title: Efficacy of vacuum bone cement mixing systems in reducing methylmethacrylate fume exposure: comparison of 7 different mixing devices and handmixing.
abstract: BACKGROUND
  Polymethylmethacrylate (PMMA) bone cements are mainly used for implant fixation in joint replacement surgery. During cement preparation for application, all staff in the operating theatre are exposed to methylmethacrylate (MMA) fumes, which are known to have toxic side effects.
  
  
  RESULTS
  In this study we found that vacuum mixing of bone cement with 7 commercially available mixing devices significantly reduced the emission of MMA vapors in the breathing zone when compared with classic hand mixing in an open bowl. Gas chromatography appears to be more sensitive for detection of MMA fumes than Photo Inonization Detection.
  
  
  CONCLUSIONS
  According to present knowledge, even repeated mixing of PMMA bone cement during a normal working day does not seem to constitute an increased health risk, particularly if vacuum mixing is implemented.
authors.affiliation: Department of Orthopaedics, University of Heidelberg, Germany.
authors.forename: Ulf J
authors.initials: UJ
authors.lastname: Schlegel
authors.forename: Michael
authors.initials: M
authors.lastname: Sturm
authors.forename: Volker
authors.initials: V
authors.lastname: Ewerbeck
authors.forename: Steffen J
authors.initials: SJ
authors.lastname: Breusch
mesh_terms: D016902:Air Pollution, Indoor / Q000032:analysis / Q000517:prevention & control; D001843:Bone Cements; D006801:Humans; D007595:Joint Prosthesis; D020366:Methylmethacrylate / Q000009:adverse effects* / Q000032:analysis; D016273:Occupational Exposure / Q000517:prevention & control*; D014618:Vacuum
chemical_list: D001843:Bone Cements; D020366:Methylmethacrylate