Nitrous oxide-induced reproductive risks: Should recreational nitrous oxide users worry?

Nitrous oxide (N₂O) is a frequently used anaesthetic. Since the year 2000, recreational use of N₂O, also known as 'laughing gas', became popular as a recreational drug due to its mild psychedelic effect. In the 1980s, several reports warned against N₂O-induced reproductive risks among healthcare personnel, questioning the occupational safety of N₂O in health care.

Data about the reproductive risks of N₂O were collected from literature.

Particularly in the past, professionals working in dental and midwifery practices, operating theatres and ambulance transport were exposed to high levels of N₂O. Adverse reproduction effects included congenital anomalies, spontaneous abortion and reduced fertility rates in females. Following occupational measures, like maximal exposure limits for ambient N₂O, this occupational risk was considerably reduced. Recreational users of N₂O, however, voluntarily and repeatedly expose themselves to (very) high doses of N₂O. As such, they exceed the health exposure limits some hundred times, but they are fully unaware of the related reproductive risks.

We advocate to increase the awareness in recreational N2O-users about its potential reproductive risks, especially in heavy users, pregnant users or those who intend to become pregnant.