1
|
Silva MAP, Figueiredo DBS, Lara JR, Paschoalinotte EE, Braz LG, Braz MG. Evaluation of genetic instability, oxidative stress, and metabolism-related gene polymorphisms in workers exposed to waste anesthetic gases. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:9609-9623. [PMID: 36057057 DOI: 10.1007/s11356-022-22765-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Professionals who work in operating rooms (ORs) may be exposed daily to waste anesthetic gases (WAGs) due to the use of inhalational anesthetics. Considering the controversial findings related to genetic damage and redox status in addition to a lack of knowledge about the effect of polymorphisms in genes related to phase I and II detoxification upon occupational exposure to WAGs, this cross-sectional study is the first to jointly evaluate biomarkers of genetic instability, oxidative stress, and susceptibility genes in professionals occupationally exposed to high trace amounts of halogenated (≥ 7 ppm) and nitrous oxide (165 ppm) anesthetics in ORs and in individuals not exposed to WAGs (control group). Elevated rates of buccal micronucleus (MN) and nuclear bud (NBUD) were observed in the exposure group and in professionals exposed aged more than 30 years. Exposed males showed a higher antioxidant capacity, as determined by the ferric reducing antioxidant power (FRAP), than exposed females; exposed females had higher frequencies of MN and NBUD than nonexposed females. Genetic instability (MN) was observed in professionals with greater weekly WAG exposure, and those exposed for longer durations (years) exhibited oxidative stress (increased lipid peroxidation and decreased FRAP). Polymorphisms in metabolic genes (cytochrome P450 2E1 (CYP2E1) and glutathione S-transferases (GSTs)) did not exert an effect, except for the effects of the GSTP1 (rs1695) AG/GG polymorphism on FRAP (both groups) and GSTP1 AG/GG and GSTT1 null polymorphisms, which were associated with greater FRAP values in exposed males. Minimizing WAG exposure is necessary to reduce impacts on healthcare workers.
Collapse
Affiliation(s)
- Mariane A P Silva
- Medical School - São Paulo State University (UNESP), Prof. Mario Rubens G. Montenegro Av. Botucatu, São Paulo, 18618-687, Brazil
| | - Drielle B S Figueiredo
- Medical School - São Paulo State University (UNESP), Prof. Mario Rubens G. Montenegro Av. Botucatu, São Paulo, 18618-687, Brazil
| | - Juliana R Lara
- Medical School - São Paulo State University (UNESP), Prof. Mario Rubens G. Montenegro Av. Botucatu, São Paulo, 18618-687, Brazil
| | - Eloisa E Paschoalinotte
- Medical School - São Paulo State University (UNESP), Prof. Mario Rubens G. Montenegro Av. Botucatu, São Paulo, 18618-687, Brazil
| | - Leandro G Braz
- Medical School - São Paulo State University (UNESP), Prof. Mario Rubens G. Montenegro Av. Botucatu, São Paulo, 18618-687, Brazil
| | - Mariana G Braz
- Medical School - São Paulo State University (UNESP), Prof. Mario Rubens G. Montenegro Av. Botucatu, São Paulo, 18618-687, Brazil.
| |
Collapse
|
2
|
Gaya da Costa M, Kalmar AF, Struys MMRF. Inhaled Anesthetics: Environmental Role, Occupational Risk, and Clinical Use. J Clin Med 2021; 10:1306. [PMID: 33810063 PMCID: PMC8004846 DOI: 10.3390/jcm10061306] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/14/2021] [Accepted: 03/18/2021] [Indexed: 12/17/2022] Open
Abstract
Inhaled anesthetics have been in clinical use for over 150 years and are still commonly used in daily practice. The initial view of inhaled anesthetics as indispensable for general anesthesia has evolved during the years and, currently, its general use has even been questioned. Beyond the traditional risks inherent to any drug in use, inhaled anesthetics are exceptionally strong greenhouse gases (GHG) and may pose considerable occupational risks. This emphasizes the importance of evaluating and considering its use in clinical practices. Despite the overwhelming scientific evidence of worsening climate changes, control measures are very slowly implemented. Therefore, it is the responsibility of all society sectors, including the health sector to maximally decrease GHG emissions where possible. Within the field of anesthesia, the potential to reduce GHG emissions can be briefly summarized as follows: Stop or avoid the use of nitrous oxide (N2O) and desflurane, consider the use of total intravenous or local-regional anesthesia, invest in the development of new technologies to minimize volatile anesthetics consumption, scavenging systems, and destruction of waste gas. The improved and sustained awareness of the medical community regarding the climate impact of inhaled anesthetics is mandatory to bring change in the current practice.
Collapse
Affiliation(s)
- Mariana Gaya da Costa
- Department of Anesthesiology, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands;
| | - Alain F. Kalmar
- Department of Anesthesia and Intensive Care Medicine, Maria Middelares Hospital, 9000 Ghent, Belgium;
- Department of Basic and Applied Medical Sciences, Ghent University, 9000 Ghent, Belgium
| | - Michel M. R. F. Struys
- Department of Anesthesiology, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands;
- Department of Basic and Applied Medical Sciences, Ghent University, 9000 Ghent, Belgium
| |
Collapse
|
3
|
Effects of sevoflurane exposure on apoptosis and cell cycle of peripheral blood lymphocytes, and immunologic function. BMC Anesthesiol 2021; 21:87. [PMID: 33743600 PMCID: PMC7980647 DOI: 10.1186/s12871-021-01305-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 02/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Waste anesthetic gases (WAGs) leaked from new-type halogenated inhalational anesthetics such as sevoflurane have been were reported to pose a risk for the health of operating room personnel. The effects of WAGs on peripheral blood lymphocytes, however, remain yet controversial. The present study was undertaken to examine the effects of occupational sevoflurane exposure on the peripheral blood lymphocytes of medical personnel who work in the operating room. METHODS A cohort of 56 medical residents were divided into exposed group (n = 28) and control group (non-exposed group) (n = 28). Gas chromatography was used to measure the concentration of sevoflurane in the medical resident's breathing zone during surgeries under inhalation anesthesia in the exposure group. The gas collection lasted an hour. Peripheral blood lymphocytes were isolated from venous blood, and then apoptosis and cell cycle were analyzed by flow cytometry. EDTA-anticoagulated whole blood was harvested to analyze the lymphocyte subsets by flow cytometry. Immunoglobulins (IgA, IgM, IgG) were quantified by immunoturbidimetry. RESULTS The average concentration of sevoflurane in the exposed group was 1.03 ppm with a range from 0.03 ppm to 2.24 ppm. No significant effects were found on the apoptosis rates or cell cycles of peripheral blood lymphocytes in the exposed group relative to the control group (P > 0.05). Similarly, there were no significant differences in the lymphocyte subsets or the levels of immunoglobulins (IgA, IgM, IgG) between the two groups (P > 0.05). CONCLUSIONS Occupational exposure to low-level sevoflurane has no significant effect on the peripheral blood lymphocytes of operating room staff, but this conclusion needs to be confirmed by multicenter and long-term follow-up studies with large samples. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION ChiCTR2000040772 , December 9, 2020 (Retrospective registration).
Collapse
|
4
|
Aun AG, Souza KM, Guedes JL, Figueiredo DBS, Lara JR, Silva MAP, Braz LG, Braz MG. Hepatotoxic and neuroendocrine effects in physicians occupationally exposed to most modern halogenated anesthetics and nitrous oxide. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 81:103515. [PMID: 33086149 DOI: 10.1016/j.etap.2020.103515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 06/11/2023]
Abstract
The lack of data on hepatic and hormonal markers for occupational exposure to most modern halogenated anesthetics has stimulated our research, which assessed liver enzymes, high-sensitivity C-reactive protein (hs-CRP) and neuroendocrine response. The study investigated 106 physicians who were categorized in an exposed group (primarily exposed to isoflurane and sevoflurane and less to desflurane and nitrous oxide) as well as as a control group. Anesthetic air monitoring was performed, and biological samples were analyzed for the most important liver enzymes, hs-CRP, adrenocorticotrophic hormone, cortisol and prolactin. No biomarkers were significantly different between the groups. Exposed males showed significant increases in cortisol and prolactin compared to unexposed males. However, values were within the reference ranges, and 22 % of exposed males versus 5 % of unexposed males exhibited higher prolactin values above the reference range. This study suggests that occupational exposure to the most commonly used inhalational anesthetics is not associated with hepatotoxicity or neurohormonal changes.
Collapse
Affiliation(s)
- Aline G Aun
- Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Kátina M Souza
- Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Júlia L Guedes
- Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Drielle B S Figueiredo
- Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Juliana R Lara
- Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Mariane A P Silva
- Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Leandro G Braz
- Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Mariana G Braz
- Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil.
| |
Collapse
|
5
|
Braz MG, Silva MAP, Figueiredo DBS, Aun AG, Marques LSK, Lara JR, Braz LG. Genetic instability assessed by telomere length and micronucleus in physicians exposed to anesthetics. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2020; 61:843-847. [PMID: 32390193 DOI: 10.1002/em.22380] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/21/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
This study evaluated both telomere length (TL) and micronucleus (MN) as indicators of genome instability in 40 anesthesiologists occupationally exposed to anesthetics and in 40 physicians without occupational exposure to anesthetics who were matched by age, sex, and lifestyle. Blood and buccal samples were collected from both groups at the same period. Anesthetic exposure assessment was performed. The studied groups were assessed regarding relative TL by quantitative polymerase chain reaction and MN by buccal MN assay. Mean trace concentrations of anesthetics were below two parts per million. No significant differences between groups were found for both biomarkers. However, MN frequency was slightly increased (1.9-fold; p = .094) in the exposed group compared to the control group and in the exposed males (2.4-fold; p = .090) compared to unexposed males. TL and age showed a significant negative correlation. Anesthetic occupational exposure below recommended levels is not associated with changes in TL and MN in anesthesiologists.
Collapse
Affiliation(s)
- Mariana G Braz
- GENOTOX Laboratory, Department of Anesthesiology, Botucatu Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Mariane A P Silva
- GENOTOX Laboratory, Department of Anesthesiology, Botucatu Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Drielle B S Figueiredo
- GENOTOX Laboratory, Department of Anesthesiology, Botucatu Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Aline G Aun
- GENOTOX Laboratory, Department of Anesthesiology, Botucatu Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Lais S K Marques
- GENOTOX Laboratory, Department of Anesthesiology, Botucatu Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Juliana R Lara
- GENOTOX Laboratory, Department of Anesthesiology, Botucatu Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| | - Leandro G Braz
- GENOTOX Laboratory, Department of Anesthesiology, Botucatu Medical School, São Paulo State University - UNESP, Botucatu, Brazil
| |
Collapse
|
6
|
Khisroon M, Humayun M, Khan A, Farooqi J, Humayun, khan J. Polymorphism in GSTM1 and GSTT1 genes influence DNA damage in personnel occupationally exposed to volatile anaesthetics (VA), from Peshawar, Pakistan. Occup Environ Med 2020; 77:769-774. [DOI: 10.1136/oemed-2020-106561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 01/19/2023]
Abstract
ObjectivesThe objective of this study was to assess the influence of antioxidant gene GSTM1 and GSTT1 on DNA damage in personnel occupationally exposed to volatile anaesthetics (VA).MethodsThe study groups were composed of 50 exposed subjects (anaesthesia workers) and 49 controls. Blood samples were collected from both subjects. DNA damage was analysed through the comet assay technique. Biomarker genes GSTM1 and GSTT1 were inspected through PCR technique for polymorphism.ResultsThe comet assay technique showed that the Total Comet Score (TCS) in exposed subjects was significantly higher (p=0.0001) than the control. Age and smoking had significant effects on TCS in the study groups (p<0.05). Duration of occupational exposure had significant positive correlation (r=0.755, p<0.001) with DNA damage. The null polymorphism in GSTM1 and GSTT1 gene showed a significant effect (p<0.001 and p<0.000) on the DNA damage.ConclusionsThe polymorphism in GSTM1 and GSTT1 gene significantly damage DNA in personnel occupationally exposed to VA.
Collapse
|
7
|
Downey PMR, Caraguel CGB, Speight N, Fabijan J, Boardman WSJ. Field immobilization using alfaxalone and alfaxalone-medetomidine in free-ranging koalas (Phascolarctos cinereus): a randomized comparative study. Vet Anaesth Analg 2020; 47:368-376. [PMID: 32276883 DOI: 10.1016/j.vaa.2019.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/10/2019] [Accepted: 10/08/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To characterize and compare two intramuscular drug protocols using alfaxalone and alfaxalone-medetomidine combination for the field immobilization of free-ranging koalas. STUDY DESIGN Blinded, randomized, comparative field study. ANIMALS A total of 66 free-ranging koalas from the Mount Lofty Ranges, South Australia. METHODS Koalas were randomly allocated into two groups. Group A animals were given alfaxalone alone at 3.5 mg kg-1. Group AM animals were given alfaxalone 2 mg kg-1 and medetomidine 40 μg kg-1, reversed with atipamezole at 0.16 mg kg-1. Blinded operators recorded heart rate (HR), respiratory rate (fR), cloacal temperature, depth of sedation and times to: first effect, sedation suitable for clinical interventions, first arousal and full recovery. Data were analysed using independent t test, Mann-Whitney U test, chi-square analysis and log-rank test at 5% level of significance. RESULTS Suitable immobilization for clinical examination and sample collection was achieved in all animals. In groups A and AM, median time to working depth was 6.5 minutes (range: 3.4-15) and 8.1 minutes (range: 4.3-24) and time to complete recovery was 66 minutes (range: 12-138) and 34 minutes (range: 4-84), respectively, following reversal. Time to first effect was significantly shorter in group A (p = 0.013), whereas time to full arousal was significantly shorter in group AM (p = 0.007) probably due to the administration of atipamezole. Maximum HR was 117 ± 28 beats minute-1 in group A, which was a significant increase from baseline values (p < 0.0001), whereas group AM showed a significant tachypnoea of 67 ± 25 (normal fR 10-15; p < 0.0001). CONCLUSIONS AND CLINICAL RELEVANCE Both the protocols produced immobilization, enabling clinical examination and sample collection; however, protocol AM was more suitable for field work due to shorter recovery times.
Collapse
Affiliation(s)
- Philip M R Downey
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, Australia
| | - Charles G B Caraguel
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, Australia
| | - Natasha Speight
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, Australia
| | - Jessica Fabijan
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, Australia
| | - Wayne S J Boardman
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, Australia.
| |
Collapse
|
8
|
Pro-Con Debate: Nitrous Oxide for Labor Analgesia. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4618798. [PMID: 31531352 PMCID: PMC6720045 DOI: 10.1155/2019/4618798] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/19/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023]
Abstract
This Pro-Con debate will provide the practitioner with an evidence-based knowledge approach to assist the clinician in determining whether to employ (Pro) or not to employ (Con) this technique in the obstetrical suite for labor analgesia. Nitrous oxide has been used safely in dentistry and medicine for many centuries. However, accumulating preclinical and clinical evidence increasingly suggests previously unrecognized adverse maternal and fetal effects of nitrous oxide, which warrants reconsideration of its use in pregnant women and a more detailed informed consent. Nitrous oxide is associated with metabolic, oxidative, genotoxic, and transgenerational epigenetic effects in animals and humans that may warrant limiting its usefulness in labor. This debate will discuss and review the clinical uses, advantages, and disadvantages of nitrous oxide on occupational effects of nitrous oxide exposure, neuroapoptosis, FDA warning on inhalational anesthetics and the developing brain, research limitations, occupational exposure safety limits, effects on global warming, and potential for diversion.
Collapse
|
9
|
Kirsch-Volders M, Fenech M, Bolognesi C. Validity of the Lymphocyte Cytokinesis-Block Micronucleus Assay (L-CBMN) as biomarker for human exposure to chemicals with different modes of action: A synthesis of systematic reviews. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2018; 836:47-52. [DOI: 10.1016/j.mrgentox.2018.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/06/2018] [Accepted: 05/07/2018] [Indexed: 10/17/2022]
|
10
|
Braz MG, Souza KM, Lucio LMC, Di Renzo GCC, Feliciano LM, Marcondes JPC, Chen CYO, Braz JRC, Braz LG. Detrimental effects detected in exfoliated buccal cells from anesthesiology medical residents occupationally exposed to inhalation anesthetics: An observational study. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2018; 832-833:61-64. [PMID: 30057022 DOI: 10.1016/j.mrgentox.2018.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/20/2018] [Accepted: 07/02/2018] [Indexed: 11/28/2022]
Abstract
Operating room professionals are scarcely aware of their individual occupational exposure to waste anesthetic gases (WAGs). Medical residents spend several hours per day in operating rooms and consequently experience occupational exposure to WAGs. Considering that no studies have yet evaluated the potential toxicity in medical residents exposed to WAGs using the buccal micronucleus cytome (BMCyt) assay, this pioneering study aimed to compare the BMCyt assay markers, including DNA damage, cell proliferation, and cell death in the exfoliated buccal cells of surgery and anesthesiology residents occupationally exposed to WAGs. The study enrolled a total of 60 physicians, including internal medicine residents (unexposed group), and residents from surgery and anesthesiology programs who were occupationally exposed to sevoflurane, isoflurane and nitrous oxide. WAGs were measured, and the mean values were higher than the international recommendation. The anesthesiology residents (high exposure) showed statistically significant lower frequencies of basal cells, and statistically significant higher frequencies of micronuclei, karyorrhexis, pyknosis, and differentiated cells than did the unexposed group; karyolysis frequencies were significantly higher in anesthesiology residents than were those in the unexposed group or in surgical residents (low exposure). The findings suggest a genetic risk for young professionals exposed to WAGs at the beginning of their careers. Thus, exposure to high WAGs concentrations leads to impairment of the buccal cell proliferative potential, genomic instability and cell death, especially in anesthesiology residents, demonstrating an early impact on their health.
Collapse
Affiliation(s)
- Mariana G Braz
- Universidade Estadual Paulista Universidade Estadual Paulista - UNESP, Faculdade de Medicina, Departamento de Anestesiologia, Botucatu, SP, Brazil.
| | - Kátina M Souza
- Universidade Estadual Paulista Universidade Estadual Paulista - UNESP, Faculdade de Medicina, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Lorena M C Lucio
- Universidade Estadual Paulista Universidade Estadual Paulista - UNESP, Faculdade de Medicina, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Giulia C C Di Renzo
- Universidade Estadual Paulista Universidade Estadual Paulista - UNESP, Faculdade de Medicina, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Luciana M Feliciano
- Universidade Estadual Paulista Universidade Estadual Paulista - UNESP, Instituto de Biociências, Departamento de Genética, Botucatu, SP, Brazil
| | - João Paulo C Marcondes
- Universidade Estadual Paulista Universidade Estadual Paulista - UNESP, Instituto de Biociências, Departamento de Genética, Botucatu, SP, Brazil
| | - C-Y Oliver Chen
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - José Reinaldo C Braz
- Universidade Estadual Paulista Universidade Estadual Paulista - UNESP, Faculdade de Medicina, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Leandro G Braz
- Universidade Estadual Paulista Universidade Estadual Paulista - UNESP, Faculdade de Medicina, Departamento de Anestesiologia, Botucatu, SP, Brazil
| |
Collapse
|
11
|
Çakmak G, Eraydın D, Berkkan A, Yağar S, Burgaz S. Genetic damage of operating and recovery room personnel occupationally exposed to waste anaesthetic gases. Hum Exp Toxicol 2018; 38:3-10. [PMID: 29932008 DOI: 10.1177/0960327118783532] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Occupational exposure to the waste anaesthetic gases (WAGs) is a crucial problem for healthcare personnel. Cancer is among the potential long-term adverse effects of WAGs. The present occupational molecular epidemiology study was conducted in healthcare personnel (anaesthetists, nurses and technicians; n = 46), working in operating rooms (ORs; n = 34) and recovery units (RUs; n = 12) of the same hospital, to assess the genotoxicity risk of WAGs exposure. Twenty-one healthy available hospital staff allocated to other wards, without the history of working in ORs and RUs were the control group. A micronucleus test was carried out for peripheral blood lymphocytes (PBLs) and buccal epithelial cells (BECs). Exposure to the anaesthetics was assessed with sevoflurane concentrations and inorganic fluoride levels in post-shift urine samples of the healthcare staff. As an exposure marker, sevoflurane concentrations in ORs and RUs were measured using passive samplers. The micronuclei frequencies were increased in both PBLs (approximately two times) and BECs (approximately three times) of the healthcare personnel. Urinary sevoflurane concentrations exceeded the biological equivalent level in 23 personnel. Air sevoflurane levels in the breathing zone in three ORs and one RU did not exceed the established occupational exposure limits. Both in surrogate tissue (PBLs) and in target tissue (BECs) of the personnel of RUs and ORs of the same hospital, the genotoxicity risk was evident and similar. Originality of this study, in addition to the WAGs exposure confirmation of the healthcare personnel, was the involvement of the RU personnel for the genotoxicity assessment, which was the first time in the scientific literature.
Collapse
Affiliation(s)
- G Çakmak
- 1 Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey
| | - D Eraydın
- 1 Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey
| | - A Berkkan
- 2 Department of Analytical Chemistry, Faculty of Pharmacy, Gazi University, Ankara, Turkey
| | - S Yağar
- 3 Clinic of Anaesthesiology and Reanimation, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - S Burgaz
- 1 Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey
| |
Collapse
|
12
|
Zafirova Z, Sheehan C, Hosseinian L. Update on nitrous oxide and its use in anesthesia practice. Best Pract Res Clin Anaesthesiol 2018; 32:113-123. [DOI: 10.1016/j.bpa.2018.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 01/22/2023]
|
13
|
Deng HB, Li FX, Cai YH, Xu SY. Waste anesthetic gas exposure and strategies for solution. J Anesth 2018; 32:269-282. [PMID: 29404778 DOI: 10.1007/s00540-018-2448-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 01/02/2018] [Indexed: 12/15/2022]
Abstract
As inhaled anesthetics are widely used, medical staff have inevitably suffered from exposure to anesthetic waste gases (WAGs). Whether chronic exposure to WAGs has an impact on the health of medical staff has long been a common concern, but conclusions are not consistent. Many measures and equipment have been proposed to reduce the concentration of WAGs as far as possible. This review aims to dissect the current exposure to WAGs and its influence on medical staff in the workplace and the environment, and summarize strategies to reduce WAGs.
Collapse
Affiliation(s)
- Hai-Bo Deng
- Department of Anesthesiology, Zhujiang Hospital of Southern Medical University, 253 Gongye Ave, Guangzhou, 510282, China
| | - Feng-Xian Li
- Department of Anesthesiology, Zhujiang Hospital of Southern Medical University, 253 Gongye Ave, Guangzhou, 510282, China
| | - Ye-Hua Cai
- Department of Anesthesiology, Zhujiang Hospital of Southern Medical University, 253 Gongye Ave, Guangzhou, 510282, China.
| | - Shi-Yuan Xu
- Department of Anesthesiology, Zhujiang Hospital of Southern Medical University, 253 Gongye Ave, Guangzhou, 510282, China.
| |
Collapse
|