Waste Anesthetic Gas

Purpose

Outline the health and safety guidelines used by students, faculty and staff involved in the administration of anesthetic gases.

Scope/Applicability

Waste anesthetic gas (WAG) is a term commonly used to describe the potential employee exposure to anesthetic gases in the environment during a surgical procedure. Employees with the greatest potential for exposure are anesthetists, post-operative care staff, surgeons (depending on the type of surgery), dentist, and researchers.

The most widely used anesthetic gases are halogenated ethers such as Forane (Isoflurane), Ethrane (Enflurane), Halothane, Desflurane, and Sevorane (Sevoflurane) coupled with Nitrous Oxide. Exposure to these gases can occur as they escape into the environment during the anesthesia administration process. These gases have very poor warning properties and odor is not an adequate indication of overexposure. The Registry of Toxic Effects of Chemical Substances reports adverse health effects in addition to central nervous system effects associated with the use of anesthetic gases. Epidemiological studies have also indicated congenital abnormalities and adverse effects on the liver and kidneys. Nitrous oxide and halogenated anesthetics have been described as tumorigens, mutagens and human reproductive effectors.

Responsibilities

The oversight of the University WAG program.
Ensuring compliance with all federal, state, and local regulations.
Area and personal air monitoring as requested to determine exposure risks.
Ensuring medical surveillance services are available when required.

Developing a site-specific Hazard Communication Program (non-laboratories) or Chemical Hygiene Plan (in a laboratory).
Maintaining and using anesthetic gas equipment in accordance with the manufacturer’s instructions, including leak checks.
Ensuring that all personnel have been trained on the proper use of the anesthesia circuit prior to use of anesthetic gas.
Following all safety guidelines for anesthetic gas use.
Reporting any liquid agent spills or releases to EHS-SRM.
Reporting results of all monitoring to employees.
Ensuring completion of the Employer’s Accident Report for any health or safety-related incidents and forwarding the report to Human Resources as required.

For more information:

Human Resources - Report Illness or Injury

The Accident Report Form can be used for “Report Only” documentation.

Receiving required training from supervisors prior to using the equipment.
Following all safety guidelines when working with anesthetic gases.
Inspecting all equipment prior to and after each use.
Ensuring a scavenging system is used with all anesthetic gas machines.
Ensuring that engineering controls (such as a fume hood, vacuum line, scavenging canisters, down draft table, a ducted bio-safety cabinet, or portable filtration extraction unit) is used when using a bell jar or any other anesthesia induction method that is not enclosed and releases anesthetic gases into the procedure area.
Reporting any problems with equipment to department management.
Reporting any liquid agent spills or releases to department management and EHS-SRM.
Following the Hazard Communication Program or Chemical Hygiene Plan as appropriate.
Reporting any health or safety concerns to department management and completing an Employer’s Accident Report if an injury, illness or exposure of concern occurs. This form must be completed for “Report Only” documentation.

Signs and Symptoms of Exposure to Waste Anesthetic Gases

Acute Exposure

nausea, vomiting, skin irritation, nose/throat/respiratory irritation, headache, dizziness, and drowsiness.

Chronic Exposure

hypotension, tachycardia, respiratory depression, and elevated blood glucose levels

Exposure Limits

National Institute for Occupational Safety and Health (NIOSH)

NIOSH has recommended a one-hour ceiling limit of 2 ppm (15 mg/m3) for all halogenated agents. The NIOSH recommended exposure limit for Nitrous Oxide is 25 ppm as an eight-hour time-weighted average. When used in combination with Nitrous Oxide, the NIOSH recommended exposure limit (REL) for halogenated anesthetic gases is 0.5 ppm.

Occupational Safety and Health Administration (OSHA)

OSHA does not have an established permissible exposure limit (PEL) for anesthetic gases.

Safety & Risk Management

Division of Administration