Genotoxicity and Occupational Exposure to Anesthetic Gases

Operating room staff are routinely exposed to trace levels of inhalational anaesthetic agents such as isoflurane, sevoflurane, desflurane and nitrous oxide. Although contemporary scavenging systems and ventilation standards have significantly reduced ambient concentrations, cumulative low-level exposure remains a concern for genotoxicity—the capacity of a substance to damage DNA and chromosomal integrity. Biomonitoring in healthcare workers has employed the comet assay, evaluations of micronucleus formation and analyses of chromosomal aberrations to detect early molecular lesions in lymphocytes. Mechanistic studies implicate reactive metabolites and oxidative stress in the induction of single- and double-strand DNA breaks, micronuclei and altered redox balance. These biomarkers have been linked to potential increases in cancer risk and adverse reproductive outcomes. Occupational exposure limits are informed by findings from animal models and human cohorts, aiming to balance anaesthetic efficacy with long-term safety. Ongoing refinement of exposure assessment techniques and real-time monitoring is essential for evidence-based risk management and the protection of medical personnel worldwide.

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Genotoxicity and Occupational Exposure to Anesthetic Gases publication trend

The graph below shows the total number of articles in genotoxicity and occupational exposure to anesthetic gases across all publications each year (not limited to Nature Index journals).

Technical terms

Comet assay: A sensitive method for detecting DNA strand breaks in single cells by electrophoresis, producing a ‘comet’-shaped image of fragmented DNA.

Micronucleus formation: The appearance of small, extranuclear bodies in dividing cells containing chromosomal fragments or whole chromosomes that were not incorporated into daughter nuclei.

Chromosomal aberrations: Structural alterations in chromosomes, such as breaks, deletions or translocations, observed in cultured lymphocytes as markers of genotoxic exposure.

γH2AX: A phosphorylated form of the H2AX histone that accumulates at sites of DNA double-strand breaks, serving as an early biomarker for DNA damage.

Scavenging system: A ventilation and capture apparatus designed to collect excess anaesthetic gases at the source, preventing their release into the operating theatre atmosphere.

References

1. Waste anesthetic gases have a significant association with deoxyribonucleic acid (DNA) damage: A systematic review and meta-analysis of 2,732 participants. Heliyon (2023).
2. DNA damage and antioxidant status in medical residents occupationally exposed to waste anesthetic gases1. Acta Cirúrgica Brasileira (2014).
3. Occupational Exposure to Halogenated Anaesthetic Gases in Hospitals: A Systematic Review of Methods and Techniques to Assess Air Concentration Levels. International Journal of Environmental Research and Public Health (2022).
4. Sevoflurane Induces DNA Damage Whereas Isoflurane Leads to Higher Antioxidative Status in Anesthetized Rats. BioMed Research International (2015).