Occupational Hazard of Halothane

Lund, Ivar; Skulberg, A; Helle, I

doi:10.1016/s0140-6736(74)92058-3

Cited by 11 publications

(4 citation statements)

References 5 publications

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“…There have been reports of liver damage in medical and paramedical personnel exposed to sub-anaesthetic doses of halothane (Belfrage, Ahlgren and Axelson, 1966;Klatskin and Kimberg, 1969;Johnston and Mendelsohn, 1971;Lund, Skulberg and Helle, 1974). Hepatitis has also been reported in those who have abused halothane (Schatzki, Kay and Dickinson, 1973); Kaplan et al, 1979) although they may have been exposed to much greater doses of halothane.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Damage After Exposure to Halothane in Medical Personnel

Neuberger

Vergani

Mieli-Vergani

et al. 1981

British Journal of Anaesthesia

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Two surgeons, in whom liver damage developed after occupational exposure to sub-anaesthetic doses of halothane, were found to have a circulating antibody which reacted specifically with halothane-altered hepatocyte membrane components. This antibody had been found previously only in those patients in whom severe hepatic necrosis developed after exposure to halothane and in no other form of liver injury. It may provide a specific diagnostic marker in patients in whom there are other possible causes of liver damage and could, therefore, remove the need for a challenge exposure and its attendant risks.

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Section: Discussionmentioning

confidence: 99%

Hepatic Damage After Exposure to Halothane in Medical Personnel

Neuberger

Vergani

Mieli-Vergani

et al. 1981

British Journal of Anaesthesia

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“…There have been several reports of occupationally exposed personnel developing hepatitis (Belfrage et al 1966;Johnston & Mendelsohn 1971;Klatskin & Kimberg 1969;Lund et al 1974;). These personnel have included surgeons, anaesthetists and anaesthetic nurses.…”

Section: Halothane Hepatitis Following Occupational Exposurementioning

confidence: 99%

Halothane and Hepatitis

Neuberger

1990

Drug Safety

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Despite early controversy, it is now recognised that halothane anaesthesia may be followed by abnormalities of liver function. The resulting hepatitis may take 1 of 2 forms: in type I, there is a minor degree of disturbance of liver function shown by increased serum transaminases or glutathione-S-transferase in up to 25 to 30% of patients; subsequent re-exposure to halothane is not necessarily associated with evidence of liver damage. In contrast, type II hepatitis is often associated with massive liver cell necrosis, frequently leading to fulminant hepatic failure. This type of liver damage has clinical, serological and immunological features compatible with an immune-mediated idiosyncratic reaction. The incidence is low (between 1 in 3500 and 1 in 35,000 anaesthetic procedures), but the mechanism of halothane hepatitis remains uncertain: there have been extensive animal models showing that halothane has a direct hepatotoxic potential, although the relevance of this to the human patient is not yet clear. Prevention of halothane hepatitis may be difficult, and the only clear way of reducing the incidence is to avoid re-exposure to halothane in those patients who have had a previous adverse reaction to the drug, demonstrated either by unexplained pyrexia or by jaundice. Halothane should also be avoided in those patients where there is a family history of sensitisation to the drug. In such cases, halothane-free equipment should be used, and exposure to other volatile non-halogenated anaesthetics should be avoided.

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“…(7,8) In addition to Halothane toxicity on patients, occupational exposure to halothane has resulted in liver damage for surgeons, anaesthetists and operating theatre personnel. (9) Attempts to inhibit or minimize the possibility of halothane metabolism have been conducted; one of them is to prepare d-halothane in which the oxygen insertion reaction at the C-H bond will be impaired. Results from this study revealed that the increased stability of the C-D bond explains the reduction in oxidative metabolites observed after exposure to d-halothane.…”

Section: Introductionmentioning

confidence: 99%

Halothane Exposure and Serum Bromide Measurements for Healthcare Professionals Working in Surgical Theatres in Jordanian Hospitals = قياس مستويات البروميد في مص الدم للكادر الطبي و التمريضي العامل في غرف العمليات في المستشفيات الأردنية التي تستخدم مادة الهالوثين

Fakhruldeen¹,

Daibes²,

Al-Jaidi³

2016

JMJ

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Background Aims: To evaluate and measure serum bromide levels for health care professionals working in operation rooms upon exposure to Halothane anesthetic in attempt to support worldwide calls to eradicate halothane from the use as a general anesthetic before surgical operations. Materials and Methods: This is a quantitative descriptive study which used the Inductively-coupled plasma-mass spectroscopy (ICP-MASS) to investigate serum bromide levels in blood samples of fifty two healthcare professionals working under Halothane atmosphere inside operation rooms. Results: This study revealed 3-10 times higher levels of serum bromide serum than the allowed non toxic levels (3-4.4 mg/l). The measured concentration ranges were 10-39.9 mg/l.. Conclusions: The observed high level of serum bromide strongly suggested an urgent call to exclude Halothane from the use as a general anesthetic in surgical operation. Meanwhile, serum bromide levels for all workers exposed to Halothane must be frequently monitored to predict the level of toxicity.

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Occupational Hazard of Halothane

Cited by 11 publications

References 5 publications

Hepatic Damage After Exposure to Halothane in Medical Personnel

Hepatic Damage After Exposure to Halothane in Medical Personnel

Halothane and Hepatitis

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