Perceptions of Polymethyl Methacrylate Cement Exposure Among Female Orthopaedic Surgeons

The medical field has long believed that polymethyl methacrylate (PMMA) vapor is dangerous to a growing fetus, and therefore, women who are pregnant should avoid exposure to it. Symptoms of vapor exposure include eye irritation, coughing, respiratory tract irritation, and irritation of exposed mucous membranes. The purpose of this study is to investigate the perceptions of PMMA cement exposure during pregnancy in female orthopaedic surgeons because it influences (1) the currently held beliefs and practices and (2) clinical and career choices.

A 23-question survey was distributed via e-mail to all active members of the Ruth Jackson Orthopaedic Society and the "Women in Orthopaedics" private Facebook group. Questions consisted of the level of training, current usage of PMMA, previous exposure during pregnancy and/or breastfeeding, and beliefs regarding current or future willingness of exposure during pregnancy/breastfeeding.

PMMA training was found to have a positive correlation with those who remained in the operating room while pregnant or would do so in the future. Overall responses found that 41.7% would leave the room in the future if PMMA were being used while they were pregnant, with 24.7% leaving if they were breastfeeding. If they were the primary surgeon, 23.7% stated that they would leave and 8.4% stated that PMMA exposure during pregnancy factored into which subspecialty they chose.

This survey demonstrates a lack of consensus among practicing female orthopaedic surgeons regarding the risks posed by remaining in a room during pregnancy and breastfeeding while PMMA is in use. Currently held beliefs and education practices should be examined to determine if they match the available literature.