Elsevier

Clinical Biochemistry

Volume 42, Issue 3, February 2009, Pages 189-193
Clinical Biochemistry

Oxidative status and DNA damage in operating room personnel

https://doi.org/10.1016/j.clinbiochem.2008.09.103Get rights and content

Abstract

Objectives

The aim of this study was to investigate the effects of occupational exposure to anesthetic gases on peripheral mononuclear leukocyte DNA damage and oxidative status in operating room personnel.

Design and methods

The population of study includes 30 operating room personnel (Group I) and 30 non-operating room personnel for control groups (Group II). DNA damage was assessed by alkaline comet assay in peripheral lymphocyte. Plasma levels of total antioxidant status (TAS), total oxidative status (TOS) were determined by using a novel automated measurement method and oxidative stress index (OSI) was calculated (OSI was calculated as: OSI = (TOS / TAS) × 100).

Results

Mononuclear leukocyte DNA damage, plasma TOS and OSI were significantly higher in Group I than Group II [p < 0.01, p < 0.05, p < 0.05 respectively]. There was also significantly decrease in plasma TAS in Group I than Group II [p < 0.05]. There were positive significant correlations between DNA damage and TOS and OSI in Group I [r = 0.84, p < 0.001, r = 0.89, p < 0.001 respectively].

Conclusions

Our findings demonstrate that, mononuclear leukocyte DNA damage was significantly higher in operating room personnel. The increase of DNA damage might depend on oxidative effects of anesthetics.

Introduction

Operating room personnel are exposed to much lower anesthetic concentrations than the patients; however, this exposure often extends over many years. They often complain of fatigue and headaches; even more serious disorders, such as reduced fertility, problems during pregnancy and increased rate of spontaneous abortion, are reported [1]. The type of anesthetics gases, length of exposure and the environmental gas concentrations are the decisive contributors.

Volatile agents are able to increase the extent of oxidative stress [2]. Oxidative stress also induces toxic effects in different tissues and organs due to enhance production of oxygen free radicals [3]. Disturbance of the pro-oxidant/antioxidant balance is considered to be a causative factor underlying the oxidative damage to cellular molecules such as DNA [4].

DNA strand breaks originate from the direct modification of DNA by chemical agents or their metabolites [5]. Known detrimental effects of volatile anesthetics are genotoxicity and cytotoxicity [6], [7], [8], [9], [10], [11]. The comet assay was originally developed to measure DNA strand breaks with high sensitivity [12]. The measurement of total antioxidant capacity and total oxidant capacity were useful tests for prediction of oxidative status [13].

It has been demonstrated that general anesthetic agents increase the reactive oxygen radicals [2]. However, the oxidative status and DNA damage among in operating room personnel have not been reported yet. In this study both the DNA damage and oxidative status in operating personnel were evaluated.

Section snippets

Patients

After written informed consent and the approval of the Institutional Review Board, 60 volunteers were included in this study. Each subject was interviewed using a standardized questionnaire with questions on drug intake, contraception, diseases and alcohol intake, exposure to indoor/outdoor pollutants, diagnostic and therapeutic radiographs during the previous 3 months. Thirty volunteers in operating room (OR) personnel 19 male, 11 female (anesthesiologist, certified registered nurse

Results

Demographic characteristics of subjects with Groups I and Groups II are shown in Table 1. There were no significant differences between the groups in age [33 ± 5 and 32 ± 5 years], body mass index [25 ± 5 and 24 ± 4 kg/m2] and duration of work in hospital [7 ± 4 and 7 ± 3] respectively. DNA damage was significantly higher in Group I than in Group II [19.7 ± 16.6 AU, 8.8 ± 4.1 AU; p < 0.01] (Table 2) (Fig. 1). Plasma TOS and OSI were higher in Group I than in Group II [26.4 ± 11.1 vs. 19.7 ± 9.7, p < 0.05; 1.0 ± 0.4 vs.

Discussion

In this study, it has been found that in operating room personnel showed not only increased DNA damage and TOS and OSI levels, but also significantly reduced TAS. To our knowledge, the current study is the first to provide evidence that individual components of in operating room personnel are correlated with increased DNA damage and decreased TAS levels. Therefore, the increased DNA damage may be related with insufficient antioxidant capacity and excessive ROS generation in operating room

References (27)

  • R. Sivaci et al.

    Cytotoxic effects of volatile anesthetics with free radicals undergoing laparoscopic surgery

    Clin. Biochem.

    (2006)
  • A.E. Aust et al.

    Mechanisms of DNA oxidation

    Proc. Soc. Exp. Biol. Med.

    (1999)
  • P. Möller et al.

    The comet assay as a rapid test in biomonitoring occupational exposure to DNA-damaging agents and effect of confounding factors

    Cancer Epidemiol., Biomarkers Prev.

    (2000)
  • Cited by (33)

    • Exposure to anesthetic gases among operating room personnel and risk of genotoxicity: A systematic review of the human biomonitoring studies

      2016, Journal of Clinical Anesthesia
      Citation Excerpt :

      However, smoking, alcohol consumption, age, gender and years of exposure showed no significant effect by the chromosome aberrations test. Baysal et al [26] investigated the effects of occupational exposure to anesthetic gases on peripheral mononuclear leukocyte DNA damage and oxidative status in operating room personnel. 30 operating room personnel and 30 non-operating room personnel for control groups were included in the work.

    • Occupational exposure to anesthetics leads to genomic instability, cytotoxicity and proliferative changes

      2016, Mutation Research - Fundamental and Molecular Mechanisms of Mutagenesis
      Citation Excerpt :

      Human monitoring has been used as a useful tool to identify and quantify the risks related to harmful effects on health. Several studies have reported detrimental effects in professionals who work in hospitals due to their occupational exposure to potentially dangerous conditions, such as ionizing radiation, toxic reagents, anticancer drugs and anesthetic gases utilized in the operating rooms (ORs) [1–4]. Prominent among the numerous known occupational hazards related to the practice of anesthesiology is the toxicity of volatile anesthetics, which have attracted special attention because of their wide clinical use and their potential to cause genetic damage in exposed professionals.

    • Balanced anesthesia with sevoflurane does not alter redox status in patients undergoing surgical procedures

      2014, Mutation Research - Genetic Toxicology and Environmental Mutagenesis
      Citation Excerpt :

      Natural scavenging systems inactivate ROS and RNS, thus avoiding oxidative damage in vulnerable targets, such as membrane unsaturated fatty acids and DNA bases [18]. When an imbalance between oxidants and antioxidants occurs, an excess of free radicals is formed, leading to oxidation of lipids, nucleic acids and proteins, causing so-called oxidative stress [19]. Sevoflurane undergoes a moderate degree of metabolism (2–5%), catalyzed by cytochrome P450 [7], which could directly trigger the generation of peroxynitrite and increase intracellular peroxides and NO [20].

    • Oxidative DNA damage and oxidative stress in subjects occupationally exposed to nitrous oxide (N<inf>2</inf>O)

      2012, Mutation Research - Fundamental and Molecular Mechanisms of Mutagenesis
      Citation Excerpt :

      Less attention, however, was devoted towards the assessment of oxidative stress in subjects occupationally exposed to anaesthetic waste gases. Partial exhaustion of the total antioxidative reserve of plasma as well as the reduced activity of enzymes of anti-oxidative defence such as GPX and superoxide dismutase were noted in two studies in operating room personnel [42,43]. The present study not only extends these previous results by demonstrating that parameters reflecting enhanced oxidative stress including ROS generation, TBARS concentration in plasma, F2 isoprostanes concentration in urine as well as DNA base oxidation are significantly increased in subjects occupationally exposed to waste anaesthetic gases, but is the first to document dose-dependent relationships between the extent of genetic damage, oxidative stress and the N2O concentration in the ambient air of operating theatre.

    View all citing articles on Scopus
    View full text