Morbidity associated with working in operating theatres

Spence, Alastair Andrew (1975) Morbidity associated with working in operating theatres. MD thesis, University of Glasgow.

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Abstract

Operating theatre air becomes contaminated with gaseous anaesthetics and these are taken up by the blood and other tissues of theatre personnel. The fact that the general anaesthetics, in concentrations which produce anaesthesia, exhibit a wide variety of actions on cell mechanisms and tissue growth, including teratogenicity and carcinogenesis, has caused speculation about possible health hazards from the much smaller concentrations to which theatre workers are exposed. This thesis describes two controlled surveys of anaesthetists in the United Kingdom. In the first, 563 married women anaesthetists were compared with 828 married women doctors who were not anaesthetists. Anaesthetists who worked during a pregnancy had an increased frequency of spontaneous abortion compared with the controls whose frequency was similar to that of a small group of non-working anaesthetists. Working anaesthetists had an increased frequency of congenital abnormality of liveborn children and the women anaesthetists, as a group, had a frequency of involuntary infertility twice that of the controls. The triad of abortion, congenital abnormality and infertility might suggest an abnormality of foetal development, perhaps as a consequence of drug toxicity. However, factors such as the pattern of abnormalities and the maturity of the abortions cast doubt on this hypothesis. In the second survey, questionnaires were mailed to all the male anaesthetists in the U.K. and an appropriate number of control doctors. 70.05% replied. There was no obvious effect on obstetric history of the marriages where the father had worked in an operating theatre (exposed). Although paternal exposure was not associated with an increase in the major congenital abnormalities, anaesthetists reported a higher proportion of minor abnormalities. However, there is reason to believe that anaesthetists are more likely to report such problems. Male anaesthetists did not appear to be less fertile than the controls. In this second survey, there were 525 pregnancies in which maternal exposure had occurred. In this group, the frequency of spontaneous abortion was 40% greater than in the controls and, while the numbers were too small to allow a confident estimate, the proportion of congenital abnormalities was increased. Retrospective matching (maternal exposure versus no exposure) with respect to maternal age, parity and smoking confirms the increased risk of abortion associated with maternal exposure which is estimated to be in the range 158 - 271%. Replies about the general health of the male respondents suggest that anaesthetists have an increased incidence of hepatitis and disorders of the lumbar spine and there is uncertainty about their susceptibility to peptic ulceration and arterial hypertension. Male anaesthetists do not appear to be specially susceptible to cancer or renal disease. These data have been re-examined in collaboration with a team which has conducted a similar enquiry in the United States. There is close agreement between the two countries regarding female exposure and abortion although the evidence concerning congenital abnormality is stronger in the U.S. than in the U.K. The increased risk of hepatitis in male anaesthetists has been confirmed, as have the U.K. data on cancer and renal disease. These findings have prompted measures to reduce operating theatre air contamination. Although such precautions are sensible, no direct link exists between morbidity in anaesthetists and theatre contamination. To assume otherwise is undesirable and prospective monitoring of the health of theatre personnel is essential.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Additional Information: Adviser: V M Hawthorne
Keywords: Medicine
Date of Award: 1975
Depositing User: Enlighten Team
Unique ID: glathesis:1975-73118
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 14 Jun 2019 08:56
Last Modified: 14 Jun 2019 08:56
URI: http://theses.gla.ac.uk/id/eprint/73118

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