{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:54:49Z","timestamp":1784674489563,"version":"3.55.0"},"reference-count":42,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T00:00:00Z","timestamp":1537315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Anatomy teaching and research relies on the use of formaldehyde (FA) as a preservation agent for human and animal tissues. Due to the recent classification of FA as a carcinogen, university hospitals are facing a challenge to (further) reduce exposure to FA. The aim of this study was to reduce exposure to FA in the anatomy teaching and research facility. Workers participated in the development of improved work practices, both technical and organizational solutions. Over a period of 6 years mitigating measures were introduced, including improvement of a down-flow ventilation system, introduction of local exhaust ventilation, collection of drain liquid from displayed specimens in closed containers and leak prevention. Furthermore, some organizational changes were made to reduce the number of FA peak exposures. Stationary and personal air sampling was performed in three different campaigns to assess the effect of these new work practices on inhalation exposure to FA. Samples were collected over 8 h (full shift) and 15 min (task-based) to support mitigation of exposure and improvement of work practices. Air was collected on an adsorbent coated with 2,4-dinitrophenylhydrazine (DNPH) and analyzed by HPLC-UV. Geometric mean (GM) concentrations of FA in the breathing zone over a work-shift were 123 \u00b5g\/m3 in 2012 and 114 \u00b5g\/m3 in 2014, exceeding the workplace standard of 150 \u00b5g\/m3 (8 h time-weighted average, TWA) on 46% of the workdays in 2012 and 38% of the workdays in 2014. This exposure was reduced to an average of 28.8 \u00b5g\/m3 in 2017 with an estimated probability of exceeding the OEL of 0.6%. Task-based measurements resulted in a mean peak exposures of 291 \u00b5g\/m3 in 2012 (n = 19) and a mean of 272 \u00b5g\/m3 in 2014 (n = 21), occasionally exceeding the standard of 500 \u00b5g\/m3 (15 min TWA), and were reduced to a mean of 88.7 \u00b5g\/m3 in 2017 (n = 12) with an estimated probability of exceeding the OEL of 1.6%.<\/jats:p>","DOI":"10.3390\/ijerph15092049","type":"journal-article","created":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T10:50:31Z","timestamp":1537354231000},"page":"2049","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Changes in Work Practices for Safe Use of Formaldehyde in a University-Based Anatomy Teaching and Research Facility"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8546-2161","authenticated-orcid":false,"given":"Paul T. J.","family":"Scheepers","sequence":"first","affiliation":[{"name":"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3003-6632","authenticated-orcid":false,"given":"Martien H. F.","family":"Graumans","sequence":"additional","affiliation":[{"name":"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwendolyn","family":"Beckmann","sequence":"additional","affiliation":[{"name":"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"},{"name":"Yacht, High Tech Campus 32, 5656 AE Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Van Dael","sequence":"additional","affiliation":[{"name":"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob B. M.","family":"Anzion","sequence":"additional","affiliation":[{"name":"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Melissen","sequence":"additional","affiliation":[{"name":"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"},{"name":"Digireg, Kranestraat 37, 5961 GX Horst, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Pinckaers","sequence":"additional","affiliation":[{"name":"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"},{"name":"WUR-RIKILT, Akkermaalsbos 2, 6708 WB Wageningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luuk","family":"Van Wel","sequence":"additional","affiliation":[{"name":"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"},{"name":"Institute for Risk Assessment Sciences (IRAS), Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie M. A.","family":"De Werdt","sequence":"additional","affiliation":[{"name":"Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"},{"name":"Arbo Unie, Europalaan 40, 3526 KS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Gelsing","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Van Linge","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1080\/15298668391405995","article-title":"Formaldehyde vapor exposures in anatomy laboratories","volume":"44","author":"Skisak","year":"1983","journal-title":"Am. Ind. Hyg. Assoc. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1097\/00043764-198511000-00013","article-title":"Formaldehyde exposure in a gross anatomy laboratory","volume":"27","author":"Perkins","year":"1985","journal-title":"J. Occup. Med."},{"key":"ref_3","first-page":"92","article-title":"Excruciating effect of formaldehyde exposure to students in gross anatomy dissection laboratory","volume":"3","author":"Onyije","year":"2012","journal-title":"Int. J. Occup. Environ. Med."},{"key":"ref_4","first-page":"26","article-title":"Formaldehyde exposure and irritative effects on medical examiners, pathologic anatomy post-graduate students and technicians","volume":"39","author":"Vimercati","year":"2010","journal-title":"Iran. J. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/0048-9697(89)90362-8","article-title":"Formaldehyde exposure at various workplaces","volume":"79","author":"Triebig","year":"1989","journal-title":"Sci. Total Environ."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1600-0536.1992.tb05194.x","article-title":"Allergic contact dermatitis from FA. A case study focusing on sources of formaldehyde exposure","volume":"27","author":"Flyvholm","year":"1992","journal-title":"Contact Dermat."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1111\/cod.12172","article-title":"Hidden exposure to formaldehyde in a swab caused allergic contact dermatitis","volume":"70","author":"Friis","year":"2014","journal-title":"Contact Dermat."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s00204-016-1733-8","article-title":"Re-evaluation of the WHO (2010) formaldehyde indoor air quality guideline for cancer risk assessment","volume":"91","author":"Nielsen","year":"2017","journal-title":"Arch. Toxicol."},{"key":"ref_9","unstructured":"IARC (2012). Chemical agents and related occupations. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, International Agency for Research on Cancer."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1093\/jnci\/djp416","article-title":"Mortality from lymphohematopoietic malignancies and brain cancer among embalmers exposed to formaldehyde","volume":"101","author":"Hauptmann","year":"2009","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40557-018-0218-z","article-title":"Does Formaldehyde have a causal association with nasopharyngeal cancer and leukaemia?","volume":"30","author":"Kwon","year":"2018","journal-title":"Ann. Occup. Environ. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1158\/1055-9965.EPI-09-0762","article-title":"Occupational exposure to formaldehyde, hematotoxicity, and leukemia-specific chromosome changes in cultured myeloid progenitor cells","volume":"19","author":"Zhang","year":"2010","journal-title":"Cancer Epidemiol. Prev. Biomark."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"661","DOI":"10.3109\/10408444.2013.818618","article-title":"Formaldehyde exposure and leukemia: Critical review and reevaluation of the results from a study that is the focus for evidence of biological plausibility","volume":"43","author":"Gentry","year":"2013","journal-title":"Crit. Rev. Toxicol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1021\/tx100083x","article-title":"Malondialdehyde-deoxyguanosine adduct formation in workers of pathology wards: The role of air FA exposure","volume":"23","author":"Bono","year":"2010","journal-title":"Chem. Res. Toxicol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"618","DOI":"10.5271\/sjweh.3358","article-title":"Chromosomal damage among medical staff occupationally exposed to volatile anesthetics, antineoplastic drugs, and formaldehyde","volume":"39","author":"Musak","year":"2013","journal-title":"Scand. J. Work Environ. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1093\/mutage\/gev002","article-title":"Increased levels of chromosomal aberrations and DNA damage in a group of workers exposed to formaldehyde","volume":"30","author":"Costa","year":"2015","journal-title":"Mutagenesis"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.mrrev.2011.07.003","article-title":"Reproductive and developmental toxicity of Formaldehyde: A systematic review","volume":"728","author":"Duong","year":"2011","journal-title":"Mutat. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1002\/ca.22623","article-title":"Formaldehyde exposure and its effects during pregnancy: Recommendations for laboratory attendance based on available data","volume":"28","author":"Haffner","year":"2015","journal-title":"Clin. Anat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1476-069X-1-6","article-title":"Maternal exposure to low-level air pollution and pregnancy outcomes: A population-based study","volume":"1","author":"Maroziene","year":"2002","journal-title":"Environ. Health"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Scheepers, P.T., Van Wel, L., Beckmann, G., and Anzion, R. (2017). Chemical characterization of the indoor air quality of a university hospital: Penetration of outdoor air pollutants. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14050497"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Armon, R., and H\u00e4nninen, O. (2015). Health-related indicators of indoor air quality. Environmental Indicators, Springer.","DOI":"10.1007\/978-94-017-9499-2"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.eti.2015.03.002","article-title":"Determination of the filter capture efficiency for safe use of fixative solutions in the biological glove box of the International Space Station","volume":"3","author":"Scheepers","year":"2015","journal-title":"Environ. Technol. Innov."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.mrfmmm.2006.05.030","article-title":"Chromosomal aberrations and SCEs as biomarkers of cancer risk","volume":"600","author":"Norppa","year":"2006","journal-title":"Mutat. Res."},{"key":"ref_24","first-page":"58","article-title":"Could formaldehyde induce mutagenic and cytotoxic effects in buccal epithelial cells during anatomy classes?","volume":"22","author":"Lorenzoni","year":"2017","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1016\/j.chemosphere.2010.11.023","article-title":"Critical evaluation of approaches in setting indoor air quality guidelines and reference values","volume":"82","author":"Salthammer","year":"2011","journal-title":"Chemosphere"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"19002","DOI":"10.1007\/s11356-015-5078-2","article-title":"Formaldehyde exposure in gross anatomy laboratory of Suranaree University of Technology: A comparison of area and personal sampling","volume":"22","author":"Saowakon","year":"2015","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"192","DOI":"10.2486\/indhealth.2016-0147","article-title":"Assessment of workplace air concentrations of formaldehyde during and before working hours in medical facilities","volume":"55","author":"Higashikubo","year":"2017","journal-title":"Ind. Health"},{"key":"ref_28","unstructured":"World Health Organization (2009). WHO Guidelines for Indoor Air Quality: Selected Compounds, The WHO European Centre for Environment and Health."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1046\/j.1469-7580.1998.19230443.x","article-title":"An improved low-formaldehyde embalming fluid to preserve cadavers for anatomy teaching","volume":"192","author":"Coleman","year":"1998","journal-title":"J. Anat."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1065\/espr2005.06.265","article-title":"Formaldehyde exposure in a gross anatomy laboratory\u2014Personal exposure level is higher than indoor concentration","volume":"13","author":"Ohmichi","year":"2006","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1080\/15459624.2013.816432","article-title":"Controlling Formaldehyde exposures in an academic gross anatomy laboratory","volume":"11","author":"Klein","year":"2014","journal-title":"J. Occup. Environ. Hyg."},{"key":"ref_32","first-page":"33","article-title":"National estimates of exposure to formaldehyde in italian workplaces","volume":"61","author":"Scarselli","year":"2017","journal-title":"Ann. Work Expo. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1080\/15459624.2016.1149182","article-title":"A comparison of engineering controls for formaldehyde exposure during grossing activities in health care anatomic pathology laboratories","volume":"13","author":"Xu","year":"2016","journal-title":"J. Occup. Environ. Hyg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1080\/104732201300367227","article-title":"Characterizing Formaldehyde emission rates in a gross anatomy laboratory","volume":"16","author":"Keil","year":"2001","journal-title":"Appl. Occup. Environ. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1080\/1047322X.1992.10388099","article-title":"Effective local exhaust ventilation for controlling formaldehyde exposures during embalming","volume":"7","author":"Gressel","year":"1992","journal-title":"Appl. Occup. Environ. Hyg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1539\/joh.47.450","article-title":"A novel local ventilation system to reduce the levels of formaldehyde exposure during a gross anatomy dissection course and its evaluation using real-time monitoring","volume":"47","author":"Yamato","year":"2005","journal-title":"J. Occup. Health"},{"key":"ref_37","first-page":"17","article-title":"Reducing the levels of formaldehyde exposure during a gross anatomy dissection course with a local ventilation system","volume":"85","author":"Kikuta","year":"2010","journal-title":"Kaibogaku Zasshi"},{"key":"ref_38","first-page":"387","article-title":"Formaldehyde in preclinical medical training (anatomy)\u2014Reduction of formaldehyde exposure during practical anatomical sessions: Technical ventilation measures","volume":"76","author":"Dahncke","year":"2016","journal-title":"Gefahrst. Reinhalt. Luft"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s12565-010-0092-4","article-title":"Local ventilation system successfully reduced FA exposure during gross anatomy dissection classes","volume":"85","author":"Takahashi","year":"2010","journal-title":"Anat. Sci. Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"108","DOI":"10.2478\/s13382-011-0004-4","article-title":"Personal formaldehyde exposure level in the gross anatomy dissecting room at College of Medicine King Saud University Riyadh","volume":"24","author":"Vohra","year":"2011","journal-title":"Int. J. Occup. Med. Environ. Health"},{"key":"ref_41","first-page":"S92","article-title":"Formaldehyde exposure of medical students and instructors and clinical symptoms during gross anatomy laboratory in Thammasat University","volume":"93","author":"Lakchayapakorn","year":"2010","journal-title":"J. Med. Assoc. Thai"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"95","DOI":"10.5625\/lar.2014.30.3.95","article-title":"Characterization of allergic response induced by repeated dermal exposure of IL-4\/Luc\/CNS-1 transgenic mice to low dose formaldehyde","volume":"30","author":"Kwak","year":"2014","journal-title":"Lab. Anim. Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/9\/2049\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:21:23Z","timestamp":1760196083000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/9\/2049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,19]]},"references-count":42,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2018,9]]}},"alternative-id":["ijerph15092049"],"URL":"https:\/\/doi.org\/10.3390\/ijerph15092049","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,19]]}}}