Comparison of 2 Formaldehyde Exposure Assessment Devices in a Physical Therapy Education Program Anatomy Laboratory

Abstract

INTRODUCTIONWhile formaldehyde (FA) has a long history as a preferred fixative in the preservation of human donors for medical education,1 it is also a known carcinogen.2,3 It is a harmful chemical that has been implicated in a number of cancers, as well as being an irritant to the nasal and lung epithelium.4'6 At room temperature, FA is a colorless gas, and while its odor can be detected at concentrations between 0.5 and 1.0 parts per million (ppm),68 it can irritate the eyes and upper respiratory tract at much lower levels (0.3 ppm).9BACKGROUNDMost medical schools utilize a Certified Industrial Hygienist (CIH), an expert highly trained in chemical hygiene and air quality assessment, to manage FA levels in the human anatomy laboratory. However, many physical therapist (PT) education programs must rely solely on the anatomist for FA management.10 There are methods available to assess for and reduce FA exposure levels, but without access to a CIH in PT education programs, anatomists may not be aware of the hazard, and therefore not motivated to take action. Oftentimes anatomy instructors are not irritated by FA, placing them in an at-risk group for overexposure and potentially making them less likely to seek out FA monitoring and management strategies.10,11 Frequently, anatomists are unaware of FA safety (monitoring and management) unless laboratory air quality becomes problematic for their students or themselves. It would be useful for anatomists to have current FA safety regulations and recommendations summarized, along with access to a CIH who could provide at least annual FA monitoring and management, and a simple, cost-effective method to monitor personal FA exposure levels on a routine basis.Formaldehyde Regulations and RecommendationsThere is often confusion regarding FA safety, as there are both recommendations as well as regulations regarding exposure limits. Mirabelli and colleagues (2011) prepared a brief summary of current FA policies, as seen in Table l.11 While the Occupational Safety and Health Administration (OSHA), the regulatory body for industry, has a permissible exposure limit (PEL) of 0.75 ppm, the World Health Organization (WHO) recommends 0.08 ppm to control for all cancers.12'14 The American Conference of Governmental Industrial Hygienists (ACGIH) acknowledges that the WHO limit cannot be met in certain settings (FA production plants, laboratories using FA), and recommends a threshold limit value of 0.3 ppm.14,15Factors Effecting Formaldehyde Exposure LevelsFormaldehyde exposure levels can be effected by the following variables in the anatomy laboratory: (1) temperature and humidity, (2) chemical makeup of the embalming and wetting solutions, (3) delivery system being used with the wetting solution, (4) number of donors being dissected, (5) regions of the body being dissected, (6) size of the laboratory, and (7) the ventilation system (turnover rate, uptake and exhaust duct placement, room pressure).16Formaldehyde Exposure MonitoringThe United States Department of Labor OSHA regulation standard 29 Code of Federal Regulations part 1910.1048(d)(2)(h) states that employers shall repeat FA monitoring each time there is a change in production, equipment, process, personnel, or control measures which may result in new or additional exposure to formaldehyde.1' Application of this OSHA regulation in the anatomy laboratory setting is typically interpreted to mean that complete FA assessments be conducted annually, as well as when conditions in the environment change (arrival of new human donors in the anatomy laboratory, or at the start of a new semester). A CIH determines FA exposure levels by assessing both ambient (room air) and personal FA exposure levels, temperature and humidity, and ventilation rates and airflow patterns. Ambient testing provides a snapshot of air quality in a laboratory, while personal FA exposure assessments provide accurate measures of individual FA exposure. …