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July 1999
Volume 63 |
Number 7
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| Waste Anesthetic
Gases: An Update on Information for Management in Anesthetizing
Areas and the Postanesthesia Care Unit |
Diana G. McGregor,
M.B., Chair
Task Force on Trace Anesthetic Gases
Committee on Occupational Health
The Task Force on Trace Anesthetic Gases of the ASA Committee
on Occupational Health has written an information booklet titled
"Waste Anesthetic Gases: Information for Management in Anesthetizing
Areas and the Postanesthesia Care Unit" to be distributed this
summer. The booklet replaces the 1981 ASA document, "Waste Anesthetics
in Operating Room Air: A Suggested Program to Reduce Personnel
Exposure," written by the earlier ASA Ad Hoc Committee on Effects
of Trace Anesthetic Agents on Health of Operating Room Personnel.
The new booklet contains a summary of research covering occupational
exposure to waste anesthetic gases to give the reader a working
knowledge of the subject. There is information about scavenging
of waste anesthetic gases and the use and maintenance of scavenging
equipment. Work practices to minimize exposure to waste anesthetic
gases are defined. The requirements of regulatory agencies such
as the Occupational Safety and Health Administration (OSHA) and
the Joint Commission on Accreditation of Healthcare Organizations
are discussed.
The task force has concluded that from currently available studies,
there is no association between occupational exposure to trace
levels of waste anesthetic gases in scavenged operating rooms
and adverse health effects. The task force has made several recommendations
to minimize trace concentrations of waste anesthetic gases in
all anesthetizing areas. Scavenging of waste anesthetic gases
is advocated together with the practice of appropriate work routines.
It is emphasized that all personnel in these areas should receive
information regarding current studies on health effects of exposure
to waste anesthetic gases, maintenance and checking of all anesthesia
delivery systems (with documentation) and appropriate work practices.
There is insufficient evidence to recommend routine monitoring
of trace levels of waste anesthetic gases in the O.R. or postanesthesia
care unit or to recommend routine medical surveillance of personnel
exposed to trace concentrations of waste anesthetic gases.
The task force has been working closely with OSHA as the federal
agency prepares a new document on waste anesthetic gases titled
"Anesthetic Gases: Workplace Exposures." OSHA recommendations
on waste anesthetic gases have never been promulgated as a standard,
and this revised OSHA document is to be published on its Web Site
as an informational document. In this new document, OSHA no longer
recommends routine medical surveillance for all personnel working
in the O.R. environment. Instead, a preplacement medical examination
is suggested, and every institution should have a system whereby
an employee can report any work-related health problem.
In 1977, when the National Institute for Occupational Safety
and Health (NIOSH) published its recommendations on waste anesthetic
gases, the newer volatile agents isoflurane, desflurane and sevoflurane
were not available.1 There has
been insufficient research to establish appropriate thresholds
for personnel with occupational exposure to these agents. Research
funding is available from NIOSH for projects related to these
areas.
Reference:
- NIOSH: Criteria for a recommended standard:
Occupational exposure to waste anesthetic gases and vapors.
Cincinnati, OH: U.S. Department of Health, Education and Welfare.
Public Health Service, Center for Disease Control, National
Institute for Occupational Safety and Health, 1977.
Diana G. McGregor, M.B., is Assistant
Professor of Anesthesiology, Mayo Medical School, Rochester, Minnesota.
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