Exposição ocupacional anestésica durante a residência médica - impacto no estresse oxidativo e nas avaliações toxicogenética, bioquímica e neuroendócrina: estudo longitudinal
Carregando...
Arquivos
Data
2021-08-27
Autores
Aun, Aline Garcia
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Para melhor compreensão da relação causa-efeito de possíveis efeitos tóxicos da exposição ocupacional aos resíduos de gases anestésicos (RGA), este estudo longitudinal foi realizado em médicos ocupacionalmente expostos aos mais modernos RGA halogenados (isoflurano, sevoflurano e desflurano) além do gás óxido nitroso durante o período de especialização. Trata-se de estudo pioneiro que monitorou as concentrações de RGA em salas operatórias e avaliou o impacto dessa exposição no estresse oxidativo, nas avaliações toxicogenéticas (danos no DNA e expressão de transcritos), bioquímicas e neuroendócrinas. Assim, os participantes foram avaliados antes do início da residência médica (antes da exposição aos RGA), após seis meses, um ano, um ano e meio, dois anos e dois anos e meio de exposição. O monitoramento anestésico foi realizado por espectrofotometria infravermelha, e as amostras biológicas foram analisadas quanto à peroxidação lipídica, oxidação proteica, dano basal e oxidativo no DNA, enzimas antioxidantes e capacidade antioxidante, expressão de alguns genes-chave, contagem leucocitária, enzimas hepáticas e resposta neuroendócrina. Os resultados mostraram que as concentrações de RGA estavam bem acima da recomendação internacional e houve indução de oxidação proteica, peroxidação lipídica, danos no DNA, alteração das atividades de glutationa peroxidase e superóxido dismutase, alteração da expressão de NRF2, HO1 e OGG1 e leves oscilações, sendo a maioria dos resultados dentro dos limites de normalidade, para contagem leucocitária, enzimas hepáticas e hormônios, ao longo dos momentos em relação ao momento controle. Em conclusão, nossos achados mostraram que a alta exposição aos RGA no ambiente de trabalho sem adequado sistema de exaustão leva ao estresse oxidativo, genotoxicidade e modulação de transcritos em jovens médicos durante o período de residência médica. Portanto, jovens profissionais, em início de carreira, já apresentam alterações moleculares. Assim, por se tratar de importante questão ocupacional, é necessário mitigar a poluição anestésica no ambiente de trabalho para reduzir a exposição ocupacional com o intuito de se minimizar o impacto da toxicidade anestésica.
To better understand the cause-effect of possible toxic effects of occupational exposure to waste anesthetic gases (WAG), this longitudinal study was carried out on physicians occupationally exposed to the most modern halogenated (isoflurane, sevoflurane e desflurane) WAG in addition to nitrous oxide gas during their specialization period. This is a pioneer study that monitored WAG concentrations in operating rooms and evaluated the impact of this exposure on oxidative stress, toxicogenetics (DNA damage and transcript expression), biochemical and neuroendocrine biomarkers. Thus, participants were evaluated before the beginning of medical residency (before exposure to WAG), after six months, one year, one and a half years, two years and two and a half years of exposure. Anesthetic monitoring was performed by infrared spectrophotometry, and biological samples were analyzed for lipid peroxidation, protein oxidation, basal and oxidative DNA damage, antioxidant enzymes and antioxidant capacity, expression of some key genes, leukocyte count, liver enzymes and neuroendocrine response. The results showed that WAG concentrations were high above the international recommendation and there was induction of protein oxidation, lipid peroxidation, DNA damage, alteration of glutathione peroxidase and superoxide dismutase activities, and changes in NRF2, HO1 and OGG1 expressions, and slight oscillations, with most of the results within normal range, for leukocyte count, liver enzymes and hormones along the time points compared to the baseline. In conclusion, our findings showed that high exposure to WAG in the workplace lacking adequate scavenging system leads to oxidative stress, genotoxicity and transcript modulation in young physicians during the medical residency. Therefore, young professionals, at the beginning of their careers, already present molecular alterations. Thus, considering that this is an important occupational issue, it is necessary to mitigate anesthetic pollution in the work environment to reduce occupational exposure minimizing the impact of anesthetic toxicity.
To better understand the cause-effect of possible toxic effects of occupational exposure to waste anesthetic gases (WAG), this longitudinal study was carried out on physicians occupationally exposed to the most modern halogenated (isoflurane, sevoflurane e desflurane) WAG in addition to nitrous oxide gas during their specialization period. This is a pioneer study that monitored WAG concentrations in operating rooms and evaluated the impact of this exposure on oxidative stress, toxicogenetics (DNA damage and transcript expression), biochemical and neuroendocrine biomarkers. Thus, participants were evaluated before the beginning of medical residency (before exposure to WAG), after six months, one year, one and a half years, two years and two and a half years of exposure. Anesthetic monitoring was performed by infrared spectrophotometry, and biological samples were analyzed for lipid peroxidation, protein oxidation, basal and oxidative DNA damage, antioxidant enzymes and antioxidant capacity, expression of some key genes, leukocyte count, liver enzymes and neuroendocrine response. The results showed that WAG concentrations were high above the international recommendation and there was induction of protein oxidation, lipid peroxidation, DNA damage, alteration of glutathione peroxidase and superoxide dismutase activities, and changes in NRF2, HO1 and OGG1 expressions, and slight oscillations, with most of the results within normal range, for leukocyte count, liver enzymes and hormones along the time points compared to the baseline. In conclusion, our findings showed that high exposure to WAG in the workplace lacking adequate scavenging system leads to oxidative stress, genotoxicity and transcript modulation in young physicians during the medical residency. Therefore, young professionals, at the beginning of their careers, already present molecular alterations. Thus, considering that this is an important occupational issue, it is necessary to mitigate anesthetic pollution in the work environment to reduce occupational exposure minimizing the impact of anesthetic toxicity.
Descrição
Palavras-chave
Exposição ocupacional, Anestésicos inalatórios, Residência médica, Estresse oxidativo, Dano no DNA, Expressão gênica, Occupational exposure, Inhalation anesthetics, Medical residency, Oxidative stress, DNA damage, Gene expression