一种用于同时评估医疗保健专业人员尿液样本中麻醉气体职业暴露的多分析方法

摘要(中文译文)

监测医院环境中的职业暴露需要有效的非侵入性暴露评估方法。本研究旨在开发一种多分析物方法，用于表征和定量医护人员尿液中麻醉气体的水平。收集了37名近期暴露人员和24名非暴露人员的尿液样本。开发并验证了一种多分析物方法，采用顶空气相色谱-质谱联用技术（HS-GC-MS）测定尿液中地氟烷、异氟烷、七氟烷及其主要代谢物六氟异丙醇的浓度。该方法成功通过验证，表现出良好的线性关系和灵敏度[相关系数（）：99.5-99.9%]。麻醉气体的检出限为0.15-0.60 ng/mL，定量限为0.5-2.0 ng/mL。回收率为95.17%-102.40%，相对标准偏差低于15%。暴露参与者中可检测到的浓度范围为：地氟烷1.0-3.80 ng/mL（均值0.53 ng/mL），七氟烷0.5-19.59 ng/mL（均值1.39 ng/mL），六氟异丙醇（HFIP）2.0-729.35 ng/mL（均值49.74 ng/mL）。在暴露志愿者中未检测到异氟烷，在非暴露志愿者中亦未检测到任何麻醉气体。本研究成功开发了一种多分析物HS-GC-MS方法，可同时测定尿液样本中的四种麻醉气体，并在医护人员的实际样本中完成了验证。未来需要进一步研究麻醉医师和手术室护士暴露于这些化合物的安全性。

Abstract

Monitoring occupational exposure in hospital settings requires valid non-invasive exposure assessment methods. We aimed to develop a multianalyte method to characterize and quantify urinary levels of anesthetic gases in healthcare professionals. Urine samples were collected from 37 recently exposed and 24 non-exposed professionals. A multianalyte method was developed and validated to determine urinary concentrations of desflurane, isoflurane, sevoflurane, and its main metabolite, hexafluoroisopropanol, using headspace gas chromatography coupled to mass spectrometry (HS-GC-MS). The methodology was successfully validated. It demonstrated adequate linearity and sensitivity [correlation coefficients ( ): 99.5-99.9%]. Limits of detection for the anesthetic gases ranged from 0.15-0.60 ng/mL, and limits of quantification from 0.5-2.0 ng/mL. The recovery percentage ranged from 95.17 to 102.40%, and relative standard deviations were below 15%. Detectable concentrations in exposed participants ranged from 1.0 to 3.80 ng/mL (mean 0.53 ng/mL) for desflurane, 0.5-19.59 ng/mL (mean 1.39 ng/mL) for sevoflurane, and 2.0-729.35 ng/mL (mean 49.74 ng/mL) for hexafluoroisopropanol (HFIP). No detectable concentrations of isoflurane were found in the exposed volunteers, nor were any of the anesthetic found in the non-exposed volunteers. A multianalyte HS-GC-MS method was successfully developed to simultaneously determine four anesthetic gases in urine samples and was validated in real-world samples from healthcare professionals. Future studies are needed to investigate the safety of exposure to these compounds for anesthesiologists and operating room nurses.

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