開刀房內醫護人員暴露於Halothane、Enflurane及Isoflurane之調查研究

Exposure of Hospital Operating Room Personnel to Halothane, Enflurane and Isoflurane in three Hospitals

本研究針對臺北市三家醫院開刀房中醫護人員暴露於Halothane、Enflurane及Isoflurane之廢麻醉氣體做暴露的評估。利用3M 3500有機蒸氣被動式採樣器（3M 3500 Organic Vapor Monitor）各進行連續八天的個人及區域採樣。分析結果發現三所醫院均較常使用isoflurane，個人暴露之幾何平均數三家醫院分別為.017ppm、0.16ppm及0.14ppm，個人暴露值均在建議容許濃度值之下，但不可忽略季節性的變動及開刀進行中可能出現的高峰值；麻醉人員的暴露量較開刀房人員暴露量高；使用半密閉式系統的麻醉機在污染控制上優於半開放式系統；依現階段的做法，區域採樣結果很難預測個人的暴露。建議利用連續偵測方式了解醫院廢麻醉氣體濃度變化的趨勢，另外可加裝活性碳於清除系統（Scavenging System）上，以降低汙染物的濃度。

The objective of this study was to estimate personal exposure to halothane、enflurane and isoflurane in the operating rooms (ORs) of three hospitals in Taipei. The area samples and personal samples were collected by using 3M 3500 organic vapor monitors, and analyzed by gas chromatography (G.C.) with flame ionization detector (FID). The results showed that isoflurane was commonly used and that the geometric mean personal exposure in the three hospitals were 0.17 ppm, 0.16 ppm and 0.14 ppm. The levels of all the samples were below the permissible exposure level (PEL) recommended by the National occupational Safety & Health (NIOSH). However, the occurrence of seasonal variations and diurnal peak concentrations should not be neglected. Moreover, the exposures of both anesthesiologists and anesthesiology nurses were greater than OR nurses. The use of a semi-closed anesthetic system resulted less waste exposure from volatile anesthetic agents than semi-open anesthetic systems. In addition, the results should that personal exposures could not be estimated by using the data from the area samples, and we suggest that it is necessary for hospitals to have actual time sampling for monitoring personal exposure and a scavenging system with activated charcoal for the removal of waste from anesthetic gases.