Objectives: The aim of this study was to assess the exposure of patients to organic substances produced and identified in surgical smoke formed in the abdominal cavity during laparoscopic cholecystectomy. Material and Methods: Identification of these substances in surgical smoke was performed by the use of gas chromatography-mass spectrometry (GC-MS) with selective ion monitoring (SIM). The selected biomarkers of exposure to surgical smoke included benzene, toluene, ethylbenzene and xylene. Their concentrations in the urine samples collected from each patient before and after the surgery were determined by SPME-GC/MS. Results: Qualitative analysis of the smoke produced during laparoscopic procedures revealed the presence of a wide variety of potentially toxic chemicals such as benzene, toluene, xylene, dioxins and other substances. The average concentrations of benzene and toluene in the urine of the patients who underwent laparoscopic cholecystectomy, in contrast to the other determined compounds, were significantly higher after the surgery than before it, which indicates that they were absorbed. Conclusions: The source of the compounds produced in the abdominal cavity during the surgery is tissue pyrolysis in the presence of carbon dioxide atmosphere. All patients undergoing laparoscopic procedures are at risk of absorbing and excreting smoke by-products. Exposure of the patient to emerging chemical compounds is usually a one-time and short-term incident, yet concentrations of benzene and toluene found in the urine were significantly higher after the surgery than before it.
Exposure to N(2)O in healthcare workers is associated with alterations of vitamin B12 metabolic status, the extent of which depends on the level of exposure.
StreszczenieWstęp: E-papierosy są obecnie powszechnie używane, a ich sprzedaż corocznie znacząco rośnie. Jednocześnie w Polsce brakuje szczegółowych przepisów prawnych regulujących sprzedaż tych wyrobów. Brakuje też informacji, jakie zagrożenia e-papierosy stwarzają dla użytkowników i osób postronnych -biernych palaczy. Celem badania było określenie składu jakościowego pły-nów do e-papierosów, które jest niezbędnym elementem działań regulujących dystrybucję takich papierosów. Materiał i metody: W badaniu opracowano metodę oznaczania składu jakościowego płynów do e-papierosów i zastosowano chromatograf gazowy ze spektrometrem mas (gas chromatography with mass spectometry -GC-MS). Wykonano badania 50 próbek płynów różnią-cych się zawartością nikotyny i składników smakowo-zapachowych. Wyniki badań skonfrontowano z informacjami zamieszczonymi przez producenta na opakowaniu produktu. Wyniki: Zastosowana metoda oznaczania jakościowego pozwoliła zidentyfikować główne składniki płynów do e-papierosów, którymi są nikotyna i glikol propylenowy. Ten ostatni składnik występował we wszystkich płynach, ponieważ jest rozpuszczalnikiem głównego komponentu, którym jest nikotyna, i składników smakowo-zapachowych. W analizowanych próbkach płynu do e-papierosów stwierdzono zgodność zawartości nikotyny i glikolu propylenowego z informacją podaną przez producenta, natomiast informacje były niezgodne w przypadku substancji smakowo-zapachowych. Wnioski: Nieprawdziwe informacje dotyczące substancji smakowo-zapachowymi stosowanych przez producenta w pły-nie e-papierosów mogą stwarzać zagrożenie dla użytkowników e-papierosów, szczególnie osób ze skłonnością do alergii. Stwierdzona w badanych próbkach płynu obecność związków z grupy nienasyconych alkoholi alifatycznych i aldehydów, niestabilnych w podwyższonej temperaturze, może być niebezpieczna dla palącego -bardziej niż związki wyjściowe (np. akroleina). W związku z tym istotne jest wprowadzenie w Polsce regulacji prawnych dotyczących e-papierosów. Med. Pr. 2016;67(2):239-253 Słowa kluczowe: klasyfikacja, nikotyna, e-papierosy, glikol propylenowy, substancje zapachowe i smakowe, analiza GC-MS Abstract Background: Electronic cigarettes are currently in common use. However, in Poland there is no specific legislation governing the sale of these products. At the same time, no information has been made public about the hazards e-cigarettes pose to the users and bystanders − passive smokers. The aim of the study was to determine the qualitative composition of the analyzed liquid, which is an essential element of regulating the distribution of such cigarettes. Material and Methods: Under this study the method for determining the composition of e-cigarette liquids was developed. This method employs gas chromatography with mass spectrometry (GC-MS). Levels of nicotine and flavoring components were determined in 50 e-liquid samples. The results were compared with the information provided by the manufacturer on the packaging. Results: The applied method of qualitative determination helped to ident...
Objectives: During laparoscopic cholecystectomy, the removal of the gall bladder, pyrolysis occurs in the peritoneal cavity. Chemical substances which are formed during this process escape into the operating room through trocars in the form of surgical smoke. The aim of this study was to identify and quantitatively measure a number of selected chemical substances found in surgical smoke and to assess the risk they carry to medical personnel. Material and Methods: The study was performed at the Maria Skłodowska-Curie Memorial Provincial Specialist Hospital in Zgierz between 2011 and 2013. Air samples were collected in the operating room during laparoscopic cholecystectomy. Results: A complete qualitative and quantitative analysis of the air samples showed a number of chemical substances present, such as aldehydes, benzene, toluene, ethylbenzene, xylene, ozone, dioxins and others. Conclusions: The concentrations of these substances were much lower than the hygienic standards allowed by the European Union Maximum Acceptable Concentration (MAC). The calculated risk of developing cancer as a result of exposure to surgical smoke during laparoscopic cholecystectomy is negligible. Yet it should be kept in mind that repeated exposure to a cocktail of these substances increases the possibility of developing adverse effects. Many of these compounds are toxic, and may possibly be carcinogenic, mutagenic or genotoxic. Therefore, it is necessary to remove surgical smoke from the operating room in order to protect medical personnel.
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