Original Articles
21 September 2022
Vol. 44 No. 3 (2022)
Nitrous oxide occupational exposure in conscious sedation procedures in endoscopic ambulatories: a pilot retrospective observational study in an Italian hospital
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Introduction. Nitrous oxide (N20) is widely used to induce sedation also outside of operating rooms; there is a chance of workplace exposures for the operators engaged in the outpatient use of nitrous oxide. The aim of this research is to assess nitrous oxide exposure in gastroenterology outpatient settings.
Methods. We performed an observational study marked by N20 environmental testing in a gastroenterology outpatient care; environmental research was supported by biological monitoring with urinary N20 analysis in exposed operators. The research was conducted both without and using a collective security device (NIKI mask).
Results. The study was rolled out in 10 sessions of day shift procedures, totaling 4105 samples. The average N20 concentration in the environment was 27.58 (SD 1.76) and 449.59 (SD 35.29), respectively with and without NIKI Mask; the distribution of gases in the environment under investigation was not homogeneous (Anovatest P=0.001). Biological testing revealed a substantial rise in urinary concentration of 8.97 (p=0.001) between the start and the end of the shift, and the use of the NIKI-mask was effective (p=.003). Discussion. The exposure levels reported exceed the limits of 50 ppm (Italy operating rooms threshold value) as well as the value of 25 ppm (NIOSH threshold-value), indicating a significant issue in the outpatient use of N20. Technical measures are needed to contain the occupational risk from N20 exposure outside of operating rooms; for the exposure results detected in this research, it is also evident that workers exposed to N20 must be subject to adequate health surveillance accounting for this occupational risk.
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How to Cite
Nitrous oxide occupational exposure in conscious sedation procedures in endoscopic ambulatories: a pilot retrospective observational study in an Italian hospital. (2022). Giornale Italiano Di Medicina Del Lavoro Ed Ergonomia, 44(3), 347-351. https://doi.org/10.4081/gimle.568
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