Acute formalin exposure is a nightmare for both the OR staff who are exposed as well as the facility at which they work. When these emergencies occur, it’s no joke. The hazard is so great that local media even reports on these incidents.
For example, in February, WQAD-TV reported on a formalin spill in the surgery department at Southeast Iowa Regional Medical Center in West Burlington that caused a hazmat team to respond. “One employee was treated; no patients were exposed,” stated the ABC affiliate, which reported that the West Burlington Fire Department was contacted to “assist with cleanup and mitigation efforts.” The staff member who suffered formalin exposure “was immediately treated in the emergency department,” reported WQAD. Hospital owner Great River Health lauded the support and response from the fire department, the West Burlington Police Department, and the Des Moines County Local Emergency Planning Committee.
When an acute case of formalin exposure occurs at your facility, what needs to be done to help the victim? According to the U.S. Occupational Safety and Health Administration (OSHA):
- If the solution is ingested and the victim is conscious, “dilute, inactivate, or absorb the ingested formaldehyde by giving milk, activated charcoal, or water. Any organic material will inactivate formaldehyde. Keep affected person warm and at rest. Get medical attention immediately. If vomiting occurs, keep head lower than hips.”
- If the solution’s fumes are inhaled, “remove the victim from the exposure area to fresh air immediately. Where the formaldehyde concentration may be very high, each rescuer must put on a self-contained breathing apparatus before attempting to remove the victim, and medical personnel should be informed of the formaldehyde exposure immediately. If breathing has stopped, give artificial respiration. Keep the affected person warm and at rest. Qualified first-aid or medical personnel should administer oxygen, if available, and maintain the patient's airways and blood pressure until the victim can be transported to a medical facility. If exposure results in a highly irritated upper respiratory tract and coughing continues for more than 10 minutes, the worker should be hospitalized for observation and treatment.”
- If there is skin contact with the solution, “remove contaminated clothing (including shoes) immediately. Wash the affected area…with soap or mild detergent and large amounts of water until no evidence of the chemical remains (at least 15 to 20 minutes). If there are chemical burns, get first aid to cover the area with sterile, dry dressing, and bandages.” The victim, OSHA adds, should access medical attention if they experience “appreciable eye or respiratory irritation.”
- If the solution gets into the staff member’s eyes, “wash the eyes immediately with large amounts of water occasionally lifting lower and upper lids, until no evidence of chemical remains (at least 15 to 20 minutes). In case of burns, apply sterile bandages loosely without medication.” OSHA advises victims to “get medical attention immediately,” and if they experience “appreciable eye irritation from a splash or excessive exposure,” they should be “referred promptly to an ophthalmologist for evaluation.”
Of course, an automated formalin dispensing system will almost entirely remove the risk of staff exposure to formalin via spills or inhalation of its fumes. For example, Sandra Sherry, MA, BSN, RN, CNOR, director of perioperative services at Chesapeake (Va.) Regional Healthcare, noted “months of formalin spills in our OR” came to an end after her facility purchased an automated dispensing system. Now, she says, there are “no more spills, breathing dangerous fumes, and skin exposures. Wouldn’t go back!”
