Formaldehyde-induced chromosomal aberrations and apoptosis in peripheral blood lymphocytes of personnel working in pathology departments

The mutagenic properties of formaldehyde and acetaldehyde: Reflections on half a century of progress

Formaldehyde and acetaldehyde are reactive, small compounds that humans are exposed to routinely, variously from endogenous and exogenous sources. Both small aldehydes are classified as human carcinogens. Investigation of the DNA damaging properties of these two compounds began some 50 years ago. In this review, we summarize progress in this field since its inception over half a century ago, distilling insights gained by the collective efforts of many research groups while highlighting areas for future directions. Over the decades, general consensus about aspects of the mutagenicity of formaldehyde and acetaldehyde has been reached. But other characteristics of formaldehyde and acetaldehyde remain incompletely understood and require additional investigation. These include crucial details about the mutational signature(s) induced and possible mechanistic role(s) during carcinogenesis.

The role of phase I, phase II, and DNA-repair gene polymorphisms in the damage induced by formaldehyde in pathologists

Formaldehyde (FA) is a human carcinogen used as formalin in hospital laboratories. We evaluated its association with human chromosomal aberrations (CAs) and the risk/protective role played by several genetic polymorphisms in this relationship, on a cohort of 57 exposed pathologists vs 48 controls. All subjects were assessed for CAs on peripheral blood lymphocytes and genotyped for the most common cancer-associated gene polymorphisms which could be related with the genotoxic outcome: CYP1A1 exon 7 (A>G), CYP1A1*2A (T>C), CYP2C19*2 (G>A), GSTT1 (Positive/Null), GSTM1 (Positive/null), GSTP1 (A>G), XRCC1 (G399A), XRCC1 (C194T), XRCC1 (A280G), XPD (A751C), XPC exon 15 (A939C), XPC exon 9 (C499T), TNFα - 308 (G>A), IL10 - 1082 (G>A), IL10 - 819 (C>T) and IL6 - 174 (G>C). Air-FA concentration was assessed through personal samplers. The comparison between pathologists and controls showed a significantly higher CAs frequency in pathologists. Significant positive correlations were found between CAs frequency and air-FA concentration while significant associations were found between variation in CAs frequency and the mutated allele for CYP1A1 exon 7 (A>G), CYP2C19*2 (G>A), GSTT1-positive, GSTM1-positive and XRCC1 (G399A). Our study confirms the role of FA as genotoxicity inductor, even in workers chronically exposed to low air-FA levels and reveals the role played by some genetic polymorphisms in this association, highlighting the importance of individual susceptibility biomarkers assessment in occupational health studies.

Occupational exposure to formaldehyde, lifetime cancer probability, and hazard quotient in pathology lab employees in Iran: a quantitative risk assessment

Formaldehyde is a colorless and highly irritating substance that is used as a preservative and chemical fixative in tissue processing in pathological laboratories. Formaldehyde is mutagenic and is classified by the IARC as the definitive carcinogen (A1 group). This cross-sectional descriptive-analytical study was performed to determine the respiratory exposure of 60 employees of pathology labs with formaldehyde and to estimate carcinogenic and non-carcinogenic risk in Iran in 2018-2019. Occupational exposure to formaldehyde was assessed in summer season using the NIOSH 3500 method and a personal sampler with flow of 1 l/min connected to two Glass Midget Impingers containing 20 ml of 1% sodium bisulfate solution. The respiratory symptoms questionnaire provided by the American Thoracic Society was used to assess the health effects of formaldehyde exposure. The carcinogenic and non-carcinogenic risk assessment of inhaled exposure to formaldehyde was also performed using the USA Environmental Protection Agency (OEHHA) method. The mean respiratory exposure of employees to formaldehyde was 0.64 mg/m³ (range: 0.1474 to 1.3757). Occupational exposure in 28.3% (n = 17) of employees was above the OSHA recommended range. Wheezing (24%), burning eyes (25%), and cough (21.7%) were the most prevalent health problems. The mean ± SD of the carcinogenic risk among the employees was 3.45 × 10^-4 ± 2.27 × 10^-4. The highest mean of carcinogenic risk was found in lab workers (4.44 × 10^-4). Given the high level of carcinogenic and non-carcinogenic risk of respiratory exposure to formaldehyde in pathological employees, especially lab worker, the use of management controls, engineering controls, and respiratory protection equipment to reduce exposure levels of all workers to less than the allowed exposure limits seems necessary.

Estimation of formaldehyde occupational exposure limit based on genetic damage in some Iranian exposed workers using benchmark dose method

The present study evaluated an occupational exposure level for formaldehyde employing benchmark dose (BMD) approach. Dose-response relationship was determined by utilizing cumulative occupational exposure dose and DNA damage. Based on this goal, outcome of comet assay for some Iranian exposed people in occupational exposure individuals was used. In order to assess formaldehyde exposure, 53 occupationally exposed individuals selected from four melamine tableware workshops and 34 unexposed subjects as a control group were examined. The occupational exposure dose was carried out according to the NIOSH-3500 method, and the DNA damage was obtained by employing comet assay in peripheral blood cells. EPA Benchmark Dose Software was employed for calculating BMD and BMDL. Cumulative exposure dose of formaldehyde was between of 2.4 and 1972 mg. According to the findings of the current study, the induction of DNA damage in the exposed persons was increased tail length and tail moment (p < 0.001), when compared to controls. Finally, an acceptable dose-response relationship was obtained in three-category information between formaldehyde cumulative exposure doses and genetic toxicity. BMDL was 0.034 mg/m³ (0.028 ppm), corresponding to genetic damage of peripheral blood cells. It can be concluded that the occupational permissible limit in Iranian people could be at levels lower than OSHA standards.

Cytogenetic surveillance of persons occupationally exposed to genotoxic chemicals

Human genotoxic exposures can occur environmentally, occupationally, or medicinally. The aim of this study was to assess cytogenetic damage (chromosomal aberrations and micronuclei) in persons exposed to chemical agents in medical, agricultural, and industrial occupations. The results showed influences of age, gender, occurrence, and duration of exposure on the extent of cytogenetic damage, but no influence of smoking. Persons exposed to pesticides were allocated significantly higher values of most examined parameters. Among all tested parameters, logistic regression analysis marked tMN, CB, and iCB as the best predictors with high discrimination accuracy of separation between exposed and unexposed persons. The obtained data encourage us to consider certain cytogenetic parameters as valuable markers for preventive medical screening as the extent of cytogenetic damage reflects cumulative exposure events and possible health consequences related to chronic occupational genotoxic exposure.

Is it possible to use biomonitoring for the quantitative assessment of formaldehyde occupational exposure?

The European classification, labeling and packaging classified formaldehyde as human carcinogen Group 1B and mutagen 2, fostering the re-evaluation of the exposure risk in occupational settings. Although formaldehyde exposure is traditionally measured in air, many efforts were made to identify specific exposure biomarkers: urinary formaldehyde, formic acid and DNA damage indicators. Though used in combination, none of these seems satisfactory. The influence of the metabolism on exogenous formaldehyde levels, the exposure to other xenobiotics, the difference in genetic background and metabolism efficiency, misled the relationship between genotoxicity and exposure data. Nevertheless, the limitation of adverse effects to the local contact sites hampers biomonitoring. Here we discuss the feasibility of formaldehyde biomonitoring and the use of DNA, DNA-protein cross-links and protein adducts as potential biomarkers.

Investigation of the protective effects of proanthocyanidin and vitamin E against the toxic effect caused by formaldehyde on the liver tissue

We aimed to investigate of protective role of proanthocyanidin (PA) and vitamin E (vit E) against to toxic effect of formaldehyde (FA). Twenty-eight Wistar albino rats were divided into four groups: control group, rats treated with FA intraperitoneal (i.p.) (10 mg/kg), FA + vit E intragastric (i.g.) (30 mg/kg), and FA + PA i.g. (100 mg/kg). We assayed superoxide dismutase (SOD), glutathione peroxidase (Gpx), myeloperoxidase (MPO) activity and levels of malondialdehyde (MDA) and total sialic acid (TSA) in liver. Liver tissue was taken in order to morphological analysis and hepatocytes apoptosis using terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay immunostaining. SOD decreased in FA and increased in FA + vit E and FA + PA (p < 0.05). Gpx didn't change in FA and increased in FA + PA (p < 0.05). No significant variation between the groups was found in MPO activity. MDA increased only in FA and decreased in FA + vit E and FA+PA (p < 0.05). TSA didn't alter in FA and FA + vit E but decreased in FA + PA (p < 0.05). Degeneration in hepatocytes and endothelial cells, cytoplasm losses, vacuolization, picnotic nuclei, and mononuclear cell infiltration were identified in FA. Degeneration in chromatin material, membrane damage in mitochondria and losses in mitochondrial cristae in hepatocytes were observed in FA. We found that partially recovery in liver as a result of FA + vit E and FA + PA. We have concluded that long term use should be investigated for complete explanation of PA's protective effects on FA toxicity.

Formaldehyde-induced paxillin-tyrosine phosphorylation and paxillin and P53 downexpression in Hela cells

Formaldehyde (FA) is an environmental pollutant and an endogenous product believed to be involved in tumorigenesis. However, the underlying mechanism of observed FA effects has not been clearly defined. Paxillin is a focal adhesion protein that may play an important role in several signaling pathways. Many paxillin-interacting proteins are involved in the regulation of actin cytoskeleton organization, which is necessary for cell motility events associated with diverse biological responses, such as embryonic development, wound repair and tumor metastasis. P53 is important in multicellular organisms, where it regulates the cell cycle and thus functions as a tumor suppressor that is involved in preventing cancer. In this study, we investigated the effects of FA on paxillin-tyrosine phosphorylation and P53 expression in Hela cells by Western blot and immunofluorescence. Western blot analysis revealed that nonlethal concentrations of FA (0.5, 1.0 and 2.0 mM, with the exposure time for 0.5, 1.0 and 2.0 h, respectively) had downregulated paxillin and wild-type p53 genes expression while upregulated paxillin-tyrosine phosphorylation significantly. At the same time, phosphotyrosine at the focal adhesion sites detected by immunofluorescence assay obviously increased in Hela cells incubated with 2.0 mM FA for 2 h. The results suggested that paxillin and p53 genes expression may be involved in FA-related adverse effects and the mechanism may be involved in paxillin-tyrosine phosphorylation.

Increased levels of chromosomal aberrations and DNA damage in a group of workers exposed to formaldehyde

Formaldehyde (FA) is a commonly used chemical in anatomy and pathology laboratories as a tissue preservative and fixative. Because of its sensitising properties, irritating effects and cancer implication, FA accounts probably for the most important chemical-exposure hazard concerning this professional group. Evidence for genotoxic effects and carcinogenic properties in humans is insufficient and conflicting, particularly in regard to the ability of inhaled FA to induce toxicity on other cells besides first contact tissues, such as buccal and nasal cells. To evaluate the effects of exposure to FA in human peripheral blood lymphocytes, a group of 84 anatomy pathology laboratory workers exposed occupationally to FA and 87 control subjects were tested for chromosomal aberrations (CAs) and DNA damage (comet assay). The level of exposure to FA in the workplace air was evaluated. The association between genotoxicity biomarkers and polymorphic genes of xenobiotic-metabolising and DNA repair enzymes were also assessed. The estimated mean level of FA exposure was 0.38±0.03 ppm. All cytogenetic endpoints assessed by CAs test and comet assay % tail DNA (%TDNA) were significantly higher in FA-exposed workers compared with controls. Regarding the effect of susceptibility biomarkers, results suggest that polymorphisms in CYP2E1 and GSTP1 metabolic genes, as well as, XRCC1 and PARP1 polymorphic genes involved in DNA repair pathways are associated with higher genetic damage in FA-exposed subjects. Data obtained in this study show a potential health risk situation of anatomy pathology laboratory workers exposed to FA (0.38 ppm). Implementation of security and hygiene measures may be crucial to decrease risk. The obtained information may also provide new important data to be used by health care programs and by governmental agencies responsible for occupational health and safety.

Cytotoxicity of four denture adhesives on human gingival fibroblast cells

OBJECTIVE

The purpose of this study was to compare the cytotoxicity of four denture adhesives on human gingival fibroblast cells.

MATERIALS AND METHODS

Immortalized human gingival fibroblasts were cultured with one of four different denture adhesives, Polident, Protefix, Staydent or Denfix-A, which was placed in insert dishes (10% w/v concentration) for 48 h. The MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay and flow cytometric apoptosis assay were used to evaluate cell viability and apoptosis rates. The fibroblasts were also examined under a scanning electron microscope.

RESULTS

The MTT assay showed that all denture adhesives resulted in a significantly lower cell viability compared to the control cells propagated in normal culture medium (p < 0.05), with Staydent demonstrating the lowest cell viability. According to the flow cytometric apoptosis assay, Staydent and Protefix showed significantly higher apoptosis rates than the control group (p < 0.05), whereas Polident and Denfix-A did not demonstrate any significant differences (p > 0.05). Staydent showed the highest apoptosis rate. Scanning electron microscopy showed that the cells of the Staydent group underwent cytoplasmic membrane shrinkage, with cell free areas containing residual fragments of the membrane of dead cells.

CONCLUSIONS

The four denture adhesives evaluated in this study imparted cytotoxic effects on human gingival fibroblast cells. Staydent showed the highest toxicity.

Formaldehyde-induced histone H3 phosphorylation via JNK and the expression of proto-oncogenes

Formaldehyde (FA) is a very reactive compound that forms DNA adducts and DNA-protein crosslinks, which are known to contribute to FA-induced mutations and carcinogenesis. Post-translational modifications to histones have recently attracted attention due to their link with cancer. In the present study, we examined histone modifications following a treatment with FA. FA significantly phosphorylated histone H3 at serine 10 (H3S10), and at serine 28 (H3S28), the time-course of which was similar to the phosphorylation of H2AX at serine 139 (γ-H2AX), a marker of DNA double strand breaks. The temporal deacetylation of H3 was observed due to the reaction of FA with the lysine residues of histones. The phosphorylation mechanism was then analyzed by focusing on H3S10. The nuclear distribution of the phosphorylation of H3S10 and γ-H2AX did not overlap, and the phosphorylation of H3S10 could not be suppressed with an inhibitor of ATM/ATR, suggesting that the phosphorylation of H3S10 was independent of the DNA damage response. ERK and JNK in the MAPK pathways were phosphorylated by the treatment with FA, in which the JNK pathway was the main target for phosphorylation. The phosphorylation of H3S10 increased at the promoter regions of c-fos and c-jun, indicating a relationship between FA-induced tumor promotion activity and phosphorylation of H3S10. These results suggested that FA both initiates and promotes cancer, as judged by an analysis of histone modifications.

A case of multiple myeloma in a poultry worker

Background

Livestock breeders including poultry workers are exposed to various agricultural chemicals including pesticides and/or organic solvents. Multiple myeloma is a rare disease in Korea, and few reports have investigated the influence of occupational exposures on multiple myeloma occurrence.

Case presentation

A 61-year-old male poultry farm worker presented with bone pain and generalized weakness. A bone marrow biopsy was performed, and he was diagnosed with multiple myeloma. The patient had worked in a poultry farm for 16 years and was exposed to various pesticides and organic solvents such as formaldehyde without any proper personal protective equipment. Results of the work reenactment revealed that the concentration of formaldehyde (17.53 ppm) greatly exceeded the time-weighted average (0.5 ppm) and short-term exposure limit (1.0 ppm) suggested in the Korean Industrial Safety and Health Act.

Conclusions

This case report suggests that poultry workers may be exposed to high levels of various hazardous chemicals including pesticides and/or organic solvents. Numerous previous studies have suggested an association between multiple myeloma and exposure to agricultural chemicals; thus, multiple myeloma in this patient might have resulted from the prolonged, high exposure to these chemicals.

Electronic supplementary material

The online version of this article (doi:10.1186/s40557-014-0035-y) contains supplementary material, which is available to authorized users.

A combination of micronucleus assay and fluorescence in situ hybridization analysis to evaluate the genotoxicity of formaldehyde

A genotoxic effect of formaldehyde (FA), particularly micronucleus (MN) induction, has been shown in several previous studies. The aim of the present study was to assess the frequency of micronuclei and to identify the type of chromosomal damage in Tunisian staff members working in the Pathologic Anatomy Laboratory of Farhat Hached hospital (Sousse, Tunisia) who were exposed to FA. Assessment of chromosomal damage was performed in peripheral lymphocytes of 31 FA-exposed employees compared with 31 control employees working in the administrative department of the same hospital. The clastogenic/aneugenic effect of FA was evaluated using the standard MN assay in combination with fluorescence in situ hybridization (FISH) using pan-centromeric probes. The mean level of exposure to FA was 3.4 ppm. The results showed a significant increase of MN frequency in lymphocytes of exposed workers compared with the control group (25.35 ± 6.28 ‰ vs. 7.08  ± 4.62 ‰, p < 0.05). As assessed by FISH, the frequency of centromeric micronuclei (C+MN) was greater in exposed subjects than in controls (18.38 ± 5.94 ‰ vs. 5.03 ± 3.64 ‰). Among the C+MN, the frequency of MN containing one centromere (C1+MN) was significantly greater in pathologists and anatomists than in controls (15.35 ± 6.0 ‰ vs. 3.33 ± 2.74 ‰, p < 0.05). The results showed an effect of sex and time of FA exposure with significantly increased frequencies of all end points measuring aneuploidy (C+MN, C1+MN, and Cx+MN [more then one MN]). The increased frequency of C1+MN observed in the exposed group may suggest a slight aneugenic effect of FA exposure.

Recent trend in risk assessment of formaldehyde exposures from indoor air

Studies about formaldehyde (FA) published since the guideline of 0.1 mg/m(3) by the World Health Organization (WHO) in 2010 have been evaluated; critical effects were eye and nasal (portal-of-entry) irritation. Also, it was considered to prevent long-term effects, including all types of cancer. The majority of the recent toxicokinetic studies showed no exposure-dependent FA-DNA adducts outside the portal-of-entry area and FA-DNA adducts at distant sites were due to endogenously generated FA. The no-observed-adverse-effect level for sensory irritation was 0.5 ppm and recently reconfirmed in hypo- and hypersensitive individuals. Investigation of the relationship between FA exposure and asthma or other airway effects in children showed no convincing association. In rats, repeated exposures showed no point mutation in the p53 and K-Ras genes at ≤15 ppm neither increased cell proliferation, histopathological changes and changes in gene expression at 0.7 ppm. Repeated controlled exposures (0.5 ppm with peaks at 1 ppm) did not increase micronucleus formation in human buccal cells or nasal tissue (0.7 ppm) or in vivo genotoxicity in peripheral blood lymphocytes (0.7 ppm), but higher occupational exposures were associated with genotoxicity in buccal cells and cultivated peripheral blood lymphocytes. It is still valid that exposures not inducing nasal squamous cell carcinoma in rats will not induce nasopharyngeal cancer or lymphohematopoietic malignancies in humans. Reproductive and developmental toxicity are not considered relevant in the absence of sensory irritation. In conclusion, the WHO guideline has been strengthened.

Mixed organic solvents induce renal injury in rats

To investigate the injury effects of organic solvents on kidney, an animal model of Sprague-Dawley (SD) rats treated with mixed organic solvents via inhalation was generated and characterized. The mixed organic solvents consisted of gasoline, dimethylbenzene and formaldehyde (GDF) in the ratio of 2∶2:1, and were used at 12,000 PPM to treat the rats twice a day, each for 3 hours. Proteinuria appeared in the rats after exposure for 5–6 weeks. The incidences of proteinuria in male and female rats after exposure for 12 weeks were 43.8% (7/16) and 25% (4/16), respectively. Urinary N-Acetyl-β-(D)-Glucosaminidase (NAG) activity was increased significantly after exposure for 4 weeks. Histological examination revealed remarkable injuries in the proximal renal tubules, including tubular epithelial cell detachment, cloud swelling and vacuole formation in the proximal tubular cells, as well as proliferation of parietal epithelium and tubular reflux in glomeruli. Ultrastructural examination found that brush border and cytoplasm of tubular epithelial cell were dropped, that tubular epithelial cells were partially disintegrated, and that the mitochondria of tubular epithelial cells were degenerated and lost. In addition to tubular lesions, glomerular damages were also observed, including segmental foot process fusion and loss of foot process covering on glomerular basement membrane (GBM). Immunofluorescence staining indicated that the expression of nephrin and podocin were both decreased after exposure of GDF. In contrast, increased expression of desmin, a marker of podocyte injury, was found in some areas of a glomerulus. TUNEL staining showed that GDF induced apoptosis in tubular cells and glomerular cells. These studies demonstrate that GDF can induce both severe proximal tubular damage and podocyte injury in rats, and the tubular lesions appear earlier than that of glomeruli.

The impact of FANCD2 deficiency on formaldehyde-induced toxicity in human lymphoblastoid cell lines

Formaldehyde (FA), a major industrial chemical and ubiquitous environmental pollutant, has recently been classified by the International Agency for Research on Cancer as a human leukemogen. The major mode of action of FA is thought to be the formation of DNA-protein cross-links (DPCs). Repair of DPCs may be mediated by the Fanconi anemia pathway; however, data supporting the involvement of this pathway are limited, particularly in human hematopoietic cells. Therefore, we assessed the role of FANCD2, a critical component of the Fanconi anemia pathway, in FA-induced toxicity in human lymphoblast cell models of FANCD2 deficiency (PD20 cells) and FANCD2 sufficiency (PD20-D2 cells). After treatment of the cells with 0-150 μM FA for 24 h, DPCs were increased in a dose-dependent manner in both cell lines, with greater increases in FANCD2-deficient PD20 cells. FA also induced cytotoxicity, micronuclei, chromosome aberrations, and apoptosis in a dose-dependent manner in both cell lines, with greater increases in cytotoxicity and apoptosis in PD20 cells. Increased levels of γ-ATR and γ-H2AX in both cell lines suggested the recognition of FA-induced DNA damage; however, the induction of BRCA2 was compromised in FANCD2-deficient PD20 cells, potentially reducing the capacity to repair DPCs. Together, these findings suggest that FANCD2 protein and the Fanconi anemia pathway are essential to protect human lymphoblastoid cells against FA toxicity. Future studies are needed to delineate the role of this pathway in mitigating FA-induced toxicity, particularly in hematopoietic stem cells, the target cells in leukemia.

Formaldehyde-induced genome instability is suppressed by an XPF-dependent pathway

Formaldehyde is a reactive chemical that is commonly used in the production of industrial, laboratory, household, and cosmetic products. The causal association between formaldehyde exposure and increased incidence of cancer led the International Agency for Research on Cancer to classify formaldehyde as a carcinogen. Formaldehyde-induced DNA-protein crosslinks (DPCs) elicit responses involving nucleotide excision repair (NER) and homologous recombination (HR) repair pathways; however, little is known about the cellular and genetic changes that subsequently lead to formaldehyde-induced genotoxic and cytotoxic effects. Herein, investigations of genes that modulate the cytotoxic effects of formaldehyde exposure revealed that of five NER-deficient Chinese Hamster Ovary (CHO) cell lines tested, XPF- and ERCC1-deficient cells were most sensitive to formaldehyde treatment as compared to wild-type cells. Cell cycle analyses revealed that formaldehyde-treated XPF-deficient cells exhibited an immediate G2/M arrest that was associated with altered cell ploidy and apoptosis. Additionally, an elevated number of DNA double-strand breaks (DSBs), chromosomal breaks and radial formation were also observed in XPF-deficient cells following formaldehyde treatment. Formaldehyde-induced DSBs occurred in a replication-dependent, but an XPF-independent manner. However, delayed DSB repair was observed in the absence of XPF function. Collectively, our findings highlight the role of an XPF-dependent pathway in mitigating the sensitivity to formaldehyde-induced DNA damage as evidenced by the increased genomic instability and reduced cell viability in an XPF-deficient background. In addition, centrosome and microtubule abnormalities, as well as enlarged nuclei, caused by formaldehyde exposure are demonstrated in a repair-proficient cell line.

Formaldehyde-induced keratopathy after strabismus surgery

We report on a patient who developed corneal haze and permanent ptosis after strabismus surgery. Formaldehyde-disinfected sodium hyaluronate which was used to protect the corneal epithelium during surgery was thought to have induced keratopathy and other findings. To our knowledge, this is the first report of corneal haze formation together with ptosis secondary to formaldehyde toxicity as a complication of strabismus surgery.

Exposure to formaldehyde and its potential human health hazards

A widely used chemical, formaldehyde is normally present in both indoor and outdoor air. The rapid growth of formaldehyde-related industries in the past two decades reflects the result of its increased use in building materials and other commercial sectors. Consequently, formaldehyde is encountered almost every day from large segments of society due to its various sources. Many governments and agencies around the world have thus issued a series of standards to regulate its exposure in homes, office buildings, workshops, public places, and food. In light of the deleterious properties of formaldehyde, this article provides an overview of its market, regulation standards, and human health effects.

Is exposure to formaldehyde in air causally associated with leukemia?--A hypothesis-based weight-of-evidence analysis

Recent scientific debate has focused on the potential for inhaled formaldehyde to cause lymphohematopoietic cancers, particularly leukemias, in humans. The concern stems from certain epidemiology studies reporting an association, although particulars of endpoints and dosimetry are inconsistent across studies and several other studies show no such effects. Animal studies generally report neither hematotoxicity nor leukemia associated with formaldehyde inhalation, and hematotoxicity studies in humans are inconsistent. Formaldehyde's reactivity has been thought to preclude systemic exposure following inhalation, and its apparent inability to reach and affect the target tissues attacked by known leukemogens has, heretofore, led to skepticism regarding its potential to cause human lymphohematopoietic cancers. Recently, however, potential modes of action for formaldehyde leukemogenesis have been hypothesized, and it has been suggested that formaldehyde be identified as a known human leukemogen. In this article, we apply our hypothesis-based weight-of-evidence (HBWoE) approach to evaluate the large body of evidence regarding formaldehyde and leukemogenesis, attending to how human, animal, and mode-of-action results inform one another. We trace the logic of inference within and across all studies, and articulate how one could account for the suite of available observations under the various proposed hypotheses. Upon comparison of alternative proposals regarding what causal processes may have led to the array of observations as we see them, we conclude that the case for a causal association is weak and strains biological plausibility. Instead, apparent association between formaldehyde inhalation and leukemia in some human studies is better interpreted as due to chance or confounding.

Combined analysis of chromosomal aberrations and glutathione S-transferase M1 and T1 polymorphisms in pathologists occupationally exposed to formaldehyde

The formaldehyde (FA) genotoxic potential in occupationally exposed individuals is conflicting. A relevant indoor-air FA pollution was found in hospitals and scientific institutions where FA is used as a bactericide and tissue preservative. In the present study, we evaluated the frequency of chromosomal aberrations (CAs) in peripheral blood lymphocytes from workers in pathology wards who have been exposed to FA, compared with a group of unexposed subjects. The subjects were also analyzed for the GSTM1 and GSTT1 metabolic gene polymorphisms. The exposed subjects showed a significant increase in the frequency of CA per cell and in the percentage of cells with aberrations compared to control subjects. The different GST genotypes did not affect the level of cytogenetic damage since CA frequencies were not statistically different between the GST "null" genotypes and the GST "positives". The generalized linear models showed that the number of CAs and cells with CAs increased with age, but, independent of age, it was significantly higher in the experimental rather than in the control group. Cubic-spline regression confirmed the linear relationship between CAs and age, but it provided evidence for a non-linear relationship between CAs and the number of years of FA exposure. Similar results were observed when the model included the number of cells with CAs as dependent variables. Our results demonstrate that air FA induces CAs even consequently to low levels of daily exposure, indicating an increased risk of genetic damage for workers exposed to this air pollutant.

Occupational exposure to formaldehyde: genotoxic risk evaluation by comet assay and micronucleus test using human peripheral lymphocytes

Formaldehyde (FA) is a world high-production compound with numerous applications ranging from production of resins to medicines. Due to its sensitizing properties, irritating effects and potential cancer hazard FA is of great environmental health concern. Numerous studies in humans and experimental animals demonstrated that inhaled FA produced toxicity, genotoxicity, and cancer at distal sites. IARC, based on sufficient data, reclassified FA as a human carcinogen. The highest level of human exposure to this aldehyde occurs in occupational settings, namely, in pathology and anatomy laboratories, where FA is commonly used as a fixative and tissue preservative. Several studies consistently showed that the levels of airborne FA in anatomy laboratories exceeded recommended exposure criteria. In order to assess the genotoxic effects of chronic occupational exposure to FA, a group of pathology/anatomy workers was assessed using a micronucleus (MN) test and comet assay. The level of exposure to FA was also determined and the time-weighted average (TWA) of exposure was calculated for each subject. The TWA mean value for FA exposed workers was 0.43 ± 0.06 ppm, exceeding national and international recommended limit levels of 0.3 ppm. Both MN frequency and comet assay parameters were significantly higher in exposed subjects. Data obtained confirm a correlation between genetic damage and occupational exposure to FA. These data, along with recent implications of human carcinogenicity, point out the need for close monitoring of occupational exposure to FA. Implementation of security and hygiene measures as well as good practices campaigns may be crucial to decrease risk.