Viegas et al.

Journal of Occupational Medicine and Toxicology 2010, 5:25

http://www.occup-med.com/content/5/1/25

RESEARCH Open Access

Genotoxic effects in occupational exposure to

formaldehyde: A study in anatomy and pathology
laboratories and formaldehyde-resins production
Susana Viegas1,3*, Carina Ladeira2,3, Carla Nunes3, Joana Malta-Vacas4, Mário Gomes5, Miguel Brito4,
Paula Mendonça2, João Prista6

Abstract
Background: According to the Report on Carcinogens, formaldehyde ranks 25th in the overall U.S. chemical
production, with more than 5 million tons produced each year. Given its economic importance and widespread
use, many people are exposed to formaldehyde environmentally and/or occupationally. Presently, the International
Agency for Research on Cancer classifies formaldehyde as carcinogenic to humans (Group 1), based on sufficient
evidence in humans and in experimental animals. Manyfold in vitro studies clearly indicated that formaldehyde can
induce genotoxic effects in proliferating cultured mammalian cells. Furthermore, some in vivo studies have found
changes in epithelial cells and in peripheral blood lymphocytes related to formaldehyde exposure.
Methods: A study was carried out in Portugal, using 80 workers occupationally exposed to formaldehyde vapours:
30 workers from formaldehyde and formaldehyde-based resins production factory and 50 from 10 pathology and
anatomy laboratories. A control group of 85 non-exposed subjects was considered. Exposure assessment was
performed by applying simultaneously two techniques of air monitoring: NIOSH Method 2541 and Photo Ionization
Detection equipment with simultaneously video recording. Evaluation of genotoxic effects was performed by
application of micronucleus test in exfoliated epithelial cells from buccal mucosa and peripheral blood
lymphocytes.
Results: Time-weighted average concentrations not exceeded the reference value (0.75 ppm) in the two
occupational settings studied. Ceiling concentrations, on the other hand, were higher than reference value (0.3
ppm) in both. The frequency of micronucleus in peripheral blood lymphocytes and in epithelial cells was
significantly higher in both exposed groups than in the control group (p < 0.001). Moreover, the frequency of
micronucleus in peripheral blood lymphocytes was significantly higher in the laboratories group than in the factory
workers (p < 0.05). A moderate positive correlation was found between duration of occupational exposure to
formaldehyde (years of exposure) and micronucleus frequency in peripheral blood lymphocytes (r = 0.401;
p < 0.001) and in epithelial cells (r = 0.209; p < 0.01).
Conclusions: The population studied is exposed to high peak concentrations of formaldehyde with a long-term
exposure. These two aspects, cumulatively, can be the cause of the observed genotoxic endpoint effects. The
association of these cytogenetic effects with formaldehyde exposure gives important information to risk
assessment process and may also be used to assess health risks for exposed workers.

* Correspondence: susana.viegas@estesl.ipl.pt
1
Environmental Health Department. Escola Superior de Tecnologia da Saúde
de Lisboa - Instituto Politécnico de Lisboa. Lisbon, Portugal
Full list of author information is available at the end of the article

© 2010 Viegas et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
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Background Frequency of micronucleus (MN) in buccal and/or

Formaldehyde (CH2O), the most simple and reactive of nasal mucosa cells is being used to investigate local gen-
all aldehydes, is a colorless, reactive and readily poly- otoxicity. According to reports concerning experimental
merizing gas at room temperature [1]. It has a pungent genotoxicity studies, MN are the most sensitive genetic
suffocating odor that is recognized by most human sub- endpoints for detection of FA induced genotoxicity [15].
jects at concentrations below 1 ppm [2]. Thus, MN test with exfoliated cells could be a powerful
According to the Report on Carcinogens, formalde- tool for detection of local genotoxic effects in humans,
hyde (FA) ranks 25th in the overall U.S. chemical pro- which is fundamental for hazard identification and risk
duction, with more than 5 million tons produced each estimation [13].
year [3]. FA annual production rises up to 21 million MN in peripheral blood lymphocytes has been exten-
tons worldwide and it has increased in China, for exam- sively used to evaluate the presence and extend of chro-
ple, in the recent years, with 7,5 million tons produced mosome damage in human populations exposed to
in 2007. Given its economic importance and widespread genotoxic agents. As advantages, this MN test provides
use, many people are exposed to FA environmentally a reliable measure of chromosomal breakage and loss at
and/or occupationally [4]. According to the Inter- lower cost and more easily than chromosomal aberra-
national Information System on Occupational Exposure tions. Moreover, the availability of cytokinesis-block
to Carcinogens (CAREX), in the period between 1990 technique eliminates potential background caused by
and 1993, 36,000 workers were occupationally exposed effects on cell division kinetics [16].
to FA in Portugal [5]. The goal of this study is to contribute to the investiga-
Occupational exposure involves not only workers in tion of genotoxic effects in workers occupationally
direct production of FA and products containing it, but exposed to FA.
also in industries utilizing these products, such as those
related with construction and household [1]. The most Methods
extensive use of FA is in production of resins with urea, Subjects
phenol and melamine, and also polyacetal resins. These This study was carried out in Portugal, in 80 workers
products are used as adhesives in manufacture of parti- occupationally exposed to FA vapors: 30 workers from
cle-board, plywood, furniture and other wood products FA and FA-based resins production factory and 50 from
[2]. FA is also used in cosmetics composition and has 10 pathology and anatomy laboratories. A control group
an important application as a disinfectant and preserva- of 85 non-exposed subjects was considered. All subjects
tive, reason why relevant workplace exposure may also were provided with the protocol and with the consent
occur in pathology and anatomy laboratories and in form, which they read and signed.
mortuaries [1,2,6]. Health conditions, medical history, medication and
Human studies have shown that chronic exposure to lifestyle factors for all studied individuals, as well as
FA by inhalation is associated with eye, nose and throat information related to working practices (such as years
irritation [7]. Mostly important, several studies report a of employment) were obtained through a standard
carcinogenic effect in humans after chronic exposure to questionnaire.
FA, in particular an increased risk for nasopharyngeal
cancer [8-12]. Since 2006, International Agency for Environmental Monitoring of FA exposure
Research on Cancer (IARC) classifies FA as carcinogenic Exposure assessment was performed by applying simul-
to humans (Group 1), based on sufficient evidence in taneously two different methods.
humans and in experimental animals [2]. IARC also In one of the methods, environmental samples were
concluded that there is a “strong but not sufficient evi- obtained by personal air sampling with low flow pumps
dence for a causal association between leukemia and during a typical working day. Sampling time was 6 to 8
occupational exposure to formaldehyde”. hours. FA levels were measured by Gas Chromatography
With actual scientific evidence we can conclude that, (GC) analysis and time-weighted average (TWA8 h) esti-
regarding to risk estimation, local toxic effects at site of mated according to the National Institute of Occupa-
first contact seem to be the most relevant health effects tional Safety and Health method (NIOSH 2541) [17].
[2,7,13]. The other method was aimed to measure ceiling
Manifold in vitro studies clearly indicated that FA can values of FA using Photo Ionization Detection (PID)
induce genotoxic effects in proliferating cultured mam- equipment (11.7 eV lamps) with simultaneously video
malian cells [2]. Furthermore, some in vivo studies recording. Measures were performed in each task and
detected changes in epithelial cells (oral and nasal) and in instantaneous values for concentration were obtained on
peripheral lymphocytes related to FA exposure [13,14]. a per second basis. This method permits to establish a
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relation between worker activities and ceiling values and according with their probability distributions). Statistical
allows also determining the major emission sources [18]. analysis was performed with SPSS for Windows statisti-
cal package, version 17.0, and significance level was
Micronucleus Test defined as 5%, for all inference studies.
Evaluation of genotoxic effects was performed by appli-
cation of MN test in exfoliated cells from buccal mucosa Results
and peripheral blood lymphocytes. Heparinized venous Characteristics of the studied population
blood and exfoliated cells (buccal mucosa cells) were The characterization of the population studied is sum-
collected between 10 a.m. and 12 p.m., from each sub- marized in Table 1. Controls and exposed workers did
ject, and were processed for each test. All samples were not differ significantly in age and in smoking habits.
coded and analyzed under blind conditions. The criter- Only for gender distribution a significant difference was
ion of scoring the MN in lymphocytes is described in found between the two groups (p = 0.002), due to the
“The Human Micronucleus Project” and the buccal cells larger number of women in the control group.
is described by Tolbert et al. [19,20]. None of the individuals presented relevant information
about health conditions, medical history, medication and
Buccal mucosa micronucleus test lifestyle factors that could influence the results of MN
Endobrush was used to collect cells from the buccal test.
mucosa. Exfoliated cells were smeared onto the slides
and fixed with Mercofix®. The standard protocol used FA exposure levels
was Feulgen staining technique without counterstain. FA exposure levels obtained by two methods (NIOSH
Two thousand cells were scored from each individual by 2541 for average concentrations - TWA8 h and Photo
four independent observers. Only cells containing intact Ionization Detection method for ceiling concentrations -
nuclei that were not clumped or overlapped were C) are shown in Table 2.
included in the analysis. Time-weighted average concentrations (TWA8 h) have
not exceeded the Occupational Safety and Health
Peripheral Lymphocyte micronucleus test Administration (OSHA) reference value (0.75 ppm). On
From each subject a blood specimen (10 mL) was col- the other hand, ceiling concentrations were higher than
lected using heparin as anticoagulant. The samples were American Conference of Industrial Hygienists (ACGIH)
kept refrigerated and processed within 6 hours of the reference value (0.3 ppm) in both occupational settings.
blood collection. Lymphocytes were isolated using Mean FA ceiling levels are higher in pathology and
Ficoll-Paque gradient and placed in RPMI 1640 culture anatomy laboratories than in resins factory. In this set-
medium with L-glutamine and phenol red added with ting, 83 tasks were studied and highest exposure level
10% inactivated fetal calf serum, 50 μg/mL streptomycin was observed during macroscopic examination of FA-
+ 50 U/mL penicillin and 10 μg/mL phytohaemaggluti- preserved specimens. Moreover, 93% of studied tasks
nin. Duplicate cultures from each subject were incu- obtained ceiling levels higher than reference value
bated at 37°C in a humidified 5% CO2 incubator for 44 (0.3 ppm). Pathologists were the professional group
hours. Cytochalasin-b 6 μg/mL was added to cultures.
After 28 hours of incubation, cells were spun onto
microscope slides using a cytocentrifuge. Smears were Table 1 Characterization of the studied population
air-dried and double stained with May-Grünwald- Control Group Exposed Group P value
Giemsa and mounted with Entellan®. Number of subjects 85 80
A total of 1000 binucleated cells with well-preserved Gender
cytoplasm were examined for each donor. The frequen- Male 31 (36.6%) 48 (60.0%) 0.002
cies of binucleated cells with MN were determined ana- Female 54 (63.5%) 32 (40.0%)
lyzing 1,000 binucleate lymphocytes from two slides for Age (years)
each subject. Range 20-55 19-56
Mean 33.87 35.74 0.180
Statistical Analysis
St. Deviation 8.262 9.470 0.024
Differences between groups (exposed workers and con-
Smoking status
trols) were analyzed with t-Student and Proportion
Non-smokers 59 (69.4%) 55 (68.8%) 0.927
tests, in order to evaluate if basic characteristics of these
Smokers 26 (30.6%) 25 (31.3%)
2 groups could be considered equivalent [20].
Years of exposure
Association between quantitative variables was tested
Range ———— 1 - 35
using correlation coefficient tests (Pearson or Spearman
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Table 2 FA exposure in the two occupational settings There was no significant difference in the frequency of
Factory Laboratories MN, both in epithelial cells and peripheral lymphocyte
Exposure duration (Years) tested for smoking habits (p = 0.31; p = 0.99) and for
Range 1 - 27 1 - 33 gender (p = 0.13; p = 0.47).
Mean 6.2 14.5 Age was found to have a weak positive correlation (r =
St. Deviation 6.74 9.12 0.194; p < 0.05) with MN frequency in peripheral blood
Working hours/day (h) 7 7 lymphocytes and a week negative correlation (r=-0.168;
p < 0.05) with MN frequency in epithelial cells. A mod-
Number of Samples (TWA measures) 2 29
erate positive correlation was found between duration of
FA exposure level (TWA8 h) (ppm)
occupational exposure to FA (years of exposure) and
Range 0.20 - 0.22 0.05 - 0.51
frequency of MN in peripheral blood lymphocytes
Mean 0.21 0.28
(r = 0.401; p < 0.05) and in epithelial cells (r = 0.209;
FA ceiling concentration (ppm)
p < 0.05) (Table 5).
Range 0.003 - 1.04 0.02 - 5.02
There was no significant difference (p > 0.05) in the
Mean 0.52 2.52
frequency of MN in both peripheral blood lymphocytes
and epithelial cells tested for smoking habits (p = 0.31;
exposed to the highest ceiling concentration values p = 0.99) and for gender (p = 0.13; p = 0.47).
(Table 3).
Exposure has been studied in normal conditions Discussion
of operation, namely with ventilation dispositives As indicated by several studies [6,21,22] exposure assess-
connected and workers not using protective masks. ment in present investigation identified that both groups
of workers (factory and laboratory) were exposed to
Micronucleus Test high peak FA concentrations.
The frequency of MN in occupationally exposed work- The importance of this consideration lies in the fact
ers was significantly higher than in the control group, that health effects (cancer) linked to FA exposure are
both in peripheral blood lymphocytes (p < 0.001) and in more related with peaks of high concentrations than
epithelial buccal cells (p < 0.001) (Table 4). with long time exposure at low levels [2,23]. The choice
When analyzing each occupational setting separately, of exposure metric should be based on the most biologi-
we found significant differences in MN frequencies in cally relevant exposure measure in order to diminish
peripheral blood lymphocytes (p < 0.001) and in epithe- misclassification of exposure, thus leading to attenuated
lial buccal cells (p < 0.005) between the laboratories and exposure-response relationships [24]. Moreover, expo-
control groups. Concerning the factory group, significant sures of short duration (peaks) are of special concern,
differences in MN frequencies were only detected in because they produce an elevated dose rate at target tis-
epithelial buccal cells (p < 0.001). sues and organs, potentially altering metabolism, over-
Finally, we compared MN frequencies between the loading protective and repair mechanisms and
two exposed groups and found that MN frequency in amplifying tissue responses [24,25].
peripheral blood lymphocytes was significantly higher in Considering this, Pyatt et al. (2008) pointed out, as a
the laboratories group (p < 0.005), but respecting to limitation in most epidemiological studies, the lack of
epithelial buccal cells there was no significant difference data about exposure to peak concentrations. Therefore,
between them (p = 0.108). in those studies, health effects resulting from

Table 3 FA Ceiling values (ppm) according to places of work, tasks and exposed workers
Places of work Tasks Ceiling Values (ppm) Exposed Workers
Factory Resins production Sample collect (Reactors) 1.09 Reactor operators
Factory Impregnation Machine operation 1.04 Impregnation machine operators
Factory Quality Laboratory Quality control 0.52 Quality Technicians
Pathology and anatomy laboratories Macroscopic examination 5.02 Pathologist
Pathology and anatomy laboratories Disposal of specimen and used solutions 0.95 Technicians and Assistants
Pathology and anatomy laboratories Jar filling 2.51 Assistants
Pathology and anatomy laboratories Specimen wash 2.28 Technicians
Pathology and anatomy laboratories Biopsy 1.91 Technicians
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Table 4 Frequency of MN in the studied population

Controls Exposed
Factory Pathology and anatomy laboratories Total
1
MN PBL
Mean ± Std. Dev 1.17 ± 1.95 1.76 ± 2.07 3.70 ± 3.86 2.97 ± 3.42
MN EBC2
Mean ± Std. Dev 0.13 ± 0.48 1.27 ± 1.55 0.64 ± 1.74 0.88 ± 1.69
1
peripheral blood lymphocytes (cytochalasin-B (binucleated) assay
2
epithelial buccal cells

occupational exposure to FA are associated to exposure method is of less utility to identify processes that should
exclusively based on time-weighted average concentra- be targeted for controls.
tions [23]. The only two studies concerning the associa- Results indicate macroscopic examination of anatomi-
tion between exposure to FA and nasopharyngeal cancer cal specimens FA-preserved as the task involving expo-
that presented data on exposure to ceiling concentra- sure to the highest values. This occurs because precision
tions obtained higher relative risk values compared with and good visibility is required and as a consequence
the other studies [1,12,26]. pathologists must lean over the specimen with conse-
Moreover, other groups also suggested ceiling concen- quent increase of proximity to FA emission sources.
trations as the most important exposure metric, when Studies developed by Goyer et al. and Orsière et al. sup-
attempting to define the relative risk of myeloid leukae- port that proximity to impregnated specimens promotes
mia in workers exposed to FA [1,27-29]. higher exposure to FA [6,22].
The present results obtained in the laboratories, evi- In factory, the task of collecting samples from resins
dence a difference between the two exposure metrics reactor present the higher exposure, because the reac-
(0.28 ppm for TWA8 h and 2.52 ppm for ceiling level). tors are consider the units with larger emissions [6,32].
These results are in good agreement with previous ones Furthermore, the sampling process is still manual in the
reported by Shaham et al. [30]. A difference of the same factory studied.
order of magnitude was described in 14 pathology It is important to notice that the information about
laboratories (0.4 ppm for TWA and 2.24 ppm for ceiling exposure determinants, emission sources and exposed
level). workers was only possible because video recording
Each one of these results would lead to different con- could be performed. This resource gives the opportunity
clusions about exposure assessment and, consequently, to directly relate performance with exposure [18,35,36].
to a different risk assessment and, though, claim our FA genotoxicity is confirmed in a variety of experi-
attention for the importance of exposure metric selec- mental systems ranging from bacteria to rodents in vivo
tion. For FA occupational exposure, ceiling concentra- [37]. Although the findings from in vivo animal studies
tions might be a better strategy to evaluate exposure may provide a basis for extrapolation to humans, cyto-
and to develop risk assessment once very high exposures genetic assays in humans have been conflicting, some-
over short periods are missed by TWA8 h method and, times with contradictory outcomes [38]. Nevertheless,
in fact, they are important to know the real risk for our results showed a significant increase in MN fre-
health [23,31]. Therefore, as in other investigations quency in epithelial cells and in lymphocytes of exposed
[33,34], it is possible to conclude that when measuring individuals compared with controls.
only TWA 8 h poor information is obtained, and the Biological evidence of toxicity on distant-site such as
peripheral lymphocytes and bone marrow is still contro-
versial [2,39]. Some authors have argued that it is biolo-
Table 5 Correlation analysis between genotoxic gically implausible for FA to cause leukaemia as FA is
endpoints and age and years of exposure (Spearman’s unlikely to reach the bone marrow and cause toxicity.
test) Due to its highly reactive nature and rapid metabolism,
Genotoxic endpoints Age Years of Exposure there is no evidence that it can damage stem and pro-
r = 0.194 r = 0.401 genitor cells (the target cells for leukemogenesis). Also,
MN PBL1 p = 0.013 p = 0.0 there is no credible experimental animal model for FA-
r = - 0.168 r = 0.209 induced leukaemia [40,41]. However, Zhang et al.
MN EBC2 p = 0.031 p = 0.008 hypothesize that FA may act on bone marrow directly
1
peripheral blood lymphocytes (cytochalasin-B (binucleated) assay) or, alternatively, may cause leukaemia by damaging the
2
epithelial buccal cells hematopoietic stem or early progenitor cells that are
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located in the circulating blood or nasal passages, which since FA is present in tobacco smoke [2]. The effect of
would then travel to bone marrow and become leukemic tobacco smoking on MN frequency in human cells has
stem cells [1,29]. Nevertheless, our findings are consis- been object of study. In most reports the results were
tent with other previous studies on epithelial cells and unexpected, as in many instance smokers had lower fre-
also on peripheral lymphocytes [42-44]. Suruda et al. quencies of MN than non-smokers [22,48]. In the pre-
reported that low-level exposure to FA was associated sent study no significant differences were found in MN
with cytogenetic changes in buccal epithelial cells and in (peripheral blood lymphocytes and epithelial buccal
blood lymphocytes in mortician students [14]. Our cells) between smokers and non-smokers. These findings
results in blood lymphocytes can be an indication that are similar to results obtained in the study of Bonassi et
cytogenetic effects can be found in tissues distant from al., [48]. These authors recommend that quantitative
the area of initial contact (nasopharyngeal) and even data about smoking habit should be collected because
reach the bone marrow and cause toxicity, supporting the sub-group of heavy smokers (≥30 cigarettes per day)
the thesis of Zhang and colleagues [1,29]. can influence the results. For notice, the questionnaire
A significant positive correlation between MN fre- results of this study revealed no heavy smokers in these
quency (both in peripheral blood lymphocytes and in workers groups.
epithelial buccal cells) and the duration of FA exposure
(years of employment) was found (Table 4). This indi- Conclusions
cates that, together with peak contacts, exposure dura- In conclusion, the population studied is exposed to high
tion also has relevance for the development of health ceiling concentrations (peaks) of FA with a long-term
effects. Furthermore, in our study, long-term exposure exposure. These two aspects, cumulatively, can be the
to high levels of FA was noted particularly in pathology cause for the increase in MN frequencies in lymphocytes
and anatomy laboratory workers (exposure duration and in epithelial buccal cells.
mean of 14.5 years), fact that may at least contribute to Results obtained suggest that preventive and protec-
explain the higher frequency of MN in peripheral blood tive measures must be applied in order to reduce occu-
lymphocytes in this group when compared to the factory pational exposure to this chemical agent in these two
group (Table 4). Regarding the influence of age, a posi- occupational settings and, subsequently, to prevent
tive correlation was found with MN frequency in per- adverse effects on workers health.
ipheral blood lymphocytes (Table 5). MN frequencies
tend to rise with age because of the progressive increase
Acknowledgements
in spontaneous chromosome instability and the loss of This work was supported by Portuguese Authority for Work Conditions (ACT:
efficiency in DNA repair mechanisms, which may result http://www.act.gov.pt/). Project reference: 075MNA/06.
in accumulation of genetic lesions with increasing age
Author details
[22,45]. On the other hand, for MN frequency in epithe- 1
Environmental Health Department. Escola Superior de Tecnologia da Saúde
lial buccal cells, a negative correlation was found (Table de Lisboa - Instituto Politécnico de Lisboa. Lisbon, Portugal. 2Anatomy and
5). This can possibly be explained by the fact that cells Pathology Department. Escola Superior de Tecnologia da Saúde de Lisboa -
Instituto Politécnico de Lisboa. Lisbon, Portugal. 3CIESP - Centro de
of buccal mucosa have a steady and rapid turnover, and Investigação e Estudos em Saúde Pública (ENSP/UNL) ENSP - Escola Nacional
therefore accumulation of genotoxic effects becomes dif- de Saúde Pública - Universidade Nova de Lisboa. Lisbon, Portugal. 4Biology
ficult [13]. Department. Escola Superior de Tecnologia da Saúde de Lisboa - Instituto
Politécnico de Lisboa. Lisbon, Portugal. 5Chemistry Department. Escola
No significant differences were obtained in MN fre- Superior de Tecnologia da Saúde de Lisboa - Instituto Politécnico de Lisboa.
quencies between women and men (both in peripheral Lisbon. Portugal and REQUIMTE/CQFB, Faculty of Sciences and Technology,
blood lymphocytes and epithelial buccal cells). However, Universidade Nova de Lisboa and SINTOR-UNINOVA, Monte de Caparica,
Portugal. 6Environmental and Occupational Health Department and CIESP -
in other studies an increase in MN frequencies in Centro de Investigação e Estudos em Saúde Pública (ENSP/UNL) ENSP -
women was found. Current knowledge on the effect of Escola Nacional de Saúde Pública - Universidade Nova de Lisboa. Lisbon,
gender on genetic damage determines a 1.5-fold greater Portugal.

MN frequency in females than in males [19,45], witch Authors’ contributions

can be explained by preferential aneugenic events invol- SV conceived the idea and designed the study, and developed also
ving the X-chromossome. Surralés et al. reported an formaldehyde exposure assessment. CL, PM, JMV and MB performed the MN
tests. MG developed chemical analysis. CN performed the statistical data
excessive overrepresentation of this chromosome in analyses. JP contributed to the study design and coordination. All authors
micronucleic lymphocytes cultured from women [46]. have read and approved the final manuscript.
Tobacco smoke contains a high number of mutagenic
Competing interests
and carcinogenic substances and is causally linked to an The authors declare that they have no competing interests.
elevated incidence of several forms of cancers [47].
Hence, smoking is an important variable to consider in Received: 5 April 2010 Accepted: 20 August 2010
Published: 20 August 2010
biomonitoring studies and, particularly in this study
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doi:10.1186/1745-6673-5-25
Cite this article as: Viegas et al.: Genotoxic effects in occupational
exposure to formaldehyde: A study in anatomy and pathology
laboratories and formaldehyde-resins production. Journal of Occupational
Medicine and Toxicology 2010 5:25.

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