Environmental safety in anaesthesia: past and future

Abstract

Air pollution with inhalation anaesthetics is a concern to persons working in operating rooms and related areas. Over the years, developments in anaesthetic equipment and techniques have reduced pollution levels but pollution is still there. Concerns about possible adverse effects were reported long ago. Epidemiological and other studies, conducted in the 1970s, suggested that occupational exposure to inhalation anaesthetics adversely affected the state of health, impaired psychomotor and cognitive functions, and resulted in reproductive and developmental toxicity. However, later critical reviews of the observations and new evidence indicate that the situation is not as bad as was then believed. Throughout the years various devices have been developed to reduce pollution levels. Today, scavenging should be common practice in order to meet regulations limiting the exposure to waste anaesthetics. Besides indoor air pollution, global atmospheric pollution associated with the use of inhalation anaesthetics is a concern. All currently used agents, in particular nitrous oxide, have the potential to contribute to the depletion of the ozone layer and to the ‘greenhouse effect’. Although the contribution of medicine is small, future regulations may affect the use of nitrous oxide in clinical practice.