[Exposure of intensive care personnel to isoflurane in long-term sedation]. 1995

K Hoerauf, and C Koller, and F Vescia, and C Metz, and J Hobbhahn
Klinik für Anästhesiologie am Klinikum, Universität Regensburg.

OBJECTIVE Isoflurane is a suitable agent to produce sedation in the intensive care unit (ICU). However, data concerning occupational exposure to isoflurane during long-term sedation are not yet available. The purpose of this study was to evaluate occupational exposure to isoflurane in the ICU. METHODS Trace concentrations of isoflurane were measured directly by means of photoacustic infrared spectrometry during isoflurane sedation in ten cases over a period of 24 hours. Values were obtained at four personnel-related and two leakage-related locations in an ICU chamber. RESULTS All measured values were low, the majority under 3 ppm isoflurane at the personnel-related points. Peak concentrations up to 40 ppm were recorded for several minutes during nursing interventions. At measurement point "nearby patient's mouth" values up to 5 ppm were recorded, at location "anaesthesia machine" values ranged from 2 to 69 ppm isoflurane. CONCLUSIONS We conclude that an effective high flow scavenging system, a low-leakage anaesthesia machine and an airconditioning equipment without recirculation could keep occupational exposure low. The majority of the measured values was below the NIOSH recommendation (2 ppm). All values was lower than a national state recommendation (10 ppm). Under other circumstances (e.g. without scavenging system) air pollution will be higher and therefore measurements at the working place are needed.

UI MeSH Term Description Entries
D007362 Intensive Care Units Hospital units providing continuous surveillance and care to acutely ill patients. ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D007530 Isoflurane A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
D008452 Maximum Allowable Concentration The maximum exposure to a biologically active physical or chemical agent that is allowed during an 8-hour period (a workday) in a population of workers, or during a 24-hour period in the general population, which does not appear to cause appreciable harm, whether immediate or delayed for any period, in the target population. (From Lewis Dictionary of Toxicology, 1st ed) Maximum Permissible Exposure Level,MPEL,Maximum Permissible Exposure Concentration,Allowable Concentration, Maximum,Allowable Concentrations, Maximum,Concentration, Maximum Allowable,Concentrations, Maximum Allowable,MPELs,Maximum Allowable Concentrations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000395 Air Pollutants, Occupational Toxic air-borne matter related to work performed They are usually produced by the specific nature of the occupation. Occupational Air Pollutants,Pollutants, Occupational Air
D013055 Spectrophotometry, Infrared Spectrophotometry in the infrared region, usually for the purpose of chemical analysis through measurement of absorption spectra associated with rotational and vibrational energy levels of molecules. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) IR Spectra,Infrared Spectrophotometry,IR Spectras,Spectra, IR
D014691 Ventilation Supplying a building or house, their rooms and corridors, with fresh air. The controlling of the environment thus may be in public or domestic sites and in medical or non-medical locales. (From Dorland, 28th ed) Ventilations
D015920 Gas Scavengers Apparatus for removing exhaled or leaked anesthetic gases or other volatile agents, thus reducing the exposure of operating room personnel to such agents, as well as preventing the buildup of potentially explosive mixtures in operating rooms or laboratories. Anesthetic Gas Scavengers,Anesthetic Gas Scavenger,Gas Scavenger,Gas Scavenger, Anesthetic,Gas Scavengers, Anesthetic,Scavenger, Anesthetic Gas,Scavenger, Gas,Scavengers, Anesthetic Gas,Scavengers, Gas
D016273 Occupational Exposure The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation. Exposure, Occupational,Exposures, Occupational,Occupational Exposures
D016292 Conscious Sedation A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines) Sedation, Conscious,Sedation, Moderate,Moderate Sedation

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