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

Anaesthesiologists as essential members of medical surgical operation teams are occupationally exposed to substantial concentrations of volatile anaesthetics. Additionally, the other members of the surgical operation teams (such as surgeons and nurses) and the patient may also be exposed. The mutagenic and carcinogenic effects of such exposures have been suggested in literature and they pose a potential genotoxic burden and health problems for individuals in various branches of medicine as well as for patients. The lymphocyte cytokinesis–block micronucleus (CBMN) assay represents a marker of biological effects and has been applied in in vivo biomonitoring studies of humans exposed either environmentally or occupationally to genotoxic chemicals. The main aim of the present report is to systematically review the published studies investigating the use of the lymphocyte CBMN assay to determine DNA damage in subjects exposed to anaesthetic gases. We also compared the performance of the CBMN assay with other DNA damage assays employed. The results on the genotoxicity of anaesthetic gases in humans were also compared with those obtained in in vitro and animal experiments. Despite the evident genotoxic effects of anaesthetic gases, the understanding of the mechanisms by which these events lead to chromosomal instability and eventually malignant transformation is incomplete and requires more research.