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Biomedical subjects

V Somenzi

Publications and source records attributed to V Somenzi.

5 recordsLinked to original sources

[Early effects of exposure to anesthetic gases and vapors. A critical review on the suitability of several indicators of the effect].

Apart from a risk excess of liver disease among operating theatre personnel and of spontaneous abortion in women exposed during pregnancy, no definitive conclusion can be drawn regarding health impairment among anaesthesiology staff. However, many studies pointed out that several adverse effects occur as a consequence of experimental, therapeutic and occupational exposure to inhalation anaesthetics. This paper reviews the early changes of the organ systems (hepatobiliary, renal, cardiac, hematopoietic, reproductive systems; immunologic functions; cytogenetic effects), which are considered to follow anaesthetics exposure, to evaluate their possible use as biological indices of effect. The liver microsomal enzyme system has received particular attention with the aim of clarifying the mechanisms involved in anaesthetics hepatotoxicity. An increased microsomal enzyme activity was observed in experimental conditions and in humans. This inductive effect, which reflects metabolic changes affecting liver function, is commonly considered the earliest sign caused by exposure to several chemicals (other than anaesthetics) and may be evaluated by means of biomarkers, among which the measurement of urinary D-glucaric acid excretion is a well established non-invasive tool. Urinary D-glucaric acid excretion represents the most promising early metabolic effect of the exposure to anaesthetics. However, its measurement is not yet suitable as an index of effect for use in biomonitoring practice. The main aspects to be studied in the future are the following: (i) the evaluation of urinary D-glucaric acid excretion in the acute and chronic exposure to low-dose anaesthetics to check the existence of a dose-response relationship; (ii) the study of other parameters (urinary enzymes, immunological profile, chromosome aberrations) in selected groups of exposed and control subjects, in which both exposure and confounding factors (age, gender, life style, former diseases) as well as concomitant occupational exposures should be carefully taken into account.

Adult↗

[Evaluation of the risk of anesthetic gases to exposed subjects with different tasks in operating rooms].

A research was carried out on risk evaluation of workers with different tasks in operating theatre. The airborne concentrations were determined by an IR analyzer with two distinct sampling lines: the first was placed in surgical zone and the second one in anesthesiological zone. The anesthetists resulted more at risk than surgical team. Nevertheless when the evaluation was based on N2O urinary concentration and data were stratified according to task a prevalent inhalation absorption resulted for non medical staff (instrumentist and professional nurse). Our data concerning N2O ranged between 95-764 ppm indoor and between 3-92 mcg/l in the urines of exposed subjects.

Anesthesia, Inhalation↗

[Risk of infectious hepatitis and risk of anesthetic gases in operating rooms: considerations on 3 cases of chronic hepatic pathology].

Three subject with professional activity in operating theatre and with a diagnosis of chronic viral "C" hepatitis are considered. All cases (Two surgeons and an anesthetist) had been continuously exposed to low level of airborne anesthetic compounds (Nitrous oxide and halogenated compounds). According to possible, but not proved, synergic effects, two cases with a clinical picture of active chronic hepatitis were classified as unqualified to specific work. The third case, affected by a persistent chronic hepatitis, was admitted to operating activities only for four hours a week, i.e. only an operating session a week. Hepatitis B and C markers must be always monitored during the medical surveillance in exposed people of operating theatre.

Air Pollutants, Occupational↗

Neurobehavioral functions in operating theatre personnel: a multicenter study.

The study was conducted to evaluate neuropsychological symptoms, subjective stress and response speed functions in subjects occupationally exposed to low levels of anesthetic gases. A group of 112 operating theatre personnel exposed to anesthetic gases (nitrous oxide and isoflurane), and 135 non exposed hospital workers from 10 hospitals in Northern Italy were examined before and after the shift on the first and the last day of the working week. Three different tasks were administered: a complex reaction time test (the Stroop Color Word); a questionnaire for neuropsychological symptoms (EURO-QUEST); the block design subtest (WAIS). Biological and atmospheric indicators of exposure were measured. In the exposed group, the geometric mean of urinary nitrous oxide at the end of the shift was 7.1 micrograms/l (95th percentile 12.4, range 1.5-43) on the first and 7.8 micrograms/l (95th percentile 21.5, range 1.0-73.3) on the last day of the working week. On the same days, end of shift urinary isoflurane was 0.7 microgram/l (95th percentile 2.6, range 0-4.7) on the first day and 0.8 microgram/l (95th percentile 2.0, range 0-5.6) on the last. The exposed and control subjects were comparable for both basic intellectual abilities and subjective stress levels. No statistical differences were observed between exposed and control subjects for neuropsychological tests and symptoms. No dose-effect relationships were observed between the exposure indicators and the test results. In conclusion, no early behavioral effect on the central nervous system was detectable at the exposure levels measured. The biological exposure limits of 13 micrograms/l for nitrous oxide and 1.8 micrograms/l for isoflurane corresponding respectively to the atmospheric concentrations of 25 ppm and 0.5 ppm seem to be adequately protective for the integrity of workers' neurobehavioral functions, as measured with the tests used.

Adolescent↗