Pub Date : 2026-01-01DOI: 10.1016/j.etap.2025.104916
Keanu Ryan , Carlijn R. Hooijmans , Fréderique Struijs , Stijn van den Munckhof , Romy Kiffen , Albert Dahan , Sebastian Hoffmann , Daniele Mandrioli , Julia ML Menon , Nel Roeleveld , Merel Ritskes-Hoitinga , Vivi Schlünssen , Michel MRF Struys , Paul TJ Scheepers
Epidemiological studies have raised concerns about health risks from occupational exposure to inhalation anesthetics. This study aimed to systematically search, select and appraise the evidence from animal studies to derive occupational exposure levels (OELs) for isoflurane and sevoflurane. Twenty-four studies for isoflurane and 7 studies for sevoflurane were included, which reported on neurological and fertility outcomes. When ranking adverse outcomes by derived benchmark dose lower bounds (BDMLs), male fertility was considered as the most critical effect for both substances. Assessment factors cover uncertainties regarding interspecies and intraspecies differences. Using the BMDL as point of departure we derived 8-h time-weighted average (TWA) OELs of 0.9 mg/m3 (0.12 ppm) for isoflurane and of 0.8 mg/m3 (0.09 ppm) for sevoflurane. For peak exposures, 15-min TWA OELs of 30 mg/m3 (3.9 ppm) and 25 mg/m3 (3.0 ppm) were derived, respectively. These levels are expected to protect workers from health effects caused by these anesthetic gases.
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