ASSESSMENT OF SOME HAEMATOLOGICAL PARAMETERS OF MORTUARY WO - PowerPoint Presentation

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ASSESSMENT OF SOME HAEMATOLOGICAL PARAMETERS OF MORTUARY WORKERS EXPOSED TO EMBALMENT CHEMICALS IN SOME MORTUARIES IN ANAMBRA STATE – NIGERIA.   ODIEGWU C.N.C, UDE R.C, OKEY – ONYESOLU C.F, ODIEGWU U.O, ONWURAH WINIFRED OA PRESENTATION AT THE 5TH WORLD HAEMATOLOGIST CONGRESAugust 18-19, 2016 London, UK . Slide2

INTROUCTIONEmbalming process involves the use of varieties of chemical agents to preserve a dead body. Out of all the chemicals used as embalming fluid, phenol and formaldehyde have been found to have the most important exposure concern in embalming (Bedino, 2005).Formaldehyde is the most frequently used chemical in modern embalming. The carcinogenicity, reprotoxicity, genotoxicity and haematoxicity of formaldehyde in humans and animal models have been reported (IARC, 2005). Slide3

INTROUCTION (CONTD)According to the Occupational Safety and Hazard Administration (OSHA), the permissible exposure limit of formaldehyde is 0.75 parts per million (ppm) averaged over an 8 hour work shift (OSHA, 1992).During embalming process the level of formaldehyde can be up to 4 parts per million which by far exceeds the permissible exposure limit (NICMAS, 2006).The odour threshold of formaldehyde for embalmers and formaldehyde workers is greater or equal to 1.0 ppm, but is less for non-formaldehyde users (DOT, 1993). Slide4

INTROUCTION (CONTD)The above information indicates that embalmers are at high risk of harmful effects of formaldehyde.In developing countries like Nigeria mortuary workers have poor attitude towards the use of personal protective equipments, and proper ventilation of embalming rooms which in turn exposes them to harmful effects of formaldehyde. Slide5

METHODOLOGYSTUDY AREAAnambra State located in the South Eastern part of NigeriaSTUDY POPULATIONEighty (80) mortuary workers exposed to embalming fluid (formaldehyde)Twenty (20) non mortuary and non formaldehyde usersETHICAL APPROVAL AND INFORMED CONSENTNnamdi Azikiwe University Teaching Hospital ethics committeeInformed consent from each participant before recruitmentSlide6

METHODOLOGY (CONTD)INCLUSION CRITERIAApparently healthy mortuary workers exposed to embalming fluid (formaldehyde) for more than one yearEXCLUSION CRITERIAFemale workersSubjects exposed for less than one yearSubjects that had a major ill-health in the previous three months.Slide7

METHODOLOGY (CONTD)SAMPLE COLLECTIONThree millilitres of blood was collected and placed into EDTA container for blood count estimation and blood film examination. METHODS OF ANALYSISComplete blood count by automated haematology analyserBlood film examination by thin film using leishmann staining methodSTATISTICAL ANALYSIS Statistical package for Social Sciences (SPSS) version 20Data was expressed as Mean ± SDANOVA , spearman’s correlation and t -test was used

P<0.05 was considered statistically significantSlide8

RESULTSSlide9

Control group N=20Mean ± SD

Mortuary workers N=80

Mean ± SD

Age (years)

31.03 ± 7.80

36.31 ± 12.19

TWBC (x10

9

/L)

5.14 ± 0.99

4

.47

± 1.33

RBC (X10

12

/L)

5.11 ± 0.42

5.04

± 0.40

HB (g/dl)

13.80 ± 1.14

14.57 ± 3.19

HCT (%)

40.75 ± 3.11

42.34 ±5.01

MCV (fl)

79.83 ± 3.70

82.07 ± 8.15

MCH (pg)

27.54 ± 3.51

32.18 ± 33.82MCHC (g/l)33.83 ± 1.4034.49 ± 2.05PLT (x109/L)199 ± 55.05205.8 ± 58.7LYMPH (%)49.38 ± 9.1344.75 ± 8.94MXD (%)16.25 ± 14.7614.9 ± 6.80NEUT (%)38.02 ± 8.9337.40 ± 11.21

Table showing the mean and standard deviation of the age and haematological parameters of mortuary workers and the control subjects.Slide10

Chart showinig the variation in the mean values of some haematological parameters of the control subjects and the mortuary workers grouped according to the duration of exposure to embalming chemicals.Slide11
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DISCUSSIONThe haemototoxicity of formaldehyde which is the most frequently used chemical for embalming have been reported. The result of the study showed a significant negative correlation between total white blood cell count.The years of exposure showed significant variation in lymphocytes among the exposed individuals. This indicates that the exposure to the embalming chemicals can cause alterations in haematopietic functions. These findings can be attributed to the poor use of personal protective equipment among the workers which was observed in the course of the research. Slide13

RECOMMENDATIONSEmbalmers should pay particular attention to the type of personal protective equipment (PPE) used during embalmingEnsure that a ventilation system (e.g. local exhaust ventilation) is in place and is effective at maintaining exposure levels below the occupational exposure standard.Respirators with organic vapor cartridges should be used in situations where formaldehyde levels above the national occupational exposure standard may be encountered and where other measures (such as ventilation) alone are insufficient to control the level of exposure.Slide14

REFERENCES Bedino J. (2005). Phenol versus formaldehyde as an exposure harzard in embalming: myths and reality. Champion Expanding Encyclopedia of Mortuary Practices. The champion company, Springfield : OH USA.International Agency for Research on Cancer (2005). Monographs on the evaluation of carcinogenic risks to humans, Wood dust and formaldehyde. volume 62.Occupational Safety and Health Administration (1992). Recommendation for occupational safety and health, compendium of policy documents and statements. Cicinnaati, OH US Department of Health Service Center for Disease Control, National Institute of Occupational Safety and Health Publication No. 92-100. National Industrial Chemicals Notification and Assessment Scheme, (2006). Priority existing chemical assessment. Formaldehyde, Sydney: National Industrial Chemicals Notification and Assessment Scheme. Report No. 28Department of Transport, (1993). Emergency Response Quick Guide 55, Washington DC : US Department of Transportation Research and Special Programs Administration.