The November 24, 2009 issue of the Journal of the National Cancer Institute contains a long-awaited study examining the link between formaldehyde exposure and specific cancers. National Cancer Institute (NCI) researchers observed an association between embalming and death from myeloid leukemia, with the greatest risk among those who practiced embalming for more than 20 years. Deaths from myeloid leukemia also were related to greater estimated formaldehyde exposure. This study is the first of its kind to relate cancer risk to duration of employment, work practices and estimated formaldehyde exposure levels in funeral service.
This latest study, which follows a 1990 report by NCI on funeral directors and embalmers, does not explain how formaldehyde causes cancer, but it does shed some light on the risk it poses to embalmers. The study found that the likelihood of developing leukemia increased with certain factors. These factors include the number of years spent embalming and the number of times a person performs embalming. Researchers noted that further research of leukemia in relation to specific embalming practices and exposures should help explain cancer risks related to formaldehyde.
For the study, NCI researchers examined professionals employed in funeral service who died between 1960 and 1986. Funeral directors who died from brain tumors, nasopharyngeal cancer, and leukemia were compared to a group of randomly selected funeral directors who died from other causes. Interviews were conducted of next of kin and co-workers to estimate a number of measures of formaldehyde exposure. The embalmers’ vital statistics information, including cause of death, was identified by searching state vital statistics offices. Formaldehyde exposure levels referenced in the study were based upon a series of embalmings conducted at the Cincinnati College of Mortuary Sciences. During the embalmings, the level of ventilation, the concentration of the embalming solution, and the type of case (autopsied or intact remains) was controlled. Ventilation was found to have the most important impact on formaldehyde concentrations in the preparation room.
Other study findings include:
In recent years, virtually every domestic and international agency that evaluates chemical risk has reexamined formaldehyde’s cancer-causing potential. For example:
A growing body of scientific studies under consideration by agencies requires serious consideration. Such widespread study will certainly cause regulators in the United States to consider whether current formaldehyde standards are stringent enough to protect workers’ health and safety.
NFDA’s goal is to educate its members about best work practices and provide information, tools and resources to enable funeral directors to create safe working conditions. As new studies become available, we enhance our efforts to educate our members.
NFDA has a history of educating members on best practices for maintaining a safe and healthy working environment through best practice documents, workshops and seminars, Webinars and teleconferences, magazine articles, and by commissioning research studies such as the “Funeral Home Wastestream Audit Report” and the “Investigation of the Removal of Formaldehyde and Phenol by Funeral Home Septic Systems.”
NFDA encourages funeral directors and embalmers to take precautions in the preparation room to limit chemical, including formaldehyde, exposure and emissions during the embalming process and to be familiar with and follow all federal, state and local environmental, OSHA, and health and safety laws and regulations when embalming human remains.
NFDA updated its Formaldehyde Best Management Practices guidance earlier this year; the document describes additional safeguards for funeral directors and embalmers in using formaldehyde to preserve the human body for funeral rituals and reducing their exposure during the preparation process.
The Formaldehyde Best Management Practices urge funeral directors to select and use the embalming and other preparation products appropriate for the condition of the remains. This includes, using the least concentrated solution in standard cases, and reserving the most highly concentrated solutions for the most difficult cases. Since the early 1990s, NFDA also has encouraged funeral directors to substitute products that are less toxic and environmentally-friendly for traditional products.
Scientific research has shown that when exposure to formaldehyde is reduced, the risk of cancer and other health risks are also reduced. NFDA encourages members to ensure their preparation room has a properly designed and effective ventilation system, which is considered one of the most significant factors in reducing exposure to formaldehyde.
This year, NFDA commissioned a soon-to-be-released study which further examines ventilation in the preparation room, and association leaders anticipate that the results of the study will yield recommendations for improved preparation room ventilation that will better protect funeral directors and embalmers from health risks associated with formaldehyde.
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