Monitoring of occupational exposure to nitrous oxide

Mehta, S.; Burton, P.; Simms, Jane

doi:10.1007/bf03006573

Cited by 14 publications

(5 citation statements)

References 7 publications

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“…The patterns of dispersion of nitrous oxide and enflurane when leaking into the operating theatre during anaesthesia are the same (24), and nitrous oxide is used in combination with all volatile halogenated anaesthetics. We therefore agree with previous suggestions (25) that nitrous oxide be used as an indicator of occupational exposure to all anaesthetic gases and vapours.…”

supporting

confidence: 93%

Plasma Fluoride and Bromide Concentrations during Occupational Exposure to Enflurane or Halothane

Carlsson

Ekstrand

Hallén

1985

Acta Anaesthesiol Scand

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The plasma fluoride and bromide concentrations were studied in operating theatre personnel. When enflurane was used, the increase in plasma fluoride concentration could not be distinguished from normal individual variations, but the plasma bromide concentration increased significantly when halothane was used. Seven patients were exposed to enflurane in a concentration of 200 parts per million for 4 h. A significant increase in the plasma concentration of fluoride was observed. The peak concentrations of fluoride occurred during exposure and the increase lasted less than 12 h. The increase in fluoride concentration was larger at this trace concentration than reported after anaesthetic concentrations. Cerebrospinal fluid (CSF) fluoride concentration was also studied; a smaller and delayed increase was found in CSF compared to plasma.

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supporting

confidence: 93%

Plasma Fluoride and Bromide Concentrations during Occupational Exposure to Enflurane or Halothane

Carlsson

Ekstrand

Hallén

1985

Acta Anaesthesiol Scand

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“…Median [interquartile range] 1 h postoperative nitrous oxide concentrations (ppm) in oncology, dental theatre, day surgery unit and MRI suite were: blood, 6 [3][4][5][6][7] [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. .............................................................................................................................................................................................................. Unpaired t-test was applied to determine if there were any significant relationships between blood sevoflurane and nitrous oxide concentration and the type of induction technique, airway management, circuit used or presence of scavenging.…”

Section: Resultsmentioning

confidence: 99%

“…The use of biological monitoring for anaesthetic agents is currently underexplored. Mehta et al [11] compared background spot sampling, integrated personal sampling (a personal environmental technique) and end-tidal sampling (as a biological technique). They suggested the use of end-tidal samples to be a simple technique providing adequate information about exposure to waste anaesthetic gases.…”

Section: Discussionmentioning

confidence: 99%

“…Potential biological indicators for evaluating exposure to waste anaesthetic gases include alveolar air, venous blood and urine. Previous studies have attempted to investigate the relationship between these biological indicators and the anaesthetic agent concentrations in the environment [11–16]. To date, no study has looked at the relationship between biological indicators, when repeated samples are taken over the duration of an operating list or in paediatric lists where the exposure is high.…”

mentioning

confidence: 99%

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

Raj¹,

Henderson

Hall

et al. 2003

Anaesthesia

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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.

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“…In the prescavenging era, environmental concentrations of nitrous oxide were routinely 1,000 -2,000 ppm. 103 Anesthetic waste gas scavenging has significantly reduced these values in the operating room, 104,105 though a recent study showed peak nitrous oxide concentrations in excess of 1,000 ppm recorded for short periods. 106 Some labor ward environments have proved difficult to scavenge efficiently, resulting in midwifery staff being exposed to nitrous oxide levels that exceed the current OELs, 107,108 although safe levels can be achieved in purpose-built facilities.…”

Section: Occupational Exposure Riskmentioning

confidence: 99%

Biologic Effects of Nitrous Oxide

Weimann²,

2008

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Nitrous oxide is the longest serving member of the anesthesiologist's pharmacologic armamentarium but remains a source of controversy because of fears over its adverse effects. Recently, the Evaluation of Nitrous oxide In a Gas Mixture for Anaesthesia (ENIGMA) trial reported that nitrous oxide use increases postoperative complications; further preclinical reports have suggested that nitrous oxide may contribute to neurocognitive dysfunction in the young and elderly. Therefore, nitrous oxide's longevity in anesthetic practice is under threat. In this article, the authors discuss the evidence for the putative toxicity of nitrous oxide, from either patient or occupational exposure, within the context of the mechanism of nitrous oxide's action. Although it would seem prudent to avoid nitrous oxide in certain vulnerable populations, current evidence in support of a more widespread prescription from clinical practice is unconvincing.

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Monitoring of occupational exposure to nitrous oxide

Cited by 14 publications

References 7 publications

Plasma Fluoride and Bromide Concentrations during Occupational Exposure to Enflurane or Halothane

Plasma Fluoride and Bromide Concentrations during Occupational Exposure to Enflurane or Halothane

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

Biologic Effects of Nitrous Oxide

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