentiner
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Thilo Wedel
- Institute of Anatomy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Janet Weigner
- Institute of Veterinary Anatomy, Freie Universität Berlin, Berlin, Germany
| | - Wolfgang J Weninger
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | | | - Imke Weyers
- Institute of Anatomy, University of Lübeck, Lübeck, Germany
| | - Jens Waschke
- Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany
- Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology Dresden, Dresden, Germany
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Zdilla MJ. Local exhaust ventilation systems for the gross anatomy laboratory. Morphologie 2020; 105:237-246. [PMID: 33279395 DOI: 10.1016/j.morpho.2020.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/19/2022]
Abstract
The inability to exhaust airborne formaldehyde and other volatile organic compounds from a gross anatomy laboratory is an impediment to gross anatomical education. Despite the importance of removing harmful airborne chemicals, there is scant information regarding how to build effective local exhaust ventilation systems. In this study, various exhaust systems were built and assessed for exhaust flow, airborne formaldehyde removal, and noise production with the aim of identifying inexpensive and simple exhaust systems that can create a healthy and quiet exhaust flow from a downdraft dissection table. The results of the study include details regarding 11 local exhaust ventilation systems, including an exhaust system that produces an exhaust flow of 777cfm, allows no detectable airborne formaldehyde (0ppm) despite a 1000mL pool of formalin (composed of 37% formaldehyde) positioned directly beneath a formaldehyde-meter, and operates at a very low noise level (maximum of 69.2dBA with coexisting baseline room noise of 38.6dBA). Furthermore, the aforementioned local exhaust ventilation system costs less than $400 (USD) to build and can be assembled in a matter of minutes with minimal know-how. The local ventilation systems assessed in this study were capable of down-drafting air away from the breathing zone; therefore, the utilization of such local ventilation systems may have the additional benefit of decreasing the person-to-person transmission of aerosolized pathogens. This information marks an improvement in laboratory health and safety measures, facilitates the creation of gross anatomy laboratories, and improves access to gross anatomical education.
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Affiliation(s)
- Matthew J Zdilla
- Department of Pathology, Anatomy, and Laboratory Medicine (PALM), West Virginia University School of Medicine, Robert C. Byrd Health Sciences Center, 26506 Morgantown, WV, USA; Department of Biology, West Liberty University, West Liberty, WV, USA; Department of Graduate Health Sciences, West Liberty University, West Liberty, WV, USA.
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