Occupational exposure to trace concentrations of waste anesthetic gases.

The relationship between exposure to trace concentrations of waste anesthetic gases in the operating room and the possible development of adverse health effects has concerned health care professionals for numerous years. Results of studies have been conflicting. In the late 1960s and early 1970s, some US and European epidemiological studies of operating room personnel showed an increase in the incidence of adverse health effects, including spontaneous abortion and development of congenital abnormalities in offspring. However, subsequent analysis of these studies by 2 independent groups showed that the apparent increase in adverse health effects was most likely due to flaws in these studies' methods and data collection. A later prospective study showed no causal relationship between exposure to trace concentrations of waste anesthetic gases and adverse health effects. Each institution should have a waste anesthetic gas management program that includes scavenging of waste anesthetic gases, work practices to reduce contamination, documented maintenance and regular checking of all equipment, and education of all personnel on this subject. A mechanism for reporting work-related health problems should be in place in each institution.