A significant health risk exists within a section of health workers that are exposed to anaesthetic gas and vapours, found in the atmosphere of treatment or operating rooms. These compounds are classified as waste anaesthetic gases (WAG). The present study aimed at identifying alterations in hepatic and haematological parameters occurring as a result of chronic exposure to WAG potentially affecting the health of team members working in hospitals. Therefore, operating room operatives, vulnerable to long-standing WAG exposure, were recruited for this study. Sevoflurane anaesthesia metabolites (inorganic fluoride and hexafluoroisopropanol (HFIP)), haematological indices and liver toxicity markers (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase and osteopontin) were measured. The collected results showed increased plasma inorganic fluoride, HFIP and liver toxicity markers, as well as disturbances in haematological parameters. In conclusion, exposure to halogenated inhalational anaesthetics, in general, and Sevoflurane, in particular, induces alterations in hepatic markers and haematological indices.

Objectives The present study aimed to evaluate the effects of waste anaesthetic gases on cytokines and oxidative stress of hospital health team members following exposure to waste anaesthetic gases (WAGs). Subjects and methods In total, 180 participants took part in this study; 60 of these were healthy male controls and the 120 participants in the intervention group were staff who work in the operating room. This latter group comprises six occupational subgroups (1) surgeons, (2) surgical assistants, (3) anaesthesiologists (4) anaesthesiology assistants, (5) nurses and (6) janitors. The following parameters were assessed: catalase (CAT), glutathione peroxidase (GSHpx) and superoxide dismutase (SOD) activities, plasma fluoride, serum interferon gamma (IFN-γ), serum interleukin 2 (IL2), serum interleukin 4 (IL4) and plasma thiobarbituric acid reactive substances (TBARS). Results Anaesthesiologists and their assistants exhibited the highest levels of plasma fluoride, serum IFN-γ and IL 2, exceeding the levels in detected in all the other occupational subgroups. Furthermore, the serum levels of IL4 were significantly raised in anaesthesiologists and the difference between this group and other groups was statistically significant. However, compared with the other subgroups, surgeons exhibited elevated plasma TBARS and reduced CAT, GSHpx and SOD; these variances were also statistically significant. Conclusion and recommendations The findings of this study indicate that operating room staff exposed to WAGs are vulnerable to experiencing immunotoxicity as the WAGs are considered to initiate oxidative stress and increase the levels of cytokines in serum. Thus, an education programme is warranted to inform staff working in environments where they may be subjected to WAGs on the effects that the gases can have upon their health and how to minimise their exposure to WAGs. An ongoing effort is also needed to ensure anaesthesia safety standards are maintained at all times. The findings of this study may provide a springboard for future research into occupational exposure to WAGs and their wider effect upon health.

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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.