In preparing the bodies of the dead for burial, funeral directors may be increasing their risk of developing a progressive neurodegenerative disease, according to the results of a new study.

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People employed as funeral directors were found to be the most likely to be exposed to intense levels of formaldehyde at work.

The study, published in the Journal of Neurology, Neurosurgery & Psychiatry, examines the association of deaths from amyotrophic lateral sclerosis (ALS) and occupational exposure to formaldehyde, a chemical found in embalming fluid.

ALS, also known as Lou Gehrig’s disease, is a motor neuron disease that came to global prominence last year through the ice bucket challenge. It attacks nerve cells in the brain and spinal cord used involuntary muscle actions, often leading to paralysis, respiratory failure and eventually death.

Previous studies have suggested that exposure to certain chemicals could increase the risk of ALS. One such chemical is formaldehyde, used in the production of many household products, as a disinfectant and as a preservative in laboratories and mortuaries.

Exposure to formaldehyde can cause symptoms such as coughing, nausea and skin irritation in the short-term while the potential effects of long-term exposure have led to its recent classification as a known human carcinogen.

Initial studies have produced mixed results when investigating the suggested link between formaldehyde exposure and ALS mortality, however. To investigate further, the researchers decided to examine the association using data obtained from the National Longitudinal Mortality Study (NLMS).

NLMS is a nationally representative US-based cohort involving almost 1.5 million adults. Participants were surveyed at the age of 25 about their occupational status and from this information the researchers calculated their likely exposure to formaldehyde.

The researchers then calculated the intensity and probability of exposure to the chemical for specific jobs and areas of industry. All of the men who were defined as having high intensity and probability of exposure to formaldehyde (493) were funeral directors, as were the majority of women.

Men whose jobs had a high probability of exposure to formaldehyde were three times as like to die from ALS than men who were not exposed to formaldehyde at all. This risk increase was not observed among women.

Among men whose jobs had a high intensity and probability of formaldehyde exposure – all funeral directors – the likelihood of dying from ALS was more than four times higher than those with no exposure to the chemical. There were only two deaths in this group, however.

“In the USA, female versus male funeral directors are more likely to interact with bereaved clients and less likely to perform embalming, where exposure to formaldehyde occurs,” write the authors. “Thus, formaldehyde exposure may vary by sex in this profession.”

The authors suggest their findings should be interpreted with caution, pointing out that jobs that involve both high intensity and probability of exposure to formaldehyde are rare, and that there were only two ALS deaths recorded among men working in these professions.

Another limitation is that formaldehyde exposure was only measured once at the beginning of the study and so may not have accurately reflected lifetime exposures to the chemical.

Formaldehyde is not the only chemical that funeral directors are exposed to during the embalming process. These workers are also exposed to various viral, bacterial and prion pathogens.

“Thus, further study of the association of ALS with high levels of formaldehyde exposure and among funeral directors is warranted,” the authors conclude.

Last month, Medical News Today reported on a study that suggested type 2 diabetes could reduce the risk of ALS.