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Forensic/hospital mortuaries and pathology laboratories
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- Measured exposure data
- Embalming
Forensic/hospital mortuaries and pathology laboratoriesFormalin solutions containing 4% formaldehyde are commonly used in the forensic /hospital mortuaries and pathology laboratories including histopathology and anatomical laboratories. However, solutions containing higher levels of formaldehyde (up to 32%) are also handled during dilution. Information on the total number of workers involved in these industries is not available. There is a potential for dermal exposure to formalin products through spills or splashes onto skin or eyes during some processes, such as manual dilution of the concentrated formalin solutions and dispensing solutions from storage tanks to specimen jars. There is also potential for inhalational exposure to formaldehyde fumes during fixing and accessioning human tissues and organs. The exposure durations in these industries vary considerably. Some workers, such as hospital staff and doctors, would have brief exposure when placing human tissues into specimen jars filled with formalin solutions whereas fixing and accessioning human tissues and organs conducted by staff at most forensic/hospital mortuaries and pathology laboratories are daily activities. The exposure duration for students studying tissues and organs fixed by formalin solutions varies, but is limited to the period they are in laboratories. Information from the industry indicates that the majority of laboratories/mortuaries are equipped with local exhaust systems and some also have an exhaust system for the whole area. Considering the degree of manual handling that the process involving formaldehyde can entail in these industries, the ergonomic design of the laboratory/mortuary and fume cabinet and their effectiveness, combined with work procedures and training, are important factors influencing the potential for exposure. Examination gloves, safety glasses and laboratory gowns are worn at the majority of laboratories/mortuaries. It was reported that respirators are also used when preparing large amounts of formalin solutions used in forensic medicine areas or anatomy laboratories. Measured exposure dataLimited Australian personal and static monitoring data during use of formalin products in mortuaries, hospitals and pathology laboratories were available (Table 15.6a and Table 15.6b, respectively). 162 Priority Existing Chemical Assessment Report No. 28 Long-term (37-428 min.) personal sampling results ranged from 0.02 ppm to 0.66 ppm in an anatomy laboratory without local exhaust ventilation (Table 15.6a), with the majority of results below 0.3 ppm. However, more recent limited data measured in a pathology laboratory showed levels up to 3 ppm. Formaldehyde levels decreased significantly after control measures were implemented. Data measured in the mid 1980s in hospital mortuaries and pathology laboratory showed higher results, ranging from 0.4 ppm to 4.8 ppm, with measurement durations between 23-77 min. Limited long-term static data showed results of 0.2 ppm to 2.66 ppm in an anatomy dissection laboratory. Short-term static data in pathology laboratories showed most levels < 0.3 ppm, but some up to 1.5 ppm. Static spot testing data measured in forensic medicine mortuaries and anatomy laboratories showed levels that ranged from < 0.1 to up to 2 ppm, with most < 0.3 ppm (425 out of 593, about 70% samples). Recent overseas personal monitoring data (Dufresne et al., 2002; Ryan & Burroughs, 2003; Akbar-khanzadeh & Pulido, 2003) found average levels of formaldehyde ranging from 0.2 to 0.9 ppm in 71 samples in total (Table 15.7). Recent overseas static monitoring data (Table 15.7) showed average levels of formaldehyde ranging from 0.5 to 1.5 ppm in anatomy laboratories (no local exhaust ventilation in one laboratory) when dissection was being undertaken (Keil & Konecny, 2001). One study showed lower average levels of < 0.2 ppm in 18 samples (Ryan & Burroughs, 2003). No details on the sampling locations and ventilation were reported in the study with the highest reading of 9.34 ppm (Kim et al., 1999). Regular spot testing for 3 to 4.5 hours (Koda et al., 1999) showed levels of 0.2 to 0.4 ppm formaldehyde around workers’ breathing zone in a laboratory without specimen storage, although no local exhaust ventilation was in place. In a laboratory with large specimen storage and no local exhaust ventilation, formaldehyde levels were higher than 2 ppm in 21 spot testing samples, particularly when dissection started and when windows were closed. Earlier overseas data reported that the mean concentrations of formaldehyde in the workroom air of anatomical theatres, pathology and hospital laboratories, and autopsy services ranged from 0.5 to 1.1 ppm. In studies of autopsy services, one study reported an average level of 4.2 ppm in 23 static samples collected, and another with 27 personal samples reported an arithmetic mean level of formaldehyde at 1.3 ppm in an autopsy service (IARC, 1995).
Formalin solutions containing up to 40% formaldehyde and paraformaldehyde prills/powder are commonly used in embalming in funeral homes, medical/anatomy laboratories and mortuaries. There are about 1700 funeral homes in Australia. However, not all funeral homes conduct embalming in Australia. The Australian Funeral Director Association (AFDA) reported that there are approximately 350 embalmers in Australia. AFDA represents 60% funeral homes in Australia. British Institute of Embalming (BIE) and New Zealand Embalming Association (NZEA) represent 40%. Embalming activities are less frequent in medical laboratories and mortuaries. Formaldehyde 163
Table 15.6a: Summary of Australian personal monitoring data during use of formalin solutions in mortuaries/pathology laboratories Hospital mortuaries Dilute formalin solution, lung perfusion 3 23-32 min. ACGIH Bisulphite Addition 1 = 0.4 Personal
mock up, pouring and decanting formalin solutions and organ washing Method
1 = 0.6 1 = 1.6
communication, 1986
NIOSH, National Institute for Occupational Safety and Health. NR, not reported; ACGIH; the American Conference of Governmental Industrial Hygienists; HPLC; High Performance Liquid Chromatography. # The results are presented as individual results (where only one sample). *’Infutrace’ is a commercial product which claims to neutralise formaldehyde in the cadavers by spraying it onto cadavers.
Table 15.6b: Summary of Australian static monitoring data during use of formalin solutions in mortuaries/pathology laboratories Use Activity/Location No. of Duration Sampling method Results# Comment Reference
samples (ppm) 1 >0.3-0.5 3 >0.5-2
Table 15.6b: Summary of Australian static monitoring data during use of formalin solutions in mortuaries/pathology laboratories (continued) Use Activity/Location No. of Duration Sampling method Results# Comment Reference samples (ppm) Pathology laboratory Tissue preservation 20 NR Passive monitor and HPLC 0.14-3.01 (mean = 0.98) Dingle et al. 2002 Hospital mortuaries On the bench next to the formalin pump
0.8 Personal communication, 1986 Hospital mortuaries Workbench next to biopsy storage area
0.3 and 0.4 Personal communication, 1986 Dissection area 1 227 min. 1.6 Brain sections impregnated with 40% formalin solution were left sitting covered with a towel. Sterilising dialysis machines Flush a dialysis machine using formalin (40%) 2 21-22 min. NIOSH Chromotropic Acid Method 1 = 0.8
1 = 0.3 Personal communication, 1987 NR, not reported; HPLC, High Performance Liquid Chromatography; NIOSH, National Institute for Occupational Safety and Health; ACGIH, the American Conference of Governmental Industrial Hygienists. # The results are presented as the number of samples in a series of result bands. Table 15.7: Summary of recent overseas monitoring data during use of formalin solutions in mortuaries and medicine-related laboratories Use Type of sampling Activity/Location No. of samples Duration Test method Results (ppm) Comment Reference Pathology laboratories static pathologists/ technicians in hospital A 185 spot testing every 2-3 min. for 4.5 hours photo acoustic infra-red detection All in range 0.2-0.4 no local exhaust ventilation, without specimen storage Koda et al., 1999
pathologists/ technicians in hospital B 62 spot testing every 2-3 min. for 3 hours photoacoustic infra-red detection 41 <2
0.6-1 ppm (n=13) when windows were open 21 >2 when dissection started, reached 8.6 ppm when windows were closed. no local exhaust ventilation, with a large specimen storage. Irritated eyes, nose and throat and cough reported. Biology laboratories personal Students in animal health training 18 3 h NIOSH 3500 0.2-0.5 (average range) Dufresne et al., 2002 Gross anatomy personal Medical students doing 21 3 h NIOSH 3500 0.9 (mean) Akbar-khanzadeh and laboratories dissecting operations static 33 3 h NIOSH 3500 0.6 (mean) Pulido, 2003 Gross anatomy static centre of laboratory and 50 3-4 h/d NIOSH 3500 0.50-1.49 (mean) no local exhaust ventilation Keil & Konecny, 2001 laboratories using 10% formalin Anatomy laboratories other locations (vary each day) personal Students and instructors 19 2-4 h NIOSH 2016 Passive dosimeter 13 2-4 h NIOSH 2016 Active sampler 0.42 (mean) Air conditioned room, No windows, doors open sometimes. 0.21 (mean) burning eyes and nose or watery eyes reported. Ryan & Burroughs, 2003
static In a middle of a dissection table & in a corner of the room 6 2-4 h NIOSH 2016 Passive dosimeter 12 2-4 h NIOSH 2016 Active sampler 0.21 (mean) 0.16 (mean)
Cadaver dissection static NR 48 1-2 h NIOSH 3500 0.16-9.34 (no details for using result bands) eye soreness and lacrimation reported Kim et al., 1999
NR, not reported; NIOSH, National Institute for Occupational Safety and Health. Embalmers are likely to be exposed by skin contact through spills or splashes onto skin or eyes during handling processes, such as dilution, arterial and cavity embalming, cleansing and disinfections of body surfaces and orifices, and equipment cleaning by hosing. Spills and splashes during embalming were observed at the site visited. The likelihood of exposure by inhalation is also high during embalming, such as during dilution of concentrated formalin solutions, application of the solution by spraying, and handling viscera covered with paraformaldehyde powder. The duration of embalming a body varies depending on body conditions and customers’ requirements, but usually takes 1 to 3 hours. The majority of the embalmers operate on a daily basis and exposure durations vary from 1 to 10 hours a day. Other staff involved in handling embalmed bodies, such as body dressing up and body lifting, may also be exposed to formaldehyde. Ventilation systems installed in embalming rooms vary at different funeral homes. In general, new premises are fitted with an airflow system that blows fumes away from embalmers, together with an exhaust fan to extract the fumes. Whereas, in old buildings, usually only an exhaust fan is available. It was reported that some mortuaries do not have exhaust ventilation. Embalmers wear PPE during embalming including safety goggles, surgical gloves, theatre gown, disposable apron and rubber boots. Respiratory protection equipment is not usually used, although half masks and air-supplied respirators are available at some funeral homes. Directory: data -> assets -> word doc -> 0006 word doc -> Commonwealth of Australia 2002 word doc -> Commonwealth of Australia 2000 word doc -> Priority Existing Chemical word doc -> Rail safety news issue 6 – October 2011 word doc -> Review of Multiple Chemical Sensitivity: Identifying 0006 -> Board Endorsed October 2009 amended 13-09-11 with extra units 0006 -> Rt Hon Andrew Lansley cbe mp secretary of State for Health 0006 -> Environmental Approvals Application Form Use this form Download 5.77 Mb. Share with your friends:
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