KONCENTRACIJE HALOTANA U VAZDUHU POJEDINIH OPERACIONIH SALA
Prokeš B, Rodić-Strugar J, Mačvanin N.
Zavod za zdravstvenu zaštitu radnika Novi Sad, Novi Sad, Srbija i Crna Gora

Dominantna profesionalna štetnost u operacionim salama je halotan.

CILJ: Provesti monitoring halotana u vazduhu 9 operacionih sala i utvrditi mesta (sale) na kojima su zdravstveni radnici izloženi prekomjernim koncentracijama halotana (većim od MDK).

MATERIJAL I METODE: Studijom je obuhvaćeno 9 operacionih sala Instituta za hirurgiju Kliničkog centra Novi Sad i 3 sale Klinike za dečju hirurgiju Instituta za zdravstvenu zaštitu dece i omladine u Novom Sadu. U svakoj sali obavljeno je po 5 merenja koncentracije halotana. Uzorci su uzimani, po principu ličnog uzimača ("Casella"; modeli: SP15 i CS1), na radnom mestu hirurga, anesteziologa, instrumentarke i anestetičara, odnosno, po 20 uzoraka u svakoj sali, ukupno 240 uzoraka. Pare halotana odredjivane su gasnom hromatografijom na gasnom hromatografu "Hewlett-Packard" serije 6890.

REZULTATI: Prosečna koncentracija halotana u vazduhu operacionih sala na Institutu za hirurgiju iznosila je 20,53mg/m3 (MDK=40mg/m3;15,55% uzoraka prelazilo je MDK), a na Klinici za dečju hirurgiju 61,13mg/m3 (48,33% uzoraka je prelazilo MDK). Najniže prosečne koncentracije u "centralnom hirurškom bloku" nadjene su u sali "1" (12,06mg/m3), a prosečno najviše u salama "3" i "4" (27,29mg/m3, 28,77mg/m3 respektivno). U obe sale bloka na Ortopediji nadjene su slične prosečne koncentracije halotana (19,86mg/m3 i 16,30mg/m3). U sali "1" bloka na Urologiji zabeležene su znatno više koncentracije halotana nego u sali "2" (32,62mg/m3 prema 4,49 mg/m3). U operacionim salama Klinike za dečju hirurgiju zabeležene su veoma različite prosečne koncentracije halotana. U sali "1" nadjeno je 29,26mg/m3, dok su u salama "2" i "3" utvrdjene vrlo visoke prosečne koncentracije (78,36mg/m3; 75,77mg/m3 respektivno). Hirurzi su bili izloženi prosečnoj koncentraciji halotana od 29,41mg/m3, anesteziolozi 34,60mg/m3, instrumentarke 28,62mg/m3 i anestetičari 30,09mg/m3.

ZAKLJUČAK: Mada su članovi hirurškog tima izloženi približno istim prosečnim koncentracijama halotana, utvrdjeno je da su anesteziolozi u 32% operacija bili izloženi koncentracijama preko MDK, hirurzi u 23%, instrumentarke u 22% i anestetičari u 18% operacija.

CONCENTRATIONS OF HALOTHANE IN THE AIR OF SOME OPERATING ROOMS
Prokeš B, Rodić-Strugar J. Mačvanin N.
Institute for Occupational Health, Novi Sad, Serbia and Montenegro

The dominant professional detrimental effect in the operating rooms has halothane.

AIM: To conduct air halothane monitoring in 9 operating rooms and to determine rooms by high halothane concentrations (>TLV) exposure of health workers.

MATERIAL AND METHODS: The study included 9 operating rooms in The Institute for surgery of The Clinical Center, Novi Sad, and 3 operating rooms in The Clinic for pediatric surgery of The Public Health Institute for Child-Care, Novi Sad. In every operating room 5 group of measurements were done. Samples were taken, according to the principle of personal sampling ("Casella"; models SP15 and CS1), at the work places of surgeon, anesthesiologist, instrument-nurse and anesthetist, that is 20 samples in every room, totally 240 samples. The determination of halothane vapour was by made on method of gas- chromatograph "Hewlett-Packard".

RESULTS: The average air halothane concentration in the operating rooms in the Institute for surgery was 20,53 mg/m3 (TLV = 40 mg/m3) (15,55% samples were more than TLV), and in the pediatric surgery clinic was 61,13 mg/m3 (48,33% samples were more than TLV). The lowest average concentrations in " central surgical cluster ", were found in operating room number "1" (12,06mg/m3), and the highest average concentrations were found in operating rooms number "3", and "4" (27,29mg/m3, 28,77mg/m3 respectively). In the both operating rooms at the Department of Orthopedics, similar average concentrations of halothane were found (in the first 19,86mg/m3; and in second 16,30mg/m3). In operating room number "1", at Urology, much higher concentrations of halothane, than in the operating room number "2", were found (32,62mg/m3, toward 4,49mg/m3). In the operating rooms of The Clinic for pediatric surgery, very different average concentrations of halothane were recorded. In the operating room number "1", it was found 29,26mg/m3, until in the operating rooms number "2" and "3", very high average concentrations were found (78,36mg/m3; 75,77mg/m3, respectively).

CONCLUSION: The surgeons were exposed to the average concentration of halothane with 29,41mg/m3, anesthesiologists with 34,60 mg/m3, instument-nurses with 28,62mg/m3 and anesthetists with 30,09mg/m3. Although the members of the surgical team were exposed to the almost the same concentration of halothane, it was determined that anesthesiologists in 32% of operations were exposed to the concentration beyond TLV, surgeons in 23%, instumenting nurses in 22% and anesthetists in 18% of operations.