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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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Heiderich S, Thoben C, Dennhardt N, Krauß T, Sümpelmann R, Zimmermann S, Reitz M, Rüffert H. Preparation of Dräger Atlan A350 and General Electric Healthcare Carestation 650 anesthesia workstations for malignant hyperthermia susceptible patients. BMC Anesthesiol 2021; 21:315. [PMID: 34903173 PMCID: PMC8667359 DOI: 10.1186/s12871-021-01533-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients at risk of malignant hyperthermia need trigger-free anesthesia. Therefore, anesthesia machines prepared for safe use in predisposed patients should be free of volatile anesthetics. The washout time depends on the composition of rubber and plastic in the anesthesia machine. Therefore, new anesthesia machines should be evaluated regarding the safe preparation for trigger-free anesthesia. This study investigates wash out procedures of volatile anesthetics for two new anesthetic workstations: Dräger Atlan A350 and General Electric Healthcare (GE) Carestation 650 and compare it with preparation using activated charcoal filters (ACF). METHODS A Dräger Atlan and a Carestation 650 were contaminated with 4% sevoflurane for 90 min. The machines were decontaminated with method (M1): using ACF, method 2 (M2): a wash out method that included exchange of internal parts, breathing circuits and soda lime canister followed by ventilating a test lung using a preliminary protocol provided by Dräger or method 3 (M3): a universal wash out instruction of GE, method 4 (M4): M3 plus exchange of breathing system and bellows. Decontamination was followed by a simulated trigger-free ventilation. All experiments were repeated with 8% desflurane contaminated machines. Volatile anesthetics were detected with a closed gas loop high-resolution ion mobility spectrometer with gas chromatographic pre-separation attached to the bacterial filter of the breathing circuits. Primary outcome was time until < 5 ppm of volatile anesthetics and total preparation time. RESULTS Time to < 5 ppm for the Atlan was 17 min (desflurane) and 50 min (sevoflurane), wash out continued for a total of 60 min according to protocol resulting in a total preparation time of 96-122 min. The Carestation needed 66 min (desflurane) and 24 min (sevoflurane) which could be abbreviated to 24 min (desflurane) if breathing system and bellows were changed. Total preparation time was 30-73 min. When using active charcoal filters time to < 5 ppm was 0 min for both machines, and total preparation time < 5 min. CONCLUSION Both wash out protocols resulted in a significant reduction of trace gas concentrations. However, due to the complexity of the protocols and prolonged total preparation time, feasibility in clinical practice remains questionable. Especially when time is limited preparation of the anesthetic machines using ACF remain superior.
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Affiliation(s)
- Sebastian Heiderich
- Clinic of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Christian Thoben
- Department of Sensors and Measurement Technology, Leibniz University Hannover, Institute of Electrical Engineering and Measurement Technology, Hannover, Germany
| | - Nils Dennhardt
- Clinic of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Terence Krauß
- Clinic of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Robert Sümpelmann
- Clinic of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stefan Zimmermann
- Department of Sensors and Measurement Technology, Leibniz University Hannover, Institute of Electrical Engineering and Measurement Technology, Hannover, Germany
| | - Michael Reitz
- Clinic of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Henrik Rüffert
- Clinic of Anaesthesiology and Intensive Care Medicine, Helios Klinik Schkeuditz, Leipzig, Germany
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Thoben C, Raddatz CR, Lippmann M, Salehimoghaddam Z, Zimmermann S. Electrospray ionization ion mobility spectrometer with new tristate ion gating for improved sensitivity for compounds with lower ion mobility. Talanta 2021; 233:122579. [PMID: 34215071 DOI: 10.1016/j.talanta.2021.122579] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/25/2022]
Abstract
An electrospray is a dispersed nebula of charged droplets produced under the influence of a strong electric field. The charged droplets subsequently result in ions in the gas phase. Therefore, electrospray is a commonly used method for transferring liquids to the gas phase while ionizing its constituents at the same time. In this work, we investigate the performance of an electrospray ionization ion mobility spectrometer by varying the electric field strength in the desolvation region. In particular, we investigate a new tristate ion shutter with increased sensitivity for ions with higher molecular mass and lower ion mobility that are usually suppressed by classical Bradbury-Nielsen or Tyndall-Powell ion shutters when using short gating times as required for high resolving power. The electric field in the tristate ion shutter affects the optimal ratio of the electric field strengths in the drift and desolvation region. Furthermore, the solvent flow rate needs to be considered when setting the field strengths in the desolvation region. However, a higher electric field strength in the desolvation region affects the field at the emitter tip. For this reason, a smaller ratio of the drift field strength and the desolvation field strength is beneficial, especially since higher solvent flow rates require higher fields to initiate an electrospray. In this work, we use tetraoctylammonium bromide as an instrument standard and the fungicide metalaxyl, the herbicide isoproturon and the antibiotic cefuroxime as model compounds.
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Affiliation(s)
- C Thoben
- Leibniz University Hannover, Institute of Electrical Engineering and Measurement Technology, Appelstr. 9A, 30167, Hannover, Germany.
| | - C-R Raddatz
- Leibniz University Hannover, Institute of Electrical Engineering and Measurement Technology, Appelstr. 9A, 30167, Hannover, Germany
| | - M Lippmann
- Leibniz University Hannover, Institute of Electrical Engineering and Measurement Technology, Appelstr. 9A, 30167, Hannover, Germany
| | - Z Salehimoghaddam
- Leibniz University Hannover, Institute of Electrical Engineering and Measurement Technology, Appelstr. 9A, 30167, Hannover, Germany
| | - S Zimmermann
- Leibniz University Hannover, Institute of Electrical Engineering and Measurement Technology, Appelstr. 9A, 30167, Hannover, Germany
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Gupta P, Bilmen J, Hopkins P. Anaesthetic management of a known or suspected malignant hyperthermia susceptible patient. BJA Educ 2021; 21:218-224. [PMID: 34026275 PMCID: PMC8134759 DOI: 10.1016/j.bjae.2021.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- P.K. Gupta
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
- University of Leeds, Leeds, UK
| | - J.G. Bilmen
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
- University of Leeds, Leeds, UK
| | - P.M. Hopkins
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
- University of Leeds, Leeds, UK
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Varughese S, Ahmed R. Environmental and Occupational Considerations of Anesthesia: A Narrative Review and Update. Anesth Analg 2021; 133:826-835. [PMID: 33857027 PMCID: PMC8415729 DOI: 10.1213/ane.0000000000005504] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
With an estimated worldwide volume of 266 million surgeries in 2015, the call for general inhalation anesthesia is considerable. However, widely used volatile anesthetics such as N2O and the highly fluorinated gases sevoflurane, desflurane, and isoflurane are greenhouse gases, ozone-depleting agents, or both. Because these agents undergo minimal metabolism in the body during clinical use and are primarily (≥95%) eliminated unchanged via exhalation, waste anesthetic gases (WAGs) in operating rooms and postanesthesia care units can pose a challenge for overall elimination and occupational exposure. The chemical properties and global warming impacts of these gases vary, with atmospheric lifetimes of 1-5 years for sevoflurane, 3-6 years for isoflurane, 9-21 years for desflurane, and 114 years for N2O. Additionally, the use of N2O as a carrier gas for the inhalation anesthetics and as a supplement to intravenous (IV) anesthetics further contributes to these impacts. At the same time, unscavenged WAGs can result in chronic occupational exposure of health care workers to potential associated adverse health effects. Few adverse effects associated with WAGs have been documented, however, when workplace exposure limits are implemented. Specific measures that can help reduce occupational exposure and the environmental impact of inhaled anesthetics include efficient ventilation and scavenging systems, regular monitoring of airborne concentrations of waste gases to remain below recommended limits, ensuring that anesthesia equipment is well maintained, avoiding desflurane and N2O if possible, and minimizing fresh gas flow rates (eg, use of low-flow anesthesia). One alternative to volatile anesthetics may be total intravenous anesthesia (TIVA). While TIVA is not associated with the risks of occupational exposure or atmospheric pollution that are inherent to volatile anesthetic gases, clinical considerations should be weighed in the choice of agent. Appropriate procedures for the disposal of IV anesthetics must be followed to minimize any potential for negative environmental effects. Overall, although their contributions are relatively low compared with those of other human-produced substances, inhaled anesthetics are intrinsically potent greenhouse gases and pose a risk to operating-room personnel if not properly managed and scavenged. Factors to reduce waste and minimize the future impact of these substances should be considered.
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Affiliation(s)
- Shane Varughese
- From the Global Medical Affairs, AbbVie Inc, North Chicago, Illinois
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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.
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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
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Heiderich S, Bastian B, Johannsen S, Klingler W, Rüffert H, Schuster F. [The European Malignant Hyperthermia Group consensus guidelines on perioperative management of malignant hyperthermia suspected or susceptible patients]. Anaesthesist 2020; 70:155-157. [PMID: 33269407 DOI: 10.1007/s00101-020-00893-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sebastian Heiderich
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30659, Hannover, Deutschland.
| | - Börge Bastian
- Zentrum für Maligne Hyperthermie, Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Stephan Johannsen
- Zentrum für Maligne Hyperthermie, Klinik und Poliklinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Werner Klingler
- Klinik für Anästhesie und Intensivmedizin, SRH Kliniken Landkreis Sigmaringen, Sigmaringen, Deutschland
| | - Henrik Rüffert
- Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, Helios Klinik Schkeuditz, Schkeuditz, Deutschland
| | - Frank Schuster
- Zentrum für Maligne Hyperthermie, Klinik und Poliklinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Würzburg, Würzburg, Deutschland
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Rüffert H, Bastian B, Bendixen D, Girard T, Heiderich S, Hellblom A, Hopkins PM, Johannsen S, Snoeck MM, Urwyler A, Glahn KPE. Consensus guidelines on perioperative management of malignant hyperthermia suspected or susceptible patients from the European Malignant Hyperthermia Group. Br J Anaesth 2020; 126:120-130. [PMID: 33131754 DOI: 10.1016/j.bja.2020.09.029] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/24/2020] [Accepted: 09/26/2020] [Indexed: 11/15/2022] Open
Abstract
Malignant hyperthermia is a potentially fatal condition, in which genetically predisposed individuals develop a hypermetabolic reaction to potent inhalation anaesthetics or succinylcholine. Because of the rarity of malignant hyperthermia and ethical limitations, there is no evidence from interventional trials to inform the optimal perioperative management of patients known or suspected with malignant hyperthermia who present for surgery. Furthermore, as the concentrations of residual volatile anaesthetics that might trigger a malignant hyperthermia crisis are unknown and manufacturers' instructions differ considerably, there are uncertainties about how individual anaesthetic machines or workstations need to be prepared to avoid inadvertent exposure of susceptible patients to trigger anaesthetic drugs. The present guidelines are intended to bundle the available knowledge about perioperative management of malignant hyperthermia-susceptible patients and the preparation of anaesthesia workstations. The latter aspect includes guidance on the use of activated charcoal filters. The guidelines were developed by members of the European Malignant Hyperthermia Group, and they are based on evaluation of the available literature and a formal consensus process. The most crucial recommendation is that malignant hyperthermia-susceptible patients should receive anaesthesia that is free of triggering agents. Providing that this can be achieved, other key recommendations include avoidance of prophylactic administration of dantrolene; that preoperative management, intraoperative monitoring, and care in the PACU are unaltered by malignant hyperthermia susceptibility; and that malignant hyperthermia patients may be anaesthetised in an outpatient setting.
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Affiliation(s)
- Henrik Rüffert
- Klinik für Anästhesie, Intensivmedizin, Schmerztherapie, Helios Klinik Schkeuditz, Leipzig-Schkeuditz, Germany; Department of Anaesthesiology and Intensive Care Medicine, MH Centre, University Hospital Leipzig, Leipzig, Germany.
| | - Börge Bastian
- Department of Anaesthesiology and Intensive Care Medicine, MH Centre, University Hospital Leipzig, Leipzig, Germany
| | - Diana Bendixen
- Danish Malignant Hyperthermia Centre, Department of Anaesthesia, University Hospital Herlev, Copenhagen, Denmark
| | - Thierry Girard
- Department of Anaesthesia and Research, University of Basel, Basel, Switzerland
| | - Sebastian Heiderich
- Clinic of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany
| | - Anna Hellblom
- Department of Anaesthesia, University Hospital, Lund, Sweden
| | - Philip M Hopkins
- Malignant Hyperthermia Unit, St James's University Hospital, Leeds, UK
| | - Stephan Johannsen
- Department of Anaesthesia and Critical Care, University of Würzburg, Würzburg, Germany
| | - Marc M Snoeck
- Department of Anaesthesiology, Canisius-Wilhelmina Ziekenhuis, Nijmegen, the Netherlands
| | - Albert Urwyler
- Department of Anaesthesia and Research, University of Basel, Basel, Switzerland
| | - Klaus P E Glahn
- Danish Malignant Hyperthermia Centre, Department of Anaesthesia, University Hospital Herlev, Copenhagen, Denmark
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Waste of anaesthetic gases may be related to impairment of nurse health in the postanaesthesia care unit. Eur J Anaesthesiol 2020; 37:614-615. [PMID: 32516180 DOI: 10.1097/eja.0000000000001205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Herzog-Niescery J, Vogelsang H, Bellgardt M, Seipp HM, Weber TP, Gude P. The Personnel's Sevoflurane Exposure in the Postanesthesia Care Unit Measured by Photoacoustic Gas Monitoring and Hexafluoroisopropanol Biomonitoring. J Perianesth Nurs 2019; 34:606-613. [PMID: 30665744 DOI: 10.1016/j.jopan.2018.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/22/2018] [Accepted: 10/27/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE Room ventilation in the postanesthesia care unit (PACU) is often poor, although patients exhale anesthetic gases. We investigated the PACU personnel's environmental and biological sevoflurane (SEVO) burden during patient care. DESIGN Prospective, observational study. METHODS Air pollution was measured by photoacoustic gas monitoring in the middle of the PACU, above the patient's face, and on the PACU corridor. Urinary SEVO and hexafluoroisopropanol concentrations were determined. FINDINGS Mean air pollution was 0.34 ± 0.07 ppm in the middle of the PACU, 0.56 ± 0.17 ppm above the patient's face, and 0.47 ± 0.06 ppm on the corridor. Biological preshift exposure levels were 0.13 ± 0.03 mcg/L (SEVO) and 4.72 ± 5.41 mcg/L (hexafluoroisopropanol). Postshift concentrations increased significantly to 0.20 ± 0.06 mcg/L (P = .004) and 42.18 ± 27.82 mcg/L (P < .001). CONCLUSIONS PACU personnel were environmentally and biologically exposed to SEVO, but exposure levels were minimal according to current recommendations.
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Kim DD, Kimura Jr A, Pontes DKL, Oliveira MLS, Cumino DO. Evaluation of anesthesiologists' knowledge about occupational health: Pilot study. BMC Anesthesiol 2018; 18:193. [PMID: 30567562 PMCID: PMC6300909 DOI: 10.1186/s12871-018-0661-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/03/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND An anesthesiologists' work presents with numerous occupational risks owing to the large amount of time spent inside the operating room where constant noise, anesthetic vapors, ionizing radiation, infectious agents, and psychological stress are present. Herein, we evaluated anesthesiologists' knowledge about occupational health. METHODS A cross-sectional study was conducted to assess 158 anesthesiologists from a tertiary hospital on their knowledge about occupational health using a structured questionnaire. RESULTS The survey revealed a lack of knowledge on the forms of prevention of occupational accidents (74.6% did not know how to act in case of a fire during surgery, 56% failed to identify the post-anesthesia care unit as the place with the highest contamination by inhalation anesthetics, and 42.7% failed to identify all personal protective equipment) and a surprisingly high rate of lack of observance of preventive measures (30.3% washed their hands before touching every patient, 52.5% did not use gloves during intravenous access, and 88.6% used protective equipment against ionizing radiation). CONCLUSIONS Despite improvements in safety standards in healthcare facilities, our research showed lack of knowledge about major topics on occupational health by physicians. Improving safety awareness is an important goal of training programs and continued medical education.
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Affiliation(s)
- Daniel Dongiu Kim
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Aldemar Kimura Jr
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Dayanne Karla Lopes Pontes
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Maycon Luiz Silva Oliveira
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Debora Oliveira Cumino
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
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