Study Design for Assessing Exposures of Embalmers for a Case-Control Study. Part I. Monitoring Results

Abstract

Abstract Epidemiologic studies of embalmers and funeral directors have found excess risks of mortality due to leukemia and brain cancer. To investigate specific occupational exposures that might account for these associations, a case-control study of these diseases among embalmers is under way. To quantify exposure levels for this study, a series of embalmings was performed using an experimental design to determine the effect of certain work parameters on the concentration of airborne contaminants. Personal exposures and area concentrations of formaldehyde, methanol, phenol, and particulates were measured during 25 embalmings while controlling the level of ventilation, the concentration of the embalming solution, and the type of case (autopsy or intact body). In addition, bischloromethyl ether (BCME) and selected microorganisms (total, fungi, and bacteria) were measured during a few embalmings. Personal formaldehyde exposures ranged from 0.31 to 8.72 parts per million (ppm) for full-period exposures (51-121 min) with an arithmetic mean (AM) of 2.58 ppm, a geometric mean (GM) of 1.90 ppm, and a geometric standard deviation (GSD) of 1.88. Peak exposures for 15 min were as high as 21 ppm. Methanol levels ranged from 0.54 to 21.83 ppm (GM=3.77, GSD=4.03). Particulate mass concentrations were low (AM=0.26 mg/m3, GM=0.21 mg/m3), and measurable phenol levels were observed in only 40 percent of procedures. Airborne microorganisms were also found to be at low levels and no BCME was detected. By analysis of the means it was found that ventilation played the most important role out of three variables that were controlled. Analyses will be performed to determine if regression models can be used to predict exposure levels in the epidemiologic study.