![]() However, recent studies observed an increased risk of spontaneous abortion and infertility in female veterinarians working in operating rooms without scavenging devices. Extensive research has failed to identify adverse health effects of trace anesthetic exposure commonly experienced in modern, scavenged operating rooms. Reducing WAG exposure via active scavenging in all anaesthetizing locations is considered standard practice. In other locations, the Occupational Safety and Health Administration (OSHA), which is the relevant federal regulatory agency in the United States, recommends that WAG exposure be kept “to the lowest practical level”. NIOSH recommends and The Joint Commission requires active WAG scavenging systems in all anaesthetizing locations. Great Britain, for example, has established an 8-hour time-weighted average exposure limit of 50 ppm for isoflurane. In 1977 the National Institute for Occupational Safety and Health (NIOSH) established a recommended relative exposure limit (REL) for halogenated anesthetic agents (without concomitant nitrous oxide) of 2 parts per million (ppm) for a period of time not to exceed 1 hour. Potential health hazards from waste anesthetic gases (WAGs) have been a concern since the introduction of inhalational anesthetics into clinical practice. Evaluating peak and cumulative sevoflurane WAG levels in the breathing zone of PACU Phase I and Phase II providers is warranted to quantify the extent and duration of exposure. This study demonstrated that clinically relevant inhalational anesthetic concentrations result in sevoflurane WAG levels that exceed current RELs. Further analysis suggests that the rate of washout of sevoflurane was dependent on the duration of anesthetic exposure. Observed WAGs in our study were explained by inhalational anesthetic pharmacokinetics. Maximum sevoflurane WAG levels in the patient breathing zone exceeded National Institute for Occupational Safety and Health (NIOSH) RELs for every 5-minute time interval measured during PACU Phase I. Following extubation, exhaled WAG from the patient breathing zone was measured 8 inches from the patient’s mouth in the PACU. In this pilot study, 20 adult day surgery patients were enrolled with anesthesia maintained with sevoflurane. The aim of this pilot study was to assess sevoflurane WAG levels while accounting for factors that affect inhalational anesthetic elimination. The potential to exceed recommended exposure levels (RELs) in the postanesthesia care unit (PACU) exists. ![]()
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