Formaldehído en ambientes laborales: revisión de la literatura y propuesta de vigilancia ocupacional

Marisol Margarita Villadiego-Molinares,Johanna Alejandra Ramírez-Martínez,Alba Isabel Rodriguez-Pulido

doi:10.15446/revfacmed.v68n3.73188

Marisol Margarita Villadiego-Molinares, Johanna Alejandra Ramírez-Martínez + Show 1 more

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https://doi.org/10.15446/revfacmed.v68n3.73188

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Abstract

Introducción. El formaldehído es una sustancia ampliamente usada a nivel industrial; sin embargo, es considerada un agente mutagénico y carcinógeno para los humanos. Para determinar el grado de riesgo de los trabajadores ocupacionalmente expuestos (TOE) al formaldehído, debe hacerse un seguimiento de sus niveles de concentración ambiental y de los biomarcadores que permiten identificar su daño potencial para la salud. En Colombia, lamentablemente, no existen lineamientos respecto a la exposición ocupacional a esta sustancia.Objetivo.Revisar estudios recientes sobre exposición ocupacional a formaldehído para diseñar una estrategia de seguimiento y vigilancia de los TOE a esta sustancia en Colombia.Materiales y métodos. Se realizó una revisión de la literatura en PubMed, MedLine, ScienceDirect y Embase mediante la siguiente estrategia de búsqueda: artículos sobre exposición ocupacional a formaldehído publicados en inglés o español entre 2013 y 2017. Los términos de búsqueda fueron “occupational exposure”, “formaldehyde” “mutagenicity test” y “DNA adducts” y sus equivalentes en español.Resultados. La búsqueda inicial arrojó 103 registros, sin embargo solo 36 artículos cumplieron los criterios de inclusión establecidos.Conclusiones. La gestión adecuada del riesgo derivado de la exposición ocupacional a formaldehido, así como el seguimiento médico apropiado de estos trabajadores, requiere la implementación de una serie de acciones interdisciplinarias que permitan la creación de un sistema de vigilancia ocupacional integral de los TOE a esta sustancia.

Highlights

Formaldehyde is a substance widely used in the industry; it is classified as mutagenic and carcinogenic to humans
Even though the Occupational Diseases List published by the Ministry of Labor[4,5] includes some of the pathologies associated with exposure to FA —such as acute bronchitis caused by chemical agents, pulmonary edema caused by chemical agents, inflammation of the upper respiratory tract caused by chemical agents, chronic diffuse emphysema, reactive airways dysfunction syndrome, pulmonary fibrosis, obliterative bronchiolitis and toxic effects, diseases related to the carcinogenic potential of this substance have not been considered
Some of the health effects reported in the articles include acute responses such as airway and eye irritation, while chronic effects were analyzed by means of genotoxicity biomarkers,[23] which allow identifying and characterizing the damages that can be caused by this pollutant

Summary

Introduction

Formaldehyde is a substance widely used in the industry; it is classified as mutagenic and carcinogenic to humans. Conclusions: Proper management of the risk derived from occupational exposure to formaldehyde, as well as the appropriate medical follow-up of these workers, requires the implementation of a series of interdisciplinary actions that allow the creation of a comprehensive occupational health surveillance system for workers exposed to this substance. Even though the Occupational Diseases List published by the Ministry of Labor[4,5] includes some of the pathologies associated with exposure to FA —such as acute bronchitis caused by chemical agents, pulmonary edema caused by chemical agents, inflammation of the upper respiratory tract caused by chemical agents, chronic diffuse emphysema, reactive airways dysfunction syndrome, pulmonary fibrosis, obliterative bronchiolitis and toxic effects—, diseases related to the carcinogenic potential of this substance have not been considered. At concentrations of 0.1-5ppm, it can cause eye irritation, tearing, upper respiratory tract irritation and coughing; at concentrations of 5-30ppm, it can cause chest pain, airway irritation, respiratory distress, headache, asthmatic reactions and can aggravate pre-existing respiratory conditions;[9,10,11] and at concentrations of 50-100ppm, it can cause pneumonia, pulmonary edema and even death.[12,13] Permanent exposure to lower concentrations of FA can produce nasopharyngeal and squamous cell carcinoma in the tissues of the nose.[7]

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