Nilsson Roland, Björdal Chatarina, Andersson Matts, Björdal Jörn, Nyberg Anna, Welin Bengt, Willman Ania
Department of Anaesthesia, Malmö University Hospital, SE-205 02 Malmö, Sweden.
J Clin Nurs. 2005 Feb;14(2):173-86. doi: 10.1111/j.1365-2702.2004.01032.x.
To provide practicing nurse anaesthetists with evidence based knowledge as to whether they are at risk handling volatile anaesthetics by answering the question: What are the health risks threatening health care personnel occupationally exposed to volatile anaesthetics?
The interpretations of results from specific scientific studies vary and preliminary research results indicate that occupational exposure to volatile anaesthetics affects the health of operating room personnel.
Review of scientific literature with a systematic approach.
The review included a systematic search in three major databases, a screening process of abstracts/articles followed by a quality assessment of the included studies. The screening process and the quality assessment were done independently by the six reviewers and followed specific protocols.
A systematic search of The Cochrane Library, MedLine and CINAHL resulted in a screening of 413 abstracts of which 31 articles were assessed for quality, all done independently by the reviewers. Finally, the reviewers agreed upon how to interpret the results of the assessed articles.
The 31 articles assessed covered areas such as genotoxic effects, neurobehavioural effects, immunology, and general health effects. In the scientific literature reviewed there is no evidence of occupational exposure to volatile anaesthetics either being associated with health risks or being harmless. Studies indicating a potential health risk are all investigating circumstances ignorant of modern environmental regulations and/or with no scavenging equipment.
Although no answer has been given, this review illuminates the methodological difficulties encountered in designing studies. The result of this review further stresses the need for scientific knowledge in this area and enhances the extensive use of scavenging equipment.
通过回答以下问题，为执业麻醉护士提供基于证据的知识，即他们在处理挥发性麻醉剂时是否面临风险：职业接触挥发性麻醉剂对医护人员构成哪些健康威胁？
特定科学研究结果的解释各不相同，初步研究结果表明，职业接触挥发性麻醉剂会影响手术室人员的健康。
采用系统方法对科学文献进行综述。
该综述包括在三个主要数据库中进行系统检索，对摘要/文章进行筛选，然后对纳入研究进行质量评估。筛选过程和质量评估由六位评审员独立完成，并遵循特定方案。
对考克兰图书馆、医学在线数据库和护理学与健康领域数据库进行系统检索，筛选出413篇摘要，其中31篇文章被评估质量，所有评估均由评审员独立完成。最后，评审员就如何解释评估文章的结果达成一致。
所评估的31篇文章涵盖了遗传毒性效应、神经行为效应、免疫学和总体健康效应等领域。在所审查的科学文献中，没有证据表明职业接触挥发性麻醉剂与健康风险相关或无害。表明存在潜在健康风险的研究均调查了无视现代环境法规和/或没有清除设备的情况。
尽管尚未给出答案，但本综述阐明了研究设计中遇到的方法学困难。本综述结果进一步强调了该领域科学知识的必要性，并加强了清除设备的广泛使用。
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