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Staff exposure to volatile anaesthetic agents

Why monitor exposure?

The Control of Substances Hazardous to Health (COSHH) Regulations require that, for every exposure to substances hazardous to health, the following should be carried out:

• Assessment of the risk
• Methods of achieving control of the risk
• Personal monitoring for exposure to substances hazardous to health

Volatile anaesthetic agents are potentially harmful to staff and are subject to the COSHH Regulations. The employer has a legal duty to ensure that exposure to these substances is kept to a minimum.

Who is at risk?

Staff working in areas where nitrous oxide and the volatile anaesthetic agents are used can be exposed to these substances. The principal risk groups are:

• midwives
• surgeons
• anaesthetists
• recovery nurses
• surgical staff

How can we help?

Quality Control West Midlands provides a number of services to enable you to meet your legal obligations under the COSHH Regulations:

• Personal exposure to nitrous oxide monitoring of staff
• Room air sampling for volatile anaesthetic agents 
• Testing of control measures
• Room ventilation (supply/extract rates)
• Room overpressures
• Anaesthetic gas scavenging systems

Sampling devices

Using activated charcoal tubes, volatile agents in the air are collected. The sample is then analysed in the laboratory by gas chromatography-mass spectrometry (GC-MS). The activated charcoal is in the form of a discreet badge which can either be posted to you and returned to the laboratory for testing or one of our chemists can attend your site to perform the sampling.

Occupational exposure limits

The Health and Safety Executive has eight principles for occupational exposure limits (OELs):

• Design and operate processes and  activities to minimise emission, release and spread of substances hazardous to health
• Take into account all relevant routes of exposure - inhalation, skin absorption and ingestion - when developing control measures
• Control exposure by measures that  are proportionate to the health risk
• Choose the most effective and reliable control options which minimise the escape and spread of substances hazardous to health
• Where adequate control of exposure cannot be achieved by other means, provide, in combination with other control measures, suitable personal protective equipment
• Check and review regularly all elements of control measures for  their continuing effectiveness
• Inform and train all employees on the hazards and risks from the substances with which they work and the use of control measures developed to minimise the risks
• Ensure that the introduction of control measures does not increase the overall risk to health and safety

The OELs for anaesthetic agents over an eight-hour time weighted average are:

• Enflurane - 50 ppm
• Isoflurane - 50 ppm

In addition to these we can also monitor for Desflurane and Sevoflurane.