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Occ Health Flashcards

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1
Q

What does being a responsible anesthesia provider entail?

A

Being aware of health and safety hazards and taking appropriate precautions

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2
Q

What are the categories of occupational hazards in anesthesia?

A
  • Chemical Hazards
  • Physical Hazards
  • Biological Hazards
  • Psychological Hazards
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3
Q

What are some examples of chemical hazards in anesthesia?

A
  • OR Smoke
  • Waste Gases
  • Methyl Methacrylate
  • Latex
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4
Q

What are some physical hazards faced by anesthesia providers?

A
  • Ionizing Radiation
  • MRI
  • Noise
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5
Q

What are some biological hazards encountered in anesthesia?

A
  • Viruses (e.g., Herpes, Influenza)
  • Bacteria (e.g., MRSA, TB)
  • CJD
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6
Q

What psychological hazards are relevant to anesthesia providers?

A
  • Burnout
  • Chemical Dependency
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7
Q

How does the injury and illness rate in hospital workers compare to other industries?

A

Nearly double the rate for private industry, higher than construction or agriculture

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8
Q

What is a significant risk factor for healthcare workers regarding SARS-CoV-2?

A

Disproportionately higher risk of infection compared to the general population

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9
Q

What percentage of anesthesiologists experienced a needle stick during residency?

A

95% of New York anesthesiologists

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10
Q

What is the median hearing threshold in anesthesiologists compared to the general population?

A

Worse than an age/sex matched general population

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11
Q

What is the risk of burnout among anesthesia providers according to a 2021 study?

A

60% are at high risk for burnout

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12
Q

What are some common protective measures that anesthesia providers fail to observe?

A
  • Washing hands before patient contact
  • Wearing gloves during IV access
  • Using protective equipment against ionizing radiation
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13
Q

What is surgical smoke?

A

Smoke from electrosurgical units (ESUs), laser devices, or harmonic scalpels

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14
Q

How does the mutagenicity of surgical smoke compare to smoking unfiltered cigarettes?

A

Ablation of 1 g of tissue produces a smoke plume equivalent to 6 unfiltered cigarettes

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15
Q

What are some health effects associated with exposure to particulate matter from surgical smoke?

A
  • Acute and chronic lung disease
  • Asthma
  • Emphysema
  • Recurrent bronchitis and pneumonia
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16
Q

What viruses have been recovered from surgical smoke?

A
  • Poliovirus
  • HIV
  • Hepatitis B virus
  • Human Papillomavirus
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17
Q

What is the maximum penetrating particle size for N95 respirator masks?

A

Approximately 0.3 um

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18
Q

What are some recommended protective measures against surgical smoke?

A
  • Appropriate room ventilation
  • Smoke evacuation devices (SEDs)
  • Masks and filters
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19
Q

What is the role of smoke evacuation devices (SEDs) in the operating room?

A

To reduce exposure to surgical smoke

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20
Q

What is the significance of the General Duty Clause in OSHA?

A

Employers must provide a workplace free of recognized hazards

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21
Q

What is one potential hazard associated with waste gases in the operating room?

A

Maximum allowable levels of N2O and halogenated anesthetics often exceeded

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22
Q

True or False: Surgical masks provide complete protection against volatile organic compounds in surgical smoke.

A

False

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23
Q

What is the purpose of smoke evacuation devices?

A

To avoid re-circulating harmful elements of plume through a filtration system.

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24
Q

Why are recommendations for smoke evacuation devices often disregarded?

A

They relate to priorities in the healthcare system.

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25
What are Waste Anesthetic Gases (WAGs)?
Gases such as N2O and halogenated anesthetics that can exceed maximum allowable levels in operating rooms.
26
What factors are associated with increased waste gas exposure?
* Mask induction (pediatric cases) * Circuit disconnect or leak * Laryngeal Mask Airways (LMAs) * Cuffless Endotracheal Tubes (ETTs) * Scavenging system issues * Filling vaporizers.
27
Where can WAG levels exceeding NIOSH recommendations occur outside the OR?
In the PACU for multiple hours after patient arrival.
28
What are potential short-term exposure hazards of WAGs?
Neurocognitive impairment.
29
What long-term exposure hazards are associated with WAGs?
* Reproductive effects (infertility, spontaneous abortions, congenital defects) * Genotoxic effects (DNA damage) * Mutagenic effects (gene mutation).
30
What did original un-blinded data from the 1970s suggest about neurocognitive impairment?
Impaired psychomotor performance was shown but has not been reproduced in scavenged environments.
31
What is the effect of N2O in un-scavenged settings?
It may be associated with reproductive adverse events when exposure exceeds NIOSH recommended levels.
32
What is the association of N2O exposure with megaloblastic anemia?
Chronic exposure can lead to functional B12 deficiency and peripheral neuropathies.
33
What was found in studies regarding WAG exposure in scavenged ORs?
No established association with reproductive adverse events.
34
What are the effects of chronic exposure to mixed WAGs in scavenged settings?
Associated with genotoxic and mutagenic events.
35
What are the acute effects of Methyl Methacrylate (MMA)?
* Allergy * Rash * Asthma * Neurologic symptoms (headache/lethargy) * Hepatotoxicity * Pulmonary toxicity * Congenital abnormalities.
36
What chronic effects are associated with MMA exposure?
* Respiratory injury * Reproductive/developmental effects * Genotoxicity (inconclusive in vitro data).
37
What did retrospective studies reveal about MMA exposure in orthopedic surgeons?
Increased risk of cancer deaths, especially esophageal and myeloproliferative cancers.
38
What methods can reduce airborne MMA levels?
* Vacuum mixing * Laminar flow ventilation.
39
What types of latex allergies exist?
* IgE mediated Type 1 reaction * CMI Type 4 reaction.
40
What is the prevalence of latex allergy among healthcare professionals?
4-17% of healthcare providers.
41
What is the highest risk factor for latex sensitization?
History of latex contact dermatitis.
42
What are the prevention strategies for latex allergies?
* Use substitutes instead of latex gloves when possible * Use powder-free, low-protein/allergen latex gloves when exposure is necessary.
43
What are the units of radiation exposure?
* Rad (0.01 Gray) * Rem (Roentgen equivalent in man).
44
What is the allowable exposure limit for ionizing radiation according to OSHA?
5 Rem/Year.
45
What increases radiation exposure for anesthesia providers?
Procedures like EP, IR, ERCP.
46
What is the average radiation exposure for anesthesia providers?
Approximately 0.5 Rem/Year.
47
What protective measures can limit exposure to ionizing radiation?
* Distance * Lead aprons * Free-standing shields * Glasses.
48
What are potential acute hazards associated with MRI?
* Acoustic injury * Projectile injury * Hypoxia * Vertigo.
49
What are the noise levels in operating rooms compared to NIOSH allowed levels?
They frequently exceed NIOSH allowed levels.
50
What are some adverse consequences of noise in the OR?
* Hearing loss * Tinnitus * Hypertension * Cognitive dysfunction * Communication failure * Stress/Fatigue.
51
What are some potential remedies for noise in the OR?
* Avoid unnecessary noise pollution * Education of OR staff * Proper OR design.
52
What are common physical hazards in the OR?
* Falls (cables, liquids) * Lifting injuries * Contusions (overhead monitors) * Lacerations (glass vials).
53
What is a potential remedy for noise pollution in the OR?
Avoid unnecessary noise pollution ## Footnote This includes behavior modification through education of OR staff and proper OR design.
54
What are some mechanical hazards in the OR?
Falls, lifting injuries, contusions, lacerations ## Footnote These hazards can arise from cables, liquids, overhead monitors, and glass vials.
55
What protects against ionizing radiation in the OR?
Distance and lead ## Footnote Lead glasses offer protection to the radiosensitive posterior lens when facing incoming radiation.
56
What is the association between OR noise and anesthesia providers?
Increased stress, fatigue, and perceived workload ## Footnote Hearing loss related to chronic noise exposure is prevalent among anesthesia providers.
57
What are some biological hazards in the OR?
Viruses and bacteria (e.g., MRSA, TB) ## Footnote Other examples include CJ Disease and various respiratory viruses.
58
What is the transmission method for influenza?
Respiratory or hand-to-eye/nose/mouth transmission ## Footnote It is an RNA virus with significant yearly mortality rates.
59
What are common side effects of the influenza vaccine?
Pain at injection site, fever, rhinorrhea, sore throat ## Footnote Allergic reactions may occur, especially in those with egg allergies.
60
What are arguments for mandatory vaccination against influenza?
Extremely contagious, significant morbidity and mortality, HCPs as transmission source ## Footnote Detection of disease prior to transmission is problematic.
61
What does 'herpetic whitlow' refer to?
HSV 1 infection of the finger ## Footnote It is especially common among anesthesia providers due to unprotected hand manipulation of mucosa.
62
What is the source of varicella-zoster virus?
Person with chicken pox or zoster ## Footnote It is extremely contagious and can be transmitted by skin contact or aerosol.
63
What is the risk of hepatitis B infection in HCWs after a needle stick?
6-30% ## Footnote PEP includes hepatitis B vaccine and/or HB Immunoglobulin (HBIG).
64
When should PEP for hepatitis B begin?
Within 24 hours of exposure ## Footnote If source or HCW vaccination status is unknown, measure them at the time of the incident.
65
What is the risk of transmission for hepatitis C from a needle stick?
Approximately 0.2% ## Footnote Mucocutaneous exposure has a 0% transmission risk.
66
What are the indications for PEP for HIV?
Exposure to body fluids from known HIV+ or high-risk patient within 72 hours ## Footnote Preferred regimen is a 28-day course of a 3-drug antiretroviral regimen.
67
What are the TB guidelines for anesthesia providers?
Annual TB testing, detailed history from high-risk patients, use of PPE ## Footnote Elective surgery should be delayed until patients are noninfectious.
68
What is Creutzfeldt-Jakob Disease (CJD)?
A prion disease causing spongiform encephalopathy ## Footnote Transmission occurs via contact with neural tissue, and it is resistant to conventional decontamination.
69
What are common clinical characteristics of burnout?
Emotional exhaustion, cynicism, feelings of ineffectiveness ## Footnote Burnout prevalence in anesthesiologists is reported at 59.2%.
70
What factors are associated with burnout in anesthesia providers?
Perceived lack of support, working over 40 hours/week, staffing shortages ## Footnote Stress is a common denominator leading to burnout.
71
What is the prevalence of chemical dependence among anesthesiologists?
3.7% residents, 1.2% faculty ## Footnote CRNAs reported a prevalence of 9.8% in a 2020 study.
72
What are common substances abused by anesthesia providers?
Opioids (especially fentanyl), propofol, ethanol ## Footnote Mortality rates from drug abuse in residency are notably high.
73
What should be done to prevent occupational hazards in anesthesia?
Use smoke evacuation systems, avoid anesthetic gas use in non-scavenged areas ## Footnote Encourage timely PEP for hepatitis B and HIV, and maintain good hygiene practices.

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