Effect Of Low-level Sevoflurane On Oxidative Stress And DNA Damage Protein ?H₂AX Of Staffs In Department Of Anesthesiology Due To Occupational Exposure

Background:Inhaled anesthetics are widely used in clinics due to their unique advantages such as good controllability,but it also inevitably cause leakage and air pollution at the same time,it leads that medical personnel in the operating room are long-term exposed to trace anesthetic gas.There is still controversy about whether the trace anesthetic gas affects the health of the medical staff in the operating room,and there are few relevant studies in China.In this study,we intend to detect the sevoflurane concentration in the operating room,and compare the differences of the sevoflurane concentration in different operating regions and operating rooms with different laminar-flow;We aim to explore the effect of low-level sevoflurane on oxidative stress and DNA damage protein ?H2AX of staffs in department of anesthesiology due to occupational exposure by SOD,GSH-px,MDA and yH2AX.Also,we have compared the hematopoietic parameters,liver and kidney function,and electrophysiology parameters.Material and MethodSubject:The department of anesthesiology was selected as the exposed group and the non-operating room medical staff was used as the control group.Methods:(1)We chose hundred level laminar flow and ten thousand level laminar flow operating rooms to detect the concentration of sevoflurane by gas chromatography,and let the anesthesiologist or anesthesia nurse(P1)wear a tedlar sampling bag and placed another sampler in the operating room where nurse working place(P2),with a flow rate of 100 ml/min for 8 hours.(2)Plasma levels of the SOD,GSH-px and MDA were detected to evaluate oxidative stress.(3)Western blot was used to detect ?H2AX in peripheral blood to assess the DNA damage.(4)We also evaluated the hematopoietic parameters,liver and kidney function parameters,and electrophysiology parameters.Results1.General informationThe population of study includes 68 in the exposed group and 82 for control groups.There was no significant difference between the two groups in terms of age,working years,sex ratio,BMI,drinking and smoking.2.The concentration of sevofluraneA total of 172 air samples were collected,the average concentration of sevoflurane was(1.11 ±0.65)ppm.The concentration of P1 region((1.44 + 0.65)ppm)was significantly higher than P2 region((0.70± 0.36)ppm).The concentration of hundred level laminar flow((0.75 + 0.31)ppm)was significantly higher than ten thousand level laminar flow operating rooms((1.43+0.72)ppm).3 Oxidative stressCompared with the control group,SOD decreased and MDA increased in the exposed group(P<0.05),but there was no significant difference in GSH-px.Compared with the control group,SOD and GSH-px decreased and MDA increased in the anesthesiologist or anesthesia nurse(P<0.05),also SOD decreased in operating room nurses(P<0.05).When the working time between 5 and 10 years,the exposed group SOD decreased and MDA increased compared with the control group.When the working time over 10 years,GSH-px was lower and MDA was higher in the exposed group than that in the control group.In the female,SOD was lower and MDA was higher in the exposed group than that in the control group(P<0.05).Compared with the control group,there was no significant difference in GSH-px.In the male,GSH-px was lower in the exposed group than that in the control group(P<0.05).4?H2AXThere was no statistically significant increase in?H2AX in the exposure group compared to the control group.The yH2AX was increased by anesthesiologists or anesthesia nurses compared to the control group(P<0.05).When the working time between 5 and 10 years,the exposed group ?H2AX increased compared with the control group(P<0.05),there was no significant difference between the other working-age groups.5 Physical examinationThe statistically significant decrease in LYM,HGB,TP and HR,and an increase of T-BIL and CRE,and a longer interval in QT and QTc in exposure group compared with control group(P<0.05),but all were within the normal range.ConclusionThe average level of sevoflurane concentration is lower than limit standard by our country,although sometimes can exceed limit standard.The exposure concentration of anesthesiologists or anesthesia nurses is higher than that of operating room nurses.The concentration of hundred level laminar flow was significantly higher than ten thousand level laminar flow operating rooms.Staffs in department of anesthesiology occupational exposure to the low-level sevoflurane can result the levels of oxidative stress and DNA damage protein ?yH2AXincreased,and associated with exposure concentration and time.Occupational exposure also can affect the matopoietic parameters,liver and kidney function,and electrophysiology parameters,although all within the normal range.