CHAPTER 37: Micronucleus Assay for Assessing Chromosomal Damage in Medical Workers Exposed to Anaesthetic Gases

Patients undergoing serious medical interventions receive medication for general anaesthesia (characterized by amnesia, analgesia, muscle paralysis, and sedation), resulting in their controlled, reversible state of unconsciousness. Anesthetized patients may therefore tolerate surgical procedures that would otherwise inflict unbearable pain, which would further complicate surgery.1 Anaesthesiologists, as essential members of operation teams may be occupationally exposed to substantial concentrations of volatile anaesthetics. Their mutagenic and carcinogenic effects have been suggested,2-7 as they pose a potential genotoxic burden and health problems for a considerable number of individuals in various branches of medicine, as well as for patients. Consequently, a conclusive assessment of chromosomal damage among medical personnel is of particular importance, as pinpointed in a recent review.1 The present chapter reviews the frequencies of micronuclei (MN), assayed using cytokinesis-block micronucleus (CBMN) assay in peripheral blood lymphocytes (PBL), among humans exposed to anaesthetic gases, mainly in operating rooms. The aim is to provide evidence as to whether or not MN in PBL cells may serve as a reliable indicator of the in vivo genotoxicity of anaesthetic gases and loss of chromosomal integrity among subjects occupationally exposed to anaesthetics. The secondary aim is to overview, more comprehensively, tentative mechanisms underlying the genotoxicity of anaesthetic gases. Insights on the genotoxic effects of anaesthetics are provided by in vitro and in vivo studies.