Waste anesthetic gas exposure: the risks extend outside the operating room

Dear Editor,

The recent article outlining the occupational hazards of waste anesthetic gas exposure by Lucio et al.¹ provided an in-depth review of the current considerations of the risks associated with occupational exposure to waste anesthetic gases. In particular, they outlined how environmental pollution occurring in the operating room (OR) could lead to DNA damage and contribute to oxidative stress. However important this area is, there are increasingly other areas outside of the OR where occupational exposure to anesthesia can result in unique risks of environmental exposure. For example, post-anesthesia care units are also an area that is often targeted for investigation of occupational anesthetic gas exposure risk.^2,3 In addition, offsite anesthetics have also been reported in the Intensive Care Unit (ICU) where volatile agents have been used for sedation.⁴ This ICU use is particularly problematic as it is a setting where scavenging may not necessarily be the same as in the OR. Indeed, the use of volatile agents in the ICU and the need for scavenging systems has been addressed by using the hospital-based vacuum systems, but this has also been identified as a potentially risky and unproven way to scavenge anesthetic gases.^5,6

Thus, occupational hazards of waste anesthetic gases likely extend far more broadly than the OR setting that Lucio et al. have outlined, further extending the potential for DNA damage and the superimposed oxidative stress in those exposed.

References

• ¹
  Lucio LMC, Braz MG, Do Nascimento Junior P, et al. Occupational hazards. DNA damage, and oxidative stress on exposure to waste anesthetic gases. Rev Bras Anestesiol. 2018;68:33-41.
• ²
  Kim S, Ozelsel T, Tsui BC. Monitoring waste anesthetic gas in the pediatric postanesthesia care unit. Can J Anaesth. 2016;63:1301-2.
• ³
  Cheung SK, Ozelsel T, Rashiq S, et al. Postoperative environmental anesthetic vapour concentrations following removal of the airway device in the operating room versus the postanesthesia care unit. Can J Anaesth. 2016;63:1016-21.
• ⁴
  Wong K, Wasowicz M, Grewal D, et al. Efficacy of a simple scavenging system for long-term critical care sedation using volatile agent-based anesthesia. Can J Anaesth. 2016;63:630-2.
• ⁵
  Dain SL. Anesthesia scavenging in critical care areas: beware of possible hazards and questionable efficacy. Can J Anaesth. 2017;64:96-7.
• ⁶
  Jerath A, Wasowicz M. In reply: anesthesia scavenging in critical care areas: beware of possible hazards and questionable efficacy. Can J Anaesth. 2017;64:98-9.

Publication Dates

• Publication in this collection
  Jul-Aug 2018