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The anesthetic gases that leak into the surrounding room during procedures are considered waste anesthetic gases (WAG). The Department of Labor estimates more than 250,000 health care professionals who work in hospitals, operating rooms, dental offices and veterinary clinics, are potentially exposed to waste anesthetic gases and are at risk of occupational illness [cite the source of this info?]. The common waste anesthetic gases and vapors of concern at NIH are nitrous oxide and halogenated agents (vapors) such as isoflurane, desflurane, sevoflurane, and occasionally halothane. Some potential effects of exposure to waste anesthetic gases are nausea, dizziness, headaches, fatigue, and irritability, increased risk for miscarriages (acute exposures), birth defects, liver and kidney disease, among operating room staff or their spouses (in the case of miscarriages and birth defects) [cite the source of this info., and at what levels do these symptoms start appearing?]. Supervisors and employees should be aware of the potential effects and are advised to take appropriate precautions. NIH workers should contact OMS in Building 10, Room 6C306 (301-496-4411) if they experience symptoms that they suspect are related to workplace conditions.
WAG Leak Tests
Each facility may conduct its own WAG leak tests for isoflurane to ensure their equipment and its connections are not leaking. While there are several instruments that can be utilized, and though NIH does not recommend for or against any particular brand of instrument, The TIF RX-1A from the SPX Corporation picks up isoflurane leaks around 1.4ppm, which is below the NIH recommendation of 2ppm TWA.
DS also conducts WAG leak tests every two years; the IH conducting the leak test or survey may apply a graded approach but will never grade-out a location.
Additionally, any employee at an NIH facility may request a WAG Leak Test be conducted by contacting DS at 301-496-3457.
If a location passes its WAG Leak Test: DS will return in about 2 years to conduct the next leak test. In the meantime, as long as the processes and equipment don't change significantly, the equipment should be safe to use. If configuration changes, ensure that the connection points from the exiting side of the vaporizer are tightly sealed (parafilm works well for this task).
If the location fails its WAG Leak Test: DS will note that it has failed and also provide recommendations on possible fixes. If the leak can't be fixed during the initial trip, once the leak has been fixed, DS will return and re-test. Anesthetic gas systems that repeatedly fail and can't be repaired should not continue to be used, as they pose a health and safety hazard to the employees as well as patients or subjects undergoing procedure(s).
