Effect Of Inhaled Anesthetics Gases On Health Staff Health Status In Al-Najaf City

Abstract

Exposure of workers to waste anaesthetic gases in the operating and recovery rooms of hospitals is of concern because of the reported adverse effects of such gases on the health of personnel in this occupational group. Objectives To determine the effect of inhaled anesthetics gases on health staff health status (headache and dizziness). And to find out the association between the effects of inhaled anesthetics gases on health staff health status and their demographic data and job related data. Methodology, A Case-Control study is carried out in Al-Najaf Health Directorate / Al-Sadder medical city, from June 1st, 2013 to September 1st, 2013. A probability stratified sample of (29) from health staff personnel working in the operative rooms selected as a study group, and (13) from health staff personnel working in the other hospital wards selected as a control group, were included in the study. The data are collected through the use of semi-structured questionnaire, which consists of three parts including, demographic and job related data, data about headache characteristics, and data about the dizziness characteristics. Results and Conclusions The study results indicate that the health staff in operative rooms are more prone to have a headache and dizziness than those who working in other wards. And that there is a significant effect of the work place and the job title on the suffering of headache and dizziness among operative room health staff. Recommendations, The researchers recommend a further studies should be employed to involve a large number of health staff with a national level. An education programs should be focusing on how to manage these gases to reduce its effects on health staff health status.

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INTERNATIONAL JOURNAL OF SCIENTIFIC & TECHNOLOGY RESEARCH VOLUME 3, ISSUE 12, December 2014 ISSN 2277-8616
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Effect Of Inhaled Anesthetics Gases On Health
Staff Health Status In Al-Najaf City
Ibrahim A. Kadhim Al-Ashour, Diaa K. Abd-Ali, Mansour A. Fallah, Iman Q. Kteo
Abstract: Exposure of workers to waste anaesthetic gases in the operating and recovery rooms of hospitals is of concern because of the reported
adverse effects of such gases on the health of personnel in this occupational group. Objectives To determine the effect of inhaled anesthetics gases on
health staff health status (headache and dizziness). And to find out the association between the effects of inhaled anesthetics gases on health staff
health status and their demographic data and job related data. Methodology, A Case-Control study is carried out in Al-Najaf Health Directorate / Al-
Sadder medical city, from June 1st, 2013 to September 1st, 2013. A probability stratified sample of (29) from health staff personnel working in the
operative rooms selected as a study group, and (13) from health staff personnel working in the other hospital wards selected as a control group, were
included in the study. The data are collected through the use of semi-structured questionnaire, which consists of three parts including, demographic and
job related data, data about headache characteristics, and data about the dizziness characteristics. Results and Conclusions The study results indicate
that the health staff in operative rooms are more prone to have a headache and dizziness than those who working in other wards. And that there is a
significant effect of the work place and the job title on the suffering of headache and dizziness among operative room health staff. Recommendations,
The researchers recommend a further studies should be employed to involve a large number of health staff with a national level. An education programs
should be focusing on how to manage these gases to reduce its effects on health staff health status.
Key wards: effect, anesthesia gases, health status ————————————————————
Introduction
Inhalation anesthetics are substances that are brought into
the body via the lungs and are distributed with the blood
into the different tissues. The main target of inhalation
anesthetics (or so-called volatile anesthetics) is the brain.
Inhalation anesthetics act either by amplifying inhibitory
function or decreasing excitatory transmission at the nerve
endings in the brain. The role of inhalation agents in
general anesthesia is changing. Volatile anesthetics are
seldom used alone in our days. A combination of inhalation
anesthetics and intravenous drugs is called balanced
anesthesia. Currently used inhalation anesthetics include
enflurane, halothane, isoflurane, sevoflurane, desflurane,
and nitrous oxide. Older volatile anesthetics include ether,
chloroform, and methoxyflurane (Wenker, 1999). Exposure
to high concentrations of anesthetics has been reported to
affect health.
Nitrous oxide concentrations as low as 50 ppm caused
measurable performance decrements in psychological tests
taken by healthy male graduate students. Nitrous oxide
may result in hematological change and abuse of nitrous
oxide causes peripheral neuropathy. Anesthetic
concentrations of halothane may result in acute hepatitis
with liver necrosis. Possible chronic effects studied in
exposed populations include cancer, and liver and kidney
disease, but the findings are inconsistent (Guirguis, et. al.,
1990). Exposure to anesthetic gases in the health sector,
whether in the operating room, recovery room, or in the
context of outpatient clinics, may entail a health risk for the
personnel exposed. Although health care workers are
exposed to much lower anesthetic concentrations than the
patients, this exposure often extends over many years.
Personnel often indicate fatigue and headaches, especially
when occupational hygiene conditions are inadequate.
More serious disorders such as reduced fertility and
problems during pregnancy are mentioned. The decisive
factors as concerns the adverse health effects of exposure
to anesthetic gases are mainly the type of gases used, the
length of exposure, and the gas concentrations
(International Section on the Prevention of Occupational
Risks in Health Services, 2001). Occupational exposure to
volatile anesthetic agents may result in various adverse
health effects. Anesthetic agents eliminated rapidly from the
body due to low solubility in blood and tissues. Genetic
material has been shown to be a sensitive target of
numerous harmful agents including anesthetic gases.
Investigate the genotoxic effect of exposure to volatile
anesthetics on leukocytes of exposed operating room
personnel [anesthetists, surgeons and nurses], determine
the effect of exposure to volatile anesthetics on oxidative
stress [super oxide dismutase [SOD] and determine work-
related subjective symptoms. Statistically significantly
higher frequency of work-related symptoms included
dizziness, headache, irritability, decreased concentration,
anxiety and easy fatigability were reported among ORP
compared to controls (Aal, et. al., 2008).
______________________________
 Ibrahim A. Kadhim Al-Ashour, Diaa K. Abd-Ali,
Mansour A. Fallah, Iman Q. Kteo
 M.Sc. Nursing, Head of fundamental of Nursing
Branch, faculty of Nursing, University of Kufa
 M.Sc. Nursing, Head of Adult Health Nursing Branch,
faculty of Nursing, University of Kufa
 M.Sc. Nursing, Head of maternity Nursing Branch,
faculty of Nursing, University of Kufa
 B.Sc. Nursing, Adult Health Nursing, College of
Nursing, University of Kufa

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Methodology
Study Design
A Case Control study is carried out in Al-Najaf Health
Directorate / Al-Sadder Medical City, from June 1st, 2013 to
September 1st, 2013.
Study Sample
A probability stratified sample of (29) from health staff
personnel working in the operative rooms selected as a
study group, and (13) from health staff personnel working in
the other hospital wards selected as a control group, were
included in the study.
Instrument
The data are collected through the use of semi-structured
questionnaire, which consists of three parts including,
demographic and job related data, data about headache
characteristics, and data about the dizziness
characteristics.
Data collection
The data are collected through the use of semi-structured
questionnaire and by means of interview with the study
subjects.
Data Analyses
In order to achieve the early stated objectives, the data of
the study were analyzed through the use of statistical
package of social sciences (SPSS) version 16 through
descriptive and inferential statistical analyses
Results
Table (1) Observed Frequencies and Percentages for
the Study Groups Demographic Data
Freq. (frequency), % (percentage), n (29 study group,
and 13 control group)
This table shows that the majority of the study sample were
male in both groups (study group and control group), with
an estimation of 86% and 76% respectively. Also in
regarding to the age groups, the study results indicate that
the 34.5% and 38.5% were for the third age group (29-37
years) among study and control groups respectively. In
addition to that and in regarding to the years of experience,
the study results indicate that the highest percentages 48.3
% and 38.5 were for 2-9 years among the study and control
groups respectively. While for the job prescription, the study
results indicate that the highest percentage (72.4%), were
for the anesthesiologist assistant among study group, while
for the control group, the higher percentage were for nurses
(61.5%). Another results indicate that the 5 days is the
dominant days that the health staff spent in work in a week,
while the 6 days is the dominant number of days that the
health staff spent in work in a week among the control
group, with an estimation of (75.9% and 100%)
respectively. Finally in this table, the study results indicate
that the health staff spent about 5-9 hours in work daily in
both study and control groups and estimated about 89.7%
and 84.6% respectively.

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Figure 1.A Observed Frequencies and Percentages for the
Study Groups Demographic Data
Figure 1.B Observed Frequencies and Percentages for the
Study Groups Demographic Data
Table (2) Observed Frequencies and Percentages for
the Study Groups Responses in regarding to Headache
and its Characteristics
This table shows that (55.2%) are suffering from headache
among the study group. While (100%) aren't have
headache among the control group. In addition, that
(34.5%) from those who are suffering from headache stated
that their headache started at the end of their work, periodic
headache (51.7%), severity between the 3 and 4 based on
visual analogue scale (17.2%), aggravating with a (8)
(27.6%), (44.8%) from them are feeling better during the
rest, and (24.1%) from them are suffering from (1) as an
associated symptoms.

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Figure 2. Observed Frequencies and Percentages for the
Study Groups Responses in regarding to Headache and its
Characteristics
Table (3) Observed Frequencies and Percentages for
the Study Groups Responses in regarding to Dizziness
and its Characteristics
Freq. (frequency), % (percentage), n (29 study group, and
13 control group)
This table shows that (69%) are suffering from dizziness
among the study group, while (84.6%) aren't have dizziness
among the control group. In addition, that (37.9% ) from
those who are suffering from dizziness are stated that their
dizziness started at the end of their work, periodic dizziness
(58.6%), aggravating with a (5) (55.2%), (62.1%) from them
are feeling better during the rest, and (41.4%) from them
are suffering from (1) as an associated symptoms.
Figure 3. Observed Frequencies and Percentages for the
Study Groups Responses in regarding to Dizziness and its
Characteristics
Table (4) Observed Mean Differences between the
Study and Control Group in Regarding to the suffering
of Headache and Dizziness with Comparison t-value
and the Level of Significance
This table shows that there is a significant differences
between the study group and the control group in regarding

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to the suffering from headache and dizziness, with a
significant differences less than 0.05.
Table (5) association between the suffering of
Headache and different demographic data
This table shows that there is a significant association
between the age groups and the job prescription and the
suffering of headache, at p-value less than 0.05. while there
is a non significant association between the health staff
gender and their years of experience and the suffering from
headache at p-value more than 0.05.
Table (6) association between the suffering of dizziness
and different demographic data
This table shows that there is a non-significant association
between the suffering of dizziness and all the demographic
data, at p-value more than 0.05, except with the job
prescription, the study results indicate that there is a
significant association, at p-value less than 0.05.
Table (7) association between the suffering of dizziness
and suffering of headache
This table shows that there is a highly significant
association between the suffering of dizziness and the
headache, at p-value less than 0.05.
Discussion
The study results indicate that more of the operative room
health staff personnel are suffering from headache and
dizziness more than those staff who are working in another
hospital units. That mean that the operative room health
staff are more prone to exposure anesthesia gases, as well
as they more attend to having a headache or dizziness.
This results is supported with Vohra,1994. Munday et al
,1995 . Dashfield et al ,1997 . berg et al, 1998 . Apfel et al
,2002. Reichle and Conzen ,2003; Johnson et. al., 2008.
They mentioned that the operative room health staff
anesthetics it causes early but not delayed post-operative
vomiting, airways irritation during induction of anesthesia,
retching, headache and restlessness, and dizziness. In
addition the study results indicate that a significant effect of
the operative rooms health staff age groups and the job
prescription on their perception of pain and dizziness. This
result is supported with Gao, 2011, their results indicate
that there is a significant effect of the operative rooms
workers and their degree of headache. Also a highly
significant effect of the suffering of dizziness on the
headache perception. This result is supported with
Brantberg, et. al. (2005), they mentioned that there is an
association between the dizziness and headache
perception.
Conclusions and Recommendations:
The researcher concluded that the health staff in operative
rooms is more prone to have a headache and dizziness
than those who working in other wards. And that there is a
significant effect of the age, and the job title on the
suffering of headache and dizziness among operative
rooms health staff. Recommendations, The researchers
recommend further studies should be employed to involve a
large number of health staff with a national level. An
education programs should be focusing on how to manage
these gases to reduce its effects on health staff health
status.
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