Toxic effects of formalin-treated cadaver on medical students, staff members, and workers in the Alexandria Faculty of Medicine

Background: Formaldehyde can be toxic, allergenic and carcinogenic. Evaporation of formaldehyde from formalin-treated cadavers in the anatomy dissection rooms can produce high exposure. This study was conducted to assess acute and chronic toxic effects of formalin-treated cadavers on medical students, staff members, and workers at the Anatomy department in the Alexandria Faculty of Medicine (AFM). Methods: A cross sectional approach was adopted to investigate medical students (n = 454). Staff members and workers at the Anatomy department (n = 16), and unexposed staff members and workers in the AFM (n = 19) were included in the study. Medical students filled self-administered predesigned questionnaire. Formalin-exposed and unexposed staff members filled a questionnaire and a Complete Blood Count was done for them. Results: The most frequently reported symptoms by medical students were unpleasant smell (91.2%), itching in the eyes (81.3%), and excessive lacrimation (76.1%). Majority of them reported duration of relief within one hour (>80%), and more than two thirds reported wearing laboratory coats and hand gloves. Formalin-exposed staff reported symptoms of skin disorders as drying (75%), eczema (68.8%), and allergic contact dermatitis (87.5%), besides, eye irritation (68.8%), respiratory tract irritation (93.8%), and work-related bronchial asthma (53.3%). The mean RBCs and platelets counts were significantly lower among formalin-exposed staff (4.08 ± 0.65 × 106/ul and 237,375 ± 71745.73/ul respectively) compared with unexposed staff (4.95 ± 0.50 × 106/ul and 280473.68 ± 54456.27/ul respectively). WBCs count was abnormal (low or high) among formalin-exposed staff members (6.2%, and 18.8% respectively), while all unexposed staff had normal WBCs counts. Conclusion: The research highlighted the irritating action of formalin on medical students, and chronic toxic effects on staff members. This necessitates re-evaluation of the concentration of formalin, proper ventilation and assessment of working practices in the dissecting rooms at the Anatomy department