The Effects of Volatile Anaesthetic Agents on Human Immune System Function Via Occupational Exposure

Karakaya, Asuman; Tunçel, Neşe; Yücesoy, Berran; Akın, Mete; Cuhruk, Handan; Şardaş, Orhan Seyfi; Beksaç, Meral

doi:10.3109/08923979209009223

Cited by 14 publications

(9 citation statements)

References 31 publications

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“…In accordance with some of the literature [14][15][16], we did not find alterations in the percentages of T or B-lymphocytes in anesthetic exposed subjects. However, in anesthetic personnel exposed to occupational concentrations of Halothane and Nitrous oxide 10-60 times greater than the advised maximum, percentages of CD2 and CD4 T lymphocytes increased significantly, while percentage of NK cells decreased significantly during exposure.…”

Section: Discussionsupporting

confidence: 79%

“…But the studies are not easily comparable due to the heterogeneity of exposed groups, considerable differences in gas type and levels, the great variability in immune parameters examined, and the methodology of the studies. Many aspects of the immune response have been evaluated with contradictory results, some studies have not found any changes in the investigated immune parameters [14][15][16] and both inhibition and stimulation has been reported depending on the cell type or function [17][18][19]. …”

Section: Introductionmentioning

confidence: 99%

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Life Style Factors Influencing Immunotoxic Effects Detected on Peripherial Blood Lymphocytes of Health Personnel Exposed to Anesthetic Gas

Bíró¹,

Tompa²

2013

Clin Exp Pharmacol

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In this study, changes in the immune phenotype of 127 subjects exposed to anesthetic gases from health services were measured by flow cytometry. The data was compared to healthy, non-exposed controls. We supposed that there is a relationship between health risk for the personnel exposed to anesthetic gases and the alteration of the measured immune parameters in the presence or absence of confounding factors such as smoking and alcohol consumption. In the group of health personnel exposed to anesthetic gases, we found a statistically significant increase in the ratio of CD25+/CD8+ cells -activated cytotoxic T cells -compared to the control. In those workplaces, where protective measures were strictly adhered to (with quality assurance) the activation of lymphocytes was at control level, however, where there was no quality assurance, activation of lymphocytes increased significantly compared to the control. In the anesthetic gas exposed smokers, there was a statistically significant shift in the T cell subpopulations: the percentage of helper T cells increased, while the percentage of cytotoxic T cell decreased, leading to an elevated Th/ Tc ratio compared to the nonsmokers. Our results suggest that our biomarkers can be useful in tracking occupational/ environmental immunotoxic effects. Smoking as a confounding factor has to be taken into account when assessing occupational exposures.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Life Style Factors Influencing Immunotoxic Effects Detected on Peripherial Blood Lymphocytes of Health Personnel Exposed to Anesthetic Gas

Bíró¹,

Tompa²

2013

Clin Exp Pharmacol

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“…The potential adverse effects of volatile anaesthetics have been the subject of several reports that linked exposure to the occurrence of adverse health effects [21][22][23][24][25][26][27][28][29][30][31][32] . However, many of these studies suffer from methodological flaws and, until now, no direct causal relationship has been demonstrated unequivocally.…”

Section: Discussionmentioning

confidence: 99%

Occupational exposure to sevoflurane during cardiopulmonary bypass

2011

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Volatile anaesthetic agents are widely used for maintenance of anaesthesia in all kinds of surgical procedures. Despite the implementation of measures such as adequate ventilation of the operating room and the use of efficient scavenging systems, concern remains about the risks for occupational exposure, especially in situations associated with an increased risk of anaesthetic gas waste, such as with the use of volatile anaesthetic agents on cardiopulmonary bypass. The present contribution reports the results of a preliminary safety assessment involving measurements of sevoflurane concentrations in the ambient air of a cardiac surgery operating room. In 22 cardiac surgical procedures with cardiopulmonary bypass (11 with open and 11 with closed venous reservoir), measurements of trace concentrations were obtained every 10 min at the following sites: at the outlet of the oxygenator, at the outlet of the cardiotomy reservoir, in the breathing zone of the perfusionist and above the surgical field. The concentrations were measured on-line using a photoacoustic infrared spectrometer. Mean sevoflurane waste concentrations remained consistently below the recommended target value of 4.68 ppm throughout the observation period at the different measurement sites. These results indicate that, with the use of sevoflurane on cardiopulmonary bypass, the recommended levels for occupational exposure are not exceeded, provided adequate operation room ventilation and waste gas scavenging is performed.

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“…Numerous studies have been conducted but the results remain controversial and, even if chronic exposure to low levels of these agents does not seem to be responsible for reported health problems, eventual hazards cannot yet be excluded [1][2][3][4][5][6][7][8][9][10][11][12][13]. Therefore, it is widely recommended to keep exposure as low as possible.…”

Section: Discussionmentioning

confidence: 99%

Occupational Exposure to Nitrous Oxide and Desflurane during Ear-Nose-Throat-Surgery

Byhahn¹

2017

Austin J Anesthesia and Analgesia

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Purpose: To determine occupational exposure of the anesthesiologist and surgeon to nitrous oxide and desflurane during general anesthesia for EarNose-Throat (ENT) surgery in children and adults.Methods: An observational clinical trial was performed in ten children (C) and ten adults (A). Tracheas were intubated, in adults, with cuffed tubes and in children with uncuffed tubes. The operating room was equipped with modern air conditioning and waste anesthetic gas scavengers. Gas samples were obtained during the operative procedure every 90 sec from the breathing zone of subjects. Time-Weighted Averages (TWA) over the time of exposure was calculated for nitrous oxide and desflurane.Results: Nitrous oxide TWAs for anesthesiologists were 0.41 ± 0.23 ppm (A) and 1.20 ± 0.32 ppm (C, P < 0.0001), and 2.24 ± 1.93 ppm (A) and 5.30 ± 0.60 ppm (C, P = 0.0001) for the surgeon who worked close to the patient's airway and thus had higher exposure (P< 0.05 [A], P< 0.0001 [C]). With regard to desflurane, the anesthesiologists' TWAs were 0.02 ± 0.03 ppm for both adults and children. The surgeon was exposed to 0.21 ± 0.24 ppm desflurane (A) and 0.30 ± 0.14 ppm (C, P: n. s.). Although the surgeon's exposure was greater (P < 0.05 [A], P < 0.0001 [C]), the threshold limits of 25ppm for nitrous oxide and 2ppm for desflurane recommended by the National Institute of Occupational Safety and Health were not exceeded. Conclusions:Under modern air conditioning, occupational exposure to inhalational anesthetics is low, and inhalational anesthesia is safe from the standpoint of modern workplace laws and health-care regulations.

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The Effects of Volatile Anaesthetic Agents on Human Immune System Function Via Occupational Exposure

Cited by 14 publications

References 31 publications

Life Style Factors Influencing Immunotoxic Effects Detected on Peripherial Blood Lymphocytes of Health Personnel Exposed to Anesthetic Gas

Life Style Factors Influencing Immunotoxic Effects Detected on Peripherial Blood Lymphocytes of Health Personnel Exposed to Anesthetic Gas

Occupational exposure to sevoflurane during cardiopulmonary bypass

Occupational Exposure to Nitrous Oxide and Desflurane during Ear-Nose-Throat-Surgery

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