Toxicity of bone marrow in dentists exposed to nitrous oxide.

Abstract

The morphology of the bone marrow of 21 dentists who habitually used nitrous oxide in their surgeries was investigated. Exposure to nitrous oxide was measured with an atmospheric sampling device, and each dentist was invited to fill in a questionnaire giving details of medical history, diet, and intake of alcohol. During the trial a full neurological and haematological investigation was carried out and a bone marrow aspirate was examined both morphologically and by the deoxyuridine suppression test. Mean exposures to nitrous oxide ranged from 159 to 4600 parts per million. In all subjects serum vitamin B12 and folate concentrations were within normal limits. Abnormal results of deoxyuridine suppression tests were obtained in three of the 20 dentists tested; two of these three had abnormal white cells in their peripheral blood films.This study provides direct evidence that occupational exposure to nitrous oxide may cause depression of vitamin B12 activity resulting in measurable changes in bone marrow secondary to impaired synthesis of deoxyribonucleic acid.

Occupational exposure to sevoflurane, halothane and nitrous oxide during paediatric anaesthesia Waste gas exposure during paediatric anaesthesia

“…Much attention has been paid to the toxic effects of nitrous oxide and halothane. Possible adverse effects on the neurological and psychomotor function, the reproductive system and the bone marrow function have been examined [6][7][8][9][10]. Unfortunately, the results from both epidemiological studies and experimental Anaesthesia, 1997, 52, pages 215-219 K. Hoerauf et al…”

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“…Numerous studies have been conducted but the results remain controversial and, even if chronic exposure to low levels of these agents does not seem to be responsible for reported health problems, eventual hazards cannot yet be excluded. [1][2][3][4][5][6][7][8][9][10][11][12][13] Therefore, it is widely recommended to keep exposure as low as possible. In some countries, strict limits for exposure have been established by governmental agencies.…”

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“…The various ill-effects reported included malignancies, neuropathy, bone marrow toxicity, a high incidence of abortions and infertility in operating theatre personnel and congenital anomalies and low birth weight in their progeny [3][4][5][6]. Of the vast number of epidemiological surveys published, concern has been focused, in particular, on those effects associated with an increased incidence of abortion among female staff [7].…”