[Histonet] Re: [PATHO-L] refreshing perspective on formaldehyde

[Bob Richmond]

A couple of provocative replies about formaldehyde outside the
pathology laboratory. In one hospital the specimens have to be
submitted in saline and transferred to formalin in the lab, while in
the other glyoxal (a different aldehyde fixative) was successfully
substituted.

First of all, since where does a nursing supervisor or a hospital
administrator get the authority to practice pathology? And what
pathologist (a lot, alas) is so ignorant of the basics of managing
tissue as to think that biopsy specimens can be put in saline? (And
I've seen worse - in one hospital the nurses insisted that
bronchoscopic specimens be sent out dry, and left in a receiving area
with no one present there.)

If I were not allowed an aldehyde fixative at all, I'd resort to the
transport media often misrepresented as fixatives, and move the
specimen to formaldehyde in the lab. Though I'd prefer glyoxal if I
could slip it by the MBAs, though as Don Ross notes you have to
readjust all your immunohistochemistry for the different fixative.

If you're going to do histology, you've got to know your materials.

Bob Richmond
Samurai Pathologist
Knoxville TN
****************************************
On Sun, Jul 8, 2012 at 1:13 PM, Don Ross MD <Don.RossMD <@t> steward.org> wrote:
> An unnecessary nuisance, I agree.  A similar concern prompted us to switch to Prefer (TM), which is alcoholic glyoxal.  A byproduct has been faster, better fixation, and easier impox (much less antigen retrieval).  The validations for ER, PR and HER2 were a bother, but we got through it alright.
>
> -----Original Message-----
> From: patho-l-bounces <@t> mailman.srv.ualberta.ca on behalf of roupen dekmezian
> Sent: Sun 7/8/2012 11:31 AM
> To: patho-l <@t> mailman.srv.ualberta.ca; histonet <@t> lists.utsouthwestern.edu
> Subject: Re: [PATHO-L] refreshing perspective on formaldehyde
>
> Funny but not so funny when OSHA hits you with a fine and bans formaldehyde from virtually everywhere in the hospital, except the pathology lab. It all started with a leak on one of the hospital floors due to a careless person who didn't close the tap tight after using the formalin container.  This led to an evacuation of the entire floor leading to all the hooplas of the media, fire and police departments. Of course this was followed by the Gov. inspectors who assessed the fines and determined that to be able to keep formalin (even the small bottles for G.I. biopsies) anywhere but the lab, we have to train the entire hospital staff for spill response. Now we use saline instead, until the specimens arrive in pathology where formalin is added. Till now we haven't had a disaster of fixation but I know it's around the corner. Soon many of you will have to contend with the "enforcers". Reminds me of the prescient statement:
>         'A listing...does not by itself mean that a substance will cause cancer,'" said Dr. John Bucher, associate director of the National
> Toxicology Program. Moreover, Dr. Bucher said the updated listings "do not trigger any immediate new restrictions on the substances, but other
> government agencies may use the information in the future as part of their regulatory decisions." (Thank you Adel Assaad)
>
> Dekmezian, Houston
>
>> Date: Sat, 7 Jul 2012 08:51:19 -0400
>> From: rsrichmond <@t> gmail.com
>> To: patho-l <@t> mailman.srv.ualberta.ca; histonet <@t> lists.utsouthwestern.edu
>> Subject: [PATHO-L] refreshing perspective on formaldehyde
>>
>> This "Stone Soup" comic strip gives you a different view of formaldehyde:
>>
>> http://www.gocomics.com/stonesoup/2012/07/07
>>
>> though tykes this size should pickle their frogs in 70% alcohol
>> (reagent alcohol or isopropanol).
>>
>> Bob Richmond
>> Samurai Pathologist
>> Knoxville TN