Staff who work in Vanderbilt Health clinics and operating suites where anesthetic gases are used, may be exposed to waste anesthetic gases (WAG) and vapors that leak into the surrounding room during medical procedures. The primary anesthetic gases in use at VUMC are Nitrous Oxide, Sevoflurane, Isoflurane and Desflurane. Search for the Safety Data Sheets for these gases here.
Some potential effects of exposure to waste anesthetic gases are nausea, dizziness, headaches, fatigue, and irritability, as well as sterility, miscarriages, birth defects, cancer, and liver and kidney disease, among operating room staff or their spouses (in the case of miscarriages and birth defects). (Reference: Occupational Safety and Health Administration Waste Anesthesia Gases)
Reduce Your Exposure
Use these methods to reduce your exposure to waste anesthesia gases:
- Complete a machine check to verify your anesthesia machine is working properly.
- Make sure the scavenging system in your area is working properly.
- Turn down fresh gas flows when preparing to intubate, or place a laryngeal mask airway (LMA); be sure to turn fresh gas flows back up following intubation/placement of LMA.
Refer to these resources for more information and additional techniques to reduce your exposure:
- Management of Waste Anesthetic Gases (American Association of Nurse Anesthetists)
- Waste Anesthetic Gases (OSHA)
- Nitrous Oxide NIOSH Resources (CDC NIOSH)
How VUMC minimizes staff exposure to anesthesia gas:
- OCRS monitors areas where gases are used on a regular basis.
- Clinical Engineering services the anesthesia equipment every 6 months for leaks within anesthesia machine. A low pressure and high pressure leak check are performed within the pneumatic circuits.
- Facilities Management performs an annual balancing test to verily that the Operating Suites have 20 or more air exchanges per hour (AEH). This is the minimum air flow recommended by the American Society for Healthcare Engineering to remove gases from the room. (Reference: American Society for Healthcare Engineering, Facility Guidelines Institute, 2014 revision: www.fgiguidelines.org.)
- Staff are monitored annually for exposure to anesthesia gases by OCRS. Staff are chosen based on the OR facility, level of exposure potential, and types of surgeries performed to obtain a good representation of exposure.
Pregnancy
If you are pregnant and are concerned about your exposure to anesthesia gases, talk to your manager if you feel comfortable doing so. You can also contact these Vanderbilt resources:
- Call the Occupational Health Clinic (OHC) at 615-936-0955 to make an appointment to speak to an OHC Provider or find more information on the Working While Pregnant page.
- Contact VUMC Human Resources for help regarding your options.
Anesthetic Gas Safety Data Sheets
Safety Data Sheets for the commonly used anesthetic gases at VUMC are available on the VUMC Top Safety Data Sheets page. Look for the category "Hazardous Drugs".
Questions?
Please send questions about waste anesthetic gas monitoring to rhonda.foster@vumc.org or mark.j.bogard@vumc.org.