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- Andréasson, Sara Näslund, et al.
(author)
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Peritonectomy with high voltage electrocautery generates higher levels of ultrafine smoke particles
- 2008
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In: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983 .- 1532-2157. ; 35:7, s. 780-784
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Journal article (peer-reviewed)abstract
- BACKGROUND: To adequately perform peritonectomy, the use of an electrocautery device at a high voltage is recommended. The aim of this study was to analyse the amount of airborne and ultrafine particles (UFP) generated during peritonectomy and to compare this with standard colon and rectal cancer surgery (CRC). METHOD: UFP was measured approximately 2-3cm from the breathing area of the surgeon (personal sampling) and 3m from where the electrocautery smoke was generated (stationary sampling) from 14 consecutive peritonectomy procedures and 11 standard CRC resections. The sampling was by P-Trak UFP counter that has the capacity to detect particle size ranging from 0.02 to 1mum. RESULTS: The cumulative level of UFP of personal sampling in the peritonectomy group was higher (9.3x10(6)particle/ml/h (pt/ml/h)) than in the control group (4.8x10(5)pt/ml/h). A higher cumulative level of UFP in stationary sampling was observed in the PC group (2.6x10(6) pt/ml/h) than in the control group (3.9x10(4)pt/ml/h). CONCLUSION: Peritonectomy procedure with high voltage electrocautery generates elevated levels of UFP than standard CRC surgery does. The level of UFP produced by a peritonectomy is comparable to cigarette smoking. More efficient smoke evacuator systems are needed in order to reduce the levels of UFP generated during electrocautery surgery.
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| 2. |
- Anundi, Helena, et al.
(author)
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Air and biological monitoring of solvent exposure during grafitti removal
- 2000
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In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 73:8, s. 561-569
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The principal aim of the study was to estimate the level of exposure to organic solvents of graffiti removers, and to identify the chemicals used in different cleaning agents. A secondary objective was to inform about the toxicity of various products and to optimise working procedures.METHODS: Exposure to organic solvents was determined by active air sampling and biological monitoring among 38 graffiti removers during an 8-h work shift in the Stockholm underground system. The air samples and biological samples were analysed by gas chromatography. Exposure to organic solvents was also assessed by a questionnaire and interviews.RESULTS: Solvents identified were N-methylpyrrolidone (NMP), dipropylene glycol monomethyl ether (DPGME), propylene glycol monomethyl ether (PGME), diethylene glycol monoethyl ether (DEGEE), toluene, xylene, pseudocumene, hemimellitine, mesitylene, ethylbenzene, limonene, nonane, decane, undecane, hexandecane and gamma-butyrolactone. The 8-h average exposures [time-weighted average (TWA)] were below 20% of the Swedish permissible exposure limit value (PEL) for all solvents identified. In poorly ventilated spaces, e.g. in elevators etc., the short-term exposures exceeded occasionally the Swedish short-term exposure limit values (STEL). The blood and urine concentrations of NMP and its metabolites were low. Glycol ethers and their metabolites (2-methoxypropionic acid (MPA), ethoxy acetic acid (EAA), butoxy acetic acid (BAA), and 2-(2-methoxyethoxy) acetic acid (MEAA)) were found in low concentrations in urine. There were significant correlation between the concentrations of NMP in air and levels of NMP and its metabolites in blood and urine. The use of personal protective equipment, i.e. gloves and respirators, was generally high.CONCLUSIONS: Many different cleaning agents were used. The average exposure to solvents was low, but some working tasks included relatively high short-term exposure. To prevent adverse health effects, it is important to inform workers about the health risks and to restrict the use of the most toxic chemicals. Furthermore, it is important to develop good working procedures and to encourage the use of personal protection equipment.
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| 5. |
- Bergsten, Eva L., 1969-, et al.
(author)
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Hälsoeffekter och förebyggande arbete vid vibrationsexponering i saneringsföretag
- 2013
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Reports (other academic/artistic)abstract
- Den övergripande målsättningen med projektet var att få en ökad kunskap om hur saneringsföretag i Uppsala, Gävleborgs och Dalarnas län arbetar för att förebygga negativa hälsoeffekter av exponering av hand- arm vibrationer. Syftet med studien var att undersöka kunskapsläget angående risker med arbete med vibrerande verktyg, samarbetet med företagshälsovården och genomförande av medicinska kontroller hos saneringsföretag i regionen. Strukturerade telefonintervjuer med 15 saneringsföretag genomfördes. Ett samarbete med ett större saneringsföretag inleddes och medicinska undersökningar genomfördes på deras anställda av ergonom ute på arbetsplatsen. Aktiviteterna i projektet inspirerade företaget att själva initiera riskbedömningar och vibrationsmätningar som en start på ett eget förbättringsarbete. Intervjuerna visade att kunskapsläget i företagen angående regelverk och arbete med vibrerande verktyg var dåligt och trots att de flesta hade företagshälsovård så uttalades ett missnöje gentemot företagshälsovården angående stöd och information i dessa frågor. Bristfällig kunskap och svårigheter att tolka regelverket kan ligga bakom att det brister vad gäller riskbedömningar och lagstadgade medicinska kontroller i saneringsföretagen. Besvärsfrekvenserna i nacke och övre extremiteter hos sanerarna i det undersökta företaget var höga och det fanns också personer med tidiga tecken på kärl- och nervskador. Resultatet av det här projektet är ett litet komplement till den kunskap som redan finns på området men visar att det finns all anledning att lägga resurser på ett förebyggande arbete för den här yrkesgruppen som tidigare inte studerats i någon större utsträckning. Det finns ett outtalat behov av informations- och utbildningsinsatser på området som till stor del beror på okunskap hos företagen men kanske också hos företagshälsovården eftersom deras insatser ser ut att ha varit begränsade. En viktig följd av projektet var att det undersökta företaget på eget initiativ men med stöd av projektet initierade en arbetsgrupp och ett förebyggande arbete för att minska exponeringen för vibrationer. Detta arbete inkluderade riktlinjer för riskbedömningar och vibrationsmätningar av verktyg samt utbildning av ledning och personal. Projektets upplägg och innehåll lämpar sig således väl för att följas av företagshälsovård i deras arbete med att stötta sina kundföretag
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| 8. |
- Langworth, S, et al.
(author)
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Acute health effects common during graffiti removal
- 2001
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In: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 74, s. 213-
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Journal article (peer-reviewed)
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| 10. |
- Näslund Andréasson, Sara, et al.
(author)
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Is Platinum Present in Blood and Urine from Treatment Givers during Hyperthermic Intraperitoneal Chemotherapy?
- 2010
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In: Journal of oncology. - : Hindawi Limited. - 1687-8469 .- 1687-8450. ; 2010, s. 649719-
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Journal article (peer-reviewed)abstract
- Background. In selected patients with peritoneal carcinomatosis (PC) originating from colorectal cancer (CRC) the high dosage of oxaliplatin (460 mg/m(2)) is recommended for hyperthermic intraperitoneal chemotherapy (HIPEC), which may be a health risk to those administering the drug. The aim of this study was to determine the risk of platinum (Pt) exposure for the two main people handling and administering the cytotoxic agent during HIPEC. Methods. Samples of blood and urine were collected from one male surgeon and one female perfusionist during oxaliplatin-based HIPEC treatment with open abdomen coliseum technique on six consecutive patients with PC from CRC. Results. All blood samples analysed were below the detection limit of <0.05 nmol/L Pt, and the urine samples were all below the detection limit of <0.03 nmol/L Pt. Conclusions. There appears to be little or no risk of Pt exposure during HIPEC when the recommended protective garment is used and the safety considerations are followed.
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| 12. |
- Näslund Andréasson, Sara, 1971-
(author)
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Work Environment in the Operating Room during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy : Factors Influencing Choice of Protective Equipment
- 2011
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Doctoral thesis (other academic/artistic)abstract
- Peritoneal carcinomatosis (PC) is a common metastatic manifestation of both gastrointestinal and gynecological malignancies. Curative modes of treatment are cytoreductive surgery (CRS) combined with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC). Surgeons and operating room (OR) staff attending these procedures are exposed to chemotherapy and electrocautery smoke. Heated chemotherapy (HIPEC) may vaporize and become inhaled by those administering it and, moreover, large quantities of electrocautery smoke may also be inhaled by surgeons and OR staff, with unknown adverse health effects. The general aim of this thesis was to investigate the work environment during major abdominal surgery and HIPEC, and to map the factors influencing the behavior of OR nurses and surgeons when choosing protective equipment against electrocautery smoke. To determine the presence of platinum, a total of 36 blood and 36 urine samples were collected from one surgeon and one perfusionist during six oxaliplatin-based HIPEC treatments (Paper I). Regarding electrocautery smoke, amounts of ultrafine particles (UFPs) in the smoke from 14 CRS procedures and 11 colorectal cancer (CRC) procedures were collected and compared (Paper II). Additionally, polycyclic aromatic hydrocarbons (PAHs) were identified and quantified in electrocautery smoke during 40 CRS procedures (Paper III). Lastly, seven OR nurses and seven surgeons were interviewed individually to explore what factors influenced their behavior when choosing protective equipment against electrocautery smoke. The transcribed texts were analyzed with qualitative content analysis (Paper IV). All blood and urine samples were below the detection limit (Paper I). The amount of UFPs produced during CRS procedures was significantly higher than from CRC procedures (Paper II), and PAHs never exceeded Swedish occupational exposure limits (OELs) (Paper III). OR nurses and surgeons had a knowledge of electrocautery smoke and were aware of risks. However, external factors governed the use of protective equipment against electrocautery smoke (Paper IV). HIPEC with oxaliplatin seems to present no risk for treatment givers. However, the possible risks from exposure of cumulative amounts of UFPs and PAHs are still unknown. OR nurses’ and surgeons’ knowledge about the possible risks of electrocautery smoke, and the use of protective equipment, are therefore important.
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