In early winter of 2003, the Massachusetts Nurse
carried an article regarding our investigation of a possible formaldehyde
substitute. With research and inquiry through individual Web sites
and contacts at the University of Maryland, I was able to reach
Dr. Stewart Lipton the owner/inventor/creator of a substitute
formaldehyde product called NOTOXhisto (NOTOX). I spoke with Dr.
Lipton and shared some of the MNA's concerns associated with the
use of formaldehyde, and we talked about the reasons why we were
trying to find a safe and effective formaldehyde substitute available
for hospitals, ambulatory care units, health care facilities and
laboratories.
I asked Dr. Lipton if he knew if NOTOX was as
effective in similar applications when used as a substitute for
formaldehyde. He noted, "I believe NOTOX has different penetration
times for different tissues when compared to formaldehyde." Dr.
Lipton agreed to give me a list of health care facilities across
the United States that recently used the product. My plan was
to ask three facilities referenced by Dr. Lipton the following
questions.
According to Thomas P. Fuller ScD, CIH and MSPH,
"Anyone working with formaldehyde must receive training on the
health effects and appropriate controls to be taken when working
with the chemical."
The best safety control is to not use formaldehyde
at all. Formaldehyde substitute chemicals such as Glyo-fixx, Prefer,
Histofix and others have appeared on the market in recent years.
Due to the chemical structures of these products they are safer
than formaldehyde and perform equally as well.
Administrative controls for formaldehyde include
chemical specific training programs, container labeling, monitoring
programs, medical surveillance and good housekeeping.
Due to the hazardous nature of formaldehyde,
the Occupational Safety and Health Administration has set the
Permissible Exposure Level (PEL) for formaldehyde at 0.75 ppm
for an eight hour work day. The formaldehyde Short Term Exposure
Level (STEL) is 2.0 ppm for a time limit up to 15 minutes four
times a day. The Action Level (AL) for formaldehyde is 0.5 ppm
and represents the concentration which workers must enter the
medical surveillance program and additional air monitoring. It
is relatively easy to reach any of these levels during typical
hospital activities where formaldehyde is used.
Although the medical community tends to be resistant
to change, as the hazardous nature of formaldehyde becomes more
and more evident, the need for product substitution and added
safety precautions become more urgent. It is very difficult to
meet OSHA and EPA safety and effluent restrictions without vigilant
actions by a facility's environmental health and safety office.
Unless your facility is performing annual air monitoring, training,
medical surveillance, and effluent testing, there is a good likelihood
that it is not in compliance."
For further information on possible formaldehyde
alternatives, contact Chris Pontus.
*SHP is the Sustainable Hospitals Project at UMass
Lowell. It can be reached at www.sustainablehospitals.org.
