Neopterin as a marker of immunostimulation: an investigation in anaesthetic workplaces

Abstract

SummaryPersonnel working in operating theatres and recovery rooms are exposed to a variety of noxious substances. The results of studies of the effects of occupational exposure on immune parameters are conflicting. Neopterin is an acknowledged marker of immunostimulation. Urinary neopterin levels of 58 anaesthetists and anaesthetic nurses were measured over a 3-week period. Neopterin analyses were performed using high performance liquid chromatography. Neopterin levels were within the normal range for all subjects. Younger subjects (aged £ 35 years) had significantly higher urinary neopterin concentrations than older subjects (aged > 35 years). The present study is the first to investigate the influence of anaesthetic exposure on neopterin levels. No evidence of immunostimulation was found.

Sevoflurane in Exhaled Air of Operating Room Personnel

“…The second slower phase has been described by Kharasch et al (15,16) with a half time of approximately three hours. This may be of importance because there is conflicting evidence concerning the effects of occupational exposure to volatile anesthetics in the OR and PACU environments on the reproductive and immune system (1,17). Some evidence has implicated the involvement of sevoflurane in the eliciting perioperative leukocytopenia because of apoptosis in vitro (4).…”

Evaluation of Changes in Immune System of Operating Room Personnel by Measurement of Urinary Neopterin Concentrations

“…Long term occupational exposure to low levels of inhalational anesthetics is thought to have adverse effects on the health of exposed personnel (5). The possible noxious agents in anesthetic work place may also affect many organs including immune system in operating room workers (3,5). The studies about the possible alteration of immune system by measuring neopterin levels are limited (3,20).…”

“…Operating room personnel such as surgeons, anesthesiologists, technicians and nurses are exposed to a variety of noxious agents in their workplace. Of particular importance are various infectious agents, trace amounts of anesthetic gases and cleaning substances and solvents (2,3). In spite of the attempt to reduce the risk by modern air-conditioning and -scavenging systems, the levels of inhalational anesthetics in air of operating rooms may often exceed those limits stated in national guidelines and may cause chronic exposure in workers (4).…”

“…may occur (4,5). The possible contaminants which may be present in air of the operation rooms may also produce oxidative stress, sensitization, inflammation, and modulation of the immune system (2,3). Therefore, routine monitoring of indoor air quality for workplaces and evaluation of health status of workers are useful and important to prevent hazards and reduce risks.…”

Pollution*: just a whiff of gas?.....

“…It is a well‐established tool for monitoring the activity of the immune system. Recently Gruber and colleagues, analysing urinary neopterin levels, reported no evidence of immunostimulation in 58 anaesthetic personnel over a 3‐week period (21). All results were within the normal range.…”