Air Quality in Operating Theatres: The Effect of Waste Anaesthetics on Personnel and Exposure Prevention Measures

Abstract

The use of gaseous anaesthetics and vapours for narcosis in operating theatres means that inevitably some fraction of these is breathed by the surgical team. The amount will depend on the anaesthetic method, the duration of the operation, and the condition of the equipment used for anaesthesia and for overall ventilation. The greatest concentrations of anaesthetics are found in the working zone of the anaesthetist, then the surgeon and the scrub nurse. Until the middle of the 1960s there was little interest in air quality in operating theatres and the occupational effect of waste anaesthetic agents on the surgical team. The situation has improved considerably since then and many studies have now been carried out. The inhalation of even low levels of these various compounds has been shown to have toxic effects. Regular occupational exposure to anaesthetics is especially dangerous for pregnant women. There is a risk of abortion and of babies born with congenital abnormalities. Prophylactic measures must be directed to monitoring (environmental, biological, medical), engineering controls and work practices. Well-designed low-leakage anaesthesia equipment and scavenging systems are needed. Air conditioning systems in operating theatres should be designed using vertical laminar flow systems of ventilation instead of horizontal ones. Proper work practices employed by the anaesthetist are very important.