THE TOXIC EFFECTS OF OCCUPATIONAL EXPOSURE TO HALOGENATED INHALATIONAL ANESTHETICS | ||||
| Egyptian Journal of Occupational Medicine | ||||
| Article 4, Volume 47, Issue 1, January 2023, Page 51-64 PDF (645.84 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejom.2022.153564.1287 | ||||
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| Authors | ||||
| Shalaby NM1; ElRafey DS2; Adel MA2; Mahmoud AR1; Sakr S3 | ||||
| 1Department of Forensic Medicine and Clinical Toxicology, Environmental and Occupational Medicine , Faculty of Medicine, Zagazig University, Egypt. | ||||
| 2Department of Community, Environmental and Occupational Medicine , Faculty of Medicine, Zagazig University, Egypt. | ||||
| 31Department of Forensic Medicine and Clinical Toxicology, Environmental and Occupational Medicine , Faculty of Medicine, Zagazig University, Egypt. | ||||
| Abstract | ||||
| Introduction: Contamination of operating theaters with the waste anesthetic gases (WAGs) is unavoidable. Halogenated anesthetics namely halothane, isoflurane, desflurane, and sevoflurane are the major constituents of WAGs. Medical personnel are exposed to lower WAGs concentrations than patients, yet their extended exposure over years magnifies the risk of WAGs-associated toxicity. Aim of Work: To investigate the possible toxic effects of exposure to the halogenated inhalational anesthetics on the general health, liver functions, oxidative parameters, and cognitive functions of occupationally exposed personnel, and to study the effect of exposure duration / years on such effects. Materials and Methods: The current study was conducted on 56 healthcare workers (HCW) (28 exposed and 28 non-exposed) who were subjected to a questionnaire, medical examination, liver function tests, oxidative stress analysis, and Montreal Cognitive Assessment (MOCA). Results: Clinical evaluation of both groups revealed a statistically significant increase in the frequency of headache, dizziness, and fatigue among the exposed group compared to the non-exposed. Also, a significant elevation in the mean values of aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin, and malondialdehyde (MDA) levels, along with reduction in the total antioxidant capacity (TAC), attention, language, delayed recall, and total MOCA score were noticed among the exposed group compared to the nonexposed. A statistically significant positive correlation was found between the duration of exposure / years and levels of ALP, bilirubin, and MDA in serum, while a statistically significant negative correlation was detected between the exposure duration / years and TAC and total MOCA score as well, among the exposed group. Conclusion and Recommendations: Occupational exposure to inhalation halogenated anesthetics is associated with adverse health effects like headache, dizziness, fatigue, altered hepatic functions, impaired redox balance, and disturbed cognitive functions. In addition, exposure duration / years positively correlates with the hepatic dysfunction and lipid peroxidation and negatively with the TAC and total MOCA score in the occupationally exposed personnel. A central high-flow scavenging system and low leakage anesthesia machines are strongly required in all the operating theaters. | ||||
| Keywords | ||||
| Halogenated anesthetics; Oxidative stress; Liver functions; Cognitive; functions; Waste anesthetic gases (WAGs) and Exposure duration | ||||
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