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. 2020 Oct 6;71(3):178-189.
doi: 10.2478/aiht-2020-71-3406. Print 2020 Sep 1.

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

Stefano Dugheri  1 , Daniela Massi  2   3 , Nicola Mucci  4 , Nicola Berti  5 , Giovanni Cappelli  4 , Giulio Arcangeli  4
Affiliations

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

Stefano Dugheri et al. Arh Hig Rada Toksikol. .

Abstract
in English, Croatian

The last two decades have been crucial for the assessment of airborne formaldehyde (FA) exposure in healthcare environments due to changes in limits and reference values, definition of carcinogenicity, and new monitoring methods. The aim of this study was to analyse twenty years (1999-2019) of experience in automatic, continuous airborne FA monitoring in the Pathology Laboratory and operating rooms at the Careggi University Hospital, Florence, Italy. These 20 years saw gradual improvements in FA monitoring of exposed employees considered at maximum risk, including improvements in analytical methods of detection and sampling strategies, which came with changes in procedures and workflow operations. In 2019, after the adoption of safe practices, including a closed-circuit system using pre-loaded containers and a vacuum sealing, 94 % of the total measurements (FA concentrations) were lower than 16 μg/m3, and only 6 % ranged from 21 to 75 μg/m3. In the studied work units, the ratio between area and personal readings ranged from 0.9 to 1.0, both for long and short-term sampling. Personal sampling was simplified with a new workstation, which integrated different monitoring systems into an innovative ergonomic armchair equipped with personal sampling devices. Area monitoring was also improved with a real-time, continuous photoacoustic instrument. Over these 20 years, FA exposure significantly dropped, which coincided with optimised histology workflow and implementation of safety practices. For high-throughput screening and cost savings we propose an innovative ergonomic armchair station which allows remote continuous monitoring.

Posljednja dva desetljeća bila su iznimno važna za procjenu izloženosti formaldehidu (FA) u zraku u zdravstvenim ustanovama zahvaljujući promjenama u preporučenim maksimalnim i referentnim vrijednostima, definiciji njegove kancerogenosti i novim metodama mjerenja/praćenja. Cilj je ovog istraživanja bio analizirati dvadeset godina (1999. – 2000.) iskustva u automatskom, kontinuiranom mjerenju razina FA-a u laboratoriju za patologiju i operacijskim dvoranama talijanske sveučilišne bolnice Careggi u Firenzi. Tijekom tih dvadeset godina bolnica je postupno poboljšavala metode praćenja razina FA-a i osoblja izloženoga najvećem riziku, analitičke metode detekcije i strategije uzorkovanja koje su bile popraćene promjenama u odgovarajućim postupcima i organizaciji rada. Nakon usvajanja novih postupaka zaštite na radu 2019., uključujući i zatvoreni sustav rukovanja spremnicima i sustav vakuumskoga zatvaranja, razine FA-a u 94 % izmjera bile su niže od 16 μg/m3, a samo 6 % izmjera kretalo se u rasponu od 21 do 75 μg/m3. Omjer izmjerenih razina prostornih i osobnih skupljača uzoraka u ispitanim scenarijima kretao se od 0,9 do 1,0, bez obzira na to je li posrijedi kratkoročno ili dugoročno mjerenje. Mjerenje osobnim mjeračima dodatno je pojednostavljeno novom radnom stanicom u obliku ergonomskoga radnog stolca, koji u sebi objedinjuje različite sustave praćenja i osobne mjerače. Nisu zaostala ni poboljšanja u prostornom mjerenju, budući da je uveden novi fotoakustični uređaj za kontinuirano mjerenje u stvarnom vremenu. U tih 20 godina izloženost FA-u drastično se smanjila, što je popraćeno poboljšanom organizacijom obrade histoloških uzoraka i zaštite na radu. Radnu stanicu u obliku ergonomskoga stolca svakako preporučujemo zbog velikog kapaciteta protoka za probirno mjerenje, značajnih ušteda i mogućnosti daljinskog upravljanja.

Keywords: air monitoring; formaldehyde; personal sampling; remote control; safe practices.

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Conflict of interest statement

Conflicts of interests

The authors declare no conflicts of interest regarding their research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Sampling strategies from 1999 to 2019. a – SkyPost Gas; b– Bravo M Plus pump; c– Lp-2,4-DNPH-S10 coated cartridge; d – GilAir-3 pump; e– FFA-PDMS/DVB SPME fibre; f– diffusive sampling fibre holder; g– Sep-Pak XpoSure sampler plus short DNPH-coated cartridge; h– GilAir Plus; i– Formaldemeter™ htV-M; j– GasCheck Basic; k – NEMo XT; l – Gasera One; m – ergonomic armchair (a) headrest with two NEMo XT and a Gascheck (b)
Figure 2
Figure 2
Box plot of the gross room FA monitoring results from 1999 to 2019. Mean, median, and quartile distribution of TWA and short-term concentrations (μg/m3)
Figure 3
Figure 3
Box plot of the specimen reception FA monitoring results from 1999 to 2019. Mean, median, and quartile distribution of TWA and short-term concentrations (μg/m3)
Figure 4
Figure 4
Box plot of the operating theatre FA monitoring results from 1999 to 2019. Mean, median, and quartile distribution of short-term concentrations (μg/m3)
See this image and copyright information in PMC

References

    1. Musiał A, Gryglewski RW, Kielczewski S, Loukas M, Wajda J. Formalin use in anatomical and histological science in the 19th and 20th centuries. Folia Med Cracov. 2016;56:31–40. PMID: 28275269. - PubMed
    1. Dimenstein IB. A pragmatic approach to formalin safety in anatomical pathology. Lab Med. 2009;40:740–6. doi: 10.1309/LMQ1HJFD4UN0WWBP. - DOI
    1. Onyije 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. - PubMed
    1. 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. 2010;39:26–34. PMCID: PMC3481685. - PMC - PubMed
    1. Flyvholm 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. - DOI - PubMed

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