title: Occupational exposure to volatile anaesthetics: a systematic review.
abstract: BACKGROUND
  The effects of long-term occupational exposure to small concentrations of volatile anaesthetics on health professionals are still uncertain despite the research literature available on this subject.
  
  
  OBJECTIVE
  To analyse the existing literature on the health effects of volatile anaesthetics on exposed health professionals.
  
  
  METHODS
  We performed a systematic review from March 2013 to January 2014. The literature was searched in the Medline and Cochrane libraries using the following keywords: 'Anaesthetics AND occupational health', 'Volatile anaesthetics AND occupational health', 'Sevoflurane AND occupational health' and 'Occupational surveillance AND anaesthetics', with no time limit. We used the Scottish Intercollegiate Guidelines Network to evaluate the quality of studies and to grade the recommendations.
  
  
  RESULTS
  From 1429 articles retrieved from the databases and an additional 20 obtained from secondary sources, we excluded 1391 (95.9%). After excluding duplicate publications, we finally included 17 articles in the review.
  
  
  CONCLUSIONS
  Evidence for adverse effects of volatile anaesthetics on exposed personnel is scarce and inconsistent, but there is no evidence of adverse effects when environmental levels are kept within legal threshold values. Further studies are needed to improve our knowledge of the effects of occupational exposure to volatile anaesthetics. New surveillance methods that include systematic data collection, clinical signs and biomarkers of exposure are required to formulate consistent and reproducible surveillance criteria for exposed personnel.
authors.affiliation: Occupational Health, Servei de Prevenció Mancomunat, Institut Català de la Salut, Corporate Centre, Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain, prevencio.ics@gencat.cat.
authors.forename: J M
authors.initials: JM
authors.lastname: Molina Aragonés
authors.affiliation: Occupational Health, Institut Català de la Salut, Hospital Vall d'Hebron, Psg. Vall d'Hebrón, 119-129 08035 Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Ayora Ayora
authors.affiliation: Occupational Health, Institut Català de la Salut, Primary Care, C/ Lope de Vega, 138 08005 Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Barbara Ribalta
authors.affiliation: Occupational Health, Institut Català de la Salut, Hospital de Viladecans, Avd. de Gavà, 38 08840 Viladecans, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gascó parici
authors.affiliation: Prevention of Occupational Risks, Institut Català de la Salut, Corporate Centre, Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Medina Lavela
authors.affiliation: Occupational Health, Institut Català de la Salut, Hospital de Tortosa, C. de les Esplanetes, 44-58 43500 Tortosa, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sol Vidiella
authors.affiliation: Prevention of Occupational Risks, Institut Català de la Salut, Corporate Centre, Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain.
authors.forename: M Herreros
authors.initials: MH
authors.lastname: Sol López
mesh_terms: D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D004780:Environment, Controlled; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D009784:Occupational Diseases / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects* / Q000517:prevention & control; D016272:Occupational Health; D009873:Operating Rooms; D017410:Practice Guidelines as Topic; D018570:Risk Assessment
chemical_list: D018685:Anesthetics, Inhalation
keywords: Healthcare workers; occupational health; volatile anaesthetics.