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职业暴露于废弃麻醉气体的手术室及恢复室人员的基因损伤。

Genetic damage of operating and recovery room personnel occupationally exposed to waste anaesthetic gases.

作者信息

Çakmak G, Eraydın D, Berkkan A, Yağar S, Burgaz S

机构信息

1 Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey.

2 Department of Analytical Chemistry, Faculty of Pharmacy, Gazi University, Ankara, Turkey.

出版信息

Hum Exp Toxicol. 2019 Jan;38(1):3-10. doi: 10.1177/0960327118783532. Epub 2018 Jun 22.

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.

摘要

职业接触废弃麻醉气体(WAGs)对医护人员来说是一个关键问题。癌症是WAGs潜在的长期不良影响之一。本职业分子流行病学研究针对同一家医院手术室(ORs;n = 34)和恢复室(RUs;n = 12)工作的医护人员(麻醉师、护士和技术人员;n = 46)进行,以评估WAGs暴露的遗传毒性风险。21名分配到其他病房、无手术室和恢复室工作史的健康医院工作人员作为对照组。对外周血淋巴细胞(PBLs)和颊黏膜上皮细胞(BECs)进行了微核试验。通过医护人员下班后尿液样本中的七氟醚浓度和无机氟水平评估麻醉剂暴露情况。作为暴露标志物,使用被动采样器测量手术室和恢复室中的七氟醚浓度。医护人员的PBLs(约两倍)和BECs(约三倍)中的微核频率均有所增加。23名人员的尿液七氟醚浓度超过了生物等效水平。三个手术室和一个恢复室呼吸区域的空气中七氟醚水平未超过既定的职业接触限值。在同一家医院手术室和恢复室人员的替代组织(PBLs)和靶组织(BECs)中,遗传毒性风险均明显且相似。本研究的独特之处在于,除了确认医护人员接触WAGs外,还将恢复室人员纳入遗传毒性评估,这在科学文献中尚属首次。

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