It is used in pressed-wood products, such as particleboard, plywood, and fiberboard; glues and adhesives; permanent-press fabrics; paper product coatings; and certain insulation materials. In addition, formaldehyde is commonly used as an industrial fungicide , germicide , and disinfectant , and as a preservative in mortuaries and medical laboratories. Formaldehyde also occurs naturally in the environment. It is produced in small amounts by most living organisms as part of normal metabolic processes.
According to a report by the U. Consumer Product Safety Commission, formaldehyde is normally present in both indoor and outdoor air at low levels, usually less than 0.
Materials containing formaldehyde can release formaldehyde gas or vapor into the air. One source of formaldehyde exposure in the air is automobile tailpipe emissions. During the s, urea-formaldehyde foam insulation UFFI was used in many homes. However, few homes are now insulated with UFFI. Homes in which UFFI was installed many years ago are not likely to have high formaldehyde levels now. Pressed-wood products containing formaldehyde resins are often a significant source of formaldehyde in homes.
Other potential indoor sources of formaldehyde include cigarette smoke and the use of unvented fuel-burning appliances, such as gas stoves, wood-burning stoves, and kerosene heaters. Industrial workers who produce formaldehyde or formaldehyde-containing products, laboratory technicians, certain health care professionals, and mortuary employees may be exposed to higher levels of formaldehyde than the general public.
Exposure occurs primarily by inhaling formaldehyde gas or vapor from the air or by absorbing liquids containing formaldehyde through the skin. When formaldehyde is present in the air at levels exceeding 0. Some people are very sensitive to formaldehyde, whereas others have no reaction to the same level of exposure.
Although the short-term health effects of formaldehyde exposure are well known, less is known about its potential long-term health effects. In , laboratory studies showed that exposure to formaldehyde could cause nasal cancer in rats. This finding raised the question of whether formaldehyde exposure could also cause cancer in humans. In , the U. Environmental Protection Agency EPA classified formaldehyde as a probable human carcinogen under conditions of unusually high or prolonged exposure 1.
Since that time, some studies of humans have suggested that formaldehyde exposure is associated with certain types of cancer. In , the National Toxicology Program, an interagency program of the Department of Health and Human Services, named formaldehyde as a known human carcinogen in its 12 th Report on Carcinogens 3.
Since the s, the National Cancer Institute NCI , a component of the National Institutes of Health NIH , has conducted studies to determine whether there is an association between occupational exposure to formaldehyde and an increase in the risk of cancer. The results of this research have provided EPA and the Occupational Safety and Health Administration OSHA with information to evaluate the potential health effects of workplace exposure to formaldehyde.
The long-term effects of formaldehyde exposure have been evaluated in epidemiologic studies studies that attempt to uncover the patterns and causes of disease in groups of people. One type of epidemiologic study is called a cohort study. A cohort is a group of people who may vary in their exposure to a particular factor, such as formaldehyde, and are followed over time to see whether they develop a disease.
Another kind of epidemiologic study is called a case-control study. Case-control studies begin with people who are diagnosed as having a disease cases and compare them to people without the disease controls , trying to identify differences in factors, such as exposure to formaldehyde, that might explain why the cases developed the disease but the controls did not.
Several NCI surveys of professionals who are potentially exposed to formaldehyde in their work, such as anatomists and embalmers, have suggested that these individuals are at an increased risk of leukemia and brain cancer compared with the general population. However, specific work practices and exposures were not characterized in these studies.
An NCI case-control study among funeral industry workers that characterized exposure to formaldehyde also found an association between increasing formaldehyde exposure and mortality from myeloid leukemia 4.
For this study, carried out among funeral industry workers who had died between and , researchers compared those who had died from hematopoietic and lymphatic cancers and brain tumors with those who died from other causes. Hematopoietic or hematologic cancers such as leukemia develop in the blood or bone marrow.
Lymphatic cancers develop in the tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This analysis showed that those who had performed the most embalming and those with the highest estimated formaldehyde exposure had the greatest risk of myeloid leukemia.
There was no association with other cancers of the hematopoietic and lymphatic systems or with brain cancer. A number of cohort studies involving workers exposed to formaldehyde have recently been completed. The results showed an increased risk of death due to leukemia, particularly myeloid leukemia, among workers exposed to formaldehyde. This risk was associated with increasing peak and average levels of exposure, as well as with the duration of exposure, but it was not associated with cumulative exposure.
An additional 10 years of data on the same workers were used in a follow-up study published in 6. This analysis continued to show a possible link between formaldehyde exposure and cancers of the hematopoietic and lymphatic systems, particularly myeloid leukemia.
As in the initial study, the risk was highest earlier in the follow-up period. Risks declined steadily over time, such that the cumulative excess risk of myeloid leukemia was no longer statistically significant at the end of the follow-up period. The researchers noted that similar patterns of risks over time had been seen for other agents known to cause leukemia. A cohort study of 11, textile workers performed by the National Institute for Occupational Safety and Health NIOSH also found an association between the duration of exposure to formaldehyde and leukemia deaths 7.
However, the evidence remains mixed because a cohort study of 14, British industry workers found no association between formaldehyde exposure and leukemia deaths 8. Formaldehyde undergoes rapid chemical changes immediately after absorption. Therefore, some scientists think that formaldehyde is unlikely to have effects at sites other than the upper respiratory tract. However, some laboratory studies suggest that formaldehyde may affect the lymphatic and hematopoietic systems.
Based on both the epidemiologic data from cohort and case-control studies and the experimental data from laboratory research, NCI investigators have concluded that exposure to formaldehyde may cause leukemia, particularly myeloid leukemia, in humans. In addition, several case-control studies, as well as analysis of the large NCI industrial cohort 6 , have found an association between formaldehyde exposure and nasopharyngeal cancer, although some other studies have not.
Data from extended follow-up of the NCI cohort found that the excess of nasopharyngeal cancer observed in the earlier report persisted 9. Earlier analysis of the NCI cohort found increased lung cancer deaths among industrial workers compared with the general U. However, the rate of lung cancer deaths did not increase with higher levels of formaldehyde exposure. This observation led the researchers to conclude that factors other than formaldehyde exposure might have caused the increased deaths.
The most recent data on lung cancer from the cohort study did not find any relationship between formaldehyde exposure and lung cancer mortality. In , OSHA established a Federal standard that reduced the amount of formaldehyde to which workers can be exposed over an 8-hour workday from 3 ppm to 1 ppm. In May , the standard was amended, and the formaldehyde exposure limit was further reduced to 0. These products emit less formaldehyde because they contain phenol resins, not urea resins.
Pressed-wood products include plywood, paneling, particleboard, and fiberboard and are not the same as pressure-treated wood products, which contain chemical preservatives and are intended for outdoor use.
Before purchasing pressed-wood products, including building materials, cabinetry, and furniture, buyers should ask about the formaldehyde content of these products.
Formaldehyde levels in homes can also be reduced by ensuring adequate ventilation, moderate temperatures, and reduced humidity levels through the use of air conditioners and dehumidifiers. The EPA offers information about the use of formaldehyde in building materials and household products.
The EPA can be contacted at:. The U. Formaldehyde Poisoning is a disorder brought about by breathing the fumes of formaldehyde.
This can occur while working directly with formaldehyde, or using equipment cleaned with formaldehyde. How much formaldehyde is in an apple? What does formaldehyde smell like? Formaldehyde is a colorless chemical with a strong pickle-like odor that is commonly used in many manufacturing processes. It easily becomes a gas at room temperature, which makes it part of a larger group of chemicals known as volatile organic compounds VOCs. Does formaldehyde dissipate over time?
Does the formaldehyde dissipate over time? Yes, typically emissions from composite wood products decrease over time. What cancer does formaldehyde cause? Studies of workers exposed to high levels of formaldehyde, such as industrial workers and embalmers, have found that formaldehyde causes myeloid leukemia and rare cancers, including cancers of the paranasal sinuses, nasal cavity, and nasopharynx.
Is formaldehyde toxic to humans? Formaldehyde is a highly toxic systemic poison that is absorbed well by inhalation. The vapor is a severe respiratory tract and skin irritant and may cause dizziness or suffocation. Skin Protection: Chemical-protective clothing is recommended because formaldehyde can cause skin irritation and burns. Is Phase 2 Formaldehyde safe? To be compliant, a product has to pass a quality control test.
Why is formaldehyde bad in nail polish? Formaldehyde Formaldehyde is used to harden and strengthen nail polishes, also serving as a preservative that protects against bacterial growth. At this low level, formaldehyde is not dangerous. However, exposure to larger doses of formaldehyde in the air or on the skin may cause cancer of the throat, nose, and blood. Victims who are conscious and able to swallow should be given 4 to 8 ounces of water or milk.
Gastric lavage with a small bore NG tube should be considered if it can be performed within 1 hour after ingestion. A soda can and straw may be of assistance when offering charcoal to a child. Consider appropriate management of chemically contaminated children at the exposure site. Also, provide reassurance to the child during decontamination, especially if separation from a parent occurs. If possible, seek assistance from a child separation expert. As soon as basic decontamination is complete, move the victim to the Support Zone.
Be certain that victims have been decontaminated properly see Decontamination Zone above. Persons who have undergone decontamination or who have been exposed only to vapor pose no serious risks of secondary contamination. Support Zone personnel require no specialized protective gear in such cases. Quickly access for a patent airway. Ensure adequate respiration and pulse.
Administer supplemental oxygen as required and establish intravenous access if necessary. Place on a cardiac monitor. Watch for signs of airway swelling and obstruction such as progressive hoarseness, stridor, or cyanosis. If water has not been given previously, administer 4 to 8 ounces of milk or water if the patient is able to swallow. In cases of respiratory compromise secure airway and respiration via endotracheal intubation. If not possible, perform cricothyroidotomy if equipped and trained to do so.
Treat patients who have bronchospasm with aerosolized bronchodilators. The use of bronchial sensitizing agents in situations of multiple chemical exposures may pose additional risks. Consider the health of the myocardium before choosing which type of bronchodilator should be administered. Cardiac sensitizing agents may be appropriate; however, the use of cardiac sensitizing agents after exposure to certain chemicals may pose enhanced risk of cardiac arrhythmias especially in the elderly.
Formaldehyde poisoning is not known to pose additional risk during the use of bronchial or cardiac sensitizing agents. Consider racemic epinephrine aerosol for children who develop stridor. Dose 0. Patients who are comatose, hypotensive, or have seizures or cardiac dysrhythmias should be treated according to advanced life support ALS protocols. Further bicarbonate therapy should be guided by arterial blood gas ABG measurements. Hemodialysis should be considered in patients with severe acid-base disturbances that are refractory to conventional therapy or in cases with significant methanol levels.
If evidence of shock or hypotension is observed begin fluid administration. Only decontaminated patients or patients not requiring decontamination should be transported to a medical facility. Report to the base station and the receiving medical facility the condition of the patient, treatment given, and estimated time of arrival at the medical facility.
If formaldehyde has been ingested, prepare the ambulance in case the victim vomits toxic material. Have ready several towels and open plastic bags to quickly clean up and isolate vomitus. If possible, consult with the base station physician or the regional poison control center for advice regarding triage of multiple victims.
Patients who have ingested formalin or have symptoms e. Patients who have no eye, skin, or throat irritation, or only mild or transient symptoms may be released from the scene after their names, addresses, and telephone numbers are recorded. Those discharged should be advised to seek medical care promptly if symptoms develop see Patient Information Sheet below.
Previously decontaminated patients and patients exposed only to formaldehyde vapor who have no skin or eye irritation may be transferred immediately to the Critical Care Area. Other patients will require decontamination as described below. Because formaldehyde is absorbed although poorly through the skin, don butyl rubber gloves and apron before treating patients.
Formaldehyde readily penetrates most rubbers and barrier fabrics or creams, but butyl rubber provides good skin protection. Be aware that use of protective equipment by the provider may cause fear in children, resulting in decreased compliance with further management efforts.
Because of their relatively larger surface area:body weight ratio, children are more vulnerable to toxicants absorbed through the skin. Also, emergency room personnel should examine children's mouths for corrosive injury because of the frequency of hand-to-mouth activity among children.
Evaluate and support airway, breathing, and circulation. Children may be more vulnerable to corrosive agents than adults because of the smaller diameter of their airways. If not possible, surgically create an airway. Patients who are comatose, hypotensive, or have seizures or ventricular dysrhythmias should be treated in the conventional manner. Further bicarbonate therapy should be guided by ABG measurements. Because contact with formalin may cause burns, ED staff should don chemical-resistant jumpsuits e.
After the patient has been decontaminated, no special protective clothing or equipment is required for ED personnel. Quickly remove and double-bag contaminated clothing and personal belongings. Flush exposed skin and hair with water preferably under a shower for 5 minutes. If possible, wash hair and skin with soap and water, then rinse thoroughly with water.
Flush exposed eyes with water or saline for at least 15 minutes. An ophthalmic anesthetic, such as 0. If pain or injury is evident, continue irrigation while transporting the patient to the Critical Care Area. If water has not been given previously, administer 4 to 8 ounces if the patient is alert and able to swallow. Be certain that appropriate decontamination has been carried out see Decontamination Area above.
Evaluate and support airway, breathing, and circulation as in ABC Reminders above. Establish intravenous access in seriously ill patients if this has not been done previously. Continuously monitor cardiac rhythm. Patients who are comatose, hypotensive, or have seizures or cardiac dysrhythmias should be treated in the conventional manner.
Administer supplemental oxygen by mask to patients who have respiratory complaints. Observe patients who are in respiratory distress for up to 12 hours and periodically repeat chest examinations and order other appropriate studies. Follow up as clinically indicated. If formalin or high concentrations of formaldehyde vapor were in contact with the skin, chemical burns may result; treat as thermal burns.
Continue irrigation for at least 15 minutes. Test visual acuity. Examine the eyes for corneal damage and treat appropriately. Immediately consult an ophthalmologist for patients who have severe corneal injuries.
Do not induce emesis. Give 4 to 8 ounces of water to alert patients who can swallow if not done previously. If a large dose has been ingested and the patient's condition is evaluated within 30 minutes after ingestion, consider gastric lavage and endoscopy to evaluate the extent of corrosive injury to the gastrointestinal tract. Care must be taken when placing the gastric tube because blind gastric-tube placement may further injure the chemically damaged esophagus or stomach.
Extreme throat swelling may require endotracheal intubation or cricothyriodotomy. Because children do not ingest large amounts of corrosive materials, and because of the risk of perforation from NG intubation, lavage is discouraged in children unless intubation is performed under endoscopic guidance.
Toxic vomitus or gastric washings should be isolated e. There is no antidote for formaldehyde. Further correction of acidosis should be guided by ABG measurements.
Hemodialysis is effective in removing formic acid formate and methanol and in correcting severe metabolic acidosis. In this setting, the target blood level of ethanol is 0.
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