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Evaluation of two nitrous oxide scavenging systems using infrared thermography tovisualize and control emissions
April M. Rademaker, MS; James D. McGlothlin, MPH, PhD; John E. Moenning, DDS, MSD; Michael Bagnoli, DDS, MD; Gary Carlson, PhD; Carl Griffin, MD
he results from 50 years of published studies have supported the use of nitrous oxide (N2O) scavenging in dental offices as a means of substantially minimizing potential adverse health effects for dental professionals,while allowing them to use N2O as an anesthetic agent that is well-suited for dental patients of all ages. The importance of scavenging N2O is underscored by the recommendations established by the American Dental Association (ADA) and statements from the National Institute for Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration (OSHA) and American Conference ofGovernmental Industrial Hygienists (ACGIH). N2O is a highly insoluble gas with a blood-gas coefficient of 0.47, and it is absorbed almost immediately by the body and is eliminated rapidly by the lungs, making it a good choice to use by itself or in combination with other anesthetic agents.1-4 It is safe for patients to receive, and dental professionals have a high level of confidence in itsapplications, particularly as an anesthetic modality to control, or to work with other drugs in controlling analgesia and anxiety in dental patients.5 Although the ben-
✷ Background. The authors conducted a study to ® determine the effectiveness of two waste anesthetic gas-scavenging systems. They also evaluated one of N the systems to determine theeffect of work practices in C U A ING EDU 3 controlling waste nitrous oxide (N2O). RT ICLE Methods. The authors collected a minimum of 13 data sets in each phase of the study that included infrared thermography, digital videography and real-time air analysis for ambient concentrations of waste N2O. Surgeon 1, who had experience using both systems, used the Safe Sedate Dental Mask (Airgas, Radnor, Pa.)system (system I) in phase I and the Porter Nitrous Oxide Sedation System (Porter Instruments, Hatfield, Pa.) (system II) in phase II. Surgeon 2, who did not have experience using system I, used it in phase III. To evaluate each system’s effectiveness, the authors collected N2O air concentration data from phases I and II and compared the data with the National Institute for Occupational Safetyand Health Recommended Exposure Limit (NIOSH REL). They also compared phases I and III to determine the effect of work practices on the systems’ effectiveness. Results. Surgeon 1 controlled occupational exposure to N2O significantly better using system I than using system II. Mean N2O air concentration levels during phases I and II were 61.6 parts per million (ppm) and 225.6 ppm, respectively....