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Formalin safety in anatomic pathology workflow and integrated air monitoring systems for the formaldehyde occupational exposure assessment

100%
Dugheri S., Massi D., Mucci N., Berti N., Cappelli G., Arcangeli G.
International Journal of Occupational Medicine and Environmental Health
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2020
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vol. 34
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issue 3
319-338
EN
The potential carcinogenicity of formaldehyde (FA) has prompted increasing preventive measures in anatomic pathology (AP) laboratories and new strategies aimed at innovating airborne FA monitoring systems. This review provides an updated overview of the most recent improvements in preventive measures, safe practices, and exposure monitoring tools in the FA usage and handling. A computer-based search of scientific and non-scientific sources was performed on PubMed, Web of Science, Google and Google Patents databases, querying the main topics of real-time, in-continuous FA monitoring instruments for sale, and commercially available tools for improving preventive measures in formalin management. In order to simplify the sampling process and to choose a better analytic solution to FA assessment, the main characteristics of each FA monitoring instrument were described. The novel technical tools recently introduced on the global market, aimed at reducing FA emissions in AP laboratories, were summarized. This review is directed at anatomic pathologists to draw their attention to the rapidly growing field of safe formalin practices. A repeated exposure assessment is recommended to evaluate technical changes in air monitoring programs to keep FA emissions low, in compliance with the limit value; thus, evolved monitoring devices are needed.
2
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Health risk assessment related to hydrogen peroxide presence in the workplace atmosphere – analytical methods evaluation for an innovative monitoring protocol

84%
Mucci N., Dugheri S., Bonari A., Farioli A., Rapisarda V., Garzaro G., Cappelli G., Arcangeli G.
International Journal of Occupational Medicine and Environmental Health
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2020
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vol. 33
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issue 2
137-150
EN
ObjectivesHydrogen peroxide (HP) accounts for 15% of the total global chemical revenue. According to the National Institute of Occupational Safety and Health, the HP concentration immediately dangerous to human life or health is 75 ppm. Operators exposed to HP should pay attention when choosing the monitoring technique that should be specific and sensitive enough to discriminate the exposure levels from background concentrations. In order to assess the long- and short-term exposure to HP in disinfection processes, the authors compared 6 industrial hygiene monitoring methods to evaluate their efficiency in measuring airborne HP concentrations.Material and MethodsAirborne HP concentrations were evaluated using an on-fiber triphenylphosphine solid-phase microextraction method, and they were compared with those obtained using a 13-mm Swinnex titanium oxysulfate filter holder and 4 portable direct-reading electrochemical sensors. A survey carried out in wood pulp bleaching, food and beverage disinfection processing, and in a hospital department to reduce the risk of spreading nosocomial infections, was performed during routine operations to access the risk of HP occupational exposure.ResultsThrough the generation of HP gaseous dynamic atmospheres (0.1–85 ppm), the authors evaluated the consistency of the results obtained using the 6 methods described. The monitoring campaigns showed that the increase in HP could be relatively high (until 67 ppm) in food and beverage processing.ConclusionsIn the authors’ opinion, the current 8-h time-weighted average limits of 1 ppm for HP do not reflect the actual risk; a short-term exposure limit would, therefore, provide a much better protection.
3
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Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs)

68%
Dugheri S., Mucci N., Bucaletti E., Squillaci D., Cappelli G., Trevisani L., Bonari A., Cecchi M., Mini E., Ghiori A., Tognoni D., Berti N., Alderighi F., Li Vigni N., Orlandi I., Arcangeli G.
Medycyna Pracy
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2022
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vol. 73
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issue 5
383-396
EN
Background Chemotherapy drugs are widely used to treat cancer, but their active compounds represent a danger for workers who could be exposed to them. However, they aren’t yet included in directive CE No. 1272/2008 and the European Biosafety Network has only recommended a limit value of 100 pg/cm2 for surface contamination. Thus, it is crucial to assess surface contaminations in healthcare environments. Currently, the technique of choice is surface wipe test combined with liquid chromatography tandem mass spectrometry to achieve high sensibility. Material and Methods A campaign involving Careggi University Hospital (Florence, Italy) was performed from January 2020 to December 2021, collecting 1449 wipe samples between administration units, preparation unit, and personnel gloves. From the obtained data, the 90th percentile was calculated for 30 antiblastic drugs and proposed as surface exposure levels (SELs); while from data concerning personnel glove contamination, weekly contamination was estimated. Results In the 2-year period only 417 wipe samples were found positive (28.8%), the majority of which regard samples coming from administration unit bathrooms. The proposed SELs are almost all <100 pg/cm2, except for few drugs which produce higher contamination on bathroom surfaces. Also, the estimation of pharmacy personnel’s glove contamination highlighted very low results (ng/week). Conclusions Deeply established protocols and procedures for safe handling of ADs allow for obtaining excellent cleaning results and thus a safer work environment, however, the risk of cytostatic contaminations cannot be avoided in healthcare workplaces, and thus a harmonization of classification and labeling of chemotherapy drugs throughout the European Union should be done.
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