Work Strain by Anaesthetic Gas and Surgical Smoke due to Tissue Coagulation as well as Safety Measures in Surgical Operating Rooms - What the Surgeon Needs to Know

Exposure of the respiratory tract during surgical interventions is an important topic of occupational medicine, which has only rarely been investigated. Based on a literature search, relevant information on the possible health risk is summarised. Within the operating room, an exposure of the respiratory tract to gas (volatile anaesthetics) and aerosols (smoking gas by coagulation) can occur. This exposure needs to be considered as a potential health risk if safety measures are not sufficient. Health risks comprise possible disturbances of gravidity and fertility, neurotoxicity and cancer generation. Such health risks can be prevented with primary preventive measures and can be early recognised/diagnosed by preventive investigations of occupational medicine (secondary prevention). Safety measures are developed according to the STOP principle (substitution, technical, organisatory and personal measures). Assessment of the potential danger begins with an appropriate description of the working procedure and detection of the toxic features of the drugs and medical products, which helps to determine individual exposure and to estimate risk potential. Required occupational safety measures can be derived from this and, subsequently, the work organisation can be optimised. In addition, employees in the operating room are to be instructed about the indicated preventive mode of behaviour. Due to better implementation of the above-mentioned basic principles, introduction of novel narcotics and technological developments, potential exposure of the respiratory tract within the operating room has been reduced over the last 10 years. Thus, risks for gravidity and possible disturbances of fertility by exposure to volatile narcotics are currently assessed to be low. However, available data on health risks of the chronic exposure to smoking gases are still deficient although toxic and cancerogenic organic pyrolysis products are generated. The protection effect of modern air conditioning (e.g., laminar air flow) is only insufficiently investigated. Therefore, further studies on these problems are required.