Comparison of Personal Formaldehyde Levels in Anatomy Laboratories of 5 Physical Therapist Education Programs

Background and Purpose. The current trend in anatomy education requires medical students to spend fewer hours with human donors, while physical therapist (PT) students are spending an increasing amount of time working in the human anatomy laboratory. Nearly all PT education programs in the United States use human donors embalmed with formaldehyde (FA), a known carcinogen and sensory irritant. Although there is literature related to FA monitoring and safety in medical schools, there is little to no existing research on this topic in PT education programs. Some existing PT programs at universities have a department of Environmental Health and Safety (EHS) that monitor FA levels. However, an estimated 42% (n = 84/201) of this country's PT programs are operating anatomy laboratories at colleges or universities that do not have a EHS department that can provide direct access to routine FA exposure monitoring and consulting. Subjects. Physical therapist students and instructors at 5 PT education programs in the United States exposed to FA during human anatomy laboratory sessions were included in this research. Physical therapist students were randomly selected to participate in this study from sites where the instructors volunteered for participation. Methods. Ambient air values, personal FA exposure, and sensory irritation levels from students and instructors at 5 PT education programs in the United States were collected and compared. Outcomes. Of the total personal FA exposure data samples taken for all sites, 57% (n = 60/105) exceeded the American Conference of Governmental Industrial Hygienists (ACGIH) ceiling level of 0.3 parts per million (ppm). The Occupational Safety and Health Administration (OSHA) short-term exposure limit (STEL) of 2.0 ppm was exceeded in 24% (n = 11/45) of sessions at 2 participating sites. Personal FA exposure levels exceeded ambient air test results in 62% (n = 66/105) of samples taken across the 5 institutions. There was no significant correlation found between personal FA exposure and reported irritation levels, or in comparison of personal FA exposure levels between students and instructors. There was a significant difference (P = 0.015) in comparing irritation levels between students and instructors, with students reporting greater than twice the irritation level as compared to their instructors. Discussion and Conclusions. In this study, individuals participating in PT program human donor-based anatomy courses were routinely exposed to higher levels of FA than reported in ambient air quality tests and limits set by ACGIH. At 2 sites, subjects were exposed to levels of FA above OSHA established STELs. These 5 instructors were not irritated by FA and, therefore, may be unlikely to seek out assistance to monitor or control for over exposure to FA.