Formaldehyde exposure and its effects during pregnancy: Recommendations for laboratory attendance based on available data

Abstract

Formalin is commonly used in fixation of cadaveric specimens. Exposure to formaldehyde, a component of formalin and a known carcinogen, during gross anatomy laboratory dissection is a continuing concern for pregnant students and instructors. Since there is little literature on this specific topic, the current review was compiled in the hope of offering recommendations to pregnant students and instructors who are engaged in human anatomical dissection where formalin is used. Relevant articles were obtained through searches of PubMed and Google Scholar for the terms "formaldehyde," "pregnant," "formalin," and "exposure." A literature search was conducted for chemical information and articles about exposure as issued by government regulatory agencies and chemical companies that produce formaldehyde. This led to the compilation of 29 articles each of which included references to previous, relevant, human research. The reviewed literature contains data strongly suggesting that pregnancy can be affected by formaldehyde exposure. Therefore, on the basis our analysis, female students who might be pregnant should avoid formaldehyde exposure, including that in a gross anatomy laboratory. Instructors should find other means of ensuring anatomical competence for these students.

Comparison of a Novel Cadaver Model (Fix for Life) With the Formalin-Fixed Cadaver and Manikin Model for Suitability and Realism in Airway Management Training

“…Exclusion criteria were pregnancy or lactation of the operator because of teratogenicity of formaldehyde. 10 , 11 Each operator was randomized by a sealed envelope technique for the order of the 3 model types in which the airway techniques were performed. The operator was instructed to complete all airway techniques on all the cadavers per model type before continuing to the next model type.…”

“…However, toxic levels of formaldehyde and tissue rigidity are a matter of concern. 10 , 11 Recently, the embalmment method Fix for Life (F4L) has been developed, which allegedly preserves the haptic quality of fresh human material while only minimal amounts of formaldehyde are needed. 12 A wide scope of opportunities for teaching and learning airway management techniques as well as other procedures in a controlled setting could be possible with this embalmment method without the disadvantages of fresh material.…”

A new substitute for formalin: Application to embalming cadavers

“…In 2006, the International Agency for Research on Cancer (IARC) classified formaldehyde as a “Group 1” item (carcinogenic to humans), on the basis that it can cause cancer of the nasopharynx and leukemia (IARC, ). Haffner et al () reviewed the literature and recommended that female students who might be pregnant should avoid formaldehyde exposure; such avoidance decreases the relative risk of low birth weight, birth malformations, and spontaneous abortions, especially during the first trimester. Currently, every medical school in Japan is required to place forced‐air ventilation equipment for formalin in the student dissection room.…”

Changes in Work Practices for Safe Use of Formaldehyde in a University-Based Anatomy Teaching and Research Facility

“…When FA is used for disinfection purposes such as in an anatomy setting it is labelled as a ‘biocide’. This use is currently regulated in the EU because FA is classified as a chemical of high concern, following classification as a human risk factor in cancer [ 9 ] and a suspected risk factor in reproductive outcome [ 17 , 18 ].…”