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ORIGINAL ARTICLE
Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 15-18

Effect of formaldehyde exposure on some cardiovascular indices among morticians in Benin City Nigeria


Department of Physiology, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin City, Nigeria

Date of Submission12-Nov-2021
Date of Acceptance21-Mar-2022
Date of Web Publication01-Jul-2022

Correspondence Address:
Dr. Frederick Oseyomon Ebojele
Department of Physiology, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin City
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njecp.njecp_42_21

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  Abstract 


Introduction: The effect of formaldehyde exposure on some indices of cardiovascular function among morticians in Benin City was studied. Materials and Methods: Fifty subjects were recruited for the study which included 10 nonmorticians and 40 morticians. Subjects were divided into five groups A, B, C, D, and E according to their duration (in years) of exposure to formaldehyde with ten subjects in each group. Group A served as the control (nonmorticians), whereas Groups B, C, D, and E served as the test groups with 0–5 years, 6–10 years, 11–20 years, and >20 years exposures, respectively. Anthropometric parameters were measured as well as some cardiovascular indices which include pulse rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, and mean arterial pressure (MAP). Statistical analysis was done using GraphPad Prism version 5.0. Results were presented as mean ± standard error of the mean analysis of variance was used to compare the means of test and control values, whereas post hoc test was done using Student‒Newman‒Keuls test and a P < 0.05 was considered as statistically significant. Results: Results showed significant increases in SBP, DBP, and MAP among Group E morticians. Conclusion: It was therefore concluded that prolonged exposure to formaldehyde could affect the cardiovascular health of morticians.

Keywords: Cardiovascular, duration, formaldehyde, morticians


How to cite this article:
Ebojele FO, Iyawe VI. Effect of formaldehyde exposure on some cardiovascular indices among morticians in Benin City Nigeria. Niger J Exp Clin Biosci 2022;10:15-8

How to cite this URL:
Ebojele FO, Iyawe VI. Effect of formaldehyde exposure on some cardiovascular indices among morticians in Benin City Nigeria. Niger J Exp Clin Biosci [serial online] 2022 [cited 2022 Aug 18];10:15-8. Available from: https://www.njecbonline.org/text.asp?2022/10/1/15/349562




  Introduction Top


Dead bodies are usually kept in the mortuary where they are preserved either by refrigeration or by embalming.[1] If they are refrigerated, they are usually exposed to a temperature of 34°F–39°F (1.1°C–3.9°C) which helps to preserve the body and keep them from decaying. A dead body without any form of preservation can only last a maximum of 72 h before it starts decaying. Embalming is done with formaldehyde and this is usually carried out by morticians who are designated to work in the mortuaries.[1] Formaldehyde is reported to produce some undesirable effects, especially in the respiratory system.[2] Available studies on acute occupational exposure in humans revealed clinical symptoms such as skin irritation, eye soreness, nose irritation, throat irritation, and rhinorrhea as well as the reduction in pulmonary functions such as forced vital capacity (FVC), FEV1/FVC, and peak expiratory flow rate (PEFR).[3],[4],[5],[6] Chronic exposure studies done in some medical schools in India reported a decrease in pulmonary function following exposure to formaldehyde.[7],[8] In some Japanese medical schools, it was observed that students developed chemical hypersensitivity and also complained of irritation of the mucous membranes of the nose and eye.[9],[10] Petushok investigated the potential of formaldehyde to produce oxidative stress in the liver of animals,[11] whereas some other researchers have tried to look at possible effects of formaldehyde on the central nervous system.[12],[13] Studies on cardiac function following formaldehyde exposure are quite few and it has been reported that in rats, formaldehyde inhalation could produce oxidative stress in the heart.[14] Some other researchers[15] reported a decrease in heart rate following exposure of medical students to formaldehyde. This present study seeks to investigate the effect of formaldehyde exposure on some cardiovascular parameters among morticians in Benin City.


  Materials and Methods Top


Occupationally exposed morticians between the ages of 20 and 60 years across some selected mortuaries in Benin City, Edo State, were recruited for this study. Subjects were apparently healthy, nonsmokers, and had no history of cardiopulmonary disease or recent abdominal or chest surgery. Informed consent was obtained from the subjects who participated in the study, whereas ethical approval was obtained from the College Research Ethics Committee, the University of Benin as well as from the Edo State Hospital Management Board before the commencement of the work. Subjects were divided into five groups (A, B, C, D, and E) according to their duration (in years) of exposure to formaldehyde with ten subjects in each group. Group A served as control (nonmorticians), whereas groups B, C, D, and E served as the test group. Group B consisted of morticians with 0–5 years exposure, Group C consisted of morticians with 6–10 years exposure, Group D consisted of morticians with 11–20 years exposure, and Group E consisted of morticians with more than 20 years exposure. Their anthropometric parameters were measured as well as some cardiovascular indices which included pulse rate (PR), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) and mean arterial pressure (MAP). Statistical analysis was done using GraphPad Prism version 5.0 (GraphPad Software, San Diego, California, USA). Results were presented as mean ± standard error of the mean analysis of variance was used to compare the means of test and control values, whereas post hoc test was done using Student‒Newman‒Keuls test and a P < 0.05 was considered as statistically significant.


  Results Top


[Table 1] shows anthropometric parameters of morticians that were studied and there were no significant differences between control and test groups. There was an increase in PR [Figure 1] across all the test groups as the duration of exposure (in years) increased, especially after 10 years of work. The increases were not significant. SBP [Figure 2], DBP [Figure 3], [Figure 4], and MAP [Figure 5] were significantly increased in Group E which had >20 years exposure when compared with the control. However, Groups B, C, and D showed an increase in these parameters as the years in the industry increased but it was not significant. An increase was also seen in the PP across all the groups [Figure 5].
Figure 1: Mean pulse rate of morticians following chronic exposure to formaldehyde

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Figure 2: Mean systolic blood pressure of morticians following chronic exposure to formaldehyde. Significant values are mean ± standard error of the mean compared to control (*P < 0.05)

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Figure 3: Mean diastolic blood pressure of morticians following chronic exposure to formaldehyde. Significant values are mean ± standard error of the mean compared to control (*P < 0.05)

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Figure 4: Mean pulse pressure of morticians following chronic exposure to formaldehyde

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Figure 5: Mean arterial pressure of morticians following chronic exposure to formaldehyde. Significant values are mean ± standard error of the mean compared to control (*P < 0.05)

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Table 1: Anthropometric parameters of morticians following chronic exposure to formaldehyde

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  Discussion Top


The adverse effects of formaldehyde have been reported in the respiratory system as seen in some studies carried out among medical students in the gross anatomy laboratory[7],[8],[15]. A study on exposed and nonexposed hospital staff was carried out by other researchers who also reported adverse effects of formaldehyde on the respiratory system.[5] Formaldehyde inhalation was also reported to worsen allergic effects and asthma in adults and children.[16],[17] Formaldehyde was reported to produce oxidative stress in the liver of Wistar rats.[11],[18] Central nervous system effect of formaldehyde has also been reported by some researchers[12],[13] who observed some alterations in brain structures of neonatal rats that were exposed to formaldehyde after birth for a duration of 30 days. Others also reported impaired memory and learning as well as altered motor activity in mice following acute exposure to formaldehyde.[19] Testicular toxicity following exposure to formaldehyde in male rats was studied by some researchers[20],[21] and they reported a decrease in testicular weight as well as some histopathological changes which include atrophy of the seminiferous tubules, a decrease in spermatogenic cells, and edematous interstitial tissue with vascular dilation and hyperemia. They also reported decreased sperm motility as well as an increased percentage of abnormal sperm. Only a few studies from the literature appeared to have evaluated the effects of formaldehyde on cardiac function: Neginhal et al.[15] who reported a decrease in heart rate following exposure of medical students to formaldehyde; Güleç et al.[14] who suggested that formaldehyde when inhaled could cause oxidative stress to the heart in rats. Observation from this present study conducted among morticians in Benin City revealed a significant increase in SBP, DBP, and MAP in Group E [Figure 2], [Figure 3], [Figure 5] who were exposed to formaldehyde for >20 years. This significant increase may be related to the effect of formaldehyde since formaldehyde exposure has also been reported to cause adverse effects in other systems of the body as stated earlier in this discussion. Again, it is also possible that this significant increase that was seen in Group E may have been as a result of increasing age since SBP, DBP, and MAP are known to increase with increasing age. Some of the speculated mechanisms in this regard include vascular aging and endothelial dysfunction,[22],[23] alteration in the production and/or bioavailability of nitric oxide,[24] endothelial replication and apoptosis,[25] oxidative stress, and inflammation in aging-related diseases.[26] There appears to be a dilemma here: Is the observation of the cardiovascular effect in this present study a result of the effect of formaldehyde or the effect of increasing age or both?


  Conclusion Top


We would like to suggest that measures be taken to reduce exposure level to formaldehyde among morticians bearing in mind that adverse effects have been reported in other systems of the body so that in the event that the cardiovascular effects seen in this present study are coming from formaldehyde, then it will be easier to protect the cardiovascular health of morticians.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Arvinder PS, Balgit SK, Anupama M, Seema, Navpreet K. Embalming and other methods of dead body preservation. Int J Med Toxicol Legal Med 2010;17:15-9.  Back to cited text no. 1
    
2.
Mathur N, Rastogi SK. Respiratory effects due to occupational exposure to formaldehyde: Systematic review with meta-analysis. Indian J Occup Environ Med 2007;11:26-31.  Back to cited text no. 2
[PUBMED]  [Full text]  
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Kim H, Kim YD, Cho SH. Formaldehyde exposure levels and serum antibodies to formaldehyde-human serum albumin of Korean medical students. Arch Environ Health 1999;54:115-8.  Back to cited text no. 4
    
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Pourmahabadian M, Azam K, Ghasemkhani M. Pulmonary function study between formaldehyde exposed and non-exposed staffs at some of the Tehran educational hospitals. J Med Sci 2006;6:621-5.  Back to cited text no. 5
    
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Wei CN, Harada K, Ohmori S, Wei QJ, Minamoto K, Ueda A. Subjective symptoms of medical students exposed to formaldehyde during a gross anatomy dissection course. Int J Immunopathol Pharmacol 2007;20:23-5.  Back to cited text no. 6
    
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Patil P, Hulke SM, Thakare A. Effect of formalin on pulmonary function: A nine months longitudinal study. Res J Pharm Biol Chem Sci 2012;3:211-6.  Back to cited text no. 7
    
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Shrivastava A, Saxena Y. Effect of formalin vapour on pulmonary function of medical students in anatomy dissection hall over a period of one year. Indian J Physiol Pharmacol 2013;57:255-60.  Back to cited text no. 8
    
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Petushok N. Activity of glutathione-related enzymes in rat tissues after formaldehyde exposure. Curr Top Biophys 2000;24:167-9.  Back to cited text no. 11
    
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Aslan H, Songur A, Tunc AT, Ozen OA, Bas O, Yagmurca M, et al. Effects of formaldehyde exposure on granule cell number and volume of dentate gyrus: A histopathological and stereological study. Brain Res 2006;1122:191-200.  Back to cited text no. 12
    
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Sarsilmaz M, Kaplan S, Songur A, Colakoglu S, Aslan H, Tunc AT, et al. Effects of postnatal formaldehyde exposure on pyramidal cell number, volume of cell layer in hippocampus and hemisphere in the rat: A stereological study. Brain Res 2007;1145:157-67.  Back to cited text no. 13
    
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Neginhal R, Herur A, Chinagudi S, Rairam GB, Kolagi S, Ambi U. Cardiorespiratory effects of acute exposure to formaldehyde in gross anatomy laboratory in medical students – A comparative study. Med Innov 2013;2:32-5.  Back to cited text no. 15
    
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Sakamoto T, Doi S, Torri S. Effects of formaldehyde as an indoor air pollutant on the airway. Allergol Int 1999;48:151-60.  Back to cited text no. 16
    
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Mendell MJ. Indoor residential chemical emissions as risk factors for respiratory and allergic effects in children: A review. Indoor Air 2007;17:259-77.  Back to cited text no. 17
    
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Sogut S, Songur A, Ozen O. Does the subacute (4-week) exposure to formaldehyde inhalation lead to oxidant/antioxidant imbalance in rat liver? Eur J Gen Med 2004;1:26-32.  Back to cited text no. 18
    
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Usanmaz S, Akarsu E, Vural N. Neurotoxic effects of acute and subacute formaldehyde exposure in mice. Environ Toxicol Pharmacol 2002;11:93-100.  Back to cited text no. 19
    
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Ozen OA, Yaman M, Sarsilmaz M, Songur A, Kus I. Testicular zinc, copper and iron concentrations in male rats exposed to subacute and subchronic formaldehyde gas inhalation. J Trace Elem Med Biol 2002;16:119-22.  Back to cited text no. 20
    
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Zhou DX, Qiu SD, Zhang J, Tian H, Wang HX. The protective effect of vitamin E against oxidative damage caused by formaldehyde in the testes of adult rats. Asian J Androl 2006;8:584-8.  Back to cited text no. 21
    
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Virmani R, Avolio AP, Mergner J. Effect of aging on aortic morphology in population with high and low prevalence of hypertension and atherosclerosis: Comparison between occidental and Chinese communities. Am J Pathol 1991;139:1119-29.  Back to cited text no. 22
    
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Lakatta EG. Central arterial aging and the epidemic of systolic hypertension and atherosclerosis. J Am Soc Hypertens 2007;1:302-40.  Back to cited text no. 23
    
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Gerhard M, Roddy MA, Creager SJ, Creager MA. Aging progressively impairs endothelium-dependent vasodilation in forearm resistance vessels of humans. Hypertension 1996;27:849-53.  Back to cited text no. 24
    
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Warner HR, Hodes RJ, Pocinki K. What does cell death have to do with aging? J Am Geriatr Soc 1997;45:1140-6.  Back to cited text no. 25
    
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Csiszar A, Ungvari Z, Koller A, Edwards JG, Kaley G. Aging-induced proinflammatory shift in cytokine expression profile in coronary arteries. FASEB J 2003;17:1183-5.  Back to cited text no. 26
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
 
 
    Tables

  [Table 1]



 

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