Anaesthetic pollution. Potential sources, their identification and control

Area of Science:

• Occupational Health
• Environmental Health
• Anesthesiology

Background:

• Anaesthetic gases can escape into the operating room environment from multiple sources, not just the anaesthetic breathing system.
• Regulations like COSHH and OES mandate risk assessment and control of anaesthetic exposure for healthcare workers.
• Scavenging equipment, while installed, may not be fully effective in controlling anaesthetic pollution.

Purpose of the Study:

• To identify and assess controllable sources of anaesthetic gas pollution in an operating theatre.
• To evaluate the effectiveness of current pollution control measures.
• To recommend methods for improving the control of anaesthetic pollution.

Main Methods:

• Utilized an infra-red analyser for leak testing and background monitoring during an initial COSHH assessment.
• Investigated various potential pollution sources including vaporiser filling, induction techniques, face mask leaks, and equipment integrity.
• Monitored specific areas such as gas outlets and connections within the anaesthetic system.

Main Results:

• Identified several controllable sources of anaesthetic gas pollution, including ill-fitting face masks, loose breathing system connections, and laryngeal mask leaks.
• Detected a significant leak of nitrous oxide (N2O) near a multigas monitor's unscavenged gas outlet.
• Highlighted that pollution sources remote from scavenging equipment can contribute to ineffective pollution control.

Conclusions:

• Infra-red leak testing is an effective method for identifying hidden sources of anaesthetic gas pollution.
• Many identified pollution sources are amenable to control and remedy, improving occupational safety.
• Recommendations include implementing regular leak testing to enhance the management of anaesthetic gas exposure.