Application of predictive models for estimation of health care workers exposure to sevoflurane

• Autorzy: Jankowska A. , Czerczak S. , Kucharska M. , Wesołowski W. , Maciaszek P. , Kupczewska-Dobecka M.
• Języki publikacji: EN

Abstrakty

EN

Objectives. The aim of this study was to assess the potential use of predictive models to estimate professional exposure to chemicals in the workplace, such as the operating room, by simultaneous determination of the levels of exposure using a model and measurements. Methods. Measurements included determinations of sevoflurane (SEV) in the workplace air of 117 operating rooms of 31 hospitals in one Polish region. Measurements were carried out at the time of various surgical procedures during administration of anaesthetics by endotracheal intubation. The measurement results were compared with the values estimated using two models: ECETOC TRA and Stoffenmanager. Results. In one case the ECETOC TRA estimated the exposure concentration almost equal to the measured concentration but, because of the need to maintain a margin of safety in case of modelling, it can be concluded that the model underestimated the concentration. The Stoffenmanager model provided accurate exposure estimates in the examined case, and it can be used as a screening tool for the assessment of occupational inhalation exposure of medical personnel to anaesthetics. Conclusions. The results are of particular importance to the circumstances in Eastern Europe, where the levels of anaesthetics often exceed the relevant occupational exposure limits.

Słowa kluczowe

EN

exposure assessment; ECETOC TRA; stoffenmanager; sevoflurane

PL

zagrożenia chemiczne; ekspozycja; sewofluran

• Wydawca: Taylor & Francis
• Czasopismo: International Journal of Occupational Safety and Ergonomics
• Rocznik: 2015
• Tom: Vol. 21, No. 4
• Strony: 471--479
• Opis fizyczny: Bibliogr. 29 poz.

Twórcy

autor

Jankowska A.

• Nofer Institute of Occupational Medicine (NIOM), Poland

autor

Czerczak S.

• Nofer Institute of Occupational Medicine (NIOM), Poland

autor

Kucharska M.

• Nofer Institute of Occupational Medicine (NIOM), Poland

autor

Wesołowski W.

• Nofer Institute of Occupational Medicine (NIOM), Poland

autor

Maciaszek P.

• Nofer Institute of Occupational Medicine (NIOM), Poland

autor

Kupczewska-Dobecka M.

• Nofer Institute of Occupational Medicine (NIOM), Poland

Bibliografia

• 1.Ehrenwerth J, Eisenkraft J, Berry J. Anesthesia equipment. Principles and applications. 2nd ed. Philadelphia: Saunders; 2013.
• 2.O'Keeffe NJ, Healy TEJ. The role of new anesthetic agents. Pharmacol Ther. 1999;84:233-248.
• 3.Abbot Laboratories. Material safety data sheet [Internet]; 2009 [cited 2013 May 29]. Available from: http://www.abbottanimalhealth.com/static/cms_workspace/pdfs/SevoFlo_MSDS.pdf
• 4.Byhahn C, Wilke HJ, Westpphal K. Occupational exposure to volatile anaesthetics: epidemiology and approaches to reducing the problem. CNS Drugs. 2001;15:197-215.
• 5.NIOSH Criteria for a recommended standard occupational exposure to waste anesthetic gases and vapors [Internet]; 1977 [cited 2013 May 29]. Publication number 77-140. Available from: http://www.cdc.gov/niosh/docs/1970/77-140.html
• 6.OSHA anesthetic gases: guidelines for workplace exposures [Internet]; 1999 [cited 2013 May 29]. Available from: http://www.osha.gov/dts/osta/anestheticgases/
• 7.Regulation of the Minister of Labour and Social Policy amending the regulation on the maximum permissible concentrations and intensities of harmful factors in the work environment. Official Journal No. 217/2002, item. 183 as amended. Polish.
• 8.Kupczewska-Dobecka M. Sewo fluran- dokumentacja dopuszczalnych wielkości narażenia zawodowego [Sevo flurane-documentation of occupational exposure limit]. Podstawy i Metody Oceny Środowiska Pracy. 2007;3:101-129.
• 9.Kucharska M, Wesołowski W. Tlenek diazotu- Metoda oznaczania [Dinitro genoxide-method for determination]. Podstawy i Metody Oceny Środowiska Pracy. 2005;1:33–37.
• 10.Kucharska M, Wesołowski W. Izofluran- Metoda oznaczania [Isoflurane-method for determination]. Podstawy i Metody Oceny Środowiska Pracy. 2007;1:133-139.
• 11.Kucharska M, Wesołowski W. Sewofluran – Metoda oznaczania [Sevoflurane-method for determination]. Podstawy i Metody Oceny Środowiska Pracy. 2008;1:49–55.
• 12.Wesołowski W, Kucharska M. Dezfluran- Metoda oznaczania [Desflurane-method for determination]. Podstawy I Metody Oceny Środowiska Pracy. 2007;1:113–119.
• 13.Hoerauf KH, Koller C, Taeger K, Hobbhahn J. Occupational exposure to sevoflurane and nitrous oxide in operating room personnel. Int Arch Occup Environ Health. 1997;69:134-138.
• 14.Hoerauf KH, Hartmann T, Zavrski A, et al. Occupational exposure to sevoflurane during sedation of adult patients. Int Arch Occup Environ Health. 1999;72:174-177.
• 15.Stieglitz P, Jacquot C. Pollution des blocs opératoires par les anesthésiques volatils et gazeux. Moyens de prévention. Ann Fr AnesthReanim. 1984;3:318-321.
• 16.Byhahn C, Strouhal U, Westphal K. Occupational exposure to sevoflurane and nitrous oxide during paediatric anaesthesia. Abstracts: Third Meeting of the International Society for Medical Gases (ISMG); Heidelberg, Germany, 29 September-1 October 1999. Eur J Anaesthesiol. 2000;17:2.
• 17.Krajewski W, Kucharska M, Wesołowski W, Stetkiewicz J, Wrońska-Nofer T. Occupational exposure to nitrous oxide - the role of scavenging and ventilation systems in reducing the exposure level in operating rooms. Int J Hyg Environ Health. 2007;210:133-138.
• 18.Palaszkiewicz P, Szulc R. Occupational exposure to inhalation anaesthetics in operating rooms in Poland. A survey. AnestezjolIntens Ter. 2010;42:60-64.
• 19.Kucharska M, Wesołowski W. Ocena narażenia zawodowego personelu medycznego na anestetyki wziewne w Polsce [Assessment of occupational exposure of medical personnel to inhalatory anaesthetics in Poland]. Med Pr. 2014;65:43-54.
• 20.ECETOC TRA. [Internet] [cited 2012 April 4]. Available from: http://www.ecetoc.org/tra
• 21.Stoffenmanager [Internet] [cited 2013 January 30]. Available from: https://www.stoffenmanager.nl
• 22.ECHA guidance on information requirements and chemical safety assessment. Chapter R.14: occupational exposure estimation. Version: 2.1, November 2012. ECHA. [Internet] [cited 2014 March 29]. Available from: http://echa.europa.eu/documents/10162/13632/information_requirements_r14_en.pdf
• 23.Tielemans E, Noy D, Schinkel J, et al. Stoffen manager exposure model: development of a quantitative algorithm. Ann OccupHyg. 2008;52(6):443–454.
• 24.Schinkel J, Fransman W, Heussen H, Kromhout H, Marquart H, Tielemans E. Cross-validation and refinement of the Stoffenmanager as a first tier exposure assessment tool for REACH. Occup Environ Med. 2010;67:125-132.
• 25.ECHA. Guidance on information requirements and chemical safety assessment, Chapter R.12: Use descriptor system. Version: 2, March 2010. ECHA. [cited 2014 March 29]. Available from: http://echa.europa.eu/documents/10162/13632/information_requirements_r12_en.pdf
• 26.ETEAM. The evaluation of tier 1 exposure assessment models under reach project [Internet] [cited 2014 March 29]. Available from: http://www.eteam-project.eu/Betweenuserreliability.aspx
• 27.Wiesner G, Harth M, Szulc R, et al. A follow-up study on occupational exposure to inhaled anaesthetics in Eastern European surgeons and circulating nurses. Int Arch Occup Environ Health. 2001;74:16–20.
• 28.Krajewski W, Kucharska M, Wesołowski W, Wrońska-Nofer T. Occupational exposure to anaesthetics: monitoring of airborne concentrations of nitrous oxide and halogenated anaesthetics in operating rooms. Pol J Environ Stud. 2003;12:115-119.
• 29.European Committee for Standardization (CEN). Workplace exposure. General requirements for the performance of procedures for the measurement of chemical agents (Standard No. EN 482:2012). Brussels: CEN; 2012.

Uwagi

PL

Opracowanie ze środków MNiSW w ramach umowy 812/P-DUN/2016 na działalność upowszechniającą naukę.