{"title":"[Health surveillance of the exposed to anesthetics in the environment: a complete program of preventive medicine for health personnel].","authors":"F Toffoletto, G Cortona, R Audisio, I Ghezzi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hospital workers often can be simultaneously exposed to several potentially hazardous (biological, chemical, and physical) agents. Consequently the environmental controls and the periodic health assessments must be overall and systematic, but not too frequent. The authors suggest the establishment of an interdisciplinary group, including: Hospital Management, Technical Staff, Occupational Physician, Occupational Health Nurses, Environmental Hygienists.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"93-5"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12518285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Gilioli, L Belotti, D Camerino, M G Cassitto, R Girelli, R Lucchini, M Margonari, G Micheloni, L Villa
{"title":"[Neurobehavioral effects of inhalation anesthetics used occupationally: a critical analysis].","authors":"R Gilioli, L Belotti, D Camerino, M G Cassitto, R Girelli, R Lucchini, M Margonari, G Micheloni, L Villa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Unlike other apparatuses, the potential effects on the nervous system of occupational exposure to anaesthetic gases have not been exhaustively reviewed. Because of the relevance of these effects, their significance of the quality of life of the exposed subjects and of the increased risk inherent in their delicate work tasks, these themes deserve the greatest attention. This paper briefly examines the data from the international literature as well as the neurobehavioral methods employed, underlines the existing gaps of knowledge and eventually proposes strategies aimed at filling these gaps of knowledge.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"35-41"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12519171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Anesthetic gases and neuropsychological tests].","authors":"D Leurini, M G Cifaldi, C Mantovani, G Gambini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Authors observed, in a group of 15 subjects working in operating theatres and occupationally exposed to anesthetic gases, an increase of simple reaction average times and an increase of the latency of the wave V of the brainstem auditory evoked potentials. The small number of subjects doesn't allow to draw conclusions. Nevertheless the findings agree with first analogous studies. The Authors, therefore, think opportune to continue the research to acquire further evidence and to ascertain the validity of the current TLV.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"71-3"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12519176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A M Pietrantonio, F Barbani, A V Anania, R Lolli, L Bertolani, C Saccani
{"title":"[Urinary measurement of D-glucaric acid in operating room personnel in the Modena USL 16 hospitals].","authors":"A M Pietrantonio, F Barbani, A V Anania, R Lolli, L Bertolani, C Saccani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Authors describe the results of a research conducted in order to evaluate the amount of D-glucaric acid in the urine of 131 operating theatre workers exposed to anesthetic gases and in a control group of 25 non-exposed hospital personnel. The comparison of the results of the two groups points out a significant difference (in the exposed members 60.7 +/- 2.4 mumol/1 to 46.7 +/- 4.3 mumol/l [+/- s.e.] in the control group; t-test: p = 0.016). The research also considered the influence of certain variables such as age, sex, smoking, alcohol, drug use and liver disorders. None of these variables has proven to be of significant influence on the D-glucaric acid urinary concentration.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"89-92"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12518283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A Cirla, T Terrana, F Toffoletto, F Donato, P Imbrogno, G Mosconi, M G Ricci, L Radice
{"title":"[Health surveillance of workers].","authors":"A Cirla, T Terrana, F Toffoletto, F Donato, P Imbrogno, G Mosconi, M G Ricci, L Radice","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The main purposes of the health surveillance of workers exposed to anaesthetic gases are: a) the finding of disorders either reliable to the exposure or incompatible with the activity in the operating theatre; b) the epidemiological evaluation of the late effects. Simple and rigorous methods to estimate the previous and the current risk are suggested. The main data to be collected during the medical examination are indicated. The registration of the data of the reproductive function by a protocol of recording is proposed. For the health surveillance of workers in Health Care Institution it's advisable to establish an interdisciplinary group, referring to a specialist on occupational medicine.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12519170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Evaluation of the risk of anesthetic gases to exposed subjects with different tasks in operating rooms].","authors":"G Bolzoni, V Somenzi, A M Cirla","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A research was carried out on risk evaluation of workers with different tasks in operating theatre. The airborne concentrations were determined by an IR analyzer with two distinct sampling lines: the first was placed in surgical zone and the second one in anesthesiological zone. The anesthetists resulted more at risk than surgical team. Nevertheless when the evaluation was based on N2O urinary concentration and data were stratified according to task a prevalent inhalation absorption resulted for non medical staff (instrumentist and professional nurse). Our data concerning N2O ranged between 95-764 ppm indoor and between 3-92 mcg/l in the urines of exposed subjects.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"55-8"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12519172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T Terrana, L Radice, A M Cirla, F Donato, F Toffoletto
{"title":"[Occupational exposure to volatile anesthetics and reproductive effects: a bibliographic review of epidemiological studies].","authors":"T Terrana, L Radice, A M Cirla, F Donato, F Toffoletto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Up to the early eighties, a variety of epidemiological studies suggest that chronic exposure to low doses of anesthetic gases, as occurs in operating rooms, is an occupational risk factor for spontaneous abortion and congenital defects. Numerous and more recent epidemiologic studies are reviewed; currently it is suggested that there is inadequate evidence to conclude that occupational exposure to anesthetic gases causes increased rates of spontaneous abortion or congenital anomalies. The improvement of environmental conditions, that has reduced airborne levels of anesthetic gases in operating rooms, has been critical in reducing the risk of abortion and congenital defects. In agreement with recent epidemiological reports, we believe that the health surveillance of exposed workers must include the study of pregnancy outcome.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"43-7"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12519274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Role of inhalation anesthetics in current anesthesiological practice].","authors":"G Torri, A Casati, A Carozzo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Inhalational anesthetic agents represented for long time the sole or mainly anesthetic technique in general anesthesia. In the last twenty years, however, their use has been also related to toxicity among operating room personnel, chronically exposed to the volatile agents. This toxicity could induce the anesthesiologist to give up the volatile anesthetic agents in favour of a total intravenous anesthetic technique. Nevertheless well constructed prospective studies have clearly demonstrated that there is no significant correlation between morbidity index and chronic exposure to inhalational anesthetics. Furthermore a valid air exchange in the operating room, as well as more appropriate anesthesiologic procedures, have significantly reduced the concentration of volatile anesthetic agents in the operating areas. Nowadays inhalational anesthetic agents represent one of the different choices to perform general anesthesia. The anesthesiologist, however, according to patient's physical status and surgical procedure, must choose the anesthetic technique compatible with minimal risk both for patient and operating room personnel.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"5-9"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12519177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Cooperation between the occupational health department and the technical assistance office to confront the problem of pollution by anesthetics].","authors":"O Lopane, R Lucchini, A Vinco, L Alessio","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the past years the problem related to occupational exposure to anaesthetic gases in operating rooms has been dealt with in different ways by each hospital administration, and frequently with little cooperation between the health departments involved. At the Spedali Civili of Brescia in the five year period, 1987-1991, a monitoring activity of nitrous oxide (N2O) and halogenated anaesthetics was performed in 30 operating rooms. This lead to a noticeable reduction of environmental concentrations of these substances. Favourable results have been achieved principally by maintenance and/or substitution of anesthesiological machine parts. In order to organize and facilitate this program a close collaboration was accomplished between the Medical Direction of the Hospital and the Occupational Health Department, with the support of the Technical Assistance Department.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"63-5"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12519174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L Alessio, A Cirla, A Forni, G Franco, R Gilioli, M Imbriani, R Lucchini, T Terrana, F Toffoletto
{"title":"[Proposal of environmental and biological monitoring and health surveillance of the exposed to inhalation anesthetics. Consensus. A Study Group on Occupational Exposure to Inhalation Anesthetics].","authors":"L Alessio, A Cirla, A Forni, G Franco, R Gilioli, M Imbriani, R Lucchini, T Terrana, F Toffoletto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Study Group on Occupational Exposure to Inhalation Anaesthetics of the Lombardy Association of Occupational Health and Industrial Hygiene prepared a document that was discussed during the Congress \"Occupational Risks due to Inhalation Anaesthetics\", held in Brescia, Italy, on May 12, 1992. The same document was then approved by the Directory Council of the Lombardy Association of Occupational Health and Industrial Hygiene. Data on environmental concentrations of Nitrous Oxide collected from 1989 to 1991 in 269 operating rooms of 47 hospitals in Lombardy are reported. The measured levels are considerably lower than those collected from the same Study Group from 1985 to 1987 in 111 operating rooms. The methodologies for exposure control are discussed, regarding both environmental and biological monitoring. These two techniques are complementary and can be used with standardized methods. The review of the literature on the early effects showed, even with some uncertainty at the current exposure levels, effects on liver and Central Nervous System. Still controversial are the data regarding the reproductive toxicity. Health surveillance programs have been organized in the last 5 years in 18 Lombardy hospitals and they indicate no cases of pathologies due to inhalation anesthetics on 1498 subjects. Operative proposals are suggested on the methodology and the frequency of environmental/biological monitoring and health surveillance. The \"technical limit values\" reported in the document from the Italian Ministry of Health are also discussed. Finally, research topics are suggested in order to assess the early effects of exposure.</p>","PeriodicalId":77147,"journal":{"name":"Giornale italiano di medicina del lavoro","volume":"14 1-6","pages":"101-4"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12519271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}