Formaldehyde in human anatomies – Evaluation of protective measures

Status:

completed 12/2022

Aims:

More than ten years ago technical measurements conducted by some German social accident insurance institutions of the public sector on inhalation exposure to formaldehyde showed exceedances of the then not yet legally binding occupational exposure limit (OEL) of 0.37 mg/m³.

Since then, to ensure OEL compliance, the anatomical institutes have taken partly extensive technical and organisational measures including ventilation as well as preparation. In this process, many of them have received advice from the Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA) in cooperation with the German social accident insurance institutions for the public sectors. This advice often involved the use of measurements.

The process was supported by the following IFA projects as the basis of the evaluation project described here:

• Project 3127 "Formaldehyde exposure in anatomical dissecting courses"
• Project 3131 "Metrological findings in anatomy – measuring programmes 9092 and 9187"
• Project 3141 "Development of a ventilation concept for rooms in which anatomical dissecting courses take place".

The purpose of this evaluation project has been twofold: to evaluate the measures taken, and to examine the role of the IFA and the accident insurance institutions in this process.

The main focus has been on the effectiveness of the measures and, where possible, on OEL compliance. The primary objective is to contribute to identify good practice in implementing protective measures.

Activities/Methods:

So far in this evaluation project, a range of existing measurement data and subjective assessments of the anatomies have been examined in three areas of activity. Each area has been evaluated for each facility and measuring occasion.

At the same time, a questionnaire was developed and distributed among a working group of the Anatomical Society. Most of the questionnaires were completed by the heads of anatomy and/or dissection. The questionnaire was about the reduction of formaldehyde in anatomical dissecting courses and the advice provided by social accident insurance institutions on this topic. The participating anatomy institutions were informed about the outcomes in a report, and the working group was informed with a presentation at a meeting.

In addition, four heads of anatomy or dissection were interviewed to obtain more in-depth information on the effectiveness of the measures that had been taken and also to receive feedback on prior advice provided by the social accident insurance institutions.

Results:

At most facilities, exposure over a period of eight hours was close to the occupational exposure limit. Contrary to the original planning, stationary measurements are not suitable for a description of exposure. The considerable variance of the measured values does not differ between the anatomical institutes. This can be attributed to the similarity in the work process (i. e. dissecting courses). Protective measures can, therefore, only affect the location parameter of the exposure distribution. Despite the large variances, some measures reduce the exposure significantly, e.g. implementation of a coordinated ventilation system (see IFA project 3141) that includes, where possible, preparation tables with extraction facilities. Other ways to minimise formaldehyde exposure include reducing formaldehyde in the preservative solutions and generally reducing the sources of exposure, i.e. fewer donated bodies and storage containers in the dissection room. Reducing the temperature within the room only had a minor impact.

The response rate in the survey was 74% and therefore quite high. In conclusion, the measures that were assessed as either effective or very effective were the ones which also impacted exposure levels in the measurements. In addition, several other measures were also seen as effective, such as wearing of respiratory protection, the enclosed storage of drapes in the room and certain aspects of the ventilation concept. In all, this means that there is a bundle of measures that are rated as effective by the institutions, including some with a positive impact on measurements.

The survey showed that 11 out of 14 institutions advised by the accident insurance institutions and the IFA felt that their advice had been very helpful, while 2 saw it as quite helpful, and 1 as not so helpful. This positive impression was also reflected in the interviews, which provided further details that underlined the positive impact of the measures. Moreover, the interviews showed that contact with accident insurance institutions and the IFA have been strengthening an awareness of the problem and stimulating a systematic quest for measures to reduce formaldehyde exposure.

The DGUV’s Expert Committee on Higher Education has been informed about the work, so that information on good practice can be made available as soon as the results have been published.

Last Update: