Occupational exposure to formaldehyde, lifetime cancer probability, and hazard quotient in pathology lab employees in Iran: a quantitative risk assessment

Abstract

Formaldehyde is a colorless and highly irritating substance that is used as a preservative and chemical fixative in tissue processing in pathological laboratories. Formaldehyde is mutagenic and is classified by the IARC as the definitive carcinogen (A1 group). This cross-sectional descriptive-analytical study was performed to determine the respiratory exposure of 60 employees of pathology labs with formaldehyde and to estimate carcinogenic and non-carcinogenic risk in Iran in 2018-2019. Occupational exposure to formaldehyde was assessed in summer season using the NIOSH 3500 method and a personal sampler with flow of 1 l/min connected to two Glass Midget Impingers containing 20 ml of 1% sodium bisulfate solution. The respiratory symptoms questionnaire provided by the American Thoracic Society was used to assess the health effects of formaldehyde exposure. The carcinogenic and non-carcinogenic risk assessment of inhaled exposure to formaldehyde was also performed using the USA Environmental Protection Agency (OEHHA) method. The mean respiratory exposure of employees to formaldehyde was 0.64 mg/m 3 (range: 0.1474 to 1.3757). Occupational exposure in 28.3% (n = 17) of employees was above the OSHA recommended range. Wheezing (24%), burning eyes (25%), and cough (21.7%) were the most prevalent health problems. The mean ± SD of the carcinogenic risk among the employees was 3.45 × 10 −4 ± 2.27 × 10 −4 . The highest mean of carcinogenic risk was found in lab workers (4.44 × 10 −4 ). Given the high level of carcinogenic and non-carcinogenic risk of respiratory exposure to formaldehyde in pathological employees, especially lab worker, 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 seems necessary.

The formation of SCEs as an effect of occupational exposure to formaldehyde

“…Recently, Costa et al ( 2019 ) reported an average FA level of 0.38 ppm (i.e. 0.47 mg/m 3 ) in hospital anatomy-pathology laboratories in Portugal, while Jalali et al ( 2021 ) measured even higher concentrations (0.64 mg/m 3 ) in Iranian pathology wards (Costa et al 2019 ; Jalali et al 2021 ). In Italy, Scarselli et al ( 2017 ) reported a general average value of 0.49 mg/m 3 (i.e., 0.40 ppm) for workers employed in hospital activities (Scarselli et al 2017 ).…”

The Carcinogenic Effects of Formaldehyde Occupational Exposure: A Systematic Review

“…Despite that, very few studies concerned the health sector, or the agri-food industry, where FA is used as a preservative. That is quite surprising, considering that there is much research about the occupational exposure to FA in pathological anatomy settings and sector rooms [ 61 , 62 , 63 ] that stress the needing for adequate preventive measures for workers [ 64 ].…”

Occupational Exposure to Carcinogens and Occupational Epidemiological Cancer Studies in Iran: A Review

“…In a few studies, exposure to formaldehyde was monitored in pathology laboratory staff through personal and stationary air sampling [45][46][47], and in one study exposure to formaldehyde was assessed by personal air sampling of plastic product workers to estimate their cancer risk [48].…”