Effect of inhaled anaesthetics gases on cytokines and oxidative stress alterations for the staff health status in hospitals

Khaled A Al-Rasheedi,Abdulmajeed A Alqasoumi,Ashraf M Emara

doi:10.1007/s00420-021-01705-y

Khaled A Al-Rasheedi, Abdulmajeed A Alqasoumi + Show 1 more

Open Access

https://doi.org/10.1007/s00420-021-01705-y

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Abstract

ObjectivesThe present study aimed to evaluate the effects of waste anaesthetic gases on cytokines and oxidative stress of hospital health team members following exposure to waste anaesthetic gases (WAGs).Subjects and methodsIn total, 180 participants took part in this study; 60 of these were healthy male controls and the 120 participants in the intervention group were staff who work in the operating room. This latter group comprises six occupational subgroups (1) surgeons, (2) surgical assistants, (3) anaesthesiologists (4) anaesthesiology assistants, (5) nurses and (6) janitors. The following parameters were assessed: catalase (CAT), glutathione peroxidase (GSHpx) and superoxide dismutase (SOD) activities, plasma fluoride, serum interferon gamma (IFN-γ), serum interleukin 2 (IL2), serum interleukin 4 (IL4) and plasma thiobarbituric acid reactive substances (TBARS).ResultsAnaesthesiologists and their assistants exhibited the highest levels of plasma fluoride, serum IFN-γ and IL 2, exceeding the levels in detected in all the other occupational subgroups. Furthermore, the serum levels of IL4 were significantly raised in anaesthesiologists and the difference between this group and other groups was statistically significant. However, compared with the other subgroups, surgeons exhibited elevated plasma TBARS and reduced CAT, GSHpx and SOD; these variances were also statistically significant.Conclusion and recommendationsThe findings of this study indicate that operating room staff exposed to WAGs are vulnerable to experiencing immunotoxicity as the WAGs are considered to initiate oxidative stress and increase the levels of cytokines in serum. Thus, an education programme is warranted to inform staff working in environments where they may be subjected to WAGs on the effects that the gases can have upon their health and how to minimise their exposure to WAGs. An ongoing effort is also needed to ensure anaesthesia safety standards are maintained at all times. The findings of this study may provide a springboard for future research into occupational exposure to WAGs and their wider effect upon health.

Highlights

When anaesthetics are administered, small amounts of volatile waste anaesthetic gases (WAGs) and vapour escape from the patient’s breathing apparatus into the operating room environment (Yasny and White 2012).WAG pollution of operating room environment is attributed to three factors: the anaesthesia workstation, anaesthetic administration techniques and the availability of a scavenging system (Yasny 2012)
Hospital staff who work in the operating room are potentially exposed to waste anaesthetic gas, which can pose risks to their health
Exposure to WAGs increases the potential of developing haematological, hepatic immunological, neurological, renal and reproductive system diseases. This claim is contentious and according to Dittmar et al (2015), the level of hazard posed to the health of operating room staff from chronic exposure to WAGs is debatable

Summary

Introduction

Small amounts of volatile waste anaesthetic gases (WAGs) and vapour escape from the patient’s breathing apparatus into the operating room environment (Yasny and White 2012). WAG pollution of operating room environment is attributed to three factors: the anaesthesia workstation, anaesthetic administration techniques and the availability of a scavenging system (Yasny 2012). WAGs occur for several reasons, including (1) gaseous anaesthesia being delivered using a facemask. During the administration of inhalation anaesthetics, all staff in the operating room environment are exposed to the volatile compounds and are at risk of experiencing adverse effects to them (Tanko et al 2014). The Saudi Arabian Ministry of Health states that the inhaled anaesthetics that were used most commonly in 2014 were isoflurane and sevoflurane. Owing to its airway and heart safety record, sevoflurane is the anaesthetic most frequently used for surgical patients in hospitals

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