Occupational Exposure to Anesthetic Gases Residue

Oliveira, Carlos Rogério Degrandi

doi:10.1590/s0034-70942009000100014

Cited by 20 publications

(13 citation statements)

References 22 publications

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“…The recommended exposure limits (REL) were set at 2 ppm for halogenated anesthetic and at 25 ppm for nitrous oxide (TWA during anesthetic administration) . These standards vary among countries, but formal regulation and safety measures are lacking in many developing nations, such as Brazil . We therefore opted to use NIOSH’s REL as a reference, even though we are aware that these recommendations do not consider modern halogenated anesthetics, such as isoflurane and sevoflurane .…”

Section: Discussionmentioning

confidence: 99%

“…49 These standards vary among countries, but formal regulation and safety measures are lacking in many developing nations, such as Brazil. 50 We therefore opted to use NIOSH's REL as a reference, even though we are aware that these recommendations do not consider modern halogenated anesthetics, such as isoflurane and sevoflurane. 2 The mean concentrations of all waste anesthetic gases detected in our operating rooms were above the REL and were higher in operating rooms without a scavenging system.…”

Section: F I G U R Ementioning

confidence: 99%

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High concentrations of waste anesthetic gases induce genetic damage and inflammation in physicians exposed for three years: A cross‐sectional study

et al. 2020

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This cross-sectional study analyzed the impact of occupational waste anesthetic gases on genetic material, oxidative stress, and inflammation status in young physicians exposed to inhalational anesthetics at the end of their medical residency.Concentrations of waste anesthetic gases were measured in the operating rooms to assess anesthetic pollution. The exposed group comprised individuals occupationally exposed to inhalational anesthetics, while the control group comprised individuals without anesthetic exposure. We quantified DNA damage; genetic instability (micronucleus-MN); protein, lipid, and DNA oxidation; antioxidant activities; and proinflammatory cytokine levels. Trace concentrations of anesthetics (isoflurane: 5.3 ± 2.5 ppm, sevoflurane: 9.7 ± 5.9 ppm, and nitrous oxide: 180 ± 150 ppm) were above international recommended thresholds. Basal DNA damage and IL-17A were significantly higher in the exposed group [27 ± 20 a.u. and 20.7(19.1;31.8) pg/mL, respectively] compared to the control group [17 ± 11 a.u. and 19.0(18.9;19.5) pg/mL, respectively], and MN frequency was slightly increased in the exposed physicians (2.3-fold). No significant difference was observed regarding oxidative stress biomarkers. The findings highlight the genetic and inflammatory risks in young physicians exposed to inhalational agents in operating rooms lacking adequate scavenging systems. This potential health hazard can accompany these subjects throughout their professional lives and reinforces the need to reduce ambient air pollution and consequently, occupational exposure. K E Y W O R D S genomic instability, indoor air pollution, inflammation, inhalation anesthetics, oxidative stress, work environment | 513 BRAZ et Al.

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Section: Discussionmentioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 99%

High concentrations of waste anesthetic gases induce genetic damage and inflammation in physicians exposed for three years: A cross‐sectional study

et al. 2020

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“…A meta-analysis reported an association between inhaled anesthetics exposure in nurses and an increased risk of poor pregnancy outcomes [67]. On the other hand, a large survey among female doctors from the UK showed that anesthesiologists do not have higher rates of infertility when compared to other specialties that are not exposed to inhaled anesthetics [68].…”

Section: Health Risks Related To Inhaled Anesthetics Occupational Expmentioning

confidence: 99%

Inhaled Anesthetics: Environmental Role, Occupational Risk, and Clinical Use

Costa

Kalmar

Struys

2021

JCM

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Inhaled anesthetics have been in clinical use for over 150 years and are still commonly used in daily practice. The initial view of inhaled anesthetics as indispensable for general anesthesia has evolved during the years and, currently, its general use has even been questioned. Beyond the traditional risks inherent to any drug in use, inhaled anesthetics are exceptionally strong greenhouse gases (GHG) and may pose considerable occupational risks. This emphasizes the importance of evaluating and considering its use in clinical practices. Despite the overwhelming scientific evidence of worsening climate changes, control measures are very slowly implemented. Therefore, it is the responsibility of all society sectors, including the health sector to maximally decrease GHG emissions where possible. Within the field of anesthesia, the potential to reduce GHG emissions can be briefly summarized as follows: Stop or avoid the use of nitrous oxide (N2O) and desflurane, consider the use of total intravenous or local-regional anesthesia, invest in the development of new technologies to minimize volatile anesthetics consumption, scavenging systems, and destruction of waste gas. The improved and sustained awareness of the medical community regarding the climate impact of inhaled anesthetics is mandatory to bring change in the current practice.

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“…Volatile anesthetic gases are currently the most common drugs used for induction and maintenance of general anesthesia. Occupational exposure to volatile anesthetic gases has been reported to cause various adverse health effects, such as impaired fertility, immune deficiency, toxicity in hepatic and renal systems, and carcinogenesis . However, the pathophysiology of these adverse effects has not yet been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%