Editing Formaldehyde (section)

=== Chronic inhalation ===
{{Cleanup section|reason=A little too scattered among different types of risks. Needs some reorganization.|date=November 2023}}
Concerns are associated with chronic (long-term) exposure by inhalation as may happen from [[Thermal decomposition|thermal]] or [[chemical decomposition]] of formaldehyde-based resins and the production of formaldehyde resulting from the [[combustion]] of a variety of organic compounds (for example, exhaust gases). As formaldehyde resins are used in many [[construction materials]], it is one of the more common [[Indoor air quality|indoor air pollutants]].<ref>{{cite web | title= Formaldehyde in indoor air of new apartments in Greece| url=http://mantanis.users.uth.gr/S2007.pdf | access-date=2024-12-24}} by [[George Mantanis]], Eleni Vouli, Chariclea Gonitsioti and Georgios Ntalos; Presentation at the COST Action E49 Conference “Measurement and Control of VOC Emissions from Wood-Based Panels”, 28-30 Nov. 2007, WKI, Braunschweig, Germany</ref><ref>{{cite web | title = Indoor Air Pollution in California | publisher = Air Resources Board, California Environmental Protection Agency | date = July 2005 | url = http://www.arb.ca.gov/research/indoor/ab1173/rpt0705.pdf | pages = 65–70 | access-date = 2012-05-19 | archive-url = https://web.archive.org/web/20190301231510/https://www.arb.ca.gov/research/indoor/ab1173/rpt0705.pdf | archive-date = 2019-03-01 | url-status = dead}}</ref> At concentrations above 0.1&nbsp;ppm in air, formaldehyde can irritate the eyes and [[mucous membrane]]s.<ref>{{cite web | title = Formaldehyde | url = https://www.osha.gov/SLTC/formaldehyde/index.html | publisher = Occupational Safety and Health Administration | date = August 2008 | access-date = 2009-09-01 | archive-url = https://web.archive.org/web/20190411185734/https://www.osha.gov/SLTC/formaldehyde/index.html | archive-date = 2019-04-11 | url-status = live}}</ref> Formaldehyde inhaled at this concentration may cause headaches, a burning sensation in the throat, and difficulty breathing, and can trigger or aggravate asthma symptoms.<ref>{{cite web | title = Formaldehyde Reference Exposure Levels | url = http://www.oehha.ca.gov/air/hot_spots/2008/AppendixD1_final.pdf#page=128 | publisher = California Office Of Health Hazard Assessment | date = December 2008 | access-date = 2012-05-19 | format = [[PDF]] | archive-url = https://web.archive.org/web/20190323081914/https://oehha.ca.gov/air/crnr/notice-adoption-air-toxics-hot-spots-program-technical-support-document-derivation#page=128 | archive-date = 2019-03-23 | url-status = dead}}</ref><ref>{{cite web | title = Formaldehyde and Indoor Air | publisher = Health Canada | url = https://www.canada.ca/en/health-canada/services/environmental-workplace-health/reports-publications/air-quality/formaldehyde-indoor-air-environment-workplace-health.html | date = 2012-03-29 | archive-url = https://web.archive.org/web/20190423081005/https://www.canada.ca/en/health-canada/services/environmental-workplace-health/reports-publications/air-quality/formaldehyde-indoor-air-environment-workplace-health.html | archive-date = 2019-04-23 | url-status = dead | access-date = 2019-04-23}}</ref>

The [[Centers for Disease Control and Prevention|CDC]] considers formaldehyde as a systemic poison. Formaldehyde poisoning can cause permanent changes in the [[nervous system]]'s functions.<ref name="cdc1">{{Cite web |title=Formaldehyde {{!}} Medical Management Guidelines {{!}} Toxic Substance Portal {{!}} ATSDR |url=https://wwwn.cdc.gov/TSP/MMG/MMGDetails.aspx?mmgid=216&toxid=39 |access-date=2021-08-25 |publisher=Centres for Disease Control and Prevention |archive-date=2021-08-25 |archive-url=https://web.archive.org/web/20210825191526/https://wwwn.cdc.gov/TSP/MMG/MMGDetails.aspx?mmgid=216&toxid=39 |url-status=live}}</ref>

A 1988 Canadian study of houses with [[urea-formaldehyde]] foam insulation found that formaldehyde levels as low as 0.046&nbsp;ppm were positively correlated with eye and nasal irritation.<ref>{{cite journal| last1=Broder| first1=I| last2=Corey| first2=P| last3=Brasher| first3=P| last4=Lipa| first4=M| last5=Cole| first5=P| title=Formaldehyde exposure and health status in households| pmc=1568408| year=1991| volume=95| pmid=1821362| pages=101–4| journal=Environmental Health Perspectives| doi=10.1289/ehp.9195101| bibcode=1991EnvHP..95..101B}}</ref>
A 2009 review of studies has shown a strong association between exposure to formaldehyde and the development of childhood [[asthma]].<ref>{{cite journal| last1=McGwin| first1=G| last2=Lienert| first2=J| last3=Kennedy| first3=JI| title=Formaldehyde Exposure and Asthma in Children: A Systematic Review| pages=313–7|journal=Environmental Health Perspectives| date=November 2009| issue=3| volume=118| pmid=20064771| pmc=2854756| doi=10.1289/ehp.0901143}}</ref>

A theory was proposed for the carcinogenesis of formaldehyde in 1978.<ref>{{Cite web | last = Lobachev | first = AN | title = РОЛЬ МИТОХОНДРИАЛЬНЫХ ПРОЦЕССОВ В РАЗВИТИИ И СТАРЕНИИ ОРГАНИЗМА. СТАРЕНИЕ И РАК | trans-title = Role of mitochondrial processes in the development and aging of organism. Aging and cancer | language = ru | url = http://aiexandr2010.narod.ru/rol.pdf | publisher = VINITI | year = 1978 | archive-url = https://web.archive.org/web/20130606032850/http://aiexandr2010.narod.ru/rol.pdf | archive-date = 2013-06-06 | url-status = dead | access-date = 2012-08-01}}</ref> In 1987 the [[United States Environmental Protection Agency]] (EPA) classified it as a ''probable human carcinogen'', and after more studies the [[WHO]] [[International Agency for Research on Cancer]] (IARC) in 1995 also classified it as a ''probable human carcinogen''. Further information and evaluation of all known data led the IARC to reclassify formaldehyde as a ''known human carcinogen''<ref name="International Agency for Research on Cancer, Monographs Vol 88">{{cite book | author = IARC Working Group on the Evaluation of Carcinogenic Risks to Humans | date = 2006 | title = IARC Monographs on the Evaluation of Carcinogenic Risks to Humans - VOLUME 88 - Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol | url = https://monographs.iarc.fr/wp-content/uploads/2018/06/mono88.pdf | url-status = dead | publisher = WHO Press | isbn = 92-832-1288-6 | archive-url = https://web.archive.org/web/20180712054034/https://monographs.iarc.fr/wp-content/uploads/2018/06/mono88.pdf | archive-date = 2018-07-12 | access-date = 2019-04-23}}</ref> associated with nasal sinus cancer and [[nasopharyngeal cancer]].<ref name="NCI">{{cite web | date = 2011-06-10 | url = http://www.cancer.gov/cancertopics/factsheet/Risk/formaldehyde | title = Formaldehyde and Cancer Risk | publisher = National Cancer Institute | archive-url = https://web.archive.org/web/20190123172307/https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/formaldehyde/formaldehyde-fact-sheet?redirect=true | archive-date = 2019-01-23 | url-status = live}}</ref> Studies in 2009 and 2010 have also shown a positive correlation between exposure to formaldehyde and the development of [[leukemia]], particularly [[myeloid leukemia]].<ref>{{cite journal |last1=Zhang |first1=Luoping |last2=Steinmaus |first2=Craig |last3=Eastmond |first3=Eastmond |last4=Xin |first4=Xin |last5=Smith |first5=Smith |title=Formaldehyde exposure and leukemia: A new meta-analysis and potential mechanisms |url=http://ehs.sph.berkeley.edu/krsmith/CRA/cancer/ZhangL_2008.pdf |date=March–June 2009 |volume=681 |pages=150–168 |pmid=18674636 |doi=10.1016/j.mrrev.2008.07.002 |journal=[[Mutation Research (journal)|Mutation Research]] |issue=2–3 |bibcode=2009MRRMR.681..150Z |archive-url=https://web.archive.org/web/20140327073359/http://ehs.sph.berkeley.edu/krsmith/CRA/cancer/ZhangL_2008.pdf |archive-date=27 March 2014 |url-status=dead}}</ref><ref>{{cite journal |doi=10.1002/em.20534 |pmid=19790261 |title=Formaldehyde and Leukemia: Epidemiology, Potential Mechanisms, and Implications for Risk Assessment |year=2010 |volume=51 |issue=3 |pages=181–191 |journal=Environmental and Molecular Mutagenesis |pmc=2839060 |last1=Zhang |first1=Luoping |last2=Freeman |first2=Laura E. Beane |last3=Nakamura |first3=Jun  |last4=Hecht |first4=Stephen S. |last5=Vandenberg |first5=John J. |last6=Smith |first6=Martyn T. |last7=Sonawane |first7=Babasaheb R. |bibcode=2010EnvMM..51..181Z}}</ref> Nasopharyngeal and sinonasal cancers are relatively rare, with a combined annual incidence in the United States of < 4,000 cases.<ref>{{cite web | url = https://www.cancer.org/cancer/nasopharyngeal-cancer/about/key-statistics.html | title = Key Statistics for Nasopharyngeal Cancer | publisher = American Cancer Society | access-date = 2019-04-22 | archive-url = https://web.archive.org/web/20190111232657/https://www.cancer.org/cancer/nasopharyngeal-cancer/about/key-statistics.html | archive-date = 2019-01-11 | url-status = live}}</ref><ref>{{cite journal |vauthors=Turner JH, Reh DD |title=Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data |journal=Head Neck |volume=34 |issue=6 |pages=877–85 |date=June 2012 |pmid=22127982 |doi=10.1002/hed.21830 |s2cid=205857872}}</ref> About 30,000 cases of myeloid leukemia occur in the United States each year.<ref>{{cite web | url = https://www.cancer.org/cancer/chronic-myeloid-leukemia/about/statistics.html | publisher = American Cancer Society | title = Key Statistics for Chronic Myeloid Leukemia | access-date = 2019-04-22 | archive-url = https://web.archive.org/web/20190423091903/https://www.cancer.org/cancer/chronic-myeloid-leukemia/about/statistics.html | archive-date = 2019-04-23 | url-status = live}}</ref><ref>{{cite web | url = https://www.cancer.org/cancer/acute-myeloid-leukemia/about/key-statistics.html | publisher = American Cancer Society | title = What are the key statistics about acute myeloid leukemia?Key Statistics for Acute Myeloid Leukemia (AML) | access-date = 2019-04-22 | archive-url = https://web.archive.org/web/20190423092307/https://www.cancer.org/cancer/acute-myeloid-leukemia/about/key-statistics.html | archive-date = 2019-04-23 | url-status = live}}</ref> Some evidence suggests that workplace exposure to formaldehyde contributes to sinonasal cancers.<ref name="cancer.org">{{cite web|url=http://www.cancer.org/cancer/nasopharyngealcancer/detailedguide/nasopharyngeal-cancer-risk-factors|title=Risk Factors for Nasopharyngeal Cancer|website=American Cancer Society|date=24 September 2018|access-date=17 September 2019|archive-date=10 December 2016|archive-url=https://web.archive.org/web/20161210033533/http://www.cancer.org/cancer/nasopharyngealcancer/detailedguide/nasopharyngeal-cancer-risk-factors|url-status=dead}}</ref> Professionals exposed to formaldehyde in their occupation, such as funeral industry workers and [[Embalming|embalmers]], showed an increased risk of leukemia and brain cancer compared with the general population.<ref>{{Cite book|title = The SAGE Encyclopedia of Cancer and Society|last = Butticè|first = Claudio|publisher = SAGE Publications|year = 2015|isbn = 9781483345734|location = Thousand Oaks|pages = 1089–1091|editor-last = Colditz|edition = Second|chapter = Solvents|editor-first = Graham A.|doi = 10.4135/9781483345758.n530|chapter-url = https://www.academia.edu/16541375|access-date = 2015-10-27|archive-date = 2021-10-14|archive-url = https://web.archive.org/web/20211014090107/https://www.academia.edu/16541375|url-status = live}}</ref> Other factors are important in determining individual risk for the development of leukemia or nasopharyngeal cancer.<ref name="cancer.org"/><ref>{{cite web | url = https://www.cancer.org/cancer/acute-myeloid-leukemia/causes-risks-prevention/risk-factors.html | title = Risk Factors for Acute Myeloid Leukemia (AML) | publisher = American Cancer Society | date = 2018-08-21 | archive-url = https://web.archive.org/web/20190423102354/https://www.cancer.org/cancer/acute-myeloid-leukemia/causes-risks-prevention/risk-factors.html | archive-date = 2019-04-23 | url-status = live}}</ref><ref>{{cite web | url = https://www.cancer.org/cancer/chronic-myeloid-leukemia/causes-risks-prevention/risk-factors.html | title = Risk Factors for Chronic Myeloid Leukemia | publisher = American Cancer Society | date = 2018-06-19 | archive-url = https://web.archive.org/web/20181212085753/https://www.cancer.org/cancer/chronic-myeloid-leukemia/causes-risks-prevention/risk-factors.html | archive-date = 2018-12-12 | url-status = live}}</ref> In yeast, formaldehyde is found to perturb pathways for DNA repair and cell cycle.<ref>Ogbede, J. U., Giaever, G., & Nislow, C. (2021). A genome-wide portrait of pervasive drug contaminants. Scientific reports, 11(1), 12487. https://doi.org/10.1038/s41598-021-91792-1 {{Webarchive|url=https://web.archive.org/web/20211204041501/https://www.nature.com/articles/s41598-021-91792-1 |date=2021-12-04}}</ref>

In the residential environment, formaldehyde exposure comes from a number of routes; formaldehyde can be emitted by treated [[wood]] products, such as [[plywood]] or [[particle board]], but it is produced by paints, [[varnishes]], floor finishes, and [[cigarette]] smoking as well.<ref>{{cite journal |last1=Dales |first1=R |last2=Liu |first2=L |last3=Wheeler |first3=AJ |last4=Gilbert |first4=NL |title=Quality of indoor residential air and health |date=July 2008 |journal=[[Canadian Medical Association Journal]] |pmid=18625986 |volume=179 |issue=2 |pmc=2443227 |doi=10.1503/cmaj.070359 |pages=147–52}}</ref> In July 2016, the U.S. EPA released a prepublication version of its final rule on Formaldehyde Emission Standards for Composite Wood Products.<ref>{{cite web | title = Formaldehyde Emission Standards for Composite Wood Products | date = 8 July 2016 | url = https://www.epa.gov/formaldehyde/formaldehyde-emission-standards-composite-wood-products-0 | publisher = EPA | access-date = 2019-04-24 | archive-url = https://web.archive.org/web/20181224003012/https://www.epa.gov/formaldehyde/formaldehyde-emission-standards-composite-wood-products | archive-date = 2018-12-24 | url-status = live}}</ref> These new rules impact manufacturers, importers, distributors, and retailers of products containing composite wood, including fiberboard, particleboard, and various laminated products, who must comply with more stringent record-keeping and labeling requirements.<ref>{{Cite news | url = http://www.natlawreview.com/article/epa-issues-final-rule-formaldehyde-emission-standards-composite-wood-products | title = EPA Issues Final Rule on Formaldehyde Emission Standards for Composite Wood Products | last1 = Passmore | first1 = Whitney | date = 2016-08-04 | work = The National Law Review | publisher = Womble Carlyle Sandridge & Rice, PLLC | last2 = Sullivan | first2 = Michael J. | access-date = 2016-08-24 | via = Google News | archive-url = https://web.archive.org/web/20180619070246/https://www.natlawreview.com/article/epa-issues-final-rule-formaldehyde-emission-standards-composite-wood-products | archive-date = 2018-06-19 | url-status = live}}</ref>

{{external media |width=210px |float=right |headerimage=[[File:Fema trailer 1 Mariel Carr Chemical Heritage Foundation Video.jpg|200px]] |video1=[https://www.sciencehistory.org/distillations/video/where-have-all-the-trailers-gone ''Where Have All the Trailers Gone?''], Video by Mariel Carr (Videographer) &amp; Nick Shapiro (Researcher), 2015, [[Science History Institute]]}}

The U.S. EPA allows no more than 0.016&nbsp;ppm formaldehyde in the air in new buildings constructed for that agency.<ref>{{cite web|title=Testing for Indoor Air Quality, Baseline IAQ, and Materials |url=http://www.epa.gov/rtp/new-bldg/environmental/s_01445.htm |publisher=Environmental Protection Agency |url-status=dead |archive-url=https://web.archive.org/web/20061015003607/http://www.epa.gov/rtp/new-bldg/environmental/s_01445.htm |archive-date=October 15, 2006}}</ref>{{Failed verification | date = April 2019 | reason = Dead URL & the archived document (multiple versions) doesn't show this limitation.}} A U.S. EPA study found a new home measured 0.076&nbsp;ppm when brand new and 0.045&nbsp;ppm after 30 days.<ref>M. Koontz, H. Rector, D. Cade, C. Wilkes, and L. Niang. 1996. ''Residential Indoor Air Formaldehyde Testing Program: Pilot Study.'' Report No. IE-2814, prepared by GEOMET Technologies, Inc. for the USEPA Office of Pollution Prevention and Toxics under EPA Contract No. 68-D3-0013, Washington, DC</ref> The [[Federal Emergency Management Agency]] (FEMA) has also announced limits on the formaldehyde levels in trailers purchased by that agency.<ref>{{cite news|last=Evans |first=Ben |title=FEMA limits formaldehyde in trailers |work=The Boston Globe |date=2008-04-11 |access-date=2008-09-04 |url=http://www.boston.com/news/nation/washington/articles/2008/04/11/fema_limits_formaldehyde_in_trailers/ |url-status=dead |archive-url=https://web.archive.org/web/20100615060506/http://www.boston.com/news/nation/washington/articles/2008/04/11/fema_limits_formaldehyde_in_trailers/ |archive-date=June 15, 2010}}</ref> The EPA recommends the use of "exterior-grade" pressed-wood products with phenol instead of urea resin to limit formaldehyde exposure, since pressed-wood products containing formaldehyde resins are often a significant source of formaldehyde in homes.<ref name="NCI"/>

The eyes are most sensitive to formaldehyde exposure: The lowest level at which many people can begin to smell formaldehyde ranges between 0.05 and 1&nbsp;ppm. The maximum concentration value at the workplace is 0.3&nbsp;ppm.<ref>{{cite web | title = Formaldehyde CAS 50-00-0 | url = http://www.inchem.org/documents/sids/sids/FORMALDEHYDE.pdf | publisher = [[United Nations Environment Programme]] | access-date = 2019-04-25 | archive-url = https://web.archive.org/web/20190328010406/http://www.inchem.org/documents/sids/sids/FORMALDEHYDE.pdf | archive-date = 2019-03-28 | url-status = dead}}</ref>{{Request quotation | date = April 2019 <!-- For the claim about the "maximum concentration in the workdplace. -->}} In controlled chamber studies, individuals begin to sense eye irritation at about 0.5&nbsp;ppm; 5 to 20 percent report eye irritation at 0.5 to 1&nbsp;ppm; and greater certainty for sensory irritation occurred at 1&nbsp;ppm and above. While some agencies have used a level as low as 0.1&nbsp;ppm as a threshold for irritation, the expert panel found that a level of 0.3&nbsp;ppm would protect against nearly all irritation. In fact, the expert panel found that a level of 1.0&nbsp;ppm would avoid eye irritation—the most sensitive endpoint—in 75–95% of all people exposed.<ref>{{cite web | author = Formaldehyde Epidemiology, Toxicology and Environmental Group, Inc | date = August 2002 | title = Formaldehyde and Facts About Health Effects | url = http://www2.dupont.com/Plastics/en_US/assets/downloads/processing/FETEG_Facts.pdf | archive-url = https://web.archive.org/web/20110511070824/http://www2.dupont.com/Plastics/en_US/assets/downloads/processing/FETEG_Facts.pdf | archive-date = 2011-05-11 | url-status = dead}}</ref>

[[File:Rowenta Intense Pure Air air purifier.jpg|thumb|upright|Some [[air purifier]]s include filtering technology that is supposed to lower indoor formaldehyde concentration.]]

Formaldehyde levels in building environments are affected by a number of factors. These include the potency of formaldehyde-emitting products present, the ratio of the surface area of emitting materials to volume of space, environmental factors, product age, interactions with other materials, and ventilation conditions. Formaldehyde emits from a variety of construction materials, furnishings, and consumer products. The three products that emit the highest concentrations are [[medium density fiberboard]], hardwood plywood, and particle board. Environmental factors such as temperature and relative humidity can elevate levels because formaldehyde has a high [[vapor pressure]]. Formaldehyde levels from building materials are the highest when a building first opens because materials would have less time to off-gas. Formaldehyde levels decrease over time as the sources suppress.

In [[operating rooms]], formaldehyde is produced as a byproduct of electrosurgery and is present in surgical smoke, exposing surgeons and healthcare workers to potentially unsafe concentrations.<ref>{{Cite journal |last1=Carroll |first1=Gregory T. |last2=Kirschman |first2=David L. |date=2023 |title=Catalytic Surgical Smoke Filtration Unit Reduces Formaldehyde Levels in a Simulated Operating Room Environment |url=https://pubs.acs.org/doi/10.1021/acs.chas.2c00071 |journal=ACS Chemical Health & Safety |language=en |volume=30 |issue=1 |pages=21–28 |doi=10.1021/acs.chas.2c00071 |s2cid=255047115 |issn=1871-5532 |access-date=2023-05-17 |archive-date=2023-05-14 |archive-url=https://web.archive.org/web/20230514040232/https://pubs.acs.org/doi/10.1021/acs.chas.2c00071 |url-status=live|url-access=subscription }}</ref>

Formaldehyde levels in air can be sampled and tested in several ways, including impinger, treated sorbent, and passive monitors.<ref>{{cite web | title = When Sampling Formaldehyde, The Medium Matters | url = http://www.galsonlabs.com/services/referenceinfo/technical_bulletins.php?tb_id=18 | publisher = Galson Labs | archive-url = https://web.archive.org/web/20110323024935/http://www.galsonlabs.com/services/referenceinfo/technical_bulletins.php?tb_id=18 | archive-date = 2011-03-23 | url-status = dead}}</ref> The [[National Institute for Occupational Safety and Health]] (NIOSH) has measurement methods numbered 2016, 2541, 3500, and 3800.<ref>{{cite web | date = 2018-11-29 | title = NIOSH Pocket Gide to Chemical Hazards: Formaldehyde | url = https://www.cdc.gov/niosh/npg/npgd0293.html | publisher = National Institute for Occupational Safety and Health, CDC | archive-url = https://web.archive.org/web/20190328010408/https://www.cdc.gov/niosh/npg/npgd0293.html | archive-date = 2019-03-28 | url-status = live}}</ref>

In June 2011, the twelfth edition of the [[National Toxicology Program]] (NTP) Report on Carcinogens (RoC) changed the listing status of formaldehyde from "reasonably anticipated to be a human carcinogen" to "known to be a human carcinogen."<ref name="Harris" /><ref name="12Report2011" /><ref name="roc2011" /> Concurrently, a [[United States National Academy of Sciences|National Academy of Sciences]] (NAS) committee was convened and issued an independent review of the draft U.S. [[EPA IRIS]] assessment of formaldehyde, providing a comprehensive health effects assessment and quantitative estimates of human risks of adverse effects.<ref>[http://ntp.niehs.nih.gov/go/roc12 Addendum to the 12th Report on Carcinogens (PDF)] {{Webarchive|url=https://web.archive.org/web/20110608205825/https://ntp.niehs.nih.gov/index.cfm?objectid=72016262-BDB7-CEBA-FA60E922B18C2540 |date=2011-06-08}} National Toxicology Program, U.S. Department of Health and Human Services. Retrieved 06-13-2011</ref>