Formaldehyde exposure and its effects during pregnancy: Recommendations for laboratory attendance based on available data

Formalin is commonly used in fixation of cadaveric specimens. Exposure to formaldehyde, a component of formalin and a known carcinogen, during gross anatomy laboratory dissection is a continuing concern for pregnant students and instructors. Since there is little literature on this specific topic, the current review was compiled in the hope of offering recommendations to pregnant students and instructors who are engaged in human anatomical dissection where formalin is used. Relevant articles were obtained through searches of PubMed and Google Scholar for the terms “formaldehyde,” “pregnant,” “formalin,” and “exposure.” A literature search was conducted for chemical information and articles about exposure as issued by government regulatory agencies and chemical companies that produce formaldehyde. This led to the compilation of 29 articles each of which included references to previous, relevant, human research. The reviewed literature contains data strongly suggesting that pregnancy can be affected by formaldehyde exposure. Therefore, on the basis our analysis, female students who might be pregnant should avoid formaldehyde exposure, including that in a gross anatomy laboratory. Instructors should find other means of ensuring anatomical competence for these students. Clin. Anat. 28:972–979, 2015. © 2015 Wiley Periodicals, Inc.     

Effectiveness of various methods of formaldehyde neutralization using monoethanolamine

Formaldehyde is the most commonly used fixative chemical for the preservation of human cadavers used for educational purposes in the United States. Formaldehyde is also a known carcinogenic agent whose exposure level is regulated by guidelines of the Occupational Safety and Health Administration. Various methods for formaldehyde neutralization exist, yet many donations programs do not take any steps to neutralize the formaldehyde in embalmed donor bodies. The effectiveness of monoethanolamine (MEA) in neutralizing formaldehyde is well documented when used as a final injection during embalming. The purpose of this study is to report the effectiveness of several post‐embalming techniques of formaldehyde neutralization. Twenty‐four donor bodies were assigned to four experimental groups of six. For the three experimental groups, the techniques tested involve delivery of a 20:1 dilution of deionized water:MEA via recannulization and gravity flow infusion, compartment injection, and alternate wetting solution containing four percent MEA. Our results indicated that spray bottle delivery was not effective in neutralization of formaldehyde compared to the control group, but that formaldehyde levels decreased when recannulization or compartment injection were used. The most effective method of formaldehyde neutralization was compartment injection of MEA solution (P < 0.01). The results of this study indicate that, in situations where MEA is not used as a final infusion during embalming, compartment injection of MEA solution is an effective method of formaldehyde neutralization. Clin. Anat. 28:449–454, 2015. © 2015 Wiley Periodicals, Inc.     

甲醛对人脐静脉内皮细胞氧化损伤作用

目的 探讨甲醛对人脐静脉内皮细胞的损伤作用及可能机制。方法 将人脐静脉内皮细胞暴露于不同浓度甲醛（0、5、10、20、40、80μmol／L）下；同时以过氧化氢为阳性对照组，抗氧化药物维生素C为保护组。24h后通过MTT比色法检测细胞生长抑制率，硫代巴比妥酸比色法检测丙二醛含量，观察甲醛是否对内皮细胞具有损伤作用及维生素C对甲醛损伤的内皮细胞是否具有保护作用。结果 甲醛能抑制细胞的生长活性，细胞生长抑制率随甲醛浓度的增加而增加；甲醛诱导细胞外丙二醛的生成，且其含量随甲醛浓度的增加而增加。维生素C能降低甲醛对内皮细胞的生长抑制率，降低细胞外MDA含量。结论 甲醛能诱导内皮细胞产生损伤作用，这种作用与其增加内皮细胞产生过多的脂质过氧化物有关。抗氧化刺维生素C能减轻甲醛对内皮细胞的氧化损伤。     

Inactivated or damaged? Comparing the effect of inactivation methods on influenza virions to optimize vaccine production

The vast majority of commercially available inactivated influenza vaccines are produced from egg-grown or cell-grown live influenza virus. The first step in the production process is virus inactivation with β-propiolactone (BPL) or formaldehyde (FA). Recommendations for production of inactivated vaccines merely define the maximal concentration for both reagents, leaving the optimization of the process to the manufacturers. We assessed the effect of inactivation with BPL and FA on 5 different influenza virus strains. The properties of the viral formulation, such as successful inactivation, preservation of hemagglutinin (HA) binding ability, fusion capacity and the potential to stimulate a Toll-like receptor 7 (TLR7) reporter cell line were then assessed and compared to the properties of the untreated virus. Inactivation with BPL resulted in undetectable infectivity levels, while FA-treated virus retained very low infectious titers. Hemagglutination and fusion ability were highly affected by those treatments that conferred higher inactivation, with BPL-treated virus binding and fusing at a lower degree compared to FA-inactivated samples. On the other hand, BPL-inactivated virus induced higher levels of activation of TLR7 than FA-inactivated virus. The alterations caused by BPL or FA treatments were virus strain dependent. This data shows that the inactivation procedures should be tailored on the virus strain, and that many other elements beside the concentration of the inactivating agent, such as incubation time and temperature, buffer and virus concentration, have to be defined to achieve a functional product.     

2013年北京市某商场空气质量监测与分析

[目的]了解某大型商场的空气质量状况,分析其变化规律及影响因素. [方法]于2013年对北京市某商场空气质量进行监测,监测点为2个商品售卖区和1个餐饮区,监测指标包括温度、湿度、可吸入颗粒物(PM10)、甲醛、一氧化碳(CO)、二氧化碳(CO2),通过远程数据传输技术收集数据并分析. [结果]监测指标中,CO2合格率(100％)最高;其次是温度、PM10、CO和甲醛,合格率分别为98.82％、96.81％、84.73％、69.41％;湿度合格率最低(仅29.36％).商场内不同季节湿度变化明显(P＜0.05); PM10浓度与室外PM10浓度、客流量存在正相关(r=0.681,r=-0.162;P＜0.05);餐饮区CO和CO2浓度高于其他2个监测点,浓度较高的时段与营业高峰时段一致;甲醛浓度波动较大,甲醛最高浓度达0.214 mg/m3,与商场内湿度呈正相关(r=0.740,P＜ 0.05),不同监测点甲醛浓度差异有统计学意义(P＜0.05).[结论] PM10、CO、甲醛是该商场空气质量的主要危害因素.室外PM10浓度和客流量是影响商场内PM10浓度的主要因素;餐饮活动是CO的主要污染来源,客流量增加引起餐饮活动增多间接影响CO浓度;甲醛污染在商场内持续存在,湿度升高加速甲醛释放,局部装修加剧污染程度.商场应采取集中空调分区域运行,及时调整新风量等措施提高空气质量.     

Effect of different fixative solutions on eyes with experimental proliferative vitreoretinopathy

The aim of this study was to evaluate the use of different fixatives on the reliability of histopathological changes in a rabbit model of proliferative vitreoretinopathy (PVR). Twenty eyes from 10 rabbits were divided into four groups. The right eyes were used in two experimental groups (each n = 5), and the left, in two control groups (each n = 5). Using a newly developed scleral incision marker, an oblique scleral incision was standardized in the experimental groups, followed by intravitreal injection of 0.4 ml autologous blood and the left for wound repair for four weeks. Eyes were enucleated at four weeks. The groups differed in the type of used fixative solution (formaldehyde 4% vs. 1% buffered formaldehyde and 1.25% glutaraldehyde). The eyes were evaluated for the development of fibrosis, retinal detachment (RD), and processed for histopathology. Fibrous ingrowth of a variable degree was present in the experimental groups originating from the trauma site. Experimental eyes fixed with formaldehyde 4% had RD extension that was greater than that fixed in formaldehyde/glutaraldehyde mixture; however, the difference did not reach statistical significance (P = 0.15). This difference was not fully explained by the fibrosis which developed. In addition, in control groups, formaldehyde 4% induced a fixative-dependent retinal separation that was absent in eyes fixed with formaldehyde/glutaraldehyde mixture (P = 0.03). In conclusion, a mixture of buffered formaldehyde 1% and glutaraldehyde 1.25% combined with standardized scleral incision resulted in consistent pathological changes. A reliable PVR model is a condition sine qua non to evaluate antifibrotic treatment strategies.     

内源性甲醛及炎症介质在血管性痴呆中的研究

目的评价炎症介质白介素-2(interleukin-2,IL-2)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及尿液内源性甲醛浓度(formaldehyde,FA)与血管性痴呆(vascular dementia,Va D)的关系,为临床Va D的早期诊断提供生化标志物诊断方法。方法选取北京老年医院精神心理门诊和病房Va D患者42例为试验组,选取社区内认知功能正常者54例为对照组,测定研究对象血浆中IL-2和TNF-α的水平,测定尿液内源性甲醛的含量,以尿液中甲醛浓度除以肌酐(creatinine,Cr)浓度值(FA/Cr)作为内源性甲醛校正浓度,比较两组上述指标的差异。结果与对照组相比,Va D患者尿液内源性甲醛浓度含量显著升高(6.31±0.53 vs 4.40±0.31,P=0.007)。结论 Va D患者尿液中内源性甲醛浓度升高,或可作为临床诊断Va D的生物标志物之一。     

Human preservation techniques in anatomy: A 21st century medical education perspective

Anatomy is the cornerstone of education for healthcare professionals with the use of human material providing an excellent teaching tool in the modern curricula. The ability and quality of preservation of human remains has enabled such use. The introduction of formaldehyde as a preservative in 1893 was an important step in the history of preservation. With the European Union directive on the use of formaldehyde and its expected banning, anatomists are trying to find a more convenient and safe substitute. In this review, we compare the different techniques used based on the need for embalming, fixative used, period of preservation and the features of the embalmed specimen. The fact that embalming is used in different disciplines, multiple purposes and described in different languages has led to the development of ambiguous interchangeable terminology. Overall, there is a lack of information specifically classifying, listing and comparing different embalming techniques, and this may be due to the fact that no internationally recognized experimental standards are adhered to in this field. Anatomists strive to find an embalming technique that allows the preserved specimen to accurately resemble the living tissue, preserve the body for a long period of time and reduces health risk concerns related to working with cadavers. There is a need for embalming to shift to an independent modern day science with well‐founded research at the heart of it. While this may take time and agreement across nations, we feel that this review adds to the literature to provide a variety of different methods that can be employed for human tissue preservation depending on the desired outcome. Clin. Anat. 28:725–734, 2015. © 2015 Wiley Periodicals, Inc.