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Nitrous oxide exposure on the labour ward
International Journal of Obstetric Anesthesia
|July 1, 1996
Summary
Midwives frequently experience occupational exposure to high levels of nitrous oxide (N2O) in labor wards. Many shifts exceed recommended exposure limits, posing potential health risks due to inadequate ventilation.
Area of Science:
- Occupational Health
- Environmental Health
- Anesthesiology
Background:
- Occupational exposure to nitrous oxide (N2O) is a concern in healthcare settings, particularly in confined spaces with poor ventilation.
- Labor wards are identified as high-risk environments for N2O exposure among healthcare professionals.
Purpose of the Study:
- To assess the occupational exposure levels of midwives to nitrous oxide during their shifts on the labor ward.
- To compare measured N2O exposure levels with established and proposed occupational exposure limits.
Main Methods:
- Personal nitrous oxide samplers were utilized to monitor exposure levels during midwife shifts.
- Monitoring was conducted across 242 midwife shifts in two separate hospital settings.
- Exposure data was analyzed in relation to the use of Entonox and work location.
Main Results:
- Seven percent (3%) of monitored shifts exceeded 500 ppm N2O, with one reaching 1638 ppm.
- Over half of the shifts (53%) showed N2O levels above 25 ppm, and 23% exceeded 100 ppm.
- Even when not directly administering Entonox, 4 out of 111 shifts exceeded 100 ppm N2O, indicating background exposure.
Conclusions:
- Midwives frequently encounter chronic occupational exposure to nitrous oxide at levels exceeding UK, US, and Swedish standards.
- Inadequate ventilation and scavenging systems in labor wards contribute significantly to elevated N2O exposure.
- Findings highlight the need for improved N2O control measures to protect healthcare workers' health.