Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.007
Brazilian Journal of Anesthesiology
Clinical Research

Measurement of anesthetic pollution in veterinary operating rooms for small animals: Isoflurane pollution in a university veterinary hospital

Mensuração da poluição anestésica em salas cirúrgicas veterinárias de pequenos animais

Drielle B.S. Figueiredo, Aline G. Aun, Juliana R. Lara, Natache A. Garofalo, Francisco José Teixeira Neto, Leandro G. Braz, Mariana G. Braz

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Abstract

Introduction
Inhaled anesthetics are used worldwide for anesthesia maintenance both in human and veterinary operating rooms. High concentrations of anesthetic gas residues can lead to health risks for the professionals exposed. Considering that anesthetic pollution in a veterinary surgical center in developing countries is unknown, this study aimed, for the first time, to measure the residual concentration of isoflurane in the air of operating rooms for small animals in a Brazilian university hospital.

Method
Residual isoflurane concentrations were measured by an infrared analyzer at the following sites: corner opposite to anesthesia machine; breathing zones of the surgeon, anesthesiologist, and patient (animal); and in front of the anesthesia machine at three time points, that is, 5, 30 and 120 minutes after anesthesia induction start time.

Results
Mean residual isoflurane concentrations gradually increased in the corner opposite to anesthesia machine and in the breathing zones of the surgeon and the anesthesiologist (p <  0.05). There was an increase at 30 minutes and 120 minutes when compared to the initial time points in the animal's breathing zone, and in the front of the anesthesia machine (p <  0.05). There was no significant difference at measurement sites regardless of the moment of assessment.

Conclusion
This study reported high residual isoflurane concentrations in veterinary operating rooms without an exhaust system, that exceeds the limit recommended by an international agency. Based on our findings, there is urgent need to implement exhaust systems to reduce anesthetic pollution and decrease occupational exposure.

Keywords

Inhaled anesthetics;  Surgery center;  Veterinary surgery;  Air pollution;  Occupational exposure

Resumo

Justificativa: Anestésicos inalatórios são amplamente utilizados mundialmente para manutenção anestésica tanto em centro cirúrgico humano quanto veterinário. Altas concentrações de resíduos de gases anestésicos podem levar a riscos à saúde nos profissionais expostos. Considerando que se desconhece a poluição anestésica em centro cirúrgico veterinário em país em desenvolvimento, este estudo teve como objetivo, de forma inédita, mensurar a concentração residual do isoflurano no ar ambiente de salas cirúrgicas de pequenos animais em hospital universitário brasileiro. Método: As concentrações residuais de isoflurano foram mensuradas por analisador infravermelho nos seguintes locais: canto oposto do equipamento de anestesia, nas zonas respiratórias do cirurgião, do anestesiologista e do paciente (animal), e na parte dianteira do equipamento de anestesia em três momentos ¯ aos 5, 30 e 120 minutos do início da indução anestésica. Resultados: Houve aumento progressivo das concentrações residuais médias de isoflurano no canto oposto ao equipamento de anestesia e nas zonas respiratórias do cirurgião e do anestesiologista (p < 0,05). Houve aumento aos 30 minutos e 120 minutos quando comparados aos momentos iniciais na zona respiratória do animal e na parte dianteira do equipamento de anestesia (p < 0,05). Não houve diferença significativa dos locais de mensuração independentemente do tempo avaliado. Conclusão: Este estudo mostrou elevadas concentrações residuais de isoflurano em salas cirúrgicas veterinárias sem sistema de exaustão, excedendo o limite recomendado por agência internacional. Diante desse panorama, urge a necessidade de implementação de sistemas de exaustão que reduzam a poluição anestésica com consequente redução da exposição ocupacional.

Palavras-chave

Anestésicos inalatórios; Centro cirúrgico; Cirurgia veterinária; Poluição do ar; Exposição ocupacional

References

1 E.P. Steffey, K.R. Mama, R.J. Brosnan Inhalation anesthetics KA Grimm, LA Lamont, WJ Tranquilli, SA Greene, SA Robertson (Eds.), Veterinary Anesthesia and Analgesia: the Fifth Edition of Lumb and Jones, John Wiley & Sons, Inc (2015), p. 297

2 EI Eger 2nd. New inhaled anesthetics Anesthesiology., 80 (1994), pp. 906-922

3 S. Safari, M. Motavaf, S.A. Seyed Siamdoust, S.M. Alavian Hepatotoxicity of halogenated inhalational anesthetics Iran Red Crescent Med J., 16 (2014), p. 20153

4 R. Nickalls, W. Mapleson Age-related iso-MAC charts for isoflurane, sevoflurane and desfurane in man Br J Anaesth., 91 (2003), pp. 170-174

5 NH Dodman, LA Lamb Survey of small animal anesthetic practice in Vermont J Am Anim Hosp Assoc., 28 (1992), pp. 439-444

6 R. Carareto, L.S. Rocha, P.N. Guerrero, et al. Retrospective study of the mortality and morbidity associated with general inhalant anesthesia in dogs Semina: Ciênc Agrár., 26 (2005), pp. 569-574

7 G Mastrangelo, V Comiati, M dell’Aquila, E Zamprogno Exposure to anesthetic gases and Parkinson’s disease: a case report BMC Neurol., 13 (2013), p. 194

8 T. Casale, T. Caciari, M.V. Rosati, et al. Anesthetic gases and occupationally exposed workers Environ Toxicol Pharmacol., 37 (2014), pp. 267-274

9 E.R. Costa Paes, M.G. Braz, J.T. Lima, et al. DNA damage and antioxidant status in medical residents occupationally exposed to waste anesthetic gases Acta Cir Bras., 29 (2014), pp. 280-286

10 K.M. Souza, L.G. Braz, F.R. Nogueira, et al. Occupational exposure to anesthetics leads to genomic instability, cytotoxicity and proliferative changes Mutat Res. (2016) 791-792:42-8

11 M.G. Braz, K.M. Souza, L.M.C. Lucio, et al. Detrimental effects detected in exfoliated buccal cells from anesthesiology medical residents occupationally exposed to inhalation anesthetics: An observational study Mutat Res., 832-833 (2018), pp. 61-64

12 K. Hoerauf, M. Lierz, G. Wiesner, et al. Genetic damage in operating room personnel exposed to isoflurane and nitrous oxide Occup Environ Med., 56 (1999), pp. 433-437

13 T. Epp, C. Waldner Occupational health hazards in veterinary medicine: physical, psychological, and chemical hazards Can Vet J., 53 (2012), pp. 151-157

14 A.C. Macedo, V.T. Mota, J.M. Tavares, et al. Work environment and occupational risk assessment for small animal Portuguese veterinary activities J Occup Environ Hyg., 15 (2018), pp. D19-D28

15 NIOSH Criteria for a recommended standard: occupational exposure to anesthetic gases and vapors. The National Institute for Occupational Safety and Health of the United States of America (1977)

16 R.J. Gardner, J. Hampton, J.S. Causton Inhalation anaesthetics: exposure and control during veterinary surgery Ann Occup Hyg., 35 (1991), pp. 377-388

17 RE Korczynski Anesthetic gas exposure in veterinary clinics Appl Occup Environ Hyg., 14 (1999), pp. 384-390

18 S. Friembichler, P. Coppens, H. Säre, Y. Moens A scavenging double mask to reduce workplace contamination during mask induction of inhalation anesthesia in dogs Acta Vet Scand., 53 (2011), p. 1

19 H. Säre, T.D. Ambrisko, Y. Moens Occupational exposure to isoflurane during anaesthesia induction with standard and scavenging double masks in dogs, pigs and ponies Lab Anim., 45 (2011), pp. 191-195

20 K.R. Johnstone, C. Lau, J.L. Whitelaw Evaluation of waste isoflurane gas exposure during rodent surgery in an Australian university J Occup Environ Hyg., 14 (2017), pp. 955-964

21 D. Newcomer, I. Chopra Evaluation of waste anesthetic gas surveillance program and isoflurane exposures during animal and human surgery J Occup Environ Hyg., 16 (2019), pp. 544-556

22 L.G. Braz, J.R.C. Braz, G.A. Cavalcante, et al. Comparison of waste anesthetic gases in operating rooms with or without an scavenging system in a Brazilian University Hospital Rev Bras Anestesiol., 67 (2017), pp. 516-520

23 A. Shirangi, L. Fritschi, C.D. Holman Associations of unscavenged anesthetic gases and long working hours with preterm delivery in female veterinarians Obstet Gynecol., 113 (2009), pp. 1008-1017

24 M.K. Vollmer, T.S. Rhee, M. Rigby, et al. Modern inhalation anesthetics: Potent greenhouse gases in the global atmosphere Geophys Res Lett., 42 (2015), pp. 1606-1611

25 CR Oliveira Occupational exposure to anesthetic gases residue Rev Bras Anestesiol., 59 (2009), pp. 110-124

26 L.M.C. Lucio, M.G. Braz, P.J. do Nascimento, J.R.C. Braz, L.G. Braz Occupational hazards, DNA damage, and oxidative stress on exposure to waste anesthetic gases Rev Bras Anestesiol., 68 (2018), pp. 33-41

27 Y. Ishizawa Special article: general anesthetic gases and the global environment Anesth Analg., 112 (2011), pp. 213-217

28 M.P. Sulbaek Andersen, S.P. Sander, O.J. Nielsen, D.S. Wagner, TJ Sanford Jr, TJ. Wallington Inhalation anaesthetics and climate change Br J Anaesth., 105 (2010), pp. 760-766

29 A.J. MacNeill, R. Lillywhite, C.J. Brown The impact of surgery on global climate: a carbon footprinting study of operating theatres in three health systems Lancet Planet Health., 1 (2017), pp. 381-388

30 R.S. Jones, E. West Environmental sustainability in veterinary anaesthesia Vet Anaesth Analg., 46 (2019), pp. 409-420
 

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