Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942009000100014
Brazilian Journal of Anesthesiology
Review Article

Exposição ocupacional a resíduos de gases anestésicos

Occupational exposure to anesthetic gases residue

Carlos Rogério Degrandi Oliveira

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Resumo

JUSTIFICATIVA E OBJETIVOS: Embora existam relatos negativos quanto aos efeitos da exposição prolongada a resíduos de gases anestésicos, há ainda muitas controvérsias. Dados contraditórios são encontrados na literatura, considerando-se a variabilidade nas respostas individuais a diferentes agentes. O objetivo deste trabalho foi apresentar revisão sobre a exposição ocupacional aos resíduos de gases anestésicos. CONTEÚDO: São discutidos os resultados dos principais artigos sobre o tema, assim como causas de contaminação do ambiente cirúrgico, ventilação, exaustão, monitoração e dosagem dos resíduos de gases anestésicos. É dada ênfase às recomendações para a minimização dos efeitos imputados aos agentes inalatórios. CONCLUSÕES: Mesmo nos trabalhos das forças-tarefas de renomadas instituições reguladoras internacionais nota-se certo grau de controvérsia sobre os efeitos da exposição ocupacional a resíduos de gases anestésicos. Observa-se estipulação de valores máximos para exposição ocupacional, porém com reconhecimento de que não existem indícios epidemiológicos de qualquer tipo de dano causado pela exposição a concentrações de gases anestésicos em locais onde as medidas-padrão de ventilação, exaustão e uso de equipamentos anestésicos estejam sendo observadas. No nosso meio essas medidas, na maioria das vezes, não são implementadas e quando o são, não corretamente fiscalizadas. Além disso, há que considerar diferenças entre as técnicas utilizadas e as condições de trabalho. Levando-se em conta a natureza multifatorial da exposição de profissionais da saúde, medidas devem ser tomadas para minimizar a exposição ocupacional aos agentes com conhecido ou provável potencial tóxico. A reivindicação por salas cirúrgicas mais bem equipadas, com sistemas de ventilação e exaustão adequados, bem como sua manutenção devem ser incentivadas.

Palavras-chave

ANESTÉSICOS, Gasoso, Volátil, COMPLICAÇÕES, COMPLICAÇÕES, COMPLICAÇÕES

Abstract

BACKGROUND AND OBJECTIVES: Although the absence of negative effects of prolonged exposure to anesthetic gases residue has been reported, controversies on the subject still linger. Contradictory data on the variability in individual response to different agents can be found in the literature. The objective of this report was to present a review of occupational exposure to anesthetic gases residue. CONTENTS: The results of the main articles on the subject, as well as the causes of contamination of the surgical environment, ventilation, exhaust system, monitoring, and dosage of anesthetic gases residues are discussed. Recommendations to minimize the supposed effects of inhalational agents are emphasized. CONCLUSIONS: Even in task-forces studies of renowned international regulating institutions, there are some controversies on the risks of occupational exposure to anesthetic gases residue. Minimal values for occupational exposure are stipulated, but acknowledging the lack of epidemiological evidence of any type of damage caused by said exposure in places where standard measures of ventilation and exhaust systems and the use of anesthetic equipment are observed. In our country, most of the time those measures are not implemented and, when they are, they are not supervised properly. Besides, differences in techniques and working conditions have to be considered. Taking into consideration the multifactorial nature of the exposure of health care professionals, measures should be undertaken to minimize occupational exposure to agents with known or probable toxic potential. The demand for better equipped operating rooms, with adequate ventilation and exhaust systems as well as their maintenance should be stimulated.

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