Original Research Article

Effects of formalin exposure among students

attending anatomy dissection in a rural medical
college in Telangana state: A cross sectional
study
Sreeharshika D1, Kishore Yadav Jothula2*, Roja Rani3, Sashi Preetham B4
1,3Tutor, 4Student,
Department of Forensic Medicine, ESIC Medical College, Sanath Nagar, Hyderabad, Telangana, INDIA.
2Associate Professor, Department of Community and Family Medicine, AIIMS, Bibinagar, Yadadri Bhuvanagiri, Telangana, INDIA.
Email: [email protected]

Abstract Background: Formalin is widely used in medical colleges as embalming solution and preservative as it is cheap and
easily available. Formaldehyde can be toxic, allergic and carcinogenic. This study has been taken to find out the
perceived symptoms of formalin exposure in first year MBBS and dental students. Materials and Methods: Institutional
based Cross sectional study conducted with a sample size of 100 students. A predesigned, pretested semi structured
questionnaire was used as study tool and date was collected by interview method. Data was analysed by using SPSS
software ver.22. Observations and Results: Most (69%) of the study subjects were boys. The most troublesome
symptom was unpleasant smell (72%) followed by excess lacrimation (56%), Headache (38%) and lack of concentration
(25%). Conclusion: Formaldehyde present in formalin definitely has a toxic effect on various body tissues which can
adversely affect the health of students who are exposed during their dissection period. So proper precautions should be
taken to prevent formalin toxicity.
Keywords: Formaldehyde, Formalin, Lacrimation, Unpleasant smell
*Address for Correspondence:
Dr Kishore Yadav Jothula, Associate Professor, Department of Community and Family Medicine, AIIMS, Bibinagar, Yadadri Bhuvanagiri ,
Telangana, INDIA.
Email: [email protected]
Received Date: 16/11/2019 Revised Date: 31/12/2019 Accepted Date: 03/02/2020
DOI: https://doi.org/10.26611/10011321

different fields like wood and plastic industries.2In

Access this article online medical field formalin is mainly used as embalming
Quick Response Code: solution and as a preservative as it is cheap and easily
Website: available. Formaldehyde can be toxic, allergic and
www.medpulse.in carcinogenic. The primary route of exposure to
formaldehyde is by inhalation, where it is absorbed by
the lungs and gastro-intestinal tract and to a much lesser
extent through the skin.3It is quickly absorbed from
Accessed Date:
nose and the upper part of lungs. Once absorbed, it is
06 February 2020 converted to a non- toxic chemical called formate,
which is excreted in the urine and is converted to carbon
dioxide and breathed out of the body. Formaldehyde has
INTRODUCTION been reported to cause acute and chronic health-related
Formaldehyde (HCHO) was discovered in 1856 by problems. The most frequent symptoms are irritation of
August WilheldVon Hofmann.1 A solution of 35 to 40 eyes, skin and upper respiratory tract, and headache
per cent of water in formaldehyde is called formalin. It which are associated with high concentration exposure.4
is widely used in medical colleges, hospitals, as The safety of formaldehyde is very complicated. The
preservative, disinfectant, embalming solution and in main concerns are associated with chronic exposure by

How to cite this article: Sreeharshika D, Kishore Yadav Jothula, Roja Rani, Sashi Preetham B. Effects of formalin exposure among
students attending anatomy dissection in a rural medical college in Telangana state: A cross sectional study. MedPulse – International
Journal of Anatomy. February 2020; 13(2): 26-28. http://www.medpulse.in/Anatomy
 MedPulse – International Journal of Anatomy, PISSN: 2550-7621, EISSN: 2636-4557 Volume 13, Issue 2, February 2020 pp 26-28

inhalation and skin contact. At concentrations above 0.1 Out of 100 participants, 69(69%) were boys and 31
ppm in air formaldehyde can irritate the eyes and (31%) were girls, with majority (58%) of participants
mucous membranes, resulting in watery eyes.5 In falling between age of 18–19 years.
medical practice, formalin exposure is mainly from
aqueous formaldehyde solutions i.e. embalming fluids Table 2: Distribution of subjects according to symptoms
during the dissection period. The evaporation of experienced on exposure to formalin (n=100)
S.No Effects of formalin No. of students %
formaldehyde from cadavers in gross anatomy
1 Unpleasant smell 72 72
laboratories can produce high exposures among Ist
2 Excess lacrimation 56 56
MBBS and Dental students. This exposure can 3 Sore throat 20 20
adversely affect their health, hence it is essential to find 4 Running nose 39 39
out the toxicity of formalin and also possible ways to 5 Skin problems 07 07
reduce the toxic effects. With this background, this 6 Lack of concentration 25 25
study has been taken to find out the perceived 7 Headache 38 38
symptoms of formalin exposure in first year MBBS and 8 Disturbance of sleep 06 06
dental students who are exposed to it routinely during 9 Disturbance of sight 18 18
their anatomy dissection for at least two hours every day 10 Unusual tiredness 12 12
throughout the year. 11 Nausea 23 23
12 Gastro intestinal problems 01 01
13 Others 02 02
MATERIALS AND METHODS Unpleasant smell (72%) was the most commonly
Study setting: A cross sectional study was undertaken experienced symptom followed by Excess lacrimation
after obtaining Institutional Ethical Clearance in a rural (56%). Other symptoms being Running nose (39%),
medical college, Telangana state. Study subjects: All Headache (38%), Lack of concentration (25%) and
first year students who were willing to participate in the Nausea (23%).
study.
Sample size: Out of 120 students (medical- 100, dental-
20) 20 had participated in the pilot study and100
DISCUSSION
In the current study 69(69%) were boys and 31 (31%)
students were included after taking consent, hence
were girls, with majority (58%) of participants falling
sample size was 100.
between age of 18–19 years. In our study the most
Study tool: A pretested, semi-structured questionnaire
troublesome symptom was unpleasant smell (72%) due
which was standardized by conducting pilot study. The
to which students cannot concentrate properly during the
questionnaire includes demographic data of the students
dissection time, followed by excess lacrimation (56%)
and side effects related to exposure to formalin.
which was the most common(74.8%) symptom to
Study period: This study was carried out for 2 months
develop in a study done by Nisa et al.4 Excess
from July 2019 to August 2019
lacrimation is due to presence of formaldehyde in
Method of data collection: Questionnaire was
formalin. Formaldehyde is a flammable, colorless and
administered to the students after explaining them the
readily polymerized gas at ambient temperature and is
importance of study and the questionnaire.
one of the major pollutants of indoor air. The primary
Confidentiality regarding the participant response for
routes of human exposure to formaldehyde are
the questions was ensured.
inhalation, eye and dermal contact. Formaldehyde being
Statistical analysis: Data was entered in Microsoft
water soluble gets dissolved in the mucosa. It then
excel and analysis was done using SPSS statistical
causes degenerative, inflammatory and hyperplastic
package version 22
changes in the mucosa of the target organ. The absorbed
formaldehyde is then converted to formate by enzymes
OBSERVATIONS AND RESULTS present in erythrocytes. Formate can cause crosslinking
Table 1: Distribution of study subjects according to their age and
gender (n=100)
of nucleic acids and amino acids causing cell death
Age (Years) No. of students Percentage (%) which is the main factor making formalin carcinogenic.
17 – 18 26 26 The other symptoms seen are running nose (39%) which
18 – 19 58 58 was about 69.5% in a study done by Elshaer et al.6
19 – 20 16 16 Headache (38%), lack of concentration (25%) and sore
Sex No. of students Percentage (%) throat (20%) are the other main symptoms in our study.
Male 69 69 In a study done by Koirala et al Nausea was found to be
Female 31 31 about 69.8% contrary to our study which was 23%.7

Copyright © 2020, Medpulse Publishing Corporation, MedPulse International Journal of Anatomy, Volume 13, Issue 2 February 2020
 Sreeharshika D, Kishore Yadav Jothula, Roja Rani, Sashi Preetham B

Formaldehyde may also affect assimilation during by using gloves, masks and aprons etc., will help in
dissection because when one is tired, dizzy, and has minimising the toxic effects of formalin.
headache little or nothing can be grasped while
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Source of Support: None Declared

Conflict of Interest: None Declared

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