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Biomonitoring occupational sevoflurane exposure at low levels by urinary sevoflurane and hexafluoroisopropanol.

Toxicology letters (2014-12-03)
Maria Luisa Scapellato, Mariella Carrieri, Isabella Maccà, Fabiola Salamon, Andrea Trevisan, Maurizio Manno, Giovanni Battista Bartolucci
ABSTRACT

This study aimed to correlate environmental sevoflurane levels with urinary concentrations of sevoflurane (Sev-U) or its metabolite hexafluoroisopropanol (HFIP) in order to assess and discuss the main issues relating to which biomarker of sevoflurane exposure is best, and possibly suggest the corresponding biological equivalent exposure limit values. Individual sevoflurane exposure was measured in 100 healthcare operators at five hospitals in north-east Italy using the passive air sampling device Radiello(®), and assaying Sev-U and HFIP concentrations in their urine collected at the end of the operating room session. All analyses were performed by gas chromatography-mass spectrometry. Environmental sevoflurane levels in the operating rooms were also monitored continuously using an infrared photoacoustic analyzer. Our results showed very low individual sevoflurane exposure levels, generally below 0.5 ppm (mean 0.116 ppm; range 0.007-0.940 ppm). Sev-U and HFIP concentrations were in the range of 0.1-17.28 μg/L and 5-550 μg/L, respectively. Both biomarkers showed a statistically significant correlation with the environmental exposure levels (Sev-U, r=0.49; HFIP, r=0.52), albeit showing fairly scattered values. Sev-U values seem to be influenced by peaks of exposure, especially at the end of the operating-room session, whereas HFIP levels by exposure on the previous day, the data being consistent with the biomarkers' very different half-lives (2.8 and 19 h, respectively). According to our results, both Sev-U and HFIP are appropriate biomarkers for assessing sevoflurane exposure at low levels, although with some differences in times/patterns of exposure. More work is needed to identify the best biomarker of sevoflurane exposure and the corresponding biological equivalent exposure limit values.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Creatinine, anhydrous, ≥98%
radiello Cartridge Adsorbents, for sampling BTEX and VOCs (thermal desorption), matrix SS net (3 x 8 μm, 4.8 mm diam.), Carbograph, pk of 20
radiello Triangular Support Plate, pk of 20
radiello Cartridge Adsorbents, for sampling Aldehydes, matrix SS net with 2,4-DNPH coated FLORISIL®, pk of 20
radiello Vertical Adapter, threaded for standard use, pk of 20
radiello Cartridge Adsorbents, for sampling BTEX and VOCs (CS2 Desorption), matrix SS net (100 mesh, 5.8 mm diam.), activated with activated charcoal (30-50 mesh), pk of 20
radiello Barcode Labels, pk of 198
radiello Anesthetic Gases and Vapor Sampler
radiello Cartridge Adsorbents, for sampling Anaesthetic Gases/Vapors, matrix SS net with mix of mol sieve and activated charcoal (30-50 mesh), pk of 20
radiello Cartridge Adsorbents, for sampling Ammonia (NH3), matrix microporous PE impregnated with phosphoric acid, pk of 20
radiello Outdoor Shelter, pk of 10
radiello Replacement Mounting Strips, for use with Radiello Outdoor Shelter, pk of 100
Supelco
Creatinine, Pharmaceutical Secondary Standard; Certified Reference Material
Sevoflurane, European Pharmacopoeia (EP) Reference Standard
Supelco
1,1,1,3,3,3-Hexafluoro-2-propanol, for GC derivatization, LiChropur, ≥99.8%
Sigma-Aldrich
1,1,1,3,3,3-Hexafluoro-2-propanol, ≥99%
radiello Filtration Kit, pk of 20
radiello BTEX/VOC Starter Kit, CS2 Desorption
radiello BTEX/VOC Starter Kit, Thermal Desorption
Supelco
radiello Aldehyde Calibration Standard, 50 μg/mL each component in acetonitrile, pkg of 10 mL
Supelco
radiello BTEX Calibration Kit (CS2 Desorption)
Supelco
radiello VOC Calibration Kit (Workplace Environment)
radiello Diffusive Bodies, yellow, configured for reduced sampling rates, pk of 20
radiello Empty Storage Tubes, polypropylene (with stopper), volume 12 mL, pk of 100
Supelco
radiello BTEX Calibration Kit (Thermal Desorption)
radiello Clips, suspending Radiello triangular support plate, pk of 20
radiello On-Field Thermometer, Includes one standard Radiello vertical adapter (RAD122) for each thermometer, configured for standard use, pk of 3
radiello Diffusive Bodies, white, configured for general use, pk of 20
radiello On-Field Thermometer, Reader, pk of 1
Supelco
radiello Methylene Blue Calibration Standard for H2S (Hydrogen Sulfide), pkg of 100 mL