ORIGINAL PAPER
Monitoring of liver and kidney profiles in anesthesiologists working in a regional reference teaching hospital in Northern Italy: analysis of health surveillance data using a linear mixed model
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1
University of Genoa, Genoa, Italy
(Department of Health Sciences (DISSAL))
2
IRCCS San Martino Polyclinic Hospital, Genoa, Italy
(Occupational Medicine Unit)
Online publication date: 2024-11-28
Corresponding author
Alborz Rahmani
University of Genoa, Department of Health Sciences (DISSAL), Via A. Pastore 1, 16132 Genoa, Italy
Int J Occup Med Environ Health. 2024;37(5):557-68
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ABSTRACT
Objectives: Anesthesiologists represent an occupational group exposed to specific occupational hazards, including potential exposure to waste anesthetic
gas released during medical procedures. In recent decades, halogenated anesthetic gases, such as desflurane and sevoflurane, have largely replaced
nitrous oxide, due to better safety profiles and lower adverse health effects. However, possible long-term effects of low concentration exposures
are unknown. A longitudinal analysis of health surveillance data was performed to test for possible changes over time in key markers of liver and kidney
function. Moreover, we assessed the appropriateness of applying linear mixed models to occupational health data. Material and Methods: A retrospective
cohort study was conducted using health surveillance data from a cohort of anesthesiologists and a cohort of unexposed physicians working
at the Polyclinic Hospital San Martino of Genoa, Italy, during 2016–2022. A 2-level linear mixed model with covariance structure of first order
autoregressive model (AR(1)) type at the first level and unstructured type at the second level was applied. Results: One hundred seventy subjects
were included in the analysis, equally divided between exposed and unexposed. At the first and last periodic examination, liver and kidney markers
were not statistically different in the 2 cohorts. The only significant change found related to estimated glomerular filtrate, which was found at
the last follow-up to be greater among the exposed (M = 104.18 vs. 90.07, p = 0.007). The linear mixed model showed that anesthetic gas exposure
was not associated with any of the outcomes. These results suggest the absence of increase in liver and kidney profile markers in the study population. Conclusions: Health surveillance data, aggregated and analyzed with appropriate statistical models, allow inferences to be made about potential
health effects of workers due to uncontrolled exposures. To this end, the linear mixed model represents a powerful tool for longitudinal analysis
of data derived from monitoring workers. Int J Occup Med Environ Health. 2024;37(5):557–68