职业接触安氟仑对健康的危害。允许浓度的试验和分析概述。

IF 0.8 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Medycyna pracy Pub Date : 2022-02-18 Epub Date: 2022-02-07 DOI:10.13075/mp.5893.01204
Małgorzata Kupczewska-Dobecka
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引用次数: 0

摘要

本工作的目的是分析安氟醚暴露对健康的危害,并分析其职业暴露限值(OEL)。本研究采用了基于在线科学期刊数据库检索的证据获取方法。安氟醚是一种吸入性麻醉剂。患者出现恶性高热、癫痫发作、心律失常、呼吸抑制和低血压。职业接触安氟醚可能发生在医疗保健专业人员中。安氟醚的靶器官是中枢神经系统,其严重后果是精神运动表现的恶化。在对暴露于安氟醚的手术室医务人员中招募的志愿者进行的研究中,显示了简单反应时间测试结果的显著恶化。世界专家组认为精神运动试验结果恶化的最低不良反应浓度(loec)值为最低麻醉浓度(MAC)值的5-10%,即6342-12 684 mg/m3。对安氟醚潜在肾毒性的评估表明,它不太可能发生,因为安氟醚在人体内的生物转化导致低峰血清氟浓度为15 μmol/l。早期关于患者肝损害的报道没有得到支持。职业暴露流行病学研究引起了人们对麻醉气体混合物对流产率或胎儿发育和儿童出生缺陷的影响的关注,但这些研究都没有具体确定所用麻醉气体的类型和浓度。致癌性和诱变性研究均为阴性。在波兰,没有监测职业性接触安氟醚的情况,因为没有为工作环境空气中的安氟醚确定标准值。有必要在OEL列表中快速介绍这种麻醉剂以及适用的极限值。中国生物医学工程学报,2012;33(1):391 - 391。
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[Health hazards resulting from occupational exposure to enfluran - overview of tests and analysis of admissible concentration values].

The aim of this work is to analyze the health hazards of enflurane exposure and to analyze the occupational exposure limits (OEL). The method of obtaining evidence based on a review of online databases of scientific journals was used. Enflurane is an inhalation anesthetic. Malignant hyperthermia, seizures, arrhythmias, respiratory depression and hypotension have been observed in patients. Occupational exposure to enflurane may occur in healthcare professionals. The target organ for enflurane is the central nervous system with a critical consequence of deterioration in psychomotor performance. In studies on volunteers recruited from the medical staff of operating rooms exposed to enflurane, a significant deterioration in the results of the Simple Reaction Time Test was shown. World experts' groups assume that the LOAEC (lowest observed adverse effect concentration) value for the deterioration of psychomotor test results is 5-10% of the MAC value (minimal anesthetic concentration), i.e., 6342-12 684 mg/m3. Assessment of the nephrotoxic potential of enflurane has shown that it is unlikely to occur because biotransformation of enflurane in humans results in a low peak serum fluoride concentration of 15 μmol/l. Early reports about liver damage in patients were not be supported. Occupational exposure epidemiological studies have raised concerns about the effects of anesthetic gas mixtures on the abortion rate or on fetal development and birth defects in children, but none of these studies specifically determined the type and concentration of anesthetic gases used. The carcinogenicity and mutagenicity studies were negative. Occupational exposure to enflurane is not monitored in Poland, as no standard value has been established for it in the air of the working environment. It is necessary to quickly introduce this anesthetic along with the applicable limit value to the OEL list. Med Pr. 2022;73(1):51-69.

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来源期刊
Medycyna pracy
Medycyna pracy PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
1.90
自引率
10.00%
发文量
35
审稿时长
6-12 weeks
期刊介绍: The journal publishes original papers, review papers and case studies in Polish and English. The subject matter of the articles includes occupational pathology, physical, chemical and biological agents at workplace, toxicology, mutagenesis, health policy, health management, health care, epidemiology, etc. The magazine also includes reports from national and international scientific conferences on occupational medicine. It also contains letters to the editor. Each first-in-year issue of the magazine comprises former-year indices of authors and keywords.
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