Minimizing formaldehyde exposure in a hospital pathology laboratory

Occupational exposure, carcinogenic and non-carcinogenic risk assessment of formaldehyde in the pathology labs of hospitals in Iran

Formaldehyde, a known carcinogenic compound, is commonly used in various medical settings. The objective of this study was to assess the carcinogenic and non-carcinogenic risks associated with occupational exposure to formaldehyde. This study was conducted in the pathology labs of four hospitals in Tehran. Cancer and non-cancer risks were evaluated using the quantitative risk assessment method proposed by the United States environmental protection agency (USEPA), along with its provided database known as the integrated risk information system (IRIS). Respiratory symptoms were assessed using the American thoracic society (ATS) questionnaire. The results indicated that 91.23% of exposure levels in occupational groups exceed the NIOSH standard of 0.016 ppm. Regarding carcinogenic risk, 41.03% of all the studied subjects were in the definite carcinogenic risk range (LCR > 10-4), 23.08% were in the possible carcinogenic risk range (10-5 < LCR < 10-4), and 35.90% were in the negligible risk range (LCR < 10-6). The highest index of occupational carcinogenesis was observed in the group of lab technicians with a risk number of 3.7 × 10-4, followed by pathologists with a risk number of 1.7 × 10-4. Furthermore, 23.08% of the studied subjects were within the permitted health risk range (HQ < 1.0), while 76.92% were within the unhealthy risk range (HQ > 1.0). Overall, the findings revealed significantly higher carcinogenic and non-carcinogenic risks among lab technicians and pathologists. Therefore, it is imperative to implement control measures across various hospital departments to mitigate occupational formaldehyde exposure levels proactively. These findings can be valuable for policymakers in the health sector, aiding in the elimination or reduction of airborne formaldehyde exposure in work environments.

Electrochemical and Optical Sensors for the Detection of Chemical Carcinogens Causing Leukemia

The incidence and mortality due to neoplastic diseases have shown an increasing tendency over the years. Based on GLOBOCAN 2020 published by the International Agency for Research on Cancer (IARC), leukemias are the thirteenth most commonly diagnosed cancer in the world, with 78.6% of leukemia cases diagnosed in countries with a very high or high Human Development Index (HDI). Carcinogenesis is a complex process initiated by a mutation in DNA that may be caused by chemical carcinogens present in polluted environments and human diet. The IARC has identified 122 human carcinogens, e.g., benzene, formaldehyde, pentachlorophenol, and 93 probable human carcinogens, e.g., styrene, diazinone. The aim of the following review is to present the chemical carcinogens involved or likely to be involved in the pathogenesis of leukemia and to summarize the latest reports on the possibility of detecting these compounds in the environment or food with the use of electrochemical sensors.

Formaldehyde causes an increase in blood pressure by activating ACE/AT1R axis

Previous studies suggest some link between formaldehyde exposure and harmful cardiovascular effects. But whether exposure to formaldehyde can cause blood pressure to rise, and if so, what the underlying mechanism is, remains unclear. In this study, C57BL/6 male mice were exposed to 0.1, 0.5, 2.5 mg/m³ of gaseous formaldehyde for 4 h daily over a three-week period. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and heart rate (HR) of the mice were measured by tail-cuff plethysmography, and any histopathological changes in the target organs of hypertension were investigated. The results showed that exposure to formaldehyde did cause a significant increase in blood pressure and heart rate, and resulted in varying degrees of damage to the heart, aortic vessels and kidneys. To explore the underlying mechanism, a specific inhibitor of angiotensin converting enzyme (ACE) was used to block the ACE/AT1R axis. We observed the levels of ACE and angiotensin II type 1 receptor (AT1R), as well as the bradykinin (BK) in cardiac cytoplasm. The data suggest that exposure to formaldehyde induced an increase in the expression of ACE and AT1R, and decreased the levels of BK. Strikingly, treatment with 5 mg/kg/d ACE inhibitor can attenuate the increase in blood pressure and the pathological changes caused by formaldehyde exposure. This result has improved our understanding of whether, and how, formaldehyde exposure affects the development of hypertension.

Occupational health risk assessment of airborne formaldehyde in medical laboratories

The professional use of formaldehyde is a major occupational health concern in medical laboratory operations. Quantification of various risks associated with chronic exposure to formaldehyde may help in understanding the related hazards. This study designed to assess the health risks associated with inhalation exposure to formaldehyde involving biological, cancer, and non-cancer risks in medical laboratories. This study was performed in the hospital laboratories at Semnan Medical Sciences University. Risk assessment was performed in pathology, bacteriology, hematology, biochemistry, and serology laboratories with 30 employees, using formaldehyde in their daily routine operations. We determined area and personal exposures to airborne contaminant, applied standard air sampling, and analytical method recommended by National Institute of Occupational Safety and Health (NIOSH). We addressed formaldehyde-specific hazard by estimating peak blood level, life cancer risk, and the hazard quotient of non-cancer risks, adapted from Environmental Protection Agency (EPA) assessment method. The airborne formaldehyde concentrations in the laboratory personal samples ranged 0.0156-0.5940 ppm (mean = 0.195 ppm, SD = 0.048) and area exposure ranged 0.0285-1.0810 ppm (mean = 0.462 ppm, SD = 0.087). Based on workplace exposure, peak blood levels of formaldehyde were estimated at minimum 0.0026 mg/l to maximum 0.152 mg/l (mean = 0.015 mg/l, SD = 0.016). The mean cancer risk levels in terms of area and personal exposures were estimated respectively at 3.93 E - 8 μg/m³ and 1.84 E - 4 μg/m³, and for the non-cancer risk levels of the same exposures measured respectively at 0.03 μg/m³ and 0.07 μg/m³. Formaldehyde levels were significantly higher among laboratory employees, especially bacteriology workers. Exposure and risk could be minimized by strengthening control measures including the use of management controls, engineering controls, and respiratory protection equipment to reduce exposure levels of all workers to less than the allowed exposure limits and improve indoor air quality in the workplace.