Inhalational exposure to formaldehyde, carcinogenic, and non-carcinogenic risk assessment: A systematic review

Amir Hossein Khoshakhlagh; Mahdiyeh Mohammadzadeh; Seyede Somayeh Manafi; Fatemeh Yousefian; Agnieszka Gruszecka-Kosowska

doi:10.1016/j.envpol.2023.121854

Inhalational exposure to formaldehyde, carcinogenic, and non-carcinogenic risk assessment: A systematic review

Environ Pollut. 2023 Aug 15;331(Pt 1):121854. doi: 10.1016/j.envpol.2023.121854. Epub 2023 May 24.

Authors

Amir Hossein Khoshakhlagh¹, Mahdiyeh Mohammadzadeh², Seyede Somayeh Manafi³, Fatemeh Yousefian⁴, Agnieszka Gruszecka-Kosowska⁵

Affiliations

¹ Department of Occupational Health Engineering, School of Health, Kashan University of Medical Sciences, Kashan, Iran.
² Social Determinants of Health (SDH) Research Center, Department of Environment Health, Kashan University of Medical Sciences, Kashan, Iran. Electronic address: m.mohammadzadeh997@gmail.com.
³ Head of Environmental and Urban Health Studies, Tehran Urban Research and Planning Center Municipality of Tehran, Tehran, Iran.
⁴ Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran.
⁵ AGH University of Science and Technology, Faculty of Geology, Geophysics, and Environmental Protection, Department of Environmental Protection, Al. Mickiewicza 30, 30-059 Krakow, Poland.

PMID: 37236589
DOI: 10.1016/j.envpol.2023.121854

Abstract

Formaldehyde is one of the most widely used substances in a variety of industries, although it was classified as a human carcinogen by the International Agency for Research on Cancer (IARC). The present systematic review was conducted to retrieve studies related to occupational exposure to formaldehyde until November 2, 2022. Aims of the study were to identify workplaces exposed to formaldehyde, to investigate the formaldehyde concentrations in various occupations and to evaluate carcinogenic and non-carcinogenic risks caused by respiratory exposure to this chemical among workers. A systematic search was done in Scopus, PubMed and Web of Science databases to find the studies done in this field. In this review, studies that did not meet the criteria specified by Population, Exposure, Comparator, and Outcomes (PECO) approach were excluded. In addition, the inclusion of studies dealing with the biological monitoring of FA in the body and review studies, conference articles, books, and letters to the editors were avoided. The quality of the selected studies was also evaluated using the Joanna Briggs Institute (JBI) checklist for analytic-cross-sectional studies. Finally, 828 studies were found, and after the investigations, 35 articles were included in this study. The results revealed that the highest formaldehyde concentrations were observed in waterpipe cafes (1,620,000 μg/m³) and anatomy and pathology laboratories (4237.5 μg/m³). Carcinogenic and non-carcinogenic risk indicated the potential health effects for employees due to respiratory exposure as acceptable levels of CR = 1.00 × 10^-4 and HQ = 1, respectively were reported to be exceeded in more than 71% and 28.57% of the investigated studies. Therefore, according to the confirmation of formaldehyde's adverse health effects, it is necessary to adopt targeted strategies to reduce or eliminate exposure to this compound from the occupational usage.

Keywords: Carcinogenic risk; Formaldehyde; Non-carcinogenic risk; Occupational exposure; Workers; Workplaces.

Publication types

Systematic Review
Review

MeSH terms

Carcinogens* / toxicity
Cross-Sectional Studies
Formaldehyde / toxicity
Humans
Industry
Occupational Exposure* / adverse effects
Risk Assessment

Substances

Carcinogens
Formaldehyde