Determinação das concentrações de resíduos de gases anestésicos e avaliação genômica e de estresse oxidativo em profissionais recém-expostos
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Data
2016-08-25
Autores
Lucio, Lorena Mendes de Carvalho [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O presente estudo objetivou determinar as concentrações dos resíduos de gases anestésicos (RGA) em salas de operação (SO) e o impacto dessa exposição ocupacional em relação aos danos genômicos e estresse oxidativo em profissionais recém-expostos. O estudo foi conduzido no Hospital das Clínicas, Faculdade de Medicina de Botucatu-UNESP. As concentrações de isoflurano, sevoflurano e óxido nitroso (N2O) foram medidas nas SO por espectrofotometria infravermelha, com equipamento portátil. Sessenta e três médicos residentes, ao final de três anos do Programa de Residência Médica, foram alocados em dois grupos: exposto (Anestesiologia e Cirurgia, n=32) e controle (Clínica Médica, n=31). Amostras de sangue periférico e células bucais foram coletadas e protegidas da luz. Avaliaram-se danos no material genético (teste do cometa - danos basais, purinas e pirimidinas oxidadas em linfócitos; 8-hidroxi-2’-desoxiguanosina no plasma), micronúcleo (MN) em células bucais, proteínas carboniladas, marcadores de lipoperoxidação (malonaldeído e 4-hidroxinonenal) e capacidade antioxidante plasmática (ferric reducing antioxidant power, oxygen radical absorbance capacity e total antioxidant performance). As concentrações médias dos RGA foram superiores aos limites internacionalmente recomendados (2,7 vezes: isoflurano; 4,9 vezes: sevoflurano; 7,2 vezes: N2O). Os grupos não diferiram quanto aos dados demográficos (p>0,05). Detectou-se aumento significativo de danos basais no DNA (p=0,01) e maior frequência de MN em células bucais (2,3 vezes; p=0,07) no grupo exposto em relação ao grupo controle, mas não houve diferença (p>0,05) entre os grupos em relação a todos os marcadores de estresse oxidativo. Em conclusão, o estudo mostra que médicos residentes expostos a altas concentrações de RGA apresentam aumento significativo de danos sistêmicos no DNA e frequência aumentada de instabilidade genômica (MN bucais), mas não de estresse oxidativo. Portanto, este estudo mostra que jovens profissionais já apresentam alterações genômicas, o que reforça a importância do biomonitoramento e da diminuição da exposição aos RGA.
This study determined the waste anesthetic gases (WAG) in operating rooms (OR) and evaluated the impact of the occupational exposure in genetic damage and oxidative stress in medical residents. The study was performed at “Hospital das Clínicas, Faculdade de Medicina de Botucatu-UNESP”. The concentrations of isoflurane, sevoflurane and nitrous oxide (N2O) were measured in ORs. Sixty-three medical residents completing their three-year Medical Residency Program were recruited for the study and were assigned to two groups: exposed group (n=32) of Anesthesiology and Surgery areas and control group (n=31) of Internal Medicine area. Blood and buccal cells were concomitantly collected from both groups and protected from light to measure genetic instability by buccal micronucleus (MN), basal and oxidized DNA damage (comet assay and 8-hydroxy-2′-deoxyguanosine), biomarkers of protein and lipid oxidation, and three different assays for plasma antioxidant activity. Mean WAG concentrations were above international thresholds (2.7-fold: isoflurane; 4.9-fold: sevoflurane; 7.2-fold: N2O). There was no significant difference between groups regarding demographic data. Basal DNA damage (p=0.01) and buccal MN frequency (by 2.3-fold; p=0.07) were increased in the exposed group compared to the control group. Results showed no significant difference for oxidative stress biomarkers between groups. In conclusion, this study shows that medical residents exposed to high WAG concentrations have increased systemic DNA damage and genomic instability (buccal MN), but not oxidative stress. Thus, these young professionals already have genetic damage in the beginning of their career. Our results reinforce the importance of the biomonitoring and also the adequate measures to decrease ambient air pollution in the OR.
This study determined the waste anesthetic gases (WAG) in operating rooms (OR) and evaluated the impact of the occupational exposure in genetic damage and oxidative stress in medical residents. The study was performed at “Hospital das Clínicas, Faculdade de Medicina de Botucatu-UNESP”. The concentrations of isoflurane, sevoflurane and nitrous oxide (N2O) were measured in ORs. Sixty-three medical residents completing their three-year Medical Residency Program were recruited for the study and were assigned to two groups: exposed group (n=32) of Anesthesiology and Surgery areas and control group (n=31) of Internal Medicine area. Blood and buccal cells were concomitantly collected from both groups and protected from light to measure genetic instability by buccal micronucleus (MN), basal and oxidized DNA damage (comet assay and 8-hydroxy-2′-deoxyguanosine), biomarkers of protein and lipid oxidation, and three different assays for plasma antioxidant activity. Mean WAG concentrations were above international thresholds (2.7-fold: isoflurane; 4.9-fold: sevoflurane; 7.2-fold: N2O). There was no significant difference between groups regarding demographic data. Basal DNA damage (p=0.01) and buccal MN frequency (by 2.3-fold; p=0.07) were increased in the exposed group compared to the control group. Results showed no significant difference for oxidative stress biomarkers between groups. In conclusion, this study shows that medical residents exposed to high WAG concentrations have increased systemic DNA damage and genomic instability (buccal MN), but not oxidative stress. Thus, these young professionals already have genetic damage in the beginning of their career. Our results reinforce the importance of the biomonitoring and also the adequate measures to decrease ambient air pollution in the OR.
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Exposição ocupacional, Poluição ambiental, Médicos residentes, Testes de genotoxicidade, Instabilidade genômica, Estresse oxidativo, Occupational exposure, Environmental pollution, Medical residencies, Genotoxicity test, Genomic instability, Oxidative stress