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How improvements in monitoring and safety practices lowered airborne formaldehyde concentrations at an Italian university hospital: a summary of 20 years of experience Cover

How improvements in monitoring and safety practices lowered airborne formaldehyde concentrations at an Italian university hospital: a summary of 20 years of experience

Open Access
|Oct 2020

Figures & Tables

Figure 1

Sampling strategies from 1999 to 2019. a – SkyPost Gas; b– Bravo M Plus pump; c– Lp-2,4-DNPH-S10 coated cartridge; d – GilAir-3 pump; e– FFA-PDMS/DVB SPME fibre; f– diffusive sampling fibre holder; g– Sep-Pak XpoSure sampler plus short DNPH-coated cartridge; h– GilAir Plus; i– Formaldemeter™ htV-M; j– GasCheck Basic; k – NEMo XT; l – Gasera One; m – ergonomic armchair (a) headrest with two NEMo XT and a Gascheck (b)
Sampling strategies from 1999 to 2019. a – SkyPost Gas; b– Bravo M Plus pump; c– Lp-2,4-DNPH-S10 coated cartridge; d – GilAir-3 pump; e– FFA-PDMS/DVB SPME fibre; f– diffusive sampling fibre holder; g– Sep-Pak XpoSure sampler plus short DNPH-coated cartridge; h– GilAir Plus; i– Formaldemeter™ htV-M; j– GasCheck Basic; k – NEMo XT; l – Gasera One; m – ergonomic armchair (a) headrest with two NEMo XT and a Gascheck (b)

Figure 2

Box plot of the gross room FA monitoring results from 1999 to 2019. Mean, median, and quartile distribution of TWA and short-term concentrations (μg/m3)
Box plot of the gross room FA monitoring results from 1999 to 2019. Mean, median, and quartile distribution of TWA and short-term concentrations (μg/m3)

Figure 3

Box plot of the specimen reception FA monitoring results from 1999 to 2019. Mean, median, and quartile distribution of TWA and short-term concentrations (μg/m3)
Box plot of the specimen reception FA monitoring results from 1999 to 2019. Mean, median, and quartile distribution of TWA and short-term concentrations (μg/m3)

Figure 4

Box plot of the operating theatre FA monitoring results from 1999 to 2019. Mean, median, and quartile distribution of short-term concentrations (μg/m3)
Box plot of the operating theatre FA monitoring results from 1999 to 2019. Mean, median, and quartile distribution of short-term concentrations (μg/m3)

Calibration data for the analytical method and direct readings in lab setting

Expected FA concentrations of gaseous standards (atmospheres)Active-sampling DNPH cartridgeDirect-reading GASERA monitor
(μg/m3)Mean ± SD (μg/m3)Mean ± SD (μg/m3)
2024±717±8
4044±863±6
8083±798±12
160166±15144±23
320323±13337±25
Simple linear regression estimation y=α+βx
R20.9920.964
β0.9930.960
(SE)(0.017)(0.038)
α-3.151-2.675
(SE)(3.008)(6.600)
p value of F test
H0: α=00.1490.131
β=1
Method parameters
LOD (μg/m3)1-
LOQ (μg/m3)31*
Within session accuracy (%)46
Within session repeatability (%)79
Inter session repeatability (%)89

2019 FA monitoring campaign overall measurements for all three work units (operating theatres, Pathology Lab gross room, and Pathology Lab specimen reception)_ The Wilcoxon rank-sum test was using whole data from the three work units_ Probability (p) and z score values are reported for each comparison of methods_ There is no evidence to reject the null hypothesis (p<0_05) for any of the tests

2019 FA monitoring campaign overall measurements for operating theatres and Pathology Lab specimen reception and gross room (μg/m3)
Active-samplingActive-samplingActive-samplingActive-samplingDirect-readingDirect-reading
DNPH cartridgeDNPH cartridgeDNPH cartridgeDNPH cartridgeNEMO MonitorGASERA Monitor
GilAir PlusGilAir PlusGasCheckGasCheck
Personal samplingErgonomic armchairArea sampling
Short-termTWAShort-termTWATWATWA
No. samplings of10376103767676
Mean (μg/m3)331829171814
Median (μg/m3)271427131411
Range (μg/m3)5–1926–615–1925–657–555–47
Wilcoxon rank-sum test
Method comparison p value (z)
Active DNPH-cartridge personal short-term sampling vs Active DNPH-cartridge GasCheck Basic automatic collector sampling0.595 (0.532)
Active DNPH-cartridge personal TWA sampling vs Active DNPH-cartridge GasCheck Basic automatic collector sampling0.252 (1.144)
Active DNPH-cartridge personal sampling vs Direct-reading NEMO monitor sampling0.816 (-0.233)
Active DNPH-cartridge GasCheck Basic automatic collector sampling vs Direct-reading Gasera monitor sampling0.195 (1.296)

Trends in FA concentrations (μg/m3) at the Careggi Hospital operating theatres and pathology lab over three periods that saw improvements in handling and measuring FA exposure_ Decreases are relative to the previous time interval

Time interval
1999–20072008–20152016–2019
Operating theatre
Short-term exposure (15 min)
  Median range (μg/m3) (no. of monitoring campaigns)158–200 (9)61–108 (8)20–28 (4)
  Mean decrease (%)182 (-)99 (46)24 (76)
Pathology laboratory – gross room
Short-term exposure (15 min)
  Median range (μg/m3) (no. of monitoring campaigns)269–613 (9)71–161 (8)15–44 (4)
  Mean decrease (%)410 (-)121 (71)29 (76)
TWA
  Median range (μg/m3) (no. of FA campaigns)706–875 (9)115–180 (8)16–37 (4)
  Mean decrease (%)301 (-)145 (52)32 (78)
Pathology laboratory – specimen reception
Short-term exposure (15 min)
  Median range (μg/m3) (no. of monitoring campaigns)180–300 (9)85–90 (8)15–37 (4)
  Mean decrease (%)211 (-)89 (58)28 (69)
TWA
  Median range (μg/m3) (no. of monitoring campaigns)127–200 (9)44–73 (8)10–33 (4)
  Mean decrease (%)160 (-)59 (63)25 (58)
DOI: https://doi.org/10.2478/aiht-2020-71-3406 | Journal eISSN: 1848-6312 | Journal ISSN: 0004-1254
Language: English, Croatian, Slovenian
Page range: 178 - 189
Submitted on: Mar 1, 2020
Accepted on: Aug 1, 2020
Published on: Oct 6, 2020
Published by: Institute for Medical Research and Occupational Health
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2020 Stefano Dugheri, Daniela Massi, Nicola Mucci, Nicola Berti, Giovanni Cappelli, Giulio Arcangeli, published by Institute for Medical Research and Occupational Health
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.