Exposure of medical personnel to methylmethacrylate vapor during percutaneous vertebroplasty

Occupational and Environmental Medicine, 1993

This study aimed to investigate the pulmonary effects of methylmethacrylate (MMA) in a group of occupationally exposed workers. In the exposed group 20% had chronic cough compared with 1% in controls. Spirometric values at the beginning of the workshift were similar in both groups, but a mild airways obstruction appeared during the workshift. The maximum expiratory flow when 50% of the forced vital capacity remained to be exhaled (MEFSO) and the ratio of MEF5O to maximal expiratory flow (MEFSO/MEF) decreased significantly during the workshift among exposed workers v controls (p = 0 04 and 0'01 respectively). Results remained unaffected after adjustment for smoking. Exposure to MMA seems to be responsible for a mild airways obstruction but further study on a larger population would be usefil.

Journal of the Pakistan Medical Association, 2020

Surgical smoke is part of the environment during operative and invasive procedures. Electric diathermy is a very important tool for a surgeon and is used in every surgical treatment nowadays. It assists the surgeon to dissect the tissue or enables securing haemostasis in lesser time and with larger delicacy. But at the same time, it has harmful effects on surgeon as well as patients. Although there is a substantial amount of evidence and guidelines from various authors and societies, yet there are no clear policies and preventive measures towards surgical smoke handling. This article presents potential harmful effects of surgical smoke and aims to build guidelines for the surgical personnel based on current evidence in literature.

International Journal of Environmental Research and Public Health, 2021

Dissecting a human cadaver is an irreplaceable practice in general training of medical students. Cadavers in anatomy laboratories are usually preserved in formalin, an embalming fluid whose basic component is formaldehyde (FA). The aim of this study is to assess the cancer risk of employees and students that are exposed to FA based on the results of three monitoring campaigns, as well as to suggest permanent solutions to the problem of FA exposure based on the results obtained. Three sampling campaigns of formaldehyde concentration in indoor environments were conducted at five different locations at the Anatomy Department of the Faculty of Medicine with the purpose of assessing permanent employees’ and medical faculty first year students’ exposure to FA. Indoor air was continuously sampled during 8 h of laboratory work and analyzed in accordance with the NIOSH Method 3500. Exceeding of the 8 h time-weighted average (8 h TWA) values recommended by Occupational Safety and Health Admin...

PloS one, 2018

Electrosurgery produces surgical smoke. Different tissues produce different quantities and types of smoke, so we studied the particle characteristics of this surgical smoke in order to analyze the implications for the occupational health of the operation room personnel. We estimated the deposition of particulate matter (PM) from surgical smoke on the respiratory tract of operation room personnel using clinically relevant tissues from Finnish landrace porcine tissues including skeletal muscle, liver, subcutaneous fat, renal pelvis, renal cortex, lung, bronchus, cerebral gray and white matter, and skin. In order to standardize the electrosurgical cuts and smoke concentrations, we built a customized computer-controlled platform. The smoke particles were analyzed with an electrical low pressure impactor (ELPI), which measures the concentration and aerodynamic size distribution of particles with a diameter between 7 nm and 10 μm. There were significant differences in the mass concentrati...

1985

Results of interviews conducted during the initial survey indicated that complaints reported by workers in the ear, nose, and throat clinic and the surgery clinic appeared to be mainly attributed to poor air quality. The results of confidential interviews conducted with 59 of the 70 employees in the operating room areas revealed: 31 (44t) complained of frequent headaches, 28 (40%) of nose or eye irritation, 25 (36%} of light headedness, 21 (30%} unusual tiredness. Seven (78%) of nine nurses in the recovery room complained of frequent headaches. Symptomatology was generally attributed either to poor ventilation or exposure to substances used in these areas. Nurses in the operating room and technicians in the instrument room reported an incidence of reproductive problems, but the investigators determined it was not above the expected background levels for the U.S. population. Personal and area samples collected in the instrument room revealed no exposures to ethylene oxide (EtO) above the limit of detection during the operation of the gas sterilizer. EtO was detected in the adjacent mechanical access room (a non-personnel area) at peak concentrations of up to 12.9 parts per million parts of air (ppm), which quickly dissipated. .NIOSH recomrrends that EtO be rega rd~d as a potential occupational carcinogen and that exposure be reduced to the lowest feasible level. The results of personal samples collected during three surgical procedures showed ti~-weighted average (TWA) concentrations of 138 ppm, 177 ppm, and 66 ppm nitrous oxide (N20) for the anesthesiologists. These results exceeded tt.e NIOS•: recommended standard of 25 ppm N20 as a TWA for the period of administration. Personal samples collected for halogenated anesthetic gases during the same procedures revealed TWA concentrations of 3.2 ppm and 0.69 ppm halothane, and 0.44 pp111 enfluranf', two of which exceeded the NIOSH recommended standard for halogenated anesthetic agents used in combination with N20 of 0.5 ppm as a TWA for the period of administration. There is currently no Occupational Safety and Health Administration standard for anesthetic agents. Based on the information obtained nur1nn this survey, it has been determined that a hazard from exposure to waste anesthetic gases and vapors did exist at the time of this survey. Recomuendations for alleviating this and other potential hazards are included in the body of • this reoort.

Journal of Clinical and Basic Research (JCBR) , 2022

Background and objectives: Electrosurgical units produce the highest level of surgical smoke. Therefore, the present study aimed to determine concentration of surgical smoke compounds produced in orthopedic surgeries. Methods: The present study was performed on 20 patients in the operating room units of 5 Azar Hospital in Gorgan, Iran. Twenty smoke specimens were collected from electrosurgical units during orthopedic surgeries. The concentration of benzene, toluene, ethylbenzene, and xylene (BTEX) was determined using an air-sampling pump and SKC charcoal sorbent tubes. The collected data were analyzed using frequency distribution as well as generalized linear and ranked logistic regression tests in SPSS software (version 17). Results: Most patients had a body mass index (BMI) level of >24 kg/m 2. The mean age of patients was 25.28 years. The average concentrations of benzene, toluene, ethylbenzene, and xylene were 540 µg/m3, 430 µg/m3, and 340µg/m3, and 390µg/m3, respectively. The concentration of particles with an aerodynamic diameter of 2.5 μm or less (PM2.5) was 22.75 µg/m 3. Benzene values were higher than the National Institute for Occupational Safety and Health limit. The PM2.5 values were unhealthy for sensitive groups according to the Air Quality Index. Moreover, BMI had a significant association with the amount of benzene produced intraoperatively (p=0.016). The findings also showed that the surgery duration had a significant association with toluene production (p=0.049). Conclusion: The concentration of BTEX compounds was low, but the PM2.5 values are high in the studied operating rooms. Long-term exposure to BTEX compounds can be considered as a health risk for operating room personnel

Dental and Medical Problems, 2019

Background. Methyl methacrylate (MMA) is one of the widely used organic monomers in dentistry. It may cause multiple adverse reactions, ranging from allergic reaction to systemic toxicity. Dentistry students are exposed to MMA in an acute manner; however, the concentration of its vapor cannot be estimated well. Objectives. The aim of this study was to evaluate the effect of acute MMA vapor inhalation on the pulmonary function of dental students, both smokers and non-smokers. Material and methods. Thirty-eight male dental students were divided into 2 groups (group 1-smokers and group 2-non-smokers). The lung function parameters of the students were tested with a spirometer during their ordinary training work in a prosthodontics laboratory, before contact with MMA and immediately after it. The lung function test was performed using a standard protocol. The students were asked not to use any perfume or aromatic overlaps for a period of 24 h before starting the tests. Results. The researchers noted a statistically significant decrease (p ≤ 0.05) in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), forced expiratory flow at 25-75% of the pulmonary volume (FEF25-75), and forced expiratory flow at 25% (FEF25) and 50% (FEF50) of the pulmonary volume in smokers and non-smokers by comparing the pre-and post-work tests. Conclusions. Acute inhalation of MMA vapor induced a moderate restriction of pulmonary function in dental students, both smokers and non-smokers, during their routine prosthodontics laboratory training work. No differences in the results of the pulmonary function tests between smokers and non-smokers were observed.

Civil and Environmental Research, 2012

The process of human cadaveric preservation uses diverse embalming formulas introduced in cadavers by means of various technical approaches. Successful embalming requires the use of adequate formulas and techniques to fulfil a long-term structural preservation and minimize shrinkage and any harmful toxic effects to personal and environment. Our aim in this study is to generate a high-quality embalming formula that generate superior embalming and to minimize chemical toxic fumes emitted that students and embalmers are exposed to. An altered low formaldehyde based formula was used in our laboratories and introduced in cadavers through arterial injection using gravity infusion pressure. Results indicate an even distribution of the formula observed exhibiting superior tissue quality and excellent joint flexibility. Final formaldehyde concentration within the embalmed cadavers was minimal. The ambient fumes detected were significantly reduced when compared with other formula's used complying with international permitted values. There was significant reduction in the symptoms the students complain about during and after contact with cadavers. We conclude that this modified formula yields a higher quality preserved cadavers with high flexibility and colour preservation. A reduction of the unwanted ambient hazardous toxic effects of formaldehyde and other chemical fumes was achieved.

Chemical Research in Toxicology, 2010

Background-Formaldehyde is a ubiquitous pollutant to which humans are exposed. Pathologists can experience high formaldehyde exposure levels. Formaldehyde-among other properties-induce oxidative stress and free radicals, which react with DNA and lipids, leading to oxidative damage and lipid peroxidation, respectively. We measured the levels of airformaldehyde exposure in a group of Italian pathologists and controls. We analyzed the effect of formaldehyde exposure on leukocyte malondialdehyde-deoxyguanosine adducts (M 1-dG), a biomarker of oxidative stress and lipid peroxidation. We studied the relationship between airformaldehyde and M 1-dG adducts. Methods-Air-formaldehyde levels were measured by personal air samplers. M 1-dG adducts were analyzed by 32 P-postlabelling assay. Results-Reduction rooms pathologists were significantly exposed to air-formaldehyde in respect to controls and to the pathologists working in other laboratory areas (p<0.001). A significant difference for M 1-dG adducts between exposed pathologists and controls was found (p=0.045). The effect becomes stronger when the evaluation of air-formaldehyde exposure was based on personal samplers (p=0.018). Increased M 1 dG adduct levels were only found in individuals exposed to air-formaldehyde concentrations higher than 66 μg/m 3. When the exposed workers and controls were subgrouped according to smoking, M 1-dG tended to increase in all the subjects but a significant association between M 1-dG and air-formaldehyde was only found in not smokers (p= 0.009). Air formaldehyde played a role positive but not significant (r = 0.355, p = 0.075, Pearson correlation) in the formation of M 1-dG, only in not smokers. Conclusions-Working in the reduction rooms and to be exposed to air-formaldehyde concentrations higher than 66 μg/m 3 is associated with increased levels of M 1-dG adducts.

International journal of occupational safety and ergonomics: JOSE

The authors acknowledge and thank Iranian Dental Technicians Association management, especially Mrs. Fariba Khayatti and Mr. Hossain Chaghari, for their sincere cooperation .

International journal of environmental research and public health, 2018

Anatomy teaching and research relies on the use of formaldehyde (FA) as a preservation agent for human and animal tissues. Due to the recent classification of FA as a carcinogen, university hospitals are facing a challenge to (further) reduce exposure to FA. The aim of this study was to reduce exposure to FA in the anatomy teaching and research facility. Workers participated in the development of improved work practices, both technical and organizational solutions. Over a period of 6 years mitigating measures were introduced, including improvement of a down-flow ventilation system, introduction of local exhaust ventilation, collection of drain liquid from displayed specimens in closed containers and leak prevention. Furthermore, some organizational changes were made to reduce the number of FA peak exposures. Stationary and personal air sampling was performed in three different campaigns to assess the effect of these new work practices on inhalation exposure to FA. Samples were colle...

This is the second in a series that will provide a 10-year review ofperioperative nursing research.

International Journal of Scientific Research and Management, 2018

Formaldehyde is an anxious gas used as a tissue preservative of cadavers in anatomy halls. Therefore, laboratory staff and students are at high risk of different clinical complications due to the continuous exposure to formaldehyde. The present questionnaire-based study evaluates the effects of formaldehyde exposure on veterinary students and staff in the anatomy gross dissection laboratory, University of Tripoli, Libya. A total of 104 students and 6 anatomy staff members completed a questionnaire of 24 questions related to the clinical symptoms observed after formaldehyde exposure and the answers were assessed using a six point (0-5) scale. Students had a high prevalence of nasal itching 78(75%), eyes burning 78(75%), excessive lacrimation 76(73%), eyes redness 60(58%), headache 64(62%) and respiratory distress 61(59%). Smoking and wearing glasses or gloves worsened many symptoms while wearing masks minimized other symptoms and male students were more affected than females. All anatomy staff members (100%) reported nasal itching, burning and congestion, eyes burning and redness, excessive lacrimation, cough and respiratory distress and less than that (83%) suffered from mouth dryness, headache, temporary loss of their ability to recognize the smell of formaldehyde and needed a physician assistance after the exposure to formaldehyde. The repeated exposure to formaldehyde in gross anatomy dissection has harmful effects on both students and staff member and finding alternative preservation methods, such as freezing, would be safer than using the formaldehyde.

Case Reports in Clinical Medicine, 2016

We report a rare complication of diffuse alveolar hemorrhage and respiratory failure following percutaneous vertebroplasty in a patient who has evidence of cement leakage. Cement injection was done two days prior to presentation and covered 2 vertebral levels for osteoporosis induced fractures.

Jordan Medical Journal

Background Aims: To evaluate and measure serum bromide levels for health care professionals working in operation rooms upon exposure to Halothane anesthetic in attempt to support worldwide calls to eradicate halothane from the use as a general anesthetic before surgical operations. Materials and Methods: This is a quantitative descriptive study which used the Inductively-coupled plasma-mass spectroscopy (ICP-MASS) to investigate serum bromide levels in blood samples of fifty two healthcare professionals working under Halothane atmosphere inside operation rooms. Results: This study revealed 3-10 times higher levels of serum bromide serum than the allowed non toxic levels (3-4.4 mg/l). The measured concentration ranges were 10-39.9 mg/l.. Conclusions: The observed high level of serum bromide strongly suggested an urgent call to exclude Halothane from the use as a general anesthetic in surgical operation. Meanwhile, serum bromide levels for all workers exposed to Halothane must be frequently monitored to predict the level of toxicity.