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Struijs F, Hooijmans CR, Buijs M, Dahan A, Hoffmann S, Kiffen R, Mandrioli D, Menon J, Ritskes-Hoitinga M, Roeleveld N, de Ruijter A, Scheffer GJ, Schlünssen V, Scheepers PTJ. Establishing a health-based recommended occupational exposure limit for isoflurane using experimental animal data: a systematic review protocol. Syst Rev 2023; 12:166. [PMID: 37710304 PMCID: PMC10503167 DOI: 10.1186/s13643-023-02331-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Isoflurane is used as an inhalation anesthetic in medical, paramedical, and veterinary practice. Epidemiological studies suggest an increased risk of miscarriages and malformations at birth related to maternal exposure to isoflurane and other inhalation anesthetics. However, these studies cannot be used to derive an occupational exposure level (OEL), because exposure was not determined quantitatively and other risk factors such as co-exposures to other inhalation anesthetics and other work-related factors may also have contributed to the observed adverse outcomes. The aim of this systematic review project is to assess all available evidence on the effects of isoflurane in studies of controlled exposures in laboratory animals to derive a health-based recommended OEL. METHODS A comprehensive search strategy was developed to retrieve all animal studies addressing isoflurane exposure from PubMed, EMBASE, and Web of Science. Title-abstract screening will be performed by machine learning, and full-text screening by one reviewer. Discrepancies will be resolved by discussion. We will include primary research in healthy, sexually mature (non human) vertebrates of single exposure to isoflurane. Studies describing combined exposure and treatments with > = 1 vol% isoflurane will be excluded. Subsequently, details regarding study identification, study design, animal model, and intervention will be summarized. All relevant exposure characteristics and outcomes will be extracted. The risk of bias will be assessed by two independent reviewers using an adapted version of the SYRCLE's risk of bias tool and an addition of the OHAT tool. For all outcomes for which dose-response curves can be derived, the benchmark dose (BMD) approach will be used to establish a point of departure for deriving a recommended health-based recommended OEL for 8 h (workshift exposure) and for 15 min (short-term exposure). DISCUSSION Included studies should be sufficiently sensitive to detect the adverse health outcomes of interest. Uncertainties in the extrapolation from animals to humans will be addressed using assessment factor. These factors are justified in accordance with current practice in chemical risk assessment. A panel of experts will be involved to reach consensus decisions regarding significant steps in this project, such as determination of the critical effects and how to extrapolate from animals to humans. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022308978.
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Affiliation(s)
- Fréderique Struijs
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Carlijn R Hooijmans
- Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marije Buijs
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Albert Dahan
- Leiden University Medical Center, Leiden, The Netherlands
| | - Sebastian Hoffmann
- The Evidence-Based Toxicology Collaboration (EBTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Romy Kiffen
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Julia Menon
- Netherlands Heart Institute, Utrecht, The Netherlands
| | | | - Nel Roeleveld
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne de Ruijter
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Gert Jan Scheffer
- Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Paul T J Scheepers
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands.
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Keller M, Cattaneo A, Spinazzè A, Carrozzo L, Campagnolo D, Rovelli S, Borghi F, Fanti G, Fustinoni S, Carrieri M, Moretto A, Cavallo DM. Occupational Exposure to Halogenated Anaesthetic Gases in Hospitals: A Systematic Review of Methods and Techniques to Assess Air Concentration Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:514. [PMID: 36612837 PMCID: PMC9819674 DOI: 10.3390/ijerph20010514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/16/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
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.
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Affiliation(s)
- Marta Keller
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - Andrea Cattaneo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - Andrea Spinazzè
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - Letizia Carrozzo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - Davide Campagnolo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - Sabrina Rovelli
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - Francesca Borghi
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - Giacomo Fanti
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - Silvia Fustinoni
- IRCCS Ca’ Granda Foundation Maggiore Policlinico Hospital, 20122 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Mariella Carrieri
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padova, Italy
| | - Angelo Moretto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padova, Italy
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Cheng NY, Chuang HC, Shie RH, Liao WH, Hwang YH. Pilot Studies of VOC Exposure Profiles during Surgical Operations. Ann Work Expo Health 2020; 63:173-183. [PMID: 30551204 DOI: 10.1093/annweh/wxy099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/23/2018] [Accepted: 11/12/2018] [Indexed: 01/09/2023] Open
Abstract
Volatile organic chemical exposure resulting from surgical operations is common in operating room personnel. The potential risk of long-term exposure to these low-level chemicals is always a concern. This study was conducted in an area hospital located in northern Taiwan to investigate the internal exposure scenario for operating room personnel. Breath samples were collected before and after surgery, whereas area samples were collected during the surgeries in process. There were 18 volatile organic compounds identified in the samples with gas chromatography-mass spectrometry. The average concentrations of sevoflurane (P = 0.0082), dimethyl sulfide (P = 0.0550), and methyl methacrylate (P = 0.0606) in breath samples collected after surgical operations were significantly higher compared to those obtained before surgical operations, whereas only slight elevations were present for benzene and hexamethyldisiloxane (P < 0.100). In addition, electrosurgical smoke-related chemicals, such as benzene, toluene, ethylbenzene, and m/p-xylene, also presented higher levels in operating room samples compared to the control area. Specifically, the findings in this preliminary study suggested the associations of elevated exposure to sevoflurane across various surgeries to methyl methacrylate with orthopedic surgery and to hexamethyldisiloxane with conventional electrosurgical units. Future study is warranted to explore the short-term high-level chemical exposure in operating rooms and to propose effective preventive measures accordingly to keep any exposure to chemicals at the lowest practical level.
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Affiliation(s)
- Nai-Yun Cheng
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, R.O.C.,Institute of Labor, Occupational Safety and Health, Ministry of Labor, Executive Yuan, Taipei, Taiwan, R.O.C
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.,Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Ruei-Hao Shie
- Industrial Technology Research Institute, Hsinchu, Taiwan, R.O.C
| | - Wei-Heng Liao
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, Executive Yuan, Taipei, Taiwan, R.O.C
| | - Yaw-Huei Hwang
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, R.O.C.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan, R.O.C
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Özelsel TJP, Kim S, Buro K, Tsui B. Elevated Waste Anaesthetic Gas Concentration in the Paediatric Post-Anaesthesia Care Unit. Turk J Anaesthesiol Reanim 2018; 46:362-366. [PMID: 30263859 DOI: 10.5152/tjar.2018.35683] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 05/13/2018] [Indexed: 11/22/2022] Open
Abstract
Objective Exposure to waste anaesthetic gas (WAG) is a recognised occupational hazard for health care professionals (HCP). In recovery rooms, scavenging and ventilation systems differ from those in the operating room, raising the question as to how efficient they are. This study aims to measure the levels of ambient sevoflurane over the course of consecutive workdays in the paediatric recovery room of a tertiary academic centre. Methods The following is a descriptive-analytic study of ambient air sevoflurane levels measured using a MIRAN® 205B Series SapphIRe portable ambient air analyser. Samples were obtained between 7:30 am and 6:30 pm for two non-consecutive weeks on consecutive weekdays in our paediatric recovery room area. Results The ambient air levels of sevoflurane exceeded the ceiling concentration of 0.5 ppm recommended by the National Institute for Occupational Safety and Health on all days of measurement. The concentration of sevoflurane in ambient air correlates directly with the number of patients present. Conclusion Even in a modern recovery room constructed according to current building standard and code, ambient air levels of WAG exceed the recommendations. Future research and practice standards are needed to reduce this occupational exposure. Disregarding whether chronic exposure to WAG is harmful, we have shown that HCP working in recovery rooms are chronically exposed to concentrations which exceed recommended levels. Strategies are needed to reduce ambient levels of WAG in post-anaesthesia care units.
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Affiliation(s)
| | - Sam Kim
- Department of Anaesthesia and Pain Medicine, University of Alberta, Edmonton, Canada
| | - Karen Buro
- Department of Mathematics and Statistics, Macewan University, Edmonton, Canada
| | - Ban Tsui
- Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, USA
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Trefz P, Kamysek S, Fuchs P, Sukul P, Schubert JK, Miekisch W. Drug detection in breath: non-invasive assessment of illicit or pharmaceutical drugs. J Breath Res 2017; 11:024001. [DOI: 10.1088/1752-7163/aa61bf] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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6
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Ghimenti S, Tabucchi S, Bellagambi FG, Lomonaco T, Onor M, Trivella MG, Fuoco R, Di Francesco F. Determination of sevoflurane and isopropyl alcohol in exhaled breath by thermal desorption gas chromatography-mass spectrometry for exposure assessment of hospital staff. J Pharm Biomed Anal 2014; 106:218-23. [PMID: 25619625 DOI: 10.1016/j.jpba.2014.11.052] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 11/04/2014] [Accepted: 11/08/2014] [Indexed: 11/28/2022]
Abstract
Volatile anaesthetics and disinfection chemicals pose ubiquitous inhalation and dermal exposure risks in hospital and clinic environments. This work demonstrates specific non-invasive breath biomonitoring methodology for assessing staff exposures to sevoflurane (SEV) anaesthetic, documenting its metabolite hexafluoroisopropanol (HFIP) and measuring exposures to isopropanol (IPA) dermal disinfection fluid. Methods are based on breath sample collection in Nalophan bags, followed by an aliquot transfer to adsorption tube, and subsequent analysis by thermal desorption gas chromatography-mass spectrometry (TD-GC-MS). Ambient levels of IPA were also monitored. These methods could be generalized to other common volatile chemicals found in medical environments. Calibration curves were linear (r(2)=0.999) in the investigated ranges: 0.01-1000 ppbv for SEV, 0.02-1700 ppbv for IPA, and 0.001-0.1 ppbv for HFIP. The instrumental detection limit was 10 pptv for IPA and 5 pptv for SEV, both estimated by extracted ion-TIC chromatograms, whereas the HFIP minimum detectable concentration was 0.5 pptv as estimated in SIM acquisition mode. The methods were applied to hospital staff working in operating rooms and clinics for blood draws. SEV and HFIP were present in all subjects at concentrations in the range of 0.7-18, and 0.002-0.024 ppbv for SEV and HFIP respectively. Correlation between IPA ambient air and breath concentration confirmed the inhalation pathway of exposure (r=0.95, p<0.001) and breath-borne IPA was measured as high as 1500 ppbv. The methodology is easy to implement and valuable for screening exposures to common hospital chemicals. Although the overall exposures documented were generally below levels of health concern in this limited study, outliers were observed that indicate potential for acute exposures.
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Affiliation(s)
- Silvia Ghimenti
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi, 3, 56124 Pisa, Italy
| | - Sara Tabucchi
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi, 3, 56124 Pisa, Italy
| | - Francesca G Bellagambi
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi, 3, 56124 Pisa, Italy
| | - Tommaso Lomonaco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi, 3, 56124 Pisa, Italy
| | - Massimo Onor
- Institute of Chemistry of Organometallic Compounds, CNR, Via Moruzzi 1, 56124 Pisa, Italy
| | | | - Roger Fuoco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi, 3, 56124 Pisa, Italy
| | - Fabio Di Francesco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi, 3, 56124 Pisa, Italy; Institute of Clinical Physiology, CNR, Via Moruzzi 1, 56124 Pisa, Italy.
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McGlothlin JD, Moenning JE, Cole SS. Evaluation and Control of Waste Anesthetic Gases in the Postanesthesia Care Unit. J Perianesth Nurs 2014; 29:298-312. [DOI: 10.1016/j.jopan.2013.09.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/26/2013] [Accepted: 09/02/2013] [Indexed: 11/26/2022]
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8
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Amann A, Costello BDL, Miekisch W, Schubert J, Buszewski B, Pleil J, Ratcliffe N, Risby T. The human volatilome: volatile organic compounds (VOCs) in exhaled breath, skin emanations, urine, feces and saliva. J Breath Res 2014; 8:034001. [PMID: 24946087 DOI: 10.1088/1752-7155/8/3/034001] [Citation(s) in RCA: 361] [Impact Index Per Article: 36.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Breath analysis is a young field of research with its roots in antiquity. Antoine Lavoisier discovered carbon dioxide in exhaled breath during the period 1777-1783, Wilhelm (Vilém) Petters discovered acetone in breath in 1857 and Johannes Müller reported the first quantitative measurements of acetone in 1898. A recent review reported 1765 volatile compounds appearing in exhaled breath, skin emanations, urine, saliva, human breast milk, blood and feces. For a large number of compounds, real-time analysis of exhaled breath or skin emanations has been performed, e.g., during exertion of effort on a stationary bicycle or during sleep. Volatile compounds in exhaled breath, which record historical exposure, are called the 'exposome'. Changes in biogenic volatile organic compound concentrations can be used to mirror metabolic or (patho)physiological processes in the whole body or blood concentrations of drugs (e.g. propofol) in clinical settings-even during artificial ventilation or during surgery. Also compounds released by bacterial strains like Pseudomonas aeruginosa or Streptococcus pneumonia could be very interesting. Methyl methacrylate (CAS 80-62-6), for example, was observed in the headspace of Streptococcus pneumonia in concentrations up to 1420 ppb. Fecal volatiles have been implicated in differentiating certain infectious bowel diseases such as Clostridium difficile, Campylobacter, Salmonella and Cholera. They have also been used to differentiate other non-infectious conditions such as irritable bowel syndrome and inflammatory bowel disease. In addition, alterations in urine volatiles have been used to detect urinary tract infections, bladder, prostate and other cancers. Peroxidation of lipids and other biomolecules by reactive oxygen species produce volatile compounds like ethane and 1-pentane. Noninvasive detection and therapeutic monitoring of oxidative stress would be highly desirable in autoimmunological, neurological, inflammatory diseases and cancer, but also during surgery and in intensive care units. The investigation of cell cultures opens up new possibilities for elucidation of the biochemical background of volatile compounds. In future studies, combined investigations of a particular compound with regard to human matrices such as breath, urine, saliva and cell culture investigations will lead to novel scientific progress in the field.
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Affiliation(s)
- Anton Amann
- Univ-Clinic for Anesthesia and Intensive Care, Innsbruck Medical University, Anichstr, 35, A-6020 Innsbruck, Austria. Breath Research Institute of the University of Innsbruck, Rathausplatz 4, A-6850 Dornbirn, Austria
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9
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Amann A, Miekisch W, Schubert J, Buszewski B, Ligor T, Jezierski T, Pleil J, Risby T. Analysis of exhaled breath for disease detection. ANNUAL REVIEW OF ANALYTICAL CHEMISTRY (PALO ALTO, CALIF.) 2014; 7:455-482. [PMID: 25014347 DOI: 10.1146/annurev-anchem-071213-020043] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath resolution in addition to the conventional central laboratory methods using gas chromatography-mass spectrometry. Breath tests are based on endogenously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of adverse outcome pathways.
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Affiliation(s)
- Anton Amann
- Breath Research Institute of the University of Innsbruck, A-6850 Dornbirn, Austria;
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Trefz P, Schmidt M, Oertel P, Obermeier J, Brock B, Kamysek S, Dunkl J, Zimmermann R, Schubert JK, Miekisch W. Continuous Real Time Breath Gas Monitoring in the Clinical Environment by Proton-Transfer-Reaction-Time-of-Flight-Mass Spectrometry. Anal Chem 2013; 85:10321-9. [DOI: 10.1021/ac402298v] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Phillip Trefz
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Markus Schmidt
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Peter Oertel
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Juliane Obermeier
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Beate Brock
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Svend Kamysek
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Jürgen Dunkl
- Ionicon Analytik GmbH, Eduard-Bodem-Gasse 3, A-6020 Innsbruck, Austria
| | - Ralf Zimmermann
- Joint Mass Spectrometry
Centre, Chair of Analytical Chemistry, University of Rostock, Dr. Lorenz Weg
1, 18059 Rostock, Germany and Joint Mass Spectrometry Centre, Cooperation Group “Comprehensive
Molecular Analytics”, Helmholtz Zentrum München, D-85764 Neuherberg, Germany
| | - Jochen K. Schubert
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Wolfram Miekisch
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
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Miekisch W, Herbig J, Schubert JK. Data interpretation in breath biomarker research: pitfalls and directions. J Breath Res 2012; 6:036007. [DOI: 10.1088/1752-7155/6/3/036007] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Irwin MG, Trinh T, Yao CL. Occupational exposure to anaesthetic gases: a role for TIVA. Expert Opin Drug Saf 2009; 8:473-83. [DOI: 10.1517/14740330903003778] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Smith RA. What you don't know can hurt you: health hazards in the work environment. J Perianesth Nurs 2009; 24:75-80. [PMID: 19332279 DOI: 10.1016/j.jopan.2008.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Accepted: 11/28/2008] [Indexed: 10/21/2022]
Abstract
Perianesthesia nurses are aware of health hazards in the work environment including radiation, chemotherapeutic drugs, and blood-borne pathogens. Results of a 2005 survey reveal that there may be more hazards to consider. Substances used by nurses and patients every day such as hand disinfecting agents, personal care products, and housekeeping chemicals may also pose a threat to the health of patients, nurses, and the nurses' children. Perianesthesia nurses are exposed to these commonly occurring hazards and to other materials including second-hand anesthetic gases, latex, and sterilizing agents. A survey of more than 1,500 nurses from across the country conducted by a coalition of environmental and nursing organizations revealed exposures that can have serious health effects. These survey results illuminate health implications all nurses need to know to take the necessary steps to protect patients, themselves, and their children.
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Affiliation(s)
- Renee A Smith
- PACU and In & Out Surgery, Geisinger Medical Center, MC 20-15, 100 N Academy Ave, Danville, PA 17822, USA.
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