Health Effects Associated With Exposure to Anesthetic Gas Nitrous Oxide-N2O in Clinical Hospital – Shtip Personel
DOI:
https://doi.org/10.3889/oamjms.2017.185Keywords:
nitrous oxide, exposure, health effects, statistical difference, OR, RRAbstract
AIM: To show certain health effects associated with acute and chronic exposure to nitrous oxide of staff of the Department of Anaesthesiology and Intensive Care at the Clinical Hospital in Shtip.
METHODS: A transversal study was conducted, that include 43 health workers (23 – exposed and 20 - unexposed) Personal exposure to nitrous oxide for this group members was assessed through continuous measurement over 8 hours shift within breathing zone of the subjects involved, using handheld electrochemical instrument with datalogging option direct. In order to determine presence of possible health effects associated with acute and chronic exposure to nitrous oxide in ORs and ICUs, a specially designed questionnaire was prepared and distributed to be anonymously filled out, by all the examinees from both examined groups. Data were statistically tested for normality and also quantitative and qualitative assessment was performed.
RESULTS: From the results obtained, a significant difference in several health effects between exposed and unexposed groups can be noted, including headaches, dizziness, nausea and vomiting, euphoria and tachycardia. Regarding the excitement, the appearance of depression, the feeling of numbness and tingling of the hands and feet, the differences between the two examined groups were not significant.
CONCLUSION: It can be concluded that chronic exposure to nitrous oxide is associated with the adverse health effects.Downloads
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References
Emmanouil DE, Quock RM. Advances in understanding the actions of nitrous oxide. Anesth Prog. 2007; 54 (1):9-18. https://doi.org/10.2344/0003-3006(2007)54[9:AIUTAO]2.0.CO;2
Sadigh Maroufi Sh, Gharavi MJ, Behnam M, Samadikuchaksaraei A. Nitrous Oxide Levels in Operating and Recovery Rooms of Iranian Hospitals. Iranian Journal of Public Health. 2011; 40(2): 75-79. PMid:23113075 PMCid:PMC3481765
Parlow JL, Milne B, Tod DA, Stewart GI, Griffiths JM, Dudgeon DJ. Self-administered nitrous oxide for the management of incident pain in terminally ill patients: a blinded case series. Palliat Med. 2005; 19(1):3-8. https://doi.org/10.1191/0269216305pm958oa PMid:15690862
Baum VC, Willschke H, Marciniak B. Is nitrous oxide necessary in the future? Paediatric Anaesthesia. 2012: 22(10): 981–7. https://doi.org/10.1111/pan.12006 PMid:22967156
Krajewski W, Kucharska M, Wesolowski W, Stetkiewicz J, Wronska-Nofer T. Occupational exposure to nitrous oxide – the role of scavenging and ventilation systems in reducing the exposure level in operating rooms. International Journal of Hygiene and Environmental Health. 2007; 210:133-38. https://doi.org/10.1016/j.ijheh.2006.07.004 PMid:17045524
Wiesner G, Hoerauf K, Schroegendorfer K, et al. High-level, but not low-level, occupational exposure to inhaled anaesthetics is associated with genotoxicity in the micronucleus assay. Anaesthesia & Analgesia. 2001; 92: 118–22. https://doi.org/10.1097/00000539-200101000-00023
Jevtovic-Todorovic V, Wozniak DF, Benshoff ND, Olney JW. A comparative evaluation of the neurotoxic properties of ketamine and nitrous oxide. Brain Research. 2001; 895: 264–267. https://doi.org/10.1016/S0006-8993(01)02079-0
Fujinaga M, Maze M. Neurobiology of nitrous oxide-induced antinociceptive effects. Mol Neurobiol. 2002; 25(2): 167–89. https://doi.org/10.1385/MN:25:2:167
Jevtovic-Todorovic V, Beals J, Benshoff N, Olney JW. Prolonged exposure to inhalational anaesthetic nitrous oxide kills neurons in adult rat brain. Neuroscience. 2003; 122: 609–616. https://doi.org/10.1016/j.neuroscience.2003.07.012 PMid:14622904
Sanders RD, Weimann J, Maze M. Biologic effects of nitrous oxide: a mechanistic and toxicologic review. Anaesthesiology. 2008; 109(4): 707-722. https://doi.org/10.1097/ALN.0b013e3181870a17 PMid:18813051
Branpton P. Review of Toxicological Data on Nitrous Oxide. Brussels: European Industrial Gases Association (EIGA), 2008.
Sanders RD, Weimann J, Maze M. Biologic effects of nitrous oxide: a mechanistic and toxicologic review. Anaesthesiology. 2008;109:707–22. https://doi.org/10.1097/ALN.0b013e3181870a17 PMid:18813051
Krajewski W, Kucharska M, Pilacik B, Fobker M, Stetkiewicz J, Nofer JR, et al. Impaired vitamin B12 metabolic status in healthcare workers occupationally exposed to nitrous oxide. British Journal of Anaesthesiology. 2007; 99: 812–18. https://doi.org/10.1093/bja/aem280 PMid:17951609
Scapellato ML, Mastrangelo G, Fedeli U, Carrieri M, Macca I, Scoizzato L, et al. A longitudinal study for investigating the exposure level of anaesthetics that impairs neurobehavioral performance. Neurotoxicology. 2008; 29:116–23. https://doi.org/10.1016/j.neuro.2007.10.001 PMid:18022695
Sardas S, Izdes S, Ozcagli E, Kanbak O, Kadioglu E. The role of antioxidant supplementation in occupational exposure to waste anaesthetic gases. International Archives of Occupational and Environmental Health. 2006; 80:154–159. https://doi.org/10.1007/s00420-006-0115-6 PMid:16710711
Pichardo D, Luginbuehl IA, Shakur Y, Wales PW, El-Sohemy A, O'Connor DL. Effect of nitrous oxide exposure during surgery on the homocysteine concentrations of children. Anaesthesiology. 2012; 117(1): 15-21. https://doi.org/10.1097/ALN.0b013e318259a8cc PMid:22584536
lee GG. Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B12 and folate. Clinical Chemistry. 2000; 46:1277-83. PMid:10926922
Guttormsen AB, Refsum H, Ueland PM. The interaction between nitrous oxide and cobalamin Biochemical effects and clinical consequences. Acta Anaestesiologica Scandinavica. 1994; 44: 653-7.
Badner NH, Beattie S, Freeman D, Spence JD. Nitrous oxide-induced elevated homocysteine concentrations are associated with increased myocardial ischemia in patients undergoing carotid endartectomy. Anesthesia & Analgesia. 2001; 91:1073-9.
Foschi D, Rizzi A, Zighetti ML, et al. Effects of surgical stress and nitrous oxide anaesthesia on peri-operative plasma levels of total homocysteine. Anaesthesia. 2001; 56: 676-7. https://doi.org/10.1046/j.1365-2044.2001.01374-2.x PMid:11437770
Fujinaga M, Baden JM, Yhap EO, Mazze RI. Reproductive and teratogenic effects of nitrous oxide, isoflurane, and their combination in Sprague-Dawley rats. Anaesthesiology. 1987; 67(6): 960–964. https://doi.org/10.1097/00000542-198712000-00014
Olfert SM. Reproductive outcomes among dental personnel: a review of selected exposures. J Can Dent Assoc. 2006; 72: 821–25. PMid:17109802
Jevtovic-Todorovic V, Benshoff N, Olney JW. Ketamine potentiates cerebrocortical damage induced by the common anaesthetic agent nitrous oxide in adult rats. British Journal of Pharmacology. 2000; 130: 1692–1698. https://doi.org/10.1038/sj.bjp.0703479 PMid:10928976 PMCid:PMC1572233
Jevtovic-Todorovic V, et al. Nitrous oxide (laughing gas) is an NMDA antagonist, neuroprotectant and neurotoxin. Nat Med. 1998; 4(4): 460–3. https://doi.org/10.1038/nm0498-460 PMid:9546794
Health Council of the Netherlands: Committee for Compounds toxic to reproduction. Nitrous oxide; Evaluation of the effects on reproduction, recommendation for classification. The Hague: Health Council of the Netherlands, publication no. 2000/03 OSH, 2000.
Judith P, Rooks. Safety and Risks of Nitrous Oxide Labor Analgesia: A Review. Journal of Midwifery &Women's Health. 2011; 56(6): 557-65. https://doi.org/10.1111/j.1542-2011.2011.00122.x PMid:22060215
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