ON OF AIR POLLUTION WITH INHALATION ANESTHETICS AND DISINFECTANTS IN OPERATING ROOMS

At present levels of air pollution with inhalation anesthetics and disinfectants in operating rooms as well as protection from their unfavorable effect on health and professional activities of the surgical personnel are underexplored. Goal of the study: to evaluate the efficiency of ORUB-3-5-KRONT air recirculator and irradiator for air cleansing from inhalation anesthetics and other organic compounds in operating rooms when using disposable air carbon filters of FUS-KRONT. Materials and methods. During the main stages of anesthesia and operation the content of sevoflurane, inhalation anesthetic and disinfectant of DeziceptI OP for treatment of surgical field was tested during 31 surgeries during operation of the wall mounted air recirculator-irradiators and without them (control group). Kolion 1B gas analyzer was used for online monitoring of the organic compounds concentration in the air of the operating room. Results. Comparative analysis has proved that during all stages of general inhalation anesthesia and surgery the sevoflurate concentration was 2.0-3.5 fold higher with no protection used compared to operation of air recirculator and it was above the ultimate permissible concentrations as per international standards. Treatment of surgical field by an antiseptic caused the up to 10-fold increase of organic substances in the air. The concentration of disinfectants reduced by 90% 2.5 times faster under operation of air recirculators compared to spontaneous cleansing. Conclusion: ORUB-3-5-KRONT air recirculator and irradiator equipped by disposable air carbon filters of FUS-KRONT reduces the content of sevoflurane in the air of operating rooms during anesthesia and surgical operation down to recommended ultimate permissible concentrations and provides fast cleansing of the air in the operating room from organic substances after treatment of the surgical field by an antiseptic.

1. Bezopasnost' raboty s ingalyatsionnymi anestetikami v klinicheskikh usloviyakh. [Safety in inhalation anesthetics use in clinical practice]. Ed. by V.V. Lazarev, Pirogov Russian National Research Medical University, Russian Ministry of Health, Publ., Moscow, 2014, 32 p.

2. Vaysman A.I. Nekotorye voprosy gigieny truda vrachey anesteziologov. Avtoref. diss. kand. med. nauk. [Certain labor hygiene issues of anesthesiologists. Cand. Diss.]. Moscow, 1967. 15 p.

3. Kosarev V.V., Babanov S.А. Professionalnye zabolevaniya meditsinskikh rabotnikov NITS Infra. [Occupational diseases of medical workers of Infra Research Center]. Moscow, 2013, pp. 175.

4. Lazarev I.I., Lazareva V.N. Safety of medical personnel when working with inhalation anesthetics. Detskaya Bolnitsa, 2013, no. 4. pp. 49-54. (In Russ.)

5. Edict no. 58 as of 18.05.2010 by Russian Chief State Sanitary Doctor On Approval of SanPiN 2.1.3.2630-10 On Sanitary Epidemiological Requirements to Medical Organizations.

6. Potievskaya V.I., Ushakov I.L., Popov А.А., Chizhov F.Ya. Monitoring of air pollution in the operating room in a reproductive technologies clinic. Vestn. Ros. Universiteta Druzhby Narodov. Seriya: Ekologiya i Bezopasnost Zhiznideyatelnosti, Moscow, 2016. no. 2. pp. 118-125. (In Russ.)

7. Trekova N.A. Аnesteziologicheskie aspekty profilaktiki tsitogeneticheskikh effektov ingalyatsionnykh anestetikov. Avtoref. diss. dokt. med. nauk. [Anesthesiologic aspects of prevention of cytogenetic effects of inhalation anesthetics. Doct. Diss.]. Moscow, 1986, 31 p.

8. Trekova N.А., Kozhevnikov V.А. Prevention of air pollution with inhalation anesthetics in operating rooms. Anesteziol. i Reanimatol., 1979, no. 4. pp. 69-74. (In Russ.)

9. Bozkurt G., Memis D., Karabogaz G. et al. Genotoxity of waste anesthetic gases. Anaesth. Int. Care, 2002, vol. 30. pp. 597‒602.

10. Chandrasekhar M., Rekhadevi P., Sailaja N. et al. Evaluation of genenic damage in operating room personal exposed to anaesthetic gases. Mutagenesis, 2006, vol. 4. pp. 249‒254.

11. Сohen E., Brown B., Bruce D. et al. Occupational disease among operating room personnel a national study. Anesthesiology, 1974, vol. 41. pp. 321-340.

12. Criteria for a recommended standarts: occupational exposure to waste anesthetic gases and vapors. DHEW (NIOSH) Publication No. 77–140, US, National Institute for Occupational Safety and Health, Cincinnati, OH-1977.

13. Hazard Cоmmunication Standart OSHA Publication. US. Department of labor, 1985.

14. Health Care without Harm Europe Newsletter – The Compaign for Environmentally. Responsible Health Care. 2008, no. 11.

15. Hoerauf K., Schrogendorfer K., Weisner G. et al. Sister chromatid exchanges in human lymphocytes exposed to isoflurane and nitrous oxide in vitro. Brit. J. Anaesth., 1999, vol. 82. pp. 268-270.

16. Karpinski T.M., Kostrzevska M., Stacheski I. et al. Genotoxicity of the desflurane in human lуmphocytes in vitro. J. Appl. Genet., 2005, vol. 46. pp. 319‒324.

17. Raj N., Henderson K., Hall J. et al. Evaluation of personal environment and biological exposure of paediatric anaesthesists to nitrous oxide and sevoflurane. Anaesthesia, 2003, vol. 58. pp. 630-636.

18. Rieder J., Livk P. Exposure to sevoflurane in otorinolaryngologic operations. Can. J. Anaesth., 2001, vol. 48. pp. 934-937.

19. Rosgaj R., Kasuba V., Jazbec A. Premilinary study of cytogenetic damage in personal exposed to anesthetic gases. Mutagenesis, 2001, vol. 16. pp. 133-149.

20. Sessler D., Badgwel J. Exposure of postoperative nurses to exhaled anesthenic gases. Anesth. Analg., 1998, vol. 78. pp. 378-380.

21. Summer G., Zirk P., Hoerauf K. et al. Sevoflurane in exhaled air of operating room personnel. Anesth Analg., 2003, vol. 97. pp. 1070-1073.

22. Weisner G., Schiewe-Langgartner F., Lindner R., Gruber M. Increased formation of sister chromate exchanges in anaesthetists exposed to low levels of sevoflurane. Anaesthesia, 2008, vol. 63. pp. 118-122.