Formaldehyde/Formalin

Code: k80
Allergen: Formaldehyde-treated  human serum albumin (HSA).
 
Certain protein allergens and chemicals capable of acting as haptens occur at high concentrations in workplace environments. They represent a significant sensitization risk also for less atopic individuals exposed due to their often high concentration in the air.

Allergen Exposure

Formaldehyde is widely used industrially, e.g. in textile, paper, rubber, adhesive and cosmetic manufacture, and as foams for cavity wall insulation.
 
Unexpected exposure
Patients undergoing chronic haemodialysis if formaldehyde has been used to sterilise dialysers and surgical devices.
 
Environment
Any workplace where formaldehyde is used in significant amounts. Formaldehyde should be considered in investigations of cases of Sick Building Syndrome.

Potential Cross-Reactivity

Other inhaled aldehydes. Inhaled organic material influenced by other aldehydes. 

Clinical Experience

IgE-mediated reactions
Asthma-like symptoms have been reported after exposure to formaldehyde (1).
 
Severe IgE-mediated anaphylaxis triggered by formaldehyde sterilised haemodialysis equipment has been published (2).
 
Other reactions
Non-immunological, irritative mechanisms are likely to be of importance.

References

  1. Hendrick DJ, Lane DJ : Occupational formalin asthma. Br J Ind Med 1977, 34, 11-18.
  2. Maurice F, Rivory J-P, Larsson, PH, Johansson, SGO, Bousquet, J :Anaphylactic shock with formaldehyde in a patient undergoing chronic hemodialysis. J Allergy Clin Immunol 1986, 77, 569-597.

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.