[Urinary hexafluoroisopropanol in the assessment of occupational exposure to sevoflurane: methodologic features and...

The increasing use of sevoflurane as anaesthetic leads to the need for finding a biological index to evaluate the occupational exposure in surgical activity. Several studies indicate that Hexafluoroisopropanol (HFIP) is a specific sevoflurane metabolite quickly glucuronidated and excreted as HFIP-glucuronide in the urine (HFIPu). Therefore the HFIP removal kinetics in occupational exposure and the correlation between sevoflurane exposure and HFIPu are poorly understood. We studied no. 86 operating room workers of Novara Hospital to evaluate the correlation between the sevoflurane individual exposure (SE) and the HFIPu at the end of the shift expressed in microgram/L (A-HFIPu) and in microgram/g creat. (C-HFIPu). Therefore, in the same group of subjects we evaluated the HFIPu in the urine sampled at 8.00 a.m. before the work. The correlation coefficient was R2 = 0.782 (p < 0.0001) for SE/A-HFIPu and R2 = 0.862 (p < 0.0001) for SE/C-HFIPu; HFIPu normalized for urinary creatinine (C-HFIPu) is an index more suitable than the A-HFIPu. Furthermore we concluded for the usefulness of pre-shift HFIPu.