Byhahn C, Westphal K, Strouhal U
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, J.-W.-Goethe-Universität Frankfurt.
Gesundheitswesen. 1998 Oct;60(10):586-91.
According to Section 4 of the German maternity law (MuSchG), pregnant and nursing women are not allowed to work in places where they may be exposed to hazardous gases. Due to MuSchG these women are often effered work in the recovery room (RR) and the surgical intensive-care unit (ICU). The present study examined the occupational exposure in the RR and the ICU to nitrous oxide, isoflurane and the new volatile agents desflurane and sevoflurane in accordance with the German work place safety and maternity laws.
Trace concentrations of inhalational agents which 10 (ICU) and 207 (RR) patients exhaled after anaesthesia were measured in the RR air and the rooms of the ICU. Measurements were effected with a real-time infrared spectrometer continuously every 90 seconds for period of 6 (ICU) and 14.5 (RR) hours.
The mean concentrations exceeded both in RR and ICU the legal limits of workplace concentrations prescribed by the German maternity law. Concentrations for both desflurane and seroflurane were up to more than twice as high as those of isoflurane. Exposition levels at the ICU and in the RR exceeded those measured in the operating theatre. The ICU personnel had a higher exposure to anaesthetic gases than those working in the RR.
To reduce the working-place concentrations below the legal threshold it is necessary to use local scavenging devices in addition to appropriate ventilation systems. According to our data, pregnant and nursing women should not be allowed to work in the RR or to nurse mechanically ventilated patients after surgery in the ICU.
