Effect of simultaneous exposure to inhalational anesthetics and radiation on the adaptive response in operating room personnel

Waste anesthetic gases have a significant association with deoxyribonucleic acid (DNA) damage: A systematic review and meta-analysis of 2,732 participants

“…Most of the studies were cross-sectional, with only three with case-control design [ [24] , [25] , [26] ] and one as the cohort study [ 4 ]. Most studies dominated by female, with 13 studies have a >50% proportion of male [ 24 , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] ]. Furthermore, smoking and alcohol consumption was reported in 16 and four studies, respectively, with an overall percentage of 33.92% smokers (326/961) and 36.54% alcoholics (95/260).…”

“… Kargar-Shouroki et al (2019) [ 42 ] Cross-sectional Iran 60/60 10/60 36.17 ± 7.36 10.95 ± 5.58 I, N, S 20.75 ± 2.8 30/60 NA NA 15. Kargar-Shouroki et al (2022) [ 35 ] Cross-sectional Iran 45/45 45/45 37.73 ± 6.91 12.36 ± 6.3 N NA 19/45 5/45 NA 16. Lewinska et al, 2005 [ 37 ] Cross-sectional Poland 46/28 0/46 42.9 ± 8.6 17.7 ± 10.1 I, N, S NA 0/46 21/46 NA 17.…”

“…There are seven types of gases reported across the investigations in the operating room environment, including Isoflurane (20 studies), Sevoflurane (20 studies), Nitrous oxide (19 studies), Halothane (7 studies), Desflurane (5 studies), Enflurane (2 studies), and Sodium pentothal (1 study). Regrettably ten investigations [ 9 , 31 , 35 , 37 , [40] , [41] , [42] , [43] , [44] , [45] ] found that the regular exposure limit for nitrous oxide (25 ppm time-weighted average/TWA) was exceeded the recommendation from the National Institute for Occupational Safety and Health (NIOSH), and six studies [ 9 , 40 , 41 , 43 , 44 , 46 ] found that the daily exposure limit for halogenated anesthetics (2 ppm) was breached. Meanwhile, fourteen studies did not report any information on WAGs concentration [ 4 , [24] , [25] , [26] , [28] , [29] , [30] , 32 , 33 , 36 , 38 , 39 , 47 , 48 ].…”

“…The comet assay was determined as DNA damage score (arbitrary unit) [ 4 , 9 , 26 , [31] , [32] , [33] , 44 ], percentage of DNA in comet tail [ 24 , 39 , 45 ], and comet tail length [ 25 , 33 , 36 , 39 ]. Meanwhile, studies that carried out micronuclei formation assay was divided into two groups, namely buccal [ 9 , 25 , 34 , 40 , 43 , 44 , 49 ] and lymphocyte micronuclei [ [33] , [34] , [35] , 37 , 38 , 41 , 50 , 51 ]. Chromosomal aberrations are also reported in eight studies [ 25 , [28] , [29] , [30] , 42 , 47 , 48 , 50 ].…”

“…Furthermore, we also found that approximately half of the included studies have higher than recommended level of WAGs than the guideline announced by the , with the recommended daily exposure limit on the concentration of WAGs in the operating room to minimize risk of occupational exposure was 25 ppm for nitrous oxide (N 2 O) and 2 ppm for halogen anesthetics such as halothane, enflurane, isoflurane, desflurane, and sevoflurane [ 56 ]. The problem of WAGs level were found particularly in N 2 O [ 32 ] which exceeds the predetermined threshold [ 9 , 31 , 35 , 37 , [40] , [41] , [42] , [43] , [44] , [45] ]. Thus, it is recommended to use a scavenging system in the operating room to reduce levels of anesthetic gas waste and prevent potential health problems [ 57 ] However, the application of this system is still difficult in the developing countries, so other preventive measures must be taken.…”