Formaldehyde Poisoning

Disease Overview

Formaldehyde Poisoning is a disorder brought about by breathing the fumes of formaldehyde. This can occur while working directly with formaldehyde, or using equipment cleaned with formaldehyde. Major symptoms may include eye, nose, and throat irritation; headaches; and/or skin rashes.

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Synonyms

Formaldehyde Exposure
Formaldehyde Toxicity
Formalin Intoxication
Formalin Toxicity

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Signs & Symptoms

Symptoms of Formaldehyde Poisoning are varied. There may be eye irritation, breathing problems, skin irritations and headaches. If formaldehyde is swallowed it causes burns to the esophagus and stomach. Poisoning of patients using dialysis machines cleaned with formaldehyde can cause loss of red blood cells (acute hemolysis). In extreme cases Formaldehyde Poisoning may include low blood pressure (hypotension), abnormalities of heart rhythm, irregular breathing, restlessness, unconsciousness and coma.

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Causes

Formaldehyde Poisoning may be caused in a variety of ways. Some people are affected when they work with products made with formaldehyde such as chip board and foam insulation. Persons may be poisoned by accidentally ingesting or swallowing formaldehyde. Breathing the vapors given off by the chemical itself in plants that manufacture it, or by working in areas where formaldehyde is used to produce other products can also cause dangerous physical reactions to the chemical. Poisoning may also occur when the chemical is being administered directly to a patient as formalin soaked packs for cysts. A form of formaldehyde (Formalin) is sometimes used as a cleaning agent for dialysis machines and other hospital equipment, and it must be carefully and completely removed before the equipment can be used on patients in order to avoid Formaldehyde Poisoning.

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Affected populations

Formaldehyde Poisoning affects males and females in equal numbers. People exposed in the workplace are most likely to be affected if they are not protected by appropriate air filtering equipment.

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Disorders with Similar Symptoms

Symptoms of the following disorders can be similar to those of Formaldehyde Poisoning. Comparisons may be useful for a differential diagnosis:

Heavy Metal Poisoning is caused by an overexposure to several types of metals. This may occur from industrial exposure, from air or water pollution, or from foods, medicines or improperly coated food containers. Symptoms of metal poisoning vary according to which type of metal overexposure is involved. (For more information on this disorder, choose “Heavy Metal” as your search term in the Rare Disease Database.)

Berylliosis is a metal poisoning or allergic disorder caused by exposure to beryllium dust or fumes. It primarily affects the lungs and coughing can become violent and exhausting. Breathing becomes difficult and blood may appear in sputum. The skin may be affected by the appearance of reddened, raised patches. There may be discolored spots on the face, neck, arms, and hands. Lymph nodes near affected skin may become enlarged. (For more information on this disorder, choose “Berylliosis” as your search term in the Rare Disease Database.)

Arsenic Poisoning can occur during the use and manufacture of pesticides. The gas from arsenic also has some industrial uses and can also cause airborne poisoning. Overexposure may cause headache, drowsiness, confusion, delirium, seizures and sometimes death. In cases of chronic arsenic poisoning, weakness, muscle aches, chills and fever may develop. (For more information on this disorder, choose “Heavy Metal” as your search term in the Rare Disease Database.)

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Standard Therapies

Prevention

Strict control and protective measures must be employed in the workplace to minimize formaldehyde exposure to the lowest possible limits. Employees should follow all workplace and safety guidelines and take any additional, appropriate steps to reduce their exposure. For example, workers who are exposed to formaldehyde must use personal protective equipment as required, such as appropriate face and eye protection, protective aprons and gloves, etc.

Treatment

For affected individuals, there is no specific medication that may oppose the action of the formaldehyde (antidote). The treatment of individuals affected by Formaldehyde Poisoning consists of appropriate symptomatic and supportive measures. Those who have experienced severe formaldehyde exposure must undergo close medical monitoring as required. With prompt, appropriate treatment, most affected individuals experience a full recovery.

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Clinical Trials and Studies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com

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References

TEXTBOOKS

Harrison’s Principles of Internal Medicine, 14th Ed.: Anthony S. Fauci et al., Eds.: McGraw-Hill Companies, Inc., 1998. P. 1435.

JOURNAL ARTICLES

Acute Intravascular Hemolysis due to Accidental Formalin Intoxication During Hemodialysis. K.K. Pun et al.; Clin Nephrol (March 1984; 21(3)). Pp. 188-90.

Formaldehyde-Induced Corrosive Gastric Cicatrization: Case Report. R. Kochhar et al.; Hum Toxicol (Dec 1986; 5 (6)). Pp. 381-82.

Occupational Exposures to Formaldehyde in Dialysis Units. MMWR Morb Mortal Wkly Rep (Jun 20 1986; 35(24)). Pp. 399-401.

Formaldehyde-Related Health Complaints of Residents Living in Mobile and Conventional Homes. I.M. Ritchie et al.; Am J Public Health (March 1987; 77(3)). Pp. 323-28.

Formaldehyde in the Occupational Environment. A Possible Cause of Chemically Induced Reactive Arthritis. D. Tilsted et al.; Ugeskr Laeger (Aug 5 1996; 158(32)). Pp. 4525-27.

Chemical Hazards in Health Care Workers. V.M. Weaver; Occup Med (Oct-Dec 1997; 12(4)). Pp. 655-67.

Micronuclei in Nasal Mucosa, Oral Mucosa and Lymphocytes in Students Exposed to Formaldehyde Vapor in Anatomy Class. C.J. Ying et al.; Biomed Environ Sci (Dec 1997; 10(4)). Pp. 451-55.

DNA-Protein Crosslinks and Sister Chromatid Exchanges as Biomarkers of Exposure to Formaldehyde. J. Shaham et al.; Int J Occup Environ Health (Apr 1997; 3(2)). Pp. 95-104.

American and White Formaldehyde Industry Workers. L.W. Figgs et al.; Am J Ind Med (Jul 1998; 34(1)). Pp. 57-64.

Contact Allergies in Healthcare Workers. Results From the IVDK. A. Schnuch et al.; Acta Derm Venereol (Sep 1998; 78(5)). Pp. 358-63.

Target Levels-Tools for Prevention. R.I. Niemela et al.; Risk Anal (Dec 1998; 18(6)). Pp. 679-88.

Occupational Allergy to Aldehydes in Health Care Workers. Clinical Observations. Experiments. M. Kiec-Swierczynska et al.; Int J Occup Med Environ Health (1998; 11(4)). Pp. 349-58.

The Role of Formaldehyde in the Occurrence of Contact Allergy. B. Krecisz et al.; Med Pr (1998; 49(6)). Pp. 609-14.

Assessment of Total Exposure to Phenol-Formaldehyde Resin Glue in Plywood Manufacturing. M. Makinen et al.; Int Arch Occup Environ Health (Aug 1999; 72(5)). Pp. 309-14.

Paraformaldehyde Sterilant Use in Vocational High School Program. R. Olcerst; Appl Occup Environ Hyg (Jun 1999; 14(6)). Pp. 391-96.

Chemical Hazards Faced by Animal Handlers. W.J. Meggs; Occup Med (Apr-Jun 1999; 14(2)). Pp. 213-24.

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Programs & Resources

RareCare^® Assistance Programs

NORD strives to open new assistance programs as funding allows. If we don’t have a program for you now, please continue to check back with us.

Additional Assistance Programs

MedicAlert Assistance Program

NORD and MedicAlert Foundation have teamed up on a new program to provide protection to rare disease patients in emergency situations.

Learn more https://rarediseases.org/patient-assistance-programs/medicalert-assistance-program/

Rare Disease Educational Support Program

Ensuring that patients and caregivers are armed with the tools they need to live their best lives while managing their rare condition is a vital part of NORD’s mission.

Learn more https://rarediseases.org/patient-assistance-programs/rare-disease-educational-support/