Norton Pedro, Pinho Paulo, Xará Daniela, Pina Fátima, Norton Maria
Occupational Health Department, Centro Hospitalar e Universitário de São João.
EPIUnit, Instituto de Saúde Pública, Universidade do Porto.
Porto Biomed J. 2020 Jul 17;5(4):e076. doi: 10.1097/j.pbj.0000000000000076. eCollection 2020 Jul-Aug.
Adverse health effects related with chronic exposure to waste anesthetic gases remain controversial. Strict threshold values are recommended to minimize possible health risks. The objective of our study was to measure the concentration of waste anesthetic gases in different hospital settings in an 11-year period.
Six-monthly assessment of nitrous oxide, sevoflurane, and desflurane was made between 2005 and 2016 in different hospital departments. Trace gas analysis was performed by infrared spectroscopy.
An anesthetic gas concentration above the upper limit of the threshold value was found in computed tomography/magnetic resonance imaging (CT/MRI) (45.5%), ambulatory operating room (34.5%), and in the burn unit (31.6%). Desflurane assessment was more frequently above the upper limit of threshold value (12.37%).
In the CT/MRI department, the small number of air cycling per hour and the frequent use of a face mask with the associated risk of leakage may explain the results. In burn unit patients inhalatory route is also frequent. Desflurane is widely used for its rapid elimination and rapid recovery, which is compatible with the results. Being odorless, it may be connected to undetected escape.
The places with more anesthetic agents exposure were the CT/MRI, the ambulatory operating room, and the burn unit. Desflurane was the anesthetic agent more frequently above the upper limit of threshold value. To complement environmental surveillance, it is essential to establish a health surveillance system for professionals exposed to anesthetic agents.
长期接触废弃麻醉气体对健康的不良影响仍存在争议。建议设定严格的阈值以尽量降低可能的健康风险。我们研究的目的是在11年期间测量不同医院环境中废弃麻醉气体的浓度。
在2005年至2016年期间，对不同医院科室每六个月进行一次一氧化二氮、七氟烷和地氟烷的评估。通过红外光谱法进行痕量气体分析。
在计算机断层扫描/磁共振成像（CT/MRI）科室（45.5%）、门诊手术室（34.5%）和烧伤科（31.6%）发现麻醉气体浓度高于阈值上限。地氟烷评估结果更频繁地高于阈值上限（12.37%）。
在CT/MRI科室，每小时空气循环次数少以及频繁使用面罩且存在泄漏风险可能解释了这些结果。在烧伤科，患者也经常采用吸入途径。地氟烷因其快速消除和快速恢复而被广泛使用，这与结果相符。由于其无味，可能存在未被检测到的泄漏情况。
接触麻醉剂较多的场所是CT/MRI科室、门诊手术室和烧伤科。地氟烷是更频繁高于阈值上限的麻醉剂。为补充环境监测，为接触麻醉剂的专业人员建立健康监测系统至关重要。
