Occupational hazards, DNA damage, and oxidative stress on exposure to waste anesthetic gases

Lucio, Lorena M.C.; Braz, Mariana Gobbo; Nascimento, Paulo do; Bráz, José Reinaldo Cerqueira; Braz, Leandro Gobbo

doi:10.1016/j.bjane.2017.07.002

Cited by 31 publications

(51 citation statements)

References 48 publications

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“…Also, in agreement with our results, Paes et al (2014) demonstrated that; medical residents occupationally exposed to waste anesthetic gases induced DNA damage and antioxidant status. Also, our results agree with Lucio et al (2018) who detected that; genotoxic and oxidative stress effects due to occupational exposure to anesthetic gases among operating room personnel. This demonstrates the requirement for an adequate system for circumventing exposure to a noxious atmosphere.…”

Section: Discussionsupporting

confidence: 93%

“…The surgical environment pollution with WAGs is essentially due to three causes: anesthetic techniques, anesthesia workstation, and with or without a scavenging system (Yasny and White 2012). There are many factors play role in occurance of WAGs such as: (1) administration of inhalational anesthesia through face mask; (2) failure to switch off the valve of gas owmeter and vaporizer; (3) spillage of anesthetic when loading the vaporizer; (4) performing ushing after nishing of surgical procedure to quicken recovery from inhalational anesthesia (common and extremely harmful practice); (5) problems accompanied facial mask such as usage of inappropriate material, wrong size or abnormalities in the patient's airway; (6) leakage of inhalational anesthesia during use of inadequate endotracheal tube cuff or laryngeal mask in ation, or uncuffed endotracheal tube (Lucio et al 2018).…”

Section: Introductionmentioning

confidence: 99%

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Effect of inhaled anesthetics gases on cytokines and oxidative stress alterations for the staff health status in hospitals

Alrasheedi¹,

Alqasoumi

Emara

2020

Preprint

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Abstract Background Waste anesthetic gases are few amounts of inhalational anesthesia that escape during its administration. Waste anesthetic gases such as sevoflurane and nitrous oxide can induce toxic effects among health team members working in hospitals. The objective of this study was to identify the harmful effects of upon the waste anesthetic gases exposure on oxidative stress and cytokines of health team members working in hospitals. Methods This study involved a control group and waste anesthetic gases exposure group. The exposed group was divided into six subgroups (Surgeons; Surgeon's assistants; Anaesthesiologists; Anesthesiologists' assistants; Nurses and Workers). Serum fluoride, tumor necrosis alpha, interleukin 2 and plasma malondialdehyde, catalase, glutathione peroxidase and superoxide dismutase activities were measured. Results A significant elevation was detected in fluoride, tumor necrosis alpha and interleukin 2 levels in anesthesia specialists and anesthesia assistances as compared with the surgeon, surgeon assistants, nurses and workers groups. On the other hand; a significant elevation in levels of malondialdehyde and a significant decline in levels of glutathione peroxidase, catalase and superoxide dismutase in surgeon group as compared with other exposed groups. However, a significant elevation was detected in serum interleukin 4 level among anesthesia specialists as compared with exposed groups. Conclusions Exposure to waste anesthetic gases explained a high prevalence of morbidity among operating room personnel which was observed in the present study due to exposure to oxidative stress and cytokines storm. Oxidative stress and inflammatory cytokines are responsible for induction or progression of some diseases. The studied groups (anesthesia specialists and anesthesia assistances) had exposure to high levels of waste anesthetic gases and were more risky to its toxic effects. Accordingly, an education program should be focusing on how to manage these gases to reduce its toxic effects on health staff, and continuous effort evaluating the safety of anesthesia in various aspects is required.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Effect of inhaled anesthetics gases on cytokines and oxidative stress alterations for the staff health status in hospitals

Alrasheedi¹,

Alqasoumi

Emara

2020

Preprint

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“…Although mechanisms by which halogenated anesthetics induce genotoxicity remain to be elucidated, plausible explanations include the production of ROS due to oxidation metabolism and/or direct genome damage. 18,37,38 Furthermore, nitrous oxide-induced impairment of methionine synthase affects nucleic acid and protein production, which in turn reduces genomic stability. 39 The evidence regarding the genotoxic and mutagenic effects of chronic (long-term) occupational exposure to waste anesthetic gases that has been reported in the literature is controversial.…”

Section: F I G U R Ementioning

confidence: 99%

“…11 Oxidative stress, defined as an imbalance between the production of reactive oxygen species (ROS) and antioxidant defenses, 12 and changes in immune parameters have also been linked to long-term waste anesthetic gas exposure. [13][14][15][16][17][18] Therefore, various studies on the hazards of occupational exposure to waste anesthetic gases have been published but have focused on chronic exposure, which means that the operating room personnel have been exposed for several years or decades. However, the impact of a shorter exposure to anesthetic gases, especially in young adult physicians at the end of their medical residency program, remains unknown.…”

Section: Introductionmentioning

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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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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“…The US National Institute for Occupational Safety and Health (NIOSH) defines waste anaesthetic gases (WAGs) as small amounts of volatile anaesthetic gases leaking into operating rooms during anaesthetic delivery [1,2]. In the USA, chronic exposure to WAGs affects more than 200,000 healthcare professionals, including anaesthesiologists, surgeons, operating room nurses and technicians [1,3,4]. Shortterm exposure (acute; during or within hours after anaesthesia procedure) to high concentrations of WAGs could lead to headache, irritability, nausea and drowsiness immediately upon or shortly after exposure, whereas longterm exposure (chronic; working over months or years in an operating room setting) to low concentrations is associated with genetic anomalies, miscarriage, birth defects and malignancy that may occur after several months [1,[5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Validation of Waste Anaesthetic Gas Exposure Limits When Using a Closed Vaporizer Filling System: A Laboratory-Based Study

Varughese

Bacher

2019

Adv Ther

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Introduction: It is desirable to minimise exposure of personnel to halogenated inhaled anaesthetics in the operating room to avoid deleterious short-term and long-term health effects. The objective of this study was to determine whether, while filling anaesthetic vaporizers with sevoflurane using AbbVie's closed vaporizer filling system (Quik-Fil TM), concentrations of sevoflurane in ambient air remained at or below recommended levels when measured at different operator heights. Methods: Nine filling runs were conducted, with measurement heights of 95, 130, 140, 150, 160, and 185 cm. Within each 15-min run, five vaporizers were sequentially filled from bottles of sevoflurane with the closed valving system. Ambient-air sevoflurane concentration in the breathing zone was continuously measured once per second by using a MIRAN SapphIRe 205BXL portable ambient air analyser. Results: The use of the closed filling system maintained a level of waste anaesthetic gas exposure that was well below (mean, 0.10 ppm; maximum, 0.16 ppm) the recommended shortterm value of 20 ppm average for 15 min provided by the Swedish Work Environment Authority and also fell below the US limit of a time-weighted average of 2 ppm provided by the National Institute for Occupational Safety and Health. Exposure to sevoflurane appeared to be independent of the height at which the measurement was made. Conclusions: The presence of sevoflurane in the work environment while using the closed filling system maintains a level of waste anaesthetic gas exposure well below the recommended levels at all tested operator heights.

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Occupational hazards, DNA damage, and oxidative stress on exposure to waste anesthetic gases

Cited by 31 publications

References 48 publications

Effect of inhaled anesthetics gases on cytokines and oxidative stress alterations for the staff health status in hospitals

Effect of inhaled anesthetics gases on cytokines and oxidative stress alterations for the staff health status in hospitals

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

Validation of Waste Anaesthetic Gas Exposure Limits When Using a Closed Vaporizer Filling System: A Laboratory-Based Study

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