Evaluation of personal, environmental and biological exposure of paediatric anaesthetists to nitrous oxide and sevoflurane*

Abstract

SummaryPaediatric anaesthetists are at higher risk of exposure to waste anaesthetic gases, which often exceed set safety limits. Recommended personal diffusive sampling techniques for monitoring exposure to waste anaesthetic gases may not give a true profile of exposure and hence biological sampling may also be necessary. We evaluated the exposure of paediatric anaesthetists to nitrous oxide and sevoflurane as assessed by personal environmental and biological samples. The influence of venue and technique, and the strength of the relationship among the various sampling techniques were analysed. The study found that exposure to nitrous oxide during paediatric anaesthetic inductions is still a major problem, although exposure to sevoflurane was usually within the accepted limits. The type of breathing system used and the presence of scavenging seem to influence this exposure, though surprisingly, the induction technique or the methods of airway control do not. No significant relationship was found between the various biological indicators measured.

The use of nitrous oxide in paediatric anaesthetic practice in the United Kingdom: a questionnaire survey*

“…Mean (SD) length of time in clinical anaesthesia was 12 (7.2) years, with 156 (53%) having ‡ 10 years' clinical experience. One hundred and fiftyfive (52%) respondents performed four or more paediatric sessions per week and the median (IQR [range]) number of sessions was 4 (2-6 [1][2][3][4][5][6][7][8][9][10][11][12]). Attitudes to the use of nitrous oxide are shown in Table 1.…”

“…Control of Substances Hazardous to Health (COSHH) Regulations 1999 state that 'exposure to anaesthetic agents must be reduced to as low as reasonably practicable' [1]. Previous studies have shown exposure to waste anaesthetic gases during paediatric operating lists to be high, especially during inhalational induction [2] and also in non-theatre areas [3] where paediatric anaesthetists may frequently operate.…”

Assessment of Nitrous Oxide Concentration in the Operating and Recovery Rooms of Babol University of Medical Sciences

“…Raj and et al N 2 O pollution of operating room. Anesthesia said that scavenging system could be effective system was considered as one of the most on the rate of N 2 O pollution and contact of effective factor in the research (8). Also, the this gas.…”

Chemical analysis of surgical smoke by infrared laser spectroscopy

“…to restore visibility), is therefore accompanied by the release of sevoflurane vapor. Hence, it is an additional source of waste anaesthetic gas (WAG) pollution [59,60,[63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79]. Known sources of WAG pollution include leakage from the patient's mask, from endotracheal coupling, from loose tube fittings and from air exhaled by the patient in the recovery room.…”