Lesson 19

Environmental Concerns

• Waste Anesthetic Gases:

  • Effects are uncertain; studies show no significant impact on reproduction or cellular toxicity with effective scavenging systems.
  • Typical levels in well-scavenged ORs are below recommended limits.

• Methyl Methacrylate Exposure:

  • Can cause skin/eye irritation, allergic reactions, neurologic signs, and organ toxicity.

• Allergic Reactions in Providers:

  • Allergies to volatile agents, muscle relaxants, or latex are possible.
  • Latex sensitivity prevalence: 12% among anesthesiologists; reactions mostly include contact dermatitis.

• Radiation Exposure Risks:

  • Increased with out-of-OR anesthesia and procedures like CT scans and cardiac catheterization.
  • OSHA limit: 5 rem annually for occupational exposure to ionizing radiation.
  • No regulations for MRI exposure limits; low-frequency electromagnetic fields may cause nausea and dizziness.

• Noise in the Operating Room:

  • Excessive noise levels (average 77 dB, music up to 105 dB) hinder communication and alerting signals.
  • OSHA limit: 90 dB for 8-hour exposure, max single level 115 dB.
  • Chronic noise exposure can result in irreversible hearing loss, especially in patients on ototoxic drugs.

• Second Victim Concept:

  • Anesthesia providers involved in poor outcomes may suffer acute stress and need immediate support.
  • Concept introduces "third victims" being the subsequent patients cared for by the stressed provider.