WCB – FUNDED PROJECTCHEMICAL EXPOSUREASSESSMENT AT LANGLEYMEMORIAL HOSPITALNurses’ Exposure: Formaldehyde in theDirty Core and Nitrous Oxide in Labour
52.2.3 Potential Health EffectsA wide variety of health effects have been potentially linked with occupational nitrous oxideexposure including: reduc
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6frequency of nitrous oxide exposure occurred was associated with reduced fecundability (timerequired to get pregnant). They found no association bet
7Studies have shown that intermittent flow apparatus produce far less pollution than continuousflow methods used by anaesthetic machines (Heath et al.
8was dispensed for approximately 5-10 seconds and the remainder of the time was spent fillingout the biopsy record sheet.Nurses wore rubber latex glov
9The ventilation control measures for nitrous oxide in the delivery room were the scavengingsystem (local exhaust ventilation) and the general dilutio
104.1.3 Silica Gel TubesEnvironmental (area) sampling was conducted using two personal pumps and treated silica geltubes. The pumps were calibrated
114.1.5 Smoke TubesSmoke tube testing was conducted to visualize the effectiveness of the general exhaustventilation in the dispensing area. The sm
12instruments developer at Geotechnical Instruments in England. Product information can befound in Appendix 11 of this report.Several WCB of BC lab t
13The sampling procedure for this study consisted of using passive dosimeters, a Miran infra-redspectrophotometer and the Medigas 3010, personal infra
14The Medigas 3010 was kept plugged in and on (with the pump off) during the down time. TheMedigas 3010 had to be kept on due to the 15 minute warm u
iSUMMARYNurses’ exposure to formaldehyde in the dirty core and nitrous oxide in labour and deliveryrooms was measured on July 10 and July 26 to August
154.2.7 StrategyThe sampling strategy using passive dosimeter, Miran and Medigas 3010 was chosen since therewould be at least one personal and one en
165.1.3 Smoke TubesThe effectiveness of the general exhaust ventilation at removing the formalin vapours from thedirty core area was tested using a s
175.2.2 Medigas 3010Personal exposure data for nurses was collected by the Medigas 3010 during 9 deliveries. Ofthese deliveries, data from Deliverie
185.2.3 Passive Dosimeter BadgesPassive dosimeters were given to 2 to 4 nurses at the beginning of their shift. In total 31 badgeswere used in this
19is 10 cfm. The balance report also contained the flow rates for the two exhausts in the mainroom, which were 203 cfm each and the bathroom exhaust
20The average exposure data collected for the Miran were higher than the average exposure datacollected by the Medigas 3010. This would be expected s
21Delivery 4 and Delivery 5 labour and deliveries occurred simultaneously. Delivery 4 wasmonitored for the entire labour and delivery and after the ba
22screaming causing the nurse to be exposed to high levels of nitrous oxide. In other cases nitrousoxide was used for a short period of time and then
237.0 CONCLUSIONSFormaldehyde:• Although worker exposure to formaldehyde in the dirty core area did not exceed WCB of BCexposure limits, exposures m
248.0 RECOMMENDATIONSFormaldehyde:• Implement an exposure control plan as per OHS Reg 5.57 (2) – Designated Substances. Thisregulation states that
iiRecommendationsFormaldehyde:• Implement an exposure control plan as per OHS Reg 5.57 (2) – Designated Substances. Thisregulation states that subst
25APPENDIX 1SAMPLING LOCATION PLANS
1Ox, CO2 and N2OcylindersShelf with IV solution andempty bucketsDoorwaySink Counter Double sinkLarge deep sinkExhaust inceilingSampleFridgeFormalindis
2BathroomDoorBedFetal incubatorstored in cupboardSofaSinkWindowN2O supply and scavenging systemExhaust 0.5 mfrom floorExhaust 0.5 mfrom floorFresh air
1APPENDIX 2PHOTOGRAPHS
2Plate 1: View of dirty core sample room on the 2nd Floor of Langley Memorial Hospitallocated in Langley, British Columbia.Plate 2: View of the cent
3Plate 3: View of the left portion of the dirty core room.Plate 4: View of the formaldehyde dispensing station.
4Plate 1: View of typical labour and delivery room on the 3rd Floor of Langley MemorialHospital located in Langley, British Columbia.Plate 5: Close-
5Plate 2: View of typical labour and delivery room.Plate 3: View of typical labour and delivery room.
6Plate 4: View of typical labour and delivery room.Plate 5: View of nitrous oxide delivery system and scavenging system.Plate 6: View of scavenging
7Plate 7: View of fresh air supply located in the ceiling of the labour and delivery room.Plate 8: View of room exhaust located approximately 40 cm
iiiTABLE OF CONTENTS1.0 Introduction ...12.0 Liter
8APPENDIX 3REFERENCES
1ACGIH. 1992. Nitrous Oxide Criteria Document. 1134-1138.Ahlborg Jr. G, Hemminki K. 1995. Reproductive Effects of Chemical Exposures inHealth Pro
2Heath BJ, Done M, Balog O, Ziccone S, Rosewarne F. 1994. The Effect of Scavengingon Nitrous Oxide Pollution in the Delivery Suite. Aust NZ J Obste
3Schumann D. 1990. Nitrous Oxide Anaesthesia: Risks to Health Personnel. Int NursRev 37: 1: 214-7.Schuyt HC, Verberk MM. 1996. Measurement and R
1APPENDIX 4FORMALDEHYDE GASTEC TUBERESULTS
1Langley Memorial Hospital, Formaldehyde Dispensing Station located in Dirty Core, July 12, 2001SampleNumberTime (Amountof TimeDispensing)Tissue Type
1APPENDIX 5NITROUS OXIDEPASSIVE DOSIMETER RESULTS
1Nurses' Exposure to Entonox in Labour and Delivery *Langley Memorial Hospital, Langley, British ColumbiaNurse Identifier Date FieldSampleNumber
2Nurse's Name Date FieldSampleNumberStartTimeStop Time Length of shift (showlength of breaks)# deliveriesin shift# N2Odeliveries inshiftBadgepro
3Nurse's Name Date FieldSampleNumberStartTimeStop Time Length of shift (showlength of breaks)# deliveriesin shift# N2Odeliveries inshiftBadgepro
ivAPPENDICESAppendix 1 – Sampling Location PlansAppendix 2 – PhotographsAppendix 3 – ReferencesAppendix 4 – Formaldehyde Gastec Tube ResultsAppendix 5
1APPENDIX 6NITROUS OXIDEMIRAN GRAPHS
1Miran Delivery 105010015020025030035021:10:4821:16:2821:22:0821:27:4821:33:2821:39:0821:44:4821:50:2821:56:0822:01:4822:07:2822:13:0822:18:4822:24:28
2Miran Delivery 20501001502002503003502:21:082:33:282:45:482:58:083:10:283:22:483:35:083:47:283:59:484:12:084:24:284:36:484:49:085:01:285:13:485:26:08
3Miran Delivery 305010015020025030035018:36:2818:38:0818:39:4818:41:2818:43:0818:44:4818:46:2818:48:0818:49:4818:51:2818:53:0818:54:4818:56:2818:58:08
4Miran Del ivery 405010015020025030035013:29:2813:32:4813:36:0813:39:2813:42:4813:46:0813:49:2813:52:4813:56:0813:59:2814:02:4814:06:0814:09:2814:12:4
5Miran Delivery 605010015020025030035019:44:0819:47:2819:50:4819:54:0819:57:2820:00:4820:04:0820:07:2820:10:4820:14:0820:17:2820:20:4820:24:0820:27:28
6Miran Delivery 70501001502002503003505:57:286:04:086:10:486:17:286:24:086:30:486:37:286:44:086:50:486:57:287:04:087:10:487:17:287:24:087:30:487:37:28
7Miran Delivery 80501001502002503003501:33:481:37:081:40:281:43:481:47:081:50:281:53:481:57:082:00:282:03:482:07:082:10:282:13:482:17:082:20:282:23:48
8Miran Delivery 905010015020025030035010:51:0810:54:2810:57:4811:01:0811:04:2811:07:4811:11:0811:14:2811:17:4811:21:0811:24:2811:27:4811:31:0811:34:28
1APPENDIX 7NITROUS OXIDEMEDIGAS 3010 GRAPHS
11.0 INTRODUCTIONBetween July 10, 2001 and August 2, 2001, Charlotte Ferguson, Masters student in OccupationalHygiene from McGill University, conduct
1Delivery 2 July 27, 20010501001502002503003502:12:012:14:012:16:012:18:012:20:012:22:012:24:012:26:012:28:012:30:012:32:012:34:012:36:012:38:012:40:0
2Delivery 3 July 27, 200105010015020025030035017:17:3017:21:3017:25:3017:29:3017:33:3017:37:3017:41:3017:45:3017:49:3017:53:3017:57:3018:01:3018:05:30
3Delivery 4 July 30, 200105010015020025030035013:35:0013:39:0013:43:0013:47:0013:51:0013:55:0013:59:0014:03:0014:07:0014:11:0014:15:0014:19:0014:23:00
4Delivery 5 July 30, 200105010015020025030035015:57:0015:58:0015:59:0016:00:0016:01:0016:02:0016:03:0016:04:0016:05:0016:06:0016:07:0016:08:0016:09:00
5Delivery 6 July 31, 200105010015020025030035019:44:3019:48:3019:52:3019:56:3020:00:3020:04:3020:08:3020:12:3020:16:3020:20:3020:24:3020:28:3020:32:30
6Delivery 7, August 1, 20010501001502002503003505:57:016:00:016:03:016:06:016:09:016:12:016:15:016:18:016:21:016:24:016:27:016:30:016:33:016:36:016:39
1APPENDIX 8PATIENT CONSENT FORM
2Patient Consent Form for study: Nurses’ Exposure to Nitrous OxideLangley Memorial Hospital, the Workers’ Compensation Board of BCand McGill Universi
3APPENDIX 9PASSIVE DOSIMETER PRODUCT INFORMATION
4
2 Formaldehyde is used as a tissue preservative in hospitals as a 10% Formalin solution. Thissolution contains formaldehyde (3-4%), methanol (0.5-1.5
5
6APPENDIX 10FORMALDEHYDE AND NITROUS OXIDEMSDS
CAS# 50-00-0Code R-240010Formula weightSupersedesNot applicable.FORMALIN SOLUTION 10%Not applicable.Formaldehyde buffered 10%, R-240010, 41915For labo
Section V. Toxicological PropertiesMay be fatal by ingestion, inhalation, or by skin absorption. Lachrymator. Target organs: central nervous system,
Section VI. First Aid MeasuresSection V. Toxicological PropertiesReaction with hydrochloric acid may form bis-chloromethyl ether which is a confirmed
While the company believes the data set forth herein are accurate as of the date hereof, the company makes no warranty with respect theretoand express
7APPENDIX 11MEDIGAS 3010 PRODUCT INFORMATION
Instruction 19-9208N2O MonitorModel 3010P/N 19-7109Operation & MaintenanceRev. 5 – December 2001Product Leadership • Training • Service • Reliabil
WARRANTYBacharach, Inc. warrants to Buyer that at the time of delivery this Product will be freefrom defects in material and manufacture and will conf
iInstruction 19-9210N2O Monitor 3010ContentsSPECIFICATIONS ... ii1.0
3In 1990 Blair et al., reviewed epidemiological evidence of the relationship between occupationalformaldehyde exposure and cancer. They reviewed 32 e
SPECIFICATIONSRange & Resolution ... 0 to 1,000 ppm N2O; 5 ppm resolutionBattery Life ... Up to 9 hours on one chargeBa
Instruction 19-9208 1N2O Monitor 30101.0 INTRODUCTION1.1 GeneralThe Bacharach N2O Monitor 3010 is easy to use, but it is essential thatthis instructio
N2O Monitor 30102 Instruction 19-92081.3 Units of MeasurementThe monitor’s LCD shows N2O concentrations expressed as either acurrent (real time) ppm r
Instruction 19-9208 3N2O Monitor 30102.0 OPERATION2.1 Important NoteAlways ensure that the monitor’s gas inlet connector (Figure 1, Item B)and outlet
N2O Monitor 30104 Instruction 19-92082.3 Start-Up DisplayThe display that appears when the monitor is first turned ON depends onwhat TWA format the mo
Instruction 19-9208 5N2O Monitor 30102.5 Time Weighted Average (TWA) ModeThe monitor’s display is toggled between its normal and TWA displaymodes by p
N2O Monitor 30106 Instruction 19-9208To start a new TWA reading after the monitor has been turned ON, pressand hold down the f1 button for 3 seconds o
Instruction 19-9208 7N2O Monitor 3010Note: Only TWA values are displayed while in the auto-stablization mode—normal ppm readings are not available.Whi
N2O Monitor 30108 Instruction 19-92082.9 Pump Operation (ppm Mode only)Important! The restrictor (Figure 1, Item C) must be removedfor the pump to ope
Instruction 19-9208 9N2O Monitor 30102.11 Battery Low DisplayWhen the battery voltage falls below a pre-determined level, the displaywill alternate be
4An article written by Munley et al., in 1986 looked at midwives’ exposure to nitrous oxide. Theyfound mean exposures that were not significantly les
N2O Monitor 301010 Instruction 19-92082.14 Flow Fail WarningWhen the pump is ON, a flow detector within the monitor will indicatewhen there is insuffi
Instruction 19-9208 11N2O Monitor 30103.0 MAINTENANCE3.1 Battery ChargingWhen the “BattLow” message is displayed (refer to Section 2.11), themonitor m
N2O Monitor 301012 Instruction 19-92083.2 CleaningKeep the monitor clean by wiping it with a soft cloth dampened with amild detergent solution. The mo
Instruction 19-9208 13N2O Monitor 3010WARNING! After resetting the monitor to its factory settings,a zero calibration must now be performed per Secti
N2O Monitor 301014 Instruction 19-92083.8 Zero CalibrationThere are two methods available to perform a zero calibration:• Fresh Air• NitrogenNote that
Instruction 19-9208 15N2O Monitor 30103.8.1 Air Calibration1. If not already done, switch ON the monitor per Section 2.2.2. Press the f3 button to tur
N2O Monitor 301016 Instruction 19-92082. Using the Bacharach Calibration Kit with an N2 cylinder attached asshown in Figure 2, adjust the regulator fo
Instruction 19-9208 17N2O Monitor 30104.0 PARTS & SERVICE4.1 Replacement Parts and AccessoriesReplacement Parts110/240 VAC USA & European Plug
N2O Monitor 301018 Instruction 19-92084.2 Bacharach Sales/Service CentersCalifornia7281 Garden Grove Blvd.,Suite HGarden Grove, CA 92841Phone: (714) 8
Instruction 19-9208 19N2O Monitor 3010
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