Details:

Alternative Title:
J Occup Environ Hyg
Personal Author:
Boiano, James M. ; Steege, Andrea L.
Boiano, James M. ; Steege, Andrea L. Less -
Description:
Scavenging systems and administrative and work practice controls for minimizing occupational exposure to waste anesthetic gases have been recommended for many years. Anesthetic gases and vapors that are released or leak out during medical procedures are considered waste anesthetic gases. To better understand the extent recommended practices are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted in 2011 among members of professional practice organizations representing anesthesia care providers including physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants. This national survey is the first to examine self-reported use of controls to minimize exposure to waste anesthetic gases among anesthesia care providers. The survey was completed by 1,783 nurse anesthetists, 1,104 physician anesthesiologists, and 100 anesthesiologist assistants who administered inhaled anesthetics in the seven days prior to the survey. Working in hospitals and outpatient surgical centers, respondents most often administered sevoflurane and, to a lesser extent desflurane and isoflurane, in combination with nitrous oxide. Use of scavenging systems was nearly universal, reported by 97% of respondents. However, adherence to other recommended practices was lacking to varying degrees and differed among those administering anesthetics to pediatric (P) or adult (A) patients. Examples of practices which increase exposure risk, expressed as percent of respondents, included: using high (fresh gas) flow anesthesia only (17% P, 6% A), starting anesthetic gas flow before delivery mask or airway mask was applied to patient (35% P; 14% A); not routinely checking anesthesia equipment for leaks (4% P, 5% A), and using a funnel-fill system to fill vaporizers (16%). Respondents also reported that facilities lacked safe handling procedures (19%) and hazard awareness training (18%). Adherence to precautionary work practices was generally highest among nurse anesthetists compared to the other anesthesia care providers. Successful management of waste anesthetic gases should include scavenging systems, hazard awareness training, availability of standard procedures to minimize exposure, regular inspection of anesthesia delivery equipment for leaks, prompt attention to spills and leaks, and medical surveillance.
Subject:
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Anesthesiologist Assistants
Anesthetic Gases
Article
Exposure Controls
Nurse Anesthetists
Physician Anesthesiologists
Precautionary Practices
Web Survey

Source:
J Occup Environ Hyg. 13(10):782-793.
Pubmed ID:
27542098
Pubmed Central ID:
PMC4994980
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:89da2f7b4180de583612f94caeaac62dfb9d23d08b8713771a12035fe9557bec
File Type:

Supporting Files

• nihms-793821.nxml

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