Valutazione geostatistica della diffusione di gas alogenati. Quale rischio di esposizione?

[Autom. eng. transl.] The occupational risk for personnel exposed to gases and anesthetic vapors (anesthesiologists, surgeons, trainers and room nurses) is of great interest due to the potential toxic action of the substances used in the operating room. The objective of this study is to verify the exposure of health personnel by detecting the concentrations of two gases (Sevoflurane and Desflurane) in an operating theater, modeling spatial distribution through geostatistical techniques. The sampling of the concentrations of anesthetic gases was carried out using a Bruel & Kjaer sampler “Multi-gas monitor model 1312” and Bruel & Kjaer “Multi-sampler 1309” with “Innova 1312-7300” software with 10 probes positioned in the operating theater at various heights, in order to determine the different exposure conditions. The results were processed using classical and georeferential statistical analysis techniques (random variables of order k). Yes 184 interventions are monitored. The mean value (± SD) of the concentration of Desflurane was 1.94 ± 3.30 ppm, that of Sevoflurane of 0.74 ± 0.79 ppm, both lower than the indicative reference limits suggested by the international literature for Sevoflurane environmental, ie between 2 ppm (Denmark and France) and 75 ppm (United States – ACGIH). However, by disaggregating the average concentrations of the two gases according to the anesthesiologist and comparing them through the Student's T test, we note a significant difference (p less than 0.05) in the use of the two gases, which does not only concern the concentrations recorded among the various operators who use the same anesthetic gas, but also those detected for the same operator who uses both anesthetic vapors. This aspect is well evidenced by the geostatistical maps that show how the operator who presents the highest environmental concentrations of Desflurane, is the same that, using Sevoflurane, maintains the least contamination of the room. In conclusion, the study highlights how, thanks to the evolution of the anesthetic technique and instrumentation, of the plant engineering of the room, etc., the environmental contamination from halogenated gases and vapors in the operating rooms is currently very limited. However, in view of the influence of the behaviors and procedures of the operators in the variation of the environmental concentration, the role of the training of the personnel, as well as of a regular surveillance and maintenance of the equipments and the installations, to guarantee all the personnel professionally exposed to anesthetic gases a practically zero risk