Occupational Exposure to Halogenated Anaesthetic Gases in Hospitals: A Systematic Review of Methods and Techniques to Assess Air Concentration Levels

Abstract

Objective During the induction of gaseous anaesthesia, waste anaesthetic gases (WAGs) can be released into workplace air. Occupational exposure to high levels of halogenated WAGs may lead to adverse health effects; hence, it is important to measure WAGs concentration levels to perform risk assessment and for health protection purposes. Methods A systematic review of the scientific literature was conducted on two different scientific databases (Scopus and PubMed). A total of 101 studies, focused on sevoflurane, desflurane and isoflurane exposures in hospitals, were included in this review. Key information was extracted to provide (1) a description of the study designs (e.g., monitoring methods, investigated occupational settings, anaesthetic gases in use); (2) an evaluation of time trends in the measured concentrations of considered WAGs; (3) a critical evaluation of the sampling strategies, monitoring methods and instruments used. Results Environmental monitoring was prevalent (68%) and mainly used for occupational exposure assessment during adult anaesthesia (84% of cases). Real-time techniques such as photoacoustic spectroscopy and infrared spectrophotometry were used in 58% of the studies, while off-line approaches such as active or passive sampling followed by GC-MS analysis were used less frequently (39%). Conclusions The combination of different instrumental techniques allowing the collection of data with different time resolutions was quite scarce (3%) despite the fact that this would give the opportunity to obtain reliable data for testing the compliance with 8 h occupational exposure limit values and at the same time to evaluate short-term exposures.

MicroRNAs-Based Theranostics against Anesthetic-Induced Neurotoxicity

“…While clinical evidence from randomized controlled trials (RCTs) is limited due to ethical considerations, real-world reports and retrospective studies have examined anesthetics’ potential neurotoxicity ( Table 2 ). Furthermore, study reports also link the risk of inhaled anesthetic neurotoxicity among the operating room personnel, patients, and anesthesiologists [ 63 , 64 ]. For instance, a recent study investigated the levels of toxic anesthetic gas isoflurane in the operating rooms of Valiasr and Shahid Beheshti teaching hospital during 2018 and assessed the associated health risks.…”

Toxicity of anesthetic gases: exposure in operating rooms and influence on the environment.

“…Pacjenci po zabiegach poprzez oddech oczyszczali swoje organizmy z podawanych wcześniej gazów anestetycznych, które kumulowały się w otoczeniu, będąc dostępnymi dla personelu medycznego. Stąd też bardzo ważne jest odpowiednie zabezpieczenie pacjenta i personelu przed nadmiernym narażeniem na te leki [13]. Kolejnym potencjalnym zagrożeniem kontaktu personelu z wziewnymi środkami znieczulającymi jest etap napełniania parowników halogenowymi anestetykami.…”