Vacuum-based preservation of surgical specimens: An environmentally-safe step towards a formalin-free hospital

Novi, Cinzia Di; Minniti, Davide; Barbaro, Silvana; Zampirolo, Maria Gabriella; Cimino, Antonio; Bussolati, Gianni

doi:10.1016/j.scitotenv.2010.04.022

Cited by 32 publications

(29 citation statements)

References 11 publications

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“…This cohort differs from the time to fixation breast cancer series in a way that tissues were vacuum sealed and stored at 4 degree Celsius (UVSC) right after surgical removal until gross dissection and immersion of the tissue into formalin (17). TMAs were constructed consisting of the 100 breast cancer specimens represented in two fold redundancy.…”

Section: Methodsmentioning

confidence: 99%

A tissue quality index: an intrinsic control for measurement of effects of preanalytical variables on FFPE tissue

Neumeister

Parisi

England

et al. 2014

Laboratory Investigation

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While efforts are made to improve tissue quality and control pre-analytical variables, pathologists are often confronted with the challenge of molecular analysis of patient samples of unknown quality. Here we describe a first attempt to construct a Tissue Quality Index (TQI) or an intrinsic control that would allow a global assessment of protein status based on quantitative measurement of a small number of selected, informative epitopes. Quantitative Immunofluorescence (QIF) of a number of proteins was performed on a series of 93 breast cancer cases where levels of expression were assessed as a function of delayed time to formalin fixation. A TQI was constructed based on the combination of proteins that most accurately reflect increased and decreased levels of expression in proportion to delay time. The TQI, defined by combinations of measurements of cytokeratin, pERK1/2 and pHSP-27 and their relationship to cold ischemic time were validated on a second build of the training series and on 2 independent breast tissue cohorts with recorded time to formalin fixation. We show an association of negative TQI values (an indicator for loss of tissue quality) with increasing cold ischemic time on both validation cohorts, as well as an association with loss of ER expression levels on all 3 breast cohorts. Using expression levels of 3 epitopes, we can begin to assess the likelihood of delayed time to fixation or decreased tissue quality. This TQI represents a proof of concept for the use of epitope expression to provide a mechanism for monitoring tissue quality.

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Section: Methodsmentioning

confidence: 99%

A tissue quality index: an intrinsic control for measurement of effects of preanalytical variables on FFPE tissue

Neumeister

Parisi

England

et al. 2014

Laboratory Investigation

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“…These data add to the already acquired experience on the advantages offered by the UVS procedure, in terms of improved tissue preservation for diagnosis and research, and appreciation of the operational feasibility of the process, by the nursing staff. 29 The present study indicates that the major source of exposure to FA is not its use in pre-filled vials for fixing small biopsies, since in fact this procedure was carried out in both types of surgical theatres, while the bulk of exposure is related to the habit of pouring liquid FA (3-5 litres at a time) in large containers. In fact, the volunteers enrolled for this study who NB exponentiation of coefficients expresses the proportion of variation for the unit of variation of log(FA).…”

Section: Discussionmentioning

confidence: 78%

“…The UVS procedure has potential for introducing some important improvements: (a) it avoids the use of FA and the consequent human FA exposure in operating rooms, (b) retains very well the anatomical and immunohistochemical features of tissues while reducing DNA damage, (c) enhances the preservation of both structure and tissue components ( proteins, nucleic acids), and (d) lengthens the useful time before tissue fixation. 28,29 Moreover, tissues processed with UVS are suitable for tissue banking and cell culture. 30 Since the use of the UVS procedure in the hospitals selected for this study was actually active only in some operating theatres, we intended to check if the adoption of this procedure implied objective differences in exposure to FA and variations in the related biological response.…”

Section: Introductionmentioning

confidence: 99%

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

Bellisario¹,

Mengozzi

Grignani

et al. 2016

Toxicol. Res.

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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.

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“…Advantages linked to this procedure have already been reported elsewhere 1,2) . This processing was tested for more than two years in a single surgical theater and is now being used in the whole hospital.…”

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confidence: 95%

Occupational Hazards of Hospital Personnel: Assessment of a Safe Alternative to Formaldehyde

Berton

Novi

2012

Journal of Occupational Health

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Occupational Hazards of Hospital Personnel: Assessment of a Safe Alternative to Formaldehyde: Fabio BERTON, et al. Department of Public Policies and Public Choice, University of Eastern Piedmont, Italy— Objectives Formaldehyde —a chemical widely used to preserve organic tissues in hospitals —is known to be carcinogenic in the long term and to cause breathing‐related symptoms in the short term. We have taken advantage of an experiment to quantify this second effect among hospital workers in terms of probability of showing respiratory symptoms with respect to a benchmark in which tissues are preserved using a procedure with arguably no impact, i.e., under‐vacuum sealing. Methods This paper exploits an experimental situation with controls for potential confounding effects to estimate a logistic regression of the probability that formalin (a solution of formaldehyde and water) causes respiratory symptoms. Results The probability for formalin users was found to be eight to ten times higher than for personnel testing under‐vacuum sealing. Conclusions The substitution of formaldehyde with under‐vacuum sealing would markedly improve the health of personnel.

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Vacuum-based preservation of surgical specimens: An environmentally-safe step towards a formalin-free hospital

Cited by 32 publications

References 11 publications

A tissue quality index: an intrinsic control for measurement of effects of preanalytical variables on FFPE tissue

A tissue quality index: an intrinsic control for measurement of effects of preanalytical variables on FFPE tissue

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

Occupational Hazards of Hospital Personnel: Assessment of a Safe Alternative to Formaldehyde

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