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Anesthesia Progress logoLink to Anesthesia Progress
. 1986 Mar-Apr;33(2):91–97.

Occupational Exposure to Nitrous Oxide in Dental Operatories

Paul J Middendorf, David E Jacobs, Kenneth A Smith, David M Mastro
PMCID: PMC2175458  PMID: 3459383

Abstract

Occupational exposures to nitrous oxide (N20) were measured in numerous dental operatories. In all cases, the National Institute of Occupational Safety and Health (NIOSH) recommended time-weighted average (for one operation) of 25 ppm was exceeded by wide margins (NIOSH considers 50 ppm to be attainable in dental operatories). However, a new risk assessment is necessary to determine appropriate exposure limits. Many of the operatories were not equipped with scavenging systems and none of them used a scavenging device in combination with a local exhaust ventilation system. Scavenging devices and local exhaust ventilation should be used to control nitrous oxide exposures. Leaks in N20 delivery systems, which were found to be commonplace, should also be controlled. Research and development efforts are needed to improve upon the already existing scavenging devices, and provision for local exhaust ventilation needs to be included in the design of dental operatories.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baden J. M., Rice S. A., Serra M., Kelley M., Mazze R. Thymidine and methionine syntheses in pregnant rats exposed to nitrous oxide. Anesth Analg. 1983 Aug;62(8):738–741. [PubMed] [Google Scholar]
  2. Campbell R. L., Hannifan M. A., Reist P. C., Gregg J. M. Exposure to anesthetic waste gas in oral surgery. J Oral Surg. 1977 Aug;35(8):625–630. [PubMed] [Google Scholar]
  3. Carlsson P., Hallén B., Hallonsten A. L., Ljungqvist B. Thermocamera studies of nitrous oxide dispersion in the dental surgery. Scand J Dent Res. 1983 Jun;91(3):224–230. doi: 10.1111/j.1600-0722.1983.tb00806.x. [DOI] [PubMed] [Google Scholar]
  4. Cohen E. N., Gift H. C., Brown B. W., Greenfield W., Wu M. L., Jones T. W., Whitcher C. E., Driscoll E. J., Brodsky J. B. Occupational disease in dentistry and chronic exposure to trace anesthetic gases. J Am Dent Assoc. 1980 Jul;101(1):21–31. doi: 10.14219/jada.archive.1980.0345. [DOI] [PubMed] [Google Scholar]
  5. Gambill A. F., McCallum R. N., Henrichs T. F. Psychomotor performance following exposure to trace concentrations of inhalation anesthetics. Anesth Analg. 1979 Nov-Dec;58(6):475–482. doi: 10.1213/00000539-197911000-00007. [DOI] [PubMed] [Google Scholar]
  6. Hallonsten A. L., Löfström J. B. Physical properties of nitrous oxide-oxygen sedation equipment used in dentistry. Swed Dent J. 1982;6(4):133–148. [PubMed] [Google Scholar]
  7. Hallonsten A. L. Nitrous oxide scavenging in dental surgery. I. A comparison of the efficiency of different scavenging devices. Swed Dent J. 1982;6(5):203–213. [PubMed] [Google Scholar]
  8. Hallonsten A. L. Nitrous oxide scavenging in dental surgery. II. An evaluation of a local exhaust system. Swed Dent J. 1982;6(5):215–223. [PubMed] [Google Scholar]
  9. Jastak J. T., Greenfield W. Trace contamination of anesthetic gases: a brief review. J Am Dent Assoc. 1977 Oct;95(4):758–762. doi: 10.14219/jada.archive.1977.0505. [DOI] [PubMed] [Google Scholar]
  10. Jones T. W., Greenfield W. Position paper of the ADA Ad Hoc Committee on trace anesthetics as a potential health hazard in dentistry. J Am Dent Assoc. 1977 Oct;95(4):751–756. doi: 10.14219/jada.archive.1977.0484. [DOI] [PubMed] [Google Scholar]
  11. Kripke B. J., Kelman A. D., Shah N. K., Balogh K., Handler A. H. Testicular reaction to prolonged exposure to nitrous oxide. Anesthesiology. 1976 Feb;44(2):104–113. doi: 10.1097/00000542-197602000-00002. [DOI] [PubMed] [Google Scholar]
  12. Lunsford J. M., Wynn M. H., Kwan W. H. Nitrous oxide-induced myeloneuropathy. J Foot Surg. 1983 Fall;22(3):222–225. [PubMed] [Google Scholar]
  13. Millard R. I., Corbett T. H. Nitrous oxide concentrations in the dental operatory. J Oral Surg. 1974 Aug;32(8):593–594. [PubMed] [Google Scholar]
  14. Scheidt M. J., Stanford H. G., Ayer W. A. Measurement of waste gas contamination during nitrous oxide sedation in a non-ventilated dental operatory. Anesth Prog. 1977 Mar-Apr;24(2):38–42. [PMC free article] [PubMed] [Google Scholar]
  15. Smith G., Shirley A. W. Failure to demonstrate effect of trace concentrations of nitrous oxide and halothane on psychomotor performance. Br J Anaesth. 1977 Jan;49(1):65–70. doi: 10.1093/bja/49.1.65. [DOI] [PubMed] [Google Scholar]
  16. Venables H., Cherry N., Waldron H. A., Buck L., Edling C., Wilson H. K. Effects of trace levels of nitrous oxide on psychomotor performance. Scand J Work Environ Health. 1983 Oct;9(5):391–396. doi: 10.5271/sjweh.2395. [DOI] [PubMed] [Google Scholar]
  17. Vieira E., Cleaton-Jones P. E., Austin J., Fatti P. L. Intermittent exposure of gravid rats to 1% nitrous oxide and the effect on the postnatal growth of their offspring. S Afr Med J. 1978 Jan 21;53(3):106–108. [PubMed] [Google Scholar]
  18. Vieira E., Cleaton-Jones P., Moyes D. Effects of intermittent 0.5% nitrous oxide/air (v/v) on the fertility of male rats and the post-natal growth of their offspring. Anaesthesia. 1983 Apr;38(4):319–323. doi: 10.1111/j.1365-2044.1983.tb10452.x. [DOI] [PubMed] [Google Scholar]

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