Search NIOSH | NIOSH Home | NIOSH Topics | Site Index | Databases and Information Resources | NIOSH Products | Contact Us |
NIOSH Publication No. 2007-151:Waste Anesthetic Gases - Occupational Hazards in Hospitals |
September 2007 |
|
IntroductionWaste anesthetic gases are small amounts of volatile anesthetic gases that leak from the patient’s anesthetic breathing circuit* into the air of operating rooms during delivery of anesthesia. These gases may also be exhaled by patients recovering from anesthesia. Waste anesthetic gases include both nitrous oxide and halogenated anesthetics such as halothane, enflurane, isoflurane, desflurane, sevoflurane, and methoxyflurane (no longer used in the United States). The halogenated anesthetics are often administered in combination with nitrous oxide. Nitrous oxide and some of the halogenated anesthetics may pose a hazard to hospital workers. The purpose of this brochure is to do the following:
*The anesthetic breathing circuit includes the mask, endotracheal tube, anesthetic gas machine, ventilator, pumps, scavenging devices, all connecting tubing, and other elements, depending on the type of anesthesia delivery system. Who is exposed to waste anesthetic gases?The following hospital workers may be exposed to waste anesthetic gases:
What are the health effects of exposure to waste anesthetic gases?Effects of exposure to high concentrations Exposure to high concentrations of waste anesthetic gases—even for a short time—may cause the following health effects:
Effects of exposure to low concentrations Although some studies report no adverse health effects from long-term exposure to low concentrations of waste anesthetic gases, several studies have linked such exposure to miscarriages, genetic damage, and cancer among operating-room workers. Studies have also reported miscarriages in the spouses of exposed workers and birth defects in their offspring. Therefore, NIOSH is concerned about worker exposures to these gases and recommends controls to prevent exposures. Where are workers most likely to be exposed to waste anesthetic gases?Workers are most likely to be exposed to waste anesthetic gases in
Even when scavenging and venting systems are in place, workers may be exposed to these gases under the following conditions:
How can employers reduce worker exposures to waste anesthetic gases?Employers can reduce exposures to waste anesthetic gases by taking the following steps:
†See Code of Federal Regulations under More Information About Waste Anesthetic Gases.
How can operating-room personnel reduce their exposures to waste anesthetic gases?Anesthetic gases cannot be detected by their odor until concentrations are very high. For example, halothane cannot be detected by 50% of the general population until the concentration is more than 125 times the NIOSH recommended exposure limit. Reduce exposures to waste anesthetic gases by following these procedures before anesthesia begins:
More information about waste anesthetic gasesBovin JF [1997]. Risk of spontaneous abortion in women occupationally exposed to anesthetic gases: a meta-analysis. Occup Environ Med 54:541–548. CFR. Code of Federal regulations. Washington, DC: U.S. Government Printing Office, Office of the Federal Register. Guirguis SS, Pelmear PL, Roy ML, Wong L [1990]. Health effects associated with exposure to anaesthetic gases in Ontario hospital personnel. Br J Ind Med 47:490–497. Hoerauf K, Lierz M, Wiesner G, Schroegendorfer K, Lierz P, Spacek A, Brunber L, Nusse M [1999]. Genetic damage in operating room personnel exposed to isoflurane and nitrous oxide. Occup Environ Med 56:433–437. NIOSH [1977]. Criteria for a recommended standard: occupational exposure to waste anesthetic gases and vapors. Cincinnati, OH: U.S. Department of Health, Education, and Welfare, Public Health Service, Center for Disease Control, National Institute for Occupational Safety and Health, DHEW (NIOSH) Publication No. 77–140. NIOSH [2004]. NIOSH respirator selection logic. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2005–100. NIOSH [1994]. Technical report. Control of nitrous oxide in dental operatories. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 94–129. OSHA [1991]. Waste anesthetic gases. Washington, DC: U.S. Department of Labor, Occupational Safety and Health Administration, OSHA Fact Sheet 91–38. OSHA[2000]. Anesthetic gases: guidelines for workplace exposures. Washington, DC: U.S. Department of Labor, Occupational Safety and Health Administration [http://www.osha.gov/dts/osta/anestheticgases/index.html]. DisclaimerMention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health (NIOSH). In addition, citations to Web sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these Web sites. Ordering InformationTo receive documents or other information about occupational safety and health topics, contact NIOSH at This document is in the public domain and may be freely copied or reprinted. |
|