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Handling formalin spills in operating theatres

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Formalin spills in operating theatres can pose a significant risk to staff and patients. That said, formalin is not something that can easily be dispensed with.

This is because it plays an important role in the preservation and optimal handling of tissue samples taken from patients in the operating theatre for histological analysis.

This analysis helps medical teams establish clinical diagnoses for patients, allowing them to make informed decisions for further treatment.

As an accurate diagnosis can only be given where the surgical specimen is handled correctly from the point of collection, formalin plays a crucial role in ensuring this.

What is formalin?

Formalin is a formulation of formaldehyde in aqueous solution. It contains around 40% of formaldehyde, which is a gas in normal conditions.

According to the UK Health Security Agency, inhalation of formaldehyde can cause issues such as sore throat and breathlessness and in severe cases issues such as laryngeal and pulmonary oedema. In addition, skin contact may cause irritation and dermatitis, and it is also irritating to the eyes.

As a result, it is perhaps no surprise that formalin is also hazardous and can cause problems with the eyes, skin and respiratory tract. In addition, as of 1st January 2016, the International Agency for Research on Cancer classified formaldehyde as a class 1 carcinogen.

How to handle a formalin spill

The Control of Substances Hazardous to Health Regulations (COSHH) 2002 requires employers to carry out risk assessments on the use of hazardous substances such as formalin, including putting in place the correct equipment and procedures to handle hazardous incidences.

As formalin spillages are a major health hazard, it is important to have the correct chemical spill kits in place to handle the spill quickly and safely.

Not only will this help to minimise the risk to staff and patients, but it will also minimise disruption that could lead to cancelled procedures and delays in histological analysis.

As formalin is used when transporting specimens, the spill might happen in the operating theatre, laboratory, or between those two locations.

As such, it can be a good idea to have a wall-mounted chemical spill station in both the operating theatres and laboratory, which is in a fixed location that staff are all aware of.

If the chemical spill station needs to be available for areas in close proximity to each other, a chemical spill station in a portable case could be a better solution.

These spills must always be handled by two members of staff who are fully trained in using the chemical spill kits and know how to clear up the spill in the correct way.

Looking for a chemical spill station?

Developed in conjunction with NHS staff, our chemical spill stations for formalin spills come in both a wall-mounted version or a fast-response carrying-case version.

For more information on our chemical spill stations for formalin spills click here.

Or if you need staff training to use the spill kits you can click here for details of our chemical spill management training.

Alternatively, call Cairn Technology’s chemical spill consultants on 0333 015 4345.

 

NHS hospitals pay the price for staff exposure to chemicals

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Exposure of hospital staff to chemicals is leading to a raft of claims for harm to their health.

According to NHS Resolution(1), they received 371 claims for harm caused by exposure to substances hazardous to health from incidents occurring between 1 April 2013 and 31 March 2023.

Of the 165 claims that were settled during that period, damages totalling £2,471,880 were paid out to claimants, with the NHS also having to pay out for defence costs.

At a time when money is tighter than ever in the NHS, avoiding costly claims is critical. But this is still only a secondary concern to the fact that staff are being wrongfully and dangerously exposed to hazardous substances in the workplace.

What sort of claims are being made?

Whilst the above claims relate to a variety of harmful substances including dust and hand hygiene products, it is interesting to note that a large percentage of claims come from chemicals and fumes.

For nurses (registered with the Nursing and Midwifery Council), 20% of claims arose from exposure to chemicals other than cleaning chemicals, whilst a further 25% came from dust and fumes.

For healthcare support staff the figures are more stark, with 40% of claims arising from exposure to chemicals other than cleaning chemicals, and 37.5% from dust and fumes.

Formalin, Acetic Acid and Peracetic Acid Exposure

Some of the chemicals used in hospitals that can pose a significant risk to healthcare staff are Formalin, Acetic Acid and Peracetic Acid (PAA).

In operating theatres, Formalin is used to preserve surgical tissue specimens for histological and pathological examination.

Formalin (formaldehyde) exposure can lead to eye, skin, nose, and throat irritation, and respiratory issues. A known human carcinogen, if staff are exposed to it over long periods of time in large amounts, they can develop bronchial asthma and possible organ damage.

In endoscopy, PAA is mainly used to sterilize or disinfect endoscopes and other reusable medical instruments after use. If exposed to PAA, staff can experience side effects such as breathing issues, eye or skin irritation, headaches, dizziness, and with higher exposures pulmonary oedema.

What action should hospitals take to protect staff?

The Control of Substances Hazardous to Health Regulations (COSHH) 2002 requires employers to carry out risk assessments on the use of hazardous substances.

This includes putting in place procedures and equipment to handle accidents such as Formalin and PAA spills. Staff must also be given adequate training into how to approach and clear spills safely to minimise the risk to their health.

By using a dedicated chemical spill station for chemicals such Formalin, Acetic Acid and Peracetic Acid, staff can clear spills safely and efficiently, using the correct personal protective equipment.

Some staff may need to use powered air fed respirator hoods where they have not been face-fit tested for the respirators in the chemical spill station or where they have facial hair that can interfere with the effectiveness of the respirator seal.

In addition, all staff should go through chemical spill management training to learn how to use the chemical spill station effectively and safely.

By assessing the risks of spills and providing the correct kit and training, NHS Trusts and private hospitals fulfil the important duty of care that they have for their staff. The result is not only likely to be fewer claims for personal injury, but more importantly far less harm to staff.

Can we help?

With 25 years of experience in handling chemical spills, and a range of spill kits developed in conjunction with healthcare staff, we can provide both the equipment and expertise to help you handle spills safely.

For information on chemical spill stations for Formalin, Acetic Acid and Peracetic Acid click here. Or for air-fed hood information click here.

For information on chemical spill management training click here.

Alternatively, call Cairn Technology’s chemical spill consultants on 0333 015 4345.