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

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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/m3 (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.

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References

  • Aliabadi M (2017) Noise control of feed water pumps in a thermal power plant. Iran Occupational Health 14:81–92

    Google Scholar 

  • Aliabadi M, Farhadian M, Jalali M, Jahangiri M, Negahban AR (2018) A new empirical approach for predicting heat strain in workers exposed to hot indoor environments. Indoor and Built Environment 27:597–605

    Google Scholar 

  • Alizadeh A, Zarghari M, Golbabaee F, Mohammad Pour RA (2003) Study on concentration of formaldehyde evaporations in the space of different wards in private and governmental hospitals of sari township 2001-2002. Journal of Mazandaran University of Medical Sciences 13:20–26 [In Persian]

    Google Scholar 

  • Arts JH, Rennen MA, de Heer C (2006) Inhaled formaldehyde: evaluation of sensory irritation in relation to carcinogenicity. Regul Toxicol Pharmacol 44:144–160

    CAS  Google Scholar 

  • Assari MJ, Bahrami A, Zolhavarieh M (2017) The investigation of relationship between ambient concentrations and personal exposure levels of formaldehyde in the pathological departments at teaching hospitals in Hamada University of Medical Sciences. Journal of Occupational Hygiene Engineering 4:33–40

    Google Scholar 

  • Azari MR, Asadi P, Jafari MJ, Soori H, Hosseini V (2012) Occupational exposure of a medical school staff to formaldehyde in Tehran. Tanaffos 11:36–41

    Google Scholar 

  • Binetti R, Costamagna FM, Marcello I (2006) Development of carcinogenicity classifications and evaluations: the case of formaldehyde. Annali-Isttuto Superiore Di Sanita 42:132

    CAS  Google Scholar 

  • Burgaz S, Erdem O, Çakmak G, Erdem N, Karakaya A, Karakaya AE (2002) Cytogenetic analysis of buccal cells from shoeworkers and pathology and anatomy laboratory workers exposed to n-hexane, toluene, methyl ethyl ketone and formaldehyde. Biomarkers 7:151–161

    CAS  Google Scholar 

  • California Environmental Protection Agency (CalEPA) (2009) Technical support document for cancer potency factors: methodologies for derivation, listing of available values, and adjustments to allow for early life stage exposures. Appendix B. Chemical-Specific Summaries of the Information Used to Derive Unit Risk and Cancer Potency Values. In. Office of Environmental Health Hazard Assessment, pp 344–352

  • California Environmental Protection Agency (CalEPA) (n.d.) Toxicity Criteria Database California. Office of Environmental Health Hazard Assessment (OEHHA). https://oehha.ca.gov/chemicals/formaldehyde. Accessed 12.24.2019

  • Cavalcante RM, Campelo CS, Barbosa MJ, Silveira ER, Carvalho TV, Nascimento RF (2006) Determination of carbonyl compounds in air and cancer risk assessment in an academic institute in Fortaleza. Brazil Atmospheric Environment 40:5701–5711

    CAS  Google Scholar 

  • Cope JM et al (2011) Comparison of personal formaldehyde levels in anatomy laboratories of 5 physical therapist education programs. Journal of Physical Therapy Education 25:21–30

    Google Scholar 

  • Dimenstein IB (2009) A pragmatic approach to formalin safety in anatomical pathology. Lab Med 40:740–746

    Google Scholar 

  • Dourson ML, Stara JF (1983) Regulatory history and experimental support of uncertainty (safety) factors. Regul Toxicol Pharmacol 3:224–238

    CAS  Google Scholar 

  • Fan W, Y-l Z, Jin F-s DL, X-p J (2006) The health effects of pathologists exposed to formaldehyde. J Environ Occup Med 23:466–468

    CAS  Google Scholar 

  • Fazlzade DM, Rostami R, Zarei A, Feizizadeh M, Mahdavi M, Mohammadi A, Eskandari D (2012) A survey of 24 hour variations of BTEX concentration in the ambient air of Tehran. Journal of Babol University of Medical Sciences 14:50–55

    Google Scholar 

  • Ferris B (1978) Epidemiology standardization project: children’s questionnaire. Am Rev Respir Dis 118:36–53

    Google Scholar 

  • Ganjali H, Ganjali M (2013) Fixation in tissue processing. Intl J Farm & Alli Sci 2:686–689

    Google Scholar 

  • Ghasemkhani M, Jahanpeyma F, Azam K (2005) Formaldehyde exposure in some educational hospitals of Tehran. Ind Health 43:703–707

    CAS  Google Scholar 

  • Gratt LB (1996) Air toxic risk assessment and management. Van Nostrand Reinhold, New York

    Google Scholar 

  • HH Z, DA S, OE M, RM S (2015) Genotoxicity of formaldehyde in peripheral blood lymphocytes among pathology laboratory workers. Egyptian Journal of Occupational Medicine 39:243–254

    Google Scholar 

  • International Programme on Chemical Safety (IPCS) (2010) Human health risk assessment toolkit: chemical hazards. World Health Organization Press, Geneva and Switzerland

    Google Scholar 

  • Jahangiri M, Najarkola SAM, Gholami T, Mohammadpour H, Jahangiri A, Hesam G, Jalali M (2015) Ergonomics intervention to reduce work-related musculoskeletal disorders in a lead mine. Health Scope 4

  • Jakab MG, Klupp T, Besenyei K, Biró A, Major J, Tompa A (2010) Formaldehyde-induced chromosomal aberrations and apoptosis in peripheral blood lymphocytes of personnel working in pathology departments. Mutation Research/Genetic Toxicology and Environmental Mutagenesis 698:11–17

    CAS  Google Scholar 

  • Jalali M, Aliabadi M, Farhadian M, Negahban S (2014) Investigation of the variation of urine density as a biomarker of dehydration conditions in workers employed in hot workplaces. Iran Occupational Health 11:99–110

    Google Scholar 

  • Jalali M, Zare Sakhvidi MJ, Bahrami A, Berijani N, Mahjub H (2016) Oxidative stress biomarkers in exhaled breath of workers exposed to crystalline silica dust by SPME-GC-MS. Journal of Research in Health Sciences 16:153–161

    Google Scholar 

  • Karami Mosafer A, Bahrami A, Assari MJ, Zolhavarie M (2017) Risk assessment of occupational exposure to formaldehyde among employees of the pathology department in educational hospitals of Hamadan city. M.Sc Thesis, Hamadan University of Medical Science

  • Lee EG, Magrm R, Kusti M, Kashon ML, Guffey S, Costas MM, Boykin CJ, Harper M (2017) Comparison between active (pumped) and passive (diffusive) sampling methods for formaldehyde in pathology and histology laboratories. J Occup Environ Hyg 14:31–39

    CAS  Google Scholar 

  • Mehralipour J, Samarghandi MR, Rahimpoor R (2018) Evaluation of exposure to BTEX in hookah smokers and carcinogenic and non-carcinogenic risk assessment. Iranian Journal of Health, Safety and Environment 5:1128–1131

    Google Scholar 

  • Mohammadpour H, Jalali M, Moussavi-Najarkola SA, Farhadi S, Kangavari M, Sartang AG (2018) Ergonomic risk assessment of distal upper extremities by job strain index in carpet weavers. Health Scope 7:e64182

    Google Scholar 

  • Mohammadyan M, Moosazadeh M, Borji A, Khanjani N, Moghadam SR, Moghadam AMB (2019) Health risk assessment of occupational exposure to styrene in Neyshabur electronic industries. Environ Sci Pollut Res 26:11920–11927

    CAS  Google Scholar 

  • Mosafer AK, Assari MJ, Bahrami A, Zolhavarie M (2017) Relationship of ambient concentrations with personal exposure level of formaldehyde in the pathology departments of teaching hospitals affiliated to Hamadan University of Medical Sciences. Hamadan, Iran Journal of Occupational Hygiene Engineering Volume 4:33–40

    Google Scholar 

  • Naya M, Nakanishi J (2005) Risk assessment of formaldehyde for the general population in Japan. Regul Toxicol Pharmacol 43:232–248

    CAS  Google Scholar 

  • Negahban SAR, Ghorbani Shahna F, Rahimpoor R, Jalali M, Rahiminejad S, Soltanian A, Bahram A (2014) Evaluating occupational exposure to carcinogenic volatile organic compounds in an oil-dependent chemical industry: a case study on benzene and epichlorohydrin. Journal of Occupational Hygiene Engineering 1:36–46

    Google Scholar 

  • Neghab M, Soltanzadeh A, Choobineh A (2010) Respiratory symptoms and functional impairments induced by occupational exposure to formaldehyde. Iran Occupational Health 7:66–58

    Google Scholar 

  • Nielsen GD, Larsen ST, Wolkoff P (2017) Re-evaluation of the WHO (2010) formaldehyde indoor air quality guideline for cancer risk assessment. Arch Toxicol 91:35–61

    CAS  Google Scholar 

  • Niosh Manual of Analytical Methods (NMAM) (1994) Formaldehyde by visible absorption spectrometry (VIS)-NIOSH Method No. 3500 Fourth edn. Centers for Disease Control and Prevention, Cincinnati, Ohio

  • Occupational Safety and Health Administration (2002) OSHA fact sheet for formaldehyde. US Department of Labor, USA

    Google Scholar 

  • Ochs SM, Grotz LO, Factorine LS, Rodrigues MR, Netto ADP (2012) Occupational exposure to formaldehyde in an institute of morphology in Brazil: a comparison of area and personal sampling. Environ Sci Pollut Res 19:2813–2819

    CAS  Google Scholar 

  • Orsiere T, Sari-Minodier I, Iarmarcovai G, Botta A (2006) Genotoxic risk assessment of pathology and anatomy laboratory workers exposed to formaldehyde by use of personal air sampling and analysis of DNA damage in peripheral lymphocytes. Mutation Research/Genetic Toxicology and Environmental Mutagenesis 605:30–41

    CAS  Google Scholar 

  • Pala M, Ugolini D, Ceppi M, Rizzo F, Maiorana L, Bolognesi C, Schilirò T, Gilli G, Bigatti P, Bono R, Vecchio D (2008) Occupational exposure to formaldehyde and biological monitoring of research institute workers. Cancer Detect Prev 32:121–126

    CAS  Google Scholar 

  • Rumchev K, Spickett J, Bulsara M, Phillips M, Stick S (2002) Domestic exposure to formaldehyde significantly increases the risk of asthma in young children. Eur Respir J 20:403–408

    CAS  Google Scholar 

  • Sousa FW, Caracas IB, Nascimento RF, Cavalcante RM (2011) Exposure and cancer risk assessment for formaldehyde and acetaldehyde in the hospitals. Fortaleza-Brazil Building and Environment 46:2115–2120

    Google Scholar 

  • Tang X, Bai Y, Duong A, Smith MT, Li L, Zhang L (2009) Formaldehyde in China: production, consumption, exposure levels, and health effects. Environ Int 35:1210–1224

    CAS  Google Scholar 

  • US EPA (1996) Proposed guidelines for carcinogen risk assessment. Office of Research and Development, Washington, DC

  • Vahhabi SM, Mazinani M, Khodakarim S, Rezazadeh AM, Kheyri H, Mousavi MAA, Zendehdel R (2016) Irritation risk assessment of occupational exposure to formaldehyde from Melamine dinnerware workshops in Tehran

  • Viegas S, Ladeira C, Nunes C, Malta-Vacas J, Gomes M, Brito M, Mendonca P, Prista J (2010) Genotoxic effects in occupational exposure to formaldehyde: a study in anatomy and pathology laboratories and formaldehyde-resins production. J Occup Med Toxicol 5:25

    Google Scholar 

  • Vimercati L, Carrus A, Martino T, Galise I, Minunni V, Caputo F, Dell'erba A, Assennato G (2010) Formaldehyde exposure and irritative effects on medical examiners, pathologic anatomy post-graduate students and technicians. Iran J Public Health 39:26–34

    CAS  Google Scholar 

  • Wu P-C, Li Y-Y, Lee C-C, Chiang C-M, Su H-J (2003) Risk assessment of formaldehyde in typical office buildings in Taiwan. Indoor Air 13:359–363

    CAS  Google Scholar 

  • Zhang L, Freeman LEB, Nakamura J, Hecht SS, Vandenberg JJ, Smith MT, Sonawane BR (2010) Formaldehyde and leukemia: epidemiology, potential mechanisms, and implications for risk assessment. Environ Mol Mutagen 51:181–191

    CAS  Google Scholar 

Download references

Acknowledgments

The researchers would like to acknowledge and thank the Vice-Chancellor of the Research and Technology Birjand University of Medical Sciences for its financial and spiritual support of this research.

Funding

This project was approved and financially supported by the Vice-Chancellor of Education and funded by the Vice-Chancellor of Research and Technology Birjand University of Medical Sciences through grant number 4153.

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Authors and Affiliations

  1. Department of Occupational Health Engineering, School of Health, Neyshabur University of Medical Sciences, Neyshabur, Iran

    Mahdi Jalali & Somayeh Rahimi Moghadam

  2. Department of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

    Mahdi Jalali

  3. Department of Environmental Health Engineering, School of Health, Birjand University of Medical Sciences (BUMS), Birjand, Iran

    Mahdi Jalali

  4. Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran

    Mansour Baziar & Hamid Reza Zakeri

  5. Student Research Committee, Department of Occupational Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Ghasem Hesam & Zahra Moradpour

Authors
  1. Mahdi Jalali
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  2. Somayeh Rahimi Moghadam
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  3. Mansour Baziar
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  4. Ghasem Hesam
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  5. Zahra Moradpour
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  6. Hamid Reza Zakeri
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Contributions

Mahdi Jalali: Investigation, writing original draft, and writing—review and editing. Somayeh Rahimi Moghadam: sampling and writing. Mansour Baziar: writing—review and editing. Ghasem Hesam: sampling and writing. Zahra Moradpour: sampling, writing—editing. Hamid Reza Zakeri: supervision, writing—review and editing.

Corresponding author

Correspondence to Hamid Reza Zakeri.

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Competing interests

The authors declare that they have no competing interests.

Ethical approval

The present study was approved by the Ethics Committee of the Birjand University of Medical Sciences through ethical code: Ir.bums.REC.1395.129.

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Responsible Editor: Lotfi Aleya

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Jalali, M., Moghadam, S.R., Baziar, M. et al. Occupational exposure to formaldehyde, lifetime cancer probability, and hazard quotient in pathology lab employees in Iran: a quantitative risk assessment. Environ Sci Pollut Res 28, 1878–1888 (2021). https://doi.org/10.1007/s11356-020-10627-0

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  • DOI: https://doi.org/10.1007/s11356-020-10627-0

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