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May 1997
Volume 61 |
Number 5
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| Strategies for
Prevention: Protecting Our Patients, Protecting Ourselves |
Arnold J. Berry, M.D., Chair
Committee on Occupational Health of Operating Room Personnel
Although the focus of most anesthesiologists' practice is devoted
to patient care and safety, anesthesiologists are exposed to many
potential occupational hazards within the perioperative environment.
Some of these exposures like trace anesthetic gases have been
studied extensively, but their significance continues to be debated.
Other emerging hazards such as latex allergy have been described
more recently. Latex allergy is partially attributable to the
advent of universal precautions and the widespread use of gloves
in response to another risk, the threat of bloodborne pathogens.
Other groups of health care workers, including surgeons, operating
room nurses and postanesthesia nurses, also work in this environment
and share our concern regarding the safety of the workplace.
To address several specific occupational health issues, three
task forces have been appointed to work with the Committee on
Occupational Health of Operating Room Personnel on specific topics.
The committee and these task forces will continue to try to provide
information to the membership on topics relevant to the health
of anesthesiologists. Last year, in response to revised recommendations
from the Centers for Disease Control
and Prevention (CDC) on postexposure prophylaxis to HIV, a
summary of the pertinent information was published in the ASA
NEWSLETTER (March 1996) and a link to the CDC was established
on the ASA's Web site.
In this issue of the NEWSLETTER, the committee has been
given the opportunity to address several topics relevant to our
safety and that of our patients. Since nosocomial infections result
in patient morbidity and additional expense to the health care
system, they have become a major focus of attention. Morris Brown,
M.D., Chair of the Task Force on Infection Control Policy, has
summarized portions of the new CDC "Guidelines
on Prevention of Intravascular Device-Related Infections"
relevant to the practice of anesthesiology. William P. Arnold
III, M.D., Chair of the Task Force on Chemical Dependence, addresses
questions that family members may pose regarding anesthesiologists
with chemical dependence. This unique perspective is most
valuable, and his article should be shared with spouses and family.
ASA has been actively involved in addressing issues regarding
potential health effects of trace levels of anesthetics in the
operating room environment. Diana G. McGregor, M.B., Chair of
the Task Force on Trace Anesthetic Gases, has reviewed the pertinent
studies assessing health risks of trace
anesthetic gases. Recent publications have prompted us to
revisit this topic, and Dr. McGregor's article provides a background
for considering new work. As health care workers have adopted
barrier precautions, the increased use of gloves has resulted
in widespread exposure to latex resulting in a rise in the prevalence
of latex allergy. In her article, Gail I. Randel, M.D., reviews
this problem and makes recommendations to reduce
sensitization to latex.
Anesthesiologists may be affected by other occupationally related
health problems that can result in temporary or permanent disability.
This appears to be an area that requires further study to characterize
the types of disabilities and to formulate strategies for prevention.
The committee will continue to work to address these and other
issues relevant to the health of anesthesiologists.
Arnold J. Berry, M.D., is Professor of
Anesthesiology at Emory University School of Medicine, Atlanta,
Georgia.
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