{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:45:11Z","timestamp":1789674311039,"version":"4.0.1"},"reference-count":59,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"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>Dissecting a human cadaver is an irreplaceable practice in general training of medical students. Cadavers in anatomy laboratories are usually preserved in formalin, an embalming fluid whose basic component is formaldehyde (FA). The aim of this study is to assess the cancer risk of employees and students that are exposed to FA based on the results of three monitoring campaigns, as well as to suggest permanent solutions to the problem of FA exposure based on the results obtained. Three sampling campaigns of formaldehyde concentration in indoor environments were conducted at five different locations at the Anatomy Department of the Faculty of Medicine with the purpose of assessing permanent employees\u2019 and medical faculty first year students\u2019 exposure to FA. Indoor air was continuously sampled during 8 h of laboratory work and analyzed in accordance with the NIOSH Method 3500. Exceeding of the 8 h time-weighted average (8 h TWA) values recommended by Occupational Safety and Health Administration (OSHA) of 0.75 ppm was recorded in 37% of the samples during the three-month monitoring campaign. Cancer risk assessment levels for permanent employees were in the range from 6.43 \u00d7 10\u22123 to 8.77 \u00d7 10\u22124, while the cancer risk assessment levels for students ranged from 8.94 \u00d7 10\u22127 to 1.83 \u00d7 10\u22126. The results of the research show that cancer risk assessment for employees is several thousand times higher than the limit recommended by the EPA (10\u22126) and point to the importance of reducing exposure to formaldehyde through the reconstruction of the existing ventilation system, continual monitoring, the use of formaldehyde-free products, and plastination of anatomical specimens.<\/jats:p>","DOI":"10.3390\/ijerph182111198","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T21:40:21Z","timestamp":1635198021000},"page":"11198","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Occupational Exposure to Formaldehyde and Cancer Risk Assessment in an Anatomy Laboratory"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2913-5390","authenticated-orcid":false,"given":"Dragan","family":"Adamovi\u0107","sequence":"first","affiliation":[{"name":"Department of Environmental Engineering and Occupational Safety and Health, Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5853-4767","authenticated-orcid":false,"given":"Zoran","family":"\u010cepi\u0107","sequence":"additional","affiliation":[{"name":"Department of Environmental Engineering and Occupational Safety and Health, Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savka","family":"Adamovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Graphic Engineering and Design, Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Sto\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Department of Environmental Engineering and Occupational Safety and Health, Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Obrovski","sequence":"additional","affiliation":[{"name":"Department of Environmental Engineering and Occupational Safety and Health, Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Slobodan","family":"Mora\u010da","sequence":"additional","affiliation":[{"name":"Department of Industrial Engineering and Engineering Management, Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjana","family":"Vojinovi\u0107 Miloradov","sequence":"additional","affiliation":[{"name":"Department of Environmental Engineering and Occupational Safety and Health, Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Scheepers, P.T.J., Graumans, M.H.F., Beckmann, G., Van Dael, M., Anzion, R.B.M., Melissen, M., Pinckaers, N., Van Wel, L., De Werdt, L.M.A., and Gelsing, V. (2018). Changes in Work Practices for Safe Use of Formaldehyde in a University-Based Anatomy Teaching and Research Facility. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15092049"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Joob, B., and Wiwanitkit, V. (2016). Formaldehyde level in anatomy laboratory teaching room and risk for cancer. Work. Health Saf., 64.","DOI":"10.1177\/2165079915607871"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.bjoms.2015.09.016","article-title":"Accidental intraoral injection of formalin during extraction: Case report","volume":"54","author":"Swami","year":"2016","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.talanta.2013.10.019","article-title":"A comprehensive factorial design study of variables affecting protein extraction from formalin-fixed kidney tissue samples","volume":"119","author":"Oliveira","year":"2014","journal-title":"Talanta"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1017\/S1551929500057060","article-title":"Formaldehyde, Formalin, Paraformaldehyde and Glutaraldehyde: What They Are and What They Do","volume":"8","author":"Kiernan","year":"2000","journal-title":"Microsc. Today"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1177\/33.8.3894502","article-title":"Formaldehyde Fixatives","volume":"33","author":"Cromey","year":"1985","journal-title":"J. Histochem. Cytochem."},{"key":"ref_7","first-page":"78","article-title":"The Evaluation of Formaldehyde Exposure in the Anatomy Laboratories and the Preventive Measures","volume":"27","author":"Liman","year":"2016","journal-title":"Gazi Med. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1002\/ase.1265","article-title":"Student perceptions of an upper-level, undergraduate human anatomy laboratory course without cadavers","volume":"5","author":"Wright","year":"2012","journal-title":"Anat. Sci. Educ."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Viegas, S., Ladeira, C., Nunes, C., Malta-Vacas, J., Gomes, M., Brito, M., Mendon\u00e7a, P., and Prista, J. (2010). Genotoxic effects in occupational exposure to formaldehyde: A study in anatomy and pathology laboratories and formaldehyde-resins production. J. Occup. Med. Toxicol., 5.","DOI":"10.1186\/1745-6673-5-25"},{"key":"ref_10","first-page":"38","article-title":"Research on formaldehyde pollution in anatomy lab of medical college","volume":"25","author":"Zhang","year":"2007","journal-title":"Chin. J. Clin. Anat."},{"key":"ref_11","first-page":"466","article-title":"The health effects of pathologists exposed to formaldehyde","volume":"23","author":"Fan","year":"2006","journal-title":"J. Env. Occup. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gahukar, S., Ramteke, U., Majumdar, D., Malviya, R., Patil, D., Trivedi, J., Rao, C., and Kale, A. (2014). Prevalence of formaldehyde in indoor air of gross anatomy laboratory and cadaver storage room of a medical college. J. Environ. Occup. Sci., 3.","DOI":"10.5455\/jeos.20140915115950"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"273","DOI":"10.5114\/dr.2016.61774","article-title":"Formaldehyde-related clinical symptoms reported by medical students during gross anatomy cadaver dissection","volume":"103","author":"Pietrzyk","year":"2016","journal-title":"Dermatol. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.toxrep.2018.03.016","article-title":"Effects of formaldehyde exposure on the development of pulmonary fibrosis induced by bleomycin in mice","volume":"5","author":"Leal","year":"2018","journal-title":"Toxicol. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.tox.2008.07.056","article-title":"Genotoxic damage in pathology anatomy laboratory workers exposed to formaldehyde","volume":"252","author":"Costa","year":"2008","journal-title":"Toxicology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3485","DOI":"10.1021\/ie980020y","article-title":"Vapor\u2212Liquid Equilibrium of Formaldehyde Mixtures Containing Methanol","volume":"37","author":"Brandani","year":"1998","journal-title":"Ind. Eng. Chem. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Aung, W.-Y., Sakamoto, H., Sato, A., Yi, E.-E., Thein, Z.-L., Nwe, M.-S., Shein, N., Linn, H., Uchiyama, S., and Kunugita, N. (2021). Indoor Formaldehyde Concentration, Personal Formaldehyde Exposure and Clinical Symptoms during Anatomy Dissection Sessions, University of Medicine 1, Yangon. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18020712"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.yrtph.2005.08.002","article-title":"Risk assessment of formaldehyde for the general population in Japan","volume":"43","author":"Naya","year":"2005","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.1080\/15459624.2015.1060328","article-title":"Advances in Inhalation Dosimetry Models and Methods for Occupational Risk Assessment and Exposure Limit Derivation","volume":"12","author":"Kuempel","year":"2015","journal-title":"J. Occup. Environ. Hyg."},{"key":"ref_20","unstructured":"Toxicological Profile for Formaldehyde (2021, September 05). ATSDR\u2019s Toxicological Profiles, Available online: https:\/\/www.atsdr.cdc.gov\/ToxProfiles\/tp111.pdf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.ad.2010.09.004","article-title":"Allergic Contact Dermatitis Caused by Formaldehyde and Formaldehyde Releasers","volume":"102","author":"Latorre","year":"2011","journal-title":"Actas Dermo-Sifiliogr\u00e1ficas"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1080\/19338244.2020.1819185","article-title":"The risk factors for occupational contact dermatitis among workers in a medium density fiberboard furniture factory in Eastern Thailand","volume":"76","author":"Thetkathuek","year":"2020","journal-title":"Arch. Environ. Occup. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"191","DOI":"10.20473\/jkl.v9i2.2017.191-199","article-title":"Air Formaldehyde Levels and Eye Irritation in Workers at Production Area of Wood Adhesive Factory in Surabaya","volume":"9","author":"Raharyaningsih","year":"2018","journal-title":"J. Kesehat. Lingkung."},{"key":"ref_24","first-page":"34","article-title":"Residential formaldehyde: Increased exposure levels aggravate adverse health effects","volume":"53","author":"Godish","year":"1990","journal-title":"J. Environ. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1111\/j.1447-0756.2010.01309.x","article-title":"Formalin: Nephrotoxic teratogen?","volume":"36","author":"Dorairajan","year":"2010","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.yrtph.2007.02.001","article-title":"Evaluation of the health impact of lowering the formaldehyde occupational exposure limit for Quebec workers","volume":"48","author":"Noisel","year":"2007","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1097\/JOM.0b013e3181ef7e31","article-title":"Formaldehyde and Leukemia: An Updated Meta-Analysis and Evaluation of Bias","volume":"52","author":"Schwilk","year":"2010","journal-title":"J. Occup. Environ. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s41021-021-00183-5","article-title":"Formaldehyde exposure and leukemia risk: A comprehensive review and network-based toxicogenomic approach","volume":"43","author":"Kang","year":"2021","journal-title":"Genes Environ."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1080\/10408440500533208","article-title":"Formaldehyde as a Potential Human Leukemogen: An Assessment of Biological Plausibility","volume":"36","author":"Golden","year":"2006","journal-title":"Crit. Rev. Toxicol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Inci, M., Zarars\u0131z, I., Davarci, M., and Gorur, S. (2013). Toxic effects of formaldehyde on the urinary system. T\u00fcrk \u00dcroloji Dergisi\/Turkish J. Urol., 39.","DOI":"10.5152\/tud.2013.010"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kumaravel, S., Wu, S.-H., Chen, G.-Z., Huang, S.-T., Lin, C.-M., Lee, Y.-C., and Chen, C.-H. (2020). Development of ratiometric electrochemical molecular switches to assay endogenous formaldehyde in live cells, whole blood and creatinine in saliva. Biosens. Bioelectron., 171.","DOI":"10.1016\/j.bios.2020.112720"},{"key":"ref_32","unstructured":"International Agency for Research on Cancer (2006). Formaldehyde, 2-butoxyethanol and 1-tert-butoxypropan-2-ol. IARC Monogr. Eval. Carcinog. Risks Hum., 88, 1\u2013478."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1177\/2165079918821701","article-title":"Laboratory Estimation of Occupational Exposures to Volatile Organic Compounds During Nail Polish Application","volume":"67","author":"Heaton","year":"2019","journal-title":"Work. Health Saf."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.scitotenv.2016.06.007","article-title":"Impact of formaldehyde and VOCs from waste treatment plants upon the ambient air nearby an urban area (Spain)","volume":"568","author":"Gallego","year":"2016","journal-title":"Sci. Total Environ."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1080\/15428119791012450","article-title":"Field precision of formaldehyde sampling and analysis using NIOSH method 3500","volume":"58","author":"Park","year":"1997","journal-title":"Am. Ind. Hyg. Assoc. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4103\/0019-5278.82997","article-title":"Preliminary study: Formaldehyde exposure in laboratories of Sharjah university in UAE","volume":"15","author":"Ahmed","year":"2011","journal-title":"Indian J. Occup. Environ. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1080\/03067310008034133","article-title":"A New Method for the Measurement of Airborne Formaldehyde Using Derivatization with 3,5-Bis(Trifluoromethyl) Phenylhydrazine and Analysis by GC-ECD and GC-MS\/SIM","volume":"76","author":"Marsella","year":"2000","journal-title":"Int. J. Environ. Anal. Chem."},{"key":"ref_38","unstructured":"US EPA IRIS (2019, May 25). Formaldehyde US EPA. Integrated Risk Information System. Acetaldehyde, Available online: https:\/\/www.epa.gov\/iris."},{"key":"ref_39","unstructured":"EPA USEPA (1989). Risk Assessment Guidance for Superfund (RAGS) Part A: Chapter 7 (Toxicity Assessment) and 8 (Risk Characterization)."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.microc.2019.03.069","article-title":"Seasonal quimiometric study of formaldehyde and acetaldehyde atmospheric levels and health risk assessment, in urban areas of Salvador-Bahia, Brazil","volume":"147","author":"Santana","year":"2019","journal-title":"Microchem. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1016\/j.buildenv.2011.04.006","article-title":"Exposure and cancer risk assessment for formaldehyde and acetaldehyde in the hospitals, Fortaleza-Brazil","volume":"46","author":"Sousa","year":"2011","journal-title":"Build. Environ."},{"key":"ref_42","unstructured":"Hc, I. (2019, May 25). Slope Factors for Carcinogens from Health Canada. Available online: http:\/\/www.popstoolkit.com\/tools\/HHRA\/SF_HealthCanada.aspx."},{"key":"ref_43","unstructured":"EPA USEPA (1997). Exposure Factors Handbook."},{"key":"ref_44","unstructured":"U.S. Environmental Protection Agency (2011). Exposure Factors Handbook."},{"key":"ref_45","unstructured":"(2021, September 01). National Industrial Chemicals Notification and Assessment Scheme (NICNAS), Formaldehyde, Available online: https:\/\/www.industrialchemicals.gov.au\/sites\/default\/files\/PEC28-Formaldehyde.pdf."},{"key":"ref_46","unstructured":"(2021, September 02). Official Gazette of the Republic of Serbia, No 54\/92, 30\/99 i 19\/2006. Directive on Limit Values, Immission Measurement Methods, Criteria for Establishing Measuring Points and Data Records (In Serbian). Available online: http:\/\/extwprlegs1.fao.org\/docs\/pdf\/srb153777.pdf."},{"key":"ref_47","unstructured":"World Health Organization (2000). Air Quality Guidelines. Air Qual. Guidel., 22, 1\u20138."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.yrtph.2014.03.007","article-title":"Formaldehyde and methylene glycol equivalence: Critical assessment of chemical and toxicological aspects","volume":"69","author":"Golden","year":"2014","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_49","unstructured":"(2021, September 05). Occupational Safety and Health Administration, Formaldehyde, Available online: https:\/\/www.osha.gov\/laws-regs\/regulations\/standardnumber\/1910\/1910.1048."},{"key":"ref_50","unstructured":"(2019, May 25). HSE-Publications-FORMALDEHYDE, Available online: http:\/\/www.hse.gov.uk\/pubns\/iacl88.htm."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.scitotenv.2011.10.047","article-title":"Formaldehyde and tobacco smoke as alkylating agents: The formation of N-methylenvaline in pathologists and in plastic laminate workers","volume":"414","author":"Bono","year":"2012","journal-title":"Sci. Total Environ."},{"key":"ref_52","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Lawrence Erlbaum Associates. [2nd ed.]."},{"key":"ref_53","unstructured":"(2021, September 05). Niosh Update of NIOSH Carcinogen Classification and Target Risk Level Policy for Chemical Hazards in the Workplace, Available online: https:\/\/www.cdc.gov\/niosh\/docket\/review\/docket240A\/pdf\/EID-CIB-11052013.pdf."},{"key":"ref_54","unstructured":"Hilts, S., White, E.R., and Yates, C. (2021, September 05). Trail Lead Program Evaluation and Selection of Author Forwarding Addresses. Available online: https:\/\/preview.thep.ca\/wp-content\/uploads\/2019\/09\/thep_tffinalreport_2001_original.pdf."},{"key":"ref_55","unstructured":"The American Association of Occupational Health Nurses, Inc. (2021, September 05). (AAOHN), Standards of Occupational and Environmental Health Nursing. Available online: http:\/\/m2.wyanokecdn.com\/54e5f300118d3f7bf2853cab2eec05a4.pdf."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1111\/joa.12160","article-title":"Human body preservation-old and new techniques","volume":"224","author":"Brenner","year":"2014","journal-title":"J. Anat."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1111\/joa.13047","article-title":"Toward safer thanatopraxy cares: Formaldehyde-releasers use","volume":"235","author":"Varlet","year":"2019","journal-title":"J. Anat."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.4067\/S0717-95022010000400014","article-title":"A Brief Review on the History, Methods and Applications of Plastination","volume":"28","author":"Pashaei","year":"2010","journal-title":"Int. J. Morphol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/ahe.12497","article-title":"History and development of plastination techniques","volume":"48","author":"Sora","year":"2019","journal-title":"Anat. Histol. Embryol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/21\/11198\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:23:08Z","timestamp":1760167388000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/21\/11198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,25]]},"references-count":59,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["ijerph182111198"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182111198","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,25]]}}}