Nitrous Oxide Exposure of Health Care Personnel in the Operating Rooms and Intensive Care Units in Hospitals in Macedonia


  • Biljana Eftimova Department of Anesthesia and Intensive Care, Clinical Hospital, Shtip
  • Dejan Mirakovski Univeristy “Goce Delcev”, Faculty of Natural and Technical Sciences, AMBICON Lab, Shtip
  • Marija Sholjakova Department of Anesthesia, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Skopje
  • Marija Hadzi-Nikolova Department of Anesthesia, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Skopje



nitrous oxide, TWA exposure, anaesthesiologists, nurses, substandard


AIM: To determine average personal exposure to nitrous oxide for anaesthesiologists and nurses working in operating rooms (ORs) and intensive care units (ICU) in Clinical Hospital in Shtip, ENT University Clinic in Skopje and General Hospital in Kochani.

METHODS: To determine TWA exposure nitrous oxide concentration was continuously measured over 8 hours shift within breathing zone of the subjects involved, using the handheld electrochemical instrument with data logging option. Results obtained were statistically processed.

RESULTS: Highest TWA exposures (well above RELs) were found for nurses and anaesthesiologists in ORs in CH – Shtip, because of high workload in substandard conditions. TWA exposures in CH – Kochani were found to be significantly lower although in substandard conditions, mostly due to lower workload. TWA exposures found in ORs in ENT UC – Skopje is within RELs due to good work practices and proper ORs equipment.

CONCLUSIONS: Study indicated significant exposure of personal working in substandard ORs in CH – Shtip. Applying proper work practices and maintain control equipment (general ventilation and scavenging systems) in operation, could provide for safe work environment.


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How to Cite

Eftimova B, Mirakovski D, Sholjakova M, Hadzi-Nikolova M. Nitrous Oxide Exposure of Health Care Personnel in the Operating Rooms and Intensive Care Units in Hospitals in Macedonia. Open Access Maced J Med Sci [Internet]. 2017 Oct. 10 [cited 2023 Mar. 31];5(6):790-3. Available from:



E - Public Health