Towards a formalin-free hospital. Levels of 15-F2t-isoprostane and malondialdehyde to monitor exposure to formaldehyde in nurses from operating theatres

Abstract

Purpose: nurses are exposed to formaldehyde when managing surgical samples that are to be later transferred to histopathology. We evaluated the conditions favouring the risk of exposure to this toxic reagent and the effect of measures to prevent it. Methods: we conducted a cross-sectional study where 94 female workers were enrolled as being potentially exposed to formaldehyde. From each nurse were collected: (1) personal air-formaldehyde by a personal dosimeter (8 hours), (2) a standardized questionnaire, (3) a urine sample to test 15-F2t-isoprostane, malondialdehyde, cotinine. Results: the results indicate a marked difference related to the adoption of the under vacuum sealing procedure, as an alternative to formaldehyde for preserving tissues. Nurses using the under vacuum sealing system in the operating rooms are exposed to levels of formaldehyde 75% lower than those who do not use that system. Oxidative stress biomarkers (15-F2t-isoprostane, malondialdehyde) are significantly higher in nurses using formaldehyde ( p < 0.001) and in the absence of the under vacuum sealing system ( p = 0.027), in particular in those workers who use liquid formaldehyde in the operating theatre ( p = 0.012). Conclusions: analysis of the biological biomarkers confirms a direct responsibility of air formaldehyde on the onset of oxidative stress while the use of the under vacuum sealing technique is associated with a significant reduction of the exposure to air-formaldehyde and redox status. Our findings can be useful to characterize the environmental health risk in operating theatres and to plan preventive measures such as the under vacuum sealing procedure.

Occupational Exposure and Risk Assessment of Formaldehyde in the Pathology Departments of Hospitals

“…Formaldehyde also is an important precursor to many other materials and chemical compounds. Because of these properties, exposure to formaldehyde has adverse effects (Jalili et al, 2019;Barkhordari et al, 2017;Attari et al, 2015) on health, including acute effects (e.g., bronchial asthma (Suzuki et al, 2017), chemosensory irritation (Bellisario et al, 2016;Persoons et al, 2011;Vimercati ppm. The recommended exposure limit (REL) of the National Institute for Occupational Safety and Health (NIOSH) for formaldehyde is 0.016 ppm (8-hour TWL) (Vohra, 2011).…”

Formaldehyde, Oxidative Stress, and FeNO in Traffic Police Officers Working in Two Cities of Northern Italy

“…Policlinico San Matteo, Pavia" protocol number: 20130000718). On the day set for sampling, the subjects wore during the working shift (8 h) a personal airsampler (Radiello ® ) to measure air-FA [11] (https://www.restek.com/pdfs/radiello-manual.pdf). At the end of the working shift, the traffic police officers filled out a questionnaire and provided a spot of urine for the quantification of 15-F2t-IsoP and cotinine, as biomarkers of OS and tobacco smoking exposure, respectively.…”

“…FA may directly originate from natural sources, from several anthropogenic activities and from indirect product via the photochemical oxidations of hydrocarbons in the atmosphere [8,9]. FA has been detected in several occupational settings involving wood-based materials, laminates, paints and urea-based resins [10] and is used as disinfectant and preservative in hospitals and in pathology units [11]. According to the International Agency for Research on Cancer (IARC) [12] and the United States Environmental Protection Agency (US EPA) [13], FA is classified as a human carcinogen.…”

“…Some previous studies investigated the influence of air pollution and FA on inflammation and Oxidative Stress (OS) induction [11,15,16] and on DNA toxicity [17,18]. Conversely, data on personal exposure to FA and OS induction in urban air settings are still lacking.…”

“…This cross-sectional study aims to evaluate the role of FA exposure and the urbanisation level on OS induction, quantified by urinary 15-F2t-Isoprostane (15-F2t-IsoP), and on airway inflammation, measured by the fraction of exhaled nitric oxide (FeNO). It is notable that 15-F2t-IsoP is a reliable and sensitive biomarker of OS, used in several other epidemiological studies [10,11,16]. FeNO is measured in a non-invasive way and is a biomarker of eosinophilic airway inflammation, useful in monitoring inflammatory processes due to air pollution exposure [20].…”