Biological indices of kidney involvement in personnel exposed to sevoflurane in surgical areas.
BACKGROUND
Fluoride, a main metabolite, and one degradation product of sevoflurane (SEV), called Compound A, are known to cause kidney effects in experimental animals. Other than in volunteers and patients, no research is available on exposed workers. The possible effects on the kidney in workers exposed in surgical areas were studied.


METHODS
Subjects exposed to SEV and nitrous oxide (N(2)O) in surgical areas (N = 61) using open (N = 25) or semi-closed (N = 36) circuits were submitted to biological monitoring. The same biological indices were determined in 43 controls also. Sevoflurane (SEVU), nitrous oxide (N(2)OU), total urinary proteins (TUP), N-acetyl-beta-D-glucosaminidase (NAGU), and glutamine synthetase (GSU) were measured in urine.


RESULTS
The mean values of environmental exposure were 31.3 ppm (range 0.9-111.6 ppm) for N(2)O and 0.28 ppm (range 0-1.88 ppm) for SEV. Exposed subjects had significantly higher excretion of TUP; a higher, not significant, excretion of GSU was also observed in subjects using open circuits. A significant correlation was found in all exposed subjects between NAGU and SEVU (r = 0.303, P < 0.05), GSU and N(2)OU (r = 0.382, P < 0.01) and, especially, GSU and SEVU (r = 0.650, P < 0.001). These correlations appeared to be influenced by the use of open circuits; infact, NAGU was well correlated to N(2)OU (r = 0.770, P < 0.001) and SEVU (r = 0.863, P < 0.001); GSU to N(2)OU (r = 0.468, P < 0.05) and SEVU (r = 0.735, P < 0.001).


CONCLUSIONS
Results show that no relevant effect on the kidney is present for the levels of exposure studied. Nevertheless, correlation between dose and response urinary indices supports that SEV, other than N(2)O, may influence kidney function, especially when open circuits are used.
Trevisan
Andrea
A
Department of Environmental Medicine and Public Health, University of Padova, Italy. andrea.trevisan@unipd.it
Venturini
Matteo Borella
MB
Carrieri
Mariella
M
Giraldo
Monica
M
Maccà
Isabella
I
Perini
Milena
M
Scapellato
Maria L
ML
Virgili
Annalisa
A
Bartolucci
Giovanni B
GB
D000328:Adult; D018685:Anesthetics, Inhalation / Q000009:adverse effects* / Q000652:urine; D005260:Female; D006282:Health Personnel; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000652:urine; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects* / Q000652:urine; D008875:Middle Aged; D009609:Nitrous Oxide / Q000009:adverse effects* / Q000652:urine; D016273:Occupational Exposure / Q000009:adverse effects*; D009873:Operating Rooms; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide