Formaldehyde-related clinical symptoms reported by medical students during gross anatomy cadaver dissection

Abstract

Introduction. Formaldehyde is a noxious gas used as a tissue preservative of cadavers in autopsy rooms. Therefore, exposure to higher concentrations applies particularly to laboratory staff, anatomists and medical students. Prolonged exposure to formaldehyde is associated with clinical complications. Objective. To assess whether exposure to repeated inhalation of low concentrations of formaldehyde (FA) experienced during a gross anatomy course triggers subjective clinical symptoms in medical students. Material and methods. All 198 first-year medical students of the Medical University of Lublin, Poland (28% with allergy history and 72% without allergy history; 69% male and 31% female) responded to a questionnaire concerning their subjective FA-related clinical symptoms. Differences in proportions of experienced symptoms between allergic vs. nonallergic, and female vs. males were compared by the Mann-Whitney U test. Results. Even though formaldehyde concentrations in the gross anatomy laboratory were relatively low (0.47-0.57 mg/m 3 ), medical students experienced various reactions (lacrimation in 85.9%, red eyes, dry and itchy eyes, runny nose, sneezing, and headache in > 50% of students, cough in 44%, and dry throat or throat irritation in 42% of students). Among students with a history of allergy, eye, nose, skin and respiratory system symptoms occurred more frequently in comparison to nonallergic students. Female individuals demonstrated higher sensitivity to FA exposure. Conclusions. Exposure to formaldehyde may result in development of clinical symptoms in medical students. Particularly unpleasant symptoms may be experienced by individuals with allergy history. It is necessary to decrease formaldehyde concentrations in the anatomy dissection laboratory. streszczenie Wprowadzenie. Formaldehyd to szkodliwa substancja chemiczna, której wodny roztwór jest powszechnie stosowany jako środek konserwujący w prosektoriach anatomicznych. Osobami szczególnie narażo-nymi na ekspozycję na formaldehyd są studenci medycyny oraz perFormaldehyde-related clinical symptoms reported by medical students during gross anatomy cadaver dissection subiektywne objawy kliniczne u studentów medycyny związane z ekspozycją na formaldehyd podczas zajęć prosektoryjnych z anatomii

Health adverse effects of formaldehyde exposure to students and staff in gross anatomy

“…Respiratory and GIT tract related symptoms were also observed among students where respiratory distress, cough and sore throat were at high prevalence. This finding was similar to that reported by previous studies [16,17,19]. Moreover, about half of students complained of low assimilation after they exposed to formaldehyde which might be due to the high prevalence of unusual tiredness, headache and dizziness documented in this study.…”

“…Most of the students and staff members were interested in finding out about the effects of formaldehyde on their health, positively responded by returning the filled questionnaires to the researchers and were enthusiastic to see the results when the research is completed. Most students in this study had common undesirable effects related to the nose and eyes which are in agreement with the data reported by other studies [17,19,23]. Respiratory and GIT tract related symptoms were also observed among students where respiratory distress, cough and sore throat were at high prevalence.…”

“…Although formaldehyde is metabolized in the body to formic acid which is a non-toxic compound excreted in the urine or converted to carbon dioxide and excreted by the lungs [10], it can be allergenic [11], carcinogenic [12,13] or toxic to many organs such as pancreas, liver, kidney and brain [14]. Many studies were conducted on medical students worldwide to explore the adverse effects of using formaldehyde in gross anatomy laboratories [4,[15][16][17][18][19][20]. These studies found that students and staff members suffered from many harmful effects caused by the exposure to formaldehyde.…”

“…Formaldehyde is used as a cadaver antiseptic and fixative in anatomy dissection laboratory courses. It is emitted from the cadavers during gross anatomy dissection and may cause several toxic effects which adversely affect the health of students and staff members [16,17,19,23]. In this study, we have reported that students and staff experienced various clinical symptoms after they repeatedly exposed to formaldehyde.…”

Occupational Exposure to Formaldehyde and Cancer Risk Assessment in an Anatomy Laboratory

“…Exposure levels in anatomy and pathology laboratories have always been extremely high, often exceeding the 2 ppm short-term exposure limit (STEL), primarily due to the evaporation of formaldehyde from the solution used for the preservation of tissues and specimens [9]. One study found that even when anatomy laboratories were not in use, minimum FA concentrations were still above 0.25 mg•m −3 , with a few extreme instances measuring between 13.01 and 20.94 mg•m −3 [10]. In a study conducted in pathological laboratories in Shanghai, the average FA concentration was 1.60 mg•m −3 , with the highest value of 5.84 mg•m −3 [11].…”