Effect of inhaled waste anaesthetic gas on blood and liver parameters among hospital staff

Abstract

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.

Waste Anesthetic Gase : A Forgotten Problems

“…Sevoflurane exposure shows significantly higher blood fluoride level which induce reduction in hemoglobin, red blood cell count and platelet. This agent also induced hepatotoxicity in healthcare workers while there were no hepatotoxic consequences in surgical patients 6,7 .…”

“…Chronic long-term effect of WAG correlate to the concentration of gas, measured in ppm and udartion of exposure 4 . Till now, studies do not show that chronic exposure lead to carcinogenic 6,7 . Chronic exposure of WAG is associated with reproductive problems, fatigue, headache, irritability, nausea, nephrotoxic, neurotoxic, hepatotoxic, immunosuppressive and reproductive toxicological effect 6,11 .…”

“…Till now, studies do not show that chronic exposure lead to carcinogenic 6,7 . Chronic exposure of WAG is associated with reproductive problems, fatigue, headache, irritability, nausea, nephrotoxic, neurotoxic, hepatotoxic, immunosuppressive and reproductive toxicological effect 6,11 . There were several animal studies shown that exposure of high levels of WAG potentially induce cellular, mutagenic, carcinogenic and teratogenic effects.…”

“…This agent also induced hepatotoxicity in healthcare workers while there were no hepatotoxic consequences in surgical patients. Till now, studies do not show that chronic exposure lead to carcinogenic 6,7 . Chronic exposure of WAG is associated with reproductive problems, fatigue, headache, irritability and nausea 6 .…”

“…In 1977 NIOSH limits the use of halothane and nitrous oxide as anesthetic agents 3 . The second edition of the Ministry of Health Formulary drug lists (2014) stated that isoflurane and sevoflurane are the most widely used inhaled anesthetics agents now 6 . Even newer anesthetic agent such as isoflurane also have potential health effects include headache, fatigue, transient blurring of vision, nausea, malignant hyperthermia in some individual, hypotension, hepatotoxicity and slight increase in risk for miscarriages at acute doses.…”