[Levels of "waste" halothane in operating rooms at gynecologic and obstetrical clinics--preliminary results]

Medical staff working in surgical wards of hospitals, people that work on transport or storaging of gases and liquids, employees working on gas tanks and gas installations, mechanics for anesthetic devices and employees in the process of production of these substances are professionally exposed to anesthetic gases or and fumes that are released in their working environment. It has been confirmed that there were some deviations of indicators of the liver function after a long term exposure of the medical staff (surgeons, anesthesiologists, instrument nurses and anesthetists) to halothane and it has been notified that the level of wasted-halothane in the indoor air of the surgical theaters should be measured in order to get a correct and complete evaluation of the professional risk. The term "wasted-halothane" in this research means fumes of halothane that leave a closed circle: anesthetic device--respiratory organs (patient)--indoor air of the workplace (operating room).

Tests were done in the theaters of the surgical wards of the Department of Gynecology and Obstetrics of Novi Sad. During the testing period no ventilation system was used in any of the theaters. Tested groups included anesthesiologists, instrument nurses and anesthetists who were the members of the surgical team. Tests have not been done on same individuals, but the same workplace. Samples were taken using the "individual sample" method from the breathing zone of the tested person using a rubber pipe fixed on the shoulder. Pumps (personal samplers--"Casella") were set to absorb 0.2 liters of air per minute. Laboratory analyses of these samples were done using a method of desorption of the halothane fumes from the active coal with benzyl-alcohol, and their evaluation on gaschromatograph (Electron-Capture-Detector). The threshold Limit Value (TLV) of halothane fumes at the workplace is 40 mg/m3.

During three days of sampling 32 samples of indoor air were taken from the surgical wards of the Department. 30 samples were taken in the surgical theaters, one in the hall between surgical theaters, and one in the room for rest of the staff. Concentration of halothane fumes in the theatre No 1 was between 6.9 mg/m3 and 27.31 mg/m3 in anesthetists, between 33.08 mg/m3 and 37.62 mg/m3 in anesthesiologists and between 6.9 mg/m3 and 27.31 mg/m3 in instrument nurses. At the theatre No 2 concentration of halothane fumes was between 31.27 mg/m3 and 37.9 mg/m3 in anesthetists, between 3.56 mg/m3 and 91.7 mg/m3 in anesthesiologists and up to 95.5 mg/m3 in instrumenting nurses. Concentration of halothane fumes in the theatre No 3 were between 4.19 mg/m3 and 17.18 mg/m3 in anesthetics, between 6.23 mg/m3 and 37.62 mg/m3 in anesthesiologists and between 8.27 mg/m3 and 12.33 mg/m3 in instrument nurses. In the hall between these surgical theaters the concentration was 3.02 mg/m3 and 0.28 mg/m3 in the room for rest.

Halothane fumes were present in the atmosphere of the working environment in significant quantities at all tested places Especially indicative were the results that showed that the concentration of halothane fumes in the theatre No 1, at the end of surgical operational program, was much higher than at the beginning, and what is even more important it was much higher than those in TLV in anesthesiologists and instrument nurses (more than twice higher). The differences of concentrations between specific occupations within the surgical team were also significant. Our results show that the most exposed were anesthesiologists and instrument nurses, who spent most time nearby the operation table. The anesthetists were much less exposed, due to the fact that they are assistants that often leave the surgical theater during the surgical interventions. Indicators illustrate that the increase of the concentration of halothane fumes depends on the length the surgical theaters were used. It shows an increase of halothane fumes co