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

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          Abstract

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

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          Most cited references24

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          Formaldehyde (CH2O) concentrations in the blood of humans and Fischer-344 rats exposed to CH2O under controlled conditions.

          The effect of exposure to formaldehyde (CH2O) on the CH2O concentration of the blood was determined. Eight male F-344 rats were exposed to 14.4 +/- 2.4 ppm of CH2O for 2 hours and the blood was collected immediately after exposure. Formaldehyde concentrations in the blood were determined by gas chromatography/mass spectrometry. The blood of eight rats unexposed to CH2O was collected and analyzed in the same manner. Measured CH2O concentrations (micrograms/g of blood) were: controls, 2.24 +/- 0.07; exposed, 2.25 +/- 0.07 (mean +/- S.E.). Formaldehyde concentrations in human blood were determined by analyzing samples of venous blood collected before and after exposure of six human volunteers (4 M, 2 F) to 1.9 +/- 0.1 ppm of CH2O for 40 min. Average CH2O concentrations (micrograms/g of blood) were: before exposure, 2.61 +/- 0.14; after exposure, 2.77 +/- 0.28. In neither experiment was there a statistically significant effect of exposure on the average CH2O concentration of the blood. However, human subjects differed significantly with respect to their blood CH2O concentrations, and significant differences (either an increase or a decrease) were found between the CH2O concentrations of the blood taken before and after exposure from some of the subjects, suggesting that blood CH2O concentrations may vary with time.
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            Maternal exposure to low-level air pollution and pregnancy outcomes: a population-based study

            Background Recent reports have shown that air pollution may increase the risk of adverse birth outcomes. We have evaluated the relationship between ambient air pollution and the occurrence of low birth weight and preterm delivery using routinely collected data in Lithuania. Methods This epidemiological study comprised all singleton newborns (N = 3,988), born to women in 1998, who resided in the City of Kaunas. Birth data and information on maternal characteristics were obtained from the Lithuanian National Birth Register. To estimate residential exposure levels, we used measurements of ambient nitrogen dioxide (NO2) and formaldehyde, which were collected at 12 monitoring posts. Multivariate logistic regression was used to estimate the effect that each pollutant would have on low birth weight (LBW) and premature birth while controlling for potential confounders. Results Adjusted odds ratios (OR) for LBW increased with increasing formaldehyde exposure (OR2nd tertile = 1.86, 95% CI 1.10–3.16; OR3rd tertile = 1.84, 95% CI 1.12–3.03). Adjusted ORs of preterm birth for the medium and high NO2 tertile exposures were OR = 1.14 (95% CI 0.77–1.68) and OR = 1.68 (95% CI 1.15–2.46), respectively. The risk of preterm birth increased by 25% (adjusted OR = 1.25, 95% CI 1.07–1.46) per 10 μg/m3 increase in NO2 concentrations. An analysis by trimester showed that pregnancy outcomes were associated with first-trimester exposure to air pollutants. However, there were no significant relationships in other pregnancy periods between preterm birth and exposure to formaldehyde or between LBW and NO2 exposure. Conclusion Our findings suggest that in the City of Kaunas there might be a relationship between maternal exposure to ambient formaldehyde and the risk of LBW, as well as between NO2 exposure and the risk of preterm birth.
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              Spontaneous abortions and malformations in the offspring of nurses exposed to anaesthetic gases, cytostatic drugs, and other potential hazards in hospitals, based on registered information of outcome.

              Nurses working in selected departments of general hospitals in Finland were collected from a central register on health personnel in Finland. Using the Hospital Discharge Register and the Register of Congenital Malformations, case nurses were selected who had had a spontaneous abortion (N = 217) or a malformed child (N = 46) between the years 1973 and 1979. Controls consisted of three nurses who had had a normal birth; the control nurses were matched for age and hospital of employment. Information on exposure in the first trimester of pregnancy was sought through the head nurses of the hospitals. No significant increase in risk of spontaneous abortion or of malformation was observed after exposure to anaesthetic gases (odds ratio for spontaneous abortion 1.2), sterilising gases and soaps, or x-rays. Handling of cytostatic drugs did not affect the frequency of spontaneous abortion but was associated with malformations in the offspring. The odds ratio, based on eight cases, was 4.7 (p = 0.02) when the logistic model was adopted. The results suggest that the exposures investigated, other than cytostatic drugs, do not cause a strong reproductive risk. Further studies are needed, particularly on cytostatic drugs.
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                Author and article information

                Journal
                Clin Anat
                Clinical anatomy (New York, N.Y.)
                Wiley
                1098-2353
                0897-3806
                Nov 2015
                : 28
                : 8
                Affiliations
                [1 ] Department of Anatomical Sciences, St. George's University, Grenada.
                [2 ] Pediatric Neurosurgery, Children's of Alabama, Birmingham, Alabama.
                [3 ] Foot and Hand Clinic, Center for Evidence-Based Sport and Orthopedic Research, Emirates Hospital, Dubai, UAE.
                [4 ] Seattle Science Foundation, Seattle, Washington.
                Article
                10.1002/ca.22623
                26375478
                0c2a18c6-3a28-40c4-809d-9cab25b6058d
                © 2015 Wiley Periodicals, Inc.
                History

                anatomy,cadavers,dissection,embalming,formaldehyde,formalin,laboratory,medical students,pregnancy,pregnant,women

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