RESUMEN
The presence of formaldehyde at workplace remains significant. Exposure to it results in local irritation of the eye, nose and upper respiratory tract mucous membranes, and it has been chronically related to a higher risk of cancer development at the paranasal sinuses, naso-oropharynx and lungs. The aim of our work has been the updating of the bibliography and the categorization of the most up to date scientific evidence of formaldehyde effects on human body. Bibliographic search on the electronic database Medline / PubMed, restricted to the last 10 years through a combination of free and controlled language.Review of 185 scientific articles, finally including 54 due to duplicity, language, and inclusion criteria. We find among the main results a major evidence regarding genotoxicity; limited, inconsistent, and contradictory evidence regarding various neoplastic pathologies; and lack of evidence regarding bronchial asthma. Further studies have to be carried out, especially longitudinal studies and greater epidemiological power, to generate new knowledge about the behavior of this toxic.
La presencia del formaldehido en el ámbito laboral sigue siendo importante. La exposición produce irritación local de mucosas oculares, nasales y del tracto respiratorio superior, y crónicamente se ha asociado con mayor riesgo de desarrollar cáncer a nivel de senos paranasales, naso-orofaringe y pulmón. Esta revisión tiene por objetivo actualizar la bibliografía y categorizar la evidencia científica más actualizada de los efectos que el formaldehido produce sobre el organismo humano. Búsqueda bibliográfica en la base de datos electrónica Medline/PubMed, limitada a los últimos 10 años mediante combinación de lenguaje libre y controlado. Se revisaron 185 artículos con inclusión final de 54 tras descartar por duplicidad, idioma y criterios de inclusión. Se observa un elevado grado de evidencia respecto a la genotoxicidad, evidencia contradictoria, inconsistente o limitada respecto a patologías neoplásicas de origen hematopoyético, laringe, naso-sinusales o de pulmón y falta de evidencia sobre la relación con el asma bronquial. Es preciso efectuar nuevos estudios, especialmente con carácter longitudinal y mayor potencia epidemiológica, para generar nuevo conocimiento sobre el comportamiento de este tóxico.
RESUMEN
BACKGROUND: The effects of long-term occupational exposure to small concentrations of volatile anaesthetics on health professionals are still uncertain despite the research literature available on this subject. AIMS: To analyse the existing literature on the health effects of volatile anaesthetics on exposed health professionals. METHODS: We performed a systematic review from March 2013 to January 2014. The literature was searched in the Medline and Cochrane libraries using the following keywords: 'Anaesthetics AND occupational health', 'Volatile anaesthetics AND occupational health', 'Sevoflurane AND occupational health' and 'Occupational surveillance AND anaesthetics', with no time limit. We used the Scottish Intercollegiate Guidelines Network to evaluate the quality of studies and to grade the recommendations. RESULTS: From 1429 articles retrieved from the databases and an additional 20 obtained from secondary sources, we excluded 1391 (95.9%). After excluding duplicate publications, we finally included 17 articles in the review. CONCLUSIONS: Evidence for adverse effects of volatile anaesthetics on exposed personnel is scarce and inconsistent, but there is no evidence of adverse effects when environmental levels are kept within legal threshold values. Further studies are needed to improve our knowledge of the effects of occupational exposure to volatile anaesthetics. New surveillance methods that include systematic data collection, clinical signs and biomarkers of exposure are required to formulate consistent and reproducible surveillance criteria for exposed personnel.
