How improvements in monitoring and safety practices lowered airborne formaldehyde concentrations at an Italian university hospital: a summary of 20 years of experience

1Musiał A, Gryglewski RW, Kielczewski S, Loukas M, Wajda J. Formalin use in anatomical and histological science in the 19^th and 20^th centuries. Folia Med Cracov 2016;56:31–40. PMID: 28275269 Musiał A Gryglewski RW Kielczewski S Loukas M Wajda J Formalin use in anatomical and histological science in the 19^th and 20^th centuries Folia Med Cracov 20165631 40 PMID: 28275269Search in Google Scholar

2Dimenstein IB. A pragmatic approach to formalin safety in anatomical pathology. Lab Med 2009;40:740–6. doi: 10.1309/LMQ1HJFD4UN0WWBP Dimenstein IB A pragmatic approach to formalin safety in anatomical pathology Lab Med 200940740 6 10.1309/LMQ1HJFD4UN0WWBPOpen DOISearch in Google Scholar

3Onyije FM, Avwioro OG. Excruciating effect of formaldehyde exposure to students in gross anatomy dissection laboratory. Int J Occup Environ Med 2012;3:92–5. PMID: 23022856 Onyije FM Avwioro OG Excruciating effect of formaldehyde exposure to students in gross anatomy dissection laboratory Int J Occup Environ Med 2012392 5 PMID: 23022856Search in Google Scholar

4Vimercati L, Carrus A, Martino T, Galise I, Minunni V, Caputo F, Dell’Erba A, Assennato G. Formaldehyde exposure and irritative effects on medical examiners, pathologic anatomy post-graduate students and technicians. Iran J Public Health 2010;39:26–34. PMCID: PMC3481685 Vimercati L Carrus A Martino T Galise I Minunni V Caputo F Dell’Erba A Assennato G Formaldehyde exposure and irritative effects on medical examiners, pathologic anatomy post-graduate students and technicians Iran J Public Health 20103926 34 PMCID: PMC3481685Search in Google Scholar

5Flyvholm MA, Menné T. Allergic contact dermatitis from FA. A case study focusing on sources of formaldehyde exposure. Contact Derm 1992;27:27–36. doi: 10.1111/j.1600-0536.1992.tb05194.x Flyvholm MA Menné T Allergic contact dermatitis from FA. A case study focusing on sources of formaldehyde exposure Contact Derm 19922727 36 10.1111/j.1600-0536.1992.tb05194.xOpen DOISearch in Google Scholar

6Nielsen GD, Larsen ST, Wolkoff P. Re-evaluation of the WHO (2010) formaldehyde indoor air quality guideline for cancer risk assessment. Arch Toxicol 2017;91:35–61. doi: 10.1007/s00204-016-1733-8 Nielsen GD Larsen ST Wolkoff P Re-evaluation of the WHO (2010) formaldehyde indoor air quality guideline for cancer risk assessment Arch Toxicol 20179135 61 10.1007/s00204-016-1733-8Open DOISearch in Google Scholar

7Friis UF, Dahlin J, Bruze M, Menné T, Johansen JD. Hidden exposure to formaldehyde in a swab caused allergic contact dermatitis. Contact Derm 2014;70:258–60. doi: 10.1111/cod.12172 Friis UF Dahlin J Bruze M Menné T Johansen JD Hidden exposure to formaldehyde in a swab caused allergic contact dermatitis Contact Derm 201470258 60 10.1111/cod.12172Open DOISearch in Google Scholar

8Dapson JC, Dapson RW. Hazardous Materials in the Histopathology Laboratory: Regulation, Risks, Handling and Disposal. 4^th ed. Battle Creek: Anatech LTD; 2005. Dapson JC Dapson RW Hazardous Materials in the Histopathology Laboratory: Regulation, Risks, Handling and Disposal 4^th ed Battle Creek Anatech LTD 2005Search in Google Scholar

9Council on Scientific Affairs, American Medical Association. Formaldehyde. JAMA 1989;261:1183–7. Council on Scientific Affairs, American Medical Association Formaldehyde. JAMA 19892611183 710.1001/jama.1989.03420080103042Search in Google Scholar

10Chemical Industry Institute of Toxicology (CIIT). Formaldehyde: Hazard Characterization and Dose-Response Assessment for Carcinogenicity by the Route of Inhalation. Corrected and republished. Research Triangle Park (NC): CIIT; 1999. Chemical Industry Institute of Toxicology (CIIT). Formaldehyde: Hazard Characterization and Dose-Response Assessment for Carcinogenicity by the Route of Inhalation Corrected and republished. Research Triangle Park (NC): CIIT 1999Search in Google Scholar

11Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological Profile for Formaldehyde. Atlanta (GA): US Department of Health and Human Services; 1999. Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological Profile for Formaldehyde. Atlanta (GA): US Department of Health and Human Services 1999Search in Google Scholar

12Hazardous Substances Data Bank (HSDB, online database) US National Library of Medicine, National Toxicology Information Program, Bethesda, MD, 1999 March. Hazardous Substances Data Bank (HSDB, online database) US National Library of Medicine, National Toxicology Information Program Bethesda, MD 1999 MarchSearch in Google Scholar

13Viegas S, Ladeira C, Costa-Veiga A, Perelman J, Gajski G. Forgotten public health impacts of cancer - an overview. Arh Hig Rada Toksikol 2017;68:287–97. doi: 10.1515/aiht-2017-68-3005 Viegas S Ladeira C Costa-Veiga A Perelman J Gajski G Forgotten public health impacts of cancer - an overview Arh Hig Rada Toksikol 201768287 97 10.1515/aiht-2017-68-3005Open DOISearch in Google Scholar

14International Agency for Research on Cancer (IARC). IARC Classifies Formaldehyde as Carcinogenic to Humans [displayed 27 December 2019]. Available at http://www.iarc.fr/pageroot/PRELEASES/pr153a.html International Agency for Research on Cancer (IARC). IARC Classifies Formaldehyde as Carcinogenic to Humans displayed 27 December 2019 Available at http://www.iarc.fr/pageroot/PRELEASES/pr153a.htmlSearch in Google Scholar

15International Agency for Research on Cancer (IARC). Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol. Monographs on the Evaluation Carcinogenic Risks on Humans. Vol. 88, 2006 [displayed 11 August 2020]. Available at https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Formaldehyde-2-Butoxyethanol-And-1-Em-Tert-Em-Butoxypropan-2-ol-2006 International Agency for Research on Cancer (IARC). Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol Monographs on the Evaluation Carcinogenic Risks on Humans Vol. 88 2006 [displayed 11 August 2020]. Available at https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Formaldehyde-2-Butoxyethanol-And-1-Em-Tert-Em-Butoxypropan-2-ol-2006Search in Google Scholar

16International Agency for Research on Cancer (IARC). Chemical agents and related occupations volume 100 F A review of human carcinogens; 2012 [displayed 28 August 2020]. Available at https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Chemical-Agents-And-Related-Occupations-2012 International Agency for Research on Cancer (IARC). Chemical agents and related occupations volume 100 F A review of human carcinogens 2012 [displayed 28 August 2020]. Available at https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Chemical-Agents-And-Related-Occupations-2012Search in Google Scholar

17Szarvas T, Szatloczky E, Volford J, Trezl L, Tyihak E, Rusznak I. Determination of endogenous formaldehyde level in human blood and urine by dimedone-¹⁴C radiometric method. J Radioanal Nucl Chem 1986;106:357–67. doi: 10.1007/BF02163668 Szarvas T Szatloczky E Volford J Trezl L Tyihak E Rusznak I Determination of endogenous formaldehyde level in human blood and urine by dimedone-¹⁴C radiometric method J Radioanal Nucl Chem 1986106357 67 10.1007/BF02163668Open DOISearch in Google Scholar

18Heck HD, Casanova-Shmitz M, Dodd PB, Schachter EN, Witec TJ, Tosun T. Formaldehyde (CH₂O) concentration in the blood of humans and Ficher-344 rats exposed to CH₂O under controlled conditions. Am Ind Hyg Assoc J 1985;46:1–3. doi: 10.1080/15298668591394275 Heck HD Casanova-Shmitz M Dodd PB Schachter EN Witec TJ Tosun T Formaldehyde (CH₂O) concentration in the blood of humans and Ficher-344 rats exposed to CH₂O under controlled conditions Am Ind Hyg Assoc J 1985461 3 10.1080/15298668591394275Open DOISearch in Google Scholar

19Spanel P, Smith D, Holland TA, Al Singary W, Elder JB. Analysis of formaldehyde in the headspace of urine from bladder and prostate cancer patients using selected ion flow tube mass spectrometry. Rapid Commun Mass Spectrom 1999;13:1354–9. doi: 10.1002/(SICI)1097-0231(19990730)13:14<1354::AID-RCM641>3.0.CO;2-J Spanel P Smith D Holland TA Al SingaryW Elder JB Analysis of formaldehyde in the headspace of urine from bladder and prostate cancer patients using selected ion flow tube mass spectrometry Rapid Commun Mass Spectrom 1999131354 9 10.1002/(SICI)1097-0231(19990730)13:14<1354::AID-RCM641>3.0.CO;2-JOpen DOISearch in Google Scholar

20Dugheri S, Bonari A, Pompilio I, Colpo M, Mucci N, Arcangeli G. An integrated air monitoring approach for assessment of formaldehyde in the workplace. Saf Health Work 2018;9:479–485. doi: 10.1016/j.shaw.2018.05.002 Dugheri S Bonari A Pompilio I Colpo M Mucci N Arcangeli G An integrated air monitoring approach for assessment of formaldehyde in the workplace Saf Health Work 20189479 485 10.1016/j.shaw.2018.05.002Open DOISearch in Google Scholar

21Scarselli A, Corfiati M, Di Marzio D, Iavicoli S. National estimates of exposure to formaldehyde in Italian workplaces. Ann Work Expo Health 2017;61:33–43. doi: 10.1093/annweh/wxw004 Scarselli A Corfiati M Di MarzioD Iavicoli S National estimates of exposure to formaldehyde in Italian workplaces Ann Work Expo Health 20176133 43 10.1093/annweh/wxw004Open DOISearch in Google Scholar

22American Chemistry Council’s (ACC). ACGIH decision to lower formaldehyde TLVs lacks transparency and scientific basis [displayed 20 December 2020]. Available at https://www.americanchemistry.com/Media/PressReleasesTranscripts/ACC-news-releases/ACGIH-Decision-to-Lower-Formaldehyde-TLVs-Lacks-Transparency-and-Scientific-Basis.html American Chemistry Council’s (ACC). ACGIH decision to lower formaldehyde TLVs lacks transparency and scientific basis [displayed 20 December 2020]. Available at https://www.americanchemistry.com/Media/PressReleasesTranscripts/ACC-news-releases/ACGIH-Decision-to-Lower-Formaldehyde-TLVs-Lacks-Transparency-and-Scientific-Basis.htmlSearch in Google Scholar

23Directive (EU) 2019/983 of the European Parliament and of the Council of 5 June 2019 amending Directive 2004/37/EC on the protection of workers from the risks related to exposure to carcinogens or mutagens at work [displayed 28 August 2020]. Available at https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=uriserv:OJ.L_.2019.164.01.0023.01.ENG Directive (EU) 2019/983 of the European Parliament and of the Council of 5 June 2019 amending Directive 2004/37/EC on the protection of workers from the risks related to exposure to carcinogens or mutagens at work [displayed 28 August 2020] Available at https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=uriserv:OJ.L_.2019.164.01.0023.01.ENGSearch in Google Scholar

24Szulejko JE, Kim KH. Derivatization techniques for determination of carbonyls in air. TrAC Trends Anal Chem 2015;64:29–41. doi: 10.1016/j.trac.2014.08.010 Szulejko JE Kim KH Derivatization techniques for determination of carbonyls in air TrAC Trends Anal Chem 20156429 41 10.1016/j.trac.2014.08.010Open DOISearch in Google Scholar

25Dugheri S, Bonari A, Pompilio I, Colpo M, Mucci N, Montalti M, Arcangeli G. Development of an innovative gas chromatography-mass spectrometry method for assessment of formaldehyde in the workplace atmosphere. Acta Chromatogr 2017;29:511–4. doi: 10.1556/1326.2016.00102 Dugheri S Bonari A Pompilio I Colpo M Mucci N Montalti M Arcangeli G Development of an innovative gas chromatography-mass spectrometry method for assessment of formaldehyde in the workplace atmosphere Acta Chromatogr 201729511 4 10.1556/1326.2016.00102Open DOISearch in Google Scholar

26Mucci N, Dugheri S, Rapisarda V, Campagna M, Garzaro G, Farioli A, Cappelli G, Arcangeli G. Occupational exposure to airborne formaldehyde in hospital: setting an automatic sampling system, comparing different monitoring methods and applying them to assess exposure. Med Lav 2019;110:446–58. doi: 10.23749/mdl.v110i6.8038 Mucci N Dugheri S Rapisarda V Campagna M Garzaro G Farioli A Cappelli G Arcangeli G Occupational exposure to airborne formaldehyde in hospital: setting an automatic sampling system, comparing different monitoring methods and applying them to assess exposure Med Lav 2019110446 58 10.23749/mdl.v110i6.8038Open DOISearch in Google Scholar

27Dugheri S, Mucci N, Cappelli G, Bonari A, Garzaro G, Marrubini G, Bartolucci G, Campagna M, Arcangeli G. Monitoring of air-dispersed formaldehyde and carbonyl compounds as vapors and adsorbed on particulate matter by denuder-filter sampling and gas chromatographic analysis. Int J Environ Res Public Health 2019;16:1969. doi: 10.3390/ijerph16111969 Dugheri S Mucci N Cappelli G Bonari A Garzaro G Marrubini G Bartolucci G Campagna M Arcangeli G Monitoring of air-dispersed formaldehyde and carbonyl compounds as vapors and adsorbed on particulate matter by denuder-filter sampling and gas chromatographic analysis Int J Environ Res Public Health 2019161969 10.3390/ijerph16111969Open DOISearch in Google Scholar

28Čavlović AO, Lučić RB, Jug M, Radmanović K, Bešlić I. Side-by-side determination of workers’ exposure to wood dust with IOM and openfaced samplers. Arh Hig Rada Toksikol 2013;64:379–84. doi: 10.2478/10004-1254-64-2013-2316 Čavlović AO Lučić RB Jug M Radmanović K Bešlić I Side-by-side determination of workers’ exposure to wood dust with IOM and openfaced samplers Arh Hig Rada Toksikol 201364379 84 10.2478/10004-1254-64-2013-2316Open DOISearch in Google Scholar

29Carrier D. Analysis of Formaldehyde and Acetaldehyde using automated DNPH derivatisation. Chromatography Technical Note No AS109 [displayed 11 August 2020]. Available at https://www.anatune.co.uk/wp-content/uploads/2015/06/as109.pdf Carrier D Analysis of Formaldehyde and Acetaldehyde using automated DNPH derivatisation Chromatography Technical Note No AS109 [displayed 11 August 2020 Available at https://www.anatune.co.uk/wp-content/uploads/2015/06/as109.pdfSearch in Google Scholar

30Dalene M, Persson P, Skarping G. Determination of formaldehyde in air by chemisorption on glass filters impregnated with 2,4-dinitrophenylhydrazine using gas chromatography with thermionic specific detection. J Chromatogr A 1992;626:284–8. doi: 10.1016/0021-9673(92)85422-P Dalene M Persson P Skarping G Determination of formaldehyde in air by chemisorption on glass filters impregnated with 2,4-dinitrophenylhydrazine using gas chromatography with thermionic specific detection J Chromatogr A 1992626284 8 10.1016/0021-9673(92)85422-POpen DOISearch in Google Scholar

31Martos PA, Pawliszyn J. Sampling and determination of formaldehyde using solid-phase microextraction with on-fiber derivatization. Anal Chem 1998;70:2311–20. doi: 10.1021/ac9711394 Martos PA Pawliszyn J Sampling and determination of formaldehyde using solid-phase microextraction with on-fiber derivatization Anal Chem 1998702311 20 10.1021/ac971139421644641Open DOISearch in Google Scholar

32Bourdin D, Desauziers V. Development of SPME on-fiber derivatization for the sampling of formaldehyde and other carbonyl compounds in indoor air. Anal Bioanal Chem 2014;406:317–28. doi: 10.1007/s00216-013-7460-6 Bourdin D Desauziers V Development of SPME on-fiber derivatization for the sampling of formaldehyde and other carbonyl compounds in indoor air Anal Bioanal Chem 2014406317 28 10.1007/s00216-013-7460-624253409Open DOISearch in Google Scholar

33Associazione per l’Unificazione nel Settore dell’Industria Chimica (Unichim). [Metodo Ufficiale n. 2237:09: Ambienti di Lavoro-Determinazione delle aldeidi aerodisperse. Metodo per microestrazione in fase solida (SPME), in Italian]. In: Analisi mediante gascromatografia accoppiata alla spettrometria di massa (GC-MS), 2009. Associazione per l’Unificazione nel Settore dell’Industria Chimica (Unichim). [Metodo Ufficiale n. 2237:09: Ambienti di Lavoro-Determinazione delle aldeidi aerodisperse. Metodo per microestrazione in fase solida (SPME), in Italian] In Analisi mediante gascromatografia accoppiata alla spettrometria di massa (GC-MS) 2009Search in Google Scholar

34Dugheri S, Mucci N, Pompilio I, Cappelli G, Bossi C, Bonari A, Arcangeli G. Determination of airborne formaldehyde and ten other carbonyl pollutants using programmed temperature vaporization-large volume injection-gas chromatography. Chinese J Chrom 2018;36:1311–22. doi: 10.3724/SP.J.1123.2018.08050 Dugheri S Mucci N Pompilio I Cappelli G Bossi C Bonari A Arcangeli G Determination of airborne formaldehyde and ten other carbonyl pollutants using programmed temperature vaporization-large volume injection-gas chromatography Chinese J Chrom 2018361311 22 10.3724/SP.J.1123.2018.0805030574711Open DOISearch in Google Scholar

35UNI - Ente Italiano di Normazione. UNI/TS 11710:2018 -Fume cupboards for chemical handling – Limit values for containment, face velocity and air exchange efficiency; 2018 [displayed 28 August 2020]. Available at http://store.uni.com/catalogo/uni-ts-11710-2018?___store=en&josso_back_to=http%3A%2F%2Fstore.uni.com%2Fjosso-security-check.php&josso_cmd=login_optional&josso_partnerapp_host=store.uni.com&___from_store=it UNI - Ente Italiano di Normazione. UNI/TS 11710:2018 - Fume cupboards for chemical handling – Limit values for containment, face velocity and air exchange efficiency ; 2018 [displayed 28 August 2020] Available at http://store.uni.com/catalogo/uni-ts-11710-2018?___store=en&josso_back_to=http%3A%2F%2Fstore.uni.com%2Fjosso-security-check.php&josso_cmd=login_optional&josso_partnerapp_host=store.uni.com&___from_store=itSearch in Google Scholar

36Ministry of Health, Higher Health Council, Italy. Section I. Guidelines tracking, collection, transport, preservation and storage of cells and tissues for diagnostic investigations of pathological anatomy; 2016 [displayed 11 August 2019]. Available at http://www.salute.gov.it/imgs/C_17_pubblicazioni_2504_allegato.pdf Ministry of Health, Higher Health Council, Italy. Section I. Guidelines tracking, collection, transport, preservation and storage of cells and tissues for diagnostic investigations of pathological anatomy 2016 [displayed 11 August 2019]. Available at http://www.salute.gov.it/imgs/C_17_pubblicazioni_2504_allegato.pdfSearch in Google Scholar

37Fiocca R, Marchetti A, Massi D, Truini M, Zanin T. [Note relative all’utilizzo della formalina, ri-classificata “cancerogena”, in Italian]. Linee di indirizzo SIAPEC-IAP Divisione Italiana 2016 Fiocca R Marchetti A Massi D Truini M Zanin T [Note relative all’utilizzo della formalina, ri-classificata “cancerogena”, in Italian] Linee di indirizzo SIAPEC-IAP Divisione Italiana 2016Search in Google Scholar

38UNI - Ente Italiano di Normazione. UNI EN 689:2018 – Workplace exposure – Measurement of exposure by inhalation to chemical agents - Strategy for testing compliance with occupational exposure limit values; 2018 [displayed 28 August 2020]. Available at http://store.uni.com/catalogo/uni-en-689-2018?___store=en&josso_back_to=http%3A%2F%2Fstore.uni.com%2Fjosso-security-check.php&josso_cmd=login_optional&josso_partnerapp_host=store.uni.com&___from_store=it UNI - Ente Italiano di Normazione. UNI EN 689:2018 – Workplace exposure – Measurement of exposure by inhalation to chemical agents - Strategy for testing compliance with occupational exposure limit values ; 2018 [displayed 28 August 2020] Available at http://store.uni.com/catalogo/uni-en-689-2018?___store=en&josso_back_to=http%3A%2F%2Fstore.uni.com%2Fjosso-security-check.php&josso_cmd=login_optional&josso_partnerapp_host=store.uni.com&___from_store=itSearch in Google Scholar

39Ochs SD M, Grotz LD O, Factorine LS, Rodrigues MR, Netto AD P. Occupational exposure to formaldehyde in an institute of morphology in Brazil: a comparison of area and personal sampling. Environ Sci Pollut Res Int 2011;19:2813–9. doi: 10.1007/s11356-012-0786-3 Ochs SD M Grotz LD O Factorine LS Rodrigues MR Netto AD P Occupational exposure to formaldehyde in an institute of morphology in Brazil: a comparison of area and personal sampling Environ Sci Pollut Res Int 2011192813 9 10.1007/s11356-012-0786-322322292Open DOISearch in Google Scholar

40Costa S, Coelho P, Costa C, Silva S, Mayana O, Santos LS, Gaspar J, Teixeira JP. Genotoxic damage in pathology anatomy laboratory workers exposed to formaldehyde. Toxicology 2008;252:40–8. doi: 10.1016/j.tox.2008.07.056 Costa S Coelho P Costa C Silva S Mayana O Santos LS Gaspar J Teixeira JP Genotoxic damage in pathology anatomy laboratory workers exposed to formaldehyde Toxicology 200825240 8 10.1016/j.tox.2008.07.05618721846Open DOISearch in Google Scholar

41Orsière T, Sari-Minodier I, Iarmarcovai G, Botta A. 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. Mutat Res Genet Toxicol Environ Mutagen 2006;605:30–41. doi: 10.1016/j.mrgentox.2006.01.006 Orsière T Sari-Minodier I Iarmarcovai G Botta A 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 Mutat Res Genet Toxicol Environ Mutagen 200660530 41 10.1016/j.mrgentox.2006.01.00616584911Open DOISearch in Google Scholar