Acute pulmonary response in healthy, nonsmoking adults to inhalation of formaldehyde and carbon

Pulmonary function test in formalin exposed and nonexposed subjects: A comparative study

Background:

The main function of the lung is gas exchange, which can be assessed in several ways. A spirometer measures the flow and the volumes of the inspired and expired air. The thoracic and abdominal muscle strength plays an important role in pulmonary function and diffusing lung capacity.

Aims and Objectives:

The aim of this study was to assess the effects of formalin exposure on the pulmonary function to compare with healthy individuals. To assess the chronic effects of formalin exposure on Pulmonary function tests (PFTs) in the faculties, lab technicians and attender of the Department of Anatomy and Pathology of SRM Medical Hospital and Research Centre, Kattankulathur.

Materials and Methods:

This prospective study was carried out in 50 healthy formalin exposed subjects (at least 5 years exposure) from Department of Anatomy and Pathology of SRM Medical College Hospital and Research Centre, Kattankulathur and 50 healthy controls of same age group of this study were included after obtaining ethical clearance and consent ‘Easy One Pro Spirometer (Ndd Medical Technologies, Cheshire SK 101LT, United Kingdom) was used to find out the PFT.

Results:

Student's t-test was applied to compare the PFT parameters between formalin exposed and formalin nonexposed group. There was a significant difference in mean and standard deviation of pulmonary parameters with the P < 0.005 in formalin exposed, which shows that they have lesser ventilatory drive.

Conclusion:

The formalin exposed subjects in our study presented with a mixed disorder of both obstructive and restrictive type. We also found that there was a negative correlation of pulmonary function with that of the degree and duration of exposure to formalin.

Non-cancer effects of formaldehyde and relevance for setting an indoor air guideline

There is considerable recent focus and concern about formaldehyde (FA). We have reviewed the literature on FA with focus on chemosensory perception in the airways and lung effects in indoor environments. Concentrations of FA, both personal and stationary, are on average in the order of 0.05 mg/m(3) or less in Europe and North America with the exception of new housing or buildings with extensive wooden surfaces, where the concentration may exceed 0.1 mg/m(3). With the eye the most sensitive organ, subjective irritation is reported at 0.3-0.5 mg/m(3), which is somewhat higher than reported odour thresholds. Objective effects in the eyes and airways occur around 0.6-1 mg/m(3). Dose-response relationships between FA and lung function effects have not been found in controlled human exposure studies below 1 mg/m(3), and epidemiological associations between FA concentrations and exacerbation of asthma in children and adults are encumbered by complex exposures. Neither experimental nor epidemiological studies point to major differences in susceptibility to FA among children, elderly, and asthmatics. People with personal trait of negative affectivity may report more symptoms. An air quality guideline of 0.1 mg/m(3) (0.08 ppm) is considered protective against both acute and chronic sensory irritation in the airways in the general population assuming a log normal distribution of nasal sensory irritation.

Evaluation and application of the RD50 for determining acceptable exposure levels of airborne sensory irritants for the general public

BACKGROUND

The RD(50) (exposure concentration producing a 50% respiratory rate decrease) test evaluates airborne chemicals for sensory irritation and has become an American Society for Testing and Materials (ASTM) standard method. Past studies reported good correlations (R(2)) between RD(50)s and the occupational exposure limits, particularly threshold limit values (TLVs).

OBJECTIVE

The main purpose of this study was to examine the relationship between RD(50)s and human sensory irritation responses in a quantitative manner, particularly for chemicals that produce burning sensation of the eyes, nose, or throat, based on lowest observed adverse effect levels (LOAELs) reported for human subjects.

METHODS

We compared RD(50)s with LOAELs and acute reference exposure levels (RELs). RELs, developed by the California Environmental Protection Agency's Office of Environmental Health Hazard Assessment, represent a level at which no adverse effects are anticipated after exposure. We collected RD(50)s from the published literature and evaluated them for consistency with ASTM procedures. We identified LOAELs for human irritation and found 25 chemicals with a corresponding RD(50) in mice.

DISCUSSION

We found the relationship between RD(50)s and LOAELs as log RD(50) = 1.16 (log LOAEL) + 0.77 with an R(2) value of 0.80. This strong correlation supports the use of the RD(50) in establishing exposure limits for the public. We further identified 16 chemical irritants with both RD(50)s and corresponding acute RELs, and calculated the relationship as log RD(50) = 0.71 (log REL) + 2.55 with an R(2) value of 0.71. This relationship could be used to identify health protective values for the public to prevent respiratory or sensory irritation.

CONCLUSION

Consequently, we believe that the RD(50) has benefits for use in setting protective levels for the health of both workers and the general population.

Does Haber's law apply to human sensory irritation?

Irritation of the eyes, nose, and throat by airborne chemicals--also referred to as "sensory irritation"--is an important endpoint in both occupational and environmental toxicology. Modeling of human sensory irritation relies on knowledge of the physical chemistry of the compound(s) involved, as well as the exposure parameters (concentration and duration). A reciprocal relationship between these two exposure variables is postulated under Haber's law, implying that protracted, low-level exposures may be toxicologically equivalent to brief, high-level exposures. Although time is recognized as having an influence on sensory irritation, the quantitative predictions of Haber's Law have been addressed for only a handful of compounds in human experimental studies. We have conducted a systematic literature review that includes a semiquantitative comparison of psychophysical data extracted from controlled human exposure studies versus. the predictions of Haber's law. Studies containing relevant data involved exposures to ammonia (2), chlorine (2), formaldehyde (1), inorganic dusts such as calcium oxide (1), and the volatile organic compound 1-octene (1). With the exception of dust exposure, varying exposure concentration has a proportionally greater effect on sensory irritation than does changing exposure duration. For selected time windows, a more generalized power law model (c(n) x t = k) rather than Haber's law per se (c x t = k) yields reasonably robust predictions. Complicating this picture, however, is the frequent observation of intensity-time "plateauing," with time effects disappearing, or even reversing, after a relatively short period, depending on the test compound. The implications of these complex temporal dynamics for risk assessment and standard setting have been incompletely explored to date.

Risk assessment of formaldehyde for the general population in Japan

Formaldehyde is used in the production of resins, molding compounds, photographic film, bactericide, and tissue preservative. The purpose of this study was to provide an up-to-date critical review of the information to the toxicological profile of formaldehyde, and to assess the risk of formaldehyde for the general population in Japan. Inhaled formaldehyde is an effective sensory irritant at a dosage of 0.5 ppm in mice. Following inhalation in laboratory animals, more than 6 ppm formaldehyde causes degenerative non-neoplastic effects in mice and monkeys and nasal tumors in rats. It is considered that formaldehyde induces genotoxic effects directly in vitro and secondarily in vivo. Sensory irritation of the eyes and respiratory tract in response to inhalation exposure to formaldehyde has been reported at 0.08 ppm and above in human study. Formaldehyde is carcinogenic at the site of contact as a consequence of epithelial cell regenerative proliferation resulting from cytotoxicity and mutation, based on studies in both animals and humans. Levels of formaldehyde in atmosphere detected in rural, suburban, and urban areas in Japan were 2.5-3.2 ppb from 1998 to 2003. The majority of the population is exposed to atmosphere concentrations of formaldehyde less than those associated with sensory irritation. The reference concentration of formaldehyde in atmosphere for the Japanese general population is recommended to be 0.01 ppm.

Inhaled formaldehyde: exposure estimation, hazard characterization, and exposure-response analysis

Formaldehyde has been assessed as a Priority Substance under the Canadian Environmental Protection Act. Probabilistic estimates of exposure of the general population in Canada to formaldehyde in ambient and indoor air are presented. Critical health effects include sensory irritation and the potential to induce tumors in the upper respiratory tract (the nasal region in rodents and potentially the lungs of humans). The majority of the general population is exposed to airborne concentrations of formaldehyde less than those typically associated with sensory irritation (i.e., 0.1 mg/m3). Based primarily upon data derived from laboratory studies, the inhalation of formaldehyde under conditions that induce cytotoxicity and sustained regenerative proliferation within the respiratory tract is considered to present a carcinogenic hazard to humans. At airborne levels for which the prevalence of sensory irritation is minimal (i.e., 0.1 mg/m3), risks of respiratory-tract cancers for the general population estimated on the basis of a biologically motivated case-specific model are exceedingly low. This biologically motivated case-specific model incorporates two-stage clonal expansion and is supported by dosimetry calculations from computational fluid dynamics analyses of formaldehyde flux in various regions of the nose and single-path modeling for the lower respiratory tract. The degree of confidence in the underlying database and uncertainties in estimates of exposure and in characterization of hazard and dose response are delineated.

Toxicological considerations in evaluating indoor air quality and human health: impact of new carpet emissions

This review article considers evidence regarding the toxicological impact of new carpet emissions on indoor air quality and human health. It compares emissions data from several studies and describes the dominant compounds found in those emissions. The toxicity of each these compounds is assessed for animal and human data, with a focus on inhalation exposure. Data for acute and chronic exposures are presented, and synergistic effects are considered. Differences and similarities between health responses caused by toxicity and/or by immunological reactions are discussed. Possible neurogenic pathways and associations between these and immune changes are considered as they might relate to inflammatory-based human reactions. Additionally, factors affecting human odor responses are described. The roles that a variety of psychological factors may also play in the etiology of potentially related phenomena, such as the sick building syndrome, pathogenic illness, and multiple chemical sensitivity, are considered. Gaps in the literature are identified within the article and suggestions for future research are offered. In particular, it is noted that few, if any, prior studies have evaluated both neurogenic and immune-mediated inflammation status within the same study. Based on the present information available, it is concluded that under normal environmental circumstances, VOC emissions from new carpets are sufficiently low such that they should not adversely affect indoor air quality or pose significant health risk to people.

Respiratory effects of organic solvent exposure

Organic solvents are widely used in industrial processes and found in many common household products. Exposures to solvents are common in both idustrialized and industrializing countries. While organic solvents exposure is well known to produce central nervous system toxicity, hepatic, renal and dermatologic injury, the respiratory effects of solvent exposure are poorly documented. Several recent population-based epidemiologic studies have found an independent association of occupational solvent exposure with respiratory symptoms, impaired pulmonary function or respiratory disease, but interpretation of these studies is limited by self-reported exposure data. Animal studies have demonstrated adverse effects in both the conducting and the respiratory airways, although often at very high exposure levels. Human chamber studies have most consistently reported irritation of the eyes, nose and throat without evidence of airway hyper-responsiveness. Case series have observed obstructive and restrictive effects in patients with high level inhalational exposures to solvents, particularly formaldehyde, but occupational epidemiologic studies have not consistently demonstrated changes in pulmonary function. Finally, mortality studied have not found increased mortality rates from respiratory disease in occupations associated with solvent use. In general, solvents have been demonstrated to cause mucosal irritation of the eyes and upper airways, but studies of pulmonary impairment following exposure have been limited and inconsistent. Solvent-mediated respiratory toxicity is biologically plausible, but further research is needed to better characterize exposures and to elucidate the specific mechanisms associated with injury.

Reversible pulmonary responses to formaldehyde. A study of clinical anatomy students

Epidemiologic studies of irritants are difficult to perform using standard epidemiologic methods for several reasons, including the reversible nature of the health outcomes, the selection of sensitive individuals from the study population, and the wide heterogeneity in normal responses to irritants. This study examined the feasibility of using repeated measurements of peak expiratory flow (PEF) and reported symptoms to study respiratory irritants and their effects in students exposed to formaldehyde during a clinical anatomy laboratory course. We studied 24 physical therapy students dissecting cadavers for 3 h per week over a 10-wk period. Formaldehyde exposures in the breathing zone ranged from 0.49 to 0.93 ppm (geometric mean +/- geometric SD, 0.73 +/- 1.22). Irritant symptoms increased strongly over the course of the average laboratory period, but this effect was stronger at the beginning than at the end of the semester. PEF measured before each laboratory session declined over the semester by an average of about 10 L/min (2% of baseline), a trend that was statistically significant in random-effects regression models. After 14 wk away from the laboratory, the group's mean baseline PEF had returned to its preexposure level. Mean PEF also declined over each laboratory period, although this effect was attenuated over the course of the semester. Other important predictors of cross-laboratory PEF decrements were asthma and reporting throat irritation during the laboratory. It appears that mild irritant effects can be detected in naive subjects using a repeated monitoring design and relatively simple instrumentation.