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ANESTHETIC PHARMACOLOGY

High-Level, but Not Low-Level, Occupational Exposure to Inhaled Anesthetics Is Associated with Genotoxicity in the Micronucleus Assay

Gunther Wiesner, MD^*, Klaus Hoerauf, MD, Klaus Schroegendorfer, MD, Pawel Sobczynski, MD, Marion Harth, MD^*, and Hugo W. Ruediger, MD^§

*Department of Anesthesiology, University of Regensburg, Germany; Department of Anesthesiology, University of Vienna, Austria; Department of Anesthesiology, University of Poznan, Poland; and §Department of Occupational Medicine, University of Vienna, Austria

Address correspondence and reprint requests to Gunther Wiesner, MD, Department of Anesthesiology, University of Regensburg, Franz-Josef-Strauß-Allee 11, D-93053 Regensburg, Germany. Address e-mail to gunther.wiesner{at}klinik.uni-regensburg.de

To minimize the possible health risks posed by waste anesthetic gases, the National Institute of Occupational Safety and Health (NIOSH) recommends exposure limits. We investigated the genotoxicity of a previously established occupational exposure exceeding these limits (high-level exposure) and of one within these limits (low-level exposure). Genotoxicity was assessed by the formation of micronucleated lymphocytes in 25 anesthetists and anesthetic nurses of an Eastern European (High-Level Exposure Group) and a German (Low-Level Exposure Group) university hospital. Each exposed group was compared with a group of nonexposed personnel of the same hospital. Compared with its Control Group, there was an increased fraction of micronucleated lymphocytes per 1000 binucleated cells in the High-Level Exposure Group (median 14.0, range 9.0–26.7 vs median 11.3, range 3.2–19.4; P < 0.05) but not in the Low-Level Exposure Group (median 9.8, range 4.2–20.0 vs median 10.5, range 5.0–20.5). We conclude that a high-level exposure to inhaled anesthetics is associated with an increase in chromosome damage, and measures are recommended to decrease exposure levels. As evidenced by the formation of micronucleated lymphocytes, the threshold values recommended by NIOSH appear to be safe.

Implications: A high level of occupational exposure to inhaled anesthetics is associated with genotoxicity (as defined by formation of micronucleated lymphocytes), whereas a low-level exposure (within National Institute of Occupational Safety and Health limits) is not.

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