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Occupational exposure to formalin increases the risk of blood cancer

It has already been designated as a proven carcinogen since 2004, due to its role in nasopharyngeal cancer.

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Occupational exposure to formalin increases the risk of blood cancer

It has already been designated as a proven carcinogen since 2004, due to its role in nasopharyngeal cancer. Occupational exposure to formaldehyde - also called "formaldehyde" - is now officially recognized as a risk factor for myeloid leukemia, a specific type of blood cancer. In any case, this is what concludes a report from ANSES (National Agency for Food, Environmental and Occupational Health Safety) published on Tuesday. The health authority has positioned itself in favor of recognizing myeloid leukemia as an occupational disease. This pathology is manifested by an excessive production of immature or abnormal white blood cells within the bone marrow, and in mirror image, a decrease in normal blood cells. With around 900 new cases per year, this type of cancer remains rare.

Several causes of myeloid leukemia were already known: ionizing radiation, benzene, certain chemotherapies, tobacco or even certain genetic anomalies (down syndrome, Fanconi disease, etc.). The causal role of formaldehyde was raised in 1982 by the International Agency for Research on Cancer, which then classified it as a “probable carcinogen”, before placing it in the “carcinogenic” category in 2006. This decision followed the results of several studies highlighting an increased incidence of nasopharyngeal cancers in people highly exposed to formaldehyde.

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But if this substance was already deemed carcinogenic by various international organizations, its involvement in increasing the risk of leukemia was still debated. In 2021, several ministries (Health, Labor) then requested the health expertise agency, ANSES, to guide their decision whether or not to recognize myeloid leukemia linked to occupational exposure to formaldehyde as an occupational disease. Decision which would then give the workers concerned the right to compensation. After analyzing the available data, the Agency finally concluded that “a proven causal relationship between occupational exposure to formaldehyde and myeloid leukemia”. It clearly opens the way to the recognition as an occupational disease of myeloid leukemia developed in contact with formaldehyde.

Some did not wait for this decision. Indeed, 8 requests for compensation were listed between 2011-2021 in France. Three of them obtained a favorable opinion (a farmer, a manufacturing worker and a skilled worker working in wood). Which remains very little. “Over the last ten years, few requests for recognition of occupational disease have been made concerning myeloid leukemia,” notes ANSES. A trend which could be explained by a “very uneven knowledge” of professional risks by hematologists, as well as by the “complexity of medico-administrative procedures for victims” or even “the difficulty of tracing professional exposure to formaldehyde”, particularly for certain professionals such as those in cleaning.

Formaldehyde is a substance which has multiple uses: it serves as a disinfectant, a preservative (preventing the development of micro-organisms), an agent to combat certain pests (insects)... But above all, it is very widely used. used for the synthesis of resins and thermoplastics. We therefore find many sectors of activity. “For example, as a disinfectant in hospitals and in agriculture, as a preservative, particularly in embalming and in many products such as detergents, paints, human or veterinary medicines, as a fixative in human pathological anatomy and cytology », Lists ANSES in its report. Formaldehyde is also found in certain products or resins used in the wood, text and rubber industries. In addition to its carcinogenic nature, this substance is irritating to the skin and eyes, and even caustic in high concentrations. It can cause skin allergies (contact eczema, hives) and respiratory allergies (allergic rhinitis, asthma).

In France, since 2007, employers have been required to replace formaldehyde as soon as technically possible. Otherwise, they must implement all possible means of protection (closed system, ventilation, personal protective equipment, staff information, etc.). An exposure limit value has also been established. As a result of these beneficial regulatory developments, the proportion of exposed workers has decreased. But “some sectors still have high levels of exposure, such as manufacturing [of certain] furniture and related furnishing industries, carpentry work, funeral services, manufacturing of wood veneer and paneling, etc. .”, specifies ANSES.

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