Neghab Masoud, Amiri Fatemeh, Zare Mehdi, Zareei Fayegheh
Department of Occupational Health Engineering, Research Center for Health Sciences, Institute of Health, School of Health, Shiraz University of Medical Sciences, Shiraz.
Department of Occupational Health Engineering, Social Determinants in Health Promotion Research Center, Research Institute for Health.
Ann Med Surg (Lond). 2023 May 9;85(6):2313-2318. doi: 10.1097/MS9.0000000000000500. eCollection 2023 Jun.
This study was undertaken to ascertain whether long-term occupational exposure to inhalational anesthetic, was associated with any significant alteration in the parameters of immune function.
This was a historical cohort study in which 30 male participants with at least one year of work experience in the operating room at the time of the study and 30 unexposed referent subjects were investigated. Exposure levels were quantified by measuring the urinary concentrations of nitrous oxide (N2O), isoflurane, and sevoflurane gases by headspace gas chromatography-mass spectrometry. Serum concentrations of interleukin-4 (IL-4), Th2-type cytokines, and interferon-gamma (IFN-γ) were measured by the ELISA method. Additionally, an automated hematology analyzer was used for the white blood cell count and white blood cell differential test. The data were analyzed using SPSS software for Windows version 21.
Mean urinary concentrations of N2O, isoflurane, and sevoflurane 211.57±75.15, 4.06±0.96, and 19.51±12.96 In simplistic statistical data analysis, significant differences were noted between exposed and control groups as far as the mean serum cytokines levels (IFN-γ, IL-4) were concerned. Furthermore, after adjusting for important confounders, statistical analysis showed that the IFN-γ, IL-4, and the ratio of IFN-γ/IL-4 were significantly higher in the exposed group than in the referent subjects.
These findings provide corroborative evidence to further substantiate the contention that exposure to anesthetics agents (N2O, isoflurane, and sevoflurane) is associated with subtle, subclinical, prepathological changes in the parameters of immune function. The long-term ramification of these changes requires further investigation.
本研究旨在确定长期职业性接触吸入性麻醉剂是否与免疫功能参数的任何显著改变有关。
这是一项历史性队列研究，对30名在研究时至少有一年手术室工作经验的男性参与者和30名未接触过的对照对象进行了调查。通过顶空气相色谱 - 质谱法测量尿液中氧化亚氮（N₂O）、异氟烷和七氟烷气体的浓度来量化接触水平。采用酶联免疫吸附测定法（ELISA）测量血清白细胞介素 - 4（IL - 4）、Th2型细胞因子和干扰素 - γ（IFN - γ）的浓度。此外，使用自动血液分析仪进行白细胞计数和白细胞分类测试。使用Windows版SPSS软件21对数据进行分析。
N₂O、异氟烷和七氟烷的平均尿液浓度分别为211.57±75.15、4.06±0.96和19.51±12.96。在简单的统计数据分析中，就平均血清细胞因子水平（IFN - γ、IL - 4）而言，暴露组和对照组之间存在显著差异。此外，在对重要混杂因素进行调整后，统计分析表明，暴露组的IFN - γ、IL - 4以及IFN - γ/IL - 4的比值均显著高于对照对象。
这些发现提供了确凿的证据，进一步证实了接触麻醉剂（N₂O、异氟烷和七氟烷）与免疫功能参数的细微、亚临床、病理前变化有关的论点。这些变化的长期影响需要进一步研究。
