Małgorzata Kucharska

DNA damage induced by nitrous oxide: study in medical personnel of operating rooms.

Occupational exposure to anaesthetics such as nitrous oxide (N(2)O) and halogenated hydrocarbons has been suggested to increase risk of genetic damage. However, the dose-dependency of genotoxic effects has not been unequivocally established and their relation to occupational exposure limit (OEL) remain obscure. In this study, the genotoxicity associated with occupational exposure to anaesthetics has been investigated in a group of 55 female nurses and 29 male anaesthesiologists active for at least 5 years in a working environment containing variable concentrations of N(2)O and halogenated hydrocarbons. 83 unexposed health care workers (52 female nurses and 31 male doctors) matched for age, gender, smoking habit and employment duration were included in the control group. Genotoxicity has been assessed using comet test. Concentrations of nitrous oxide, sevoflurane and isoflurane monitored by gas chromatography and mass spectrometry made possible to relate the extent of DNA damage to the level of exposure. Our results for the first time document a positive correlation between the DNA damage and the N(2)O levels in the ambient air. By contrast, no correlation has been observed between genotoxic effects and concentrations of sevoflurane and isoflurane. The extent of genetic injury was especially aggravated among nurses and anaesthesiologists exposed to N(2)O in concentrations exceeding OEL (180 mg/m(3)). We conclude that occupational exposure to N(2)O is associated with increased DNA damage and that the level of exposure plays a critical role in this regard.

Unmetabolized VOCs in urine as biomarkers of low level occupational exposure

OBJECTIVES To compare the usefulness of determining unchanged forms of volatile organic compounds (VOCs), namely toluene (TOL), ethylbenzene (EB) and xylene (XYL), in urine with the effectiveness of the already used biomarkers of occupational exposure. MATERIALS AND METHODS Surveys were conducted in two workplaces (paint factory and footwear factory). In total, 65 subjects participated in the study. Air samples were collected using individual samplers during work shift. Urine and blood samples were collected at the end of work shift. Urine samples were analyzed for unchanged compounds and selected metabolites, while blood samples were tested for unchanged compounds. VOCs in blood and urine were determined by solid phase microextraction gas chromatography (SPME-GC-MS). RESULTS In the paint factory, the geometric mean (GM) concentrations of VOCs in the air ranged as follows: 0.2-4.7 mg/m(3) for TOL, 0.4-40.9 mg/m(3) for EB and 0.1-122.6 mg/m(3) for XYL. In the footwear factory, the GM concentration of TOL in the air amounted to 105.4 mg/m(3). A significant correlation (p < 0.05) was observed between VOCs in blood, urine and air. The regression analyses performed for paint factory workers showed that TOL-U and TOL-B were better biomarkers of exposure (r = 0.72 and r = 0.81) than benzoic acid (r = 0.12) or o-cresol (r = 0.55). CONCLUSION The findings of the study point out that the concentration of unchanged VOCs in urine can be a reliable biological indicator of low level occupational exposure to these compounds.

Chemical composition of surgical smoke formed in the abdominal cavity during laparoscopic cholecystectomy – Assessment of the risk to the patient

ObjectivesThe aim of this study was to assess the exposure of patients to organic substances produced and identified in surgical smoke formed in the abdominal cavity during laparoscopic cholecystectomy.Material and MethodsIdentification of these substances in surgical smoke was performed by the use of gas chromatography-mass spectrometry (GC-MS) with selective ion monitoring (SIM). The selected biomarkers of exposure to surgical smoke included benzene, toluene, ethylbenzene and xylene. Their concentrations in the urine samples collected from each patient before and after the surgery were determined by SPME-GC/MS.ResultsQualitative analysis of the smoke produced during laparoscopic procedures revealed the presence of a wide variety of potentially toxic chemicals such as benzene, toluene, xylene, dioxins and other substances. The average concentrations of benzene and toluene in the urine of the patients who underwent laparoscopic cholecystectomy, in contrast to the other determined compounds, were significantly higher after the surgery than before it, which indicates that they were absorbed.ConclusionsThe source of the compounds produced in the abdominal cavity during the surgery is tissue pyrolysis in the presence of carbon dioxide atmosphere. All patients undergoing laparoscopic procedures are at risk of absorbing and excreting smoke by-products. Exposure of the patient to emerging chemical compounds is usually a one-time and short-term incident, yet concentrations of benzene and toluene found in the urine were significantly higher after the surgery than before it.

Testing of the composition of e-cigarette liquids – Manufacturer-declared vs. true contents in a selected series of products

BACKGROUND Electronic cigarettes are currently in common use. However, in Poland there is no specific legislation governing the sale of these products. At the same time, no information has been made public about the hazards e-cigarettes pose to the users and bystanders - passive smokers. The aim of the study was to determine the qualitative composition of the analyzed liquid, which is an essential element of regulating the distribution of such cigarettes. MATERIAL AND METHODS Under this study the method for determining the composition of e-cigarette liquids was developed. This method employs gas chromatography with mass spectrometry (GC-MS). Levels of nicotine and flavoring components were determined in 50 e-liquid samples. The results were compared with the information provided by the manufacturer on the packaging. RESULTS The applied method of qualitative determination helped to identify the main ingredients, such as nicotine and propylene glycol (PG). Propylene glycol was found to be present in all liquids, because it was used as the solvent for nicotine and flavors. There was a good agreement between the declared and the determined content of nicotine in the analyzed samples. The agreement was considerably poorer for the remaining e-liquid ingredients, mainly flavors. CONCLUSIONS There was no agreement between the flavor substances specified by the manufacturer and aroma identified in the e-cigarette liquid, which may pose a risk to users of e-cigarettes, particularly those susceptible to allergies. Several unsaturated aliphatic alcohols and aldehydes found to be present in the liquids, unstable at elevated temperatures, may be more harmful to the smoker than the original compounds. Therefore, it is essential to implement in Poland the legal provisions regarding e-cigarettes. Med Pr 2016;67(2):239-253.

Application of predictive models for estimation of health care workers exposure to sevoflurane.

Objectives. The aim of this study was to assess the potential use of predictive models to estimate professional exposure to chemicals in the workplace, such as the operating room, by simultaneous determination of the levels of exposure using a model and measurements. Methods. Measurements included determinations of sevoflurane (SEV) in the workplace air of 117 operating rooms of 31 hospitals in one Polish region. Measurements were carried out at the time of various surgical procedures during administration of anaesthetics by endotracheal intubation. The measurement results were compared with the values estimated using two models: ECETOC TRA and Stoffenmanager. Results. In one case the ECETOC TRA estimated the exposure concentration almost equal to the measured concentration but, because of the need to maintain a margin of safety in case of modelling, it can be concluded that the model underestimated the concentration. The Stoffenmanager model provided accurate exposure estimates in the examined case, and it can be used as a screening tool for the assessment of occupational inhalation exposure of medical personnel to anaesthetics. Conclusions. The results are of particular importance to the circumstances in Eastern Europe, where the levels of anaesthetics often exceed the relevant occupational exposure limits.

Health risk to medical personnel of surgical smoke produced during laparoscopic surgery.

OBJECTIVES During laparoscopic cholecystectomy, the removal of the gall bladder, pyrolysis occurs in the peritoneal cavity. Chemical substances which are formed during this process escape into the operating room through trocars in the form of surgical smoke. The aim of this study was to identify and quantitatively measure a number of selected chemical substances found in surgical smoke and to assess the risk they carry to medical personnel. MATERIAL AND METHODS The study was performed at the Maria Skłodowska-Curie Memorial Provincial Specialist Hospital in Zgierz between 2011 and 2013. Air samples were collected in the operating room during laparoscopic cholecystectomy. RESULTS A complete qualitative and quantitative analysis of the air samples showed a number of chemical substances present, such as aldehydes, benzene, toluene, ethylbenzene, xylene, ozone, dioxins and others. CONCLUSIONS The concentrations of these substances were much lower than the hygienic standards allowed by the European Union Maximum Acceptable Concentration (MAC). The calculated risk of developing cancer as a result of exposure to surgical smoke during laparoscopic cholecystectomy is negligible. Yet it should be kept in mind that repeated exposure to a cocktail of these substances increases the possibility of developing adverse effects. Many of these compounds are toxic, and may possibly be carcinogenic, mutagenic or genotoxic. Therefore, it is necessary to remove surgical smoke from the operating room in order to protect medical personnel.

Comparison of chemical composition of selected essential oils used in respiratory diseases

BACKGROUND Essential oils are fragrances extracted from plants. They have a smooth consistency and pleasant smell. Essential oils have been applied in aromatherapy, cosmetics, food and pharmaceutical products. The aim of the study was to analyze the composition of selected essential oils used in respiratory diseases. MATERIAL AND METHODS The qualitative analysis was performed by gas chromatography with mass spectrometry. For the study 6 essential oils available in Polish shops and used in various respiratory diseases were chosen. The results were compared with the information provided by the manufacturer and the literature. RESULTS The method used in the presented work allowed to qualitatively identify the main components in studied essential oils. In the analyzed samples generally occurred: α- i β-pinene, limonene, terpinen-4-ol and caryophyllene. In addition to limonene, the presence of linalool, eugonol and geraniol, potentially allergenic substances, were also detected. CONCLUSIONS The qualitative composition of the studied essential oils comply with the existing literature data. Their main ingredients show antimicrobial and antiviral activities, therefore they are used to eradicate the symptoms of infection. However, the attention should be paid to the composition of the products because they often comprise potential allergens. Information on the presence of such a substance in the preparation should be clearly marked by the manufacturer on the packaging. Fragrances are also found in a number of household products that increase their concentration in the air of living premises, thereby increasing the risk of side effects especially in people with allergies or sensitive. Med Pr 2018;69(2):167-178.