Anesthesiology · 1985 · 149 citations · 0 references
Health ExperiencesHealthy Work EnvironmentNon-operating Room AnesthesiaOccupational ExposureObstetricsPublic HealthMedical Error PreventionOperating Room DesignSummary RrMaternal HealthOutcomes ResearchNursingHealth ManagementHospital EnvironmentPatient SafetyLiver DiseaseMedicineEmergency MedicineAnesthesiology
Existing studies on operating‑room staff health rely on self‑reported data, focus on work rather than anesthetic exposure, and may be biased, especially as scavenging systems have improved over the past decade. The authors performed a meta‑analysis of six studies to estimate relative risks of adverse outcomes among operating‑room personnel and highlighted the need for prospective cohort studies on anesthetic gas exposure. They combined data from six studies to compute summary relative risks and 95% confidence limits for each outcome. The analysis found a 30 % higher risk of spontaneous abortion (RR 1.3) and significant increases in liver disease risk (RR 1.6 in men, 1.5 in women).
In an attempt to evaluate health experiences of operating room personnel using previously published reports, the authors calculated summary relative risks (RRs) for each outcome under investigation by combining data from six studies. For each summary RR, they also calculated 95% confidence limits; when the range of the confidence interval excludes 1.0, the increased risk is statistically significant at the 0.05 level. The most consistent evidence was for spontaneous abortion among pregnant physicians and nurses who work in operating rooms, where the RR was 1.3 (95% confidence limits from 1.2 to 1.4). For liver disease there were statistically significant increased RRs among both men (1.6, 1.3-1.9) and women (1.5, 1.2-1.9), but these were based on smaller numbers of studies. Although the results of pooled analyses are suggestive, most studies of this issue have relied on voluntary responses and self-reported outcomes, so that response and/or recall bias could explain these findings. In addition, these investigations generally have examined working in operating rooms rather than actual exposure to anesthetic gases. Finally, there have been considerable improvements in operating room scavenging systems during the last decade. Thus, prospective cohort studies are needed to determine whether there is a relationship between current levels of occupational exposure to anesthetic gases and adverse outcomes, particularly spontaneous abortion and liver disease.