AANA December 2025 Journal Course: Are You Safe Behind the Drape: Considerations for Mitigating Occupational Hazards-Are You Safe Behind the Drape: Considerations for Mitigating Occupational Hazards Among Anesthesia Providers

Are You Safe Behind the Drape: Considerations for Mitigating Occupational Hazards Among Anesthesia Providers

Pdf Summary

This manuscript, titled "Are you safe behind the drape? Occupational hazards among anesthesia providers," addresses critical occupational health risks faced by anesthesia professionals working in perioperative environments. Hospitals rank among the most hazardous workplaces, with healthcare reporting over 250,000 work-related injuries and illnesses in 2011, surpassing traditional high-risk industries. Anesthesia providers, due to their work environment, encounter various physical, chemical, and biological occupational hazards that contribute to injury, illness, and reduced productivity.<br /><br />Key occupational hazards discussed include radiation exposure, waste anesthetic gases (WAGs), methyl methacrylate (MMA), excessive noise, and surgical smoke. Radiation exposure primarily stems from fluoroscopy and imaging used in orthopedic, spine, and vascular surgeries. Ionizing radiation damages DNA, increasing risks of cancer, hypothyroidism, cataracts, and fetal harm. The CDC’s ALARA principle—minimizing time, maximizing distance, and using shielding such as lead aprons and glasses—helps reduce exposure. Dosimeter badges monitor radiation doses.<br /><br />Volatile anesthetics, inhaled agents like sevoflurane and isoflurane, can pose chemical hazards via waste gases if scavenging systems fail. Chronic exposure increases risks for liver, renal, neurological diseases, cancers, and reproductive issues, such as miscarriage and fetal anomalies. Pediatric anesthesia providers face higher exposure risks during inhalation inductions. Preventive measures include total intravenous anesthesia, maintaining low fresh gas flows, ensuring mask seals, and using scavenging systems.<br /><br />Methyl methacrylate, used as bone cement in surgeries, can irritate mucous membranes and lungs, causing hypersensitive pneumonitis and cellular DNA damage that may increase cancer risk. Pregnant providers are advised to avoid exposures due to limited safety data. Closed mixing systems, adequate ventilation, and activated carbon masks reduce hazards.<br /><br />Excessive noise in ORs contributes to occupational noise-induced hearing loss (ONIHL), stress, and cognitive impairment including dementia risk. The NIOSH recommends an 8-hour exposure limit of 85 dBA; many OR environments exceed this. Preventive strategies include monitoring noise levels, regular hearing tests, and using flat attenuation earplugs or noise-canceling earmuffs.<br /><br />Surgical smoke from electrocautery and lasers contains harmful chemicals, particulates, and infectious agents such as HPV and hepatitis B virus. It causes respiratory irritation and carcinogenic risks equivalent to smoking 27-30 unfiltered cigarettes per day. Effective removal relies on smoke evacuation devices (SEDs) with HEPA/ULPA filters, complemented by appropriate ventilation and N95 or activated carbon filter masks.<br /><br />The review highlights a widespread lack of awareness and inconsistent use of protective measures among anesthesia providers. It emphasizes the need for education, policy implementation, and adherence to safety protocols to mitigate occupational hazard risks, ensuring safer, healthier work environments and longer, more productive careers for anesthesia professionals.

Keywords

occupational hazards

anesthesia providers

radiation exposure

waste anesthetic gases

methyl methacrylate

noise-induced hearing loss

surgical smoke

perioperative safety

protective measures

healthcare workplace risks