Path now as my first choice but xylene exposure a concern?

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Hi all,
I'm enjoying every bit of my path rotation and I'm going to apply this cycle. I, however, am concerned about the xylene exposure. Recently, I have been getting throat and eye irritation when around xylene. Should this be a concern and therefore should find other fields to go into? As a pathologist, will I always be exposed to high levels of xylene causing eye irritation or is it just that there are institutions that have inadequate ventilation or hoods?

thanks. any advice is appreciated.

Are you sure it's the xylene and not formalin? I was playing with a formalin-soaked heart the other day and I felt like I was chopping onions.

On a side note, I love the smell of xylene.

Originally Posted by Entgegen

Are you sure it's the xylene and not formalin? I was playing with a formalin-soaked heart the other day and I felt like I was chopping onions.

On a side note, I love the smell of xylene.

Some programs have workstations where there's a built-in vent/hood so you wont be smelling anything.

Dude, do you sniff xylene after hours? I think theres a 1-800 number for you if you love the smell of xylene. BTW, Xylene is toxic I think.

Never said I made a habit out of inhaling xylene fumes, just that I think it smells good.

Xylene you will not be working with all the time. When staining frozens, you will use some. I have not heard of people being sensitive to it in general, although I guess anything's possible.

Formalin is the one that people sometimes have a problem with. This is a known irritant but there is also a known desensitization phenomenon whereby fairly quickly, you will no longer notice it. At occupational exposure levels (OSHA-regulated, by the way), it is not thought to actually be hazardous. I think one paper suggested an association with sinonasal adenocarcinoma but there is nothing else to back that up.

Remember that after your training, even if you do take an AP-heavy job, you will probably not be in the gross (or autopsy) room very much. If you were thinking of becoming a PA or histotech, that would be something else.

Any time you work with a chemical which gets in the air like formalin and xylene can, you should be working in an appropriately ventilated environment. Formalin you'll be exposed to a lot during residency, xylene less so. As an attending it's variable -- some jobs may require a lot of time around that (grossing, etc.), but most seem not to. We used to have someone from occupational health come by our pathology department a few times per year to measure formalin levels in certain areas, to ensure we were exposed to only "safe" levels. It can get pretty high (even intolerable) quite quickly if you're just dumping a formalin bucket with soaked organs on an unventilated autopsy table and leaning over it. But at a proper gross station, as with suitable venting right in front of you, from my experience you almost have to wipe your face with the specimen to notice it.

Sounds more like formalin. I have no idea how you get tested for formalin allergy but have you tried wearing a mask? If you have tried that, have you tried using a real mask like a respirator mask?

Originally Posted by CAthunder

Hi all,
I'm enjoying every bit of my path rotation and I'm going to apply this cycle. I, however, am concerned about the xylene exposure. Recently, I have been getting throat and eye irritation when around xylene. Should this be a concern and therefore should find other fields to go into? As a pathologist, will I always be exposed to high levels of xylene causing eye irritation or is it just that there are institutions that have inadequate ventilation or hoods?

thanks. any advice is appreciated.

Maybe the ventilation isn't so great where you are. At most places I interviewed, you can't smell the formalin (or xylene, ETOH for frozens) in the gross room because the hoods are so strong. My med school program autopsy suite was pretty bad tho. Almost no ventilation. Horrible. Don't forget to ask to see the autopsy suite if they don't show it to you. I wouldn't worry too much in general. You can always wear goggles, mask and face shield on top of great ventilation and you really won't smell anything.

Originally Posted by CAthunder

Hi all,
I'm enjoying every bit of my path rotation and I'm going to apply this cycle. I, however, am concerned about the xylene exposure. Recently, I have been getting throat and eye irritation when around xylene. Should this be a concern and therefore should find other fields to go into? As a pathologist, will I always be exposed to high levels of xylene causing eye irritation or is it just that there are institutions that have inadequate ventilation or hoods?

thanks. any advice is appreciated.

definitely depends on your work environment and current rotation.

@md anderson in the cytology dept.. there are 4 "immediate assessment" areas where the slides are hot off the presses.. meaning dripping with xylene and cytoseal.. a xylene based mounting media.. the attendings/fellows dont wear gloves and your nose is right over the slide and scope.. and the sign out rooms are not ventilated any more than a regular room....so in these areas you definitely will be inhaling and touching lots of xylene.. the other areas that are non immediate assessment, usually have slides that are dried already before they make it to an attending/fellow..

hope this helps

Originally Posted by CAthunder

Hi all,
I'm enjoying every bit of my path rotation and I'm going to apply this cycle. I, however, am concerned about the xylene exposure. Recently, I have been getting throat and eye irritation when around xylene. Should this be a concern and therefore should find other fields to go into? As a pathologist, will I always be exposed to high levels of xylene causing eye irritation or is it just that there are institutions that have inadequate ventilation or hoods?

thanks. any advice is appreciated.

I have an asthma attack every time I'm in the presence of xylene, without fail! The only time I ever come in contact with xylene, though, is in the frozen lab with the stainer. It's not that often and I just have to remember to come prepared. It isn't enough for me to consider not doing pathology.

I agree with the previous posters, though. Your symptoms sound a lot more like what most people experience with formalin, and that does get better.

Originally Posted by IkeBoy18

definitely depends on your work environment and current rotation.

@md anderson in the cytology dept.. there are 4 "immediate assessment" areas where the slides are hot off the presses.. meaning dripping with xylene and cytoseal.. a xylene based mounting media.. the attendings/fellows dont wear gloves and your nose is right over the slide and scope.. and the sign out rooms are not ventilated any more than a regular room....so in these areas you definitely will be inhaling and touching lots of xylene.. the other areas that are non immediate assessment, usually have slides that are dried already before they make it to an attending/fellow..

hope this helps

You guys do H&E on your "immediate assessments"? Can't think what else the xylene's for.

Originally Posted by gschl1234

You guys do H&E on your "immediate assessments"? Can't think what else the xylene's for.

definitely. typically an even split of h&e & diff quik's. for ly/le and a higher % of h&e for everything else...because of the speed at which int. radiologists/surgeons require a result.. the h&e are cover slipped and immediately given to staff.. always dripping with xylene to the point where its normal to keep paper towels to blot the sides of the slides..or even just use the folder. the stage also needs cleaning frequently due to dried glue and xylene.

Originally Posted by IkeBoy18

definitely. typically an even split of h&e & diff quik's. for ly/le and a higher % of h&e for everything else...because of the speed at which int. radiologists/surgeons require a result.. the h&e are cover slipped and immediately given to staff.. always dripping with xylene to the point where its normal to keep paper towels to blot the sides of the slides..or even just use the folder. the stage also needs cleaning frequently due to dried glue and xylene.

That's cool. All we do is Diff-Quik and 1/2 are put in ETOH for pap later. We only do H&E if there's a cell block. Do you guys get a lot out of the H&E? I'd think there wouldn't be enough nuclear or cytoplasmic detail on that stain, but I guess it depends on how your eye is calibrated. Do you guys do 1/3, 1/3, 1/3--DQ, H&E, pap?

Originally Posted by gschl1234

That's cool. All we do is Diff-Quik and 1/2 are put in ETOH for pap later. We only do H&E if there's a cell block. Do you guys get a lot out of the H&E? I'd think there wouldn't be enough nuclear or cytoplasmic detail on that stain, but I guess it depends on how your eye is calibrated. Do you guys do 1/3, 1/3, 1/3--DQ, H&E, pap?

sorry apparently ive been sniffing too much xylene.. lol.. everything i meant earlier ..i meant pap.. not h&e... h&e is also reserved for cell blocks at mda... so basically 50/50 pap/dq on ly/le.. and 75/25 pap/dq on everything else.. except touch preps for surg. path consult is also 50/50..

Anytime Im around xylenes they go in the vent hood or I get a headache in almost no time at all. it loves to explore.

entgegen, I dont understand how you could like the smell of xylene but at the same time, I really like the smell of methylsalicylate... minty bubblegum goodness... but that stuff goes straight in the hood too. why must nature tease us with such pleasant toxins?

Xylene and formalin filter out the weak in pathology. Like Sparta, only room for the strong.

Seriously? Xylene? What about concern for HIV or Hep C? What if one of the gross room techs goes on a stabbing spree in the lab? Guess there is always radiology where you can have glowing gonads!