Effective mitigation strategies for reducing workers’ exposure to formaldehyde. A systematic review

Formaldehyde is a toxic and carcinogenic compound, still used in several occupational settings due to its properties. Thus, in these working scenarios, it is necessary to provide effective measures to reduce workers’ exposure to formaldehyde. The aim of this systematic review is to provide a picture of the worldwide mitigation strategies implemented in occupational environments for minimizing the exposure to formaldehyde and which ones are the most effective for this purpose. The systematic review was performed according to PRISMA statement; the protocol was registered in PROSPERO (CRD42022302207). The search was performed on three electronic databases (PubMed, Scopus, and Web of Science). Studies were considered eligible if they describe strategies for mitigating formaldehyde occupational exposure and their efficacy. We included articles reporting observational studies, semi-experimental, and experimental studies and published in the English language, from the inception to March 26th, 2023. The quality assessment was performed using the Newcastle–Ottawa Quality Assessment Scale. In total, 28 articles were included in the review. The employment scenarios/activities studied were human and veterinary anatomy, autopsy, histopathology or pathology laboratories, embalming procedures, hospital, operating theaters, aquaculture, textile or foundry industries, industry using 3-D printers, offices, and firefighters’ activities. Different methods have proven useful in mitigating formaldehyde exposure, such as the use of personal protective equipment, engineering control methods, organization methods, and technical strategies, with a reduction of airborne formaldehyde until to 99.6%. The highest reduction was obtained in an anatomy laboratory through locally exhausted dissection tables equipped with activated carbon filters. The specific suitable procedures should be standardized and applied in all work settings for an appropriate risk management, in order to protect the health of exposed workers.