Toxic effects of formalin-treated cadaver on medical students, staff members, and workers in the Alexandria Faculty of Medicine

Abstract

Background: Formaldehyde can be toxic, allergenic and carcinogenic. Evaporation of formaldehyde from formalin-treated cadavers in the anatomy dissection rooms can produce high exposure. This study was conducted to assess acute and chronic toxic effects of formalin-treated cadavers on medical students, staff members, and workers at the Anatomy department in the Alexandria Faculty of Medicine (AFM). Methods: A cross sectional approach was adopted to investigate medical students (n = 454). Staff members and workers at the Anatomy department (n = 16), and unexposed staff members and workers in the AFM (n = 19) were included in the study. Medical students filled self-administered predesigned questionnaire. Formalin-exposed and unexposed staff members filled a questionnaire and a Complete Blood Count was done for them. Results: The most frequently reported symptoms by medical students were unpleasant smell (91.2%), itching in the eyes (81.3%), and excessive lacrimation (76.1%). Majority of them reported duration of relief within one hour (>80%), and more than two thirds reported wearing laboratory coats and hand gloves. Formalin-exposed staff reported symptoms of skin disorders as drying (75%), eczema (68.8%), and allergic contact dermatitis (87.5%), besides, eye irritation (68.8%), respiratory tract irritation (93.8%), and workrelated bronchial asthma (53.3%). The mean RBCs and platelets counts were significantly lower among formalin-exposed staff (4.08 ± 0.65 Â 10 6 /ul and 237,375 ± 71745.73/ul respectively) compared with unexposed staff (4.95 ± 0.50 Â 10 6 /ul and 280473.68 ± 54456.27/ul respectively). WBCs count was abnormal (low or high) among formalin-exposed staff members (6.2%, and 18.8% respectively), while all unexposed staff had normal WBCs counts. Conclusion:The research highlighted the irritating action of formalin on medical students, and chronic toxic effects on staff members. This necessitates re-evaluation of the concentration of formalin, proper ventilation and assessment of working practices in the dissecting rooms at the Anatomy department.

Indoor Formaldehyde Concentration, Personal Formaldehyde Exposure and Clinical Symptoms during Anatomy Dissection Sessions, University of Medicine 1, Yangon

“…Some individuals were highly sensitive to the FA while others were more resistant and had no reaction to the same level of exposure [ 40 ]. In our study, the most frequent complaint reported by the exposed students was the unpleasant smell (78.8%) ( Figure 9 ), and this occurrence is consistent with some previous studies which also reported this symptom as the most predominant one at 68% [ 21 ], 80% [ 41 ], 77% [ 42 ], 57.5% [ 35 ], 91.2% [ 43 ] and, 70.3% [ 44 ]. This common finding simply reflects that FA exposure is mainly by inhalation during the dissection sessions.…”

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“…Formate can cause crosslinking of nucleic acids and amino acids causing cell death which is the main factor making formalin carcinogenic. The other symptoms seen are running nose (39%) which was about 69.5% in a study done by Elshaer et al 6 Headache (38%), lack of concentration (25%) and sore throat (20%) are the other main symptoms in our study. In a study done by Koirala et al Nausea was found to be about 69.8% contrary to our study which was 23%.…”

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

“…Nurses and clinicians have different occupational and ergonomic problems (Afshari et al, 2014). However, formaldehyde poses a health risk for nurses, clinicians and physicians (Elshaer and Mahmoud, 2017) but even more so for those employed in the healthcare industry as these individuals may be exposed to formaldehyde, in addition to other various genotoxic substances. So, the risk assessment of occupational exposure to chemicals is an important step in chemical monitoring and control in pathology departments.…”