A health-based recommended occupational exposure limit for nitrous oxide using experimental animal data based on a systematic review and dose-response analysis

Menon, Julia M. L.; Luijk, Judith A.K.R. van; Swinkels, Janne; Lukas, Eva; Ritskes‐Hoitinga, Merel; Roeleveld, Nel; Schlünssen, Vivi; Mandrioli, Daniele; Hoffmann, Sebastian; Popa, Mădălina; Scheepers, Paul T.J.

doi:10.1016/j.envres.2021.111575

Cited by 4 publications

(5 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, other studies failed to detect adverse effects of N 2 O on fertility. For a review on animal reproduction toxicity of N 2 O, see DHC (2000) and Menon et al (2021).…”

Section: Reproductive Risks Of N2omentioning

confidence: 99%

“…The Dutch Health Council (DHC, 2000) has recommended to classify N 2 O as a substance that causes concern for human fertility (possible risk for impaired fertility) and development (possible risk of harm to the unborn child). Based on all available evidence for reproductive toxicity and adverse developmental outcomes in animals exposed to N 2 O, a health-based OEL of 20 mg/m 3 (11 ppm) as 8 h time-weighted average was derived (Menon et al, 2021). In the United States, the NIOSH recommended a somewhat higher threshold limit value of 25 ppm or 46 mg/m 3 (National Institute for Occupational Safety and Health (NIOSH), 2019).…”

Section: Reproductive Risks Of N2omentioning

confidence: 99%

“…On average, one inhales over one 8 h day (480 min, at a frequency of 15 inhalations per minute and 0.5 L per inhalation) a volume of 3.6 m 3 of air. Based on an OEL value of 20 mg/m 3 as 8 h time-weighted average (Menon et al, 2021), the daily allowed inhaled dose of N 2 O for an employee is on average 3.6 × 20 mg N 2 O = 72 mg N 2 O. In recreational use, the inhalation of one bulb represents a dose of 8000 mg (8 g) of N 2 O, which is about 100 times the allowed daily occupational dose.…”

Section: Relevance For Recreational N2o Usersmentioning

confidence: 99%

“…Although acute exposure to a high dose does not compare well with long-term occupational exposure to relatively low doses, this 100-fold difference in exposure is significant. Even if one realizes that an uncertainty factor of 50 was used to account for extrapolation from rats to humans (factor 10) and interindividual variability within the population (factor 5) to calculate the OEL (Menon et al, 2021), this 100-fold exposure is relevant within this comparison. Moreover, one should apply an addition uncertainty factor to account for the young age of many recreational users and their unfinished maturation.…”

Section: Relevance For Recreational N 2 O Usersmentioning

confidence: 99%

See 3 more Smart Citations

Nitrous oxide–induced reproductive risks: Should recreational nitrous oxide users worry?

Amsterdam

Brink

2022

J Psychopharmacol

View full text Add to dashboard Cite

Background: Nitrous oxide (N2O) is a frequently used anaesthetic. Since the year 2000, recreational use of N2O, also known as ‘laughing gas’, became popular as a recreational drug due to its mild psychedelic effect. In the 1980s, several reports warned against N2O-induced reproductive risks among healthcare personnel, questioning the occupational safety of N2O in health care. Methods: Data about the reproductive risks of N2O were collected from literature. Results: Particularly in the past, professionals working in dental and midwifery practices, operating theatres and ambulance transport were exposed to high levels of N2O. Adverse reproduction effects included congenital anomalies, spontaneous abortion and reduced fertility rates in females. Following occupational measures, like maximal exposure limits for ambient N2O, this occupational risk was considerably reduced. Recreational users of N2O, however, voluntarily and repeatedly expose themselves to (very) high doses of N2O. As such, they exceed the health exposure limits some hundred times, but they are fully unaware of the related reproductive risks. Conclusion: We advocate to increase the awareness in recreational N2O-users about its potential reproductive risks, especially in heavy users, pregnant users or those who intend to become pregnant.

show abstract

“…However, other studies failed to detect adverse effects of N 2 O on fertility. For a review on animal reproduction toxicity of N 2 O, see DHC (2000) and Menon et al (2021).…”

Section: Reproductive Risks Of N2omentioning

confidence: 99%

Section: Reproductive Risks Of N2omentioning

confidence: 99%

Section: Relevance For Recreational N2o Usersmentioning

confidence: 99%

Section: Relevance For Recreational N 2 O Usersmentioning

confidence: 99%

See 2 more Smart Citations

Nitrous oxide–induced reproductive risks: Should recreational nitrous oxide users worry?

Amsterdam

Brink

2022

J Psychopharmacol

View full text Add to dashboard Cite

show abstract

“…Some studies, conducted with laboratory animals, pointed to adverse effects during pregnancy that were associated with long periods of exposure to inhalational anesthetics at high concentrations, as well as coinciding with the period of organogenesis [ 6 , 7 , 8 , 9 ], conditions that are difficult to reproduce in humans. Research on their use in humans has detected some genetic alterations that may be potentially teratogenic [ 10 , 11 , 12 , 13 , 14 ], although a subsequent review failed to establish a relationship between inhalational anesthetics and genotoxic effects [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Occupational Exposure to Inhalational Anesthetics and Teratogenic Effects: A Systematic Review

et al. 2023

View full text Add to dashboard Cite

(1) Background: In the current healthcare environment, there is a large proportion of female staff of childbearing age, so, according to existing conflicting studies, the teratogenic effects that inhalational anesthetics may have on exposed pregnant workers should be assessed. This investigation aims to analyze the teratogenic effects of inhalational anesthetics in conditions of actual use, determining any association with spontaneous abortion or congenital malformations. (2) Methods: A systematic review was carried out according to the PRISMA statement based on PICO (problem of interest–intervention to be considered–intervention compared–outcome) (Do inhalational anesthetics have teratogenic effects in current clinical practice?). The level of evidence of the selected articles was evaluated using the SIGN scale. The databases used were PubMed, Embase, Scopus, Web of Science, Google academic and Opengrey. Primary studies conducted in professionals exposed to inhalational anesthetics that evaluate spontaneous abortions or congenital malformations, conducted in any country and language and published within the last ten years were selected. (3) Results: Of the 541 studies identified, 6 met all inclusion criteria in answering the research question. Since many methodological differences were found in estimating exposure to inhalational anesthetics, a qualitative systematic review was performed. The selected studies have a retrospective cohort design and mostly present a low level of evidence and a low grade of recommendation. Studies with the highest level of evidence do not find an association between the use of inhalational anesthetics and the occurrence of miscarriage or congenital malformations. (4) Conclusions: The administration of inhalational anesthetics, especially with gas extraction systems (scavenging systems) and the adequate ventilation of operating rooms, is not associated with the occurrence of spontaneous abortions or congenital malformations.

show abstract

Occupational hazards and pregnancy in orthopaedics: female surgeons are at increased risk of infertility and pregnancy complications

Garcia,

Mandaleson,

Stannage

et al. 2024

ANZ Journal of Surgery

View full text Add to dashboard Cite

Female surgeons have increased rates of infertility and pregnancy complications compared to the general population. Reported infertility rates in surgeons are 32% compared to 10.9% in the general population. Reported pregnancy complication rates in surgeons range from 25% to 35%. In the orthopaedic operating theatre occupational hazards that have an effect on pregnancy outcomes include radiation, exposure to methyl methacrylate in bone cement, surgical smoke, sharps injuries, exposure to anaesthetic waste gases and the effects of the physical demands of surgery including prolonged work hours and night shift work. Outside the operating theatre exposure to nitrous oxide, formaldehyde, surgical scrub also have evidence of negative pregnancy outcomes. This review summarizes the available evidence as it relates to specific occupational hazards that face health workers in an orthopaedic operating theatre. This information, while targeted at orthopaedic health workers, is also relevant to anaesthetists, radiographers, nursing staff, medical device company representatives and female surgeons in other specialties.

show abstract

A health-based recommended occupational exposure limit for nitrous oxide using experimental animal data based on a systematic review and dose-response analysis

Cited by 4 publications

References 46 publications

Nitrous oxide–induced reproductive risks: Should recreational nitrous oxide users worry?

Nitrous oxide–induced reproductive risks: Should recreational nitrous oxide users worry?

Occupational Exposure to Inhalational Anesthetics and Teratogenic Effects: A Systematic Review

Occupational hazards and pregnancy in orthopaedics: female surgeons are at increased risk of infertility and pregnancy complications

Contact Info

Product

Resources

About