Effect of Inhalational Anesthetics Exposure on Reproductive Outcomes and Its Predictors Among Healthcare Personnel in Jimma Zone Public Hospitals: A Comparative Cross-Sectional Study

Abstract

Background: Emerging of anesthetics opens a new era to medical discipline in relieving patients' pain and stress when undergoing surgery but simultaneously exposes the healthcare personnel working in areas of anesthetics exposure to many adverse health effects including reproductive outcomes effects. Thus, this study aimed to assess the effect of inhalational anesthetics exposure on reproductive outcomes and its predictors among health care personnel in hospitals of Jimma zone public hospitals. Methods: A comparative cross-sectional study was conducted from May 01 to 30, 2021. We approached 483 healthcare personnel in Jimma zone public hospitals to partake in this study. Of this number, we recruited 292 healthcare personnel, comprising 146 exposed healthcare personnel and 146 unexposed healthcare personnel. Structured questionnaires were used to assess the reproductive outcomes. Data were entered into EPI-data version 4.6.1 and exported to SPSS version 24 for analysis. Binary logistic regressions were carried out to identify associated factors with reproductive outcomes. Statistical significance was declared using a p value <0.05. Results: The overall prevalence of bad reproductive outcome status was high (30.8%) and the prevalence was much higher among exposed HCPs (20.9%) when compared to unexposed HCPs (9.9%). Among a total of 292 HCPs the likelihood of occurred bad reproductive outcomes was higher among an exposed group (AOR=3.17, 95% CI: 1.40-7.16) and those who smoke cigarettes (AOR=8.44, 95% CI: 1.93-36.91). The occurrence rate of bad reproductive outcome was higher among 30-45h/week exposure (AOR=11.94, 95% CI: 1.25-24.95) if separately analyzed among exposed and age of couple above 41 years among unexposed (AOR=5.87, 95% CI: 1.56-22.06) were significantly associated with bad reproductive outcomes. Conclusion: Prevalence of bad reproductive outcomes was higher among exposed HCPs. Hence, it requires attention to create awareness about the danger of anesthetics exposure in the study setting, suggesting the need to further minimize the exposure.

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

“…Study 6 [ 37 ]. Title: “Effect of exposure to inhalational anesthetics on reproductive outcomes and its predictors among healthcare workers in Jimma zone public hospitals: A Comparative Cross-Sectional Study”.…”

“…Although all the studies selected for this review have a retrospective cohort design, they present important methodological differences, especially in the way of calculating the degree of exposure. Most of the studies analyzed [ 16 , 33 , 34 , 36 , 37 ] calculate the degree of exposure based on the time worked in an environment where inhalational anesthetics could be used and do not evaluate, as would be more appropriate, their environmental concentration and the individual exposure of each worker [ 37 ]. This is an essential issue in order to properly classify the study subjects within the cohort of exposed or unexposed healthcare professionals and, thus, to be able to determine the existence of a causal relationship between occupational exposure to inhalational anesthetics and the teratogenic effects that appear in pregnant healthcare professionals who are in contact with them, effects that could manifest themselves in an increase in spontaneous abortions or congenital malformations.…”

“…The studies analyzed that find an association between the use of inhalational anesthetics and spontaneous abortions or congenital malformations [ 34 , 36 , 37 ] have a lower level of SIGN evidence and lack a SIGN grade of recommendation. This is because they present a high possibility of confounding bias by not taking into account other occupational or lifestyle risk factors to which healthcare professionals are also subjected and may result in spontaneous abortions or congenital malformations.…”

“…This is because they present a high possibility of confounding bias by not taking into account other occupational or lifestyle risk factors to which healthcare professionals are also subjected and may result in spontaneous abortions or congenital malformations. These factors include exposure to antineoplastic drugs, ionizing radiation or sterilizing agents; the consumption of coffee, alcohol or tobacco; age; stress; jobs involving heavy lifting; long working hours; and highly variable schedules that prevent adequate rest [ 34 , 36 , 37 ]. They also present confounding biases because the cohorts of exposed and unexposed healthcare professionals perform their work in very different working conditions, such as operating rooms and hospital outpatient clinics, which do not differ exclusively in the use of inhalational anesthetics, making it difficult to establish a causal relationship between their use and the occurrence of spontaneous abortion or congenital malformations [ 36 , 37 ].…”

“…These factors include exposure to antineoplastic drugs, ionizing radiation or sterilizing agents; the consumption of coffee, alcohol or tobacco; age; stress; jobs involving heavy lifting; long working hours; and highly variable schedules that prevent adequate rest [ 34 , 36 , 37 ]. They also present confounding biases because the cohorts of exposed and unexposed healthcare professionals perform their work in very different working conditions, such as operating rooms and hospital outpatient clinics, which do not differ exclusively in the use of inhalational anesthetics, making it difficult to establish a causal relationship between their use and the occurrence of spontaneous abortion or congenital malformations [ 36 , 37 ]. In addition, two of these studies have a high nonresponse bias [ 34 , 37 ], since a large percentage of the healthcare professionals surveyed did not respond to the questionnaire, which may lead to erroneous results, since the sample analyzed may not be representative of the study population.…”