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Biological monitoring of the occupational exposure to halothane (fluothane) in operating room personnel.

The concentration of halothane (fluothane) in the ambient atmosphere was determined in five operating theaters of two hospitals in Italy. The concentrations of halothane in the ambient air exceeded the NIOSH recommended time-weighted average exposure levels (median value: 10.38 mg/m3). Halothane was detected in the urine of 58 exposed subjects (anesthetists, surgeons, and nurses). A significant correlation was found between the halothane concentration in urine produced during the shift (Cu, micrograms/L) and halothane environmental concentration (CI, mg/m3) (Cu = 0.242 x CI + 3.51) (N = 58; r = 0.92; p less than 0.0001). The results show that the urinary halothane concentration can be used as an appropriate biological exposure index. The biological values proposed are: 92 micrograms/L, corresponding to a 50 ppm of environmental exposure; 6.5 micrograms/L, corresponding to 2 ppm of environmental exposure and 3.9 micrograms/L, corresponding to a 0.5 ppm of environmental exposure.

Adult↗

Survey of operating room pollution within an N.H.S. district.

Pollution by waste anaesthetic gases was measured in all operating departments in a typical N.H.S. district. Methods were chosen to provide time-weighted average levels over the period of each operating session. The results showed that air-conditioning alone could not guarantee pollution levels below suggested maximum levels and that to meet those requirements air-conditioning plus scavenging was necessary. Background pollution levels were found to be representative of the personal exposure of nursing staff but approximated to only one third of the anaesthetists' personal exposure. Dental clinics presented special problems, namely the very high levels of pollution to which the dentist and his assistants were exposed.

Air Conditioning↗

Shortwave ultraviolet radiation in operating rooms.

We have evaluated the effect of shortwave ultraviolet radiation on bacterial levels in an operating theatre, both in experimental conditions and during 20 hip operations. When compared with the use of sham blue light, there was a significant reduction in the number of bacteria. The reduced level was comparable with that suggested for ultraclean air ventilation systems.

Air Microbiology↗

[Stimulation of medical personnel work in operating rooms].

Preliminary results of experimental trial on stimulation of medical staff's labour in the operation unit, held in medical institutions of Chelyabinsk, has been analysed. As a basis for calculation of the payments for the work, the labour expenditures of each member of surgical team (surgeon, assistant, anesthesiologist, surgical nurse, anesthesist, litter bearer nurse) and the cost of 1 hour work were assessed, the degree of the difficulty of each operation, as well as the total cost of the procedure was determined. Registration of the work of all members of the surgical team and its payment, according to the quantity and the quality of the performed operations, demonstrates the stage of transition to the system of payment for the labour, i.e.--for the concrete work, done by somebody of the staff (for the treatment of some patient, etc.). The evaluation of the work according to the number of treated patients (operations being done) and to the quality of the treatment provides the conditions for personal financial incentive of surgical staff to intensification of their work and contributes to the achievements of favourable final results and in the same time--it provides decrease of the terms for patients' stay in the hospital, saving money and material resources.

Costs and Cost Analysis↗

[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↗