Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, ECTB 166-11b, 1989 Sep; :1-60
The functions and uses of the Fraser-Harlake Scavenging System to control nitrous-oxide (10024972) (N2O) during dental surgery were described. The physical and toxic properties of nitrous-oxide were reviewed, including its systemic effects, effects on the reproductive system in humans and animals, the results of carcinogenesis studies, liver and kidney effects and its role in the production of central nervous system damage. Engineering controls reviewed include the use of anesthesia equipment both with and without scavenging machines along with proper ventilation equipment. A number of site visits were made to the Children's Hospital Medical Center Dental Facility in Cincinnati, Ohio, where this scavenging system was in use. During each of nine dental operations, N2O was measured and recorded continuously. Samples were taken in the breathing zone of the dentists and dental assistants as well as in the general area of the room and near exhaust vents. Work practices were evaluated to identify potential anesthetic gas exposures during surgery. Leak testing of the scavenging equipment was also performed. The field survey data indicated that the use of a scavenging system did not guarantee a reduction in the safe working levels of N2O. In all of the sampling runs evaluated, dentists and dental assistants were overexposed to N2O anesthetic during dental surgery. The major source of exposure was during delivery of N2O to the patient. The authors recommend measures for reducing these exposures.
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