Enabling Fresh-Produce Availability in Long-Term Care via Hydroponic Green Walls: A Multisite Operational and Cost Evaluation.

Formalin is commonly used in medical and veterinary schools for preserving cadavers and biological specimens, but its potential toxicity in dissection halls is often overlooked (). In medical schools, a cadaver is preserved by infusing chemical substances, including formalin, carbolic acid, alcohol, dye, and glycerine, through the internal carotid or femoral arteries (). Formaldehyde fumes released from preserved cadavers and preservation fluids can adversely affect the health of instructors, embalmers, anatomists, laboratory personnel, and medical, dental, and veterinary students. Reported effects include irritation, immunologically mediated sensitisation, and carcinogenicity (). Common acute symptoms include headache, upper respiratory tract irritation, skin irritation, and eye irritation (, ). Formaldehyde has been demonstrated to cause nasal squamous cell carcinoma in experimental rats and irritate the respiratory tract and ocular mucosa. Accordingly, many international environmental protection agencies list formaldehyde as a possible human carcinogen (, ). Occupational formaldehyde exposure is linked to increased systemic health impairments (). Formaldehyde effects vary by anatomical location and dose, notably impairing the respiratory system. Nevertheless, comprehensive studies examining its impact on diverse organ systems and reversal/protective mechanisms are lacking. The high solubility of formaldehyde in water leads to rapid absorption in the respiratory and gastrointestinal tracts (). Once absorbed, formaldehyde is rapidly broken down into formate, which can then be oxidised to and exhaled as carbon dioxide or incorporated into biological matrices. Formate can be measured in blood and urine and has been proposed as a biomarker of formaldehyde exposure (). However, biological monitoring of formaldehyde exposure is not a common practice. Formalin is widely used in all public university laboratories in Malaysia. Because of its necessity for tissue specimen preservation, it is inevitable in the daily workflow of a laboratory. Despite this widespread use, to date no study has investigated the adverse effects of formaldehyde exposure among students and personnel working directly with formalin in university laboratories, particularly in Sabah, a state in Malaysian Borneo. Sabah has one of the largest public higher learning institutes in Malaysia, with numerous medical students and laboratory staff in the Faculty of Medicine and Health Science and the Borneo Marine Research Institute. These populations are routinely exposed to formalinised human/animal cadavers and biological specimens, highlighting the need to ascertain the exposure level and associated health effects in this vulnerable population.