Hazards in the OR

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xtina0

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Anesthesia hopeful here,

I was wondering if anyone could comment on the potential hazards anesthesiologists are exposed to in the OR.

1. Inhaled anesthetics being teratogenic? I had an attending anesthesiologist swear that his colleague's two children were born with mental deficits because of the exposure.

2. Also the amount of radiation we are exposed to in the OR everyday. I had a CT scan once and was paranoid for weeks. Now I sit through hours fluoro (with my lead of course.)

3. Thirdly 1g of vaporized tissue = 3 cigarettes, read that one the other day.

maybe I'm a bit of a hypochondriac :scared:
 
downs-syndrome-boy.jpg


one of the crnas kids.. looks just like this one..
 
The stress of the job is probably just as bad than breathing in those poisonous gases at a low levels constantly.. Surging catecholomines constantlycant be good for you not to mention the knives you are pulling out of your back constantly..

BUt seriously, when i was in medical school I thought that a couple of anesthesiologists had liver cancer on account of all those gases..
 
there are signs hanging by the or's where I am, not sure how valid it is but either way it got me thinking
 
So it turns out I'm the co-author for the Miller Chapter on occupational safety (the NEXT edition; I think it comes out this autumn), so I'll take a stab at your questions:

1) Maybe. There's very little data on teratogenicity in humans (the bulk of the literature focuses on spontaneous abortion and these data are very mixed). The ASA's taskforce is on record saying they don't believe there's a risk. There was a 1999 study form the UK which used non-anesthesia physicians as a control group and no difference (a broad range of bad outcomes including abortion and congenital malformations) was found.

2) Radiation exposure is a legitimate concern for the anesthesiologist as more and more cases are done in IR and with the use of fluoro. Radiation is thought to disperse between 3-6 feet from the reflected object (most experts think the bulk of occupational exposure is not from the beam itself, but from the beam bouncing off the imaged object). Providers should wear lead, leaded glasses, and dosimeter badges. Cataracts are thought to be the most frequent, tangible effect of OR radiation exposure.

3) We don't really measure vapor in grams and there's no reason to think (or evidence) that inhalational anesthetics are damaging to lung tissue (in the way cigarettes are), although the DO change V/Q matching and hypoxemic pulmonary vasoconstriction. It should be noted, though, that there are limits to the amount of agent that is "allowed" to persist in the OR, that these levels are supposed to be checked twice per year, and that the levels are frequently exceed (as a general rule, of you can smell the agent, the levels are likely many multiples of the acceptable level (which itself is somewhat arbitrary).

Hope that helps.
 
cchoukal said:
3) We don't really measure vapor in grams and there's no reason to think (or evidence) that inhalational anesthetics are damaging to lung tissue (in the way cigarettes are), although the DO change V/Q matching and hypoxemic pulmonary vasoconstriction. It should be noted, though, that there are limits to the amount of agent that is "allowed" to persist in the OR, that these levels are supposed to be checked twice per year, and that the levels are frequently exceed (as a general rule, of you can smell the agent, the levels are likely many multiples of the acceptable level (which itself is somewhat arbitrary).
Click to expand...

The OP's question was about aerosolized tissue, the kind that would be created by bovie cauterization of human flesh. There is some concern about this, but any quantification (i.e. cigarette equivalents) is probably just conjecture. Wear a mask, dont breathe fumes directly, etc.
 
imho the biggest occupational hazard in the or for anesthesiologists is addiction. one of our crnas was just discovered to be "diverting"...
 
Far more risk tripping over the nest of power cords, tubing, cables, etc. that are an ever-increasing presence in the OR.
 
I am at a very high risk of developing carpal tunnel syndrome from the hundreds of times I sign my name daily.
 
:laugh:

Isn't that the truth. I need to get a stamp or something.
 
+1 to jwk's comment.

... and totally curious about the inhaled tissue statement.
 
Idiopathic said:
The OP's question was about aerosolized tissue, the kind that would be created by bovie cauterization of human flesh. There is some concern about this, but any quantification (i.e. cigarette equivalents) is probably just conjecture. Wear a mask, dont breathe fumes directly, etc.
Click to expand...

Totally misread that; thanks.
 
sevoflurane said:
+1 to jwk's comment.

... and totally curious about the inhaled tissue statement.
Click to expand...

I've wondered about that as well. The only data that seems to get published is older data on lasering papillomata (thought to be HPV) and it's generally understood that this vapor DOES have the potential to transmit the disease.
 
That was real helpful cchoukal, thanks.

And also going back to what someone else said, and what I've been hearing yes, addiction does seem to be an issue where I've rotated through.

So much so that a resident I knew actually overdosed on propofol.

Knowing that will never be me, I'm more concerned with the occupational hazards.
 
Haha very true, I actually laughed about that after I submitted.
 
If i was a women anesthesiologist i would probably would not want to work any time during my pregnancy.
 
Kahreek said:
If i was a women anesthesiologist i would probably would not want to work any time during my pregnancy.
Click to expand...

The pregnant anesthesiologists and CRNAs I've known have just stayed out of the fluoro rooms which seems pretty reasonable. Some avoided the peds ENT rooms too, because of all the mask inductions and sevo pollution, but I half-think they just seized the excuse to skip a high turnover day dealing with snotty kids and snottier parents.

Maybe if I was MH susceptible, I would worry about volatile exposure risk.

There are more rational areas for us to reduce risk in our lives. I wear lead, don't huff the vapor or sniff the bovie smoke, and accept the remaining OR hazard risk.
 
Kahreek said:
If i was a women anesthesiologist i would probably would not want to work any time during my pregnancy.
Click to expand...

Wouldn't you just not want to work period? Irrespective of specialty I mean.
 
pgg said:
...sevo pollution...
Click to expand...

What are you saying man...? I'm offended. 😛

One of our partners had a little one not too long ago. She worked right up until the last week before delivery.
 
sevoflurane said:
What are you saying man...? I'm offended. 😛

One of our partners had a little one not too long ago. She worked right up until the last week before delivery.
Click to expand...

Ours are given an extended lunch break at time of delivery, but are expected back that day to finish their shift.🙂
 
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